Documentation and billing for the services provided to a critically ill patient can be complex and challenging. Critical care, evaluation and management, and procedures can be billed to get reimbursed for the services provided. An understanding of the documentation requirements and contextual application is fundamentally important to optimize revenue capture. Billing correctly for situations such as advance care planning and extracorporeal membrane oxygenation requires special considerations and supportive documentation. A compliance program that oversees accurate documentation and billing not only provides for clinician education but also minimizes risk to the organization.