Part B Insider - 2020 Issue 4
Reader Question: Critical Care is Unscheduled
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Article Overview
This reader question article discusses critical care E/M coding in an inpatient or critical care unit context. It is aimed at professional coders, billers, and physician practices that need general guidance on selecting the correct evaluation and management category for time-based critical care services. The article explains the broad circumstances under which critical care billing is considered and clarifies that the setting, timing, and service context all matter.
Why This Topic Matters
Correctly distinguishing critical care from other inpatient evaluation and management services affects coding accuracy and compliance for hospital-based physician encounters.
What You Will Learn
- How critical care coding is evaluated in an inpatient setting
- Why the care setting alone does not determine code selection
- The general service characteristics associated with critical care documentation and timing requirements
- How reader questions can clarify common coding misunderstandings
Who Should Read This
- Professional coders
- Medical billers
- Physician practices
- Hospital-based coding staff
Codes Discussed
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