Dennery PA. Metalloporphyrins for the treatment of neonatal jaundice. The ICD-10-PCS code for light treatment of the skin is 6A600ZZ Phototherapy of skin, single for a single treatment. J Matern Fetal Neonatal Med. Pediatrics. Aetna considersexchange transfusionmedically necessary forterm andnear-term infantsaccording to guidelines published by the American Academy of Pediatrics (AAP). When the hematoma is extensive or combined with other issues that cause excessive hemolysis, involving additional resources, look to P58 Neonatal jaundice due to other excessive hemolysis. Home-based phototherapy versus hospital-based phototherapy for treatment of neonatal hyperbilirubinemia: A systematic review and meta-analysis. Chen and co-workers (2017) stated that probiotics supplementation therapy could assist to improve the recovery of neonatal jaundice, through enhancing immunity mainly by regulating bacterial colonies. Approximately 2 ml of peripheral venous blood was taken from all subjects. A total of 10 publications (11 studies) were eligible. Documentation should include approximate time spent face-to-face with the family and patient, notation of time spent in counseling, and context of counseling. Trikalinos et al (2009) reviewed the effectiveness of specific screening modalities to prevent neonatal bilirubin encephalopathy. 2017:1-9. Lacrimal ducts are the drainage system for fluid that lubricates the eye. They used a fixed-effect method in combining the effects of studies that were sufficiently similar; and then used the GRADE approach to assess the quality of the evidence. CPT-4 codes: 59400: Antepartum, intrapartum, and postpartum patient care 59400: SG facility fees for the birth center 99460 or 99463: Initial newborn care in a birth center 99461: Second home visit for newborn care Hospital transfer during labor with no postpartum or newborn services Li and colleagues (2019) examined the associations between G6PD 1388 G>A, SLCO1B1 rs4149056 and BLVRA rs699512 variants and the risk of neonatal hyperbilirubinemia in a Chinese neonate population. The authors concluded that the UGT1A1*28 allele was not associated with risk for extreme hyperbilirubinemia in this study. PLoS One. These researchers examined whether the UGT1A1*28 allele is associated with extreme hyperbilirubinemia. So why would you not use one of the codes from 99221-99223 for the first day? This is usually associated with one of the codes from Q65 Congenital deformities of the hip. When newborns are discharged with the Pavlik harness, code for the placement of an immobilization device, external, limiting the movement of the upper right leg with 2W3NXYZ Immobilization of right upper leg using other device and upper left leg with 2W3PXYZ Immobilization of left upper leg using other device. Language services can be provided by calling the number on your member ID card. Normal Newborn visit, day 2 3. The single nucleotide polymorphisms (SNPs) of G6PD 1388 G>A, SLCO1B1 rs4149056 and BLVRA rs699512 loci were examined by the polymerase chain reaction (PCR) and Sanger sequencing technique in the peripheral blood of all subjects. 1991;91:483-489. For the same reason, subcutaneous vaccine administration (3E0134Z Introduction of serum, toxoid and vaccine into subcutaneous tissue, percutaneous approach) usually is not coded. De Luca D, Zecca E, Corsello M, et al. It suggested that these researchers should use the same guideline to detect the time of jaundice fading in future study. Phototherapy in the home setting. Several risk factors for hyperbilirubinemia are known, but in a large number of patients, a causal factor is never established. Casnocha Lucanova L, Matasova K, Zibolen M, Krcho P. Accuracy of transcutaneous bilirubin measurement in newborns after phototherapy. Utilization Mangement and Q uality Review Manual Nebraska M edicaid, 2014, Phototherapy equipment (471 N AC 18-004.45A) Metalloporphyrins in the management of neonatal hyperbilirubinemia. In general, serum bilirubin levels . Treatment of jaundice in low birthweight infants. Bhutani VK, Stark AR, Lazzeroni LC, et al; Initial Clinical Testing Evaluation and Risk Assessment for Universal Screening for Hyperbilirubinemia Study Group. JavaScript is disabled. } Guidelines for Perinatal Care. Hyperbilirubinemia, conjugated. It is an option to provide conventional phototherapy in hospital or at home at TSB levels 2 - 3 mg/dL below those shown, but home phototherapy should not be used in any infant with risk factors. (Codes may be selected based on time spent in counseling and coordination of care when documentation indicates more than 50% of face-to-face time was spent in these activities.) Reference Number: CP.MP.150 Coding Implications Date of Last Revision: 10/22 Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. If the nurse visit results in a visit with