Question

A 10-day-old infant is seen in the ED in respiratory distress. He is admitted and intubated with ventilation management. An echocardiogram was performed and read by the physician as congenital heart disease. What are the appropriate codes for the physician?

A. 99291-25, 93303
B. 99471-25, 31500, 94002, 93303
C. 99468-25, 93304-26
D. 99460-25, 31500, 94002, 93303

Answer 1

The correct billing codes for physician services provided to a 10-day-old infant in respiratory distress, who received intubation with ventilation management and was diagnosed with congenital heart disease, are 99471-25, 31500, 94002, and 93303 (option B).

Step-by-step explanation:

A 10-day-old infant presented in respiratory distress and received medical treatment including intubation with ventilation management and an echocardiogram, which confirmed congenital heart disease.


The proper billing codes for physician services in this scenario would need to reflect critical care provided to the infant, the performance of an endotracheal intubation, ventilatory management, and the interpretation of an echocardiogram.


The correct codes from the options given would be:

• 99471-25: Critical care services for the evaluation and management of a critically ill infant, with modifier -25 indicating that significant, separately identifiable evaluation and management service was provided on the same day as the procedure.
  
  
• 31500: Intubation, endotracheal, emergency procedure.
  
  
• 94002: Ventilatory management for acute respiratory failure.
  
  
• 93303: Transthoracic echocardiography for congenital cardiac anomalies; complete.

This set of codes matches the description of services rendered in the question, as it accounts for the critical care service, the intubation procedure, the need for ventilatory management, and the performance and interpretation of the echocardiogram to diagnose the congenital heart disease.