Wiki Critical Care


Capital City Coders
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Dr received a call from a rural hospital looking to transfer a pt w/ STEMI to our facility to be admitted to cath lab. physician spent 18 minutes in anticipation of patient arrival arranging activation of cath lab and consulting with other providers. pt arrives and is provided critical care services and is admitted to cath lab after 19 minutes. Dr would like to bill 37 min critical care.

I am conflicted as to weather to bill CC. On the one hand dr spent significant time emergently coordinating care for this patient. On the other, the patient was only physically present for 19 minutes. Does anyone one have any advice / expreience with this type situation?

Tiffany, CPC
Quoting from page 23 of the AMA professional 2012 CPT under the heading critical care services the fourth to the last paragraph, "Time spent in activites that occur outside of the unit or off the floor (eg, telephone calls whether taken at hiome, in the office, or elsewhere in the hospital) may not be reported as critical cae since the physician is not immediately available to the patient......" I may be wrong, but as the patient is not where the physician can be immediately available to the patient then CC can not be counted while patient is not present.