Physician reimbursement for critical care services integrating palliative care for patients who are critically ill

Dana R. Lustbader, Judith E. Nelson, David E. Weissman, Ross M. Hays, Anne C. Mosenthal, Colleen Mulkerin, Kathleen A. Puntillo, Daniel E. Ray, Rick Bassett, Renee D. Boss, Karen Brasel, Margaret L. Campbell, Therese B. Cortez, J. Randall Curtis

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Patients with advanced illness often spend time in an ICU, while nearly one-third of patients with advanced cancer who receive Medicare die in hospitals, often with failed ICU care. For most, death occurs following the withdrawal or withholding of life-sustaining treatments. The integration of palliative care is essential for high-quality critical care. Although palliative care specialists are becoming increasingly available, intensivists and other physicians are also expected to provide basic palliative care, including symptom treatment and communication about goals of care. Patients who are critically ill are often unable to make decisions about their care. In these situations, physicians must meet with family members or other surrogates to determine appropriate medical treatments. These meetings require clinical expertise to ensure that patient values are explored for medical decision making about therapeutic options, including palliative care. Meetings with families take time. Issues related to the disease process, prognosis, and treatment plan are complex, and decisions about the use or limitation of intensive care therapies have life-or-death implications. Inadequate reimbursement for physician services may be a barrier to the optimal delivery of high-quality palliative care, including effective communication. Appropriate documentation of time spent integrating palliative and critical care for patients who are critically ill can be consistent with the Current Procedural Terminology codes (99291 and 99292) for critical care services. The purpose of this article is to help intensivists and other providers understand the circumstances in which integration of palliative and critical care meets the definition of critical care services for billing purposes.

Original languageEnglish (US)
Pages (from-to)787-792
Number of pages6
JournalChest
Volume141
Issue number3
DOIs
StatePublished - Mar 2012
Externally publishedYes

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Critical Care
Palliative Care
Critical Illness
Physicians
Quality of Health Care
Therapeutics
Current Procedural Terminology
Communication
Patient Care Planning
Medicare
Documentation
Neoplasms

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Lustbader, D. R., Nelson, J. E., Weissman, D. E., Hays, R. M., Mosenthal, A. C., Mulkerin, C., ... Curtis, J. R. (2012). Physician reimbursement for critical care services integrating palliative care for patients who are critically ill. Chest, 141(3), 787-792. https://doi.org/10.1378/chest.11-2012

Physician reimbursement for critical care services integrating palliative care for patients who are critically ill. / Lustbader, Dana R.; Nelson, Judith E.; Weissman, David E.; Hays, Ross M.; Mosenthal, Anne C.; Mulkerin, Colleen; Puntillo, Kathleen A.; Ray, Daniel E.; Bassett, Rick; Boss, Renee D.; Brasel, Karen; Campbell, Margaret L.; Cortez, Therese B.; Curtis, J. Randall.

In: Chest, Vol. 141, No. 3, 03.2012, p. 787-792.

Research output: Contribution to journalArticle

Lustbader, DR, Nelson, JE, Weissman, DE, Hays, RM, Mosenthal, AC, Mulkerin, C, Puntillo, KA, Ray, DE, Bassett, R, Boss, RD, Brasel, K, Campbell, ML, Cortez, TB & Curtis, JR 2012, 'Physician reimbursement for critical care services integrating palliative care for patients who are critically ill', Chest, vol. 141, no. 3, pp. 787-792. https://doi.org/10.1378/chest.11-2012
Lustbader DR, Nelson JE, Weissman DE, Hays RM, Mosenthal AC, Mulkerin C et al. Physician reimbursement for critical care services integrating palliative care for patients who are critically ill. Chest. 2012 Mar;141(3):787-792. https://doi.org/10.1378/chest.11-2012
Lustbader, Dana R. ; Nelson, Judith E. ; Weissman, David E. ; Hays, Ross M. ; Mosenthal, Anne C. ; Mulkerin, Colleen ; Puntillo, Kathleen A. ; Ray, Daniel E. ; Bassett, Rick ; Boss, Renee D. ; Brasel, Karen ; Campbell, Margaret L. ; Cortez, Therese B. ; Curtis, J. Randall. / Physician reimbursement for critical care services integrating palliative care for patients who are critically ill. In: Chest. 2012 ; Vol. 141, No. 3. pp. 787-792.
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