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Information for Neonatologists

In the spotlight


Friday, October 21, 2016

MiDCaN (Mid Career Neonatologists) SONPM Group to Focus on Special Interests of those Mid Career Neonatologists(7-17 years after Fellowship)-both Private Practice and Academic settings.

We will have the first meeting of the MiDCaN Group at the NCE with a Workshop focusing on Career and Leadership Development and a session on Burnout! The workshop is free for participants to attend. MiDCaN District and State representatives have been selected, but all are welcome.

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SONPM leadership and other AAP Section representatives recently met with the CDC in Atlanta to update and revise the current “Interim Guidelines for Health Care Providers Caring for Infants and Children with Possible Zika Virus Infection.” Please refer to the newly released guidelines for management of neonates born with possible Zika virus infection.

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New! NeoReviews Question Bank

The AAP-SoNPM is providing the NeoReviews Question Bank from the years 2004 to 2011 for free as an exciting new educational offering. The questions have been categorized into systems as well as by year for the convenience of the readers. This intensively peer-reviewed state-of-the art Question Bank is developed by leading neonatal-perinatal specialists for all providers of neonatal care. Case-based questions will challenge your knowledge in the extensive scope of this specialty. Thorough explanations of preferred responses are included with the most up-to-date references available for your review.

NeoReviews Question Bank »

Tips for the Early Career Neonatologist

As an early career neonatologist, especially as an educator, one has to juggle many academic endeavors at the same time. Many of these are unique to this career phase. Attached is an article from the leaders of the Early Career Medical Educators from Canada where they consolidate their knowledge into 12 succinct tips.

Early Career Medical Educators Article »

New! SoNPM Online Journal Club

The American Academy of Pediatrics Section on Neonatal Perinatal Medicine (AAP-SoNPM) in collaboration with EB-NEO are happy to announce a new initiative. The SONPM Journal Club is an online forum for trainees and early neonatologist to critically evaluate medical literature relevant to the care of newborn infants. Authors are encouraged to submit a constructive and well reasoned critical review of available literature related to neonatology. The Journal Club articles will be peer-reviewed by the AAP-SoNPM Editorial board before being published online.

Journal Club Introduction »

Upcoming Meetings

National Conference & Exhibition

October 21-24, 2016
San Francisco, CA

The SONPM has put together a wonderful educational program in San Francisco. Maria Delivoria-Papadopoulos, MD will be the featured Cone History Lecturer and Dr. Jeff Reese will speak on “The Future of Prematurity: New Approaches for Detection and Prevention of Preterm Labor” at the Merenstein Lecture. We have also scheduled an exciting Joint session on Saturday: Section on Neonatal Perinatal Medicine and Section on Child Neurology and Section On Hospice and Palliative Care.

See you there!

For More Information and Registration »

Download Brochure »

New Policy Statements

Oxygen Targeting in Extremely Low Birth Weight Infants

This clinical report discusses the benefits and limitations of pulse oximetry for assessing oxygenation, summarizes randomized clinical trials of oxygen saturation targeting, and addresses implications for practice.

Oxygen Targeting in Extremely Low Birth Weight Infants»

Other Recent Statements in Pediatrics

Noninvasive Respiratory Support »

Patent Ductus Arteriosus in Preterm Infants »

Apnea of Prematurity »

Prevention and Management of Procedural Pain in the Neonate: An Update »

Articles of Interest

The Perinatal Section Website Working Group has posted all new monthly Articles of Interest to neonatologists from the top journals. Access this website first to find the most recent clinical trials and research related to neonatology.

Current Articles of Interest »

CDC Releases Resource Guide for Perinatal Quality Collaboratives: A Resource Guide for States

Perinatal quality collaboratives, or PQCs, are networks of perinatal care providers and public health professionals working in multdisciplinary teams to improve measurable outcomes for women and newborns through continuous quality improvement.

The Centers for Disease Control and Prevention (CDC) recognizes the value that PQCs can bring to improving perinatal health and worked with experts to develop a resource guide to help develop and advance the work of state PQCs. The guide includes information about starting a state-wide collaborative, launching initiatives, data and measurement, sustainability, and links to other useful resources for perinatal quality improvement work.

