Pediatric Coding Alert

In the October issue of Pediatric Coding Alert, CPT 31500 (intubation, endotracheal, emergency procedure) was recommended for visualization of the cord by laryngoscopy when called to a delivery for meconium. The more appropriate code for this setting is 31515 (laryngoscopy direct, with or without tracheoscopy; for aspiration).
 
Use 31500 for infants who require emergency intubation for airway management or mechanical ventilation, writes Geoffrey G. Binney Jr., MD, MPH, director of newborn services at the Floating Hospital for Children in Boston.
 
He further notes that 31515 is not included in 99295 (initial neonatal intensive care, per day, for the evaluation and management of a critically ill neonate or infant), which alters the relative value unit (RVU) calculations for the scenario.  
 
Using prolonged services and individual procedures, you would have 25.13 RVUs if an arterial is used or 24.87 if a umbilical venous catheter (UVC) is used. Using 99295, 99436 (attendance at delivery [when requested by delivering physician] and initial stabilization of newborn) and 31515 you would have an RVU total of 26.01. But, as Binney notes, the more important consideration is whether the payer will accept 99295 at both transferring and receiving facilities.