#299 - The Hidden Language of NICU Billing with Dr. Scott Duncan

In this episode of The Incubator, Ben and Daphna speak with Dr. Scott Duncan, Division Chief at the University of Louisville, about the critical importance of medical billing and coding in neonatology. The discussion explores how accurate documentation and thoughtful use of codes can impact everything from individual reimbursement to hospital funding and staffing. Dr. Duncan explains the key differences between critical care and intensive care coding, highlighting how misunderstanding these definitions can lead to missed opportunities for appropriate billing. The conversation also delves into the complexities of CPT and ICD-10 codes, bundled versus unbundled services, and how Diagnosis-Related Group (DRG) systems influence hospital revenue. They discuss how proper coding affects downstream resources, including staffing, and why the financial viability of neonatal units depends in part on getting this right. Dr. Duncan reflects on the need for better education in this area, particularly for trainees, and shares practical resources and upcoming initiatives aimed at helping clinicians build this essential skill set. This episode offers an eye-opening look at a topic often overlooked in medical training, but vital to the sustainability of neonatal care.

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!