Question ICU bed


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Can someone please help me. Appreciate it in advance. When a pt is admitted to ICU or transferred to an ICU bed, does it require an MD order on top of the IP order? If so, can someone please guide me where I can locate this guideline for CMS? I can’t find anything with this verbiage. Thank you!


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I've never seen a regulation that says a separate order is needed for an ICU bed. ICU does not have a separate status within an inpatient stay - it's simply one location where particular types of services are available and rendered. The requirement for a physician is for the specific services that are needed to treat the patient, not for the type of bed, and the facility would determine from those orders where the most appropriate place is to provide those services. And in some cases, a patient may be admitted to an ICU bed simply because there is no bed available in another location.

I could be wrong, but I don't believe CMS has any requirement for a physician order for an ICU bed. Since the compensation is based on the DRG, which is derived only from diagnoses and procedures, the type of unit or bed itself wouldn't make any difference to the payment determination of the stay, so there really wouldn't be any purpose to such a requirement.