Wrong code family for the day
Critical care billed on a day the infant met intensive-care criteria, or the reverse. We review status and weight documentation for every day billed.
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Neonatology medical billing services
Neonatology billing is dominated by per-day critical and intensive care codes that depend on the infant's weight and condition, with strict rules on who bills what on the day of birth and transfer. It is high-value, high-scrutiny billing where one wrong code family costs thousands.
What makes neonatology billing different
General billers treat every specialty the same. These are the rules, code families and payer habits that decide whether neonatology claims pay the first time.
- Neonatal critical care (99468–99469) and intensive care (99477–99480) are daily global codes selected by the infant's status and, for intensive care, present body weight.
- Delivery attendance (99464) and newborn resuscitation (99465) have specific documentation requirements and cannot be billed together.
- The day of birth, transfers between facilities and the transition from critical to intensive to normal newborn care each change which code family applies.
- Only one provider may bill the daily global code; co-managing physicians need to coordinate or claims are denied as duplicates.
Denials we see most in neonatology
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
Duplicate daily codes
Two providers billing the same global day. We coordinate with the hospitalist and transferring teams before submission.
Resuscitation and attendance conflicts
99464 and 99465 billed together, or without the required documentation. We apply the right one with the supporting note.
How Core MB bills for neonatology
A dedicated team that already knows your payers' rules, plus the reporting to prove it is working. Credentialing for new neonatology providers runs in the same system, tracked live in your client portal.
- Daily status and weight review against the code family billed, every day of the stay.
- Coordination across admitting, co-managing and transferring providers to prevent duplicate claims.
- Appeals built on the clinical record for critical and intensive care denials.
Everything in the service
The full revenue cycle as standard for neonatology practices, priced on what we collect for you. Take all of it, or start with one piece such as AR recovery or credentialing.
- Insurance verification and eligibility checks
- Charge entry and specialty-specific coding review
- Claim scrubbing and electronic submission
- Payer follow-up on every open claim
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable recovery
- Patient statements and balance support
- Monthly reporting you can read in five minutes
- Provider credentialing and payer enrollment
Neonatology billing questions
How are neonatal critical care days billed?
With daily global codes chosen by the infant's status on that day — critical, intensive or normal newborn — and for intensive care, by weight band. We verify the criteria for every day billed.
Who can bill on the day of birth?
It depends on what was done: delivery attendance, resuscitation and initial critical or newborn care each have rules. We make sure one provider bills each service correctly.
Do you handle NICU billing for hospital-employed groups?
Yes. We bill professional services for neonatology groups, coordinating with the facility's billing so professional and facility claims align.
How do we get started with Core MB for neonatology billing?
Send us your specialty, provider count and monthly claim volume through the quote form and we will come back with a written proposal. Transitions run alongside your current billing so nothing is dropped, and credentialing for new neonatology providers can start at the same time.
Find out what your neonatology billing is leaving on the table
Send us a snapshot of your current billing and we will come back with a quote and a realistic view of recoverable revenue.