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Guidelines for Processing Mother/Newborn Charges

Effective September 2, 2003, Blue Cross and Blue Shield of Alabama will begin the following guidelines for processing Mother/Newborn charges. These guidelines will process the Mother/Newborn charges according to Revenue Code regardless of diagnosis. All of our contracted hospitals will be following the new guidelines.

Well Baby Billing Guidelines:

Note: Mother’s claim would include her normal room and board plus any normal newborn revenues for General Classification (0170), Newborn Level I (0171) or Nursery/Other (0179). One applicable deductible and/or co-pay will be taken.

Sick Baby Billing Guidelines:

Note: Admission date for baby’s claim will be date patient began treatment for Level II (Revenue 0172), Level III (Revenue 0173) or Level IV (Revenue 0174) care.

New Rejection Codes:

If revenue codes 0170, 0171 or 0179 are billed on a baby’s claim you will receive rejection code 9MB described as follows:

Well baby delivery charges are considered as part of the global allowance for the mother’s hospital charges. These charges should be filed together.

If revenue codes 0172, 0173 or 0174 are billed on a Mother’s claim for a baby you will receive rejection code 9GU described as follows:

Contact your Network Service representative if you have any questions.