Advanced Search

Pediatric Coding Alert

Determine When To Bill for Interpreting X-Rays With Modifier -26
Sometimes a pediatrician, not a radiologist, interprets x-rays performed on a patient.... Read more
An Anthrax Coding Primer for Pediatricians
While it's highly unlikely that you will have a case of anthrax in your office, you ha... Read more
Anthrax Coding Report Free on Web
Physicians and other healthcare professionals who provide services to any patients with ... Read more
AAP Complaint Changes BC/BS Vaccination Policy
Since the vaccine-administration codes (90471, immunization administration [includes percu... Read more
New Fee Schedule Raises RVUs for Venipuncture
The Medicare Fee Schedule released Nov. 1, 2001, shows a big increase in the relative v... Read more
Fight Circumcision Edits
Private-payer bundling of newborn circumcisions with E/M visits has caused decreased rei... Read more
Clarification:
Laryngoscopy
In the October issue of Pediatric Coding Alert, CPT 31500 (intubation, endotracheal, emer... Read more
Reader Question:
Non-Patient Consult
Question: How should I bill for a physician who performs a 30-minute consultation with a p... Read more
Reader Question:
Pre-Vacation Check
Question: How should I code for a patient whose parent wants to make sure he is ok befor... Read more
Reader Question:
Preoperative Exams
Question: I have a doctor who is often called in to perform preoperative exams on chil... Read more
You Be the Coder:
Conscious Sedation
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
New Intranasal Codes Nothing To Sneeze at:
CPT Codes for 2002 Affect Pediatricians
A number of new and revised CPT codes will affect pediatricians in... Read more
New Sore-Throat Codes Top List of ICD-9 Changes for 2002
New and revised ICD9 Codes for 2002 in several categories, such as sore t... Read more
Get Paid for Same-Day E/M Services and Minor Procedures
Pediatricians lose revenue if they do not bill for minor procedures done during an off... Read more
Perform Neonatal Circumcision in the Office With Anesthesia
Many insurance companies will not pay for a newborn circumcision in addition to a hospital... Read more
Use S Codes for Private Payers
Pediatric coders may be unfamiliar with S codes, a set of HCPCS Codes that applies to su... Read more
Reader Question:
Nurse Counseling
Question: How should I bill for a nurse who spends more than half an hour counseling a par... Read more
Reader Question:
E/M With Starred Procedure
Question: Our physician charges an E/M service with a starred procedure (e.g., foreign bod... Read more
Reader Question:
Intubation
Question: What is the correct code for intubation?Maryland Subscriber Answer: The cod... Read more
You Be the Coder:
Strep Test
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Meet the Challenge of Diagnosing Drug- and Alcohol-Affected Infants and Children
When a baby is (or might be) born affected by drugs or alcohol, the attending pedi... Read more
Five Tips To Cope With Vaccine Administration Bundling
Pediatricians across the country have noticed with increasing alarm that payers are ... Read more
Follow Standard of Practice To Bill Conscious Sedation
Along with vaccine administration, another bundling edit that affects mainly pediatric s... Read more
National Conference Targets Pediatric and Ob-Gyn Coding and Compliance
The National Pediatric and Ob-Gyn Coding and Compliance Conference: 2001 will be held in ... Read more
Reader Question:
WIC Check
Question: When a child comes in for a WIC (Women, Infants and Children) check and has weig... Read more
Reader Question:
Transfer to New Facility
Question: When caring for a high-risk newborn who is transferred to another facility, is... Read more
Reader Question:
Epinephrine Administration
Question: How should we code for giving an epinephrine shot after a bee sting?Connecticut ... Read more
Reader Question:
Checking Tubes
Question: How should we code for looking at tubes when the child has no symptoms?Michiga... Read more
You Be the Coder:
Nurse-Provided Services
Test your coding knowledge.  Determine how you would code this situation before... Read more
Choose the Best Option for Billing School-Mandated Sports Examinations
Now that school has begun, pediatricians will be performing sports exams, which are genera... Read more
Get Paid for Time Spent on E/M Services
The most commonly used pediatric codes are E/M services, and when pediatricians l... Read more
Coding Options for Developmental Screenings
Most pediatricians perform developmental screening as a part of well visits. But a new AAP... Read more
Know When To Bill Consultations in the ED
When a pediatrician sees a patient in the emergency department (ED), he or she may bill ... Read more
Reader Question:
Medicaid Versus Commercial Payer Billing
