Wiki Coding multiple critical care visits

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medicode3

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Hello, I am new to the neurosurgery and neurology coding and have a question. There is a new physician who I have just started coding for and he is a neuro intensivist. He works in the neuology ICU. My question is......is there a limit on how many days in a row that he can code CCT? He documents very well and is truly with the patient giving critical care. I have told him that when he goes into the 3rd or 4th days of charging for it there needs to be other dx's added to explain why the patient is still critical. Has anyoone ever run across this before?

Thank you!!:)
 
There are no limits. I do recommend both of you reviewing the qualifications for critical care including medical necessity and "treatment of vital organ failure" and prevention of further life threatening deterioration of the patient’s condition, etc. There are numerous presentations from CMS as well as your MAC.

As far as changing the diagnosis, I do not subscribe to this practice. The diagnoses should match the documentation for each day.
 
Neuro critical care

I have been coding for neuro intensivists for over 9 years. It is not uncommon to see some of these patients in the ICU for long periods of time with multiple dates of critical care billing. My advice is to make sure the diagnosis is appropriate and that the charting substantiates the providers billing. (Time documentation is key.) One of my neuro intensivists was audited and it was found that everyone of his notes supported his billing even though their were multiple critical care dates billed. I would also recommend spending a little time with the provider and get to know a little more about neuro critical care patients, it becomes easier to know what to look for when you know more about the patient population and this one is definitely unique.
 
Critical Care Services

Thank you to both of you for your help. I really appreciate it. I do know a lot about CCT itself as I worked for ICU physicians but normally they would not go into 4, 5, 6 days of billing CCT. Thanks again. Your help is very much appreciated. :)
 
Thank you for the helpful information. I am also billing multiple critical care codes for our Neurointerventionalist. I have sat down and talked to her with our auditor so we both have a betting understanding of the documentation requirements.
 
I realize this thread is a few months old but have been looking for some clarification of documentation requirements of critical care time so thought I'd post my question here hoping maybe someone would still respond.
Does documentation of critical care require the time statement to be worded to state that the provider spent ">45 minutes providing critical care" or is this type of time statement also acceptable if provider documents a statment like this? ">45 minutes spent in care of this critically ill patient"
Does stating the patient is "critically ill" meet the documentation requirement or does the provider have to specifically state that they were "providing critical care"?
Any information would be appreciated
tkcole1
 
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