Critical care - patient code

JJENNETT

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Critical care coding question:

Does the patient code status ( DNR, DNI, Full code ) have any impact on weather it is critical care or not ? and if it does why. We have heard that it is one of the items that should be taken into account when deciding if it is critical care or not.
thank you
 
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No impact

The patient's status does not have any impact as long as the care provided is critical care.
However, if all you are providing are comfort measures for a patient who is DNR and truly at the end of life, then you are not providing critical care.

For example:
When my father went to the hospital with pneumonia he was critically ill, in respiratory distress and with signs of heart failure; they did provide critical care for a couple of days, in hopes that he would manage to recover. He had fought off two otherr bouts of pneumonia earlier in the same year. However, when it was clear that he wouldn't recover this time without more heroic measures (which we all agreed not to pursue), they ceased the critical care measures, and transitioned to providing end-of-life comfort measures.

His DNR status was the same (and on file with the physicians and hospital) throughout the hospital stay (and for the other hospital stays earlier the same year). But when he presented in critical condition, and critical care was provided, that was the appropriate code set to use.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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leighd

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So to clarify part of this since I'm just beginning to learn about hospital coding --

I know the critical care codes are 99221 and 99222. Do these codes go anywhere on the hospital chart, or are they just for MDs? Does it tie in somehow with the patient code status?

Thanks from a total newbie.
 

jmcpolin

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We have been seeing denials for critical care place of service, per CPT location does not matter. Has anyone else seen these denials?
 
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