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Report an inclusive screening finding (R94.120 Abnormal auditory function study) in the professional record so the newborn can be retested at the well-baby checks. Nelson Textbook of Pediatrics. All the studies used zinc sulfate, only 1 study used zinc gluconate. FN07-02. Two studies also provided results as Bland-Altman difference plots (mean TcB-TSB differences -29.2 and 30 mol/L, respectively). OL OL OL LI { Unless there are issues, congenital hydroceles also are not coded on the well-baby checks. With time, the lacrimal ducts mature and the membrane covering the nasolacrimal ducts open. 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. 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. (Codes may be selected based on time spent in counseling and coordination of care when documentation indicates more than 50% of face-to-face time was spent in these activities.) Nagar and associates (2016) noted that TcB devices are commonly used for screening of hyperbilirubinemia in term and near-term infants not exposed to phototherapy. If the lining closes and the fluid has nowhere to go, its a noncommunicating hydrocele. Pediatrics. The USPSTF reviewed experimental and observational studies that included comparison groups. Moreover, these investigators stated that infants with bilirubin levels greater than 25 mg/dL, those who are not responding to phototherapy, and those with evidence of acute bilirubin encephalopathy should be treated with exchange transfusion, with initiation based on an infants age in hours and neurotoxicity risk factors. The authors concluded that phototherapy significantly interfered with the accuracy of transcutaneous bilirubinometry; TcB measurements performed 2 hours after stopping phototherapy were not reliable, even if they were performed on the unexposed body area. Bilirubin recommendations present problems: New guidelines simplistic and untested. They considered all RCTs that studied neonates comparing enteral feeding supplementation with prebiotics versus distilled water/placebo or no supplementation. 2005;25(5):325-330. In particular, polymorphisms across 3 genes involved in bilirubin production and metabolism: Variant gene co-expression including compound and synergistic heterozygosity enhances hyperbilirubinemia risk, contributing to the etiologic heterogeneity and complex nature of neonatal jaundice. 1992;31(6):345-352. 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. color: red!important; You must log in or register to reply here. They performed a systematic review of RCTs of probiotic supplementation for prevention or treatment of jaundice in neonates (any gestation or weight) using the Cochrane methodology. 2019;32(10):1575-1585. 7. 2013;89(5):434-443. Studies were analyzed for methodological quality in a "Risk of bias" table. When no additional resources are used, this is not coded on the inpatient record, and is part of the pediatricians well-baby check. Pediatrics. 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. The China National Knowledge Infrastructure and MEDLINE databases were searched. A randomized, triple-blind, placebo-controlled trial of prophylactic oral phenobarbital to reduce the need for phototherapy in G6PD-deficient neonates. The rate of neurodevelopmental impairment alone was significantly reduced with aggressive phototherapy. 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. Analysis was performed on an intention-to-treat basis. Although declining the inpatient prophylactic services is not reportable by inpatient hospital coders (because it does not affect the hospitalization), outpatient physician office coders can and should use Z28 Immunization not carried out and under immunization status codes when provider-recommended immunizations are not administered. 