Pediatric Coding Alert

Question: A neonatologist was called into the delivery room for a consult and had to resuscitate the newborn. How do you suggest coding this? Would we use the consult codes (99251-99255) with modifier -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) and 99440, or would we use the attendance at delivery code 99436 with 99440?

New York Subscriber

Answer: You cannot code both 99436 (attendance at delivery [when requested by delivering physician] and initial stabilization of newborn) and 99440 (newborn resuscitation: provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output). In this case, if resuscitation (bag and mask positive pressure ventilation) were required, 99440 is used. If the consultation is only to attend the delivery, there is no evaluation and management services code used only 99436 (no positive pressure ventilation) or 99440 (positive pressure ventilation). You cannot consult on a newborn until after the baby is born and resuscitated.