As neonatal practice involves caring for the most vulnerable patients, primarily newborn babies, billing requires special care and attention. Neonatal consideration administrations contain a significant level of complication in overseeing, screening, and treating a sick patient. NEO MD’s Neonatology Billing Services help practices in choosing the best CPT code to provide the most reimbursement for doctor and payer clear codes for ongoing medical clinic treatment at various basic consideration levels; low birth weight (LBW) or exceptionally low birth weight (VLBW). Hospital-Based and Private Practices must have electronic access to emergency clinics in order to recover clinical records and face sheet data for timely and productive billing.
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Neonatology Billing Services
Neonatology is a specialization of pediatrics that focuses on the medical care of newborn infants, particularly those who are sick or premature. It is a hospital-based specialty typically provided in neonatal intensive care units (NICUs). However, private clinics also offer services to neonates except for NICUs care. Neonatologists’ primary patients are newborn babies who are unwell or require particular medical care owing to:
- Low birth weight
- Congenital malformations or disabilities
- Intrauterine growth restriction
- Pulmonary hypoplasia
- Birth asphyxia
The tiniest humans presenting the most challenging & extensive problems are under the care of a neonatologist, responsible for their survival and complete recovery. Partnering or outsourcing the management of your Neonatology Billing Services to a company like NEO MD lessens the burden of streamlining the practice’s financial aspect.
What do you mean by Neonatal Intensive Care Unit (NICU)?
The Neonatal Intensive Care Unit (NICU) in a hospital is a critical care center for newborn infants who require specialized care. The NICU combines modern technology and a qualified professional NICU team. While the majority of newborns admitted to the NICU are premature, others are born at term but have medical problems such as infections or birth abnormalities. An infant may also be admitted to the NICU if there are associated maternal risk factors or if the delivery is problematic.
How We Assist Practices in Neonatology Billing Services?
NEOMDINC. has been providing Neonatology Billing Services to the practices for the past 15 years. Our experts deliver precise Medical Billing and coding, allowing you to get reimbursements on schedule. Additionally, we guarantee that you promptly receive Neonatology services and steer clear of claim denials.
Our specialized Neonatology Billing Services include the following:
Eligibility Verification Services
We check to see if the patients qualify for insurance benefits. We assess if their insurance covers the Neonatal Billing or not. Consequently, we are able to determine the patient’s deductible and copayment. NEO MD Neonatology Billing ensures optimal cash flow, maximum reimbursements, and improved revenue streams.
Comprehensive Neonatology Billing Analysis
NEO MD has a team of revenue cycle specialists that examine all aspects of Neonatal Billing. Furthermore, we ensure that the Medical Billing codes are proper in order to avoid claim denials. There is a risk of losing potential revenue if the coding and billing are inaccurate. As a result, we address complicated billing concerns for physicians in order to optimize their revenue cycle.
Account Receivable Management Services
Our billing specialists assist in reducing the days of Neonatology claims in A/R. Similarly, the account receivable management staff ensures that physicians receive payments on time for their services. Consequently, we perform the arduous and time-consuming process on your behalf. Furthermore, physicians may concentrate on providing excellent treatment while we manage Neonatal Billing.
Neonatology Denial Management Services
Physicians suffer significant revenue losses as a result of claim denials. Secondly, it is critical to maintain track of claim submissions. As a result, the NEO MD Neonatology Billing Services team determines the true causes of claim denials. Following that, they correct the errors and resubmit the medical claims. Moreover, they ensure that the application is completed within the filing deadline to minimize revenue losses.
Provider credentialing is an important phase in the revenue cycle, and physicians must enroll with insurance payers before starting a business. Moreover, establishing relationships with payers allows practitioners to expand their network and increase the number of patients. NEO MD Neonatology Billing Services enable patients to pay for medical treatments using their insurance coverage.
Neonatology Billing and Coding for Newborn Care Services
Physicians should report Newborn Care Services codes for evaluation and management (E/M) services delivered to normal infants in the first days of life prior to hospital discharge.
- Care of the Normal Newborn Infant
Evaluation and management (E/M) services delivered to normal newborn infants in the first days of life prior to hospital release could document using Newborn Care Services codes. To administer the first care to a newborn, use the following CPT Codes:
Codes For the Early Care of The Normal Newborn
|99460||Initial hospital or birthing center care, per day, for E/M of a normal newborn infant|
|99461||Initial care per day for E/M of the normal newborn baby seen in other than a hospital or birthing center|
|99463||Initial hospital or birthing center care, per day, for E/M of a normal newborn infant, admitted and discharged on the same date.|
Newborn Care in the Office
It is usual to check on the baby to see if there are any feeding issues or jaundice after the newborn has been sent home. The service provider determines the coding for this service and whether the visit is a follow-up to an already diagnosed problem or a screening for problems.
