critical care on newborn

[mrolf]

Could someone please help me with a cpt code for critical care on a newborn. Baby was delivered premature and total critical care time documented was 1 hr in our CAH, then was transferred to a specialist in larger hospital. Questioning if should use 99291, 99466 or 99468. Any help would be appreciated. Thanks

 

[FTessaBartels]

Would need the notes to be sure

I would need to see the notes to be sure.

Read the guidelines in CPT, which specifically state: If inpatient critical care services are reported in the referring facility prior to transfer to the receiving hospital, use the critical care codes (99291, 99292). (2011 CPT Professional edition, pg 38 under guidelines for Pediatric Critical Care Patient Transport.

You can code 99466 ONLY if he physician went along on the ambulance ride with the critically ill neonate when transfering the baby to the receiving hospital. If your physician turned the baby over to the transport team and didn't go along in the ambulance with the baby, you cannot code 99466.

You would NOT use 99468. Only one physician can report this code per day. The neonatologist at the receiving specialty hospital will use that code.

Hope that helps.

F Tessa Bartels, CPC, CEMC