Physician Attendance at Delivery for Newborn Care
|Original Policy Date
|Last Review Status/Date
Reviewed by consensus/4:2003
|Return to Medical Policy Index|
Our medical policies are designed for informational purposes only and are not an authorization, or an explanation of benefits, or a contract. Receipt of benefits is subject to satisfaction of all terms and conditions of the coverage. Medical technology is constantly changing, and we reserve the right to review and update our policies periodically.
A qualified physician (specifically, a pediatrician or a neonatologist) is physically present in the delivery room or operating room to receive an infant on delivery.
The services of an additional physician for the neonate at a cesarean section or vaginal delivery are considered medically necessary when requested by the attending physician and there is documentation of fetal distress or reasonable anticipation of newborn distress and the additional physician in attendance is directly involved in providing a service to the infant.
The initial newborn examination is included as part of the service by the physician in attendance at delivery.
Services by the additional physician are routinely not covered if subsequent professional services are not rendered by the same physician. When subsequent professional services are rendered by the same physician, the attendance is not paid as a separate service; it is an integral part of subsequent services.
BlueCard/National Account Issues
The information compiled for this policy was a combination of standard billing practices, Plan policies, and claims experience.
No applicable information
|CPT||99357||Prolonged physician service|
|ICD-9 Procedure||Code applicable “delivery” codes|
|ICD-9 Diagnosis||768.2–768.4||Fetal distress|
|Type of Service||OB/GYN|
|Place of Service||Inpatient|
Attendance at delivery, physician
Cesarean section, physician at attendance
Delivery, physician at attendance
Physician attendance at delivery
|11/30/96||Add to Administrative section||New policy|
|05/15/02||Replace policy||Policy reviewed without literature review; new review date only|
|12/17/03||Replace policy||Policy reviewed by consensus without literature review; no changes in policy; no further review scheduled.|