Critical Care: Take This Advice for Correct Critical Care Coding

Why This Topic Matters

Critical care claims are frequently reviewed, so understanding the documentation expectations and the distinction between critical care and other evaluation and management services can affect compliant reporting.

Article Sections

1. Start with the Definition

   Introduces the general CMS definition and related conceptual explanation of critical care.

2. Know the Particulars

   Summarizes the basic documentation and time-related criteria discussed for critical care services, along with the main code family referenced.

3. Scenario 1: Use An E/M Code

   Presents an office-based scenario and discusses related evaluation and management and injection coding topics, including modifier use and separately reportable services.

4. Scenario 2: Report Inpatient Code

   Reviews an acute event scenario involving office and hospital settings and compares outpatient, emergency department, and initial hospital care coding concepts.

5. Scenario 3: Know What ‘Intensive Care’ Really Means

   Addresses an ICU setting scenario and distinguishes place of service from the type of care described in the article.