Many pediatricians are apprehensive about reporting critical care services, whether performed in the office or hospital. To help allay any uneasiness, physicians should first learn the Current Procedural Terminology (CPT®) definition of critical care, then understand the requirements for reporting critical care based on the location in which services are provided (eg, office/outpatient setting, facility).

Critical care is the provision of medical care to a patient who is critically ill or critically injured. A critical illness or injury is defined as one that acutely impairs one or more vital organs such that there is a high probability of imminent or life-threatening deterioration of the patient's condition (see Figure). Organ failure may include but is not limited to failure of the central nervous, circulatory, hepatic, renal, metabolic, and respiratory systems. Shock is also listed as a condition of organ failure.

It is the physician's responsibility to determine if a patient's condition...

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