Code 99477

ARCPC9491

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Stafford, VA
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Does anyone have experience with 99477?

Would phototherapy be justified? They need to be watched closer than normal, ie, getting extra glucoses, watching their temp. etc.

I want to be sure because the reimbursement is way higher. The reimbursement is $313 vs $30 for sub care!!:p
 

pennys73

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Boonville, MO
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99477

According to the "Coding for Pediatrics", if the child is in NICU, and is having phototherepy and thermal support, this justifies using this code.
 
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Milwaukee WI
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Only INITIAL care

The description of the code states "Initial hospital care, per day ..." so I believe this can only be billed for the admit day. The "per day" qualifier also means that it is intended to cover all cares for a 24-hour period.

After that initial care, if the neonate is neither cricially ill, nor low-birth weight and requiring intensive monitoring, you would report subsequent hospital visits 99231-33.

F Tessa Bartels, CPC, CPC-E/M
 
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