Wiki Pediatric Critical Care

[gracerobin2004]

Morning,
I understood central venous access was included in the 99291 & +99292 codes regardless of the age of the patient BUT a recent scenario on an exam showed the correct answer with the central access coded separately. Which is correct? Thanks

 

[CBLENNIE]

There are separate critical care codes for patients younger than 6 years of age as 99291-99292 applies to ages 6 years and up.

• 99468-99469: neonates (0-28 days)
• 99471-99472: 29 days to 24 months
• 99475-99476: 2 through 5 years of age

These critical care codes include all of the services included in 99291-99292, and 99291-99292 do not include central venous access; however, 99468-99469, 99471-99472 and 99475-99476 do include central venous access 36555-insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age.

So, for critical care billed with codes 99291-99292, you need to bill the appropriate code for insertion of central venous access.

 

[gracerobin2004]

Thank you for that complete answer! the child was 20 days old. I read the case as CC services provided in the ER but the services took place after the child was admitted to the NICU so on several counts I coded the primary incorrectly which would have given me the answer. Thanks again.