Evans D. Neonatal jaundice. Numerous skin findings may be noted, but are not coded in the inpatient record unless they are clinically significant. Brown AK, Seidman DS, Stevenson DK. } text-decoration: line-through; Seidman DS, Stevenson DK, Ergaz Z, et al. Ip S, Glicken S, Kulig J, et al. A total of 416 records were identified through database searching; 4 studies (3 randomized studies and 1 retrospective study) meet the final inclusion criteria. Usually, clicking hips lead to no findings but are noted so other providers know there is not issue. Even if it meets the technical meaning of conjunctivitis (inflammation of the conjunctiva), it isnt contagious; its self-limiting and does not affect medical decision-making, so it cannot be coded on the pediatricians encounter. TcB should not be used in patients undergoing phototherapy.". OL LI { Ambalavanan N, Carlo WA. Studies were analyzed for methodological quality in a "Risk of bias" table. These services include intensive cardiac and respiratory monitoring, continuous and/or frequent vital sign monitoring, heat maintenance, enteral and/or parenteral nutritional adjustments, laboratory and oxygen monitoring, and constant observation by the health care team under direct physician supervision. None of the studies showed any effect on the duration of phototherapy, incidence of phototherapy, age of starting of phototherapy and any serious adverse effect. 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). J Pediatr Health Care. The SLCO1B1 521 T>C mutation showed a low risk of neonatal hyperbilirubinemia in Chinese neonates, while no significant associations were found in Brazilian, white, Asian, Thai, and Malaysian neonates. 2017;30(16):1953-1962. The authors stated that this study had several drawbacks. Comp arative Effectiveness of Fiberoptic Phototherapy for Hyperbilirubinemia in Term Infants. Dennery PA. Metalloporphyrins for the treatment of neonatal jaundice. 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. They stated that further research is needed before the use of TcB devices can be recommended for these settings. Sometimes issues heal without interventions, such as minor hematomas from the birth process and laceration from the fetal monitoring electrode. Although early corticosteroid treatment facilitates extubation and reduces the risk of chronic lung disease and patent ductus arteriosus, it causes short-term adverse effects including gastro-intestinal bleeding, intestinal perforation, hyperglycaemia, hypertension, hypertrophic cardiomyopathy and growth failure. list-style-type: lower-alpha; There is no CPT code because these hospital screenings are usually done by hospital staff who are trained by an audiologist. Screening is usually done as close as possible to inpatient discharge for this reason. width: 100%; Study authors were contacted for additional information. 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. Chawla D, Parmar V. Phenobarbitone for prevention and treatment of unconjugated hyperbilirubinemia in preterm neonates: A systematic review and meta-analysis. 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. Bhutani VK, Stark AR, Lazzeroni LC, et al; Initial Clinical Testing Evaluation and Risk Assessment for Universal Screening for Hyperbilirubinemia Study Group. Home Birth Coding Examples | Kaiser Permanente Washington Several risk factors for hyperbilirubinemia are known, but in a large number of patients, a causal factor is never established. Systematic review of global clinical practice guidelines for neonatal hyperbilirubinemia. Stevenson DK, Fanaroff AA, Maisels MJ, et al. But unless the breech presentation or other malpresentation caused a significant finding for the newborn, do not code it on the inpatient hospital record. Home phototherapy. Toggle navigation. 2002;3(1). Intensive phototherapy in form of double light is used worldwide in the treatment of severe neonatal hyperbilirubinemia. I have a provider that ordered phototherapy for a newborn in the hospital with jaundice and he is wanting to bill 96900. 2004;114(1):297-316. 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. color: blue Multiple treatments is coded 6A601ZZ Phototherapy of skin, multiple. Severe neonatal hyperbilirubinemia and UGT1A1 promoter polymorphism. Most of the included studies only mentioned the use of random allocation, but they did not describe the specific random allocation method. In a Cochrane review, Thomas et al (2007) stated that neonates from isoimmunized pregnancies have increased morbidity from neonatal jaundice. In a Cochrane review, Gholitabar et al (2012) examined the safety and effectiveness of clofibrate in combination with phototherapy versus phototherapy alone in unconjugated neonatal hyperbilirubinemia. Consistent with available guidelines, continued phototherapy is not medically necessary for healthy term infants when the following criteria for discontinuation of phototherapy are met: A delay in discharge from the hospital in order to observe the infant for rebound once the bilirubin has decreased is not considered medically necessary. They included English-language publications evaluating the effects of screening for bilirubin encephalopathy using early TSB, TcB measurements, or risk scores. Pediatrics. There were no probiotic-related adverse effects. Cochrane Database Syst Rev. There was diagnostic testing or a specialty inpatient consult; or. This is not the same as for professional services coding, where the first-listed diagnosis is the reason for the encounter. Extreme neonatal hyperbilirubinemia and a specific genotype: A population-based case-control study. Halliday HL, Ehrenkranz RA, Doyle LW. If your newborn is too warm, remove the curtains or cover from around the light set. The main outcomes of the trials were analyzed by Review Manager 5.3 software. 