STANDARD

Neonatal Intensive Care Codes (codes 99295 and 99296) are used to report services by the physician directing the care of the critically ill neonate. (If the physician is present for the delivery and resuscitation of the infant, the physician may also use codes 99360, 99436 and 99440.) These codes are used for newborns which are 30 days of age or less at the time of admission to an ICU.

(Note: Neonatal Intensive Care Codes are not based on minutes, but are billed once per day per critically ill neonate regardless of total minutes spent Code 99295 is used in connection with services furnished on the date of admission and code 99296 is used in connection with services furnished on the ensuing days of the inpatient stay.)

The following represents the care management involved for these patients:

Enteral and parental nutritional maintenance;

Metabolic and hematological maintenance;

Pharmacological control of the circulatory system;

Parent counseling;

Case management services; and

Direct supervision of the health care team in the performance of cognitive and procedural activities.

The following services are included as part of the global descriptors:

Umbilical venous and umbilical arterial catheters, central or peripheral vessel catheterization;

Other arterial catheters

Laboratory and blood gas interpretations;

Oral or nasogastric tube placement;

Endotracheal intubation;

Lumbar puncture;

Suprapubic bladder aspiration;

Bladder catheterization;

Initiation and management of mechanical ventilation or continuous positive pressure (CPAP);

Surfactant administration;

Intravascular fluid administration;

Transfusion of blood components;

Vascular punctures;

Invasive or non-invasive electronic monitoring of vital signs;

Bedside pulmonary function testing and/or monitoring or interpretation of blood gases or oxygen saturation; and

Immediate preoperative evaluation and stabilization for neonates with life threatening surgical or cardiac conditions.

Any services performed that are not listed above should be reported separately.

Addendum: Codes 99295 and 99296 should be used only in connection with critically ill neonates. Care for infants who no longer meet the definition of critically ill but require intensive care and present with a current low or very low body weight are reported using the subsequent intensive care recovering low birth weight services codes (99298 and 99299).