A prenatal visit is important, especially for high-risk expectant families. AAP recommends a pediatric prenatal visit during the third trimester with a pediatrician to help establish a child’s medical home as well as build a supportive and trusting family-pediatric relationship prior to the baby’s birth. The prenatal visit is important for high-risk expectant families. Less than 5% of urban poor pregnant women see a pediatrician during the prenatal period although they are at higher risk of adverse pregnancy outcomes pregnant women in rural areas may have even more difficulty accessing a prenatal visit
During the postpartum period infants are seen frequently by pediatricians and expectant families are seen less frequently by their health care providers. Although the American College of Obstetrics recommends all expectant families be seen within 3 weeks of delivery, it is typical to see a provider 6 weeks after birth. Thus, the pediatrician is vital in supporting both infants and expectant families during this critical health period.
Disparities in access to health care services, lack of paid family leave, and other social drivers of health (SDOH), can impact expecting families’ ability to sustain or obtain optimal health, directly impacting the care the family can provide to their baby.
- Centers for Disease Control and Prevention (CDC). Preventing Pregnancy-Related Deaths. 2019.
- Hoyert, CDC. Maternal Mortality Rates in the United States, 2020. 2022.
- March of Dimes. Nowhere To Go: Maternity Care Deserts Across the U.S. (2022 Report). 2022.
Pediatrician Prenatal Visit Payment
Pediatricians and their care teams may discuss whether the visit will be covered by the expectant family’s insurance and whether a referral will be required. Payment advocacy is often required with payers. Office visits for new outpatient payment codes include 99201, 99202, 99203, 99204, and 99205 based on medical decision-making complexity and length of visit. Pediatricians and other providers can use the ICD-10 CM code Z76.81 for expectant parent(s) prebirth pediatrician visit.
Prenatal Visit Objectives
- Provide a foundation on which to build a positive family-pediatric partnership, a crucial part of the patient-centered medical home.
- Access pertinent aspects of the past obstetric and present prenatal history; to review family history of genetic or chromosomal disorders and to review fetal exposure to substances that may affect the infant.
- Introduce anticipatory guidance about early infant care and infant safety practices.
- Identify psychosocial factors that may affect family function and family adjustment to the newborn.
Follow these steps to improve maternal health and well-being care.
American Academy of Pediatrics