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Emergert Mandatory Attendance of baby in L&D

Pam Posted Mon 06th of May, 2013 16:20:09 PM

If Neonatologist is called Mandatory emergently problem with newborn in L&D (we were not asked to attend the delivery or consult) Neo arrives after the initial drying, stiulation, PPV, O2 administration by the L&D nurse, what does the Neo bill if their is no resucitation and the Neo determines baby is able to go to Regular Newborn?

SuperCoder Answered Tue 07th of May, 2013 21:11:30 PM


I have forwarded this query to my editor. She will get back with the answer soon.


SuperCoder Answered Wed 08th of May, 2013 00:14:09 AM

Hi there! Did the neonatologist do any standard newborn care services (or any services at all)? Thanks!

Torrey Kim, CPC
Editor, Pediatric Coding Alert

Pam Posted Wed 15th of May, 2013 18:42:18 PM

'36245' - Mandatory emergently problem with newborn. Doctor arrives after the initial drying, stimulation, ppv and 02. He checked the baby over and determined the problem was resolved and pink and healthy enought to go on to regulary newborn. Does that answer your question? He did check the baby over to determine problem were resolved and baby was ok. Thank you.

SuperCoder Answered Sat 18th of May, 2013 22:43:24 PM

The bottom line is that as the scenario is described, the only billable service is for the normal newborn care: 99460.
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, they arrived after delivery and initial stabilization and would not be able to use this code.
Another code to consider is 99360, physician standby service, requiring prolonged physician attendance, each 30 minutes. There is 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 is provided 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 L & D.

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