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99468-99469: Calculating Neonate's Age in Days

  1. Question 99468-99469: Calculating Neonate's Age in Days
    Medical Coding Books
    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
    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. 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
    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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