Texas Medicare Contractor Answers Critical Care Coding Questions
By Emma Freer

Confused about how to quantify critical care services or delegate such services to nonphysician practitioners? You’re in luck.

Novitas Solutions, the Medicare administrative contractor for Texas, recently updated its evaluation and management codes FAQ to include critical care codes.

Critical care codes apply to patients with critical illnesses or injuries, which Novitas defines as one or more vital organ system failures, according to its website. These codes are especially relevant to emergency medicine physicians.

The updated FAQ now addresses the following topics:

  • How to code when a nonphysician practitioner and a physician in the same practice each see a patient separately for critical care services on the same day;
  • How to code when a nonphysician practitioner and a physician in the same practice see a patient together;
  • How to code when a physician sees a patient for critical care twice in the same day; and
  • When to use modifier 24, which relates to an unrelated service performed during a post-operative period. 

Texas Medical Association member physicians can call TMA’s billing and coding hotline at (512) 370-1414 to speak to certified coders and staff experts. TMA Practice Consulting also offers an in-depth review of documentation and claims coding.

Last Updated On

May 25, 2022

Originally Published On

May 25, 2022

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Emma Freer

Associate Editor

(512) 370-1383
 

Emma Freer is a reporter for Texas Medicine. She previously worked in local news, covering city politics, economic development, and public health. A native Clevelander, she graduated from Columbia Journalism School and the University of St. Andrews.

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