Primary Care Coding Alert

Question: What services are included in the new neonatal initial hospital intensive care code 99477?

North Carolina Subscriber

Answer: Many of the same services that CPT includes in neonatal and pediatric critical care (99293-99296) are also included in 99477 (Initial hospital care, per day, for the evaluation and management of the neonate, 28 days of age or less, who requires intensive observation, frequent interventions, and other intensive care services). The same bundles also apply to initial and subsequent intensive care codes (99298-99300, 99477).

Numerous services are inherent in 99477. When using 99477, you cannot separately bill these items:

- umbilical venous (36510) and umbilical arterial catheters (36660)

- other arterial catheters (36140, 36620) or central (36555) or peripheral vessel catheterization (36000)

- vascular access procedures (36400, 36405, 36406)

- vascular punctures (36420, 36600)

- naso- or oro-gastric tube placement (43752)

- endotracheal intubation (31500)

- lumbar puncture (62270)

- suprapubic bladder aspiration (51100) or bladder catheterization (51701, 51702)

- ventilator management (94002-94004)

- continuous positive airway pressure (or CPAP, 94660)

- surfactant administration (94610)

- transfusion of blood components (36430, 36440)

- invasive or noninvasive electronic monitoring of vital signs, bedside pulmonary function testing (94375)

- monitoring or interpretation of blood gases or oxygen saturation (94760-94762).