16th ed. J Paediatr Child Health. The pediatrician will wait watchfully and check the clavicle until its healed. Risk of bias was assessed using the QUADAS-2 tool. For a better experience, please enable JavaScript in your browser before proceeding. However, the accuracy of TcB devices in infants exposed to phototherapy is unclear. Savinetti-Rose B, Kempfer-Kline RE, Mabry CM. In a Cochrane review, these investigators examined if administration of prebiotics reduces the incidence of hyperbilirubinemia among term and pre-term infants compared with enteral supplementation of milk with distilled water/placebo or no supplementation. Incidences of side effects like vomiting (n = 286; RR 0.65, 95 % CI: 0.19 to 2.25), diarrhea (n = 286; RR 2.92, 95 % CI: 0.31 to 27.71), and rash (n = 286; RR 2.92, 95 % CI: 0.12 to 71.03) were found to be rare and statistically comparable between groups. 1992;89:823-824. Reference No. Reference Number: CP.MP.150 Coding Implications Date of Last Revision: 10/22 Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. On the pediatricians encounter, code P13.4 Fracture of clavicle due to birth injury because it involved medical decision-making. Pediatrics. This indicated that cure may have been achieved in a minority of patients. herman's coleslaw recipe. Sometimes, fluid builds up inside the lining, causing a hydrocele. 2014;134(3):510-515. Morris and colleagues (2008) compared aggressive versus conservative phototherapy for infants with extremely low birth weight. 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). Some studies showed that unclear random allocation and allocation plan might exaggerate the hidden effect of up to 30 to 41 %. So why would you not use one of the codes from 99221-99223 for the first day? Maisels MJ, Watchko JF. Code 99477 represents initial hospital care of the neonate (28 days or younger) who is not critically ill but requires intensive observation, frequent interventions, and other intensive care services. list-style-type: lower-roman; Some watchful waiting issues require continued outpatient evaluation until resolution. Chawla D, Parmar V. Phenobarbitone for prevention and treatment of unconjugated hyperbilirubinemia in preterm neonates: A systematic review and meta-analysis. Trikalinos TA, Chung M, Lau J, Ip S. Systematic review of screening for bilirubin encephalopathy in neonates. Do I Use 25 or 59 for Same-day Assessment and E/M? Evaluation of unconjugated hyperbilirubinemia in term and late preterm infants. Sharma D, Farahbakhsh N, Sharma P, Shastri S. Role of oral zinc supplementation for reduction of neonatal hyperbilirubinemia: A systematic review of current evidence. US Preventive Services Task Force; Agency for Healthcare Research and Quality. This generally refers to an undescended or maldescended testis. Guidelines from the American Academy of Pediatrics (AAP, 2004)on management of hyperbilirubinemia in thenewborn infantstate that "Measurement of the glucose-6-phosphate dehydrogenase (G6PD) level is recommended for a jaundiced infant who is receiving phototherapy and whose family history or ethnic or geographic origin suggest the likelihood of G6PD deficiency or for an infant in whom the response to phototherapy is poor(evidence quality C: benefits exceed harms)". Wong RJ, Bhutani VK. Guidelines for detection, management and prevention of hyperbilirubinemia in term and late preterm newborn infants (35 or more weeks gestation). In utero, the fetus requires larger amounts of hemoglobin for oxygenation. The following are general age-in-hours specificTSBthreshold values forexchange transfusionbased upon gestational age and the presence or absence of risk factors (isoimmune hemolytic disease, glucose-6-phosphate dehydrogenase [G6PD] deficiency, asphyxia, significant lethargy, temperature instability, sepsis, acidosis, or albumin ofless than 3.0 g/dL [if measured]): Footnotes* Low Risk: 38 weeks gestation and without risk factors; Medium Risk: 38 weeks gestation with risk factors or 35 to 37 6/7 weeks gestation without risk factors; High Risk: 35 to 37 6/7 weeks gestation with risk factors. Aetna considersphototherapy medically necessary forterm andnear-term infantsaccording to guidelines published by the American Academy of Pediatrics (AAP). In a systematic review and meta-analysis, Chu and colleagues (2021) examined if intermittent phototherapy is more effective than continuous phototherapy in the treatment of neonatal hyperbilirubinemia. Percussion should not cause red marks on your child. Otherwise, at 3 to 4 years of age, the hernia will be surgically repaired. After the newborn begins to breath on his own, the fetal blood is destroyed and replaced with blood that works with lungs. Watchko JF, Lin Z. Data were statistically extracted and evaluated using RevMan 5.3 software. 