Codapedia Forum - Questions & Answers
Q/A: Neonatologist was at the birth of a very critical child, she billed 99468 and then it was decided to transfer the child to another facility, she also billed 99291 and 99292 x 3. Her time was denied, how should she have billed for the initial critical care and additional time spent with
A: According to the AMA Guidelines;
“When critical care services are provided to neonates or pediatric patients less than 6 years of age at two separate institutions by an individual from a different group on the same date of service”
In addition, the AMA States;
“the individual from the referring institution should report
The AMA’s requirements if the infant becomes
“When the neonate or infant becomes critically ill on a day when initial or subsequent intensive care services (99477-99480), hospital services (99221-99233), or normal newborn services (99460, 99461, 99462) have been performed by one individual and is transferred to a critical care level of care provided by a different individual in a different group, the transferring individual reports either the time-based critical care services performed (99291, 99292) for the time spent providing critical care to the patient, the intensive care service (99477-99480), hospital care services (99221-99233), or normal newborn service (99460, 99461, 99462) performed, but only one service.”
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