Coding Corner: Using the New Critical Care FT Modifier | Jhalak Dholakia, MD
Scenario: A patient who had a cytoreductive procedure for ovarian cancer 16 days ago is admitted to the intensive care unit for respiratory distress with concern for community acquired pneumonia.
For Calendar Year (CY) 2022, The Centers for Medicare and Medicaid Services (CMS) has added a new billing modifier for use during critical care visits that occur during a global surgical period but are unrelated to the procedure and for critical care visits on the same day as another evaluation and management (E/M) visit if the critical care visit comes after. This modifier, -FT, can be used on critical care codes 99291 and 99292. This change allows additional billing during the global surgical period to recognize and reflect events and care extending beyond routine peri-operative care and complications. Note that these encounters must be unrelated to the surgical procedure performed. In addition, these encounters must not be related to any other surgical procedure and therefore cannot be combined with modifiers -79 or -24.
For more information, please visit the CMS Manual for Medicare Claims Processing, section 188.8.131.52.
Related articles by the SGO Coding and Reimbursement Subcommittee:
- Coding Corner: Billing for Emergency Surgery
- Coding Corner: When is a Post-op Visit Not a ‘Post-op Visit’
- Coding Q&A: Post-Op Issues
Jhalak Dholakia, MD, is a gynecologic oncology fellow at the University of Alabama at Birmingham.