Pulmonology Coding Alert

Ensure thorough documentation to facilitate optimum reimbursements. When a patient suffers from a critical illness or an injury such as acute respiratory failure, your pulmonologist might provide critical care services that involve a high level of complex decision making to assess, manage, stabilize the patient and prevent a further deterioration of the patient's life-threatening condition. Use this coding refresher to arm yourself with indicators you will need to capture your pulmonologist's critical care services. Assess Patient's Condition to Know if Critical Care can be Reported Ensure that the patient's condition qualifies as critical. CPT® guidelines state that "critical care is the direct care provided by a physician to critically ill or injured patient" and "the critical illness or injury acutely impairs one or more vital organ systems such that there is a high probability of imminent or life threatening deterioration in the patient's condition." CMS states that "Critical care services [...]