2006;(4):CD004592. When the newborn jaundice requires additional resources, the correct diagnosis is usually found under P58 Neonatal jaundice due to other excessive hemolysis or P59 Neonatal jaundice from other and unspecified causes codes. Although generally seen as safe, there is rising concern regarding phototherapy and its potentially damaging effects on DNA and increased side effects particularly for pre-term infants. Phototherapy Coding and Documentation in the Time of Biologics Assign codes for conditions that have been specified by the provider as having implications for future healthcare needs. A total of 3 small studies evaluating 154 infants were included in this review. Otherwise, at 3 to 4 years of age, the hernia will be surgically repaired. Treatment effects on the following outcomes were determined: mean change in bilirubin levels, mean duration of treatment with phototherapy, number of exchange transfusions needed, adverse effects of clofibrate, bilirubin encephalopathy and neonatal mortality. Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. Support teaching, research, and patient care. Behrman RE, ed. Cochrane Database Syst Rev. J Matern Fetal Neonatal Med. Copyright 2023 American Academy of Family Physicians. Read more Therefore, its functional efficiency is important for your market reputation. For a better experience, please enable JavaScript in your browser before proceeding. Home Phototherapy for Neonatal Jaundice (07.06.02) COVERED: ACCORDING TO CERTAIN CRITERIA Phototherapy is often used to treat neonatal jaundice and involves the continuous application of ultraviolet light via a lamp or a beroptic system to a newborn for a prescribed period of time. 2011;12:CD007969. Do not subtract direct (conjugated) bilirubin. Aetna considersphototherapy medically necessary forterm andnear-term infantsaccording to guidelines published by the American Academy of Pediatrics (AAP). OL OL OL LI { 2018;31(10):1311-1317. Metalloporphyrins for treatment of unconjugated hyperbilirubinemia in neonates. The smallest but significant difference between TSB and TcB was found on the lower abdomen. newborn, known as hyperbilirubenemia. Per the ICD-10-PCS Official Guidelines for Coding and Reporting, only clinically significant conditions are reported. Sharma and colleagues (2017) examined the role of oral zinc supplementation for reduction of neonatal hyperbilirubinemia in term and preterm infants. If a nurse visit is provided (e.g., weight screen only), code 99211 may be reported. 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. Approximately 10 to 20 percent of newborns have an umbilical hernia. The authors concluded that effects of screening on the rates of bilirubin encephalopathy are unknown. Murki S, Dutta S, Narang A, et al. There is no CPT code because these hospital screenings are usually done by hospital staff who are trained by an audiologist. Although an undescended testicle usually is described as palpable or impalpable, also get the location, if you can. 2011;128(4):e1046-e1052. Databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Database (Wan Fang), Chinese Biomedical Literature Database (CBM), VIP Database for Chinese Technical Periodicals (VIP) were searched and the deadline was December 2016; RCTs of probiotics supplementation for pathological neonatal jaundice in publications were extracted by 2 reviewers. Waltham, MA: UpToDate;reviewed January 2015; January 2017. Search All ICD-10 Toggle Dropdown. A total of 13 RCTs involving 1,067 neonatal with jaundice were included in the meta-analysis. Pediatrics. PDF Clinical Policy: Phototherapy for Neonatal Hyperbilirubinemia 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. Kernicterus in full-term infants--United States, 1994-1998. It not only decreased the total serum bilirubin level after 3 days [MD: -18.05, 95 % CI: -25.51 to -10.58), p < 0.00001], 5 days [MD: -23.49, 95 % CI: -32.80 to -14.18), p < 0.00001], 7 days [MD: -33.01, 95 % CI: -37.31 to -28.70), p < 0.00001] treatment, but also decreased time of jaundice fading [MD: -1.91, 95 % CI: -2.06 to -1.75), p < 0.00001], as well as the duration of phototherapy [MD: -0.64, 95 % CI: -0.84 to -0.44), p < 0.00001] and hospitalization [MD: -2.68, 95 % CI: -3.18 to -2.17), p < 0.00001], when compared with the control group. 