critical care

The discussion of billing for critical care always come up with understanding the definition- ex. physician spends 35min but patient only has a concussion. Would this be 99291? I say know if the concussion is not causing imminent or life threatening deterioration to one or more vital organ. I think that most physician are thinking because the time is there that it is ok to bill the critica care..but as i read further in the CPT® book it states" Although CC typically requires interpretation of mulitple physiologic parameters/or application of advance tech, cc may be provided when these elements are not present" what does that mean in english..

critical care and concussion

Is the patient critically ill? What critical interventions are being made?
Watchful waiting is not critical care.

Can you add detail?

it is confusing

At a recent conference, our loyal editor was asked by a plastic surgeon about billing for critical care time for a consult he saw in the ICU- the patient was critically ill and on a ventilator and pressors but he was seeing the patient for a bedsore. That does not qualify as critical care by the plastic surgeon.

In your case, a concussion is not critical care. The patient is in ICU for nursing neuro checks only. If the patient developed a seizure and pupils suddenly changed, then it would be critical care when the doc goes to evaluate and order a new scan and start seizure meds. If the patient had a gaping head wound and brain matter dribbling out thru the doctor's fingers, and all the doctor did was stand there and hold it in so the surgeon could get ready for surgery then it would be critical care.

crital care

So in our meeting with our Ethics/Audit Compliance person..One of the surg.gave an example..pt in the ICU with TBI hemorrage..not intubated but all treatment for this is being provided..he sees that as critical care even though the hemorrage is not still active but without the intervention will or could be..the ethics/audit person still believes that will not be critical care..it should be an E/M..

I agree- E&M

That visit is probably 10 minutes- "how ya doin?" wiggle your toes, stick out your tongue" etc. then looking at the CT scan and writing a note. (that is a gross underestimation but you get the point). If the doc was adjusting the intracranial monitor, flushing the port, doing a bedside burr hole, that would be critical care.