Wiki LCD Sufficient Resource

[nturner1]

Some are using CPT code 96900 bill for newborns with hyperbilirubinemia receiving light therapy. However, some believe this code is on for Dermatology patients that get UV narrow band treatment for various skin disorders.

The LCD does not list diagnosis for hyperbilirubinemia.

Would you consider LCD to be sufficient resource to support NOT using CPT code?

Thanks!

 

[mitchellde]

are you doing this in the office setting?

 

[nturner1]

Inpatient setting for newborns

 

[mitchellde]

ok.. next question, are you coding for the facility or the physician.
since this is performed in the facility setting and performed by facility equipment and monitored by facility staff, there should be no code on the physician claim.

 

[thomas7331]

Agreed, this code should not be used for professional billing in a facility setting as it is a facility expense - the code is designated as an 'incident to code' (PC/TC indicator 5). And for a facility claim, there would be no use for this code on an inpatient claim since any procedures performed would be coded with ICD-10-PCS codes.