Newborn Circ Coverage

tsalo

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It is my understanding that circs done within the 48/96 timeframe are billed under the moms insurance number using "baby boy" ie Smith as the patient. Can someone please confirm? Also, dx of phimosis. Thanks!
 

fcallahan

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This maybe true for Hospital Billing--UB04 form.

As for the Physician Billing baby must be added on the parent's plan and must have a name that's not baby boy.

It is ok to use "Baby Boy" or Baby Girl" for Government plans, ex..Medicaid, Peach State, Wellcare, Amerigroup because Baby will have his/her own id numbers.

If you have any further questions, please reply to Thread.
 

thomas7331

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Do you have any success billing a consult in addition to the circ, the provider is an OB/GYN.. any thoughts would be appreciated..

A consultation for what problem, and requested by whom? I believe in routine situations a consultation could not be supported. Since a circumcision is a minor procedure, the evaluation and decision to do the procedure is considered inclusive. A consultation is not appropriate to bill unless there is a separate problem being evaluated, and which would also need to meet the definitions of a consultation, i.e. with a request initiated by another physician, etc.
 
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