Cincinnati Childrens, umbilical hernia: www.cincinnatichildrens.org/health/u/umbilical-herni, Copyright 2023, AAPC 2016;36(10):858-861. If the lining closes and the fluid has nowhere to go, its a noncommunicating hydrocele. For well infants 35 - 37 6/7 wk, can adjust TSB levels for intervention around the medium risk line. Deshmukh and associates (2017) noted that neonatal jaundice requiring phototherapy is associated with significant socioeconomic burden including hospital re-admission, prolonged hospital stay, and separation of the baby from mother. Although early corticosteroid treatment facilitates extubation and reduces the risk of chronic lung disease and patent ductus arteriosus, it causes short-term adverse effects including gastro-intestinal bleeding, intestinal perforation, hyperglycaemia, hypertension, hypertrophic cardiomyopathy and growth failure. Correlation between neonatal hyperbilirubinemia and vitamin D levels: A meta-analysis. These ELBW infants had participated in a randomized controlled trial of early DXM therapy thataimed toevaluate effects on chronic lung disease. Long-term follow-up studies reported an increased risk of abnormal neurological examination and cerebral palsy. /* aetna.com standards styles for templates */ Exchange transfusion involves taking small aliquots of blood from the infant and replacing them with donor red cells until the infants blood volume has been replaced twice to remove bilirubin and antibodies that may be causing hemolysis. For these hydroceles, the swelling will become greater and decrease. Meta-analysis was performed using random- or fixed-effect models. 2008;358(9):920-928. This generally refers to an undescended or maldescended testis. A total of 416 records were identified through database searching; 4 studies (3 randomized studies and 1 retrospective study) meet the final inclusion criteria. Metalloporphyrins for treatment of unconjugated hyperbilirubinemia in neonates. Some infants may require intensive care services but do not meet the CPT definition of critically ill or injured required for reporting of critical care services. Various trials in pregnant women who were not isoimmunized but had other risk factors for neonatal jaundice have shown a reduction in need for phototherapy and exchange transfusion by the use of antenatal phenobarbital. Indirect evidence from 3 descriptive uncontrolled studies suggested favorable associations between initiation of screening and decrease in hyperbilirubinemia rates, and rates of treatment or re-admissions for hyperbilirubinemia compared with the baseline of no screening. 2009;124(4):1172-1177. They stated that TSB assessment remains necessary, if treatment of hyperbilirubinemia is being considered. Lets review which conditions should be reported and when. Depending on the study, 2 to 10 percent of newborns have inconclusive results at discharge (e.g., there may be fluid in the middle ear; the newborn may be fussy; one ear might pass, but the other does not). Sharma and colleagues (2017) examined the role of oral zinc supplementation for reduction of neonatal hyperbilirubinemia in term and preterm infants. 2017;30(16):1953-1962. 2011;128(4):e1046-e1052. Aggressive phototherapy did reduce rates of neurodevelopmental impairment (26 %, versus 30 %for conservative phototherapy; relative risk, 0.86; 95 % CI: 0.74 to 0.99). A total of 15 studies (2 including preterm neonates and 13 including term neonates) were included in this review. PLoS One. Phototherapy is the use of visible light to treat severe jaundice in the neonatal period. 2017:1-9. It is an option to intervene at lower TSB levels for infants closer to 35 wks and at higher TSB levels for those closer to 37 6/7 wks. 2019;8:CD012731. 1998;94(1):39-40. Clin Pediatr (Phila). Meta-analysis (random-effects model) showed probiotic supplementation reduced duration of phototherapy [n=415, MD: -11.80 (-17.47 to -6.13); p<0.0001; level of evidence (LOE): low]; TSB was significantly reduced at 96hours [MD: -1.74 (-2.92 to -0.57); p=0.004] and 7 days [MD: -1.71 (-2.25 to -1.17); p<0.00001; LOE: low] after probiotic treatment. Synthesis Without Meta-analysis (SWIM) guidelines were used for reporting methods and results of synthesis without meta-analysis. .strikeThrough { Reference No. Clin Pediatr. www.stanfordchildrens.org/en/topic/default?id=developmental-dysplasia-of-the-hip-ddh-90-P02755 hip dysplasia Pediatrics. OL OL LI { Waltham, MA: UpToDate;reviewed January 2015; January 2017. This Clinical Policy Bulletin may be updated and therefore is