hospital consult

If one of our MD where consulted into the ICU to confirm if a patient
is brain dead. What code would they bill? Would it be an ICU code or a consult
code. The physician seems to think we can bill a high consult like 99255.

Please inform

Thank you

Hospital Consult

The level of Consultation will depend on the documentation and medical necessity. If a Comprehensive history and exam are performed I would assume it was medically necessary.
I would not use critical care codes because it doesn't sound like your MD is performing the requirements of critical care such as support or treatment of a vital organ system.

Without the documentation it is difficult to advise but I would assume the complexity could audit out to a high level.


Grab an audit tool and see what you come up with.

Good Luck
Louise

Hospital consult

You couldn't use critical care code, because your physician is not actively intervening.

As for the consult code, I agree you have to get an audit tool and see how it audits. From my experience of auditing notes done in the ICU, I would be doubtful it would reach a 99255.

Sometimes, physicians think that risk and complexity are *trump* cards in selecting an E/M code, but of course that's not true.