The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA
An interactive resource for moms on easy steps they can take to reduce exposure to chemical toxins during pregnancy.
Other excellent resources about avoiding toxins during pregnancy
These are easy to read and understand and are beautifully presented.
The American Academy of Pediatrics recommends that pediatricians examine all infants "in the first few days after discharge to assess infant well-being and the presence or absence of jaundice," to Management of Hyperbilirubinemia in the Newborn Infant 35 Weeks or More of Gestation. But many providers are unsure how to bill these visits.
Case study: Leticia Bibian, director of patient accounts at Northeast
Valley Health Corp. in San Fernando, Calif., says her pediatricians see
newborn babies three to five days after birth to check if the baby is feeding
well, to check his weight, and determine if there is jaundice. "How would
you code this type of visit?" she asks.
The visit is to check for specific problems. "The encounter is for a follow-up of the hospital visit and to ensure the transition home has gone well," says Charles A. Scott, MD, FAAP, pediatrician at Medford Pediatric & Adolescent Medicine PA in Medford, N.J.
Solution: Report a postdischarge bilirubin/weight check with the appropriate-level office visit code (9920 1- 992 15, Office or other outpatient visit for a new or established patient ...). If the pediatricians initially saw the newborn in the hospital, code an established patient office visit (992 12-99215).
Reserve the initial well-visit code for when the parent and infant return
for the "first official" well-child checkup, usually a week later. "Use
V20.2 (Routine infant or child health check including immunizations appropriate
for age) at that visit with 99391 (Periodic comprehensive preventive medicine
re-evaluation and management of an individual including an age- and gender-appropriate
history, examination, counseling/anticipatory guidance/risk factor reduction
interventions, and the ordering of appropriate immunization [s], laboratory/diagnostic
procedures, established patient; infant [age under 1 year])," Scott says.
Some possible ICD-9 codes include:
Using these principles, the code for a "bili check" in which the pediatrician finds no jaundice may include any of the following:
(Continued on next page . . . but not included here in this critique.)
Pediatric Coding Alert/September 2005
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