New Remark Code for Limited Newborn Benefit Payments
Effective July 1, 2012, the Remittance Advice (RA) for claims processed under the limited newborn benefit will reflect the MS-DRG grouped by the claims administration system instead of the normal newborn MS-DRG (795). The Allowed Charges will continue to be based on the established limited newborn benefit.
This is only a change to the MS-DRG listed on the RA. There is no change in the way the payment is calculated or the way the benefit is administered.
The following Remark Code will be included on the RA to identify the MS-DRG number used to determine the Allowed Charges and to indicate that the limited newborn benefit was applied:
MS-DRG 795 applied to the Limited Newborn Benefit
The member will continue to be responsible for any charges over and above the routine limited newborn benefit payment regardless of the facility’s Network or non-Network status.
Questions can be directed to the Network Management/Provider Relations Division at 1-405-717-8790 or toll-free 1-800-543-6044. Please send email inquiries to firstname.lastname@example.org.