Neurosurgery Coding Alert

Location Isn't Always the Critical Care Answer

Physical status is your key. Critical care is usually provided in the critical care units or the emergency room, but don't automatically make that assumption. Instead: Critical care reporting is determined by the patient's physical status and not the physical location where she receives treatment, says Mary Mulholland, MHA, RN, CPC, with University of Pennsylvania Health System in Philadelphia. "At times, patients might be admitted to the critical care unit and receive medically necessary services that do not meet the definition of critical care," Mulholland explains. "In those circumstances, you should report professional services using the appropriate evaluation and management code instead of critical care."
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