Download Resource Guide »

Learn More About PQCs »

Visit CDC's Division of Reporductive Health »

Coding Corner

AAP Perinatal Coding Experts answer your questions

Question 1.) Coding question by Satyan Lakshminrusimha, MD: Coding question by Satyan Lakshminrusimha, MD: I need a clarification regarding the ICD-10 codes for growth restriction.

  • There are a set of codes P05.00 to 05.08 – newborn light for gestational age.
  • There is a second set P05.10 to 05.18 – newborn small for gestational age (light and small)
  • Is “light” referring to weight only (such as asymmetric IUGR) and “small” refer to weight and height?

The answer from Edward A. Liechty MD
Yes, Satyan is correct – use P05.00 to 05.08 – newborn light for gestational age – asymmetric IUGR Use P05.10 to 05.18 – newborn small for gestational age (light and small) for symmetric growth restriction.

Also, these sets of codes should only be used for infants <2500 g. COCN has requested from the ICD Editorial Board a new set of codes for infants who are growth restricted but birth weight > 2500 g. COCN will inform members when these new codes are published – hopefully in 2016 but possibly not until 2017.

Question 2.) Coding question by CarolAnn Schilz CPC:
The Neonatologist provides interfacility transport and admitted to our NICU unit in Montana, on the same date the patient requires transport to Denver Children’s Hospital.
We would code for the face-to-face time in interfacility transport, but what would be code for the NICU initial assessment and discharge prior to transport to Denver on the same day?

The answer from Edward A. Liechty MD and Stephen A. Pearlman, MD, MSHQS
No, the Montana neo should charge hourly critical care for the time in the unit, and face to face transport for the time during transit
This all assumes the infant meets critical care status definition

Some additional reasoning is that the doctors in Denver will use the global daily critical care code (again assuming the baby is critical). Payers will only honor one global daily critical care code per patient per day. In order for the Montana neonatologist to get remuneration for his/her services they need to use the hourly critical care codes (99291 first 30-74 minutes and 99292 each additional 30 minutes) for the amount of face-to-face time they spent with the patient in the NICU. In addition, if they provided the transport services themselves, they would use 99466 and 99467. These are for critically ill neonates only and are also time-based. Of note, many procedures are already bundled in the transport and critical care hourly codes but some are not. Of note intubation, umbilical vessel catheterization and peripheral arterial catheterization can be billed for separately. Of course all the time spent and services provided must be very clearly documented.

Question 3.) Coding question by J Kirk Bass:
What is the code to use to charge for 24 hour continuous EEG monitoring?

The answer from Edward A. Liechty MD and Stephen A. Pearlman, MD, MSHQS
For the EEG itself – probably 95951.

I just want to add a couple of caveats here. The neonatologist should not be billing for a 24 EEG unless they are the one’s doing the interpretation of it (which I doubt but perhaps some do). However assuming our colleague is reading EEGs, 95950 is for the 24 hour EEG that has 8 channels, 95951 is for a 24 hour EEG that has 16 or more channels. Furthermore, I would recommend the use a 26 modifier which indicates that the provider is only responsible for the professional component of the test (i.e. the interpretation) and is not the person who sets up the study etc. Hope this helps.

Ed: I agree with Stephan’s comments. The question was confusing as it was not clear whether he was asking for the neo code or the EEG code. Here is the intraservice work for 95951. “For each seizure during a 24-hour period (typically several), review nursing notes and review and interpret both the video and EEG recordings from before, during, and after seizure. For each 24-hour period write a note describing the behavioral and EEG findings for seizures that day.”

Answers to this and previous coding questions »

Send us your coding questions »

Download the 2014 Perinatal Pediatrics Coding Toolkit »

What is the Section of Neonatal- Perinatal Medicine?

The Section on Perinatal Pediatrics is the home organization for specialists in Neonatal-Perinatal Medicine and also welcomes affiliate members working in related disciplines. At a membership of nearly 3,500, the Section is the largest specialty group of the American Academy of Pediatrics. The Section's highest priority is to ensure optimal health and well-being of babies and mothers and this is accomplished through the Section's core activities in the realms of advocacy, education, outreach and support of clinicians and researchers.

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