PopQuiz: Child Needs Intubation

[Ruth Sheets]

A 34 month old boy with whooping cough and associated pneumonia is suffering from acute respiratory distress. He is admitted to the hospital. The physician performs intubation and provides 75 minutes of critical care time.

A. 99475, 31500, 518.82, 033.9, 484.3
B. 99291, 99292, 31500, 518.82, 484.3
C. 99291, 99292-25, 31500, 518.82, 033.9, 484.3
D. 99475, 518.82, 033.9, 484.3

See answer and rationale in next post.

 

[Ruth Sheets]

99291 and 99475 are both critical care codes, but 99475 is correct because the inpatient is a pediatric, with age 2 through 5 years. So B and C are incorrect. According to the guidelines for the section on Inpatient Neonatal and Pediatric Critical Care, endotracheal intubation (31500) is included, and therefore, should not be coded separately. This eliminates choice A. Diagnosis codes 518.82 (acute respiratory distress), 033.9 (whooping cough, unspecified organism), and 484.3 (pneumonia in whooping cough) are correct. So the answer is D.