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Newborn Critical Care transport

Messages
12
Location
Green Valley and Tucson,AZ
Best answers
0
Good afternoon,

I work at a community health center and we have Internal medicine, Family practice, OB/GYN and Pediatrics. I am not yet specialized in pediatrics.

I had a pediatric provider ask me what codes he should be using for transporting a patient to NICU at a different facility in a different city.

Our providers never travel with the patients to the other facility. So I advised the provider to code 99485 and 99486 for non face to face transport. He normally treats the patient to stabilize them prior to transport. So i am currently looking into what codes he should be using for that time he is treating the patient.

I looked at the CPT book under 99468-99476 and under excludes, it says "Services performed by transferring individual, prior to transfer of a patient, to a different individual in a different group use (99221-99223 or 99291-99292 or 99460-99462 or 99477-99480)

I then referred to 99291 and 99292 and saw that under excludes, it states "inpatient critical care services provided to neonates that are age 28 days or less use (99468-99469).

I was wondering what codes I should be using. In both it states that the provider should be coding the other set of codes.

if you need an example of the situation, please ask and I will upload it.

Any feedback would be helpful.

Thanks,
Leslie :confused:
 

aocardenas281

Contributor
Messages
11
Location
Orange
Best answers
0
Hello,

Can you please provide me with a specific example so as to aid in the selection of the correct cpt code(s)?

Thanks.

Ann :)
Good afternoon,

I work at a community health center and we have Internal medicine, Family practice, OB/GYN and Pediatrics. I am not yet specialized in pediatrics.

I had a pediatric provider ask me what codes he should be using for transporting a patient to NICU at a different facility in a different city.

Our providers never travel with the patients to the other facility. So I advised the provider to code 99485 and 99486 for non face to face transport. He normally treats the patient to stabilize them prior to transport. So i am currently looking into what codes he should be using for that time he is treating the patient.

I looked at the CPT book under 99468-99476 and under excludes, it says "Services performed by transferring individual, prior to transfer of a patient, to a different individual in a different group use (99221-99223 or 99291-99292 or 99460-99462 or 99477-99480)

I then referred to 99291 and 99292 and saw that under excludes, it states "inpatient critical care services provided to neonates that are age 28 days or less use (99468-99469).

I was wondering what codes I should be using. In both it states that the provider should be coding the other set of codes.

if you need an example of the situation, please ask and I will upload it.

Any feedback would be helpful.

Thanks,
Leslie :confused:
 
Messages
12
Location
Green Valley and Tucson,AZ
Best answers
0
Yes. I would be glad to. The scenerio i am working with right now is:

The provider is at the hospital (Nogales,AZ) waiting for the OB/GYN to deliver the baby, So he's just standing by. He did not document how long he was standing by, So i need to query him. The baby was delivered and about 3 hours after being born, the baby became dyspenic and hypoxic. The pediatrician (my doc) then started him oxygen and IVs.. Once the baby was stabilized, he called EMS. The Provider attended the baby in critical care for approximately 30 minutes. Once EMS arrived, the baby was transported to Tucson, AZ (about a 1.5 hour drive from Nogales). The provider did not travel with the patient.

How can I code this? Stand by code, critical care code, and transport code?

Thank you.
 
Messages
286
Best answers
0
If the OB/GYN requested, attendance at delivery would be charged (not reported if the physician was only there due to hospital policy). You must have 30 minutes or more of documented critical care time to report the 99291 and your physician would not report the daily critical care codes because of the transfer. If you cannot report critical care, see the initial hospital care codes. You would report supervision of transport only if the physician provided supervision to the transport team with communication time of 16minutes or more (99485).
 
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