Mississippi Administrative Code › Title 20 - Labor › Part 2 - Mississippi Workers' Compensation Medical Fee Schedule › EVALUATION AND MANAGEMENT › Section 20-2-IX - CRITICAL CARE SERVICES (99291-99292)

Current through June 25, 2024
Critical care is the direct delivery by a physician(s) 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. Critical care involves high complexity decision making
				  to assess, manipulate, and support vital system function(s) to treat single or
				  multiple vital organ system failure and/or to prevent further life threatening
				  deterioration of the patient's condition. Examples of vital organ system
				  failure include, but are not limited to: central nervous system failure,
				  circulatory failure, shock, renal, hepatic, metabolic, and/or respiratory
				  failure. Although critical care typically requires interpretation of multiple
				  physiologic parameters and/or application of advanced technology(s), critical
				  care may be provided in life threatening situations when these elements are not
				  present. Critical care may be provided on multiple days, even if no changes are
				  made in the treatment rendered to the patient, provided that the patient's
				  condition continues to require the level of physician attention described
				  above.
Providing medical care to a critically ill, injured, or
				  postoperative patient qualifies as a critical care service only if both the
				  illness or injury and the treatment being provided meet the above requirements.
				  Critical care is usually, but not always, given in a critical care area, such
				  as the coronary care unit, intensive care unit, pediatric intensive care unit,
				  respiratory care unit, or the emergency care facility.
Services for a patient who is not critically ill but happens
				  to be in a critical care unit are reported using other appropriate E/M codes.
Critical care and other E/M services may be provided to the
				  same patient on the same date by the same individual.
The following services are included in reporting critical
				  care when performed during the critical period by the physician(s) providing
				  critical care: the interpretation of cardiac output measurements (93561,
				  93562), chest x-rays (71045, 71046) , pulse oximetry (94760, 94761, 94762),
				  blood gases, and collection and interpretation of physiologic data (eg, ECGs,
				  blood pressures, hematologic data);); gastric intubation (43752, 43753);
				  temporary transcutaneous pacing (92953); ventilatory management (94002-94004,
				  94660, 94662); and vascular access procedures (36000, 36410, 36415, 36591,
				  36600). Any services performed which are not included in this listing should be
				  reported separately.
Facilities may report the above services separately. The
				  critical care codes 99291 and 99292 are used to report the total duration of
				  time spent in provision of critical care services to a critically ill or
				  critically injured patient, even if the time spent providing care on that date
				  is not continuous. For any given period of time spent providing critical care
				  services, the individual must devote his or her full attention to the patient
				  and, therefore, cannot provide services to any other patient during the same
				  period of time.