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Thread: newborn hospital billing

  1. #1

    Default newborn hospital billing

    AAPC: Back to School
    Dr A billed 99460 and 99462 pt admitted on 09/12/09 and discharged on 09/14/09 Dr B billed 99462 should he of have billed out 99238? he states

    "I don't usually use a discharge code for normal newborns. If it is a sick newborn I usually do. If I should be using a discharge code for normal newborns please let me know."

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default 99462 vs 99238

    I can see your doctor's point of view.

    CPT 2009 (Professional edition, pg 14) guidelines tell us that Hospital Discharge codes 99238-99239 include, "as appropriate, final exaination of the patient, discussion of the hospital stay, even if the time spent by the physician on that date is not continuous, insttructions for continuing care to all relevant caregivers, and preparation of discharge records, prescriptions and referral forms."

    CPT also tells us (2009 Professional edition, pg 32) that For E/M services provided to newborns who are other than normal, see codes for hospital inpatient services... (emphasis added by FTB)

    I don't think there is anything wrong with his coding 99462 for the "normal" newborn. FYI, it has a lower RVU value than 99238.

    Hope that helps,
    F Tessa Bartels, CPC, CEMC

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