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. J Matern Fetal Neonatal Med. 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. The longer the newborn has before an auditory function screening, the greater the chance of a successful screening. Watchful waiting conditions usually are not coded by hospital inpatient coders because the conditions do not use significant hospital resources and do not affect newborn hospitalization. Pediatrics. 2009;124(4):1162-1171. Do not report Q10.3 Q10.6 or any of the H04 Disorders of lacrimal system for immaturity of the lacrimal ducts. Last Review All but 1 of the included studies were conducted in Iran. No (TA)8 repeat was found in the 2 groups. Poland RL. color: blue!important; 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. The correlation coefficient improved marginally in the post-phototherapy phase (r = 0.72, 95 % CI: 0.64 to 0.78, 4 studies). In preterm infants, phototherapy should be initiated at 50 to 70 % of the maximum indirect levels below: * Complications include but are not limited to prenatal asphyxia, acidosis, hypoxia, hypoalbuminemia, meningitis, intraventricular hemorrhage, hemolysis, hypoglycemia, or signs of kernicterus. Clin Pediatr (Phila). MMWR Morb Mortal Wkly Rep. 2001;50(23):491-494. If the nurse visit results in a visit with the physician, only the physician services would be reported. Depending on the study, 2 to 10 percent of newborns have inconclusive results at discharge (e.g., there may be fluid in the middle ear; the newborn may be fussy; one ear might pass, but the other does not). Links to various non-Aetna sites are provided for your convenience only. These investigators evaluated the effects of antenatal phenobarbital in red cell isoimmunized pregnancies in reducing the incidence of phototherapy and exchange transfusion for the neonate. Practice parameter: Management of hyperbilirubinemia in the healthy term newborn. 2023 ICD-10-PCS Procedure Code 6A600ZZ: Phototherapy of Skin, Single Newman TB, Maisels MJ. cpt code for phototherapy of newborn - mycyberplug.com Swelling in such a hydrocele is uniform, over time, until the fluid is absorbed by the body. Meta-analysis of the 3 studies showed a significant increase in stool frequency in the prebiotic groups (MD 1.18, 95 % CI: 0.90 to 1.46, I = 90 %; 3 studies, 154 infants; high-quality evidence). The ointment is administered by the hospital staff, so there is no professional component to the service. 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. Malpresentations are almost always noted on the inpatient record. Grabert BE, Wardwell C, Harburg SK. Associations between G6PD, OATP1B1 and BLVRA variants and susceptibility to neonatal hyperbilirubinaemia in a Chinese Han population. For harms associated with phototherapy, case reports or case series were also included. .newText { Kernicterus. Seven (2 prospective) studies evaluated the ability of risk factors (n = 3), early TSB (n = 3), TcB (n = 2), or combinations of risk factors and early TSB (n = 1) to predict hyperbilirubinemia (typically TSBgreater than 95th hour-specific percentile 24 hours to 30 days post-partum). The authors concluded that early DXM treatment does not affect the severity of neonatal hyperbilirubinemia in ELBW preterm infants. Newborn Care 1. Hyperbilirubinemia, conjugated. 2. 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. This code may be reported only once per day and by only one physician. An UpToDate review on "Evaluation of unconjugated hyperbilirubinemia in term and late preterm infants" (Wong and Bhutani, 2015) does not mention genotyping of SLCO1B1 and UGT1A1 as management tools. 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 upon the present body weight of the infant as below. Oral zinc was administered in a dose of 5 ml twice-daily from day 2 to day 7 post-partum. Mean STB levels, mg/dL, at 72 12 hours were comparable in both the groups (n = 286; mean difference (MD) -0.20; 95 % CI: -1.03 to 0.63). The G6PD 1388 G>A, SLCO1B1 rs4149056 and BLVRA rs699512 SNPs had a significant impact on STB levels. 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. These researchers systematically evaluated the safety and efficacy of probiotics supplement therapy for pathological neonatal jaundice. /* aetna.com standards styles for templates */ Published March 24, 2016 (updated June 1 2, 2018). More commonly seen in the documentation are: Without a diagnosis, abnormal results of routine screenings should not be coded unless the pediatrician states the abnormal results have implications for future healthcare. } This indicated that cure may have been achieved in a minority of patients. These researchers identified studies through Medline searches, perusing reference lists and by consulting with United States Preventive Services Task Force(USPSTF) lead experts. Results were summarized as per GRADE guidelines. The receiver operating characteristic analysis (for serum bilirubin levels greater than 205.2 micromol/L or greater than 239.4 micromol/L) showed significantly higher areas under the curve for BiliCheck than those for BiliMed (p < 0.001). 