Critical Care
Description
In this course, participants will gain a comprehensive understanding of critical care services in healthcare settings. Through detailed lessons and expert guidance, students will learn to define critical care, grasp the essential documentation requirements, and master the art of accurately coding for critical care services. Topics covered include Critical Care CPT and HCPCS codes, the distinction between included and separately reportable services, critical care documentation and billing guidelines, shared visits, and the impact of critical care on global surgical packages.
Included Lessons:
- What is Critical Care?
- What is Critical Care Services?
- What are not Critical Care Services?
- Critical Care CPT Codes
- Critical Care HCPCS Codes
- Included Services - Not Separately Reported
- Separately Reportable Services
- Documentation and Billing Guidelines
- Critical Care Provided on Same Day as E/M Service
- Who Can Bill for Critical Care?
- Shared Visit and Critical Care
- ED Critical Care
- Critical Care and Global Surgical Package
- Combining Time of Two Providers
- When Documentation does not Support Critical Care Criteria
- Critical Care Code Time Table
- Organizational Impact
CEUs available for the following credentials:
AAPC
COC, CPC, CPC-P, CANPC, CEDC, CEMC, CIC, CPB, CPPM
AHIMA
CCA, CCS, CCS-P, RHIT, RHIA, CDIP, CHDA, CHPS
Key Takeaways
- Understanding of Critical Care: Students will have a clear understanding of what constitutes critical care in medical terms, including the definition, the criteria for identifying critically ill patients, and the complexity of decision-making involved.
- Scope of Providers: Coders will understand who can provide critical care services, including physicians and non-physician providers, and the importance of adhering to state licensure requirements and scope of practice.
- Cumulative Time Billing: Students will learn to calculate cumulative critical care time when provided by the same or different providers within the same specialty group.
- Medical Necessity Assessment: Coders will be able to assess whether critical care services are medically necessary based on the patient's condition and documentation, ensuring proper reimbursement.
- Teaching Physician Guidelines: Those completing the course will understand the guidelines for teaching physicians and residents in the context of critical care services.
- Modifiers and Exception Cases: Coders will learn when to use modifiers, such as Modifier 25, and understand exception cases where critical care can be reported during a global surgical period or for unrelated conditions.
- Organizational Impact: The course will emphasize the financial significance of accurate coding and documentation, highlighting the potential consequences of improper coding and the importance of compliance with CMS regulations.
Benefits of Taking this Course
- Increased Coding Accuracy
- Skills in Critical Care Services
- Increased Confidence in Complex Coding Scenarios
- Reduced Error Risk
- Compliance Confidence
FAQs
What is the definition of critical care, and how does it differ from other medical care?
What are the key criteria for determining whether a service qualifies as critical care?
To qualify as critical care, both the illness or injury and the treatment being provided must meet documentation and billing requirements. Key criteria include medical necessity, the provider's emergent response, acutely impaired body systems, evidence of imminent deterioration, and the prevention of further decline in life-threatening conditions.
About our Medical Coding Courses
HIAlearn, powered by Health Information Associates (HIA)—a leader in medical coding and auditing for more than three decades—offers a comprehensive online education platform for medical coders. With a catalog of over 200 medical coding courses accepted by the American Health Information Management Association (AHIMA) for Continuing Education Units (CEUs) and a selection approved by the American Academy of Professional Coders (AAPC), HIAlearn caters to both beginners and experienced medical coders seeking to enhance their skills. The platform provides an array of training plans tailored to meet individual learning needs, from mastering challenging coding procedures to understanding broad conceptual frameworks within the coding world. Courses are available across various coding types including CPT, E/M, ICD-10-CM, ICD-10-PCS, and are designed to cater to different coder levels and coding specialties such as inpatient, outpatient, profee, and CDI. Additionally, HIAlearn offers a Coding Updates bundle to ensure coders are up-to-date with the annual changes in ICD-10-CM, ICD-10-PCS, CPT, and IPPS. Beyond individual learning, HIAlearn supports organizations with group discounts, promoting enhanced coding accuracy, efficiency, and compliance across teams.
Overview
.png)