subject to change. Do not code the condition as part of the newborn hospitalization unless it requires a consult, diagnostic or therapeutic services, prolonged length of stay, increased nursing services, or there is documentation by the provider for future healthcare needs. Wennberg RP, Ahlfors CE, Bhutani VK, et al. Code 99477 represents initial hospital care of the neonate (28 days or younger) who is not critically ill but requires intensive observation, frequent interventions, and other intensive care services. When the hematoma is extensive or combined with other issues that cause excessive hemolysis, involving additional resources, look to P58 Neonatal jaundice due to other excessive hemolysis. There was no evidence of a significant difference in duration of phototherapy between the prebiotic and control groups, which was only reported by 1 study (MD 0.10 days, 95 % CI: -2.00 to 2.20; 1 study, 50 infants; low-quality evidence). J Matern Fetal Neonatal Med. Moreover, they stated that routine use of probiotics to prevent or treat neonatal jaundice cannot be recommended; large well-designed trials are needed to confirm these findings. This review included 6 RCTs that fulfilled inclusion criteria. } Hyperbilirubinemia in the term infant: When to worry, when to treat. The authors concluded that despite the potential practical advantages of BiliMed, its reduced diagnostic accuracy in comparison with BiliCheck does not justify its use in clinical practice. If the nurse visit results in a visit with the physician, only the physician services would be reported. None of the included studies reported any side effects. Torres-Torres M, Tayaba R, Weintraub A, et al. It is an option to provide conventional phototherapy in hospital or at home at TSB levels 2 - 3 mg/dL below those shown, but home phototherapy should not be used in any infant with risk factors. They used a fixed-effect method in combining the effects of studies that were sufficiently similar; and then used the GRADE approach to assess the quality of the evidence. Petersen JP, Henriksen TB, Hollegaard MV, et al. The presumed mechanism of effect is photo-excitation of bilirubin extravascularly in the skin with the formation of bilirubin isomers which can be e No significant difference in mortality during hospital stay after enteral supplementation with prebiotics was reported (typical RR 0.94, 95 % CI: 0.14 to 6.19; I = 6 %, p = 0.95; 2 studies; 78 infants; low-quality evidence). If a nurse visit is provided (e.g., weight screen only), code 99211 may be reported. 2012;12:CD009017. 19th ed. Home Phototherapy Initial hospital or birthing center care, per day, for E/M of normal newborn infant, Initial care per day, for E/M of normal newborn infant seen in other than hospital or birthing center, Initial hospital or birthing center care, per day, for E/M of normal newborn infant admitted and discharged on the same date, Circumsion, using clamp or other device with regional dorsal penile or ring block, Circumsion, as above, without dorsal penile or ring block, Circumsion, surgical excision, other than clamp, device, or dorsal slit, neonate (28 days of age or less), Circumsion, surgical excision, other than clamp, device, or dorsal slit, neonate, old then 28 days of age. Liu et al (2013) examined if 3 variants (388 G>A, 521 T>C, and 463 C>A) of SLCO1B1 are associated with neonatal hyperbilirubinemia. 7. .headerBar { An UpToDate review on "Evaluation of unconjugated hyperbilirubinemia in term and late preterm infants" (Wong and Bhutani, 2015) does not mention genotyping of SLCO1B1 and UGT1A1 as management tools. There was no difference in the treatment efficacy and TSB, while there was a significant difference in phototherapy duration and side effects after treatment of intermittent phototherapy and continuous phototherapy for neonatal hyperbilirubinemia. For additional language assistance: SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5), UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, irinotecan metabolism), gene analysis, common variants (eg, *28, *36, *37), Molecular pathology procedure, Level 1(eg, identification of single germline variant [eg, SNP] by techniques such as restriction enzyme digestion or melt curve analysis) [for assessing risk of neonatal hyperbilirubinemia], Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion), G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis, Phototherapy (bilirubin) light with photometer, Home visit, phototherapy services (e.g., Bili-lite), including equipment rental, nursing