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Dubowitz Ballard Exam

Town & Country Pediatrics & Posted Wed 08th of January, 2014 15:12:08 PM

The pediatrician I work for performed a Dubowitz Ballard Exam for gestational age on a premature infant at a newborn well-visit. Does this qualify for '96110' - developmental testing?

SuperCoder Answered Thu 09th of January, 2014 16:21:40 PM

I think you can bill that code , but I'm checking with my editor just to be sure because I'm not that familiar with the test. I will let you know as soon as she writes me back.

SuperCoder Answered Mon 13th of January, 2014 11:01:24 AM

The Dubowitz Ballard exam is a long established scorable test to assess newborn gestational age using physical and neuromuscular maturity parameters. It would fit as a 96110 from the perspective of being a standardized scoreable test, however, it should be performed by 24 hours of age and therefore is only appropriately used in the newborn nursery. It would not be indicated in the office setting, specifically, at a newborn well-visit as cited in this question.When provided in the hospital, it would not be billable by the physician, but would be included in the hospital facility fee.

Town & Country Pediatrics & Posted Tue 14th of January, 2014 13:58:36 PM

The pediatrician asked if you can please clarify the following: what if the pediatrician himself performs the Dubowitz Ballard in the hospital within 24 hours of age? Can he bill 96110 along with his other charges for visiting the baby in the hospital (99460), or is it included?

SuperCoder Answered Tue 14th of January, 2014 16:40:33 PM

In this case, it's included in the hospital facility fee.

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