Critical care billing is time-based and unforgiving — a few minutes miscalculated means a lower E/M level, and concurrent care rules are frequently violated, creating costly audit exposure.
- Time-based documentation review — verifying that provider documentation supports the critical care time claimed for 99291 (30–74 min) and 99292 add-on units
- Mechanical ventilation billing — 94002 (initial) and 94003 (subsequent day) ventilator management coding with appropriate E/M coordination and concurrent care modifier application
- Concurrent care billing rules — proper modifier usage when multiple critical care providers are billing on the same date for the same patient
- Procedure bundling compliance — ensuring separately billable procedures are properly unbundled from critical care time with correct modifiers and documentation