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What is the age of a neonate?
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A newborn infant who is 0 to 28 days old.
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Codes to report initial services for normal newborns, subsequent E/M of normal newborns, & delivery to provide stabilization &/or resuscitation?
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Newborn Care Services 99460-99465
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Direct Dr. services during transport of a critically ill, neonatal/pediatric critical care in the hospital setting, and intensive care unit
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Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services 99466-99480
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Neonates have a separate set of critical adn intensive care codes. Other codes are used to accurately report the services provided.
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Similar to the E/M services Status, location, and place of service are factors that have to be considered.
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1st consideration of the Newborn is their?
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Status - Normal 99460-99463, Resuscitation 99465, Critically ill 99468-99469 or 99291-99292(pos), ICU (non-critical) 99477-99480 or sub. 99231-99233
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2nd consideration to locate the proper code is?
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Location - hospital or office or other outpatient
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Initial service in the hospital setting normal newborn 99460 (hx & exam) Subsequent 99462 per day
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Critical Care Services outpatient setting 99291-99292, same services
Inpatient setting 99468-99469
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Initial newborn services for outpt. setting 99201-99205 (just as you would any other new patient)
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3rd consideration for the proper code is the? Type of Service
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If the 1st service was an outpt. preventive medicine service what code would be used?
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99381 - Initial comprehensive preventive medicine service provided to an infant (under 1 year).
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NCC
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Neonatal Critical Care
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What is important in the use of inpatient NCC codes?
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Is 28 or less days old
is critically ill
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Codes to use for a critically ill neonate ( 28 days or less of age) is?
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99468 & 99469 (Inpatient) or Critical care codes 99291 and 99292 (Outpatient/ER/etc)
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What must the medical record contain to use those codes mentioned?
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The neonate is in an acute life-threatening situation.
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How often can the Inpatient NCC codes be reported?
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Once every 24 hours (same day). There are no hourly service codes as there are in other critical care codes.
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What if a critically ill infant is older than 28 days and less than 24mo's of age what codes would be used?
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Admitted to an intensive care unit use Pediatric Critical Care Service codes 99471-99476, also reported per day codes.
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