2025 CPT code 99479
Subsequent intensive care, per day, for a low birth weight infant (1500-2500 grams).
Modifiers may be applicable depending on the circumstances (e.g., modifier 25 if reported with other significant, separately identifiable E&M services on the same day).
Medical necessity is established by the infant's low birth weight, prematurity, or other conditions requiring intensive observation and frequent interventions to ensure stability and prevent complications.Documentation must support the need for intensive care beyond routine newborn care.
The physician or other qualified healthcare professional directs the continuing intensive care of the infant, overseeing all aspects of their care, including monitoring, interventions, and nutritional adjustments.
- Evaluation and Management > Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services
- Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services
In simple words: This code is for the ongoing daily care of a low-weight baby (weighing between 3.3 and 5.5 pounds) who needs close watching and frequent attention in the hospital, but isn't critically ill.The doctor or nurse oversees their care, making sure they get the right food and oxygen, and monitoring their health closely.
This code reports subsequent daily intensive care services for a low birth weight infant (present body weight 1500-2500 grams) who is not critically ill but requires intensive observation, frequent interventions, and other intensive care services.These services include intensive cardiac and respiratory monitoring, continuous/frequent vital sign monitoring, heat maintenance, enteral/parenteral nutritional adjustments, laboratory and oxygen monitoring, and constant observation by the healthcare team under physician or qualified healthcare professional supervision.The code should be reported only once per day, per patient, in a given facility.It does not include services already bundled with other critical care codes (e.g., 99468, 99469, 99471-99476).
Example 1: A 2000-gram infant, born prematurely, is stable but requires close monitoring of oxygen saturation, feeding tolerance, and temperature regulation.99479 is reported for each subsequent day of intensive care., A 2200-gram infant with respiratory distress syndrome is improving but still requires continuous respiratory support, frequent blood gas monitoring, and close observation. 99479 is billed for each day this care is provided., A 1800-gram infant born at 32 weeks gestation requires enteral feedings and close monitoring of weight gain, fluid balance, and vital signs.The physician directs intensive care, and 99479 is used for subsequent days of care.
Detailed daily progress notes documenting the infant's clinical status, interventions provided (e.g., respiratory support, nutritional adjustments, medications), monitoring parameters (e.g., vital signs, oxygen saturation, blood gases), and the level of nursing care required.Weight documentation is also crucial.
** The weight range (1500-2500 grams) must be the infant's current weight, not birth weight. This code should only be used for infants who are not critically ill.If the infant's condition worsens and requires critical care, the appropriate critical care codes should be used instead.
- Payment Status: Active
- Specialties:Neonatology, Pediatrics
- Place of Service:Inpatient Hospital, Neonatal Intensive Care Unit (NICU)