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Inpatient Transferred to PICU

  1. Cool Inpatient Transferred to PICU
    Medical Coding Books
    16-day-old patient is admitted as inpatient and, due to deteriorating health status, is tranferred later the same day to the pediatric ICU (PICU) in the same facility. Presumably, the Admitting Physician bills Initial Hospital Care (99221-99223). Does the Intensivist (not in the same group as the Admitting Physician) to whom this child's care has been transferred bill Initial Inpatient Neonatal Critical Care or Subsequent Inpatient Neonatal Critical Care? This is a new patient for the Intensivist, and the patient is critically ill. My concern is that the Admitting Physician and the Intensivist might both be billing Initial visits on the same date.

    I have been researching this matter for the past hour and haven't come up with a definitive answer; however, my sense is that the Intensivist can bill Initial Inpatient Neonatal Critical Care.

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

  2. #2
    I agree with you, I see no reason why they wouldn't be able to bill the initial critical care.

    Laura, CPC, CEMC

  3. #3
    Milwaukee WI
    Default Admitting Physician different specialty
    If the admitting physician is of a different specialty (or different group), then s/he may also be able to bill 99291-99292. See CPT 2009 (professional edition), Inpatient Neonatal and Pediatric Critical Care guidelines, page 34 (in my book), second to last paragraph ...
    "Critical care services provided by a second physician of a different specialty not reporting a per-day neonatal or pediatric critical care code can be reported with 99291-99292. "

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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