Wiki Critical Care

mbarbour

Networker
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Location
Raleigh, NC
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According to critical care descriptors , a patient that is in ventricular fibrillation(severe life-threatening disease) is always considered critical care, but what if a patient has a diagnosis of congestive heart failure due to left ventricular systolic dysfunction. Could this also be considered critical care?
 
I don't go by those descriptors alone when coding critical care. It depends on the NOPP and how the provider treats it. If a patient presents to the ED with a chronic condition but has acute exacerbation such as shortness of breath, chest pain, etc and the provider performs emergency intubation, inserts a central line, etc and it's clear that the patient's condition would deteriorate without these life-saving measures, I would consider it CC. The provider should also document CC time appropriately. If they don't I would query the provider or code the appropriate E&M level.

Hope that helps!
 
Reporting Critical Care in the ED

There is more to CC than the final impression. At our facility, we follow the CMS and ACEP guidelines of CC and report CC based on treatments/procedures to include constant monitoring and parenteral IV meds given during the encounter. Our providers must document the CC time, interventions/treatments and what organ system is failing or in jeopardy of failing.
 
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