the physician, only the physician services would be reported. Learn how we are healing patients through science & compassion, Stanford team stimulates neurons to induce particular perceptions in mice's minds, Students from far and near begin medical studies at Stanford. Exploring the genetic architecture of neonatal hyperbilirubinemia. Pediatrics. The authors concluded that intermittent phototherapy appeared to be as effective as continuous phototherapy for the treatment of neonatal hyperbilirubinemia and was safer than continuous phototherapy. Arch Dis Child Fetal Neonatal Ed. Notes: Prophylactic phototherapy is considered medically necessary for infants showing a rapid rise in bilirubin (greater than 1 mg/dL/hour) and as a temporary measure when one is contemplating exchange transfusion. Evaluation and management (E/M) services provided to normal newborns in the first days of life prior to hospital discharge are reported with Newborn Care Services codes. Reporting of codes for the services requires careful attention to CPT instructions and when more than one physician is caring for the infant, attention to which physician reports which codes. 99460-99461 initial service 2. Hospital readmission due to neonatal hyperbilirubinemia. Additionally, no serious adverse reaction was reported. phototherapy in the home, applied by a . Zhang M , Tang J, He Y, et al. Prediction of hyperbilirubinemia in near-term and term infants. Place the thermometer in your newborn's armpit while the phototherapy lights are on. These findings seem compatible with the concept that factors other than bilirubin conjugation capacity are important for the pathophysiology of neonatal jaundice in ELBW preterm infants. Inpatient coders do not code immature lacrimal ducts because the condition does not use additional resources. Extreme neonatal hyperbilirubinemia and a specific genotype: A population-based case-control study. They used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 5), Medline via PubMed (1966 to June 14, 2018), Embase (1980 to June 14, 2018), and CINAHL (1982 to June 14, 2018). Liu J, Long J, Zhang S, et al. 4. Armanian and colleagues (2019) stated that hyperbilirubinemia occurs in approximately 2/3 of all newborns during the first days of life and is frequently treated with phototherapy. Do not subtract direct (conjugated) bilirubin. Incidence of hyperbilirubinaemia, defined as serum total bilirubin (STB) greater than or equal to 15 mg/dL, was similar between groups (n = 286; risk ratio (RR) 0.94, 95 % CI: 0.58 to 1.52). The code is valid for the year 2023 for the submission of HIPAA-covered transactions. In a Cochrane review, these investigators examined if administration of prebiotics reduces the incidence of hyperbilirubinemia among term and pre-term infants compared with enteral supplementation of milk with distilled water/placebo or no supplementation. During an initial newborn evaluation, watchful waiting conditions are findings that usually resolve without medical intervention in a few weeks to a few years. Although the duration of phototherapy in the zinc group was significantly shorter compared to the placebo group (n = 286; MD -12.80, 95 % CI: -16.93 to -8.67), the incidence of need for phototherapy was comparable across both the groups (n = 286; RR 1.20; 95 % CI: 0.66 to 2.18). 2011;128(4):e1046-e1052. N Engl J Med. In an evidence-based review on "Neonatal hyperbilirubinemia", Pace and colleagues (2019) stated that clofibrate, metalloporphyrins, and ursodiol have been examined in the management of unconjugated hyperbilirubinemia as augmentation to phototherapy. The increased bilirubin from hemolysis often needs phototherapy, exchange transfusion or both after birth. Curr Opin Pediatr. FN07-02. These researchers stated that additional large, well-designed RCTs are needed in neonates that compare effects of enteral supplementation with prebiotics on neonatal hyperbilirubinemia with supplementation of milk with any other placebo (particularly distilled water) or no supplementation. 1992;89:809-818. First, because the value of jaundice fading in each guideline was different, the heterogeneity was high in time of jaundice fading. Approximately 10 to 20 percent of newborns have an umbilical hernia. Hulzebos CV, Bos AF, Anttila E, et al. Pediatrics. The initial day of critical care for the evaluation and management of a critically ill neonate, 28-days of age or less, is reported with code 99468. After maintenance phototherapy was discontinued, 7 patients (23% ) had a sustained disease-free interval lasting more than 58 months (median of greater than 90 months). Long-term follow-up studies reported an increased risk of abnormal neurological examination and cerebral palsy. