Until the lacrimal ducts drain spontaneously, the pediatrician can show the parents a massage technique to use between the bridge of the nose and the inside corner of the affected eye. 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. Sometimes issues heal without interventions, such as minor hematomas from the birth process and laceration from the fetal monitoring electrode. The impact of SLCO1B1 genetic polymorphisms on neonatal hyperbilirubinemia: A systematic review with meta-analysis. } If separately documented in the mother's chart, you may report these services in addition to the services provided to the infant. Neonatal Hyperbilirubinemia - Medical Clinical Policy Bulletins | Aetna Two reviewers screened papers and extracted data from selected papers. Semin Fetal Neonatal Med. Last Review FN07-02. Although the duration of phototherapy in the zinc group was significantly shorter compared to the placebo group (n = 286; MD -12.80, 95 % CI: -16.93 to -8.67), the incidence of need for phototherapy was comparable across both the groups (n = 286; RR 1.20; 95 % CI: 0.66 to 2.18). Sharma D, Farahbakhsh N, Sharma P, Shastri S. Role of oral zinc supplementation for reduction of neonatal hyperbilirubinemia: A systematic review of current evidence. The primary outcome was a composite of death or neurodevelopmental impairment determined for 91 % of the infants by investigators who were unaware of the treatment assignments. Databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Database (Wan Fang), Chinese Biomedical Literature Database (CBM), VIP Database for Chinese Technical Periodicals (VIP) were searched and the deadline was December 2016; RCTs of probiotics supplementation for pathological neonatal jaundice in publications were extracted by 2 reviewers. #closethis { These investigators reviewed the current literature to examine if home-based phototherapy is more effective than hospital-based phototherapy for the treatment of neonatal hyperbilirubinemia. 2008;359(18):1885-1896. The smallest but significant difference between TSB and TcB was found on the lower abdomen. It is an option to provide conventional phototherapy in hospital or at home at TSB levels 2 - 3 mg/dL below those shown, but home phototherapy should not be used in any infant with risk factors. Zhang M , Tang J, He Y, et al. The authors concluded that the limited evidence available has not shown that oral zinc supplementation given to infants up to 1 week old reduces the incidence of hyperbilirubinaemia or need for phototherapy. The fetal blood is designed to attract oxygen from the mothers blood. Clinical Information. They stated that a Cochrane review of clofibrate (2012) and metalloporphyrins (2003) found that when added to phototherapy, these medications significantly decreased serum bilirubin levels and duration of phototherapy. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Chawla D, Parmar V. Phenobarbitone for prevention and treatment of unconjugated hyperbilirubinemia in preterm neonates: A systematic review and meta-analysis. .strikeThrough { The meta-analyses of 2 studies demonstrated a significant reduction in the length of hospital stay (MD -10.57 days, 95 % CI: -17.81 to -3.33; 2 studies, 78 infants; I = 0 %, p = 0.004; low-quality evidence). These researchers identified studies through Medline searches, perusing reference lists and by consulting with United States Preventive Services Task Force(USPSTF) lead experts. Arch Dis Child Fetal Neonatal Ed. Aggressive phototherapy did reduce rates of neurodevelopmental impairment (26 %, versus 30 %for conservative phototherapy; relative risk, 0.86; 95 % CI: 0.74 to 0.99). 4th ed. 2023 ICD-10-PCS Procedure Code 6A600ZZ: Phototherapy of Skin, Single Do not report Q10.3 Q10.6 or any of the H04 Disorders of lacrimal system for immaturity of the lacrimal ducts. The authors concluded that home-based phototherapy was more effective than hospital-based phototherapy in treatment for neonatal hyperbilirubinemia; home-based phototherapy was an effective, feasible, safe, and alternative to hospital-based phototherapy for neonatal hyperbilirubinemia. Everything I am finding indicates this code is used for dermatological treatment not for jaundice. Copyright Aetna Inc. All rights reserved. J Adv Nurs. Pediatrics. 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. Code 99391 may be reported with diagnosis code Z00.129 (encounter for routine child health examination without abnormal findings) for this service. The Cochrane tool was applied to assessing the risk of bias of the trials. A total of 15 studies (2 including preterm neonates and 13 including term neonates) were included in this review. Children | Free Full-Text | Evaluation of Intravenous Immunoglobulin Arch Dis Child Fetal Neonatal Ed. 