CPT Changes Pediatric Critical Transport Code Bundles This Year

This year CPT brought a whole new crop of bundles with pediatric critical care and transport services. As a matter of fact, CPT went retro with pediatric critical care transport codes 99466-99467, reverting the bundles back to the 2007 rules.

CPT 2011 has changed which services are bundled into critical care codes 99291-99292 based on whether a facility or professional reports the services. In addition, CPT has returned the list of services bundled into 99466-99467 to the bundles that were in effect as of 2007.

This year, the following services are included when carried out during the pediatric patient transport by the physician providing critical care and may not be reported separately: Routine monitoring evaluations, interpretation of cardiac output measurements (93562), Chest x-rays (71010-71020), Pulse oximetry (94760-94762), Blood gases and information data stored in computers (for instance, ECGs, blood pressures, hematologic data - 99090), Gastric intubation (43752-43753), Temporary transcutaneous pacing (92953), Ventilatory management (94002-94003, 94660-94662), Vascular access procedures (36000, 36400-36406, 36415, 36591, and 3660

Critical care: In the present year, pediatricians from your practice will still face the following services as being bundled into critical care: interpretations of cardiac output measurements, chest xrays, pulse oximetry, blood gases, information data stored in computers, gastric intubation, temporary transcutaneous pacing, vent management, and vascular access. But then, facilities will be able to report these services separately from critical care and will not face the bundles.

Bear in mind: This means that you can report the critical care code ( Source "http://www.supercoder.com")only, even if the facility is reporting the critical care codes in addition to the separate x-rays, intubation, and other services separately.

You should not report new observation care codes with other E/M service. CPT 2011 adds 99224-99226 as far as coding subsequent observation care is concerned. Even though confusion surrounded these codes when CPT first debuted, recently some rules have come to light on how you can report them.

When to bill: Subsequent observation care starts after the initial observation care DOS.

In addition, you should not report subsequent observation care on the same date as initial observation care codes (99218-99220), nor can you report observation services on the same date as office or emergency department services. What's more, you cannot report the new subsequent observation codes on the same date as observation care discharge (99217).