New born child exam

Hi,

I have a concern here, I submitted the claim to the insurance with the dx code V20.31 and CPT® code 99222 for a new newborn baby.

According to insurance the dx code is not appropriate with CPT® code used.

the written diagnosis was newborn child exam.

Anybody who can tell me, what code should I use for a new born child exam.

Thank you

re: New born child exam

V20.31 Applies To Health check for newborn under 8 days old.
Look at: CPT® codes 99460-99463

re: New born child exam

ok.. on the medical record that I have. The diagnosis was newborn child exam and I used V20.31, should I only modify the CPT®? And the dx code will remain or as is.

thanks

re: New born child exam

Yes, change the CPT® code

re: New born child exam

99222 is a hospital code. If he was seen in the office you need to use a office E&M (I usually use 99212)

re: New born child exam

hi, the new born baby was seen at the hospital together with his mother, they stayed for 3 days. We used 99222 but they denied it. They said that there is a suitable dx code for the CPT® or vise versa.

Thanks again

re: New born child exam

in the hospital you would use a hospital newborn code. for day 3 it would be 99462, or 99238 if being discharged that day. The ICD-9 would be the V30.xx series depending on whether it is vaginal, CX, twin, etc.

re: New born child exam

I think I could use 99460 mother delivered her child on the same day 6/19 and the PCP check the baby on the same day.
Am I right?


Thanks to all of you guys!!

re: New born child exam

I agree with you.