I'll be blunt: your Auditor is not being prudent in his/her judgment.
Critical Care, as define in CPT, has specific requirements that must be met; among them,
* "Critical Care Services"
(I'm with you, that is not what it sounds like was offered in the ER, at least, not properly documented.)
* "Providing med.care to a critically ill, injured . . . patient qualifies as a crit care service only if BOTH the illness/injury and the treatments being provided meet the above requirements."
(I'd ask the auditor to substantiate his/her suggestion that critical, life sustaining services were provided, then slap down that quote out of CPT).
* You don't mention any time being documented. That would be a requirement for properly coding crit. care services.
Just my opinion.
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join