Reimbursement Advisor

When is an infant no longer a newborn?

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Q We performed a circumcision in the office. Code 54150 is listed as “Circumcision with a clamp on a newborn,” while 54152 is simply “Circumcision with a clamp.” What is the definition of newborn?

A “Newborn” refers to a liveborn infant during the first 25 days, 23 hours, and 59 minutes of life (from the 1972 American College of Obstetricians and Gynecologists book Obstetric-Gynecologic Terminology, edited by Edward C. Hughes, MD). CPT uses this same definition.

Ms. Witt, former program manager in the Department of Coding and Nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant. Reimbursement Adviser reflects the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter, check with your individual payer.

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