Surgical Critical Care EHR and AI Medical Billing Software

Surgical intensivists care for critically ill surgical and trauma patients around the clock. XEHR records critical care time and daily notes and bills them correctly against surgical global periods.

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Chart · Office visit

Lastname, Firstname M. Sample patient · DOB 01/01/1980 · Commercial

Eligible

BP128/82

HR72

BMI26.4

Temp98.6

Progress noteAI Scribe draft

Day 2 after bowel resection; low blood pressure, on pressors.

R65.21 Severe sepsis with septic shock

ReviewSign note

Diagnosis carried to the claimR65.21

THE HARD PARTS

What makes surgical critical care billing hard

Critical care billed by time

Critical care is paid by documented time, and time spent on separate procedures cannot be counted twice.

Overlap with the surgeon’s global period

ICU care after an operation may be part of the surgery or separately billable, depending on who provides it and why.

Shift handoffs

Several intensivists may see the same patient in one day, and each needs their own time and note.

WHERE THE WORK HAPPENS

How surgical critical care care is delivered and billed

Surgical critical care happens in surgical, trauma and burn intensive care units. Everything is billed on the professional claim with the hospital place of service, mostly as critical care time and daily hospital visits, plus bedside procedures such as central lines and bronchoscopy. Many patients are inside a surgeon’s global period, which makes documentation of who did what, and why, essential.

What payers check on surgical critical care claims

Critical care is billed by total documented time on the date, and time for separately billed procedures is excluded.
Routine post-operative ICU care by the operating surgeon is part of the surgery’s global period.
Critical care by a different physician, or for a problem unrelated to the surgery, can be billed when documented as such.
Sepsis with septic shock is coded with the underlying infection first, then the severe sepsis code.
Injury codes need a seventh character for initial, subsequent or sequela encounters.

Common surgical critical care diagnoses ICD-10-CM

R65.21	Severe sepsis with septic shock
J96.01	Acute respiratory failure with hypoxia
N17.9	Acute kidney failure, unspecified
K65.0	Generalized (acute) peritonitis
T81.40XA	Infection following a procedure, unspecified, initial encounter
S36.116A	Major laceration of liver, initial encounter

Examples only. The provider chooses the code that matches the documented diagnosis, and XEHR checks it against the note and the payer's rules before the claim goes out.

A VISIT ON XEHR

A surgical critical care visit, start to payment

1
Take the handoff

The overnight course, lines, drips and results are in the chart for the incoming intensivist.
2
Treat and record time

Critical care time is recorded with the note, and bedside procedures are documented separately.
3
Coordinate with surgery

The operating surgeon’s plan and global period are visible, so care is split and documented correctly.
4
Bill the day

Critical care time, visits and procedures go out on checked claims with the hospital place of service.

How XEHR helps

From the surgical critical care visit to the payment

Time captured as it happensCritical care time is recorded with the note, excluding separately billed procedures.
Global period shownThe patient’s surgery and its global period are visible, so billable critical care is clear.
Daily notes from one recordEvery intensivist’s note and time is recorded against the same patient day.
AI that waits for youThe AI drafts notes and prepares claims; your providers sign and your billers approve.

Claim · CMS-1500

Sample claimLastname, Firstname M. · DOS 03/04/2026

Scrub passed

Scrubbed
Submitted
Accepted
Paid

Service	Dx	Units	Charge
Office visit	E11.9	1	145.00
A1c test	E11.9	1	28.00
Total			173.00

ERA postedPayment applied, no re-keying

Agentic AI for surgical critical care

AI medical billing for surgical critical care practices

XEHR is an agentic EHR: AI agents do the administrative work around every surgical critical care visit, and your team approves what matters. How agentic AI works

Before the claim leaves

The claim-check agent looks for

Critical care is billed by total documented time on the date, and time for separately billed procedures is excluded.
Routine post-operative ICU care by the operating surgeon is part of the surgery’s global period.
Critical care by a different physician, or for a problem unrelated to the surgery, can be billed when documented as such.
Sepsis with septic shock is coded with the underlying infection first, then the severe sepsis code.

Around the visit

Agents run on their own

Coverage checked before each surgical critical care visit
The visit note drafted for the provider to sign
Insurance payments matched and posted
Open claims tracked, denials read and appeals drafted

People decide

Your team stays in charge

Providers sign every note
Billers approve every claim and appeal
Staff submit prior authorizations
Any check can be overridden, with a reason

BUYER'S GUIDE

Questions to ask before you choose a surgical critical care EHR

Ask every vendor, including us. The answers show whether a system was built for surgical critical care work or only adapted to it.

Ask us on a demo

Is critical care time captured with each note, with procedure time kept out?
Is the surgery’s global period visible on the ICU patient’s chart?
Can several intensivists document and bill on the same day?
Are bedside procedures documented separately?
Are injury codes captured with the right encounter character?

QUESTIONS

Surgical Critical Care practices ask us

Does XEHR capture critical care time?

Yes. Time is recorded with each note and separately billed procedures are kept out of it.

Can surgical intensivists bill ICU care after surgery?

Yes, when it is unrelated to the routine post-operative care or provided by a different physician as payers allow; the note must show why.

Does XEHR support trauma ICU documentation?

Yes. Injury details, procedures and daily critical care notes are documented in one record.

Can several intensivists bill the same patient on one day?

Yes. Each records their own time and note, and the claim follows the payer’s rules for the group.

Does XEHR support burn ICUs?

Yes. Burn extent, procedures and daily critical care are documented in one record.

Can XEHR show why critical care is separately billable?

Yes. The note records the unrelated problem or the different physician providing care.

Can family meetings be documented in the ICU?

Yes. Meetings, decisions and time are recorded.

How much does XEHR cost for a surgical critical care practice?

Pricing is published: $189 per provider per month for the Clinical plan, $449 per provider per month for the Practice Suite with billing, or 2.5% of collections for RCM as a Service. Month-to-month, with a BAA on every plan. See pricing.

How long does it take a surgical critical care practice to go live?

Small practices are usually live in 2 to 4 weeks, including setup, data migration and training. We agree the plan with you before you sign.

Related specialties

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See XEHR set up for surgical critical care

A 30-minute walkthrough on a live test environment, with your specialty's templates and billing.

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