The neurologist that I code for provides consultations for strokes, seizures, and many other high-risk diagnoses. My issue is, that doctor feels the diagnosis is the driving factor in critical care time. I have explained that critical care time is based upon the time spent in coordination of care excluding procedures. That the reason must be life threatening, and that the care provided is documented. A lot of these patients are seen in the ED, and the neurologist is providing consultation. Some are admitted to ICU by the doctor. I have also explained that the place of service does not determine the critical care status either.
Each case is so different, that I cannot provide an explanation to the doctor as to what may or may not be considered critical care. The doctor feels as if each stroke patient that comes in may be critical care. Sometimes the patient is given a tPa in the ED, or was rushed to have a thrombectomy performed prior to the doctor seeing the patient. To me, if the doctor is not providing services on that day to prevent the threat than it is not critical care. If the patient is status post coiling day 13, is it really critical care? If the patient is status post thrombectomy, and some labs were drawn, is it really critical care?
I think my issue is that I do not know if the work that is being done is considered high risk MDM other than my risk table. I also believe that the doctor has a lack of documentation. The doctor may have performed more care that is not documented.
Does anyone code critical care often, or code critical care for a neurologist? I would appreciate any help! I have checked the E/M University, Medicare website, Neuro sites, and my local MAC.
Thank you!
Each case is so different, that I cannot provide an explanation to the doctor as to what may or may not be considered critical care. The doctor feels as if each stroke patient that comes in may be critical care. Sometimes the patient is given a tPa in the ED, or was rushed to have a thrombectomy performed prior to the doctor seeing the patient. To me, if the doctor is not providing services on that day to prevent the threat than it is not critical care. If the patient is status post coiling day 13, is it really critical care? If the patient is status post thrombectomy, and some labs were drawn, is it really critical care?
I think my issue is that I do not know if the work that is being done is considered high risk MDM other than my risk table. I also believe that the doctor has a lack of documentation. The doctor may have performed more care that is not documented.
Does anyone code critical care often, or code critical care for a neurologist? I would appreciate any help! I have checked the E/M University, Medicare website, Neuro sites, and my local MAC.
Thank you!