Wiki Critical Care

[CPC4life]

If a pulmonologist saw a patient at 8 am and the Internal Medicine physician saw the same patient at 12 noon for critical care

Who gets the charge for critical care?
Can both physicians get paid?

Thanks in advance for any feedback

 

[LTibbetts]

BOTH physicians can charge for it (based on their time spent with patient). See your critical care guidelines in the CPT book in the E/M section. Some of it is pretty confusing but it states this particular rule quite clearly. Hope this helps

 

[LLovett]

I agree they would both be able to charge for it but the way you have this worded makes me think that it may not be critical care. They don't see a patient for critical care, they provide it when necessary. It sounds to me like they were doing rounds in the ICU based on those times. But with the limited info that is a guess on my part just something to consider.

Laura, CPC, CEMC

 

[LTibbetts]

After going back over your initial post, I have to strongly agree with Laura on this. In your CPT book, it also states what constitutes as critical care time. Also, on the ACEP(American College of Emergency Physicians) I found a lot of info specifically about critical care coding and descriptions of care, etc. It might be worth a look over for you and also it could possibly help you plead your case to the providers if they are trying to charge for critical care inappropriately and you need proof to back yourself up.

 

[CPC4life]

Thank you both!