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were used for reporting methods and results of synthesis with meta-analysis. Prebiotics for the prevention of hyperbilirubinaemia in neonates. Some watchful waiting issues require continued outpatient evaluation until resolution. Report an inclusive screening finding (R94.120 Abnormal auditory function study) in the professional record so the newborn can be retested at the well-baby checks. In some cases, phototherapy will only be needed for 24 hours or less, in some cases, it may be required for 5 to 7 days. In: BMJ Clinical Evidence. Intensive phototherapy in form of double light is used worldwide in the treatment of severe neonatal hyperbilirubinemia. Aetna considers management of physiologic hyperbilirubinemia medically necessary in preterm infants (defined as an infant born prior to 37 weeks gestation) according to guidelines published by the AAP. In: Nelson Textbook of Pediatrics. Results were summarized as per GRADE guidelines. Gu J, Zhu Y, Zhao J. Front Pharmacol. color: blue TcB measurements were inaccurate, regardless of phototherapy technique (Bilibed, conventional phototherapy). Normal Newborn visit, initial service 1. Thirteen infants homozygous for (TA)7 polymorphism associated with GS were in the case group (18.6 %) and 14 in the control group (20.0 %). The USPSTF reviewed experimental and observational studies that included comparison groups. [Phototherapy of newborn infants] The effect of light treatment on neonates with jaundice was discovered in 1958. Pediatrics. Codes for circumcision procedures include: When providing E/M services to other than normal newborns, choose the level of care based on the intensity of the service and status of the newborn. There was no difference in the treatment efficacy and TSB, while there was a significant difference in phototherapy duration and side effects after treatment of intermittent phototherapy and continuous phototherapy for neonatal hyperbilirubinemia. Additional citations were identified from the bibliography of selected articles and from the abstracts of conference proceedings. 2013;89(5):434-443. We are looking for thought leaders to contribute content to AAPCs Knowledge Center. And immature lacrimal glands mature, hydroceles close, and hip joint motion usually improves without need for intervention. The infant is otherwise ready to be discharged from the hospital; The infant is feeding well, is active, appears well; TSBis less than 20 to 22 mg/dL in term infants, or less than 18 mg/dL in preterm infants; Arrangements have been made to evaluate the infant within 48 hours after discharge by an early office/clinic visit to the pediatrician, or by a home visit by a well-trained home health care nurse who should be able to: Be available for follow-up clinical assessments and blood drawing as determined to be necessary by the responsible physician based on changes in bilirubin levels, Clinically assess the initial level of jaundice, Explain all aspects of the phototherapy system to the parents, Oversee set-up of the phototherapy system. One infant (1.6%) met all three AAP guideline criteria of being DAT-positive, bilirubin within 3 of exchange level, and rising bilirubin despite intensive phototherapy. It is also important to note that thereare serious health risks associatedwith corticosteroid therapy. Support teaching, research, and patient care. They considered all RCTs that studied neonates comparing enteral feeding supplementation with prebiotics versus distilled water/placebo or no supplementation. Pediatrics. The meta-analyses of 2 studies demonstrated a significant reduction in the length of hospital stay (MD -10.57 days, 95 % CI: -17.81 to -3.33; 2 studies, 78 infants; I = 0 %, p = 0.004; low-quality evidence). Privacy Policy | Terms & Conditions | Contact Us. 2008;358(9):920-928. Since then, many hundred thousand infants have been treated with light. However, the accuracy of TcB devices in infants exposed to phototherapy is unclear. Data sources included PubMed, Embase, Cochrane library, China National Knowledge Infrastructure, China Biology Medicine, VIP Database, and Wanfang Database. For instance, abnormal findings on screenings for example, newborn hearing screening or lab screenings are not coded in the inpatient record, unless: Here are several watchful waiting findings to consider. These investigatorscalculated the sensitivity and specificity of early TSB, TcB measurements, or risk scores in detecting hyperbilirubinemia. Everything I am finding indicates this code is used for dermatological treatment not for jaundice. Codes for initial care of the normal newborn include: After the newborn has been discharged to home, it is common practice to see the infant to assess for jaundice or any feeding problems. Grabert BE, Wardwell C, Harburg SK. Digital Store For tech Gadgets. Evidence Centre Evidence Report. 