I am not sure how to code this scenario. A baby is born and admitted to the hospital by one of our doctors. Later that day, another one of our doctors sees the baby because she is having complications and tranfers her over to the NICU. This doctor doesn't actually admit the baby to the NICU. That is done by a different doctor. My question is, can we code for the doctor transferring the baby? How would we do this? I appreciate all help!!
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Wiki Admit and transfer same DOS?
- Thread starter anne32
- Start date
Pam Warren
True Blue
You wouldn't bill for a transfer. Typically, (except for critical care), you can bill only one E&M per day, in your case the newborn admission. The AAFP has a great article on billing newborn services. http://www.aafp.org/practice-management/payment/coding/newborn.html
Cynthia Hughes
Expert
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If the payer follows NCCI edits, the two services cannot be separately reported. The level of initial hospital care for the combined services would be reported as this service will have a higher RVU value than normal newborn care and more accurately reflect the intensity of service. However, if the sick visit met the level of intensive care (99477) or hourly critical care (99291-99292), those services should be reported in addition to the normal newborn care based on CPT instruction.