tci E/M Coding Alert - 2024 Issue Q1

Reader Questions: Understand Neonate-Specific Coding Conventions

Question: Our hospital physician provided a neonate with critical care throughout the first 28 days of life, and we billed the subsequent visits with the neonate code. But, when the patient is 29 days old and receives critical care, do I bill that as an initial visit because it’s a new code set, or do I bill as a subsequent visit because the physician has been seeing the patient all along? AAPC Forum Participant Answer: Starting on day 29, you’ll bill 99472 (Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically...

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