Wiki Weight used for 99478-99480?

[angeslow]

Hello all!

When billing for neonatal weight based services (99478-99480) what is the appropriate weight to go by? Dosing or actual weight? Sometimes it differs and could be either depending on what you go by. I was taught to go by dosing weight but now am being told to use actual weight. Is there anywhere that has that in writing? I don't want to get audited and have it come back on me.

Thanks!

 

[Tami_F]

Hello all!

When billing for neonatal weight based services (99478-99480) what is the appropriate weight to go by? Dosing or actual weight? Sometimes it differs and could be either depending on what you go by. I was taught to go by dosing weight but now am being told to use actual weight. Is there anywhere that has that in writing? I don't want to get audited and have it come back on me.

Thanks!

The CPT definitions of these codes specify "present body weight".

Coding for Pediatrics 2018 elaborates:
"Codes 99478-99480 are reported once per calendar day of subsequent intensive (but not critical) care for the E/M of the recovering infant weighing 5,000 g or less. Selection of the code will be dependent on the present body weight of the infant, not the infant's age, on the date of service. Therefore, code selection may change from one day to the next depending on the infant's present body weight and condition." (p 329)


I am inclined to go with actual weight, since that seems to better fit the code definitions and instruction from the AAP.