Wiki Neonatal Critical Care versus Intensive Care

[gillitzk]

I'm having difficulty deciphering the difference between Neonatal Critical Care (99468-99476) vs Intensive Care (99477-99480) and their appropriate applications. When I share the CPT descriptions of these codes with our OB/Newborn providers, they interpret the codes to mean critical care is for their work in preparing an infant for transfer, and intensive care codes are for the receiving provider on transfer. I don't agree, but am unable to explain well the code application differences.

What are the code application difference in these two code series?
What best practices have you implemented for documentation to best describe these professional services?

Please provide links or support; I'd like to share with my coding team and our CDI team.
thanks,

 

[SharonCollachi]

Here is an article on intensive care vs critical care from AHIMA.

 

[lauraleerdh]

The link is no longer active.
This is in the CPC course - chapter 19 Evaluation and Management.

"Codes 99477–99480 describe initial (99477) and continuing (99478–99480)intensive care services for a child. Intensive care is not the same as critical care. CPT® clarifies that children requiring intensive care are not critically ill, but require intensive observation, frequent interventions, and other intensive care services."

See page 45 of the 2023 CPT Professional Editiion for their defining of the two. Its in the first paragraph under Initial and Continuing Intensive Care Servies: "These services are for infants and neotates who are not critically ill but continue to require intenstive cardiac and respiratory monitoring, heat maintenance, enteral and/or parenteral nutritional adjustments, laboratory and oxygen monitoring, and constant observation by the health care team under direct supervision of the physician or other qualified health care professional."