99464 CPT Code: Newborn Attendance at Delivery and Resuscitation

What is 99464 CPT Code

The 99464 CPT code is designated for the attendance of a healthcare provider during the delivery of a newborn requiring resuscitation. This code is essential for proper billing of the immediate care provided to newborns who face respiratory challenges right after birth. It reflects the significant role of healthcare professionals in ensuring the safety and health of neonates during a critical period.

Healthcare providers must understand the importance of this code as it not only affects their billing but also highlights the critical nature of resuscitation efforts. Accurate coding is vital for appropriate reimbursement and reflects the provider's commitment to high‑quality neonatal care.

Services Covered Under 99464 CPT Code

This section outlines the services that fall under the 99464 CPT code, ensuring clarity for medical coders and providers alike.

Who Can Use the 99464 CPT Code?

This code can be billed by various healthcare professionals involved in newborn delivery and resuscitation. Here's who can appropriately use this code:

• Physicians: Obstetricians or pediatricians who are present during the delivery and provide necessary care.
• Nurse Practitioners: Advanced practice nurses who have the authority to perform resuscitation and attend to newborns.
• Physician Assistants: Medical professionals who support physicians in deliveries and can participate in resuscitation efforts.

How to Use 99464 CPT Code

Accurate usage of this code is critical for proper reimbursement and record‑keeping. Here are the best practices:

• Document Attendance: Ensure that you clearly note the time spent attending the delivery and the specifics of the resuscitation efforts. For example, if a physician was present for 30 minutes and performed chest compressions, this should be documented.
• Record Resuscitation Actions: Detail the interventions performed, such as the administration of oxygen or intubation, along with the newborn's response. For instance, if supplemental oxygen was administered and the infant's heart rate stabilized, this must be included in the notes.
• Indicate Team Involvement: If multiple healthcare providers are present, document their roles to clarify contributions to the resuscitation efforts. For example, if a nurse assisted with monitoring vital signs while the physician performed resuscitation, this should be recorded.

Reimbursement Rates for 99464 CPT Code

Reimbursement rates for this code can vary significantly between private and public insurance. Below is an overview:

Disclaimer: Reimbursement rates change frequently and can depend on various factors such as location, specific insurance policies, and negotiation terms. We strive to keep this information updated with average prices.

Benefits of 99464 CPT Code

This code provides numerous benefits to healthcare providers and the healthcare system. Here are the main advantages:

Common Mistakes to Avoid with 99464 CPT Code

Misuse of this code can lead to audits, denials, and loss of reimbursement. Understanding common pitfalls is essential for accurate coding.

• Insufficient Documentation: Failing to provide detailed notes about the resuscitation process can lead to denials. For example, if a provider does not document the newborn's condition or actions taken, it creates a lack of evidence for billing.
• Incorrect Time Reporting: Not accurately recording the duration of attendance can impact reimbursement. For instance, if a provider claims attendance for an hour but was only present for 20 minutes, it raises red flags.
• Billing for Non-Resuscitation Cases: Using this code when no resuscitation was performed can lead to compliance issues. For example, if a newborn required only routine monitoring without interventions, this code should not be applied.

99464 CPT Code vs other codes

Understanding how this code compares to others in similar situations is crucial for accurate billing. Below is a comparison with some related codes:

Conclusion

The 99464 CPT code is essential for capturing the attendance and resuscitation efforts provided to newborns immediately after delivery. Proper documentation is crucial, as it not only facilitates accurate billing but also ensures compliance with healthcare regulations.

Healthcare providers, including physicians, nurse practitioners, and physician assistants, can utilize this code effectively by understanding its requirements and avoiding common pitfalls.

Disclaimer: This article is for informational purposes only and does not constitute legal or medical advice. Always consult professional guidelines and regulatory bodies for specific compliance requirements.