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Critical Care Guidelines-Confused


Heiskell, TN
Best answers
Can anyone decipher the following statement from CMS Critical Care Guidelines for me?

"The treatment and management of the patient's condition, while not necessarily emergent, shall be required, based on the threat of imminent deterioration (i.e. the patient shall be critically ill or injured at the time of the physician's visit)."

The part in parenthesis is what is really throwing me off. What kind of clinical scenario would this apply to? And how can a patient who is critically ill or injured not be in need of "necessarily emergent" treatment/care?

Gotta love Medicare.........:)
Milwaukee WI
Best answers
Stable but Critical

A patient may remain in critical condition, requiring the high-level monitoring and possibility of intervention but not necessarily CURRENTLY requiring emergent intervention at the time of the physician visit.

For example ... a patient in respiratory failure may now be stable on a ventilator, but s/he is still in critical condition.

Or ... a patient with 70% TBSA 2d and 3rd degree burns is in critical condition, but currently stable (i.e. not requiring emergent intervention).

Hope that helps.

F Tessa Bartels, CPC, CEMC