CPT E/M for Inpatient Neonatal Intensive Care Services and Pediatric & Neonatal Critical Care Services
face-to-face
beings when the physician assumes primary responsibility of the pediatric patient at the referring hospital and ends when the receiving hospital accepts responsibility for the patient care
bundled or global services
certain other routine services included with a level of E/M service
bundled services for Pediatric Critical Care Transport
these services are included and may not be reported separately: 1) routine monitoring evaluations 2) interpretation of cardiac output measurements, chest x-rays, pulse oximetry, blood gases, and information data stored on computers 3) gastric intubation 4) temporary transcutaneous pacing 5) ventilatory management 6) vascular access procedures (*any services not included above are reported separately)
Initial and Continuing Intensive Care Services
used to report services provided once per day per patient by one physician to neonatal inpatients, 28 days or younger, who are not critically ill or injured but require intensive observation, frequent interventions, and other intensive care services
Services included w/ Inpatient Neonate Critical Care
1) repetitive evaluation of patient 2) therapy adjustment 3) supervision of the health care team by the physician 4) all bundled services included w/ for critical care services 5) list of additional services in CPT Code Book
pediatric patient (for transport)
a patient who is 24 months or less
Code 99467
add-on code used to report each additional 30 minute block of Pediatric Critical Care Transport (face-to-face)
Code 99486
add-on code used to report each additional 30 minute block of Pediatric Critical Care Transport (non-face-to-face)
pediatric inpatient
an inpatient who is 29 days to less than 6 years of age
neonate inpatient
an inpatient who is equal to or less than 28 days of age
Inpatient Neonatal Critical Care
used to report services provided once per day per patient by one physician who directs the initial and subsequent days of critical care of a critically ill or injured neonatal inpatient
Inpatient Pediatric Critical Care
used to report services provided once per day per patient by one physician who directs the initial and subsequent days of critical care of a critically ill or injured pediatric inpatient
Code 99469
used to report the E/M service provided on a subsequent day(s) to a critically ill or injured neonate inpatient, 28 days or younger
Code 99472
used to report the E/M service provided on a subsequent day(s) to a critically ill or injured pediatric inpatient, 29 days to 24 months
Code 99476
used to report the E/M service provided on a subsequent day(s) to a critically ill or injured pediatric patient, 2 through 5 years of age
Code 99468
used to report the E/M service provided on the date of admission to a critically ill or injured neonate inpatient, 28 days or younger
Code 99471
used to report the E/M service provided on the date of admission to a critically ill or injured pediatric inpatient, 29 days to 24 months
Code 99475
used to report the E/M service provided on the date of admission to a critically ill or injured pediatric patient, 2 through 5 years of age
Code 99480
used to report the E/M services provided on subsequent day(s) for a recovering infant of 2501 - 5000 grams present weight
Code 99479
used to report the E/M services provided on subsequent day(s) for a recovering low birth weight infant between 1500 - 2500 grams present weight
Code 99478
used to report the E/M services provided on subsequent day(s) for a recovering very low birth weight infant of less than 1500 grams present weight
Code 99477
used to report the E/M services provided on the day of initial hospital care to a neonatal inpatient, 28 days or younger, who is not critically ill or injured but requires intensive observation, frequent interventions, and other intensive care services
Pediatric Critical Care Transport (non-face-to-face)
used to report the control physician's non-face-to-face supervision of the interfacility transport of a critically ill or injured pediatric patient, 24 months of age or younger
Code 99466
used to report the first 30 to 74 minutes of Pediatric Critical Care Transport (face-to-face)
Code 99485
used to report the first 30 to 74 minutes of Pediatric Critical Care Transport (non-face-to-face)
Pediatric Critical Care Transport (face-to-face)
used to report the physical attendance and direct face-to-face care provided by a physician during the interfacility transport of a critically ill or injured pediatric patient, 24 months of age or younger