Health Information Management

ICU documentation is critical: Reflect patient severity to get credit where credit is due

Medical Records Briefing, May 1, 2009

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Understand the definition of critical care

There are two general functions that we perform in an ICU. The first is the management of complex and ill patients to maintain their stability or prevent decompensation. The second is critical care. The difference between the two is significant from an ethical as well as a financial viewpoint. Critical care delivery refers to care for which a hospitalist or intensivist can bill a critical care CPT code in the 99291–99292 range, with code 99291 for the first hour and code 99292 for each subsequent half hour. We may report code 99292 more than once per day. Alternative codes that can be used for an ICU include subsequent visit codes (99231–99233) and consultation codes (99251–99263), as appropriate.

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