Critical care is a complex service provided to a patient who has vital organ 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
- Other E/M services and critical care on the same calendar day
- Who may provide critical care
- 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
CPT® 2020 Professional Edition, American Medical Association
CMS Medicare Claims Processing Manual, Chapter 12, Section 30.6.12
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