Get Expert Help with Your Medical Coding or Compliance Issues. Request a Free Consultation

OIG Adds Critical Care to Work Plan

OIG Adds Critical Care to Work Plan August 17, 2018

The OIG added critical care services to their August Work Plan update.

Critical care is a time based, evaluation and management service, for critically ill or injured patients.  Critical care may not be reported when care is less than 30 minutes, and critical care may not be reported as a split shared service.  Documentation must support:

  • Direct medical care of a critically ill or injured patient.  Specifically, the patient must have a critical illness or injury that impairs one or more vital organ systems such that there is a high probability of imminent or life threatening deterioration.
  • 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 (i.e. central nervous system failure, circulatory failure, shock, rental, hepatic, metabolic and/or respiratory failure).
  • Time spent performing critical care, exclusive of separately reportable services, exceeds 30 minutes

We recommend you review the Work Plan and conduct proactive audits of identified known risks that are applicable to your organization. HBE’s team of experts is available to assist you with these audits and any necessary education and training.

The OIG Work Plan can be found at https://oig.hhs.gov/reports-and-publications/workplan/index.asp

Ready to discuss your project with us?