Ob-Gyn Coding Alert

Question: Here is a problem that applies to ob/gyns asking other physicians to stand by at deliveries to care for the newborn. Some physicians have been complaining about the reimbursement for standby and resuscitation. If newborn resuscitation (99440) has a work value of 2.93 and attendance at the delivery (99436) has a work value of 1.50, how can 99436 be considered to be bundled into 99440? If you do a resuscitation, do you just forego the standby?

Multi- Specialty Coder, Houston, TX

Answer: The codes outlined above were added to CPT in 1997. They were formulated by the medical specialty society that requested the codes and were valued based on the clinical vignette and description of work supplied by that society. Once a code is added to CPT, the information about the typical patient and a description of the pre-, intra- and post-physician work is used to survey physicians about the procedure. This may be a surprise, but it is physicians who valued the physician RVU for these new codes based on the original submission. Theres nothing you can do to go around the valuation except take this question up with the AMA CPT Editorial Panel for an explanation of why 99436 is considered bundled into 99440.