1. 00081 is to be used for the evaluation, diagnosis and treatment of a critically ill patient who requires constant bedside care by the physician.
2. A critically ill patient may be defined as a patient with an immediately life threatening illness/injury associated with any of the following conditions:(which are given as examples)
a) Cardiac Arrest
b) Multiple Trauma
c) Acute Respiratory Failure
f) Cardiac Arrhythmia with haemodynamic compromise
h) Other immediate life threatening situations
3. 00081 includes the following procedure items where required: defibrillation, cardioversion, peripheral intravenous lines, arterial blood gases, nasogastric tubes with or without lavage and urinary catheters (as part of a cardiac arrest).
4. 00081 includes the time required for the use and monitoring by the physician of pharmacologic agents such as inotropic or thrombolytic drugs.
5. All other procedural fee items not specifically listed in #3 above are not included in 00081. Below are listed some of the procedures that are not included and which therefore, may be billed in addition when rendered:
(note - the time required for these procedures should be noted with the claim and deducted from the 00081 time).
a) Endotracheal Intubation - as a separate entity, i.e. not part of a cardiac arrest or followed by an anesthetic.
c) Venous cutdown
d) Arterial catheter
e) Diagnostic peritoneal lavage
f) Chest tube insertion
g) Pacemaker insertion
6. 00081 is not intended for standby time such as waiting for laboratory results, or simple monitoring of the patient.
7. When a consultation fee is charged in addition to 00081, for billing purposes the consultation fee shall constitute the first half hour of the time spent with the patient.
8. When surgery is performed by the same doctor after prolonged emergency care, the surgical fee may be charged in addition to the appropriate emergency care fee.
9. When a second or third physician becomes involved in the emergency care of a acutely ill patient requiring continuous bedside care, item 00081 is applicable just as it is to the attending physician who is first on the scene.
Please reference the billing pre-amble for these relevant interpretations of this billing code:See Pre-Amble Notes