extreme prematurity, transfer for procedure and returned
I'm having difficulty finding a coding clinic or advice for this topic. Patient was born extremely premature and transferred out for a procedure that is not done at our hospital. The baby stayed a couple days there for monitoring and returned back to us. This baby would have stayed in house until d/c if we performed this procedure here and principle would have remained; single liveborn c section with extreme prematurity as a secondary dx. As we all know the pcode for immaturity has a coding clinic and we can use it for the lifespan of this baby if it impacts the care, future needs etc. In this scenario where the baby returns for growth, weaning off the o2 that they have not yet weaned off of since birth, and feeding, should it be used as principle? Ultimately these things are all due to the prematurity. I personally would sequence it as principle and believe I have found some support for this in past but can not locate it now. Does anyone have advice or coding guidelines in sequencing this as principle in such scenario?
Comments
I have written to coding clinic on this exact subject because I have it happen with fair frequency. The answer was simply that the P codes could be used throughout the lifespan of the patient....- what is in the guidelines but they did not answer the primary question of whether or not that P code could be the PDX. I take that answer as saying they have not made a guidelines or decision on that and do not choose to. The good news is, if you use the P code as PDX after 28 days it is not going to put you into a newborn DRG. So, follow the principal you would of any other newborn who is over 28 days transferred to your facility for whatever it is they still need to decide on PDX. As you said- sometimes its feeding issues, sometimes its respiratory issues, etc.
Great! Thank you, Amy. I appreciate your input.