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Billing Consult and NICU Admission together

Pam Posted Mon 06th of May, 2013 15:02:31 PM

Can a Neonatologist be called to a consult 99251and then determine the baby needs to be admitted 99477 to NICU and bill for both, or does it need to be one or the other?

SuperCoder Answered Tue 07th of May, 2013 21:38:38 PM


This is with my editor.Please be patient as we are trying to get you a definitive answer.


SuperCoder Answered Wed 08th of May, 2013 00:15:04 AM

Hi there! Are these the same day or separate days?

Torrey Kim, CPC
Editor, Pediatric Coding Alert

Pam Posted Wed 15th of May, 2013 18:26:36 PM

'36245' - yes the consult 99251 and admit 99477 would be on the same day, buy the same Neonatologist. Wanted to ask if you could be both or if you would just bill the admit code of 99477? Thank you.

SuperCoder Answered Fri 17th of May, 2013 00:17:00 AM

Most insurers will not allow you to report both. Instead, the work your doctor performed during the consult will be included in the "per day" payment for the initial hospital care code 99477.

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