Billing and Coding

Coding and billing critical care services is an essential part of the critical care clinician. It serves both to justify services provided and to facilitate the financial support of clinicians and institutions. Subject to national, regional, and even local variations, critical care coding and billing is many times absent in the curriculum. Many aspects of billing are subject to controversy and multitude of opinions and perceptions. In addition, critical care is subject to time-billing making it very much different from normal evaluation and management (E&M) coding. Team collaboration and care, a genuine characteristic of critical care, is subject to particularities in regards to billing requiring accurate documentation and diagnostic appropriateness. Particular aspects of the critical care billing include the interaction with nonphysician providers (NPPs) as well as teaching residents and fellows. Documentation of clinical encounters, procedures, and even family meetings has to meet particular requirements. Clinicians must always be aware about their local rules and regulations as those might differ from area to area.