BC Advantage - 2022 Issue 5
Concurrent Critical Care
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Article Overview
This article explains a CMS Claims Processing Manual update related to concurrent critical care and how it is addressed in reporting guidance for practitioners in the same group and specialty. It is aimed at coding professionals, compliance staff, and medical practices that need to stay current on critical care policy changes and related documentation or policy updates. The article focuses on the general CMS update, historical context, and the practical need for organizational review of critical care billing procedures.
Why This Topic Matters
Concurrent critical care is a specialized billing scenario that can affect how services are reported when multiple practitioners are involved in the same patient encounter. Understanding the update helps organizations align compliance policies and coding workflows with current CMS guidance.
Article Sections
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Concurrent Critical Care overview
Introduces the topic and explains why the CMS update is being discussed in the context of critical care reporting changes. It provides general background on the service scenario and its relevance to current practice.
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Historical workaround and evolving guidance
Describes the earlier approach used for shared critical care encounters and the broader shift toward more explicit published guidance. The section frames how reporting practices have changed over time.
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CMS Claims Processing Manual excerpt
Presents the cited CMS manual language that addresses cumulative critical care time and reporting conditions for concurrent services. The section focuses on the policy source referenced by the article.
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Operational impact and compliance follow-up
Explains the significance of the update for compliance review, organizational policy revision, and internal communication. It emphasizes the need to evaluate current procedures in light of the new guidance.
What You Will Learn
- The general CMS policy context for concurrent critical care reporting
- How the article frames changes to shared critical care workflows
- Why compliance and policy review are emphasized after the update
- What type of manual guidance the article highlights
Who Should Read This
- Medical coders
- Auditors
- Compliance departments
- Billing staff
- Physician practices
- Inpatient facility administrative teams
Codes Discussed
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