On the third day as an inpatient, a 21-day-old newborn becomes apneic and is intubated and ventilated for 3.5 hours until the transport team arrives. Coding resources indicate that Current Procedural Terminology (CPT®) codes 99291–99292 are for outpatient settings or inpatient settings for a child older than 24 months, but it appears that these are the appropriate codes when physicians do not manage the patient in the neonatal intensive care unit (NICU), but do provide critical care services until the transport team arrives. How should this care and time be reported?

The crux of the issue is how to code concurrent neonatal critical care provided to a single patient on a single date of service by more than one physician.

While the optimal code to report in this situation would be 99295, initial neonatal critical care, if that code is reported, the neonatologist who assumes management of...

You do not currently have access to this content.