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Wiki Coding guidelines for neonatal feeding

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rlgast1

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I bill for the physician's services in the NICU. I am trying to find hard facts about neonate feeding guidelines. Would TPN, OG or gavage feeds alone automatically qualify a patient for a critical care code? I have always said no to this question. I have a colleague who feels otherwise but we have no docoumentation to solve this disupte. There is very little out there on Neonatal Critical Care. Please help. Thx Rebecca
 
rlgast1 said:
I bill for the physician's services in the NICU. I am trying to find hard facts about neonate feeding guidelines. Would TPN, OG or gavage feeds alone automatically qualify a patient for a critical care code? I have always said no to this question. I have a colleague who feels otherwise but we have no docoumentation to solve this disupte. There is very little out there on Neonatal Critical Care. Please help. Thx Rebecca
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I am not sure about your scenario, but this is a definition of Critical Care from Clinical Practice Management FAQs online:

"CPT currently defines a critical illness or injury as an illness or injury that acutely impairs one or more vital organ systems such that there is a high probability of imminent or life threatening deterioration in the patient's condition.

Critical care services are defined as a physician's direct delivery of medical care for a critically ill or critically injured patient. It involves decision making of high complexity to assess, manipulate, and support vital organ system failure and/or to prevent further life threatening deterioration of the patient's condition. Examples of vital organ system failure include, but are not limited to: central nervous system failure, circulatory failure, shock, renal, hepatic, metabolic, and/or respiratory failure."
 
Neonate Critical Care

I am looking for the documentation requirements for neonatal critical care and neonatal intensive care. Can someone direct me to the requirements? Thanks
 
In my division we created a list of critical/intensive indicators with the doc's to determine what is intensive and/or critical.

TPN, OG, and Gavage are intensive indicators for us as they require continuous montioring, but arent immediately life-threatening and dont constitute a deterioration of the patients condition and/or impending organ failure.

Also, this artical I found on AAPC was helpful.
'Neonatal Care: Out with the Old, In with the New' - Feb. 1, 2009
 
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