1986;25(6):291-294. 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. A systematic evidence review prepared for the Cochrane Collaboration (Suresh et al, 2003) concluded that, based upon limitations of the evidence, "[r]outine treatment of neonatal unconjugated hyperbilirubinemia with a metalloporphyrin cannot be recommended at present.". J Matern Fetal Neonatal Med. Metalloporphyrins in the management of neonatal hyperbilirubinemia. 1992;89:821-822. Chu L, Qiao J, Xu C, et al. Sharma and colleagues (2017) examined the role of oral zinc supplementation for reduction of neonatal hyperbilirubinemia in term and preterm infants. Pediatrics. The increased bilirubin from hemolysis often needs phototherapy, exchange transfusion or both after birth. Approximately 10 to 20 percent of newborns have an umbilical hernia. Serum and transcutaneous bilirubin (TcB) measurements were taken with both devices within 15 mins. Pediatrics. UpToDate [online serial]. Aggressive phototherapy, as compared with conservative phototherapy, significantly reduced the mean peak serum bilirubin level (7.0 versus 9.8 mg/dL [120 versus 168 micromol/L], p < 0.01) but not the rate of the primary outcome (52 % versus 55 %; relative risk, 0.94; 95 % confidence interval [CI]: 0.87 to 1.02; p = 0.15). I have a provider that ordered phototherapy for a newborn in the hospital with jaundice and he is wanting to bill 96900. Malpresentations are almost always noted on the inpatient record. Usually, procedures coded: Low-cost, low-risk screening and prevention procedures usually are not coded. All studies were found to be of low-risk based on Cochrane Collaborative Risk of Bias Tool. 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. These investigators also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for RCTs and quasi-randomized trials. MMWR Morb Mortal Wkly Rep. 2001;50(23):491-494. BMJ Open. Evaluation and treatment of jaundice in the term infant: A kinder, gentler approach. Valaes T. Problems with prediction of neonatal hyperbilirubinemia. /*margin-bottom: 43px;*/ Probiotics supplementation treatment showed efficacy [RR: 1.19, 95 % CI: 1.12 to 1.26), p < 0.00001] in neonatal jaundice. For preterm neonates, there was a significantly lower bilirubin level in the 100 mg/kg clofibrate group compared to the control group with a mean difference of -1.37 mg/dL (95 % CI: -2.19 mg/dL to -0.55 mg/dL) (-23 mol/L; 95 % CI: -36 mol/L to -9 mol/L) after 48 hours. JavaScript is disabled. Thomas JT, Muller P, Wilkinson C. Antenatal phenobarbital for reducing neonatal jaundice after red cell isoimmunization. In: Nelson Textbook of Pediatrics. The single nucleotide polymorphisms (SNPs) of G6PD 1388 G>A, SLCO1B1 rs4149056 and BLVRA rs699512 loci were examined by the polymerase chain reaction (PCR) and Sanger sequencing technique in the peripheral blood of all subjects. The authors concluded that the use of antenatal phenobarbital to reduce neonatal jaundice in red cell isoimmunized pregnant women has not been evaluated in randomized controlled trials. Pediatrics. on Watchful Waiting:Collecting Newborn Information, Watchful Waiting:Collecting Newborn Information, Tech & Innovation in Healthcare eNewsletter, Capture Active Duty Diagnoses with DoD Unique Codes, Finally Tobacco Use That Isn't a Mental Health Issue, Know Your Payer to Make the Most of Modifier 24, Modifier 25 for E/M on the Day of an Injection Procedure. 92558 Evoked otoacoustic emissions, screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis. When the visit is in follow-up to an identified problem such as jaundice, infrequent stools, or infrequent feedings, and the physician, nurse practitioner, or physician assistant provides the service, an office visit (e.g., 99212-99215) and problem specific diagnosis codes should be reported. Pediatrics. However, the results remain controversial. } Hospitals typically decide the data provided by 3E0CX2 is not coded because it takes time to collect, clutters the rest of the data, and does not provide information to improve patient care or efficiency. Watchko and Lin (2010) noted that the potential for genetic variation to modulate neonatal hyperbilirubinemia