Category: Critical Care
Keywords: anaphylaxis, urticaria, angioedema, shock (PubMed Search)
Posted: 1/20/2009 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Clinical Manifestations of Anaphylaxis
Winters ME. Anaphylaxis. In: Field JM (ed) The Textbook of Emergency Cardiovascular Care and CPR. Philadelphia, Lippincott Williams & Wilkins, 2009:530-7.
Category: Critical Care
Keywords: sepsis, mechanical ventilation, oxygen delivery (PubMed Search)
Posted: 1/13/2009 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Sepsis and Mechanical Ventilation
Category: Critical Care
Keywords: intracerebral hemorrhage, normal saline, hypertonic saline (PubMed Search)
Posted: 1/7/2009 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Intracerebral hemorrhage and fluid management
Rincon F, Mayer SA. Clinical review: critical care management of spontaneous intracerebral hemorrhage. Crit Care 2008;12:237.
Category: Critical Care
Keywords: blood pressure, intracerebral hemorrhage (PubMed Search)
Posted: 12/31/2008 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Blood Pressure Control in ICH
Rincon F, Mayer SA. Clinical review: critical care management of spontaneous intracerebral hemorrhage. Crit Care 2008;12:237.
Category: Critical Care
Keywords: renal replacement therapy, hemofiltration (PubMed Search)
Posted: 12/23/2008 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Hemofiltration
Category: Critical Care
Keywords: Critical Care, reimburshment, billing (PubMed Search)
Posted: 12/20/2008 by Michael Bond, MD
(Updated: 11/2/2024)
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Critical Care Billing Pearls:
Level | RVU | Medicare | Commerical |
99285 ED E/M, Level 5 | 4.71 | $170 | $304 |
99291 Critical Care, first hour | 5.84 | $211 | $363 |
As the table shows Critical Care billing will earn you approximately 25% more with no additional overhead. Critical care time must be at least 30 minutes, and the following procedures are included in the critical care code:
The following procedures are not bundled into critical care time, so they can be billed separately, therefore the time you spend doing these procedures can not be included in your total critical care time:
Remember critical care time does not need to be continuous but you need to be immediately available to the patient for the time to count. You can not count time going off the floor to review an xray or CT, but this time can be counted if you do it in the immediate vacinity of the patient.
FINAL CAVEAT To help your coders bill appropriately it helps to include a statement such as "Critical Care time XX minutes where I was directly involved in the care of this patient exclusive of all other separately billable procedures."
$2
Category: Critical Care
Keywords: central venous catheter (PubMed Search)
Posted: 12/16/2008 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Catheter Positioning
Category: Critical Care
Keywords: central venous catheter, tissue plasminogen activator (PubMed Search)
Posted: 12/9/2008 by Mike Winters, MBA, MD
(Emailed: 12/11/2008)
(Updated: 11/2/2024)
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Central Venous Catheter Occlusion
Category: Critical Care
Keywords: hemodialysis catheters (PubMed Search)
Posted: 12/2/2008 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Hemodialysis Catheters
Two weeks ago, we had a PEA arrest of a patient receiving HD. A significant delay occurred in administering fluids and medications as a result of "no iv access". Don't forget that in these situations you can use the hemodialysis catheter.
Category: Critical Care
Keywords: stress related mucosal injury, histamine antagonists, proton pump inhibitors, sucralfate (PubMed Search)
Posted: 11/25/2008 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Stress Related Mucosal Injury (SRMI)
Category: Critical Care
Keywords: dopamine, hemodynamic medication, vasopressors (PubMed Search)
Posted: 11/18/2008 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Dopamine in the ED
Marino PL. Hemodynamic drugs. In: The Little ICU Book of Facts and Formulas. 2009 Ed. Lippincott Williams & Wilkins, Philadelphia, PA.
Category: Critical Care
Keywords: seizure, metabolic (PubMed Search)
Posted: 11/11/2008 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Seizures in the Critically Ill
Mirski MA, Varelas PN. Seizures and status epilepticus in the critically ill. Crit Care Clin 2008;24:115-147.
Category: Critical Care
Keywords: auto-peep, mechanical ventilation (PubMed Search)
Posted: 11/4/2008 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Auto-PEEP in the non-COPD patient
Mughal MM, Minai OA, Culver DA, et al. Auto-positive end-expiratory pressure: mechanisms and treatment. Clev Clin J Med 2005;72:801-9.
Category: Critical Care
Keywords: PEEP, mechanical ventilation, ARDS (PubMed Search)
Posted: 10/28/2008 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Ventilator Therapy for ED Patients with ARDS
Category: Critical Care
Keywords: influenza, zanamivir, oseltamivir (PubMed Search)
Posted: 10/21/2008 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Influenza and the Critically Ill
Beigel JH. Influenza. Crit Care Med 2008;36:2660-6.
Category: Critical Care
Keywords: gastrothorax, pneumothorax (PubMed Search)
Posted: 10/8/2008 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Tension gastrothorax?
Patton J, Gonzales J, Dillard TA, Szerlip HM. Chest 2008;134:872-5.
Category: Critical Care
Keywords: insulin, hyperglycemia, critically ill (PubMed Search)
Posted: 9/30/2008 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Subcutaneous Insulin in the Critically Ill
Shipman K, Frankel HL. Do not use subcutaneous insulin in the intensive care unit population. In: Marcucci L, et al. Avoiding Common ICU Errors. Lippincott Williams & Wilkins; Phildelphia, PA, 2007
Category: Critical Care
Keywords: AIDS, intraabdominal hypertension, abdominal compartment syndrome (PubMed Search)
Posted: 9/23/2008 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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AIDS: coming to a critically ill patient in your ED
Malbrain M, De laet I. AIDS is coming to your ICU: be prepared for acute bowel injury and acute intestinal distress syndrome. Intensive Care Med 2008;34:1565-9.
Category: Critical Care
Keywords: intraabdominal pressure, intraabdominal hypertension, bladder pressure (PubMed Search)
Posted: 9/8/2008 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Intraabdominal Hypertension and the Critically Ill
Cheatham ML. Intraabdominal pressure monitoring during fluid resuscitation. Curr Opin Crit Care 2008;14:327-33.
Category: Critical Care
Keywords: sodium bicarbonate, lactic acidosis, hypoperfusion, shock (PubMed Search)
Posted: 9/3/2008 by Mike Winters, MBA, MD
(Updated: 11/2/2024)
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Bicarbonate for severe lactic acidosis from shock?
Boyd JH, Walley KR. Is there a role for sodium bicarbonate in treating lactic acidosis from shock? Curr Opin Crit Care 2008;14:379-83.