(LDH Retracted) Clarification of Billing for Inpatient Hospital Neonatal Days (IB 25-8)

Date: 03/07/25

Louisiana Healthcare Connections is sharing Clarification of Billing for Inpatient Hospital Neonatal Days (IB 25-8) published on March 6, 2025.

Hospitals shall bill neonatal days in accordance with the Uniform Billing (UB) Editor defined levels of care (LOC) needed for each infant inpatient day with the corresponding revenue billing codes. These LOCs and revenue codes indicate the nursing care provided to newborn and premature infants in nursery accomodations. The below revenue codes range from a healthy newborn to neonatal intensive care and correlate to the intensity of medical care provided to an infant for each day of service and not the NICU facility certification level attested to by hospital:

0170 = General.
0171 = Newborn – UB Level I: Routine care of apparently normal full-term or pre-term neonates. (Newborn Nursery)
0172 = Newborn – UB Level II: Low birth-weight neonates who are not sick, but require frequent feeding, and neonates who require more hours of nursing than do normal neonates. (Continuing Care)
0173 = Newborn – UB Level III: Sick neonates, who do not require intensive care, but require 6-12 hours of nursing each day. (Intermediate Care)
0174 = Newborn – Level IV: Constant nursing and continuous cardiopulmonary and other support for severely ill infants. (Intensive Care)

Hospitals are expected to comply with the above instructions and under no circumstances should HR 0174 be billed for days during a stay that do not require or meet intensive LOC. Claims shall be reviewed by Louisiana Healthcare Connections or Gainwell Technologies and retrospective post payment audits will be performed, if deemed necessary.

Questions regarding this message and fee-for-service claims are to be directed to Gainwell Technologies at (800) 473-2783 or (225) 924-5040.

Providers with additional claim questions can contact Provider Services at (866) 595-8133.