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.
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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.