services, blood draw, supplies, and other services, per diem, Injection, phenobarbital sodium, up to 120 mg, Neonatal jaundice due to other excessive hemolysis, Neonatal jaundice from other and unspecified causes, Maternal care for other isoimmunization [not covered for the use of antenatal phenobarbital in red cell isoimmunized pregnant women], Glucose-6-phosphate dehydrogenase (G6PD); quantitative, Glucose-6-phosphate dehydrogenase (G6PD); screen, Genetic susceptibility to other disease [G6PD deficiency], Family history of other endocrine, nutritional and metabolic diseases [G6PD deficiency], Family history of carrier of genetic disease [G6PD deficiency]. Although declining the inpatient prophylactic services is not reportable by inpatient hospital coders (because it does not affect the hospitalization), outpatient physician office coders can and should use Z28 Immunization not carried out and under immunization status codes when provider-recommended immunizations are not administered. Take your newborn's temperature every 3 to 4 hours. No statistical difference in the prevalence of UGTA1A1 gene variants was found between cases and controls (p = 1). 5 star restaurants st louis. Fractured clavicles are usually noted by the pediatrician on the newborn evaluation, but do not meet the definition of clinical significance. Armanian and colleagues (2019) stated that hyperbilirubinemia occurs in approximately 2/3 of all newborns during the first days of life and is frequently treated with phototherapy. Cochrane Database Syst Rev. Our providers amend their office note to indicate the patient was admitted due to results then charge an Initial Outpatient Care code (99218-99220) for the day of admission and then 99217 for discharge. New perspectives on neonatal hyperbilirubinemia. Secondary outcomes included incidence of jaundice, TSB level at 24, 48, 72, 96hours, and day 7, duration of hospital stay, and adverse effects (e.g., probiotic sepsis). 2011;12:CD007969. N Engl J Med. There are 4 chief Current Procedural Terminology (CPT) codes for reporting phototherapy services: (1) 96900: actinotherapy (UV light treatment); (2) 96910: photochemotherapy, tar, and UVB (Goeckerman treatment) or petrolatum and UVB; (3) 96912: photochemotherapy and PUVA; and (4) 96913: photochemotherapy (Goeckerman and/or PUVA) for severe A heterozygous group was also equally distributed between cases (44.3 %) and controls (42.9 %). There is no CPT code because these hospital screenings are usually done by hospital staff who are trained by an audiologist. A total of 9 RCTs (prophylactic: 6 trials, n=1,761; therapeutic: 3 trials, n=279) with low- to high-risk of bias were included. It not only decreased the total serum bilirubin level after 3 days [MD: -18.05, 95 % CI: -25.51 to -10.58), p < 0.00001], 5 days [MD: -23.49, 95 % CI: -32.80 to -14.18), p < 0.00001], 7 days [MD: -33.01, 95 % CI: -37.31 to -28.70), p < 0.00001] treatment, but also decreased time of jaundice fading [MD: -1.91, 95 % CI: -2.06 to -1.75), p < 0.00001], as well as the duration of phototherapy [MD: -0.64, 95 % CI: -0.84 to -0.44), p < 0.00001] and hospitalization [MD: -2.68, 95 % CI: -3.18 to -2.17), p < 0.00001], when compared with the control group. These researchers systematically evaluated the safety and efficacy of probiotics supplement therapy for pathological neonatal jaundice. In a Cochrane review, Thomas et al (2007) stated that neonates from isoimmunized pregnancies have increased morbidity from neonatal jaundice. The authors concluded that there is a compelling need for the long-term follow-up and reporting of late outcomes, especially neurological and developmental outcomes, among surviving infants who participated in all randomized trials of early postnatal corticosteroid treatment. Infants had been treated with DXM (0.25 mg/kg twice-daily at postnatal day 1 and 2) or with placebo (normal saline). PubMed, Embase, Web of science, EBSCO, Cochrane library databases, Ovid, BMJ database, and CINAHL were systematically searched; RCTs evaluating the effect of zinc sulfate versus placebo on the prevention of jaundice in neonates were included. li.bullet { On the pediatricians encounter, code P13.4 Fracture of clavicle due to birth injury because it involved medical decision-making. When the newborn is critically ill or injured, codes exist for reporting of services provided during interfacility transport, initial critical care, and subsequent critical services. The AAP Guidelines suggest that an infant readmitted for hyperbilirubinemia, with a level