em2177
Expert
How are weight checks being handled in your office? Do you bill an E/M visit for this or is this considered a Nurse Visit?
DX: V20.32
Thank you!
DX: V20.32
Thank you!
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Wiki Infant Weight Checks
- Thread starter em2177
- Start date
cdavis022972
Contributor
weight check
I have a question to go along with this one. What if the baby is failure to thrive and the office has them come in for a weight check, is this considered a billable encounter?
Christina Davis, CPC
Certified Coder
Pediatric Billing Supervisor
University of Louisville Physicians
I have a question to go along with this one. What if the baby is failure to thrive and the office has them come in for a weight check, is this considered a billable encounter?
Christina Davis, CPC
Certified Coder
Pediatric Billing Supervisor
University of Louisville Physicians
Cynthia Hughes
Expert
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It is appropriate to charge either the first of the six recommended preventive services in the first year of life (if the physician or NPP provides the service as recommended in preventive guidelines for the 3-5 day visit) or if assessed by clinical staff other than a qualified healthcare professional, a nursing visit (incident to the physician's plan of care most likely documented at the hospital discharge visit). This visit is necessary to evaluate for jaundice, feeding problems, or other concerns that may not have been apparent at discharge due to the short hospital stays that are now common. The guidelines are as follows.
For newborns discharged less than 48 hours after delivery, an appointment should be made for the newborn to be examined by a licensed health care professional, preferably within 48 hours of discharge, based on risk factors, but no later than 72 hours in most cases. The purpose of the follow-up visit is to
•Weigh the newborn; assess the newborn’s general health, hydration, and extent of jaundice; identify any new problems; review feeding pattern and technique; and obtain historical evidence of adequate urination and defecation patterns for the newborn.
•Assess quality of mother-baby attachment and details of newborn behavior.
•Reinforce maternal or family education in newborn care, particularly concerning feeding and safety such as breastfeeding, back to sleep, and child safety seats.
•Review the results of outstanding laboratory tests, such as newborn metabolic screens, performed before discharge.
•Perform screening tests in accordance with state regulations and other tests that are clinically indicated, such as bilirubin measurement.
•Verify the plan for health care maintenance, including a method for obtaining emergency services, preventive care and immunizations, periodic evaluations and physical examinations, and necessary screenings.
•Assess for parental well-being, including postpartum depression in the mother.
Most payers have published preventive benefit policies that include the 3-5 day visit. If the weight check is in follow-up to a known problem such as a feeding problem, then the visit is not preventive and is reported with the appropriate level of E/M service (may be a 99211 if physician or QHP does not provide service) and related diagnosis.
Cindy
For newborns discharged less than 48 hours after delivery, an appointment should be made for the newborn to be examined by a licensed health care professional, preferably within 48 hours of discharge, based on risk factors, but no later than 72 hours in most cases. The purpose of the follow-up visit is to
•Weigh the newborn; assess the newborn’s general health, hydration, and extent of jaundice; identify any new problems; review feeding pattern and technique; and obtain historical evidence of adequate urination and defecation patterns for the newborn.
•Assess quality of mother-baby attachment and details of newborn behavior.
•Reinforce maternal or family education in newborn care, particularly concerning feeding and safety such as breastfeeding, back to sleep, and child safety seats.
•Review the results of outstanding laboratory tests, such as newborn metabolic screens, performed before discharge.
•Perform screening tests in accordance with state regulations and other tests that are clinically indicated, such as bilirubin measurement.
•Verify the plan for health care maintenance, including a method for obtaining emergency services, preventive care and immunizations, periodic evaluations and physical examinations, and necessary screenings.
•Assess for parental well-being, including postpartum depression in the mother.
Most payers have published preventive benefit policies that include the 3-5 day visit. If the weight check is in follow-up to a known problem such as a feeding problem, then the visit is not preventive and is reported with the appropriate level of E/M service (may be a 99211 if physician or QHP does not provide service) and related diagnosis.
Cindy
m.edwards
Networker
Any thoughts??
What would you do if there is no documented problem at the first visit and the baby is now in for a follow up, the visit is scheduled as a weight check and the baby is doing fine? Our provider is billing a 99213 with a diagnosis of V20.32.
What would you do if there is no documented problem at the first visit and the baby is now in for a follow up, the visit is scheduled as a weight check and the baby is doing fine? Our provider is billing a 99213 with a diagnosis of V20.32.