Wiki 99463 - NB Admit/DC same date

[Love Coding!]

I am having trouble wrapping my head around the interpretation of this code. From my understanding..

Baby born on May 1st. The baby is seen and discharged at 4:00am May 2nd. Am I to look at this scenario as:

1. Code 99463 since the duration between the two different times are less than 24 hours?

or

2. Code 99460 for May 1st and 99238 for May 2nd.?

Does the day "reset" itself at midnight as to what is considered the second day?

 

[Love Coding!]

I am really interested in what others think regarding this code. All thoughts welcomed. I cannot really find anything about the "actual" rules based on admit/DC same day. I was told as long as it was within a 24 hour period regardless if it expanded into the next day. I have also heard that the 24 hours starts at midnight, thus making it a new day. Please help

Thank you,

Denise

 

[slik]

I use it as admit & discharge within 24 hours. I have never been told or heard of a "reset" at midnight.

 

[Cynthia Hughes]

The code, 99463, states "per day" and "admitted and discharged on the same date" so per CPT standards, this is reported only when the physician provides initial newborn care to the normal newborn and discharges the patient on the same date. Otherwise, codes 99460 for the initial date of service (may be different than date of birth when physician does not see until the next day) and appropriate discharge service (99238-99239) on the next date.

Unless specifically required by a payer, I would follow CPT instruction.

 

[LINDA]

I know this is late, but I just saw the post. Since the doctor did not actually see the baby on the 1st, you can't bill any services for that date (even though that was the actual birth/admit date). I would use the 99463, as the initial evaluation and discharge on the same date (for the 2nd). Even though baby was admitted to the hospital on the 1st, the doctor performed the initial eval and discharge services on the same day. That's been my interpretation anyway. Hope this helps.

 

[jjjdr]

99463

What I have been told is the the newborn codes are for physician charges and you use 99463 if the doctor sees them one time. That would be writing an admission and discharge note the same day. No one else will see the baby and discharge them. The admission and same day services do not really relate to the hospital.