Wiki Help! Critical Care Interventions

[adri3421]

I need help proving to my trauma surgeons that critical care requires not only a critical illness or injury, time of 30 min or >, but also an aggressive intervention. They sometimes have trauma patients who they state are critically injured and require intensive monitoring or constant bedside attention due to the risk of imminent deterioration. These patients sometimes may not have organ failure but they often do have multiple trauma and are high risk due to the mechanism of their injuries. My physicians state that their assessment and presence alone is the "intervention" and that sometimes the best intervention is no intervention at all. I have given them the Medicare Guidelines stating that they must assess, manipulate, and support vital system functions. They still argue the aggressive intervention is not necessary. Help! Am I wrong....? This is such a grey area to me.

 

[cjdeporter]

Critical Care help.

" The duration of critical care services for both CPT and Medicare is based on the physician?s documentation of total time spent evaluating, managing, and providing care to the critical patient, as well as time spent in documenting such activities. During this time the physician must devote full attention to the particular patient. This time may be spent at the patient?s immediate bedside or elsewhere on the unit, so long as the physician is immediately available to the patient.

Physician time for critical care services encompasses time spent engaged in work directly related to the individual patient?s care whether that time was spent at the immediate bedside or elsewhere. For example, time spent can be at the bedside, reviewing test results, discussing the case with staff, documenting the medical record and time spent with family members (or surrogate decision makers) discussing specific treatment issues when the patient is unable or clinically incompetent to participate in providing history or making management decisions. The "critical care clock" stops when separately reportable procedures or services are performed; these should not be included in the total time reported as critical care time. Time involved in activities that do not directly contribute to the treatment of the critical patient may not be counted toward the critical care time. "