Critical care covered service - Not billed seperately

Included Services for Critical Care

The following services are inclusive of critical care services and should not be reported separately the interpretation of cardiac output measurements (93561, 93562), chest x-rays (71010, 71015, 71020), blood draw for specimen (36415), blood gases and information data stored in computers (e.g., ECGs, blood pressures, hematologic data) (99090), gastric intubations (43752, 91105), pulse oximetry (94760, 94761, 94762), temporary transcutaneous pacing (92953), ventilator management (94002-94004, 94660, 94662), and vascular access procedures (36000, 36410, 36415, 36591, 36600).

Family Counseling/Discussions

Routine daily updates to family members are considered part of critical care services and not separately billable. However, time spent with family member or other surrogate decision makers may be counted toward critical care time when these criteria are met:

  • The patient is unable or clinically incompetent to participate in giving a history and/or decision making and

  • The discussion is necessary for determining treatment decisions

A summary of any family discussion is to be documented within the medical record and should include that the patient was unable or incompetent to participate and the necessity of the discussion and any treatment decisions made. Telephone calls to family members and/or surrogate decision makers may be counted provided that they meet the same criteria as described above. All other family discussions, no matter how lengthy, may not be counted towards critical care time.

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