Convulsions in a newborn case: which codes should be used?

Convulsions in a newborn case: which codes should be used?

• A. P91, 99212
• B. P89, 99213
• C. P90, 99213
• D. P90, 99223

Answer: (C)

Diagnosing a newborn with convulsions uses the specific perinatal code for that condition, paired with the appropriate outpatient evaluation-and-management visit code. The perinatal code for convulsions in a newborn is P90. Because this is an outpatient encounter, the CPT code that best fits the level of service is 99213, which indicates a moderate level of evaluation and management with enough history, examination, and decision making to address a newborn presenting with a problem like convulsions. Using a lower-level outpatient code would underestimate the work, and an inpatient code (99223) would apply only if the infant were admitted to the hospital. The other perinatal codes listed describe different conditions and would not accurately represent convulsions in the newborn.

Diagnosing a newborn with convulsions uses the specific perinatal code for that condition, paired with the appropriate outpatient evaluation-and-management visit code. The perinatal code for convulsions in a newborn is P90. Because this is an outpatient encounter, the CPT code that best fits the level of service is 99213, which indicates a moderate level of evaluation and management with enough history, examination, and decision making to address a newborn presenting with a problem like convulsions. Using a lower-level outpatient code would underestimate the work, and an inpatient code (99223) would apply only if the infant were admitted to the hospital. The other perinatal codes listed describe different conditions and would not accurately represent convulsions in the newborn.