When the visit is in response to a previously documented condition, such as jaundice, infrequent stools, or infrequent feedings. The doctor, nurse practitioner, or physician assistant should report the office visit (e.g., 99212-99215) and the diagnostic codes for the problem when they offer the treatment.
Suppose no feeding or other health concerns have been noticed. In that case, this appointment may be the first well-child visit delivered by a physician or nurse practitioner. It is possible to submit code 99391 along with diagnostic code Z00.129 (Encounter for routine child health checkup). This service includes time spent dealing with normal feeding issues.
However, suppose counseling takes more time than is typical for an infant preventive treatment. In that case, physicians may report a problem-oriented service (99212-99215) with modifier -25 to reflect the substantial and independently identifiable services performed on the same day. Documentation should contain the estimated amount of time spent face-to-face with the family and patient. Additionally, the amount of time spent in counseling and the counseling context. (If more than 50% of the face-to-face time is spent on counseling and care coordination, codes may be assigned based on these activities). This encounter may classify as Z00.121 (Normal child health checkup with abnormal results), along with the appropriate issue diagnosis.
Nurses may report code 99211 when they visit (such as a weight check alone). Suppose the doctor visits after the nurse visit, just the doctor’s services will be documented.
When treating a newborn child, as a family doctor, you may also address the mother’s needs (e.g., lactation problems). You may report these services in addition to the care delivered to the newborn if separately reported in the mother’s chart.
If you want to know about C-Section/Caesarion delivery CPT Codes, Read Our Detailed OBGYN Billing Blog; https://neomdinc.com/obgyn-medical-billing-a-thorough-guidelines-for-2022-coding/
Caring for Sick Newborns (Neonatology Billing Services)
When delivering E/M services to babies that are not normal, pick the degree of care based on the intensity of the service and the newborn’s status. Care for abnormal neonates who do not require intense services may be documented using first hospital care codes (99221-99223). Some infants may require intensive care but do not satisfy the CPT criteria of severely sick or wounded, which is necessary for critical care service reporting. (See the Critical Care Services portion of CPT preceding codes 99291-99292 for a definition of seriously sick or wounded.)
Code 99477 indicates the initial hospitalization of a newborn (28 days or younger) who is not critically sick but needs close observation, frequent interventions, and other intensive care treatments. These services include frequent and/or continuous vital sign monitoring, heat management, enteral and/or parenteral dietary modifications, laboratory and oxygen monitoring, and constant observation by the medical staff while under the direct supervision of the treating physician. A single physician may record this code just once every day.
Procedures included under the services indicated by code 99477 include those mentioned in the Critical Care Services part of CPT (codes 99291 and 99292). However, it also includes additional procedures specified in the Inpatient Neonatal and Pediatric Critical Care subsection (codes 99468-99476, 99466-99467). These include, among others, lumbar puncture, bladder aspiration, nasogastric tube placement, airway and breathing management procedures, and vascular access procedures.
It is acceptable to report codes 99478-99480 for infants who require intensive care after their initial hospitalization. Additionally, if a neonate is not severely ill or injured as defined by CPT but with a very low birth weight and needs those services as stated in code 99477 above.
The term “Subsequent intensive care, each day, for the treatment and evaluation of the recovering low or very low birth weight newborn” describes each of the ICD-10 codes 99478 – 99480. The Baby’s current weight decides the selection of the correct codes, as displayed below.
|99478||Present body weight less than 1500 grams|
|99479||Present body weight of 1500-2500 grams|
|99480||Present body weight of 2501-5000 grams|
- Newborn Critical Care
When a baby is seriously ill or wounded, there are codes for documenting services delivered during interfacility transport, initial critical care, and ongoing critical care. Reporting codes for services requires careful adherence to CPT guidelines. Furthermore, it demands attention to which physician reports which code when more than one physician is caring for the newborn.
- Neonatal Intensive Care Unit
Code 99468 is assigned to the first day of critical care to examine and manage a severely unwell infant aged 28 days or less. Only one physician may report this code. A different physician must report critical care services to the neonate on the same day using the critical care service codes 99291-99292.
Subsequent days of critical care for the severely unwell neonate are coded as 99469. On the same day as the initial critical care, only one physician may submit code 99469.
Why Outsource Your Neonatology Billing Services to us?
