Pediatric Coding Alert
1999 Codes for Immunizations, Neonatal Intensive Care are on the Horizon
Its too early to get the actual code numbers, but its not too soon to rejoice in the new CPT codes for 1999. Sources advise PCA that there will be vast changes to the immunization codes, including two codes for administration. And, there will be a fourth code for neonatal intensive care.
First of all, there will finally be codes for administering vaccines. One code will be for a single vaccination, and one will be for multiples, reflecting the extra work involved in drawing down more than one vaccine. This is good news for all of the pediatric practices who very much want to bill for administration. However, the bad news is that the two codes havent yet been assigned relative values. This may confuse Medicaid immunizations, says Charles Schulte, MD, FAAP,, the American Academy of Pediatrics (AAP) representative on the AMAs CPT coding committee. Many states pay for administration under Medicaid, notes Schulte. And they will pay for only one code. The fact that there are no relative values yet means its unclear what you will be able to charge, he explains. I guess you can charge what you want, he adds, tongue-in-cheek.
It is also unfortunate that there is only one code for administering multiple vaccines, says Schulte. Sometimes you have to draw down four or five, he notes.
There will also be many more codes for vaccines. Thats because the Centers for Disease Control and Prevention in Atlanta now wants to track all of the vaccines as closely as possible, by dosage form and manufacturer, says Schulte.
There are currently three codes for neonatal intensive care: an admission code (99295), a code for critically ill and unstable babies (99296), and a code for critically ill and stable babies (99297). There is an obvious gapinfants who need to be in intensive care but are not critically ill. Next year there will be a code for those babies, says Schulte. It will be weight-specific, with 1,500 grams at birth being the limit. Infants would not have to be critically ill to qualify for this code, but they would have to require intensive monitoring.
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1999 Codes for Immunizations, Neonatal Intensive Care are on the Horizon
Its too early to get the actual code numbers, but its not too soon to [...]
