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Thread: Coding guidelines for neonatal feeding

  1. #1
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    Default Coding guidelines for neonatal feeding

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    I bill for the physician's services in the NICU. I am trying to find hard facts about neonate feeding guidelines. Would TPN, OG or gavage feeds alone automatically qualify a patient for a critical care code? I have always said no to this question. I have a colleague who feels otherwise but we have no docoumentation to solve this disupte. There is very little out there on Neonatal Critical Care. Please help. Thx Rebecca

  2. #2
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    Quote Originally Posted by rlgast1 View Post
    I bill for the physician's services in the NICU. I am trying to find hard facts about neonate feeding guidelines. Would TPN, OG or gavage feeds alone automatically qualify a patient for a critical care code? I have always said no to this question. I have a colleague who feels otherwise but we have no docoumentation to solve this disupte. There is very little out there on Neonatal Critical Care. Please help. Thx Rebecca
    I am not sure about your scenario, but this is a definition of Critical Care from Clinical Practice Management FAQs online:

    "CPT currently defines a critical illness or injury as an illness or injury that acutely impairs one or more vital organ systems such that there is a high probability of imminent or life threatening deterioration in the patient's condition.

    Critical care services are defined as a physician's direct delivery of medical care for a critically ill or critically injured patient. It involves decision making of high complexity to assess, manipulate, and support vital organ system failure and/or to prevent further life threatening deterioration of the patient's condition. Examples of vital organ system failure include, but are not limited to: central nervous system failure, circulatory failure, shock, renal, hepatic, metabolic, and/or respiratory failure."
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  3. #3

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    Did you ever find an answer to this? I'm looking for the same info-thanks!

  4. #4
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    Dothan, Alabama
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    Default Neonate Critical Care

    I am looking for the documentation requirements for neonatal critical care and neonatal intensive care. Can someone direct me to the requirements? Thanks

  5. #5

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    In my division we created a list of critical/intensive indicators with the doc's to determine what is intensive and/or critical.

    TPN, OG, and Gavage are intensive indicators for us as they require continuous montioring, but arent immediately life-threatening and dont constitute a deterioration of the patients condition and/or impending organ failure.

    Also, this artical I found on AAPC was helpful.
    'Neonatal Care: Out with the Old, In with the New' - Feb. 1, 2009

  6. #6
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    I agree. Thank you amcvay531.
    Last edited by rlgast1; 11-14-2014 at 08:04 AM. Reason: adddendum to original response

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