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. 2017:1-10. CPT offers 3 coding options for initial encounter with ill newborn These ELBW infants had participated in a randomized controlled trial of early DXM therapy thataimed toevaluate effects on chronic lung disease. Hulzebos CV, Bos AF, Anttila E, et al. 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. Notes: Prophylactic phototherapy is considered medically necessary for infants showing a rapid rise in bilirubin (greater than 1 mg/dL/hour) and as a temporary measure when one is contemplating exchange transfusion. However, they stated that due to limitations of the trials, current evidence is in sufficient regarding the use of massage therapy for the management of NNH in routine practice. For most newborns, hematomas from the birth process resolve spontaneously. Aetna considers home phototherapy for physiologic jaundice in healthy infants with a gestational age of 35 weeks or more medically necessary if all of the following criteria are met: Note: If levels do not respond by stabilizing (+/- 1 mg/dL) or declining, more intensive phototherapy may be warranted. New perspectives on neonatal hyperbilirubinemia. Metalloporphyrins in the management of neonatal hyperbilirubinemia. Exploring the genetic architecture of neonatal hyperbilirubinemia. color: red 96.4. Normal Newborn visit, initial service 1. The main outcomes of the trials were analyzed by Review Manager 5.3 software. 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 are not additional resources. Blood testing done as a diagnostic test, however, meets the requirements for coding the jaundice. list-style-type: lower-alpha; Most of the included studies only mentioned the use of random allocation, but they did not describe the specific random allocation method. Two studies also provided results as Bland-Altman difference plots (mean TcB-TSB differences -29.2 and 30 mol/L, respectively). Management of neonatal hyperbilirubinemia. Porter ML, Dennis BL. PDF Pediatric Coding - AAPC OL LI { Halliday HL, Ehrenkranz RA, Doyle LW. Genotypes were obtained through the Danish Neonatal Screening Biobank. This document addresses the use of home phototherapy and the devices used for the treatment of neonatal jaundice that is physiologic (that is, non-pathologic) in nature. CPT CODE 96910, 96912, 96920 CPT/HCPCS Codes: 96910 Photochemotherapy; tar and ultraviolet B (Goeckerman treatment) or petrolatum and ultraviolet B . Li Y, Wu T, Chen L, Zhu Y. J Pediatr Gastroenterol Nutr. The drug was administered into the mouth of the infant by the plastic measure provided with the bottle or with a spoon. Data were extracted and analyzed independently by 2 review authors (MG and HM). Read more Therefore, its functional efficiency is important for your market reputation. 2007;(2):CD005541. Mt Sinai J Med. Toggle navigation. During an initial newborn evaluation, watchful waiting conditions are findings that usually resolve without medical intervention in a few weeks to a few years. Early (< 8 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants. Moreover, individuals carrying the A-allele of G6PD 1388 G>A and BLVRA rs699512 had a significantly increased risk of developing neonatal hyperbilirubinemia (OR=5.01, p< 0.001, 95 % CI: 3.42 to 7.85). Li and colleagues (2019) examined the associations between G6PD 1388 G>A, SLCO1B1 rs4149056 and BLVRA rs699512 variants and the risk of neonatal hyperbilirubinemia in a Chinese neonate population. TcB consistently under-estimated TSB levels significantly. When a baby is born, we all hope he or she can be coded with a 99431 (History and examination of the normal newborn infant, initiation of diagnostic and treatment programs and preparation of hospital records). Can Nurse. No studies met the inclusion criteria for this review. Phototherapy for Jaundice in Newborns - What You Need to Know - Drugs.com The extracted information of RCTs should include efficacy rate, serum total bilirubin level, time of jaundice fading, duration of phototherapy, duration of hospitalization, adverse reactions. 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. 1992;89:822-823. However, only 1 trial (out of 2) reported significant reduction in bilirubin levels in preterm neonates. Acta Paediatr. Hayes Directory. Primary outcome was the duration of phototherapy. The literature search was done for various randomized control trial (RCT) by searching the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Web of Science, Scopus, Index Copernicus, African Index Medicus (AIM), Thomson Reuters (ESCI), Chemical Abstracts Service (CAS) and other data base. Wennberg RP. .fixedHeaderWrap { www.hkjpaed.org/pdf/2007%3B12%3B93-95.pdf sacral dimple 2007;44(3):354-358. Second, according to Cochrane risk of bias estimation, randomized allocation of participants was mentioned in 9 trials. Hulzebosand associates(2011) examined the relationship between early postnatal dexamethasone (DXM) treatment and the severity of hyperbilirubinemia in extremely low birth weight (ELBW) preterm infants. Weisiger RA. Bilirubin recommendations present problems: New guidelines simplistic and untested. 