In simple words: This code covers the doctor's daily care for a recovering premature baby weighing less than 3 pounds, 5 ounces who is not critically ill but still needs close monitoring and frequent care in the hospital.

This code reports the subsequent hospital care, per day, for the evaluation and management of a recovering very low birth weight infant (less than 1500 grams) who does not meet the criteria for critical care but still requires intensive observation, frequent interventions, and other intensive care services.These services may include intensive cardiac and respiratory monitoring, continuous and/or frequent vital sign monitoring, heat maintenance, enteral and/or parenteral nutritional adjustments, laboratory and oxygen monitoring, and constant observation by the health care team under the direct supervision of the physician or other qualified health care professional.

Example 1: A premature infant born at 28 weeks gestation weighing 1200 grams is admitted to the neonatal intensive care unit. After the initial day of care (99477), the infant is stable but still requires intensive monitoring and frequent interventions. Code 99478 is reported for subsequent days of this intensive care., A 10-day-old infant, weighing 1450 grams, is recovering from respiratory distress syndrome and is being weaned off supplemental oxygen.The infant requires ongoing monitoring of oxygen saturation, respiratory rate, and heart rate, as well as frequent adjustments to ventilator settings. Code 99478 is reported for each subsequent day of this care., A two-week-old infant, weighing 1300 grams, is recovering from surgery for necrotizing enterocolitis. While the infant is no longer critically ill, they require intensive monitoring of their vital signs, fluid and electrolyte balance, and nutritional intake. Code 99478 is reported for each subsequent day of intensive care.

Documentation should support the medical necessity of the intensive care services, including the infant's weight, vital signs, interventions performed, and the physician's involvement in directing the care. The specific reasons why the infant continues to require intensive observation and frequent interventions should be clearly documented.