Akeshia1026
New
Are there any rules or guidelines around billing revenue code 203 if the patient is older than 18 years of age? We are working with a Virginia children's facility who contracted with a large commercial payer to pay ICU rates when the claim is billed with revenue code 203. CMS defines pediatrics as 18 years of age and younger, and the American Academy of Pediatrics as well as the state of Virginia defines pediatrics as 21 years of age or younger. On the rare occasion, there are patient's being treated at the children's facility who are older than 18 years of age and are in an ICU bed. Is it possible to still bill 203 or is there anything that would prevent us from doing so? Is it any different if the patient is 21 or older vs. 18 or older? Thanks in advance for the guidance!