As neonatologists, you are responsible for the tiniest patients who may cause the most problems. Babies who are premature, underweight, or suffering from a serious illness require round-the-clock care to ensure they arrive home safely. Families rely on you and your team to think about their children, but dealing with complex billing concerns can be inconvenient. Our professional coders and billers can handle the financial aspects of your specialty, allowing you to devote your time and resources to patients and their families. NEO MD Neonatology Billing Services provides a variety of coding and reviewing administrations to assist providers with their documentation expert administrations. We ensure correct and error-free coding, which may be your strongest defense in avoiding or resolving a review scenario.
Medical practices need long-term revenue cycle management if they want to be competitive in the market for an extended time. Partner with Medical Billing Companies that utilize knowledgeable and trained coders to guarantee you follow the most recent CMS Neonatology Medical Billing Guidelines. In terms of billing services for healthcare professionals, NEO MD Medical Billing has made great strides. For specialty Medical Billing services, NEO MD has been rated the best among its competitor’s revenue cycle management companies.
All practices, regardless of size, may benefit from our services. NEO MD services help to reduce overhead costs caused by incorrect billing. We review data, resolve procedure errors, and move fast to verify and remedy problems where necessary. Our Neonatology Billing Services closely ensure legislation changes that might improve operational effectiveness and cash flow. We also offer Medical Billing services for small practices, medium, and large offices. Furthermore, as the best Medical Billing company near me, healthcare practices may get our tailored services.
What Makes Us the Best Medical Billing Company?
NEO MD stood best among competitors Medical Billing Companies due to the following cores;
- Improve RCM system efficiency with a robust credentialing team.
- Refunds adjustment and Payment posting to improve the cash flow.
- Increase the accuracy of fees and collection.
- Deliver customized Revenue Cycle Management Services to unearth operation shortcomings.
- Our experts work hard to reduce your front-end denials by 20%.
- Offer Services that are easily scalable at all times.
- Offer internal audits to uncover loopholes
- We have consistently increased the collection rate for our clients because of the faster Processing of accounts receivable and on-time follow-up.
- We offer free Medical Billing Audits.
- Provide fortnightly financial and practice overviews. Use the latest technology and tools.
- Out of Network Negotiations.
- Provide collection and Neonatology Billing Services that are of high quality and error-free.
What does “neonatal intensive care unit” (NICU) refer to?
A hospital’s Neonatal Intensive Care Unit (NICU) is a critical care facility for newborn babies who need specialized care. The NICU blends cutting-edge technology with a skilled, experienced NICU team. While most infants admitted to the NICU are born prematurely, others suffer health issues, including infections or birth anomalies while being delivered at term.
What is a Neonatologist?
A neonatologist is a medical practitioner (MD or DO) who specializes in caring for preterm and ill neonates. All neonatologists are pediatricians who have completed medical school and a thorough pediatric residency. They then finish a three-year fellowship program in neonatal medicine.
What Is the Role of a Neonatologist?
In general, neonatologists provide the following types of care:
1. Prenatal Consultations
2. Attendance at High-Risk Deliveries
3. Respiratory Therapy
4. Stabilize Fragile Newborns
5. Diagnose and Treat Illnesses
6. Provide Proper Nutrition
7. Coordinate Neonatal Care Team
8. Educate Family Members
What is code 99460 used for?
CPT Code 99460 is used for the Care of the Normal Newborn Infant. Its description includes Initial hospital or birthing center care, per day, for E/M of a normal newborn infant.
What procedures do neonatologists do?
In addition to handling severely sick newborns daily, neonatologists attend high-risk deliveries, provide supportive care to infants from birth, and regularly undertake technical procedures such as endotracheal intubation and the placement of central venous and arterial catheters.
What are the 4 levels of NICU?
The four categories are:
- Level I: Well, newborn nursery.
- Level II: Special care nursery.
- Level III: Neonatal intensive care unit (NICU)
- Level IV: Regional neonatal intensive-care unit (regional NICU)
What is procedure code 99480?
CPT codes 99478 – 99480 are used to describe care delivered by a physician after the day of admission to a very low birth weight newborn who no longer meets the definition of being critically sick.
What does CPT code 99238 mean?
Hospital Discharge Day Management Service
A face-to-face evaluation and management (E/M) service is provided to the patient and his or her attending physician as part of the hospital discharge day management service (CPT code 99238 or 99239).
Does 99460 need a modifier?
To distinguish 99460-99463 from the minor E/M codes included in surgical codes, insert modifier 25 to 99460-99463. (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service).