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Patricia Posted Fri 10th of March, 2017 15:09:21 PM
Hello, Please let me know how you bill a newborn in the hospital that is sick and not in NICU, but heart monitor, Labs for Hyperbilirubinemia, drug exposure. We are confused as to what to bill? Thanks for your help in advance, Patricia
SuperCoder Answered Tue 14th of March, 2017 06:20:25 AM

Hi,

 

As per the above documentation, appropriate code would be 99477, as the intensive services, such as heart monitor, laboratory had been performed.

This code deals in the initial hospital intensive care, per day, for the evaluation and management of the ill neonate, 28 days of age or less, who requires intensive observation and monitoring. Infants of any present body weight who are not critically ill but continue to require intensive cardiac and respiratory monitoring, continuous and/or frequent vital sign monitoring, heat maintenance, enteral and/or parenteral nutritional adjustments, laboratory and oxygen monitoring and constant observation by the health care team under direct physician supervision.

 

Also, care of new-borns who are not normal but do not require intensive services may be reported with codes for initial hospital care (99221-99223). 

 

Hope that helps!

 

Thank you

 

 

Patricia Posted Wed 15th of March, 2017 15:55:01 PM
Good Afternoon, I am so sorry to bother you but now I am being told this is an NICU code. Please let me know if so... Thanks.
SuperCoder Answered Thu 16th of March, 2017 04:14:32 AM

Hi,

 

There are different code ranges for service rendered to the new born.

 

For Inpatient Neonatal Intensive Care services and Paediatric and neonatal critical care services: 99466-99486

 

Inpatient Neonatal and Paediatric critical care: 99468-99476

 

 

As per your scenario, the new born was not in NICU; however, was sick and heart monitoring, laboratory was performed, for which, the appropriate code would be 99477, as this code deals with patients who are not critically ill, but requires, intensive care.

 

 

Kindly refer the below link for more clarity.

 

https://www.supercoder.com/coding-newsletters/my-family-practice-coding-alert/cpt-update-use-99477-to-capture-care-beyond-99223-article

 

Thank you!

Patricia Posted Thu 16th of March, 2017 13:05:46 PM
THANKS THIS IS WHAT I READ AND THE OFFICE MANAGER STATED IT WAS FOR THE NICU UNIT ONLY... THANKS AGAIN FOR YOUR HELP. PFD
SuperCoder Answered Fri 17th of March, 2017 01:21:12 AM

Happy to help!

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