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Newborn Hearing Screening Program (newborn)

By Audrey Gordon,2014-04-26 19:43
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Newborn Hearing Screening Program (newborn)

    newborn

    Newborn Hearing Screening Program 1

    This section contains information about the Newborn Hearing Screening Program.

    INTRODUCTION

    Program Overview The California Newborn Hearing Screening Program (NHSP) was

     established as a result of Assembly Bill 2780, Chapter 310, Statutes of 1998. This law requires the establishment of a comprehensive hearing screening program for the early detection of hearing loss in newborns and infants, with access to diagnostic evaluations and follow-up services, and provisions for data collection and reporting. The Department of Health Care Services (DHCS), specifically the Children's Medical Services (CMS) Branch, has responsibility for the implementation and oversight of this program.

    The NHSP is a comprehensive and coordinated system of early identification, tracking and monitoring of hearing screening, access to diagnostic services, and coordination of appropriate intervention and support services for newborns and infants with hearing loss. The goal of the program is to identify newborns and infants with a hearing loss prior to three months of age and to implement audiological and early intervention services by six months of age.

    Under the NHSP, all hospitals with licensed perinatal services are required to provide inpatient hearing screening for all newborns, with the parent's permission, prior to hospital discharge. All infants receiving care in an Intensive Care Newborn Nursery/Neonatal Intensive Care Unit (ICNN/NICU) must receive inpatient infant hearing screening services prior to discharge. Inpatient infant hearing screening includes a repeat hearing screen prior to discharge if the newborn or infant did not pass the initial inpatient hearing screening. Inpatient providers must be certified prior to submitting claims for reimbursement. Standards for certification are listed in “IP

    Standards” on the California Newborn Hearing Screening Program

    Provider Standards page of the DHCS website.

    Complete policy information about the NHSP can be found in the California Newborn Hearing Screening Program Provider Manual,

    which is available on the DHCS website at

    www.dhcs.ca.gov/services/nhsp.

    Referral for Rescreening Newborns and infants who do not pass the inpatient infant hearing screening are referred to an outpatient infant hearing screening provider for hearing rescreening that should be performed within one month of discharge. Newborns and infants who were discharged from the birthing hospital before inpatient infant hearing screening services were provided will be referred to an outpatient infant hearing screening provider.

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    Newborns and infants who do not pass the outpatient initial hearing

    screening or the outpatient hearing rescreening are referred to a

    California Children’s Services (CCS)-approved Type C

    Communication Disorder Center for a diagnostic hearing evaluation

    and to the local CCS program for authorization of this evaluation.

     Upon identification of a hearing loss, infants and their families are

    referred to the local Early Start Program for access to early

    intervention and related services. The results of the diagnostic

    hearing evaluation are sent to the local CCS program so that

    eligibility for the program’s treatment services can be determined.

    Subsequent to the eligibility determination, ongoing audiologic

    services including habilitation and amplification, if chosen by the

    family, can be authorized.

    Outpatient Infant Hearing Providers who can be certified as outpatient infant hearing screening Screening Providers providers include: NHSP-certified inpatient infant hearing screening

    providers; CCS-approved Type A, B and C Communication Disorder

    Centers and CCS-paneled audiologists, pediatricians,

    otolaryngologists and family practice physicians.

     To participate in the NHSP, outpatient providers of hearing screening

     services must be certified as being in compliance with the standards

    described in OP Standards” on the California Newborn Hearing

    Screening Program Provider Standards page of the DHCS website.

    Certified outpatient providers will be able to bill Medi-Cal or CCS for

    eligible newborns and infants who received hearing screening

    services on or after the effective date of certification. The

    certification process for outpatient infant hearing screening providers

    is conducted by the Centers for Medicare & Medicaid Services (CMS)

    branch staff.

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REIMBURSEMENT REQUIREMENTS

    Authorization Authorization is not required for inpatient or outpatient infant hearing

    screening or rescreening services. Authorization is required for

    diagnostic hearing evaluations. For information regarding

    authorization requirements for diagnostic hearing evaluations, refer to

    the "Referral For Diagnostic Hearing Evaluation" section in the

    California Newborn Hearing Screening Program Provider Manual.

    Billing The NHSP is not impacted by the elimination of nine optional benefits

    under Medi-Cal, which was implemented on July 1, 2009. NHSP

    screening services for infants remain reimbursable for NHSP-certified

    providers billed as an outpatient claim.

     Newborn hearing screening services can be performed either on an

    inpatient or an outpatient basis. However, the rendering provider

    must use the appropriate procedure code when billing for the service.

    Providers must use the claim forms appropriate to their place of

    service.

     Note: Prior to rendering services and submitting a claim, providers

    are responsible for determining what hearing screening

    services the newborn or infant may have already received.

     The following codes can be used for billing newborn hearing

    screening:

    HCPCS

    Code Description

     Z9725 Initial infant hearing screening

    hospital/inpatient

     Z9726 Initial infant hearing screening outpatient

     Z9727 Infant hearing rescreening outpatient

     Hospital inpatient ancillary codes for audiology services (0470, 0471,

    0472 and 0479) cannot be used for billing NHSP. Providers should

    review the California Newborn Hearing Screening Program Provider

    Manual on the DHCS website at www.dhcs.ca.gov for complete

    policy information about NHSP.

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    Medical Justification Required Providers must supply medical justification when using hospital

    inpatient ancillary codes for audiology services (0470, 0471, 0472,

    0479) either in the Remarks field (Box 80)/Reserved for Local Use

    field (Box 19) or as an attachment to the claim. Claims with

    audiology services ancillary codes submitted for newborn hearing

    screening will be denied.

    Certified Service Providers Only inpatient or outpatient infant hearing screening providers

    certified by the DHCS CMS Branch can render NHSP services.

    Providers interested in becoming an NHSP-certified infant screening

    provider, should call (916) 322-5794 or 1-877-388-5301, or send an e-

    mail request to nhsp3@dhcs.ca.gov.

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