The American Academy of Pediatrics (AAP) has been successful in its effort to get CPT (Current Procedural Terminology) codes assigned to car seat/car bed challenge procedures (also known as angle tolerance tests). This is an important accomplishment because medical services with an assigned CPT code can be submitted by the practitioner for insurance reimbursement. This means that these procedures are likely to become more routine and widespread for at-risk infants.
Effective January 1, 2012, hospitals may bill for car seat/car bed challenges using the following CPT codes:
- 94780: Car seat/bed testing for airway integrity, neonate, with continual nursing* observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; 60 minutes.
- 94781: Each additional full 30 minutes of the procedure described in code #94780. (List separately in addition to the code for primary procedure.)
Becky Dolan, health policy analyst at the AAP, offers further advice for those at medical facilities who are responsible for reporting codes: “All NICU/PICU (neonatal/pediatric intensive care unit) (#99468–‐99476) and intensive care (#99477–‐99480) codes do bundle these new codes for car seat testing as part of the global care. However, if the testing is done on the date of discharge (#99238 or 99239) or when a patient receives hospital care services (#99231–‐99233) and is not receiving critical or intensive care services, then the car seat testing codes are not included and must be reported separately.”
The codes are only to be reported when a baby requires car seat challenge testing prior to discharge to determine if he can be sent home in a car seat or must instead be placed in a car bed for transport. These codes should also be used when a car seat challenge is repeated for a baby after hospital discharge to determine when it is safe to transition from a car bed to a car seat.
Contact Becky Dolan at BDolan@aap.org for further details.
—Tammy Franks, Randall Children’s Hospital at Legacy Emanuel
—Becky Dolan, American Academy of Pediatrics
*CPT does not define who is qualified to perform this service. CPT does not define who is qualified to perform this service. Refer to specific state scope of practice laws and/or facility rules and regulations for further guidance.