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Critical Care billing is time dependent and includes all time spent caring for and coordinating (i.e.: reviewing records, talking to consultants or family) the care of the patient except for the time spent doing separately billable procedures (i.e. central line, CPR, etc). The following procedures taken from the ACEP website are included in the Critical Care code so the time spent doing these procedures should BE included in your total Critical Care time .
They are :
- The interpretation of cardiac output measurements
- Interpretation of chest x-rays
- Interpretation of pulse oximetry
- Interpretation of blood gases, and information data stored in computers
- Placement of Oral or Nasal gastric tube
- Temporary transcutaneous pacing
- Ventilatory management (i.e.: Adjusting the vent, but not the intubation)
- Vascular access procedures (i.e.: peripherial access)
ACADEMIC MEDICINE CAVEAT: For the reporting of time-based services, such as critical care or moderate sedation, the teaching physician must be directly present during the entire reported time period.
References
ACEP Coding and Reimburshment Website http://www.acep.org/practres.aspx?LinkIdentifier=id&id=33484&fid=910&Mo=No&taxid=117956#critcare