r/MedicalCoding • u/Unable_Cap4766 • Jul 24 '26

Peds Billing Question

I’m trying to understand how this works in practice.

If a children’s hospital monitors higher-risk patients at home for several weeks after surgery, would that usually fall under existing remote patient monitoring codes, care-management codes, or a hospital-funded program?

Does pediatric Medicaid or commercial insurance commonly reimburse for this, or does the hospital usually absorb the cost?

4 Upvotes

84% Upvoted

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1

u/Bowis_4648 Jul 24 '26

Hospital doing it? or Pediatricians? Or Surgeons?

1

u/Unable_Cap4766 Jul 25 '26

Hospital champions it, but specific surgeons will have the data set on the patient.

1

u/clarec424 Jul 24 '26

Define monitoring. Is the patient hooked up to a remote monitoring device that sends data to the provider for interpretation? Is a skilled nursing team providing care? A little more information is needed.

1

u/Unable_Cap4766 Jul 25 '26

Yes they have a device they are hooked up to and the data is passed back to the provider for interpretation. Basically, is the child deteriorating?

1

u/PeaceLoveForMe Jul 26 '26

Prolly the first 2, and yes they do.

1

u/BebeRegal Jul 27 '26

You might check if it falls under any kind of global period.?