Question: Do I have to bill Medicaid and commercial patients the same way?Pennsylvania S... Read more
Reader Question:
Splinter Removal
Question: How can we get paid fairly for extra time spent removing a splinter?Wyoming Subs... Read more
Reader Question:
Blood Draw
Question: Which code should we use for drawing blood from an antecubital vein? If the chil... Read more
Reader Question:
Office Visit With Fracture Repair
Question: When can we bill an office visit in addition to a fracture repair? Ohio Subscrib... Read more
Reader Question:
Cerumen Removal
Question: When can we bill for cerumen removal in addition to an office visit? Louisiana... Read more
You Be the Coder:
Pulse Oximetry
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Identify and Document the Problem To Get Paid for a Pelvic Exam During a Well Visit
Pediatricians who perform pelvic exams on teens must code caref... Read more
Modifier -25:
How To Insist on Payment
A classic pediatric coding dilemma is the well visit that turns into a sick-well visit com... Read more
Dont Panic When Coding for Meningitis Counseling
Chances are that few, if any, of your patients will contract meningococcal meningitis ... Read more
News Brief:
Special Modifier in the Works
The American ... Read more
Reader Question:
Angelmans Syndrome
Question: What is the correct diagnosis code for Angelman's syndrome?Louisiana Subscribe... Read more
Reader Question:
Hearing and Vision Screening
Question: How do we get reimbursed for hearing and vision screens done during a well visit... Read more
Reader Question:
Modifier -22 With Difficult Procedure
Question: When we perform a difficult procedure such as catheterization, can we bill ext... Read more
You Be the Coder:
Newborn Exam After Home Birth
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Capture Deserved Reimbursement for Fracture Evaluation and Repair
Treating a child with a possible fracture can require a lot of time. The pediatricia... Read more
Billing an Office Visit With Allergy Shots
Allergies and allergic asthma have been on the upswing among children. But the... Read more
Code Attending Deliveries Properly
Pediatricians are accustomed to being summoned to the delivery room by the obs... Read more
Reader Question:
New Vaccine Administration Codes
Question: I have heard there are new vaccine administration codes. What are they? &nb... Read more
Reader Question:
Consultations Versus Preventive Medicine Codes
Question: Is it better to use consultation codes than preventive medicine codes for sc... Read more
Reader Question:
Consults From ED
Question: A patient is referred to one of our pediatricians by an emergency room physi... Read more
Reader Question:
Recheck Diagnoses
Question: Which diagnosis should we use for rechecks? Pennsylvania Subscriber  ... Read more
Reader Question:
Fracture Repair for Dislocated Finger
Question: My doctor reduced and splinted a dislocated pinky by taping two fingers togeth... Read more
Reader Question:
Conscious Sedation
Question: We are sometimes called to administer conscious sedation in the hospital to ... Read more
Reader Question:
Handling of Lab Specimens
Question: When we prepare a urine specimen for culture, and the lab picks it up at our o... Read more
You Be the Coder:
In-office Hearing Screens
Test your coding knowledge.  Determine how you would code this situation before l... Read more
Several Options Provide Reimbursement for Telephone Calls With Subspecialists
Often, pediatricians must discuss a patients care via telephone with other healthcare prov... Read more
Use Diagnosis Codes, Not V Codes, for Preoperative Clearance
Reviewed on May 11, 2015 Many private payers refuse to recognize V codes V72.81 (pre... Read more
Know the Options When Coding Nebulizer Treatments
When coding for nebulizer treatments, pediatricians may choose either CPT 94640 (nonpress... Read more
Reader Question:
Coding 99432
Question: Can we use 99432 for routine office visits for a normal newborn within the first... Read more
Reader Question:
Well Visits
Question: The number of codes necessary for first-year well visits seems excessive. How, f... Read more
Reader Question:
Rapid Influenza Test
Question: How do we code for rapid influenza tests done in the office? New Hampshire ... Read more
Reader Question:
Lactation Consultation
Question: How can we bill for lactation consultation given in our office by a registered n... Read more
You Be the Coder:
E/M With Catheterization
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Secure Reimbursement for Time Spent on Violence-prevention Counseling
With media coverage of school shootings and violence among children increasing, pediatrici... Read more
Code High-level Office Visit for Child Molestation Exams
Normally, when coding an examination for suspected molestation, the pediatrician should us... Read more
Who Should Do the Coding:
Pediatrician or Coder?