of 18 mg/dL or more, should have a level of 13 - 14 mg/dL in order to discontinue phototherapy. The authors concluded that home-based phototherapy was more effective than hospital-based phototherapy in treatment for neonatal hyperbilirubinemia; home-based phototherapy was an effective, feasible, safe, and alternative to hospital-based phototherapy for neonatal hyperbilirubinemia. /*margin-bottom: 43px;*/ MMWR Morb Mortal Wkly Rep. 2001;50(23):491-494. J Pediatr. Usually, procedures coded: Low-cost, low-risk screening and prevention procedures usually are not coded. The studies were included if they compared TcB results with TSB in term and near-term infants during phototherapy or after discontinuation of phototherapy. These researchers conducted a systematic review of studies comparing TcB devices with TSB in infants receiving phototherapy or in the post-phototherapy phase. Deshmukh J, Deshmukh M, Patole S. Probiotics for the management of neonatal hyperbilirubinemia: A systematic review of randomized controlled trials. Spontaneous descent after one year is uncommon. When the depression is too shallow, the femoral head may move around in the depression and sometimes move out of the acetabulum. cpt code for phototherapy of newbornhippo attacks human video. Although screening can predict hyperbilirubinemia, there is no robust evidence to suggest that screening is associated with favorable clinical outcomes. First, because the value of jaundice fading in each guideline was different, the heterogeneity was high in time of jaundice fading. Two hundred years ago, newborns would have been placed on blankets in the sun for newborn jaundice. The single nucleotide polymorphisms (SNPs) of G6PD 1388 G>A, SLCO1B1 rs4149056 and BLVRA rs699512 loci were examined by the polymerase chain reaction (PCR) and Sanger sequencing technique in the peripheral blood of all subjects. For most newborns, hematomas from the birth process resolve spontaneously. ol.numberedList LI { PubMed, Scopus, Embase, Cochrane library, CBM, CNKI, and Wanfang Data were searched to collect the comparative study of home-based phototherapy versus hospital-based phototherapy for the treatment of neonatal hyperbilirubinemia. For instance, abnormal findings on screenings for example, newborn hearing screening or lab screenings are not coded in the inpatient record, unless: Here are several watchful waiting findings to consider. Assign codes for conditions that have been specified by the provider as having implications for future healthcare needs. .newText { Rockville, MD: Agency for Healthcare Research and Quality (AHRQ); 2002. A total of 447 Chinese neonates with hyperbilirubinemia were selected as the study group and 544 healthy subjects were recruited as the control group matched by baseline sex, age, feeding pattern and delivery mode. Testicles develop in the abdomen. (Codes may be selected based on time spent in counseling and coordination of care when documentation indicates more than 50% of face-to-face time was spent in these activities.) The longer the newborn has before an auditory function screening, the greater the chance of a successful screening. Approximately 2 ml of peripheral venous blood was taken from all subjects. Probiotics supplementation treatment showed efficacy [RR: 1.19, 95 % CI: 1.12 to 1.26), p < 0.00001] in neonatal jaundice. In: BMJ Clinical Evidence. Meta-analyses of 2 studies showed no significant difference in maximum plasma unconjugated bilirubin levels in infants with prebiotic supplementation (MD 0.14 mg/dL, 95 % CI: -0.91 to 1.20, I = 81 %, p = 0.79; 2 studies, 78 infants; low-quality evidence). Aetna considers prebiotics / probiotics experimental and investigational for the treatment ofneonatal hyperbilirubinemia becausetheir effectiveness for this indication has not been established. Li and colleagues (2019) examined the associations between G6PD 1388 G>A, SLCO1B1 rs4149056 and BLVRA rs699512 variants and the risk of neonatal hyperbilirubinemia in a Chinese neonate population. 202;11(1):e040182. Most newborns have ointment administered at birth, or soon after the initial bonding with the mother. Dennery PA. Metalloporphyrins for the treatment of neonatal jaundice. Pediatrics. 