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Billing For Phototherapy UV

George Posted Tue 25th of June, 2013 19:44:03 PM

We are Hospital based Neonatologist's. Our patients are seen while in the NICU department under our care. What CPT would we bill for a child diagnosed with Jaundice/hyperbilirubinemia being treated with Phototherapy. Normally we have been using 96900 or 97028 but recently have been having several denials either stating 97028 is some type of Physical therapy and that 96900 is inclusive to our subsequent visit. Is there a more appropriate CPT for Billing Phototherapy?

SuperCoder Answered Thu 27th of June, 2013 04:15:28 AM

Hi,

My Senior Editor is working on this. She will respond you soon.

Thanks

SuperCoder Answered Mon 01st of July, 2013 13:05:51 PM

I checked some Local Coverage Determinations for 97028 and they do not include the neonatal jaundice ICD-9 codes such as 774.2 or 774.6.

Dr. Tuck, the consulting editor for Pediatric Coding Alert, and I researched jaundice/hyperbilirubinemia phototherapy coding some years ago and concluded that it is included in the per day EM code.

Sincerely,
Jen Godreau, CPC, CPMA, CPEDC

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