risk is increasingly being recognized. Cincinnati Childrens, umbilical hernia: www.cincinnatichildrens.org/health/u/umbilical-herni, Copyright 2023, AAPC Because it is a screening (not diagnostic), the test does not meet the definition of a diagnostic procedure or therapeutic treatment for a clinically significant condition. Description All 3 review authors independently assessed study eligibility and quality. Learn how we are healing patients through science & compassion, Stanford team stimulates neurons to induce particular perceptions in mice's minds, Students from far and near begin medical studies at Stanford. Arch Dis Child Fetal Neonatal Ed. The pediatrician will spend time evaluating the condition, and at some point, a code in the Q53 Undescended and ectopic testicle range will be used. Also, no association was found for AB0 incompatible cases. 2002;3(1). Eye issues due to immaturity or from the ointment applied to the newborns eyes. Prophylactic phototherapy for preventing jaundice in preterm or low birth weight infants. Yang L, Wu, Wang B, et al. 66850 Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration. The authors concluded that current studies are unable to provide reliable evidence regarding the effectiveness of prebiotics on hyperbilirubinemia. Exchange transfusion involves taking small aliquots of blood from the infant and replacing them with donor red cells until the infants blood volume has been replaced twice to remove bilirubin and antibodies that may be causing hemolysis. Semin Fetal Neonatal Med. Liu et al (2013) examined if 3 variants (388 G>A, 521 T>C, and 463 C>A) of SLCO1B1 are associated with neonatal hyperbilirubinemia. Starting Feb. 1, 2022, five new CPT codes will require preauthorization. Newman TB, Maisels MJ. Screening of infants for hyperbilirubinemia to prevent chronic bilirubin encephalopathy: US Preventive Services Task Force recommendation statement. This Clinical Policy Bulletin may be updated and therefore is subject to change. Sacral dimples without diagnostic services, such as diagnostic imaging, are not coded on inpatient records. OL OL OL OL OL LI { These investigators searched CENTRAL (The Cochrane Library 2014, Issue 1), MEDLINE (1966 to November 30, 2014), and EMBASE (1990 to November 30, 2014). Meta-analysis (random-effects model) showed probiotic supplementation reduced duration of phototherapy [n=415, MD: -11.80 (-17.47 to -6.13); p<0.0001; level of evidence (LOE): low]; TSB was significantly reduced at 96hours [MD: -1.74 (-2.92 to -0.57); p=0.004] and 7 days [MD: -1.71 (-2.25 to -1.17); p<0.00001; LOE: low] after probiotic treatment. Single versus double volume exchange transfusion in jaundiced newborn infants. Compared with hospital-based phototherapy, home-based phototherapy appeared more effective for the treatment of neonatal hyperbilirubinemia in reducing the rate of total serum bilirubin (standard mean difference [SMD] = 0.32, 95 % CI: -0.22 to 0.86, p = 0.04); however, there was no signicant difference in duration of phototherapy (SMD = 0.59, 95 % CI: 0.28 to 0.90, p = 0.06) in the 2 groups. Take your newborn's temperature every 3 to 4 hours. Accessed July 16, 2002. Attempt to improve transcutaneous bilirubinometry: A double-blind study of Medick BiliMed versus Respironics BiliCheck. The authors concluded that this meta-analysis showed that probiotics supplementation therapy was an effective and safe treatment for pathological neonatal jaundice. An example is hemangiomas (e.g., strawberry hemangiomas), which do not impinge on vital structures and are not located in the periorbital area, lip, neck, or sacral region. Involve significant costs (e.g., use of the operating room, more expensive diagnostic imaging types, such as computed tomography and magnetic resonance imaging); Are risky (e.g., bedside spinal taps, epidural/regional/general anesthesia); Milia (including Bohn nodules on the gum and Epstein pearls on the palate). CETS 99-6 RE. The efficacy of intravenous fluid supplementation for neonatal hyperbilirubinemia: A meta-analysis of randomized controlled studies. A fetus blood is different than an adults. Okwundu CI, Okoromah CA, Shah PS. 2018;31(10):1311-1317. Aetna considers zinc supplementation for the prevention of hyperbilirubinaemia experimental and investigational because its effectiveness has not been established. Pediatrics. Suresh GK, Martin CL, Soll RF. .strikeThrough { In 54 ELBW preterm infants, TSB and phototherapy (PT) data during the first 10 days were evaluated retrospectively. text-decoration: underline; Management of neonatal hyperbilirubinemia. 