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Thread: 99464

  1. #1
    Join Date
    Apr 2007

    Default 99464

    Have I made something up in my mind? I have this vague idea in my head that I heard/read this somewhere and now cannot find documentation for it....

    If a hospital has a policy that they want an NICU NP at every cesearean (regardless of med necessity) can they actually bill for attendance at delivery if there is nothing wrong with the mom or fetus?

    I completely understand if there are problems with mom or baby, but I thought I read somewhere that if a provider is there just because its policy, that they couldnt bill???

    Am I crazy?

    Melissa Tescher, CPC, CPMA, CEMC Compliance and Coding Specialist
    Willamette Valley Professional Services member National Advisory Board 2013-2015

  2. #2
    Join Date
    Apr 2007
    Frederick, MD


    No you are not crazy. A c-section is often the reason our neonatologists are called in for attendance. There is usually a reason (and dx) for the c-section. There are some dx for mom that translate into codes for the baby.

    Check these out in the ICD9:
    Premature seperation of placenta
    Fetal Distress

    I hope this helps.
    Always Seeking

  3. #3
    Join Date
    Apr 2007


    I code for NICU NNPs for attendance at delivieries ONLY when there is medical necessity for it and the Physician requests their attendance and why. We have a protocol at the hospital where I work that all c-sections will be attended by NICU NNPs regardless of complications or not. When there are no complications in the mother or the baby (say for elective or repeat c-sections), we do not code 99464. I hope this helps.
    Annette, CPC, CEMC

  4. #4
    Join Date
    Apr 2007


    Additional information on 99464: CPT Assistant August 2004 Page 9: Last paragraph: "...99464 Attendnace at delivery (when requested by delivering physician)...code includes initial drying, stimulation, suctioning, blow by oxygen and cursory visual inspection of the infant."

    I hope this is helpful too.
    Annette W., CPC, CEMC

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