How To Use CPT Code 99184

CPT 99184 describes the initiation of selective head or total body hypothermia in critically ill neonates. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 99184?

CPT 99184 can be used to describe the initiation of selective head or total body hypothermia in critically ill neonates. This code is used when a qualified healthcare provider reduces the temperature of a neonate after careful consideration of various selection criteria. The provider monitors the infant’s temperature using an esophageal probe and performs the service when the neonate experiences hypoxic events, such as perinatal hypoxic-ischemic encephalopathy (HIE).

2. Official Description

The official description of CPT code 99184 is: ‘Initiation of selective head or total body hypothermia in the critically ill neonate, includes appropriate patient selection by review of clinical, imaging and laboratory data, confirmation of esophageal temperature probe location, evaluation of amplitude EEG, supervision of controlled hypothermia, and assessment of patient tolerance of cooling.’

3. Procedure

1. The healthcare provider confirms the proper location of a previously placed esophageal temperature probe.
2. The provider selects a method to cool the patient’s temperature, such as a cooling cap, cooling mattress, blanket, or body wrap.
3. The provider monitors the patient’s temperature using the esophageal probe and keeps it in the range of 33 degrees Celsius.
4. The provider also monitors the patient’s blood pressure, vital functions, and laboratory data to ensure the well-being of the patient.
5. The provider maintains the controlled hypothermia for a specific duration and then rewarms the patient.

4. Qualifying circumstances

CPT 99184 is used for critically ill neonates who meet specific selection criteria. The provider considers various factors, such as clinical, imaging, and laboratory data, electroencephalographic monitoring of brain function, and assessment based on weeks of gestation, birth weight, and time elapsed since hypoxic-ischemic encephalopathy. The procedure is performed to reduce the temperature of the neonate and manage hypoxic events, such as perinatal HIE.

5. When to use CPT code 99184

CPT code 99184 should be used when a qualified healthcare provider initiates selective head or total body hypothermia in a critically ill neonate. It is appropriate to bill this code when the provider performs the necessary steps, including patient selection, confirmation of esophageal temperature probe location, evaluation of amplitude EEG, supervision of controlled hypothermia, and assessment of patient tolerance of cooling.

6. Documentation requirements

To support a claim for CPT 99184, the healthcare provider must document the following information:

• Patient’s clinical, imaging, and laboratory data
• Confirmation of esophageal temperature probe location
• Evaluation of amplitude EEG
• Start and end time of the procedure
• Monitoring of patient’s temperature, blood pressure, vital functions, and laboratory data
• Assessment of patient tolerance of cooling

7. Billing guidelines

When billing for CPT 99184, ensure that the procedure is performed by a qualified healthcare provider and meets the necessary criteria. It is important to follow the specific documentation requirements and guidelines for reporting this code. CPT code 99184 should not be reported more than once per hospital stay. It is also important to consider any Medicare changes or restrictions that may apply.

8. Historical information

CPT 99184 was added to the Current Procedural Terminology system on January 1, 2015. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A qualified healthcare provider initiates selective head hypothermia in a critically ill neonate with perinatal hypoxic-ischemic encephalopathy (HIE).
2. A healthcare provider confirms the proper location of an esophageal temperature probe and initiates total body hypothermia in a critically ill neonate with hypoxic events.
3. A qualified healthcare provider evaluates the amplitude EEG and supervises controlled hypothermia in a critically ill neonate with perinatal HIE.
4. A healthcare provider assesses the patient’s tolerance of cooling and rewarms a critically ill neonate after a period of controlled hypothermia.
5. A qualified healthcare provider reviews clinical, imaging, and laboratory data to select a critically ill neonate for selective head or total body hypothermia.
6. A healthcare provider monitors the patient’s temperature, blood pressure, vital functions, and laboratory data during the procedure to ensure the well-being of the critically ill neonate.
7. A qualified healthcare provider initiates selective head or total body hypothermia in a critically ill neonate based on the weeks of gestation, birth weight, and time elapsed since hypoxic-ischemic encephalopathy.
8. A healthcare provider confirms the proper location of an esophageal temperature probe and evaluates the amplitude EEG before initiating selective head or total body hypothermia in a critically ill neonate.
9. A qualified healthcare provider supervises controlled hypothermia in a critically ill neonate and assesses the patient’s tolerance of cooling throughout the procedure.
10. A healthcare provider rewarms a critically ill neonate after a period of controlled hypothermia and monitors the patient’s temperature, blood pressure, vital functions, and laboratory data.