Pediatric Coding Alert

Question: Can we use 99479 for a newborn (34 weeks estimated gestational age) that has a weight of 2,948 grams and is on day 31 of the hospital stay? I can’t tell if that code is for only 28 weeks or less. We are providing parenteral feeding treatment.

Nevada Subscriber

Answer: It is not appropriate to report code 99479 (Subsequent intensive care, per day, for the evaluation and management of the recovering low birth weight infant [present body weight of 1,500-2,500 grams) because it is not applicable for weights above 2,500 grams. However, you can report 99480 (Subsequent intensive care, per day, for the evaluation and management of the recovering infant [present body weight of 2,501-5,000 grams), which is for weights between 2,501 and 5,000 grams.