Pediatrician present at delivery

ddraizeddraize
edited May 2016 in Pediatrics
Hi wondering if anyone can help me out. I received the following question- Dr. D heard that peds/FP was more likely to get paid for attending the delivery if the OB physician had placed an order for them to attend. My coding supervisor says that she doesn't know of any denials that we have received but that she thought an order would further establish medical necessity. I don't generally look at OB charts. Can anyone help to clarify.
Thanks

Diane Draize RN, CPHM,CCDS
Clinical Documentation Specialist

Ministry Door County Medical Center
diane.draize@ministryhealth.org
920-743-5566 ex 3143

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Comments

  • Unknown
    edited May 2016
    I was curious about the answer to your question, so I asked our professional fee coders this question and here is the response I received. Hope this helps:

    "CPT guidelines require that there be a specific request from the delivering provider in order for another provider to report attendance at delivery. That can be documented in the delivering provider’s note or in the note of the provider who is asked to attend. I always tell my providers to document in their note who requested the attendance as I cannot see the note of the delivering physician to verify whether there was a request and it is highly unlikely that the delivering physician ever documents this request. As far as an order, I think this is even less likely to happen. The attendance request is a gray area as there is a protocol written for the hospitals that establishes the criteria for which there will be a request. So the delivering provider doesn’t actually make the request, the delivery room team follows the protocol which all the delivering physicians have agreed to and signed off on. So this in their mind constitutes the request. I just tell my providers to document the name of the delivering physician in their note as the requestor since that delivering physician is aware of the request. I’ve never heard of a denial for any of my cases because of a missing request."

    Linda Haynes, RHIT, CCDS
    Manager, CDI
    Legacy Health
    lhaynes@lhs.org
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