Trendale
Guru
Hello,
I have a doctor that bills critical care when a patient is in ICU. He frequently bills this, even when the patient's staus has not changed. Through reading and research, I do understand that the patient's conditon has to be life threatening, has to have one or more organ failure. I do understand that even if the patient is stable, the patient's condition can still be critical thus constituting a critical care charge. I have read the CC gudelines that have stated all of the above, it also helped me to realize that daily management on a patient that is on chronic ventilator support does not necessarily constitute a CC charge.So the more I am reading I am understanding this more, I am left with a few grey areas with one being, are there any other Dx's other than failure, shock, and injury that will support a CC charge? Some of the examples in the CC guidelines mentioned pneumonia, AAA, seizure related to renal failure, etc. things of that sort. My physcician does not always have a organ failure or shock ( sometimes he would document suspected shock, can that be considered?) or injury documented. here is two for example:
Quiescent seizure disorder, Pulm HTN, COPD exacerbation, Dysphagia and thrombocytopenia
Example 2"
Chest tube in situ and complicated CAP/S/P decortication for empyema
Also is there a code for ischemic cardiac injury, and does this constitute a critical care charge?
Can suspected shock, sepsis or any other suspected conditions be considered as CC?
What about hypoxic induced injury?
I apologize for all of the questions, But I code over a thousand visits for two critical care intensivist pulmonary doctors in addition to four other doctors.
So my brain is on overload, ANY INFORMATION WOULD HELP!
I have a doctor that bills critical care when a patient is in ICU. He frequently bills this, even when the patient's staus has not changed. Through reading and research, I do understand that the patient's conditon has to be life threatening, has to have one or more organ failure. I do understand that even if the patient is stable, the patient's condition can still be critical thus constituting a critical care charge. I have read the CC gudelines that have stated all of the above, it also helped me to realize that daily management on a patient that is on chronic ventilator support does not necessarily constitute a CC charge.So the more I am reading I am understanding this more, I am left with a few grey areas with one being, are there any other Dx's other than failure, shock, and injury that will support a CC charge? Some of the examples in the CC guidelines mentioned pneumonia, AAA, seizure related to renal failure, etc. things of that sort. My physcician does not always have a organ failure or shock ( sometimes he would document suspected shock, can that be considered?) or injury documented. here is two for example:
Quiescent seizure disorder, Pulm HTN, COPD exacerbation, Dysphagia and thrombocytopenia
Example 2"
Chest tube in situ and complicated CAP/S/P decortication for empyema
Also is there a code for ischemic cardiac injury, and does this constitute a critical care charge?
Can suspected shock, sepsis or any other suspected conditions be considered as CC?
What about hypoxic induced injury?
I apologize for all of the questions, But I code over a thousand visits for two critical care intensivist pulmonary doctors in addition to four other doctors.
So my brain is on overload, ANY INFORMATION WOULD HELP!