Pediatricians shouldnt rely on the billing department to choose procedure (CPT Codes ) a... Read more
Reader Question:
Subsequent Hospital Care
Question: What are the documentation requirements for subsequent hospital care (99433) c... Read more
Reader Question:
In-office Test
Question: When I perform an in-office test, can I just document that the test is normal, o... Read more
Reader Question:
Behavioral Problems
Question: Our office treats several children with behavioral problems. We use diagnosis co... Read more
Reader Question:
Office Visit
Question: Our office recently had a patient for whom we performed a complete history and e... Read more
Reader Question:
Preventive Medicine Service
Question: If a child comes in for a well visit and it turns out that the child is sick (fo... Read more
Reader Question:
Peak Flow Test
Question: What is the correct CPT Code for a peak flow test before and after nebulizer ... Read more
Reader Question:
Diagnosis Codes
Question: If a child comes in several times within a two- to three-week period, how should... Read more
Reader Question:
Special Services
Question: Can you give us some guidance for use of CPT 92506, 92507 and 92508? We have bee... Read more
You Be the Coder:
Ear Piercing
Question: We are often asked to perform ear piercing. What code can we use?Connecticut Sub... Read more
Receive Deserved Reimbursement:
Bill 24640* And Office Visit for Nursemaid Elbow
Pediatricians should always code 24640* (closed treatment of radial head subluxation in ch... Read more
Choose Conscious Sedation or Anesthesiology Codes Appropriately for Optimal Payment
Conscious sedation codes 99141 (intravenous, intramuscular or inhalation) and 99142 (oral,... Read more
Case Study:
Use Consultation, Hospital Codes for Co-management
Proper use of consultation or hospital codes allows a pediatrician co-managing a complicat... Read more
Use Hospital Admission Codes For Problem Newborns
Coders are often unsure whether to bill a normal newborn or hospital admission code for ... Read more
Reader Question:
Casting Material
Question: Can we bill a supply code for casting material in conjunction with global fractu... Read more
Reader Question:
Office Consultation
Question: Under what circumstances may we use the office consultation codes?Massachusetts ... Read more
Reader Question:
Foreign Body Removal
Question: How should we code for foreign body removal of an earring underneath the skin?Vi... Read more
Reader Question:
Attendance at Delivery
Question: How should I bill for attending delivery of a baby if the on-call pediatrician... Read more
You Be the Coder:
Normal Newborn Care
Question: I recently sent two coders to a coding seminar, and they were told they could ... Read more
Claim Deserved Reimbursement:
Coding Sick Visits With Preventive Medicine Services
According to CPT, a physician may bill a sick visit (office or other outpatient services c... Read more
Case Study:
Three Scenarios Demonstrate Coding Solutions for Abdominal Pain Diagnosis
The common complaint of abdominal pain can result in many potential diagnoses, and may lea... Read more
News Brief:
Two New Administration Codes for 2002 Can Be Used Now
In an early release of 2002 codes, the AMA has announced two new vaccine administration co... Read more
CCI Suspension Stresses Need For Proper Modifier -25 Use
HCFA has temporarily suspended edits introduced in version 6.3 of the national Correct C... Read more
Reader Question:
Weight Checks
Question: How should we code for weight checks?Texas Subscriber Answer: If you asked that ... Read more
Reader Question:
Consult With Neonatologist
Question: A neonatologist was called into the delivery room for a consult and had to resus... Read more
Reader Question:
Multiple Immunizations
Question: What diagnoses should we use when administering multiple immunizations? We use V... Read more
Reader Question:
Handling Fee for PKU Test
Question: Our states Medicaid program does not reimburse a drawing fee in the office setti... Read more
Reader Question:
Pure Tone Audiometry
Question: According to CCI, codes for pure tone audiometry (CPT 92552 ) are bundled with o... Read more
You Be the Coder:
New or Established Patients?
Question: If a pediatrician closes his solo practice and joins a group practice with a d... Read more
Preventive Medicine Codes and 99173 Provide Optimal Reimbursement for Vision Screens
"The addition of two new vision screening codes 99173 in 2000 and 99172 in 2001 has... Read more
Use Modifiers and Prolonged Services Codes to Ensure Payment For Difficult, Unusual and Incomplete Procedures
On occasion a pediatrician attempts a procedure but, due to unusual or unforeseen circumst... Read more
Clarification:
Newborn Checkup
Decembers You Be the Coder reported that an established patient office visit (99211-9921... Read more
Breaking News:
HCFA Rejects Modifier -60
HCFA has decided not to recognize modifier -60 (altered surgical field). The new surgica... Read more
Reader Question:
Fetal Alcohol Syndrome
Question: How do we code office visits for a baby/child with fetal alcohol syndrome? How s... Read more
Reader Question:
E/M With Flu Shot
Question: How do we code for a child who comes to the office for a flu shot (administered ... Read more
Reader Question:
SIDS Diagnosis
Question: What is the best code for monitoring an apparently normal, well newborn/infant w... Read more
Reader Question:
Conscious Sedation
Question: Our pediatrician spent two hours providing rectal conscious sedation with Brev... Read more
You Be the Coder:
Same-day Services
Question: How do we code when a physician sees the patient in the morning for a well visit... Read more
Choose the Correct E/M Level to Optimize Reimbursement Ethically
Pediatricians who see four to six patients an hour may think they dont have time to calc... Read more
News Brief:
Unit Edits on 90472 Still Unresolved; Bundling on 90471/90472 Fixed
Immunization administration codes 90471 (immunization administration [includes percutaneou... Read more
Protect Your Reimbursement by Fighting Automatic Downcoding
When patterns review software first threatened to cut reimbursements for pediatricians in ... Read more
Reader Question:
Tuberculosis Test
Question: Can I code CPT 99211 for tuberculosis (PPD) checks? What is the corresponding d... Read more
Reader Question:
Venipuncture
Question: How should we code for a venipuncture? We use CPT 36415 *, but only when sending... Read more
Reader Question:
Allergen Immunotherapy
Question: How should I code for allergen immunotherapy? Does it matter if our practice giv... Read more
Reader Question:
Suture Removal
Question: What CPT and ICD-9 codes should we use when suture removal is done in the pediat... Read more
Reader Question:
Subsequent Hospital Care
Question: What documentation is necessary to code subsequent hospital care (99433)? ... Read more
You Be the Coder:
Normal Newborn Discharge
Question: Can I bill a discharge for a normal newborn?Wisconsin SubscriberTest your coding... Read more
Available Years:  2001  2000  1999  1998