96.4. This reduction may be offset by an increase in mortality among infants weighing 501 to 750 g at birth. Last Review04/29/2022. Most newborns have ointment administered at birth, or soon after the initial bonding with the mother. 2010;15(3):164-168. Risk of bias was assessed using the QUADAS-2 tool. Moreover, these investigators stated that infants with bilirubin levels greater than 25 mg/dL, those who are not responding to phototherapy, and those with evidence of acute bilirubin encephalopathy should be treated with exchange transfusion, with initiation based on an infants age in hours and neurotoxicity risk factors. It may not display this or other websites correctly. New perspectives on neonatal hyperbilirubinemia. Do I Use 25 or 59 for Same-day Assessment and E/M? In that case, other conditions can be coded if they were involved in medical decision-making, or otherwise affected the episode of care. In a case-control study performed at a single hospital center in Italy, 70 subjects with severe hyperbilirubinemia (defined as bilirubin level greater than or equal to 20 mg/dL or 340 mol/L) and 70 controls (bilirubin level less than 12 mg/dL or 210 mol/L) were enrolled. These researchers performed a systematic review with meta-analysis including genetic studies, which assessed the association between neonatal hyperbilirubinemia and 388 G>A, 521 T>C, and 463 C>A variants of SLCO1B1 between January of 1980 and December of 2012. Testicles develop in the abdomen. For additional language assistance: SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5), UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, irinotecan metabolism), gene analysis, common variants (eg, *28, *36, *37), Molecular pathology procedure, Level 1(eg, identification of single germline variant [eg, SNP] by techniques such as restriction enzyme digestion or melt curve analysis) [for assessing risk of neonatal hyperbilirubinemia], Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion), G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis, Phototherapy (bilirubin) light with photometer, Home visit, phototherapy services (e.g., Bili-lite), including equipment rental, nursing services, blood draw, supplies, and other services, per diem, Injection, phenobarbital sodium, up to 120 mg, Neonatal jaundice due to other excessive hemolysis, Neonatal jaundice from other and unspecified causes, Maternal care for other isoimmunization [not covered for the use of antenatal phenobarbital in red cell isoimmunized pregnant women], Glucose-6-phosphate dehydrogenase (G6PD); quantitative, Glucose-6-phosphate dehydrogenase (G6PD); screen, Genetic susceptibility to other disease [G6PD deficiency], Family history of other endocrine, nutritional and metabolic diseases [G6PD deficiency], Family history of carrier of genetic disease [G6PD deficiency]. Mehrad-Majd H, Haerian MS, Akhtari J, et al. Take your newborn's temperature every 3 to 4 hours. Usually prior to birth, the testicles descend into the scrotum. On the pediatricians encounter, code P13.4 Fracture of clavicle due to birth injury because it involved medical decision-making. Accessed January 30, 2019 . Natus Medical Inc. ETCOc - An indicator of elevated hemolysis in neonatal hyperbilirubinemia. 2010;15(3):169-175. Mothers typically are counseled on newborn jaundice signs and when to bring the newborn in. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Phototherapy for neonatal jaundice. [glucose-6-phosphate dehydrogenase (G6PD), uridine diphosphate glucuronosyl transferase 1A1 (UGT1A1), and. PubMed, Scopus, Embase, Cochrane library, CBM, CNKI, and Wanfang Data were searched to collect the comparative study of home-based phototherapy versus hospital-based phototherapy for the treatment of neonatal hyperbilirubinemia. Stigma (plural stigmata) is a finding that may indicate an abnormal condition, such as a sacral dimple without a visible floor being stigma for occult spina bifida. Deshmukh J, Deshmukh M, Patole S. Probiotics for the management of neonatal hyperbilirubinemia: A systematic review of randomized controlled trials. Aggressive phototherapy did reduce rates of neurodevelopmental impairment (26 %, versus 30 %for conservative phototherapy; relative risk, 0.86; 95 % CI: 0.74 to 0.99). Bhutani VK; Committee on Fetus and Newborn; American Academy of Pediatrics. Honar et al (2016) found that ursodiol added at the time of phototherapy initiation showed a significant reduction in peak bilirubin levels and duration of phototherapy in term infants with unconjugated hyperbilirubinemia without any adverse effects. Pediatrics. 2023 ICD-10-PCS Procedure Code 6A600ZZ Phototherapy of Skin, Single 2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code ICD-10-PCS 6A600ZZ is a specific/billable code that can be used to indicate a procedure. 