Neonatal Care

March 1, 2006

How do I code if a baby needs extra time in the hospital for phototherapy, a circumcision, or to answer a mom's breast-feeding questions?

Question: How do I code if a baby needs extra time in the hospital for phototherapy, a circumcision, or to answer a mom's breast-feeding questions?

Answer: Emily Hill says that according to the American Academy of Pediatrics publication, Coding for Pediatrics, care for the neonate who is being observed for progression of jaundice, possible late development of signs of infection, or who is recovering from a low Apgar score, still qualifies for the normal newborn codes. Services to neonates who are born with or develop an illness are reported using initial (99221-99223) and subsequent hospital care codes (99231-99233). The documentation must support the level of service selected. The book also suggests that in choosing the correct codes, the physician should distinguish the work performed by the physician from the type of monitoring, use of technology, or the experience provided by the nursing staff. Payers use the E&M CPT codes to reflect the amount of work a physician has performed.