tci ED Coding & Reimbursement Alert - 2004 Issue 4

Reader Question: Treat Mother and Baby as Individuals

Question: If a baby is born in the emergency department, and the ED physician examines the baby or has to perform a procedure on the baby, how should I bill these services? Are they included under the mother's evaluation, or are the mother and baby two separate patients?Oregon Subscriber Answer: In this scenario, you should approach the mother and baby as two separate patients. You may consider reporting code 99431 (History and exam of the normal newborn infant, initiation of diagnostic and treatment programs and preparation of hospital records. [this code should also be used for birthing room...

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