AAPC - Back to school
Results 1 to 4 of 4

Thread: Pediatric Admission Coding

  1. #1

    Default Pediatric Admission Coding

    AAPC: Back to School
    I would appreciate input on the following pediatric coding scenario. If a baby is seen in the well baby nursery by a physician for a normal newborn admission, and is seen again later the same day for a problem that developed on the same day CPT allows billing for both admission codes using modifier 25 on the second code.

    If the newborn is admitted on Day 1 and a Normal Newborn admission code is billed and the baby becomes ill on Day 2, is it appropriate to bill a second admission code with the appropriate diagnosis on that day or should a subsequent hospital visit code be used.

    The same physician is rendering the service in both scenarios.

  2. #2
    Join Date
    Apr 2007
    Loma Linda,CA


    I'm not to familiar with inpatient, but under the -Newborn Care Services- it states "When normal newborn services are provided by the same physican on the same date that the newborn later becomes ill and receives additional intensice or critical care services, report the appropriate E/M code with modifier 25 for these services in addition to the normal newborn code".

  3. #3


    I do not use the normal newborn codes once the newborn becomes ill, I use the 99221 - 99223 depending on the level on the initial date of service and the 99231 - 99233 for subsequent day. Of course if the you would use the subsequent codes if the newborn became ill on say second day of life.

    Hope this helps.

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default Child requires NICU?

    Are you saying that the baby was so ill as to require intensive care in the NICU?

    If YES ... then I believe you can code the appropriate Pediatric / Neonatal initial critical care code. (BUT ... my NICU specialist is out on leave for the next several weeks, so I can't confirm with her.)

    Hope that answers your question.

    F Tessa Bartels, CPC, CEMC

Similar Threads

  1. Need help Coding Admission during PO Global
    By Hopp in forum General Surgery
    Replies: 1
    Last Post: 06-23-2010, 01:41 PM
  2. Documented "Admission" Done on Day After Hospital-Billed Admission
    By Belinda Frisch in forum Medicare Regulations
    Replies: 8
    Last Post: 05-04-2009, 07:52 AM
  3. Coding-Same Day Admission
    By Hopp in forum General Surgery
    Replies: 3
    Last Post: 11-30-2008, 05:58 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.