Wiki newborn hospital billing

[clark100]

When billing a 99460 for initial care of a newborn, is it appropriate to also bill an inpatient admission (99221-99223)?

With 99465 (PPV testing) do you also bill an inpatient admission?

We keep seeing "normal" baby and most of our babies are "normal"... does the admission charge only apply to "abnormal" babies and what does that mean?

Any and all help will be greatly appreciated.

 

[LLovett]

No you can not bill the 99460 with the 99221-99223. 99460 is for normal (ie nothing wrong, routine care), other than normal is when you use 99221-99223.

99465 is not testing, it is delivery/birthing room resuscitation, and yes this would be an "other than normal" newborn.

Laura, CPC

 

[midarza]

hospital admissions

When billing a 99460 for initial care of a newborn, is it appropriate to also bill an inpatient admission (99221-99223)?

With 99465 (PPV testing) do you also bill an inpatient admission?

We keep seeing "normal" baby and most of our babies are "normal"... does the admission charge only apply to "abnormal" babies and what does that mean?

Any and all help will be greatly appreciated.

Clark,
hospital admissions imply the presence of a condition/illness. You don't admit normal patients. You have to add a "sick" diagnosis in order to get the claim paid.

When coding for a newborn care visit, that in itself is an "admission" to the nursery.

Hope this helps,

Miguel

 

[martyzal]

dx code

What dx code do you bill for the newborn? We have been billng V30.00 or
V30.01 depending if Cesearn of vaginal birth. Medicaid is not accepting this dx code. Any suggestions?

 

[mitchellde]

The dx for newborn is the V 30.xx code and Medicaid should accept this dx. It is first listed only and you do not need to assign a sick dx "just to make the claim pay". There is really some other reason for your Medicaid denials, it is possible that the baby has yet to have Medicaid coverage, you cannot bill the baby using the moms Medicaid. You have so many days following the birth to activte the baby's Medicaid staus to get the newborn care covered. If you are wanting to bill for the delivery then that is the mom's status which would be the correct chapter 11 code for the delivery then a V27 dx code as secondary for the outcome of the delivery. So it really depends on who are you billing for the mom's delivery or the baby's arrival. But I can pretty well gurantee that Medicaid is not denying newborn services for the V30.x codes to bill for the arrival of the infant.

 

[dmetz]

I am new with Pediatric billing. Do we use any other code besides the V30.00 on the physcians claim? Some other V code to say it is a "well ck-up"? Also, if he see's the infant a couple days but is still a "well newborn" do we use the same V30.00 each day?