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Error JW
Medium UrgencyCritical Care Billing Conflict
Visit or consultation fees are not payable with critical care fees on the same day.
Official Description: 01200-01202, 01205-01207 and 01215-01217 are not payable in addition to adult and paediatric critical care fees (01411-0 1441, 01412-1442 and 01413-01443).
How to Fix It
Follow these steps in order to resolve the error.
- Review the rejected claim to confirm a visit/consultation fee (e.g., 01200) was billed on the same day as a critical care fee (e.g., 01411).
- This is a definitive refusal. The critical care fee is comprehensive and already includes the cost of the visit or consultation.
- Remove the conflicting visit/consultation fee code from the claim.
- Resubmit the claim with only the critical care fee code for that date of service.