Wiki Inpatient Coding-Newborn Resuscitation

[earlec]

In patient Coding (New born resuscitation)
So lets say a peds doctor admits a patient into the hospital ,they do newborn rescucitation and spend hours with the patient. Then a neonate Md takes over the care of the patient and also bills the resuscitation and the global critical care. What is the Pediatric doctor supposed to bill? Any thoughts/info would be much appreciated...thanks!

 

[FTessaBartels]

99291-92

Per CPT 2009 Professional Edition, page 35, Left column ... Critical care services provided by a second physician of a different specialty not reporting a 24-hour global code can be reported with the critical care codes 99291-99292.
So your peds doctor should be using the 99291-99292 code for critical care services.

But I am a little confused about the scenario ...
You say your peds doctor "admits a patient to the hospital" ... So was this the neonate's date of birth? -OR- Was this an infant who was already at home and then brought to the hospital?

99465 Is specifically for Delivery/birthing room resuscitation. If this was NOT the baby's date of birth, then you can use the usual CPR code 92950.

If YOUR physician was in the birthing/delivery room and performed 99465, then the neonatologist who took over later, and may have had to perform CPR again should be using 92950 for that subsequent resuscitation.

It does NOT seem that the neonatologist should be using 99465 in any case.

Hope that helps.

F Tessa Bartels, CPC, CEMC

 

[earlec]

In patient

Well thats just it, the second physician IS the one reporting global critical care codes.(The neonate MD) The first physician is the pediatrician who may be performing resucitation, etc.

 

[FTessaBartels]

Second physician

The term "second physician" does not refer to the order in which the services were provided, but to the fact that more than one physician provided critical care services on the same date of service.

The pediatrician would use the critical care codes 99291-99292 as appropriate based on time spent. You'll probably need a -25 modifier as well (since the neonatologist will be using the global NICU code).

F Tessa Bartels, CPC, CEMC