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Thread: Newborn & Medicaid

  1. #1

    Default Newborn & Medicaid

    AAPC: Back to School
    I work for an emergency transportation company and our claims are being denied by Texas Medicaid because the diagnosis codes do not fall under their Emergency Medical Condition Codes. My problem is that we transport newborns and there are no perinatal period or congenital anomaly codes on the listing.

    Can I use a regular code (not one from the perinatal period) to use instead? Is there a rule or something that legally states I have to use a newborn code? I read the guidelines in the beginning of the ICD-9-CM book and it does not state you are obligated to use a newborn code. If you know any link or website that can help me clarify that would be great!

  2. #2


    I just got a rejection from Medicaid for newborn hospital care, saying that the diagnosis is not covered. This has never happened before, I have been coding for Peds for almost a year. (I am not in Texas)

    Is anyone else having problems with Medicaid and newborns?

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