Pediatric Coding Alert

Reader Question:

Neonatologist Code Depends on Infant Location

Published on Mon Apr 02, 2012

Question: We have a "Neonatal Rapid Response Team" (NRRT) in which a respiratory therapist and a neonatologist and specially trained nurses are called at the request of any nurse, or anyone in the delivery area that might believe there would be a problem with a newborn. Sometimes the neonatologist will get there after the delivery. The neonatologist will examine and evaluate the patient as stable and send the baby to the newborn nursery. In this case the pediatrician will charge for the initial hospital newborn 99460. My thoughts are since there wasn't an attendance at delivery or any resuscitation performed, they should bill a subsequent hospital visit 99462. Can you advise?

Missouri Subscriber

Answer: According to Gil Martin, MD, who is the neonatologist representative to the CPT editorial advisory panel, if the baby is still in the delivery room or a delivery area, the neonatologist can still use 99464 even if he arrives after the delivery.

The pediatrician will then code 99460 for examining the baby in the regular nursery. So in your example, the pediatrician can continue to use 99460 for examining the baby in the nursery, and the neonatologist can use 99464 for attending the delivery.

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