I'm not a clinician, but is the use of P96.1 "...use of drugs of addiction" appropriate for patients on MAT?

Do you continue using the Finnegan's and ESC?

At Geisinger, we are moving to using 04.14 for the exposed and symptomatic newborn and use P 96.1 for the symptomatic newborn receiving pharmacologic OR non-pharmacologic treatment.

Do patients coded as 04.14 NOT receive nonpharmacological treatment?

04.14 is for exposed and asymptomatic, sorry.

got it - disregard previous question!

Do you get consent for maternal testing?

Susan, we don’t get written consent but ob tells mom what we’re doing and why. Our prenatal consults also cover this.

What is a weighted code?

Billing for “subsequent intensive” is broken into weight categories. <1500g, 1500-2500g, >2500g

May not have the numbers exactly right

There are also the 99221-99223 codes that can be used (like on the peds floor), but these get complicated with respect to documentation in the notes.

Does anyone have any experience with insurance companies not paying for higher levels of care for 1. Babies on opiate therapy, 2. Babies not on opiate therapy, but requiring non-pharmacologic care for symptomatic withdrawal?

For health plan/billing-related questions, the PA PQC can help to connect your teams to the PA PQC health plan teams.

YES! Dave that is really the question. Those non pharm interventions can be really intensive and require almost one to one nursing care.

That would be great!

Thank you

Thanks everyone! This was very informative. Robert - thanks for following up with the health plans.

Thank you to everyone!

Thank you!

Thank you