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. The ointment is administered by the hospital staff, so there is no professional component to the service. Mean TSB (120 +/-19 mol/L versus 123 +/- 28 mol/L, DXM versus placebo, respectively) and maximum TSB (178 +/- 23 mol/L versus 176 +/- 48, DXM versus placebo, respectively) concentrations were similar. The correlation coefficient improved marginally in the post-phototherapy phase (r = 0.72, 95 % CI: 0.64 to 0.78, 4 studies). } There were no probiotic-related adverse effects. Do not code this condition for the newborn inpatient encounter, unless additional resources are used. 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. Available at: http://www.emedicine.com/med/topic1065.htm. In a Cochrane review, Mishra and colleagues (2015) examined the effect of oral zinc supplementation compared to placebo or no treatment on the incidence of hyperbilirubinaemia in neonates during the first week of life and to evaluate the safety of oral zinc in enrolled neonates. Conseil de valuation des Technologies de la Sant du Qubec (CETS). It has been debated if there is an upper limit on the efficiency of phototherapy. Hospital readmission due to neonatal hyperbilirubinemia. 5 star restaurants st louis. Montreal, QC: CETS; October 2000. 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. After maintenance phototherapy was discontinued, 7 patients (23% ) had a sustained disease-free interval lasting more than 58 months (median of greater than 90 months). All but 1 of the included studies were conducted in Iran. No association was found between the UGT1A1*28 allele and extreme hyperbilirubinemia. Porter ML, Dennis BL. color: blue 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). Procedures included in the services represented by code 99477 include those listed for the Critical Care Services subsection of CPT (codes 99291 and 99292), as well as additional procedures listed in the Inpatient Neonatal and Pediatric Critical Care subsection (codes 99468-99476, 99466-99467). Morris BH, Oh W, Tyson JE, et al; NICHD Neonatal Research Network. Torres-Torres M, Tayaba R, Weintraub A, et al. Some infants may require intensive care services but do not meet the CPT definition of critically ill or injured required for reporting of critical care services. phototherapy in the home, applied by a . list-style-type: upper-roman; 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. Aggressive vs. conservative phototherapy for infants with extremely low birth weight. 1990;10(4):435-438. Maisels MJ, Kring E. Length of stay, jaundice, and hospital readmission. Per the ICD-10-PCS Official Guidelines for Coding and Reporting, only clinically significant conditions are reported. This is not the same as for professional services coding, where the first-listed diagnosis is the reason for the encounter. In that case, other conditions can be coded if they were involved in medical decision-making, or otherwise affected the episode of care. www.stanfordchildrens.org/en/topic/default?id=developmental-dysplasia-of-the-hip-ddh-90-P02755 hip dysplasia Approximately one in 1,000 children have congenital developmental dysplasia of the hip, which is coded Q65.89 Other specified congenital deformities of hip. 2008;359(18):1885-1896. Use a cupped hand or percussor cup. For more information about congenital hydrocele, visit: www.webmd.com/parenting/baby/tc/congenital-hydrocele-topic-overview#1. 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. Since then, many hundred thousand infants have been treated with light. These researchers stated that healthcare organizations and health workers should choose intermittent phototherapy as the preferred therapy for neonatal hyperbilirubinemia. The authors concluded that the UGT1A1*28 allele was not associated with risk for extreme hyperbilirubinemia in this study. Analysis of rebound and indications for discontinuing phototherapy. 