Several Key Areas Are Affected by New CPT 2000 Codes for Pediatricians
Published on Mon Nov 01, 1999
There are some significant new codes and changes in coding language in CPT 2000 for pediatricians which affect vaccine administration, neonatal intensive care codes, Dermabond, Synagis, vision screening and colposcopy for child abuse. These changes take effect in January, although past experience shows that many insurance companies wait until well into the new year to load them into their systems.
Vaccine Administration
1. Revised code for vaccine administration. The vaccine administration codes issued in 1999 were found faulty immediately. 90471, which is for one vaccine, is fine. But 90472 is for two or more (i.e., whether you give two or four you can only use the CPT 99472 code once), and that, when pediatricians are frequently administering three, four, or even five is not fair. CPT 2000 will redefine the second code to be for each subsequent vaccination. So now, you will be able to bill for each vaccine you administer.
90472 - Immunization administration (includes percutaneous, intradermal, subcutaneous, intramuscular and jet injections and/or intranasal or oral administration); each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure)
Neonatal Intensive Care Codes
2. New verbiage in introduction to neonatal intensive care codes. There will not be any new codes, but there will be new verbiage making it clear that these codes are to be used for neonates who are admitted at the age of 30 days or less, and can be used as long as the child qualifies for critical care during this stay. They can not be used for babies who are admitted over the age of 30 days. The pertinent new verbiage is below.
The neonatal critical care codes (99295, 99296, 99297, 99298) are applied to neonates (30 days of age or less) admitted to an intensive care unit. These codes will be applicable as long as the child qualifies for critical care services during this hospital stay. Infants admitted to an intensive care unit older than one month of age would be coded with hourly critical care codes (99291, 99292) if they qualify for critical care services. These neonatal codes are not applied based upon the type of unit (e.g., pediatric or neonatal critical care unit) in which the child receives care nor the type of provider delivering the care.
Using Dermabond
3. New verbiage to allow use of laceration repair codes with Dermabond. There will be a code for wound closure using tissue adhesive (Dermabond) instead of (or in conjunction with) sutures. This is necessary because the laceration repair codes currently contain no verbiage about Dermabond. The pertinent new verbiage is below.
Use the codes in this section to designate wound closure utilizing sutures, staples, or tissue adhesives (e.g., [...]