2014;134(3):510-515. At the well-baby check, report K42.9 Umbilical hernia without obstruction or gangrene if the condition is addressed (not merely noted in the documentation). Exchange transfusion should be performed in a neonatal intensive care unit (NICU) due to significant risks. All searches were re-run on April 2, 2012. Sacral dimples without diagnostic services, such as diagnostic imaging, are not coded on inpatient records. 2008;93(2):F135-F139. 1992;89:821-822. Secondary outcomes included incidence of jaundice, TSB level at 24, 48, 72, 96hours, and day 7, duration of hospital stay, and adverse effects (e.g., probiotic sepsis). Everything I am finding indicates this code is used for dermatological treatment not for jaundice. .newText { Initial hospital or birthing center care, per day, for E/M of normal newborn infant, Initial care per day, for E/M of normal newborn infant seen in other than hospital or birthing center, Initial hospital or birthing center care, per day, for E/M of normal newborn infant admitted and discharged on the same date, Circumsion, using clamp or other device with regional dorsal penile or ring block, Circumsion, as above, without dorsal penile or ring block, Circumsion, surgical excision, other than clamp, device, or dorsal slit, neonate (28 days of age or less), Circumsion, surgical excision, other than clamp, device, or dorsal slit, neonate, old then 28 days of age. 2002;65(4):599-606. With the common genotype as reference, the odds ratio of extreme hyperbilirubinemia was 0.87 (range of 0.68 to 1.13) for UGT1A1*28 heterozygotes and 0.77 (range of 0.46 to 1.27) for homozygotes. These ELBW infants had participated in a randomized controlled trial of early DXM therapy thataimed toevaluate effects on chronic lung disease. The pediatrician notes the abnormal results have implications for future healthcare. 6. Subsequent hospital care of infants who are not critically ill or injured as defined in CPT but who had a very low birth weight and continue to require intensive care services as described for code 99477 above may be reported with codes 99478-99480. Chen Z, Zhang L, Zeng L, et al. 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. The literature search was done for various RCTs by searching the Cochrane Library, PubMed, and Embase. The authors concluded that there is a compelling need for the long-term follow-up and reporting of late outcomes, especially neurological and developmental outcomes, among surviving infants who participated in all randomized trials of early postnatal corticosteroid treatment. Incidence is as high as 30 percent in premature male neonates. Earn CEUs and the respect of your peers. Prediction of hyperbilirubinemia in near-term and term infants. Accessed July 16, 2002. 99460-99461 initial service 2. }. 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 Digital Store For tech Gadgets. Mothers typically are counseled on newborn jaundice signs and when to bring the newborn in. These investigators assessed the safety and efficacy of probiotics in reducing the need for phototherapy and its duration in NNH. Phototherapy is the use of visible light to treat severe jaundice in the neonatal period. A total of 259 neonates were included in the meta-analysis. Sharma D, Farahbakhsh N, Sharma P, Shastri S. Role of oral zinc supplementation for reduction of neonatal hyperbilirubinemia: A systematic review of current evidence. The total number of neonates enrolled in these different RCT were 749. Aetna considers the use of metalloporphyrins (e.g., stannsoporfin (tin mesoporphyrin), Stanate, WellSpring Pharmaceutical Corporation, Neptune, NJ) for the treatment of neonatal jaundice experimental and investigational because their safety and effectiveness for this indication has not been established. Tin-mesoporphyrin is not approved by the U.S. Food and Drug Administration. The genotype of Gilbert syndrome, the UGT1A1*28 allele, causes markedly reduced activity of this enzyme, but its association with neonatal hyperbilirubinemia is uncertain and its relationship with extreme hyperbilirubinemia has not been studied. } In 54 ELBW preterm infants, TSB and phototherapy (PT) data during the first 10 days were evaluated retrospectively. When no additional resources are used, this is not coded on the inpatient record, and is part of the pediatricians well-baby check. 2012;1:CD007966. Moreover, individuals carrying the A-allele of G6PD 1388 G>A and BLVRA rs699512 had a significantly increased risk of developing neonatal hyperbilirubinemia (OR=5.01, p< 0.001, 95 % CI: 3.42 to 7.85). Front Pharmacol. list-style-type: decimal; CETS 99-6 RE. A fetus blood is different than an adults. 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. The authors concluded that the role of zinc in the prevention of neonatal hyperbilirubinemia is not supported by the current evidence. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were used for reporting methods and results of synthesis with meta-analysis. Coding Guidelines 18, 19 The third trimester is the time of rapid weight gain, development of muscle mass and fat stores for the newborn. Overall, compared with placebo, zinc sulfate supplementation failed to significantly reduce TSB on 3 days (MD=0.09mg/dL; 95 % CI:-0.49 to 0.67; p=0.77), TSB on 7 days (MD=-0.37mg/dL; 95 % CI:-98 to 0.25; p=0.25) as well as the incidence of hyperbilirubinemia (OR=1.14; 95 % CI:0.74 to 1.76; p=0.56). @media print { However, only 1 trial (out of 2) reported significant reduction in bilirubin levels in preterm neonates. Garg BD, Kabra NS, Balasubramanian H. Role of massage therapy on reduction of neonatal hyperbilirubinemia in term and preterm neonates: A review of clinical trials. Aetna does not provide health care services and, therefore, cannot guarantee any results or outcomes. J Matern Fetal Neonatal Med. Other methods, such as enteral feeding supplementation with prebiotics, may have an effective use in the management of hyperbilirubinemia in neonates. Otherwise healthy newborn infants with hyperbilirubinemia without signs of hemolytic disease; gestational age 33 weeks; birth weight . All studies were found to be of low-risk based on Cochrane Collaborative Risk of Bias Tool. Digestive System Disorders. The authors concluded that limited low-quality evidence indicated that probiotic supplementation may reduce the duration of phototherapy in neonates with 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. So, it was hard for these investigators to determine whether the allocation scheme was appropriate and whether blinding of participants and personnel was implemented. With the sleeve pinned to the t-shirt, the newborn has restricted arm movement, and the clavicle heals without intervention. Wennberg RP. 2008;358(9):920-928. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Jaundice in healthy term neonates: Do we need new action levels or new approaches? The correlation between TSB and TcB was found to be moderately close (r = 0.4 to 0.5). Use total bilirubin. Documentation should include approximate time spent face-to-face with the family and patient, notation of time spent in counseling, and context of counseling. Deshmukh J, Deshmukh M, Patole S. Probiotics for the management of neonatal hyperbilirubinemia: A systematic review of randomized controlled trials. Fractured clavicles are usually noted by the pediatrician on the newborn evaluation, but do not meet the definition of clinical significance. Arch Dis Child Fetal Neonatal Ed. Maisels MJ, Kring E. Length of stay, jaundice, and hospital readmission. 4th ed. J Pediatr Gastroenterol Nutr. These researchers stated that healthcare organizations and health workers should choose intermittent phototherapy as the preferred therapy for neonatal hyperbilirubinemia. Pediatrics. Casnocha Lucanova L, Matasova K, Zibolen M, Krcho P. Accuracy of transcutaneous bilirubin measurement in newborns after phototherapy. Merenstein GB. Neonatal hyperbilirubinemia: An evidence-based approach. Cochrane Database Syst Rev. cpt code for phototherapy of newbornhippo attacks human video. Discharge normal newborn day 3 _____ 2. Evaluation of unconjugated hyperbilirubinemia in term and late preterm infants. Pediatrics. These researchers evaluated the role of massage therapy for reduction of NNH in both term and preterm neonates. Do not percuss over the backbone, breastbone, or lower two ribs. There was a significantly lower duration of phototherapy in the clofibrate group compared to the control group for both preterm and term neonates with a weighted mean difference of -23.82 hours (95 % CI: -30.46 hours to -17.18 hours) and -25.40 hours (95 % CI: -28.94 hours to -21.86 hours), respectively. Thomas JT, Muller P, Wilkinson C. Antenatal phenobarbital for reducing neonatal jaundice after red cell isoimmunization. 2003;88(6):F459-F463. Aggressive vs. conservative phototherapy for infants with extremely low birth weight. Normal newborn care services are reported with these codes: 99460 Initial hospital or birthing center care, per day, for E/M of normal newborn infant 99462 Subsequent hospital care, per day, for E/M of normal newborn The Coding for Pediatrics manual defines a normal newborn as the following: Transitions to life in the usual manner. cpt code for phototherapy of newborn - ccecortland.org Percussion should not cause red marks on your child. In a prospective double-blind study, De Lucaet al (2008) compared the accuracy of a new transcutaneous bilirubinometer, BiliMed (Medick SA, Paris, France) with BiliCheck (Respironics, Marietta, GA), a widely available instrument, and with total serum bilirubin (TSB) measurement. Pediatrics. RM Kliegman, BF Stanton, JW St. Geme, et al., eds. 2017:1-10. 99238-99239 _____ 99463 Normal Newborn evaluated & discharged same day 9 Normal Newborn Care 99460 Initial hospital or birthing center care- normal newborn Risk of bias was assessed using the QUADAS-2 tool. If the fractured clavicle does not use additional resources during the hospitalization (a safety pin is not additional resources), do not code the condition on the hospital encounter.