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Code 99477

  1. #1
    Default Code 99477
    Medical Coding Books
    Does anyone have experience with 99477?

    Would phototherapy be justified? They need to be watched closer than normal, ie, getting extra glucoses, watching their temp. etc.

    I want to be sure because the reimbursement is way higher. The reimbursement is $313 vs $30 for sub care!!

  2. Default 99477
    According to the "Coding for Pediatrics", if the child is in NICU, and is having phototherepy and thermal support, this justifies using this code.

  3. #3
    Greeley, Colorado
    I agree with pennys73 - we have used this code in this kind of situation and been paid.
    Lisa Bledsoe, CPC, CPMA

  4. #4
    Milwaukee WI
    Default Only INITIAL care
    The description of the code states "Initial hospital care, per day ..." so I believe this can only be billed for the admit day. The "per day" qualifier also means that it is intended to cover all cares for a 24-hour period.

    After that initial care, if the neonate is neither cricially ill, nor low-birth weight and requiring intensive monitoring, you would report subsequent hospital visits 99231-33.

    F Tessa Bartels, CPC, CPC-E/M

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