Wiki Help with Critical Care

[randiroyder]

My doctor dictates"

"I agree with the documentation as outlined by ________PA. Ms. patient is critically ill and approximately 1 hour of critical care time was spent in treatment of this patient."

The PA documents that she and the doctor saw this patient multiple times during the day for a total of 1 hour critical care.

I just didn't know if the doctor can document his note refering to the PA note for critical care.

Thanks for the help.

 

[Melonie07]

critical care

Hi
Shared visits are not allowed for SNF/NF setting, consultations, or critical care.
I just sat in on a critical care audio conference yesterday and as July 2008 the Medicare regs changed and the initial critical care time must be met by a single physician or NPP.
Melonie

 

[sparkles1077]

Is the PA acting as a scribe? If so, scribe note should be used. I do not believe midlevels are allowed to perform Critical Care. Only physicians

 

[randiroyder]

PA's can code for critical care. My question is, both the doctor and PA saw the patient. The doctor billed, my question is in reguards to the documentation. This is what the doctor documented.

"I agree with the documentation as outlined by __________PA-C. Ms patient is critically ill and 1 hour of critical care time was spent in the treatment of this patient"

Can he document like this or does he need to state the reason fot cc. The PA's note states the doctors name and that they both spent 1 hour cc time on this patient.

Thanks

 

[sparkles1077]

Yes, I did read the CMS guidelines and noticed NPs can perform critical care. I guess PAs could also do CC - I did not see anything in guidelines.

I would agree with Melanie above based on rereading the CMS guidelines. The CC time can not be shared. The physician would need to document the amount of time he/she spent performing critical care.