Pediatric and Neonatal Critical and Intensive Care Services Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial Plans

Overview

This policy addresses the reporting of pediatric and neonatal critical and intensive care services, Current Procedural Terminology (CPT®) codes 99468-99476 and 99477-99480, based on instruction from the American Medical Association (AMA) CPT book.

Policy Codes

Find your specific codes below.

This policy contains more codes than can be displayed on one screen. Find your specific code below.

Enter your code here As you input 2 or more characters, a clear button becomes available, and codes will dynamically display below. The number of returned codes will decrease as you enter more characters.

  • 31500
  • 36000
  • 36140
  • 36400
  • 36405
  • 36406
  • 36410
  • 36415
  • 36420
  • 36430
  • 36440
  • 36510
  • 36555
  • 36591
  • 36600
  • 36620
  • 36660
  • 43752
  • 43753
  • 51100
  • 51701
  • 51702
  • 62270
  • 71020
  • 71045
  • 71046
  • 92953
  • 93561
  • 93562
  • 94002
  • 94003
  • 94004
  • 94375
  • 94610
  • 94660
  • 94662
  • 94760
  • 94761
  • 94762
  • 94780
  • 94781
  • 99468
  • 99469
  • 99471
  • 99472
  • 99475
  • 99476
  • 99477
  • 99478
  • 99479
  • 99480
* COMM-Pediatric-Neonatal-Critical-Intensive-Care-Services-Policy.pdf
Click to Download: Pediatric and Neonatal Critical and Intensive Care Services Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial Plans

Questions and Answers

Q: If pediatric and neonatal critical and/or intensive care services are performed for the same patient on the same day as other evaluation and management (E/M) services, are both of these services reimbursable?

A: Pediatric and neonatal critical and/or intensive care services may be subject to additional UnitedHealthcare reimbursement policies.  Refer to UnitedHealthcare’s Same Day/Same Service policy for further details regarding reimbursement of E/M codes billed on the same day by physicians and/orother health care professionals in the same group practice who are of the same specialty, and UnitedHealthcare’sRebundling policy for information regarding reimbursement of E/M codes billed on the same day by the same individual physician and/or other health careprofessional.