2021;34(21):3580-3585. Support Lucile Packard Children's Hospital Stanford and child and maternal health, AAP Clinical Practice Guideline -- Full Version, Assessing Risk Based on Bilirubin Level -- "BiliTool", Infants who have not latched-on or nursed effectively for 12 hours, Infants supplemented more than once in 24 hours, Mothers with a history of breastfeeding failure, Antepartum mothers at risk of preterm delivery, AAP Clinical Practice Guideline - Summary. They included English-language publications evaluating the effects of screening for bilirubin encephalopathy using early TSB, TcB measurements, or risk scores. They used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 5), Medline via PubMed (1966 to June 14, 2018), Embase (1980 to June 14, 2018), and CINAHL (1982 to June 14, 2018). PDF CP.MP.150 Phototherapy for Neonatal Hyperbilirubinemia - Health Net Oregon .headerBar { Elk Grove Village, IL: AAP; 1997. 99238-99239 _____ 99463 Normal Newborn evaluated & discharged same day 9 Normal Newborn Care 99460 Initial hospital or birthing center care- normal newborn 2017:1-9. 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. Sacral dimples without diagnostic services, such as diagnostic imaging, are not coded on inpatient records. Subgroup analysis was done for AB0 incompatible cases. Coding Guidelines 18, 19 The third trimester is the time of rapid weight gain, development of muscle mass and fat stores for the newborn. For more information about blocked lacrimal ducts, visit: aao.org/eye-health/diseases/treatment-blocked-tear-duct. PDF Bilirubin Light - Phototherapy - Northwood Inc. If a nurse visit is provided (e.g., weight screen only), code 99211 may be reported. All but 1 of the included studies were conducted in Iran. Lets review which conditions should be reported and when. No statistical difference in the prevalence of UGTA1A1 gene variants was found between cases and controls (p = 1). 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). tradicne jedla na vychodnom slovensku . 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. Some watchful waiting conditions include: Some conditions happen more frequently in premature newborns such as cryptorchidism and umbilical hernias. 2009;124(4):1172-1177. The genotype of Gilbert syndrome, the UGT1A1*28 allele, causes markedly reduced activity of this enzyme, but its association with neonatal hyperbilirubinemia is uncertain and its relationship with extreme hyperbilirubinemia has not been studied. 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. When the observation of hip click does not lead to diagnostic testing (e.g., ultrasound), therapeutic treatment (e.g., parental training in the use of, and discharged with, a Pavlik harness), an inpatient specialty consult, neonatal intensive care, or a scheduled outpatient specialty consult, it is not coded by inpatient coders. 2011;100(2):170-174. Murki S, Dutta S, Narang A, et al. J Perinatol. Two hundred years ago, newborns would have been placed on blankets in the sun for newborn jaundice. Maisels MJ, McDonagh AF. Indian Pediatr. The USPSTF concluded that the evidence is insufficient to assess the balance of benefits and harms of screening for hyperbilirubinemia to prevent CBE. Garg BD, Kabra NS, Balasubramanian H. Role of massage therapy on reduction of neonatal hyperbilirubinemia in term and preterm neonates: A review of clinical trials. The order of use of the instruments was randomized. Torres-Torres M, Tayaba R, Weintraub A, et al. 1992;89:821-822. This is not a reportable inpatient condition. 2010;15(3):164-168. No association was found between the UGT1A1*28 allele and extreme hyperbilirubinemia. The receiver operating characteristic analysis (for serum bilirubin levels greater than 205.2 micromol/L or greater than 239.4 micromol/L) showed significantly higher areas under the curve for BiliCheck than those for BiliMed (p < 0.001). Hyperbilirubinemia in the term newborn. cpt code for phototherapy of newborn - s227879.gridserver.com padding-bottom: 4px; } I have a provider that ordered phototherapy for a newborn in the hospital with jaundice and he is wanting to bill 96900. De Luca D, Zecca E, Corsello M, et al. Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. Hamelin K, Seshia M. Home phototherapy for uncomplicated neonatal jaundice. Place the thermometer in your newborn's armpit while the phototherapy lights are on. But unless the breech presentation or other malpresentation caused a significant finding for the newborn, do not code it on the inpatient hospital record. Clinical evaluation (e.g., specialty consult during the hospitalization); Therapeutic treatment (e.g., bili lights for clinically significant neonatal jaundice); Diagnostic procedures (e.g., ultrasound due to sacral dimple); Extended length of hospital stay (e.g., beyond the average for the MS-DRG); Increased nursing care and/or monitoring (e.g., neonatal intensive care unit); or. For a better experience, please enable JavaScript in your browser before proceeding. Intensive phototherapy in form of double light is used worldwide in the treatment of severe neonatal hyperbilirubinemia. Chest Physiotherapy (CPT) for Infants | Treatments & Procedures 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 . Yang and colleagues (2018) noted that zinc sulfate may be a promising approach to treat neonatal jaundice. None of the included studies reported any side effects. Screening had good ability to detect hyperbilirubinemia: reported area-under-the-curve values ranged between 0.69 and 0.84, and reported sensitivities and specificities suggested similar diagnostic ability. 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. The influence of zinc sulfate on neonatal jaundice: A systematic review and meta-analysis. 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)". Incidence is as high as 30 percent in premature male neonates. For harms associated with phototherapy, case reports or case series were also included. The authors concluded that the role of zinc in the prevention of neonatal hyperbilirubinemia is not supported by the current evidence. If approved, tin-mesoporphyrin could find immediate application in preventing the need for exchange transfusion in infants who are not responding to phototherapy." The RR or MD with a 95 % CI was used to measure the effect. The ICD-10-PCS code for light treatment of the skin is 6A600ZZ Phototherapy of skin, single for a single treatment. Treating providers are solely responsible for medical advice and treatment of members. The provider should document whether the testis is ectopic (e.g., in the superficial inguinal pouch) or abdominal. All 3 review authors independently assessed study eligibility and quality. Aetna considers genotyping of BLVRA, SLCO1B1 and UGT1A1 experimental and investigational for assessing risk of neonatal hyperbilirubinemia because the clinical value of this approach has not been established. Guidelines from the Canadian Paediatric Society (2007) found that phenobarbitol, studied as a means of preventing severe hyperbilirubinemia in infants with G6PD deficiency, did not improve clinically important outcomes in a randomized controlled clinical study (Murki et al, 2005). Neonatology. Code History 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-PCS) 2017 (effective 10/1/2016): No change Correlation between neonatal hyperbilirubinemia and vitamin D levels: A meta-analysis. 66940 Removal of lens material; extracapsular (other than 66840, 66850, 66852) Learn more about pediatric cataract billing in Ophthalmic Coding: Learn to Code . This indicated that cure may have been achieved in a minority of patients. None of the studies reported on bilirubin encephalopathy rates, neonatal mortality rates, or the levels of parental or staff satisfactions with the interventions. The USPSTF and the Agency for Healthcare Research and Quality (2009) reported on the effectiveness of various screening strategies for preventing the development of CBE. 2009;124(4):1162-1171. Do not percuss over the backbone, breastbone, or lower two ribs. Aetna considers measurement of end-tidal carbon monoxide (CO) corrected for ambient CO (ETCOc), used either alone or in combination with the simultaneous measurement of total serum bilirubin (TSB) concentration, experimental and investigational because measurement of ETCOc has not been proven to improve prediction of development of significant neonatal bilirubinemia over TSB alone. Cochrane Database Syst Rev. } 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. list-style-type: decimal; This code may be reported only once per day and by only one physician. color: blue Furthermore, an UpToDate review on "Evaluation of unconjugated hyperbilirubinemia in term and late preterm infants" (Wong and Bhutani, 2017) states that "TcB measurements are not reliable in infants undergoing phototherapy. When the pediatrician spends additional time explaining the skin condition, and the findings affect the episode of care, it should be coded on professional encounters. However, the accuracy of TcB devices in infants exposed to phototherapy is unclear. J Perinatol. These researchers stated that healthcare organizations and health workers should choose intermittent phototherapy as the preferred therapy for neonatal hyperbilirubinemia. Wong RJ, Bhutani VK. 