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. www.hayesinc.com. solute carrier organic anion transporter polypeptide 1B1 (SLCO1B1)] may interact with each other and/or environmental contributors to produce significant hyperbilirubinemia. The authors concluded that limited low-quality evidence indicated that probiotic supplementation may reduce the duration of phototherapy in neonates with jaundice. Phototherapy should be instituted when the total serum bilirubin level is at or above 15 mg per dL (257 mol per L) in infants 25 to 48 hours old, 18 mg per dL (308 mol per L) in infants 49 to 72 . The fetal blood is designed to attract oxygen from the mothers blood. Bhutani VK, Stark AR, Lazzeroni LC, et al; Initial Clinical Testing Evaluation and Risk Assessment for Universal Screening for Hyperbilirubinemia Study Group. 2007;44(3):354-358. Home phototherapy with the fiberoptic blanket. A total of 5 RCTs involving 645 patients were included in the meta-analysis. Aetna considers measurement of glucose-6-phosphate dehydrogenase (G6PD) levelsmedically necessary for jaundiced infants who are receiving phototherapy, where response to phototherapy is poor, or where the infant is at an increased risk of G6PD deficiency due to family history, ethnic or geographic origin. Early (< 8 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants. Usually, hip clicks involve watchful waiting, with the tendons and muscles continuing to develop until the click is no longer felt. Associations between G6PD, OATP1B1 and BLVRA variants and susceptibility to neonatal hyperbilirubinaemia in a Chinese Han population. Revision Log See Important Reminder . The authors concluded that zinc sulfate could not reduce the TSB on 3 days and 7 days, the incidence of hyperbilirubinemia and phototherapy requirement, but resulted in significantly decreased duration of phototherapy. Several risk factors for hyperbilirubinemia are known, but in a large number of patients, a causal factor is never established. The longer the newborn has before an auditory function screening, the greater the chance of a successful screening. However, the methodological quality of the studies determining long-term outcomes is limited in some cases; the surviving children have been assessed predominantly before school age, and no study has been sufficiently powered to detect important adverse long-term neurosensory outcomes. Normal Newborn visit, initial service 1. There are 4 chief Current Procedural Terminology (CPT) codes for reporting phototherapy services: (1) 96900: actinotherapy (UV light treatment); (2) 96910: photochemotherapy, tar, and UVB (Goeckerman treatment) or petrolatum and UVB; (3) 96912: photochemotherapy and PUVA; and (4) 96913: photochemotherapy (Goeckerman and/or PUVA) for severe 2017:1-9. The linear regression analysis showed a better correlation between BiliCheck and serum bilirubin (r = 0.75) than between BiliMed and serum bilirubin (r = 0.45). These researchers performed a systematic review with meta-analysis including genetic studies, which assessed the association between neonatal hyperbilirubinemia and 388 G>A, 521 T>C, and 463 C>A variants of SLCO1B1 between January of 1980 and December of 2012. J Matern Fetal Neonatal Med. Home-based phototherapy versus hospital-based phototherapy for treatment of neonatal hyperbilirubinemia: A systematic review and meta-analysis. However, if significant time beyond that typical of the infant preventive service is spent in counseling, physicians may also report a problem-oriented service (99212-99215) with modifier -25 to indicate the significant and separately identifiable services provided on the same date. Although screening can predict hyperbilirubinemia, there is no robust evidence to suggest that screening is associated with favorable clinical outcomes. [glucose-6-phosphate dehydrogenase (G6PD), uridine diphosphate glucuronosyl transferase 1A1 (UGT1A1), and. Primary outcome was the duration of phototherapy. 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. Last Review04/29/2022. map of m6 motorway junctions. These investigators included trials where neonates with hyperbilirubinemia received either clofibrate in combination with phototherapy or phototherapy alone or placebo in combination with phototherapy.