Payment may be made for routine in-patient care of a newborn.

If the doctor who performs the delivery also provides routine care for the newborn after delivery, payment may be made for both services.

When reported, payment may be made for attendance at delivery for an at risk neonate to a doctor other than the doctor who performs the delivery.

• For attendance at a cesarean section or attendance at a vaginal delivery, use code 99464.
• Payment may be made for one attendance (99464) for each newborn per delivery session (i.e., multiple births).
• Any specific procedures that are necessary to care for the sick infant(s) should be reported under the appropriate procedure code (e.g., intubation - 31500, resuscitation - 99465).
• When attendance at delivery (99464) and resuscitation (99465) are reported by the same doctor, the charges should be combined and processed under code 99465. The allowance for the resuscitation includes the allowance for the attendance at the delivery. Modifier 25 may be reported with medical care to identify it as a significant, separately identifiable service from the attendance at delivery or resuscitation. When modifier 25 is reported, the patient’s records must clearly document that separately identifiable medical care was rendered.
• If a doctor other than the doctor performing the delivery reports both attendance at the delivery and daily medical care of the newborn, payment may be made for both services.

This medical policy may not apply to FEP.  Medical policy is not an authorization, certification, explanation of benefits, or a contract.  Benefits are determined by the Federal Employee Program.