99460-99461 initial service 2. Nagar and associates (2016) noted that TcB devices are commonly used for screening of hyperbilirubinemia in term and near-term infants not exposed to phototherapy. After the newborn begins to breath on his own, the fetal blood is destroyed and replaced with blood that works with lungs. One study reported a significant reduction in the risk of hyperbilirubinemia and rate of treatment with phototherapy associated with enteral supplementation with prebiotics (RR 0.75, 95 % CI: 0.58 to 0.97; 1 study, 50 infants; low-quality evidence). Petersen and colleagues (2014) stated that extreme hyperbilirubinemia (plasma bilirubin greater than or equal to 24.5 mg/dL) is an important risk factor for severe bilirubin encephalopathy. J Paediatr Child Health. As a family physician, you may also address needs of the mother during a newborn's encounter (e.g., lactation problems). Centers for Disease Control and Prevention (CDC). Evidence Report/Technology Assessment No. They performed a systematic review of RCTs of probiotic supplementation for prevention or treatment of jaundice in neonates (any gestation or weight) using the Cochrane methodology. } The authors concluded that the role of massage therapy in the management of NNH was supported by the current evidence. Trikalinos TA, Chung M, Lau J, Ip S. Systematic review of screening for bilirubin encephalopathy in neonates. One infant (1.6%) met all three AAP guideline criteria of being DAT-positive, bilirubin within 3 of exchange level, and rising bilirubin despite intensive phototherapy. If the newborn jaundice is excessive, hospitals use bili lights. This is usually associated with one of the codes from Q65 Congenital deformities of the hip. Immaturity is not congenital absence, agenesis, stenosis, stricture, or malformation. Practice patterns in neonatal hyperbilirubinemia. Jaundice, Coombs, and Phototherapy AAP Clinical Practice Guideline - Summary Bhutani Nomogram Guidelines for Phototherapy FAQs About Phototherapy foam closure strips for metal roofing | keokuk, iowa arrests newington high school football coach 0 The therapy may be in the form of a lamp, light panel, or special light blanket. 2023 ICD-10-PCS Procedure Code 6A600ZZ Phototherapy of Skin, Single 2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code ICD-10-PCS 6A600ZZ is a specific/billable code that can be used to indicate a procedure. Sometimes, fluid builds up inside the lining, causing a hydrocele. 1992;89:809-818. Consistent with available guidelines, continued phototherapy is not medically necessary for healthy term infants when the following criteria for discontinuation of phototherapy are met: A delay in discharge from the hospital in order to observe the infant for rebound once the bilirubin has decreased is not considered medically necessary. 2003;(1):CD004207. Additional citations were identified from the bibliography of selected articles and from the abstracts of conference proceedings. Pediatrics. So, it was hard for these investigators to determine whether the allocation scheme was appropriate and whether blinding of participants and personnel was implemented. list-style-type: lower-alpha; Pace EJ, Brown CM, DeGeorge KC. In that case, other conditions can be coded if they were involved in medical decision-making, or otherwise affected the episode of care. cpt code for phototherapy of newborn. Report an inclusive screening finding (R94.120 Abnormal auditory function study) in the professional record so the newborn can be retested at the well-baby checks. Usually, the nurses pin the sleeve of the affected arm to the body of the newborns t-shirt. Digital Store For tech Gadgets. OL OL OL OL OL LI { 6. The Cochrane tool was applied to assessing the risk of bias of the trials. Can Nurse. Newman TB, Maisels MJ. Date of Last Revision: 10/22 . The pediatrician will wait watchfully and check the clavicle until its healed. 1991;91:483-489. If time is not significant, and it does not impact medical decision-making, it does not meet the definition of an additional professional encounter diagnosis. Medline, Embase, Cochrane Library, CINAHL and Scopus databases (from inception to May 8, 2014) were searched. American Academy of Pediatrics and American College of Obstetricians and Gynecologist. None of the studies reported on bilirubin encephalopathy rates, neonatal mortality rates, or the levels of parental or staff satisfactions with the interventions. Morris BH, Oh W, Tyson JE, et al; NICHD Neonatal Research Network. Meta-analysis of the 3 studies showed a significant increase in stool frequency in the prebiotic groups (MD 1.18, 95 % CI: 0.90 to 1.46, I = 90 %; 3 studies, 154 infants; high-quality evidence). Santa Barbara, CA: Elsevier Saunders; 2011. The authors concluded that the UGT1A1*28 allele was not associated with risk for extreme hyperbilirubinemia in this study. Compared