ACGME Critical Case Log Info

The Critical Care Index Cases (CCIC) log will document management of a broad scope of critical care patients as follows:

  1. Each resident will develop a log of at least 20 critical care patients who best represent the broad scope of critical care index management.
  2. Each of the patients listed on the log should include management of at least 2 of the 7 categories listed below.
  3. The completed logs should include experience with at least one patient in all 7 of the following essential categories:
    1. Ventilatory Management
    2. Bleeding (non-trauma) greater than 3 units necessitating transfusion and monitoring in ICU settings
    3. Hemodynamic Instability
    4. Organ Dysfunction/Failure (etiology/mode of management)
    5. Dysrhythmias
    6. Invasive Line Management and Monitoring
    7. Nutrition

Residents can identify the required minimum 20 surgical critical care index cases by using CPT code 99292. Code 99292 will map to all 7 of the surgical critical care conditions. CPT code 99292 is different from the other codes. CPT Code 99292 (and it alone) will allow credit to be taken for multiple procedures on the same patient on the same day.

RRC Code Assignment to Surgical Critical Care Procedures

  • 8410 – Ventilatory Management (>24 hours on ventilator)
  • 8420 – Bleeding (non-trauma patient >3 units)
  • 8430 – Hemodynamic instability (Req. Inotropic/pressor support)
  • 8440 – Organ Dysfunction (renal, hepatic, cardiac failure)
  • 8450 – Dysrhythmias (requiring drug management)
  • 8460 – Invasive line management/monitoring (Swan-Ganz, catheter, arterial lines, etc.)
  • 8470 – Parenteral/enteral nutrition