If the same provider gives critical care services in both outpatient and inpatient settings on the same day, what should they report?

When a provider delivers critical care services in both outpatient and inpatient settings on the same day, they are guided by the coding guidelines for critical care. In this case, the appropriate response is to report only the appropriate neonatal or pediatric critical care code when applicable.

The rationale for this choice lies in the specific coding rules for critical care services. In many instances, if both neonates and pediatric patients are involved, the coding becomes distinctly focused on their unique needs and the specific type of care administered. These codes typically have specific instructions that differentiate them from standard adult critical care codes.

Consequently, it is crucial to adhere to the guidelines that apply to these specialized populations, ensuring the services are accurately represented and billed correctly. Therefore, when critical care is administered to neonatal or pediatric patients, only those codes are reported to reflect the intensity and demand for care appropriately.