Pediatric Coding Alert

Before you panic about a CPT 2009 resuscitation inclusion, realize the information is wrong. Several parenthetical instructions made services appear to be shockingly bundled. You can check for errata on CPT's Web site, pointed out Marie L.

Mindeman, BA, RHIT, with the AMA Department of Coding and Nomenclature at the CPT and RBRVS 2009 Annual Symposium in Chicago.

You should cross out portions of the first parenthetical instruction following 99465 (Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or

cardiac output; 2008 code 99440, Newborn resuscitation: provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output), advised Richard Whitten, MD, MBA, FACP,

medical director for Medicare Part B for Alaska, Hawaii, and Washington during the CPT and RBRVS 2009 session "Pediatric Services." The erroneous advice states, "Do not report 99465 in conjunction with 99460, 99468, 99477." These codes in

2008 are 99431 (Initial hospital or birthing center care, per day, for the evaluation and management of the normal newborn infant), 99295 (Initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate,

28 days of age or less), and 99477 (Initial hospital care, per day, for the evaluation and management of the neonate, 28 days of age or less, who requires intensive observation, frequent interventions, and other intensive care services), which

remains the same.Medically necessary newborn resuscitation will not be bundled with initial hospital care, intensive care or critical care. "This directive is a mistake; the coding is as it was," said the CPT conference pediatric services' speaker

Richard Molteni, MD, AMA CPT Advisor for the American Academy of Pediatrics and a neonatalogist.

Revise the note to instruct that 99465 is allowed with the listed services, according to the AMA's "Corrections Document -- CPT 2009" (http://www.ama-assn.org/ama1/pub/upload/mm/362/2009cptcorrections-111308.pdf). Add the following

italicized words to make the directive read, "99465 may be reported in conjunction with 99460, 99468, 99477."

On the inside cover of your CPT book, scratch out the word "unusual." The abbreviated "Modifiers" tool requires an update to modifier 22's CPT 2008 revised definition: Increased procedural services.