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