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August 30, 2025

Coding Guide – Critical Care Services


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Critical care is a complex service provided to a patient who has vital organ system failure or to prevent further life-threatening deterioration of the patient’s condition.  The CPT® definitions and instructions regarding critical care haven’t changed. However, CMS’s 2023 time rule indicates that Medicare is not following CPT’s time chart this guide discusses that.

The 2018 Medicare CERT report found a 19.7% error rate in critical care services. Of those, almost 40% were denied because of insufficient documentation.

Table of Contents:

  • What is critical care
  • E/M services and critical care on the same calendar day
  • Reporting by more than one clinician
  • What may be included in critical care time
  • What may not be included in critical care time
  • Bundled services included in critical care time
  • Critical Care during the global surgical period
  • Key reminders about billing critical care services
  • Reviewing critical care notes

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Last revised May 28, 2025 - Betsy Nicoletti
Tags: critical care services

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Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions.

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