Pediatric Coding Alert

Question: Can we use 99432 for routine office visits for a normal newborn within the first 29 days of life, or is it only for care provided immediately after birth?

Wisconsin Subscriber

Answer: Although CPT defines a newborn as under 30 days of age, you should not code 99432 (normal newborn care in other than hospital or birthing room setting, including physician examination of baby and conference[s] with parent[s]) for office visits.

Because 99432 is not explicitly banned for use in the office, pediatricians might think they can access this code for a newborns first exam. But 99432 is for services provided immediately after birth only. This code is not meant for babies who are born in the hospital, do not see the pediatrician there and sometime later are brought to the office for the initial newborn examination. Such visits should be coded 99201-99205 (office or other outpatient visit for the evaluation and management of a new patient ) or, if a preventive medicine service is provided, 99381 (initial preventive medicine evaluation and management ).