My organization recently took on the physician coding for NICU providers and there are times when one of the NICU providers is called by another hospital that does not have a NICU to transport a critically ill newborn from their facility to another facility for a higher level of care. At what point does the provider start monitoring time to bill the 99466/99467 codes? Does time start when they receive the initial phone call from the originating hospital since it is at that point they are taking critical information on the patient or when they get to the originating hospital to pick the baby up for transport?
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Wiki Neonatal Transportation Time?
- Thread starter tracyl.seaman@gmail.com
- Start date
lgardner
Guest
per the Coders' Desk Reference for Procedures 2023 (emphasis added by me):
99466 - 99467 -
Pediatric critical care patient transport services report time the physician provides direct or supervisory care of a critically ill/injured patient aged 24 months or younger during interfacility transportation.
The timing takes place when the physician acquires initial responsibility for the patient at the first facility and concludes one the receiving facility takes over.
For direct patient care, the physician is in contact with the patient during transfer.
For supervisory care, the physician is responsible for communication with the transport staff before transfer, at the originating facility, and during transfer to the receiving facility.
Additionally, the physician provides instruction on the treatment of the patient to the transport staff who are in direct contact with the patient and provide the care. Several services are included in the care of these patients and are not separately reportable, such as monitoring vital signs, cardiac output evaluation, chest s-rays, pulse oximetry measurement, bloos gas, ECGs, intubation, temproary pacing, ventilation oversight, and any required vascular access.
per the Auditors' Desk Reference 2023 (emphasis added by me):
99466-99467 -
"Time is calculated beginning when the physician assumes responsibility at the referring center and ends when the receiving facility accepts responsibility for the patient."
"Codes 99466-99467 are reported based upon the face-to-face time spent by the physician. Only one provider may report critical care transport for the same episode of care. In addition, a transport of less than 30 minutes is not reported separately. Documentation must include all services and monitoring provided and the time spent by the physician."
"There are no absolute limits on the amount of critical care transport time that can be billed per day as long as the medical records can support the need for all critical services provided. Payment is dependent upon carrier policies for critical care."
99466 - 99467 -
Pediatric critical care patient transport services report time the physician provides direct or supervisory care of a critically ill/injured patient aged 24 months or younger during interfacility transportation.
The timing takes place when the physician acquires initial responsibility for the patient at the first facility and concludes one the receiving facility takes over.
For direct patient care, the physician is in contact with the patient during transfer.
For supervisory care, the physician is responsible for communication with the transport staff before transfer, at the originating facility, and during transfer to the receiving facility.
Additionally, the physician provides instruction on the treatment of the patient to the transport staff who are in direct contact with the patient and provide the care. Several services are included in the care of these patients and are not separately reportable, such as monitoring vital signs, cardiac output evaluation, chest s-rays, pulse oximetry measurement, bloos gas, ECGs, intubation, temproary pacing, ventilation oversight, and any required vascular access.
per the Auditors' Desk Reference 2023 (emphasis added by me):
99466-99467 -
"Time is calculated beginning when the physician assumes responsibility at the referring center and ends when the receiving facility accepts responsibility for the patient."
"Codes 99466-99467 are reported based upon the face-to-face time spent by the physician. Only one provider may report critical care transport for the same episode of care. In addition, a transport of less than 30 minutes is not reported separately. Documentation must include all services and monitoring provided and the time spent by the physician."
"There are no absolute limits on the amount of critical care transport time that can be billed per day as long as the medical records can support the need for all critical services provided. Payment is dependent upon carrier policies for critical care."