tci E/M Coding Alert - 2014 Issue 2

You Be the Coder: Separate Hospital Stay -- 99468 or 99469?

Question: Our pediatrician admits a newborn baby with severe respiratory distress and we reported 99468. The baby is discharged six days later, but the physician has to admit the baby two weeks after (at 22 days old), critically ill with neonatal sepsis. This by definition does not fit within the criteria of “per hospital stay,” as this is a different hospital stay. Therefore, could I report 99468 again? Ohio Subscriber Answer: You can absolutely report 99468 (Initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age...

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