QUEST Integration - Neonatal Intensive Care

Original Effective Date:
08/01/1996
Current Effective Date:
01/01/2015

HMSA’s Plan for QUEST Integration Members includes services provided by a physician directing the care of a neonate or infant in a neonatal intensive care unit (NICU).

Services Included in Neonatal Intensive Care

Neonatal intensive care is paid a global fee and includes the following services.

• Invasive or non-invasive electronic monitoring of vital signs
• Bedside pulmonary function testing
• Endotracheal intubation
• Vascular punctures
• Intravascular fluid administration
• Transfusion of blood, blood components
• Oral or nasogastric tube placement
• Surfactant administration (through inhalation)
• Peripheral vessel catheterization
• Catheterization of umbilical vein
• Catheterization of umbilical artery
• Suprapubic bladder aspiration
• Bladder catheterization
• Lumbar puncture
• Blood gases
• Oxygen saturation
• Initiation and management of mechanical ventilation or continuous positive airway pressure (CPAP)
• Newborn resuscitation

Claims Filing Information

Care starts at the date of admission to the NICU and is reported once a day using codes 99468 and 99469. Services must be rendered in the NICU.

Submit critical care notes with the claim to include the following information:

• Procedure(s) performed
• Service(s) rendered
• Patient’s condition
• Names of other physicians in attendance

Revision History