newborn code 99435

lmjd

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Please give your opinion as to this code: 99435
The discriptor states that it is for assessment and discharge on the same day (H&P,medical record prep etc) and excludes discharge services provided on a date other than admission but includes services for pts admitted and discharged on the same dos- I am confused! is this only for newborns admitted and discharged on the same day? I have a physician new to our practice that disagrees that this is only for same day admit and discharge.
Thanks so much!
 
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99435 only for Newborn Admit / DC on same DOS

You are correct ... this code is ONLY for the newborn who is admitted and discharged on the same date of service. In the CPT 2008 professional edition, page 33, under the major heading "Newborn Care," second paragraph states: "For newborn hospital discharge services provided on a date subsequent to the admission date of the newborn, use 99238."

So, if your physician saw the newborn yesterday, but discharged the baby today, you would bill 99431 for yesterday's visit and 99238 for today's service.

I think this is very clearly stated in CPT; I wonder why your new physician believes otherwise? Could s/he have attended some seminar that gave conflicting information?
Tessa Bartels
 
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