Print

Print


Perhaps this definition may be of help.
 
“Critical care is the direct delivery by a physician of medical care for a critically ill or critically injured patient. A 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. “
We have been through many discussions of what constitutes critical care, but this is the best definition we could find.
Basic febrile neonatal sepsis workups would not meet these criteria unless there was an organ system that was impaired, i.e. hypoxia, hypothermia, hypotension, etc.  However, vital signs and lab values can indicate organ system impairment or possible life threatening conditions and then the discussions regarding transfer and critical care of the patient apply to the critical care time spent.
 
 
I hope this helps.
 
 
 
 
Mark Roddy, MD
Holy Cross Hospital
Silver Spring, MD
 
 
5906 Oxford Rd
Glen Echo, MD 20812
 
Home: 301-263-1110
cell phone: (202) 641-1184
 
[log in to unmask]
 > Date: Mon, 26 Jan 2009 14:32:46 -0600> From: [log in to unmask]> Subject: Re: CC coding> To: [log in to unmask]> > I have not . Of course if the infant is really septic, then yes. I think the> CC requirements that the physician's energy is needed to support, or prevent> a failing organ system is a good one to use as a gauge.> There are lots of things that come to the ED that I spend more than 31> minutes on when you consider H&P, treatment, consultation and management and> documentation. How about the crying infant? How about the suspected child> sexual abuse? I am sure we can find lots of other examples.> > I am sorry that there is time and expertise involved in working up a febrile> infant but that alone doesn't constitute critical care.> How many times is that febrile infant actually septic? 1% maybe if you> stretch it. Most of the time we spend way too much money , time and effort> on an otherwise normal child with a cold.> > I can't see anyway to justify CC unless the baby is having apnea, or is in> shock (compensated or not).> > Marty> > > On Mon, Jan 26, 2009 at 1:40 PM, <[log in to unmask]> wrote:> > > Does anyone out there in Ped EM land code for critical care for your "rule> > out sepsis" patients.> >> >> > ?> >> >> > If we have direct pt. care of 30 minutes, not including a spinal tap, are> > talking to PMD's, reviewing office and / or birth records, reviewing and> > documenting labs, updating parents, documenting repeat exams, going through> > admit process....> >> >> > ?> >> >> > Just curious what our thoughts are, and any other tips/tricks/suggestions> > on CC coding.> >> >> > Thanks,> >> >> >> >> >> >> >> > Dr. Todd Zimmerman> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> >> 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