Attendance at Delivery & Stabilization

Family physicians who provide maternity services are the only specialists who care for the mother, the family, and the newborn. Physicians not managing labor and delivery or assisting/performing a cesarean delivery may be asked by the physician who is attending the mother to provide other services such as standby during cesarean or high-risk delivery, attendance at delivery with initial stabilization of the newborn, or newborn resuscitation in the delivery or birthing room.

There are codes for each of these services and these may be reported in addition to other codes on the same date.

For information on codes related to newborn care beyond initial stabilization or resuscitation, see Coding Newborn Care Services.

Standby service is described by the CPT book as a service "requested by another physician and . . . involves prolonged physician attendance without direct (face-to-face) patient contact." In addition, "The physician may not be providing care or service to other patients during this time period. This code is not used to report time spent proctoring another physician."

Physicians should use code 99360 to report the total time spent on standby on a given date. Code 99360 is reported with 1 unit of service for each 30 minutes of standby. The physician can only report standby service if a full 30 minutes or more of standby is provided. Standby services of less than 30 minutes cannot be reported separately. In addition, the physician can only report second and subsequent standby periods if a full 30 minutes of standby is provided for each unit of service reported.

Standby services may be reported in addition to initial history and examination of the newborn, critical care and resuscitation. Standby services are not reported in addition to attendance at delivery and initial stabilization of the newborn as reported with code 99464.

When the physician managing the patient's delivery requests your attendance at the delivery and you provide initial stabilization of the newborn, this may be reported with code 99464.

When reporting code 99464 for these services, you may separately report codes for initial hospital or birthing center care for evaluation and management of a newborn infant on the same date. However codes for standby (99360) and delivery or birthing room resuscitation (99465) may not be reported in conjunction with code 99464.

Resuscitation of a newborn in the delivery or birthing room is reported with code 99465. This code indicates the provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output. Suctioning without intubation is also included in resuscitation services. (For intubation to suction meconium, report code 31500. Do not report code 99465 for intubation.)

Procedures such as intubation or insertion of vascular lines that are performed as a necessary component of resuscitation are reported separately in addition to code 99465. These procedures are not separately reported when performed as a convenience before admission to the neonatal intensive care unit.

Code 99465 is not reported in conjunction with code 99464 for attendance at delivery and initial stabilization of a newborn. Physicians may separately report the provision of standby services (99360) and/or initial newborn care (e.g, 99460, 99468, or 99477) on the same date as resuscitation, 99465.