Billing for Bedside Procedures

  • Marc J. ShapiroEmail author
  • Mark M. Melendez


In the USA, in the year 2000, critical care medicine accounted for 14.4% of inpatient days and 0.56%, or $55.5 billion, of the gross domestic product.1 The act of billing for these services has become an art with all the rules and regulations that must be adhered to in order to get compensated for the work that one does. To have a clear understanding of the billing process, this chapter begins with an introduction into the US billing and reimbursement program and then progresses to the process of cognitive and procedural reimbursement.


Critical Care Current Procedural Terminology Direct Patient Care Current Procedural Terminology Code Health Care Financing Administration 
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  1. 1.
    Halpern NA, Pastores SM, Thaler HT, Greenstein RJ. Critical care medicine use and cost among medicare beneficiaries 1995–2000: major discrepancies between two United States federal Medicare databases. Crit Care Med. 2007;35(3):692–699.PubMedCrossRefGoogle Scholar
  2. 2.
    Dorman T, Loeb L, Sample G. Evaluation and management codes: from current procedural terminology through relative update commission to Center for Medicare and Medicaid Services. Crit Care Med. 2006;34(suppl 3):S71–S77.PubMedCrossRefGoogle Scholar
  3. 3.
    American Medical Association (AMA). CPT 2009. Chicago, IL: American Medical Association; 2009:17–18.Google Scholar
  4. 4.
    Mabry C. The global surgical package – let’s get the facts straight. J Trauma. 2008;64(2):385–387.PubMedCrossRefGoogle Scholar
  5. 5.
    Department of Health and Human Services. Medicare Reimbursement for Critical Care Services. Washington, DC: Office of Inspector General, Department of Health and Human Services; 2001, OEI:05:00:00420.Google Scholar
  6. 6.
    Marinelli AM. Optimizing Critical Care Coding. ATS; 2007.
  7. 7.
    Fakhry SM. Billing, coding, and documentation in the critical care environment. Surg Clin N Am. 2000;80(3):1067–1083.PubMedCrossRefGoogle Scholar
  8. 8.
    Gerber DR, Bekes CE, Parrillo JE. Economics of critical care: medicare part A versus part B payments. Crit Care Med. 2006;34(suppl 3):S82–S87.PubMedCrossRefGoogle Scholar
  9. 9.
    Fahy BG. Implementation of a handheld electronic point of care billing system improves efficiency in the critical care unit. J Intensive Care Med. 2007;22(6):374–380.PubMedCrossRefGoogle Scholar
  10. 10.
    Reed RL, Luchette FA, Esposito TJ, Pyrz K, Gamelli R. Medicare’s global terrorism: where is the pay for performance? J Truama. 2008;64(2):374–389.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of SurgerySUNY – Stony Brook University Medical CenterStony BrookUSA

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