Medical Coding Training Ameerpet

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What is critical Care coding ?
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Critical Care 

•  
• Critical care is the direct delivery of medical
  care, by a physician(s), for a critically ill or
  critically injured patient. CMS defines
  critically ill and injured patients as those who
  are experiencing one or more vital organ
  failure(s) and who have a high probability
  of life-threatening deterioration in their
  condition. Critical care requires high complexity
  medical decision-making to assess, manipulate and
  support vital organ system function in order to
  treat single or multiple vital organ system
  failure.

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• Critical care may be provided on multiple days,
  even if no changes are made in the treatment
  rendered to the patient, provided that the
  patients condition remains critical.Critical
  care DOES NOT need to be provided solely in an
  intensive care unit.  Critical care and other E/M
  services may be provided on the same day by the
  same physician. Know more At Medical Coding
  Training

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• The following services are INCLUDED in critical
  care and should not be reported separately
• 1)      Cardiac output measurements
• 2)      Chest X-ray interpretation
• 3)      Pulse oximetry
• 4)      ABGs
• 5)      EKG interpretation
• 6)      Gastric intubation
• 7)      Transcutaneous pacing
• 8)      Ventilator management
• 9)      Peripheral venous access
• 10)  Arterial puncture  

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The Key Elements of Critical Care

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• 1)99291
• 2)99292

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• 99291 This Code is Used for Critical care,
  evaluation, and management of the critically ill
  or critically injured patient first 30-74
  minutes. It is to be reported only once per day
  per physician or group member of the same
  specialty.

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• 99292 Critical care, evaluation, and
  management of the critically ill or critically
  injured patient each additional 30 minutes (List
  separately in addition to code for primary
  service). This code is used ONLY in conjunction
  with the 99291 code.  EACH additional thirty
  minutes beyond the first hour of critical care is
  reported using this code.  For example, if you
  spend 90 minutes on critical care in one calendar
  date, the encounter would be reported by using
  the 99291 for the first hour, plus one 99292 code
  used to report the additional 30 minutes.

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Critical care settings 

• Large medical facilities usually have intensive
  care units (ICU), where critical patients receive
  care. Some facilities have multiple units
  depending on the circumstances and needs of the
  community. ICUs might be located near the
  operating rooms for critical postoperative
  patients, or near the telemetry floor for
  patients who have life-threatening cardiac issues
  (e.g., cardiac care units).

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Services included in critical care codes 

• The following services are included in critical
  care codes, so coders should not report them
  separately 
•  The interpretation of cardiac output
  measurements
•   The interpretation of chest x-rays
•  Noninvasive ear or pulse oximetry for oxygen
  saturation 
•   Analysis of clinical data, stored in computers
  (e.g., electrocardiograms, blood pressures,
  hematologic data)

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•   Gastric intubations, requiring a physicians
  skill as well as fluoroscopy, image documentation
  and report
•   Temporary transcutaneous pacing (i.e., a
  temporary method of keeping the patient's heart
  beating by delivering small jolts of electricity
  to the heart)
•   Ventilatory management for patients who have
  been placed on ventilators to assist with
  breathing
•   Vascular access procedures for the purpose of
  drawing blood samples

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 Time-based codes

• Report critical care based on the time spent
  providing care. There are two codes used for
  critical care
•   CPT code 99291 Critical care, evaluation, and
  management of the critically ill or critically
  injured patient first 3074 minutes.
•   CPT code 99292 Critical care, evaluation,
  and management of the critically ill or
  critically injured patient each additional 30
  minutes. (List separately in addition to primary
  service.)
• Report code 99292 more than one time if the
  physician spends more than 30 additional minutes.
  

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• For example, consider the following
•  
•   For 75104 minutes Use 99291 X 1 and 99292 X
  1
•   For 105134 minutes Use 99291 X 1 and 99292 X
  2
•   For 135164 minutes Use 99291 X 1 and 99292 X
  3
•   For 165194 minutes Use 99291 X 1 and 99292 X
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• The critical care codes coders assign should
  reflect the total time spent for each 24-hour
  period the physician provided critical care. The
  time does not have to be continuous. Get More
  Info at Medical Coding Training Hyderabad

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