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Thread: 99468-99469: Calculating Neonate's Age in Days

  1. #1

    Question 99468-99469: Calculating Neonate's Age in Days

    AAPC: Back to School
    What is the general rule of thumb for calculating a neonate's age in days for such codes as Neonatal Critical Care (99468 & 99469) and Pediatric Critical Care (99471 & 99472)? Is the birth date counted as Day 1 or Day 0? I could argue this either way, but I'm hoping there's a published industry standard regarding this that I can share with our neonatologists and intensivists.

    Thanks for any help anyone can provide.
    Nancy, CPC, CPC-H

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default DOB PLUS 28 days

    The neonate is 28 "days old" on his/her 29th day of life. Day of birth is 0.

    So a child born on 1-1-09 is 28 days old on 1-29-09. Beginning with Date of service 1-30-09 we no longer use 99468-99469.

    F Tessa Bartels, CPC, CEMC

  3. #3

    Red face

    Thanks so much for your prompt reply.

    How do we fight this fight with an insurance company? Do you know of anything published to which we could refer to make our point? Or do we have to roll over on this one and submit to a payor-specific rule?

    Thanks for any additional help you can provide!
    Nancy, CPC, CPC-H

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default MIght be payor specific

    We don't bother to fight these if the payor wants to argue about 1 day.

    F Tessa Bartels, CPC, CEMC

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