A full-term newborn is delivered by a nurse midwife in the mother's home. Later that day, the father brings the baby to the physician's office for her first checkup. Prenatal, family, and social histories are reviewed and a complete examination of the newborn is performed. Issues discussed include routine feeding, circumcision, immunizations, car safety, and use of the health care system. How should this service be reported?

Current Procedural Terminology (CPT®) code 99461 (initial care, per day, for evaluation and management [E/M] of normal newborn infant seen in other than hospital or birthing center) should be reported. Some payers inappropriately deny this service when it is provided in a physician's office. If a payer denies payment, appeal the claim.

During an E/M visit, the mother describes the child's extremely disruptive behavior as reported to her by his teacher. She is not seeing the same behavior at home. The...

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