2025 CPT code 99460
(Active) Effective Date: N/A Revision Date: N/A Evaluation and Management - Newborn Care Services Evaluation and Management Feed
Initial hospital or birthing center care, per day, for evaluation and management of a normal newborn infant.
Modifier 25 may be appended if significant, separately identifiable E/M services are provided on the same day as other procedures or services.
Medical necessity is established by the need for initial assessment and stabilization of the newborn following birth.Documentation must support the normal status of the infant and the services rendered.
The provider's responsibilities include initial newborn assessment, resuscitation if necessary (codes 99464 and 99465 would be added if needed), physical examination, ordering of diagnostic tests,family consultation, and documentation.
In simple words: This code covers the doctor's visit and care for a healthy baby right after birth, usually at the hospital or birthing center. It includes a check-up, tests if needed, and talking with the parents about the baby's health.
This CPT code reports the initial evaluation and management services provided to a normal newborn infant during their first days of life in a hospital or birthing center.The services include a comprehensive assessment of the newborn's health, considering maternal and fetal history, a thorough physical examination, ordering of necessary diagnostic tests and treatments, consultations with the family, and detailed documentation in the medical record. This code is specifically for normal newborns who do not require intensive or critical care.
Example 1: A healthy newborn is delivered vaginally and requires routine suctioning, umbilical cord ligation, and a brief physical exam in the delivery room. No significant complications are noted., A normal newborn is born via Cesarean section.The provider performs routine suctioning, umbilical cord care, and a complete physical exam.The baby's weight and vital signs are recorded, and the provider documents a detailed assessment., A healthy term infant is born via vaginal delivery. The provider performs a routine assessment in the delivery room, including clearing of airway and initial assessment.In addition to the routine care, the baby requires additional assessment due to maternal diabetes.
Detailed maternal and fetal history, including prenatal care and delivery details; complete newborn physical examination, including measurements and vital signs; any ordered diagnostic tests and their results; any treatments administered; notes from family consultations; and comprehensive documentation in the medical record.
** This code is for initial care only. Subsequent care is reported using code 99462. A normal newborn is defined as one who transitions to life in the usual manner, may require some delivery room interventions but is normal after transition, may require some testing or follow-up assessment (e.g., bilirubin, complete blood cell count, culture), but does not require significant intervention.
- Revenue Code: M6 (Consultations)
- RVU: Information not available in provided sources.RVUs vary based on geographic location and payer.
- Global Days: Information not available in provided sources.The global period may vary depending on the specific service and payer.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Information not available in provided sources.
- Specialties:Obstetrics, Neonatology, Family Medicine, Pediatrics
- Place of Service:Inpatient Hospital, Birthing Center