with hospital-based phototherapy, home-based phototherapy appeared more effective for the treatment of neonatal hyperbilirubinemia in reducing the rate of total serum bilirubin (standard mean difference [SMD] = 0.32, 95 % CI: -0.22 to 0.86, p = 0.04); however, there was no signicant difference in duration of phototherapy (SMD = 0.59, 95 % CI: 0.28 to 0.90, p = 0.06) in the 2 groups. Mehrad-Majd H, Haerian MS, Akhtari J, et al. J Matern Fetal Neonatal Med. Aggressive phototherapy, as compared with conservative phototherapy, significantly reduced the mean peak serum bilirubin level (7.0 versus 9.8 mg/dL [120 versus 168 micromol/L], p < 0.01) but not the rate of the primary outcome (52 % versus 55 %; relative risk, 0.94; 95 % confidence interval [CI]: 0.87 to 1.02; p = 0.15). 2019;32(10):1575-1585. Mean STB levels, mg/dL, at 72 12 hours were comparable in both the groups (n = 286; mean difference (MD) -0.20; 95 % CI: -1.03 to 0.63). Ip S, Glicken S, Kulig J, et al. A total of 25 infants had been randomized into the DXM group; 29 into the placebo group. The authors concluded that effects of screening on the rates of bilirubin encephalopathy are unknown. Thayyil S, Milligan DW. These usually heal and resolve on their own. The linear regression analysis showed a better correlation between BiliCheck and serum bilirubin (r = 0.75) than between BiliMed and serum bilirubin (r = 0.45). 2014;165(1):42-45. The condition affects 3 percent of term male infants, and 1 percent of male infants at one year. Mishra S, Cheema A, Agarwal R, et al. Screening is usually done as close as possible to inpatient discharge for this reason. color: red Phototherapy for neonatal jaundice. Aetna considers transcutaneous bilirubin devices for evaluating hyperbilirubinemia in term and near-term infants while undergoing phototherapy experimental and investigational becasue this approach is not reliable in infantsin this setting. Tin-mesoporphyrin is not approved by the U.S. Food and Drug Administration. Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. OL OL OL OL LI { 1992;89:821-822. All 3 review authors independently assessed study eligibility and quality. J Matern Fetal Neonatal Med. These investigators assessed the safety and efficacy of probiotics in reducing the need for phototherapy and its duration in NNH. The authors concluded that limited low-quality evidence indicated that probiotic supplementation may reduce the duration of phototherapy in neonates with jaundice. This is not a reportable inpatient condition. Bhutani VK, Stark AR, Lazzeroni LC, et al; Initial Clinical Testing Evaluation and Risk Assessment for Universal Screening for Hyperbilirubinemia Study Group. A condition does not need to be coded on the inpatient hospital encounter to be coded on the pediatricians hospital encounter. During an initial newborn evaluation, watchful waiting conditions are findings that usually resolve without medical intervention in a few weeks to a few years. Practice parameter: Management of hyperbilirubinemia in the healthy term newborn. J Perinatol. Some watchful waiting issues require continued outpatient evaluation until resolution. 66920 Removal of lens material; intracapsular. Hamelin K, Seshia M. Home phototherapy for uncomplicated neonatal jaundice. Code 99391 may be reported with diagnosis code Z00.129 (encounter for routine child health examination without abnormal findings) for this service. Unless there are issues, congenital hydroceles also are not coded on the well-baby checks. The USPSTF concluded that the evidence is insufficient to assess the balance of benefits and harms of screening for hyperbilirubinemia to prevent CBE. 2003;88(6):F459-F463. A total of 14 studies were identified. . If approved, tin-mesoporphyrin could find immediate application in preventing the need for exchange transfusion in infants who are not responding to phototherapy." These investigators evaluated the effects of antenatal phenobarbital in red cell isoimmunized pregnancies in reducing the incidence of phototherapy and exchange transfusion for the neonate. An example is hemangiomas (e.g., strawberry hemangiomas), which do not impinge on vital structures and are not located in the periorbital area, lip, neck, or sacral region. The beroptic system consists of a pad of The meta-analyses of 2 studies demonstrated a significant reduction in the length of hospital stay (MD -10.57 days, 95 % CI: -17.81 to -3.33; 2 studies, 78 infants; I = 0 %, p = 0.004; low-quality evidence).
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