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Newborn Coding - Attended Delivery 99464 and 99477-99480 vs. 99221-99223 &99231-99233

grizzliesfan

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Newborn Coding - Attended Delivery 99464 and 99477-99480 vs. 99221-99223 &99231-99233

I have a couple of questions. 1. If the physician is trying to bill for attended delivery 99464, but she states in her H&P that she was present immediately after delivery and per nursing, infant had spontaneous cry and was vigorous immediately after birth. She received routine transitional care and was transferred to the nursery for further evaluation. I am thinking she cannot bill for the attendance at delivery, since she arrived immediately after even though she went to the delivery room. Does anyone disagree with my thoughts on this?

2. This same baby was preterm (Approximately 36 weeks gestation by Ballard exam) and 2190 grams. Also, the mother smoked during pregnancy(5-10 cigarretts per day) and a urine drug screen on day of birth was positive for marijuana and cocaine. She had also, tested positive for trichomas about two weeks prior to delivery. Since this is a preterm infant with suspected sepsis and maternal drug abuse, would you use codes fron 99477-99480 for the admit and subsequent visits or would you use the codes for a regular hospital admit 99221-99223 and SQ visit codes 99231-99233? I am unsure when you actually use the codes 99477-99480 and if they have to be in the NICU when these codes are used. Any help on this would be greatly appreciated and any resources to use for newborn coding would be helpful too.

Thank you.
 

efrohna

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Grizzliesfan,
I have the same question in regards to the codes (99464 & 99465) "attendance" at delivery when the billing provider is not present. In my opinion, should not be billed as he/she was not present until AFTER the birth. My question, then becomes what to bill? 99460 only?

In regards to your second question, I agree with you that the baby will need to be continuously monitored due to the mom's problems that you described. As long as the documentation and the diagnoses agree with the 99477 codes that is what I would go with for the neonate.
 

grizzliesfan

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Newborn Coding

Evangelina,

Thank you for your response. In answer to your question, I think in the case where the physician arrived after delivery, you would just bill 99460 or if Critical Care was performed, you would use the 99468.

In using the codes 99478-99480, it is my understanding that they have to document the present weight of the newborn to use these codes. In my case, the current weight was not documented, so in that case would you just use the 99231-99233 codes for the Subsequent visits? I have another case where the provider is trying to bill 99480 for a newborn who became tachpneic on day 2 of life and they are monitoring the newborn, but the present weight is not documented in the progress note. In this case I am thinking I would just use a code from 992131-99233.

Thank you again for your reply.
 
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