Question

question 16

a pediatrician is asked to be in the room during the delivery of a baby at risk for complications. the pediatrician is in the room for 45 minutes. the baby is born and is completely healthy, not requiring the services of the pediatrician. what cpt® coding is reported by the pediatrician?

99219
99360 x 2
99252
99360

Explanation:

Identify the clinical scenario and service type

The pediatrician is requested to be present in the delivery room for standby in case of complications. The pediatrician spends 45 minutes on standby, but the baby is born healthy and does not require active resuscitation or direct clinical services. This constitutes physician standby service.

Determine the appropriate CPT code

CPT code 99360 is used to report physician standby services requiring prolonged physician attendance, each 30 minutes.

Calculate the units of service

• Standby service must be at least 30 minutes to be reported.
• Subsequent blocks of standby service are reported only if a full additional 30 minutes is met (i.e., 30 minutes = 1 unit; 60 minutes = 2 units).
• Since the pediatrician spent 45 minutes, only 1 unit of 99360 is reported because the second full 30-minute increment (requiring a total of 60 minutes) was not reached.

Answer:

• 99219
• 99360 x 2
• 99252
• 99360 (Correct answer)