Physicians’ Current Procedural Terminology (CPT®) gives only partial guidance to the physician who sees a patient on the same day in a number of locations or with a variety of clinical conditions. This leads to confusion, which is accentuated when global critical care, low birth weight, and normal newborn codes are considered. Because critical care codes (hourly and global neonatal and pediatric codes) also have bundled procedures, how and when to report procedures that are bundled into one set of codes but not into another is a source of consternation and confusion for coders and physicians alike. In some situations, modifiers can assist in informing payers of the unique circumstances involved in reporting multiple services on the same date. In other situations, appropriate identifiers do not presently exist in the CPT universe.
The following is a summary of CPT instructions to physicians that influence the suggestions offered in...