Pediatric Coding Alert
Hospital Bills Dubowitz-Ballard
Question: Our pediatrician performed a Dubowitz Ballard Exam for gestational age on a premature infant at a newborn well-visit. Does this qualify for us to report code 96110 (Developmental screening, with interpretation and report, per standardized instrument form)?
Answer: The Dubowitz Ballard exam is a long-established scorable test to assess newborn gestational age using physical and neuromuscular maturity parameters. It would fit under the umbrella of 96110 from the perspective of being a standardized scorable test. However, this test is typically performed by 24 hours of age and therefore is only appropriately used in the newborn nursery. It would not be indicated in the office setting, specifically at a newborn well-visit as cited in your question.
When provided in the hospital, unfortunately, this test is not billable by the physician, but would be included in the hospital facility fee. Therefore, in most cases you will not bill separately for this test.
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