Z00.110 denial

Recently had two claims for above code denied as already paid. One of the local hospital nursery (MD and NPs) have routinely billed NB admission as well as next day note (if 3 day stay) and Z00.110 code on discharge day. I’ve spoken to the Neonatal MD and she claims that the hospital has told them to bill this code. Perhaps they’ve received denials before, but mine have just started… Is there a ruling that prohibits them from doing this on the basis of “place of service” ??
Suggestions re how to handle w/ insurance companies?
Thanks in advance for your ideas/help…

We code Z00.110 with 99381 or 99391 and don’t receive any denials. However if you code it with E&M codes 99212-99215, it may deny. When you examine a well infant it is a well visit and therefore you would address all the components as per Bright Futures schedule for the 3-5 day visit. Hope that helps.

Thanks foryour reply;
I’m talking about an INSCO denying payment to my office because they had already paid the claim… Paod it to the hospital of birth of the baby and the peds team there. Place of service was the hospital nursery, where they have already billed the NB care ( Day 1 and 2) then submitting a bill for day of discharge as Z00.110… My billing is correct BUT my question is is there a regulation regarding where the 99391 (new patient) can be billed… Place of service offce or hospital nursery??
Thanks for having me clear this up

It seems that the hospital is in error for billing the codes 99381 or 99391. Preventive medicine codes are not billed in the inpatient setting.
Please see https://www.aapc.com/discuss/threads/99381-not-covered-in-hospital-setting.123359/
Codes for newborn care in hospital settings are at this link. https://www.aafp.org/family-physician/practice-and-career/getting-paid/coding/newborn-care-services.html
Ask the hospital to do a corrected claim. Once their claim is voided then you can ask your claim to be adjusted.

Thanks… will read referred to articles tonight…
I appreciate your help and will post reply from INSCO when and if I get one!