Wiki Help with critical care codes, please

[poyersaug]

If an intensivist is called to the ER for a new patient consult, the patient starts crashing, the intensivist spends an hour with the patient, besides a critical care code, could a consult be billed with a modifier?

 

[maudys]

"Critical Care and other E/M services may be provided to the same patient on the same date by the same physician" is indicated in CPT under the critical care section.

 

[poyersaug]

critical care

thank you, so the intensivist can charge for an H&P, and also a critical care code from the ER. Is there any necessary documentation for the H&P, to make sure that the critical care code is also paid. Would you use a modifier?

 

[FTessaBartels]

TIme can't overlap

Just be sure that the time spent performing critical care does NOT include any time spent in providing the H&P ... For this reason, alone, we never code the initial hospital visit or ER consult in addition to critical care. Usually, in my conversations with the intensivists or trauma surgeons, the physician is busy attending to the patient's critical care needs from the get-go. ALL the time spent is critical care and so that is the only code(s) we use.

Hope that helps.

F Tessa Bartels, CPC, CEMC