HCPF reminds hospitals to bill mother and newborn separately and to report covered/noncovered days correctly

Diva Wood, hospital policy specialist at the Colorado Department of Health Care Policy & Financing, reviewed two billing policies for hospital billing staff: separate claims for birthing parent and newborn, and correct reporting of covered and noncovered days.

Wood said that effective July 1, 2020, services for the birthing parent and the newborn baby must be billed under each member’s own ID number as separate claims. The policy and additional guidance are available in the department’s billing manual. She also explained that value code 80 should report covered days and value code 81 should report noncovered days on claims, and that occurrence span code 74 should document a period of noncovered level of care or a leave‑of‑absence during an otherwise covered stay.

Andrew Abalos added historical context: the department previously allowed combined mother/baby claims but changed to separate claims to align with APR‑DRG weighting and rebasing; hospitals still billing the old way should review and, if necessary, submit separate claims to avoid missing revenue.

Next steps: staff offered to answer follow‑up questions via email (contacts on the last slide) and to include newsletter links in the meeting chat.