Definition and Explanation of Critical Care Service Definition: Coding service for caring for a critically ill or injured patient Explanation: Critical care has high relative value units and payments so it’s important to know the coding rules. This article describes what can be included in the time of critical care what can’t be included, and […]
Coding Guide – Critical Care Services
The CPT® coding rules and the CMS reimbursement rules can be confusing. This guide explains the CPT® coding rules and the CMS reimbursement rules in one place.
Coding Critical Care Services | Webinar
Recorded January 2023
CMS made significant changes to critical care coding effective in 2022. Not only did CMS adopt CPT prefatory language and rules, they did a 180 degree turn on allowing non-physician practitioners (NPPs) and physicians of the same specialty, in the same group to perform critical care as a split/shared visit. CMS developed a HCPCS modifiers for shared services, and for unrelated critical care in the post op period. This webinar will describe when those modifiers should be used.
CPT® and CMS Rules for Critical Care | What’s the Difference?
CMS and CPT count critical care time differently. CMS issued a “technical correction” in the 2023 PFS Final Rule. They stated that it is their policy that add-on code 99292 can only be reported when critical care time is 104 minutes, not 74 minutes as stated in CPT®. CMS noted they stated this in the […]
Critical Care for General Surgery and Trauma Surgeons
Critical care provided as a stand alone service is based on the seriousness of the patient, the types of interventions, and time. Critical care provided by a surgeon to a patient in a global period for procedures with a 10 or 90 day global period, must also follow the rules for critical care, with the […]