Maternal Smoker

jillian.bisbejillian.bisbe
in Pediatrics

Question: When do you think it would be acceptable to use the code P9689 Exposure to tobacco smoke in the perinatal period? If mom is a smoker, is that enough? Or do I have to have some type of documentation stating an affect on the newborn?

It confuses me because there is already P042 Newborn affected by in utero exposure to tobacco which I would use if, for example, documentation states "SGA due to maternal smoking".

Seems like a silly question, but this code (P9689) changes the APR-DRG on a chart I am reviewing.

Comments

  • jillian.bisbejillian.bisbe

    Thanks! Yes, I meant P9681. I must have been lacking coffee because I completely messed up my question. Geez, let me try this again.

    This is a normal newborn with commercial insurance. The addition of P9681 takes the chart from DRG 795 Normal Newborn to DRG 794 Neonate with other significant problems- higher weight, higher reimbursement.

    I don't see how this code qualifies as a secondary diagnosis just because mom smoked? I'm thinking I would need some documentation to prove additional monitoring, testing, etc was done to use it? Thoughts?





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