Health Information Management

Tip: Learn the requirements for trauma activation

APCs Insider, August 6, 2010

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Several conditions must apply before CMS will pay the trauma activation fee. First, the trauma center must be designated or licensed by a state or local government authority or must be verified by the American College of Surgeons (ACS). 

ACS verification is designed to assist hospitals in the evaluation and improvement of trauma care. It also helps provide information about the trauma system’s capacity to function, its performance, and its trauma system development. Verified trauma centers must meet criteria described in ACS’ “Resources for Optimal Care of the Injured Patient.”

Second, trauma team activation or notification of key hospital personnel must occur based on receipt of triage information. Without this pre-hospital notification, you may not bill for trauma activation.

Third, the hospital must bill for critical care services. Report CPT codes 99291 (critical care, evaluation and management of the critically ill or critically injured patient, at least 30 minutes, for the first 30–74 minutes) and 99292 (for each additional 30 minutes) when appropriate.

This tip is adapted from “Effectively and accurately report trauma activation with critical care in the ED” in the August issue of Briefings on APCs.
 



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