Wiki Newborn admission and discharge same day but different providers

[annaprice]

If we have a newborn who was admitted and discharged the same day by the same physician, we know to code with 99463. Would you code differently if one physician did the admission exam and a different physician did the discharge exam?

 

[danskangel313]

If we have a newborn who was admitted and discharged the same day by the same physician, we know to code with 99463. Would you code differently if one physician did the admission exam and a different physician did the discharge exam?

For 99463, SuperCoder states:
"The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center, through the time of discharge, or release, from the facility later the same day.

Clinical Responsibility
The provider may perform the initial care of a newborn immediately after birth in a hospital or birthing center, in which he clears mucus from the mouth, nose and throat of the infant using a suction bulb, and ligates the umbilicus. Subsequently, or at the point where he assumes care, he reviews the medical history and prenatal care of the mother, reviews the newborn’s history to date, conducts a physical examination, orders any necessary diagnostic tests or treatments, and meets with the family to discuss his findings. He documents his services and findings in the medical record. He reassesses the patient again prior to discharge later the same day and provides the parents with additional instructions."

Following this logic, the assumption is that one provider is overseeing the care for the entire day. If a different provider discharges the newborn, I'm not sure that either provider could bill 99463.

I'd look at 99460 (for the original provider) as the only code to bill for that DOS.

 

[CodingKing]

Is this well baby or sick baby. Most payers will not pay for more than 1 E&M per stay for a well newborn who is discharged same day as mom.