Critical Care – An Update: Are you under or over utilizing Critical Care Codes? This webinar is AAPC-approved for 1.5 CEUs. Can be split between Core A, CEDC, CEMC, CDEO and CPMA provided you score a 70% or higher on the post test. Test takers should read all test instructions, and complete the Required Information fields at the top of the test. This test consists of 15 questions. Please select one best answer for each test question by clicking on the square next to the answer you have selected. This test is not timed; however, the test must be taken in one sitting. When all 15 questions have been answered, please click on the Submit Test button. Your score, as well as logic-reach reasoning for answers to any test questions that you missed, will be displayed immediately following completion and successful transmission of this test. For technical support for your Emergency Medicine Coding and Reimbursement Webinar Library subscription please call or email: Cari Laplace Webinar Technical Support Administrator BSA Healthcare Phone: 1-561-434-4740 Email: claplace@bsanda.com NameCompany NameEmailThe national all payer Critical Care average is approximately 15%. True or False? True FalseAn indication that a provider may be over utilizing the Critical Care designation is: A provider’s Medicare Critical Care distribution average is 40% or greater than the state Medicare carrier’s Critical Care distribution. A provider’s all payer Critical Care distribution is equal to the state Medicare carrier’s Critical Care distribution. A provider’s Medicare Critical Care distribution is approximately 1%. None of the aboveCritical Care encompasses which of the following: A high probability of imminent or life threatening deterioration The highest level of doctor preparedness Direct personal management by the provider All of the aboveThe use of Critical Care Code 99291 requires that a provider spend _____________ minutes treating the patient in question: between 20 and 45 between 30 and 74 between 15 and 30 None of the aboveCritical Care Code 99292 requires that a provider spend _____________ minutes treating the patient in question: 30 minutes beyond the initial 74 minutes required to fulfill the 99291 requirement an additional 74 minutes beyond the initial 74 minutes required to fulfill the 99291 requirement an additional 60 minutes beyond the initial 74 minutes required to fulfill the 99291 requirement None of the aboveCritical Care time includes time spent managing patients other than the Critical Care patient. True FalseWhich of the following constitute “full attention” with regards to Critical Care: Bedside patient care, review of ancillary studies, discussions with family, patient, nurses, and other clinicians, and chart completion Bedside patient care, review of ancillary studies, and discussions with family, patient, nurses, and other clinicians Separately billable procedures and review of ancillary studies Separately billable proceduresWhich statement should be documented by a clinician who has provided Critical Care services to a patient: Time to perform separately billable procedures included in Critical Care time Bedside patient care, review of ancillary studies, and discussions with family, patient, nurses, and other clinicians is included in Critical Care time Time to perform separately billable procedures subtracted from Critical Care time I did not perform any separately billable proceduresWhich of the following is a separately billable procedure that, when performed, does not count towards Critical Care time: Conversations with the medical examiner CPR or ACLS Ordering and review of ancillary studies Chart completionAccording to CMS Memo 1548, in a teaching environment, the following condition must be met for all claims submitted with a Critical Care code(s): Any treatment provided by the teaching physician does not have to be documented on the chart Teaching physician does not have to be present for the entire time that the Critical Care patient is being managed Teaching physician and resident documentation should not be combined The teaching physician must document why he/she feels the case is a Critical Care case and, in addition, must add a statement that covers the treatment that the teaching physician provided with or without a discussion with the resident. Which of the following scenarios is indicative of a potential Critical Care-type patient scenario: A 4-year-old who fell off a bike sustaining a head injury with brief loss of consciousness A healthy, young adult patient who sustained a blunt head injury with local swelling and bruising without subsequent confusion, loss of consciousness or memory deficit A 24-year-old male is brought in by EMS with a gunshot wound to the abdomen and is taken to the Operating Room. A 65-year-old female is brought in via EMS after an auto accident. She is restrained with cervical precautions and complains of brief LOC and pain in the neck. Which of the following scenarios is indicative of a potential Critical Care-type patient scenario: A 42-year-old male who is not diabetic and has no other chronic disease presents with a three-day history of a right leg red streak going up the medial aspect of the leg. He is non-toxic appearing and is afebrile. An 18-year-old male fell on the side of a walkway and presents with a moderate to severe sprained ankle. The ankle is swollen and discolored and he is unable to put weight on it. A 20-year old female presents to the ED with a fever of 102.5° and a pulse ox 94%. A 36-year old male falls from a 12’ ladder and presents to the ED with an angulated fracture of the distal femur with skin tenting overlying the fracture.Which of the following medical conditions is indicative of a potential Critical Care-type patient scenario: Extremity or Fournier’s Gangrene of the perineal area Trauma patient who has extremity injuries with x-rays of non-adjacent sites (e.g., shoulder and elbow; forearm and hand; knee and elbow, etc.) Isolated pelvic or hip fracture with no other workup in the ED except the pertinent x-rays Extremity injury that is admitted for surgical repair, reduction or stabilizationWhich of the following procedures are commonly seen in Critical Care-type cases: Pacemaker insertion Pericardiocentesis Cardioversion All the aboveWhich of the following lab values is indicative of a potential Critical Care-type case: Hemoglobin > 6 Potassium levels < 2 or > 6.5 Platelet count > 10,000 PO2 > 60
