AAPC - Back to school
Results 1 to 7 of 7

Thread: Need help on disharge from birthing center on next day

  1. #1

    Default Need help on disharge from birthing center on next day

    AAPC: Back to School
    Hi All,

    We have a denial on CPT 99238 for disharge of new born from a birthing center, stating it was incompatable with the type of service performed. Rep sd they have received the claim with place of service code 25 which denotes the service rendered @ Free Standing Ambulatory Surgical Facility. But as per the actual description it denotes birthing center.

    My questions are, 1)is there any rule that CPT 99238 should be billed with only POS 21,
    2) Is there any other code for discharge from birthing center on some other date.

    Please some one help me on this denial.

    Thanks a lot in advance!!

    Prem Kumar,B.Pharm,CPC

  2. #2


    We bill for many free standing birth centers. They are classified as Ambulatory Surgical Centers, which means it is not considered in-patient. As such, there is no hospital admit or discharge. These services are included in the facility fee.

    If the new mom leaves the birth center the next calandar date, we bill two dates of service for the facility fee, the second date being pro-rated.

  3. #3


    Hi Sugihara,

    Thanx for your reply. What do you mean by second DOS being pro-rated? can I bill same CPT 99460 for the two dates of service initial and the next date?

    Please advice!


  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default Discharge from observation

    If you are in an outpatient setting, you will need to look at the Discharge from Observation codes.

    F Tessa Bartels, CPC, CEMC

  5. #5


    Hi Bartels,

    Our place of service is birthing center 25.

    Please give me some information on the second day in birthing center (getting discharged on second day).


  6. #6


    Sorry, I was refering to the facility fee being pro-rated, not the newborn care code. We have never been reimbursed for 99460 with POS 25. We always use 99463, which includes the first 24 hours of care. It does create a problem when baby is born at 11:45PM, but it is the best code available. I have spoken to many insurance supervisors about this, and they have (so far) all agreed that 99463 is acceptable, even if baby went home the next calendar date.

    I hope this is helpful.

  7. #7

    Default Facility charges for birthing center


    Can you tell me how you bill for the facility charges for the birthing center?
    Last edited by Bmarinelli; 03-12-2014 at 07:13 PM.

Similar Threads

  1. Birthing Tub
    By staceylh in forum OB/GYN
    Replies: 0
    Last Post: 09-25-2014, 12:08 PM
  2. Birthing Center facility codes
    By Bmarinelli in forum Anesthesia
    Replies: 0
    Last Post: 03-12-2014, 07:11 PM
  3. E&M coding for Adult Day Care Center
    By sandy.vaillancart@prlnh.com in forum E/M
    Replies: 1
    Last Post: 10-18-2011, 08:27 AM
  4. Birthing center question
    By Mayra E. Ramirez in forum OB/GYN
    Replies: 0
    Last Post: 02-23-2011, 12:23 PM
  5. Birthing classes
    By lacyblue in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 01-08-2010, 10:36 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.