Medical Billing Forum
Coding => Coding => : midwifebiller July 17, 2009, 06:15:22 AM
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Since they changed all of the newborn codes this year, we've had to rethink the way we bill for certain services. Here is one of them:
Midwife stays longer than usual, observing baby for a suspected neurological condition. Baby is ultimately OK and midwife leaves. (Baby was born at home.)
Question: Can we tack the prolonged care codes 99354 and 99355 onto the new NB care code 99461? My first reaction is no, since 99461 is for initial NORMAL newborn care. But baby was eventually pronounced "normal", so I'm not sure. Perhaps we should bill a scenario like this without 99461 and tack the prolonged care codes onto an initial home visit (or office visit for a birth center) instead--?
Comments are appreciated!
~Kelli
Midwife Billing & Business, LLC
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The description for the 99461 is 'per day' and doesn't give a time (ie 30 -45 minutes) so I don't think you can attach the prolonged visit codes. Since the baby is eventually pronounced "normal" it would seem like the 99461 is appropriate. I don't see a way around it. Maybe someone else has come across this as well.
Michele
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Yes, the new initial newborn care code 99461 is 'per day', not 'per visit' as before. I actually prefer it this way, but sometimes questions arise. I appreciate your input and agree with you. We have midwives who want to bill extra $$ for the extra observation time, so I am seeing what we can do to accomodate them (ethically, of course).
Anyone else have any experience with NB care?
~Kelli
Midwife Billing & Business, LLC