Evaluation and management (E/M) services provided to normal newborns are limited to initial care of the newborn in the first days after birth prior to home discharge. Codes for initial and subsequent care of the normal newborn are as follows:

Coding Well Newborns

Discharge services provided on a date subsequent to admission must be reported with code 99238 or 99239 depending on documented time.

Evaluation and Management Services for Newborns Age 28 Days or Less include the following:

  • Family consultation
  • Healthy newborn history and physical
  • Medical record documentation
  • Ordering of diagnostic test and treatments
  • Services provided to healthy newborns age 28 days or less

Evaluation and Management Services for Newborns Age 28 Days or Less exclude the following:

  • Neonatal intensive and critical care services (99466-99469, 99477-99480)
  • Newborn follow up services in an office or outpatient setting (99201-99215, 99381, 99391)
  • Newborn hospital discharge services if provided on a date subsequent to the admission date (99238-99239)
  • Non-routine neonatal inpatient evaluation and management services (99221-99233)

There are no procedures bundled into the Newborn Care Services codes; therefore, any procedures performed on the same day as a Newborn Care Service (e.g., code 54150, newborn circumcision), must be separately reported.

Source:

2014 American Academy of Family Physicians. CPT 2014 Professional Edition, AMA 2014 Section: Evaluation and Management/ Newborn Care Services pages 40-45.

This commentary is a summary prepared by McKesson’s Business Performance Services division and highlights certain changes, not all changes, in 2014 CPT® codes relating to the specialty of academic, multi-specialty and office based physicians. This commentary does not supplant the American Medical Association’s current listing of CPT® codes, its documentation in the annual CPT Changes publications, and other related publications from American Medical Association, which are the authoritative source for information about CPT® codes. Please refer to your 2014 CPT® Code Book, annual CPT® Changes publication, HCPCS Book and Payer Bulletins for additional information, including additions, deletions, changes and interpretations that may not be reflected in this document.

CPT is a registered trademark of the American Medical Association (“AMA”). The AMA is the owner of all copyright, trademark and other rights to CPT® and its updates. 

Author - Female

About the author

Stephanie Johnson, CHC, RHIT, CPC, CPEDS is Compliance Manager – Academic, Office-based and Multi-specialty Physicians of McKesson Business Performance Services.