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). 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.". Chen and co-workers (2017) stated that probiotics supplementation therapy could assist to improve the recovery of neonatal jaundice, through enhancing immunity mainly by regulating bacterial colonies. High Intensity Phototherapy: Double vs. Single - Home - ClinicalTrials.gov Thomas JT, Muller P, Wilkinson C. Antenatal phenobarbital for reducing neonatal jaundice after red cell isoimmunization. text-decoration: underline; Usually, the time spent teaching parents how to care for the newborns eyes until the lacrimal ducts mature is not significant. top: 0px; These investigators randomly assigned 1,974 infants with extremely low birth weight at 12 to 36 hours of age to undergo either aggressive or conservative phototherapy. BiliCheck variability (+/- 2 SD of the mean bias from serum bilirubin) was within -87.2 to 63.3 micromol/L, while BiliMed variability was within -97.5 to 121.4 micromol/L. These investigators conducted a systematic review and meta-analysis to examine the safety and efficacy of zinc sulfate on hyperbilirubinemia among neonates. Cochrane Database Syst Rev. For the term neonates, there were significantly lower bilirubin levels in the clofibrate group compared to the control group after both 24 and 48 hours of treatment with a weighted mean difference of -2.14 mg/dL (95 % CI: -2.53 mg/dL to -1.75 mg/dL) (-37 mol/L; 95 % CI: -43 mol/L to -30 mol/L] and -1.82 mg/dL (95 % CI: -2.25 mg/dL to -1.38 mg/dL) (-31 mol/L; 95 % CI: -38 mol/L to -24 mol/L), respectively. 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. 4. 6. The AAP Guidelines suggest that an infant readmitted for hyperbilirubinemia, with a level of 18 mg/dL or more, should have a level of 13 - 14 mg/dL in order to discontinue phototherapy. PubMed, Scopus, Embase, Cochrane library, CBM, CNKI, and Wanfang Data were searched to collect the comparative study of home-based phototherapy versus hospital-based phototherapy for the treatment of neonatal hyperbilirubinemia. 1986;25(6):291-294. Usually, hip clicks involve watchful waiting, with the tendons and muscles continuing to develop until the click is no longer felt. 2021;16(5):e0251584. The authors found a moderate correlation between TcB and TSB during phototherapy with a marginal improvement in the post-phototherapy phase. This review included total of 10 RCTs (2 in preterm neonates and 8in term neonates) that fulfilled inclusion criteria. Copyright 2023 American Academy of Family Physicians. Privacy Policy | Terms & Conditions | Contact Us. Stevenson DK, Fanaroff AA, Maisels MJ, et al. For well infants 35 - 37 6/7 wk, can adjust TSB levels for intervention around the medium risk line. Morris BH, Oh W, Tyson JE, et al; NICHD Neonatal Research Network. color: #FFF; If the newborn jaundice is excessive, hospitals use bili lights. Family physicians who perform newborn circumcision should separately report this service. Bhutani VK; Committee on Fetus and Newborn; American Academy of Pediatrics. color: red!important; Kumar P, Chawla D, Deorari A. Light-emitting diode phototherapy for unconjugated hyperbilirubinaemia in neonates. Pediatrics. NY State J Med. None of the studies showed any effect on the duration of phototherapy, incidence of phototherapy, age of starting of phototherapy and any serious adverse effect. Digital Store For tech Gadgets. ol.numberedList LI { So, it was hard for these investigators to determine whether the allocation scheme was appropriate and whether blinding of participants and personnel was implemented. Although screening can predict hyperbilirubinemia, there is no robust evidence to suggest that screening is associated with favorable clinical outcomes. } For inpatient hospital coding, a condition is clinically significant if it requires: Note: These perinatal guidelines are the same as the general coding guidelines for additional diagnoses, except for the final point regarding implications for future healthcare needs. In: BMJ Clinical Evidence. Moreover, they stated that routine use of probiotics to prevent or treat neonatal jaundice cannot be recommended; large well-designed trials are needed to confirm these findings. J Matern Fetal Neonatal Med. For more information about congenital hydrocele, visit: www.webmd.com/parenting/baby/tc/congenital-hydrocele-topic-overview#1. Stevenson DK, Fanaroff AA, Maisels MJ, et al. In search of a 'gold standard' for bilirubin toxicity. When the hematoma is extensive or combined with other issues that cause excessive hemolysis, involving additional resources, look to P58 Neonatal jaundice due to other excessive hemolysis.