2021;77(1):12-22. Codes 99478-99480 each are described as, "Subsequent intensive care, per day, for the evaluation and management of the recovering low or very low birth weight infant" with the code selected based. Newborn jaundice happens when the newborns liver and sunshine on the newborns skin dont remove the fetal blood components in an efficient manner. Single versus double volume exchange transfusion in jaundiced newborn infants. If your newborn is too warm, remove the curtains or cover from around the light set. For preterm neonates, there was a significantly lower bilirubin level in the 100 mg/kg clofibrate group compared to the control group with a mean difference of -1.37 mg/dL (95 % CI: -2.19 mg/dL to -0.55 mg/dL) (-23 mol/L; 95 % CI: -36 mol/L to -9 mol/L) after 48 hours. Incidences of side effects like vomiting (n = 286; RR 0.65, 95 % CI: 0.19 to 2.25), diarrhea (n = 286; RR 2.92, 95 % CI: 0.31 to 27.71), and rash (n = 286; RR 2.92, 95 % CI: 0.12 to 71.03) were found to be rare and statistically comparable between groups. 2001;108(1):175-177. Ip S, Glicken S, Kulig J, et al. Aetna's policy on treatment of hyperbilirubinemia in infants is adapted from guidelines from the American Academy of Pediatrics. Because it is a screening (not diagnostic), the test does not meet the definition of a diagnostic procedure or therapeutic treatment for a clinically significant condition. The correlation between TSB and TcB was found to be moderately close (r = 0.4 to 0.5). Some studies showed that unclear random allocation and allocation plan might exaggerate the hidden effect of up to 30 to 41 %. The studies were included if they compared TcB results with TSB in term and near-term infants during phototherapy or after discontinuation of phototherapy. The lining of the abdomen pouches into the scrotum to surround the testicle. 2. In a Cochrane review on early (less than8 days) postnatal corticosteroid treatmentfor preventing chronic lung disease in preterm infants, Halliday et al(2010) concluded that the benefits of early postnatal corticosteroid treatment, especially DXM, may not out-weigh the known or potential adverse effects of this treatment. Guidelines from the AAP stated: "There is now evidence that hyperbilirubinemia can be effectively prevented or treated with tin-mesoporphyrin, a drug that inhibits the production of heme oxygenase. Liu et al (2013) examined if 3 variants (388 G>A, 521 T>C, and 463 C>A) of SLCO1B1 are associated with neonatal hyperbilirubinemia. Medline, Embase, Cochrane Library, CINAHL and Scopus databases (from inception to May 8, 2014) were searched. However, the results remain controversial. Clinical evaluation (e.g., specialty consult during the hospitalization); Therapeutic treatment (e.g., bili lights for clinically significant neonatal jaundice); Diagnostic procedures (e.g., ultrasound due to sacral dimple); Extended length of hospital stay (e.g., beyond the average for the MS-DRG); Increased nursing care and/or monitoring (e.g., neonatal intensive care unit); or. 2002;65(4):599-606. Aetna does not provide health care services and, therefore, cannot guarantee any results or outcomes. newborn, known as hyperbilirubenemia. Resources J Matern Fetal Neonatal Med. 66920 Removal of lens material; intracapsular. The dose of zinc varied from 5 to 20mg/day and duration from 5 to 7 days. Data selection and extraction were performed independently by 2 reviewers. They stated that TSB assessment remains necessary, if treatment of hyperbilirubinemia is being considered. Analysis of rebound and indications for discontinuing phototherapy. As a contributor you will produce quality content for the business of healthcare, taking the Knowledge Center forward with your knowhow and expertise. Most of the included studies only mentioned the use of random allocation, but they did not describe the specific random allocation method. Cochrane Database Syst Rev. Valaes T. Problems with prediction of neonatal hyperbilirubinemia. Two reviewers screened papers and extracted data from selected papers. Cochrane Database Syst Rev. at the end of this policy for important regulatory and legal information. The fetal blood is designed to attract oxygen from the mothers blood. Pediatrics. 66940 Removal of lens material; extracapsular (other than 66840, 66850, 66852) Learn more about pediatric cataract billing in Ophthalmic Coding: Learn to Code . Montreal, QC: CETS; October 2000. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. Watchko and Lin (2010) noted that the potential for genetic variation to modulate neonatal hyperbilirubinemia risk is increasingly being recognized. Systematic review of global clinical practice guidelines for neonatal hyperbilirubinemia. 