Critical Care
Description
Critical Care Coding is an online, self-paced course for outpatient and professional fee coders who report CPT and HCPCS codes for critical care services. This course explains how critical care is defined clinically, what documentation is required to support reporting, and how to apply critical care coding and billing guidelines accurately. Coders will learn how to distinguish included versus separately reportable services, apply rules for shared visits, and understand how critical care interacts with global surgical packages. The course includes 1 AHIMA CEU and 1 AAPC CEU and helps coders code critical care services with greater accuracy, consistency, and compliance.
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 will I learn about accurately coding critical care services?
This course explains how to correctly report critical care services using CPT guidelines, including how critical care is defined and when it is medically necessary. You’ll learn how time-based reporting works, what services are included in critical care, and how to determine when critical care codes are appropriate based on provider documentation.
How does the course help coders understand critical care time and what can be counted toward it?
The course breaks down how critical care time is calculated and what activities may or may not be included. You’ll learn how to interpret time statements, identify qualifying critical care services, and apply CPT rules when multiple providers or services are involved, helping ensure accurate and compliant time reporting.
Will this course improve my ability to identify documentation requirements for compliant critical care coding?
Yes. The course highlights the key documentation elements coders must confirm, including the patient’s critical condition, provider involvement, total time spent, and services rendered. You’ll learn how to recognize incomplete or conflicting documentation and when clarification may be needed to support accurate critical care code assignment.
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 flexible, online education platform designed for today’s coders. With a growing catalog of AHIMA and AAPC-approved coding courses, HIAlearn supports both beginners and experienced coders looking to build confidence, accuracy, and CEU credits.
Courses are available across various coding types including CPT, E/M, ICD-10-CM, and ICD-10-PCS, and are designed for multiple specialties including inpatient, outpatient, profee, and CDI.
To stay up to date, coders can explore our Coding Updates hub for the latest ICD-10-CM, ICD-10-PCS, CPT, and IPPS changes. HIAlearn also supports organizations with group discounts and scalable team access, promoting accuracy, compliance, and continuous professional development across departments.
Overview
Code Type
.png)
Keep learning with more medical coding courses from HIAlearn.
Inpatient Neonatal and Pediatric Critical Care
Expands critical care coding to the neonatal/pediatric population, including shared visits with advanced practice providers.
Mechanical Ventilation Coding in ICD‑10‑PCS
Provides procedural coding guidance for mechanical ventilation—a service frequently billed alongside critical care.
Emergency Department Evaluation and Management
Explains core emergency department evaluation and management principles that support appropriate critical care identification and documentation when a patient’s condition escalates to require critical care services.