Organ System Failure

 Central nervous system failure 

 Hepatic Failure system failure 

 Encephalopathy 

 Stroke 

 Circulatory failure 

 Acute MI 

 Shock 

 Severe trauma 

 Encephalopathy 

 Coagulopathy 

 Metabolic failure 

 Toxic Ingestion (methanol) 

 Severe Acidosis 

 Respiratory Failure 

 Renal failure 

 New onset 

 Hyperkalemia 

 Pneumonia

Critical Care Requirements

 Clinical Requirement of high probability of Clinical Clinical Requirement Requirement of high probability probability of deterioration 

 Time requirement 

 Minimum 30 minutes 

 Excludes separate procedures

“Full Attention And Physician Time”

 Time counted must be exclusively devoted to Time counted counted must be exclusively exclusively devoted devoted to patient 

 Does not have to be continuous 

 Physician must document total time on chart 

 Must document that time involved in Must document that time involved in separately separately billable  as not counted to a  billable  procedures  toward CC time 

 Attestation with check box or fill in the blank OK