Pediatric Coding Alert

Another Two Carriers for 99436

Published on Wed Apr 01, 1998

In our continuing saga (which started in the March 1998 issue) of which payers are willing to reimburse for the new attendance at delivery code -- 99436 -- we have a yes from Blue Cross/Blue Shield of Massachusetts. According to spokesperson Susan Leahy, the insurance carrier will pay for the code, but will only pay one provider. In addition, the company will not pay if it is just hospital protocol that a pediatrician be in attendance at all deliveries -- for example, says Leahy, if the hospital is a teaching hospital that has such a policy. So, if the newborn is covered by BC/BS of Massachusetts, just make sure that you have documented that the delivering physician has indeed requested your attendance.

Also paying for 99436 is Blue Cross/Blue Shield of Texas. Spokesperson Bill Murray tells us he checked with the reimbursement department, and that code is definitely loaded in their system and being reimbursed

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