Pediatric Coding Alert

Question: Our neonatologist was called for a mandatory emergently problem with newborn in labor and delivery (we were not asked to attend the delivery or consult). The neonatologist arrived after the initial drying, stimulation, PPV, and administration by the labor and delivery nurse. What does the neonatologist bill if there is no resuscitation and he checked the baby over and determined the problem was resolved and pink and healthy enough to go on to regular newborn care? We are leaning toward 99464 but aren’t sure if it’s accurate.

Arkansas Subscriber

Answer: Unfortunately, code 99464 (Attendance at delivery) requires that the physician actually be present at delivery, when requested by the delivering physician (which should be documented), and includes initial stabilization of the newborn. In the scenario provided, the doctor arrived after delivery so this code is not applicable. Instead, your neonatologist will most likely report normal newborn care (99460).

Another code to consider is 99360 (standby service, requiring prolonged attendance, each 30 minutes…). This code has the additional requirement that the physician may not be providing care or services to other patients during this period. It also requires a full 30 minutes or more of standby time in order to use the code. Again, in this scenario, the neonatologist was not there waiting for the newborn to be delivered, but was called on an emergent basis to labor and delivery.