Advanced Search

Pediatric Coding Alert

Reader Question:

Neonatal Critical Care

Published on Fri Dec 01, 2000

Question: A baby developed problems several days after birth. The pediatrician transferred the newborn to the neonatal intensive care unit (NICU) in the middle of the night, but the baby remained with the pediatricians service. How should we bill for the next days visit and subsequent visits? Also, if a baby who has been in the NICU is transferred from neonatology back to the pediatric service, is this billed as a consult?

Florida Subscriber

Answer: If the child is critically ill and transferred to the NICU but the services are provided by the original pediatrician, the neonatal critical care code (99295) applies. This is a daily, global code that covers essentially all the procedures performed in a NICU.

If the baby continues to be critically ill and remains in the NICU, then 99296-99298, subsequent day neonatal intensive care codes, are used for each following day. If the infant transfers from the NICU neonatology service to a general pediatric service, then use codes 99231-99233 (subsequent hospital care).
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Pediatric Coding Alert

View All