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Error JV
Medium UrgencyNICU Re-admission Billing Rule
For a NICU re-admission after 48 hours, you must bill a 'second day' fee, not a subsequent day fee.
Official Description: When a patient is admitted to NICU after 48 hours, second day rates will apply again (01521, 01522, 01523).
How to Fix It
Follow these steps in order to resolve the error.
- Review the patient's hospital chart to confirm the exact date and time of the initial NICU discharge and the subsequent re-admission.
- Calculate the time elapsed between the discharge and re-admission. Determine if it is more than 48 hours.
- If more than 48 hours passed, the service date for the re-admission must be billed with a 'second day' NICU fee item (01521, 01522, or 01523), depending on the level of care.
- Correct the fee item on the rejected claim. Replace the 'subsequent day' fee item with the appropriate 'second day' fee item.
- Resubmit the corrected claim to Teleplan.
- If you believe the claim was submitted correctly or this rule does not apply, contact the Teleplan Data Centre (604-683-7151) for further clarification.