Chapter 23: Initial and Continuing Intensive Care: Infant (99477-99480)
Initial and continuing intensive care codes 99477-99480 describe services the physician provides to infants who require intensive observation, frequent interventions and other intensive services. Subsequent intensive care codes are restricted to infants 5,000 grams or less (approximately 11 pounds).
Documentation Needs to Support Services
Documentation must show that the neonate needs intensive care services, including (but not limited to) the following:
â€¢intensive cardiac and respiratory monitory
â€¢continuous and/or frequent vital sign monitoring
â€¢enteral and/or parenteral nutritional adjustments
â€¢laboratory and oxygen monitoring, and
â€¢constant observation by the health care team under direct physician supervision.
As long as the patient meets the above requirements and weighs 5,000 grams or less, you can apply the intensive care codes. The patient need not have previously been in critical condition to qualify for continuing intensive care.
The neonatologist doesnt have to be in constant attendance to report 99477-99480. Instead, he must provide direct supervision of the healthcare team that provides constant observation of the recovering infant.
Translation:The attending physician must provide direct patient contact and be readily available. The doctor doesnt have to do the procedures or provide 24-hour in-house coverage, but he needs to be physically present at some time during that 24-hour period to examine the patient and review the patients care and plan with the healthcare team.
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