Wiki Newborn coding

[cmbizpro]

I have a question about the newborn hospital coding. I am billing a 99460 on the initial visit with V30.XX. What is included in the normal NB E&M? We have had NB with some other findings; ie. abnormal hearing, minor lacerations on the head, feeding difficulties on initial exam, and hyperbili, etc. In these cases should I be adding a 99224-99226?

 

[jbos]

Healthy Newborn vs Non-routine Newborn visits

Hi,
Per the 2013 E&M services for age 28 days or less,
99460 Includes Family consultation, Healthy Newborn H&P, Medical record documentation, Ordering of diagnostic tests and treatments & services provided to Healthy newborns <28 days.
But DOES NOT include:
Neonatal intensive and cirtical care, Hospital discharge or Non-routine neonatal impatient E&M services (99221-99233)
Codes 99224-99226 are for 'Subsequent Observation' which includes changes in patient's status, medical record review and review of diagnostic test results.

So, I would say that if the newborn care warrented additional services because of the additional 'non-routine' diagnostic findings, you could bill for one of the 'subsequent' visit codes (99224-99226), however, if the physician did not see the patient any time other than the initial newborn visit, you could not bill additional charges, but COULD add additional diagnosis' to 99460.

 

[cmbizpro]

Thank you.

 

[JerieT]

If the baby has problems after being born should a subsequent newborn or a subsequent Inpatient code be used? I've noticed some of our physician's are using 99232 for a newborn (under 28 days) with neonatal opiate withdrawal or when the diagnosis is "pre-mature." This baby has been in the hospital for 2 - 3 weeks.