rrhernandez
New
I'm hoping somebody can help with this since I've talked it out with others already and we're differing on our interpretation of the guidelines for these codes. It's also been difficult to find information on this subject.
My situation is as follows: I code for our Neurology physicians' visits to the NICU. Most of the time the baby will be admitted to the NICU, let's say on Tuesday, because of extreme premature birth, etc. In this case the physician will bill a 99468 Critical Care E/M code. On Wednesday the NICU team may notice that the baby is "jittery" and request a Neurologist to evaluate the patient for possible seizures. My question is: Does our Neurologist use the 99468 code (all criteria has been met for critical care and this has not been deemed to be a "Consult") since this is their first time seeing the patient, or do they use the 99469 subsequent code? Or something else?
The confusion is in the CPT guidelines and how they're being intrepreted. If you have any experience with this same type of scenario I could really use your help. Thanks!
My situation is as follows: I code for our Neurology physicians' visits to the NICU. Most of the time the baby will be admitted to the NICU, let's say on Tuesday, because of extreme premature birth, etc. In this case the physician will bill a 99468 Critical Care E/M code. On Wednesday the NICU team may notice that the baby is "jittery" and request a Neurologist to evaluate the patient for possible seizures. My question is: Does our Neurologist use the 99468 code (all criteria has been met for critical care and this has not been deemed to be a "Consult") since this is their first time seeing the patient, or do they use the 99469 subsequent code? Or something else?
The confusion is in the CPT guidelines and how they're being intrepreted. If you have any experience with this same type of scenario I could really use your help. Thanks!