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Thread: Critical Care Question

  1. #1
    Join Date
    Apr 2007

    Default Critical Care Question

    AAPC: Back to School
    Can someone please provide a link regarding the requirements to bill critical care? We have a provider who feels that if a patient comes in through Flight for Life as the patient was involved in a car accident with deployment of the airbag. Patient complains of facial pain and headache. The provider does all the critical care work up and the during the course of the physical exam he is neurotically normal and x-rays reveal no subarachnoid hemorrhage and patient's final diagnosis is headache. Does this constitute critical care?

  2. #2


    CPT guidelines for Critical Care Services are helpful in determining what qualifies for crtitical care services.
    "...critical illness or injury that acutely impairs one or more vital organ systems such that there is a high probability of life threatening deterioration in the pt's condition.

    ...both the illness or injury & treatment being provided must meet the specified requirements."

    In addition see the NGS/CMS link below


    Hope this helps,
    Anthony McCallum, CPC, CIRCC, CPC-I, CCS

  3. #3
    Join Date
    Apr 2007
    Milwaukee WI

    Default Flight for Life isn't enough

    Just arriving by Flight For Life is not sufficient to code critical care. Given the potential for serious neurologic impact (Natasha Richardson), it's prudent to airlift a head-injury patient to a level 1 Trauma Center. But the lucky patient will not have critical injuries, and will not require critical care.

    F Tessa Bartels, CPC, CEMC

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