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Hospital question for providing resuscitation

Joaquin Posted Wed 02nd of April, 2014 18:45:32 PM

The Neonatal Specialist did the initial code of '99468' on a newborn, and our provider was called in and did the resuscitation and stayed (provided direct care) with the patient for 3 hrs prior to transfer. What cpt code would our provider bill?

SuperCoder Answered Thu 03rd of April, 2014 16:31:14 PM

The initial day neonatal critical care code (99468) can be used in addition to 99464 or 99465 as appropriate, when the physician or other qualified health care professional is present for the delivery (99464) or resuscitation (99465) is required. Other procedures performed as a necessary part of the resuscitation (eg, endotracheal intubation [31500]) are also reported separately when performed as part of the pre-admission delivery room care. In order to report these procedures separately, they must be performed as a necessary component of the resuscitation and not simply as a convenience before admission to the neonatal intensive care unit.

Joaquin Posted Fri 04th of April, 2014 09:58:01 AM

So then 99465 would be the correct code because the other provider used 99468? Also, would the 3 hrs our provider (separate from the Neonatal Specialist) provided by staying with the patient be bundled into the 99465 or would another applicable code apply?

Joaquin Posted Wed 09th of April, 2014 07:40:17 AM

Were you still researching my question from 4 days ago?

SuperCoder Answered Wed 09th of April, 2014 16:10:50 PM

I am taking the opinion of my CE regarding this. She will come up with an answer soon. We want to be sure before delivering it to you now.

Thanks for being patient..

SuperCoder Answered Thu 10th of April, 2014 13:38:00 PM

Hi there! Sorry for the delay - I have been having a hard time finding the answer to this without a little more information. I would like to investigate your question further - I am the editor of Pediatric Coding Alert. Can you please email me directly with the specifics of what your doctor did vs. what the other physician did? Once we have more information I can research this more and get back to you ASAP. Thank you!

Torrey Kim, CPC
torreyk@codinginstitute.com

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