Wiki Billing Neonate transfer to NICU

sdhines

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I have a baby born at 11pm, had to be resuscitated and intubated by our pediatrician shortly after birth. Pediatrician stayed with him until he was transferred to another facilities NICU the following morning at 6am. How would you code this? :confused: The provider want to code 99468 for date of delivery, but she's isn't sure what she wants to bill for the following morning. I think we should bill a 99291 for 11pm-12am, then code 99291 and 99292x9 for the following day before the transfer. Any advice is appreciated!
 
I would first verify that the documentation clearly shows that the patient was critically ill and the time that the physician spent providing critical care. Technically, if the resuscitation took place prior to admission to the nursery, code 99465 would be reported for this portion of the work. If admission to the nursery occurred on the same calendar date as the birth and critical care continued after the admission, code 99468 could be reported. However, if the neonate was no longer critically ill and/or did not require critical care services after admission but required intensive observation, see code 99477. You are correct that if critical care was provided on the date after the day of birth, only the time-based codes could be reported as the receiving physician at the other facility will report the daily critical care for that date. Again I would be sure documentation supports the total number of units billed (exclude any time where the physician's full attention was not on this patient or other critical care requirements were not met). Hope that helps.
 
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