Wiki critical care

[natfos6]

needing some assistance........pulmonologists sees pt for critical care, 6 hours later (call change) partner goes in to check on patient and although a little better still critical and he spends another 30 minutes taking care of patient. Typically we would bill combined time under the first physician who tended to the patient. However, the second physicians note has time listed and what meds he is messing with but no diagnosis or statement of why he is seeing the patient. He is under the understanding that his note is just part of the initial m.d.'s note and we should be able to add times......is it or does his 30minutes need to be able to stand on their own in order to be counted as critical care??

 

[FTessaBartels]

Does he say the patient remains critically ill?

If he states that the patient remains critically ill and refers to his colleague's earlier note he's fine.

If he just states "change X med to Y dose - 30 minutes" (or something to that effect), then I wouldn't count it.

To bill critical care, you need to have a critically ill patient and provide critical care, face-to-face for 30 minutes or more. If the documentation doesn't clearly show either of these criteria, then you can't code critical care.

Hope that helps.

F Tessa Bartels, CPC, CEMC