Results 1 to 10 of 10

99463- it appropriate

  1. Question 99463- it appropriate
    Exam Training Packages
    Is it appropriate to bill 99463 if the provider does the h&p and discharge on the same day but the baby was born the day prior to these services being done?

  2. #2
    99463 specifically states E&M of normal newborn infant admitted and discharged on the same date. When was the newborn actually admitted?

  3. Question
    Heres the scenerio--

    Baby is delivered on 5/28/09 and discharged on 5/31/09. For some reason the h&p and discharge are both done on 5/31/09. The attendance at delivery was done on 5/28/09.

  4. #4
    Milwaukee WI
    Default Date of service
    The date of service is the date the service was actually provided ... even if the documentation wasn't done for a couple of days.

    So if the physician actually saw the infant on date of birth and admitted the child, but didn't do the H&P until two days later ... then the H&P should start with something like "Late entry for service provided on mm/dd/yy."

    Or are you saying that no physician saw the infant until 5/31/09?

    There is also the possiblity, of course, that the transcription service has the wrong date of service on the H&P (it happens) ...

    F Tessa Bartels, CPC, CEMC
    Last edited by FTessaBartels; 07-16-2009 at 01:22 PM.

  5. Question
    Most of the time our providers dont do the initial h&p the day of birth but rather one or two days after, and sometimes they will then discharge the baby later that same day. We were not sure if it would be appropriate to bill a 99463 (admit and discharge on same day) since the baby wasnt born the day of service being submitted but rather the h&p and discharge just happen to be provided on that day. Or would it be more appropriate to just bill 99460and 99238.

  6. #6
    Milwaukee WI
    Default Doing H&P does NOT equal admitting
    Doing the H&P is a paperwork administrative function required by the hospital. It does not equal admitting the patient, or providing the initial service to the patient.

    That being said, if your doctors are FIRST laying eyes on the baby three days after birth, then WHO actually admitted the baby to the hospital?

    But you also say "attendance at delivery was done 5-28-09."

    I'm not sure I'm really understanding the scenario.

    Physicians should document what they do, when they do it. And coders should code what was documented.

    F Tessa Bartels, CPC, CEMC

  7. Default
    Ok, here's my situation. The baby was born/admitted on 8/4/09. He was not seen for the newborn physical until the next day. After the physical, he was discharged.

    I can't bill both 99460 & 99238 on the same day, and 99463 is for a 1 day stay. Do I bill only the 99460?
    Last edited by bdsteffens; 08-27-2009 at 02:10 PM.

  8. Default 99463
    We have read the AAP interpretation which appears to make sense but would like a definitive answer. The wording states admission and discharge the same day. Our providers state they are admitting and discharging the same day. They are doing and admission note and then a separate discharge note and using 99463. Isn't the wording open to interpretation and who makes the final decision as to accurate coding?
    Thanks, jjjdrpeds

  9. Default
    I actually found an AAPC presentation along with an AAP article that states 99463 is for physician services and the admit is the physician's admission and discharge on the same day, not the hospital. We document both services an admission note and a discharge note on the same day and use 99463.
    Thanks, jjjdrpeds

  10. Default
    That is exactly what we are doing. Per the AAP and an AAPC tutorial the "admission and discharge" applies to the physcian services and not the hospital dates. Physicians who are doing both and no other doctor will be seeing them are providing more services than a 99460 so we are using 99463.
    Thanks, jjjdrpeds

Similar Threads

  1. 99463 - NB Admit/DC same date
    By Love Coding! in forum Pediatrics
    Replies: 5
    Last Post: 08-31-2016, 04:04 PM
  2. 99463
    By jjjdr in forum Pediatrics
    Replies: 0
    Last Post: 06-09-2014, 12:26 PM
  3. Newborn 99460-99462-99463
    By thebis in forum Auditing General Discussion
    Replies: 0
    Last Post: 08-12-2011, 09:25 AM
  4. 99463?
    By renifejn in forum E/M
    Replies: 1
    Last Post: 05-27-2011, 10:03 AM

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.