Question Abrupt status in neurological status

peabodym

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If a patient has known seizure disorder and is admitted for VEEG, is the problem consider high risk on the table of risk? I was told by one auditor, that just because the patient had seizure that does not make the risk high if the patient is admitted for seizure Would seizure disorder be consider an abrupt change in neurological status if this is known illness?
 

tiaralady6466

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taken directly from the CMS website E & M training book

LEVEL OF RISK PRESENTING PROBLEM(S) DIAGNOSTIC PROCEDURE(S) ORDERED MANAGEMENT OPTIONS SELECTED High •
One or more chronic illnesses with severe exacerbation, progression, or side effects of treatment
• Acute or chronic illnesses or injuries that pose a threat to life or bodily function (for example, multiple trauma, acute MI, pulmonary embolus, severe respiratory distress, progressive severe rheumatoid arthritis, psychiatric illness with potential threat to self or others, peritonitis, acute renal failure)
• An abrupt change in neurologic status (for example, seizure, TIA, weakness, sensory loss)
 

Tami_F

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If a patient has known seizure disorder and is admitted for VEEG, is the problem consider high risk on the table of risk? I was told by one auditor, that just because the patient had seizure that does not make the risk high if the patient is admitted for seizure Would seizure disorder be consider an abrupt change in neurological status if this is known illness?
I agree with your auditor. A known seizure disorder alone is not high risk. I would not qualify that as an "abrupt change in neurological status". A patient that is in status epilepticus or actively seizing would better fit that description. Many antiepileptic medications require monitoring for toxicity, though, which could qualify as high risk. In my experience, when a patient is admitted for the purpose of performing a VEEG of whatever duration, toxicity is not being monitored at those times. As always, it is dependent upon the documentation.
 
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