Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95

Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

Jaundice Baby Requiring Photo therapy and extra time in the hospital setting

Patricia Posted Mon 26th of September, 2016 15:51:00 PM
Please let me know which codes are used for the above. Thanks
SuperCoder Answered Tue 27th of September, 2016 01:04:04 AM

Hi,

For billing phototherapy for the newborn suffering from jaundice, there are few guidelines which you need to follow:

  • To identify a sick  (99221-99223) but not intensively sick or critically ill new born, look for following conditions:
  1. Observation for infection but no treatment
  2. minor depression at birth
  3. jaundice with phototherapy prescription, but otherwise healthy

For the infants first day on phototherapy you would use 99232, indicating that there are minor complications, or 99233, indicating a significant new problem or major complications.For the subsequent days, when the infant is stable or recovering, you would use 99231.

HCPCS codes E0202 ; Phototherapy (bilirubin) light with photometer, S9098 ;Home visit, phototherapy services (e.g., Bili-lite), including equipment rental, nursing services, blood draw, supplies, and other services, per diem

  • For intensive newborn (99477) who requires intensive observations, frequent interventions and other intensive care services but is not critically ill, look for following conditions:
  1. Hyperbilirubinemia requiring hospital therapy or additional close monitoring but not an exchange transfusion.
  2. significant feeding problems
  3. respiratory distress
  4. potential infection signs
  5. hypoglycemia

Source : Pediatric coding alert

Hope this helps.

Thanks.

Patricia Posted Wed 28th of September, 2016 12:15:46 PM
Thanks so much for your help. Would we used the 99354 with these codes should extra time be spent? Thanks
SuperCoder Answered Thu 29th of September, 2016 04:44:33 AM

Hi, 

The CPT 99354 will be coded only if the following criteria is met:

If it is documented by the physician that, prolonged services (30-74 minutes) were involved face-to-face patient contact or psychotherapy services beyond the typical service time . Itshould only be reported once per day. They are add-on codes and as such must always be reported in conjunction with the primary procedure; for example, the designated level of E/M service or psychotherapy. Direct patient contact also includes additional non face-to-face time such as time spent on the patient's floor or unit in the hospital or nursing facility setting. 

If the above mentioned data is documented by the physicia, thwn we would report 99354.

Hope this helps.

Thanks.

Related Topics