# Critical Care issue



## kcpyrz (Jun 17, 2009)

A critically ill trauma patient arrives at a trauma center.  Because the trauma surgeon on call is tied up in the operating room, the Emergency Room physician performs the initial assessment, resuscitation, and ventilator management on the patient.  For the sake of argument, assume that the patient meets the criteria for being critically ill and the physician is at the bedside providing critical care for an hour and 10 minutes before the trauma surgeon arrives.  The trauma surgeon spends another 45 minutes of critical care managing the patient and moving him to the ICU.

Thus, a total of one hour and 55 minutes of critical care have been provided, but by two specialy codes: Surgery's 02, and Emergency Medicine 93.  Any insights on how this would be handled?


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## FTessaBartels (Jun 17, 2009)

*Coding for PHYSICIAN*

Accepting your assumption that patient is critically ill and care provided is critical care, and time is documented ... 

If coding for the physicians involved:

ER doc: 99291 (if CPR and intubation performed then code those as well and put a -25 mod on the 99291 ... critical care time has to be EXCLUSIVE of procedures)

Trauma surgeon: 99291 (with possible a -57 modifier if decision for surgery was made)

F Tessa Bartels, CPC, CEMC


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