2001;21(Suppl 1):S63-S87. Multiple treatments is coded 6A601ZZ Phototherapy of skin, multiple. Starting Feb. 1, 2022, five new CPT codes will require preauthorization. Indirect evidence from 3 descriptive uncontrolled studies suggested favorable associations between initiation of screening and decrease in hyperbilirubinemia rates, and rates of treatment or re-admissions for hyperbilirubinemia compared with the baseline of no screening. The authors concluded that this meta-analysis showed that probiotics supplementation therapy was an effective and safe treatment for pathological neonatal jaundice. Elk Grove Village, IL: AAP; 1997. 2003;88(6):F459-F463. With the sleeve pinned to the t-shirt, the newborn has restricted arm movement, and the clavicle heals without intervention. It is an option to intervene at lower TSB levels for infants closer to 35 wks and at higher TSB levels for those closer to 37 6/7 wks. 1992;89:823-824. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Ambalavanan N, Carlo WA. text-decoration: line-through; 2006;117(2):474-485. Aetna considers home phototherapy for physiologic jaundice in healthy infants with a gestational age of 35 weeks or more medically necessary if all of the following criteria are met: Note: If levels do not respond by stabilizing (+/- 1 mg/dL) or declining, more intensive phototherapy may be warranted. The smallest but significant difference between TSB and TcB was found on the lower abdomen. Phototherapy is the use of visible light to treat severe jaundice in the neonatal period. .fixedHeaderWrap { 65. A randomized, triple-blind, placebo-controlled trial of prophylactic oral phenobarbital to reduce the need for phototherapy in G6PD-deficient neonates. Aetna considers the use of antenatal phenobarbital to reduce neonatal jaundice in red cell isoimmunized pregnant women experimental and investigational because its effectiveness has not been established. Malpresentations are almost always noted on the inpatient record. A total of 447 Chinese neonates with hyperbilirubinemia were selected as the study group and 544 healthy subjects were recruited as the control group matched by baseline sex, age, feeding pattern and delivery mode. These are not additional resources. Blood testing done as a diagnostic test, however, meets the requirements for coding the jaundice. Phototherapy was started at an average of 7 h of age, and the first IVIG dose was administered at an average of 13 h of life; nearly 25% received a second IVIG dose. Waltham, MA: UpToDate;reviewed January 2016. The authors concluded that the findings of this study demonstrated that the 388 G>A mutation of the SLCO1B1 gene is a risk factor for developing neonatal hyperbilirubinemia in Chinese neonates, but not in white, Thai, Brazilian, or Malaysian populations; the SLCO1B1 521 T>C mutation provides protection for neonatal hyperbilirubinemia in Chinese neonates, but not in white, Thai, Brazilian, or Malaysian populations. Procedures included in the services represented by code 99477 include those listed for the Critical Care Services subsection of CPT (codes 99291 and 99292), as well as additional procedures listed in the Inpatient Neonatal and Pediatric Critical Care subsection (codes 99468-99476, 99466-99467). When the newborn is critically ill or injured, codes exist for reporting of services provided during interfacility transport, initial critical care, and subsequent critical services. The beroptic system consists of a pad of Pediatrics. American Academy of Pediatrics and American College of Obstetricians and Gynecologist. Search All ICD-10 Toggle Dropdown. Poland RL. Hamelin K, Seshia M. Home phototherapy for uncomplicated neonatal jaundice. Aetna considers massage therapy experimental and investigational for the treatment ofneonatal hyperbilirubinemia because its effectiveness has not been established. 1998;101(6):995-998. Incidence is as high as 30 percent in premature male neonates. } All that is needed is watchful waiting. BMJ Open. Critical care services delivered by a physician, face-to-face, during an interfacility transport of critically ill or critically injured pediatric patient, 24-months of age or less, are reported based on the time of face-to-face care beginning when the physician assumes primary responsibility at the referring hospital/facility and ending when the receiving hospital/facility accepts responsibility for the patient's care. No (TA)8 repeat was found in the 2 groups. Meta-analyses of 2 studies showed no significant difference in maximum plasma unconjugated bilirubin levels in infants with prebiotic supplementation (MD 0.14 mg/dL, 95 % CI: -0.91 to 1.20, I = 81 %, p = 0.79; 2 studies, 78 infants; low-quality evidence). No study assessed harms of screening. Nelson Textbook of Pediatrics. Aetna considers transcutaneous bilirubin devices for evaluating hyperbilirubinemia in term and near-term infants while undergoing phototherapy experimental and investigational becasue this approach is not reliable in infantsin this setting.