Coding Guide – Critical Care Services

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^® coding rules and the CMS reimbursement rules can be confusing. The payment for this time-based service is high, and payers frequently do pre or post payment review.

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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