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Deborah Grider, CPC, CPC-P, CPC-I, COC, CPMA, CEMC, CCS-P, CDIP
Neonatal and pediatric critical care coding guidelines have been modified over the years, but the definitions remain the same. The patient must meet the same clinical criteria as for the adult critical care codes 99291 and 99292. Critical care can be provided by a physician(s) or other qualified healthcare professional(s) of medical care for critically ill or injured patients.
According to CPT, “A critical illness or injury acutely impairs one or more vital organ systems such that there is a high probability of imminent or life-threatening deterioration in the patient’s condition. Critical care involves high complexity decision making to assess, manipulate, and support vital system function(s) to treat single or multiple vital organ system failure and/or to prevent further life threatening deterioration of the patient’s condition.”1
The neonatal and pediatric critical care codes are not time based but rather are reported per calendar day for the evaluation and management of a neonatal or pediatric patient. The codes are selected based on: