Pediatric Coding Alert
Four Revised Definitions, Three New Codes:
Make Way for an Overhaul of Pediatric Critical Care Services With CPT 2003
Pediatricians who were just beginning to understand the subtlet... Read more
Make Way for an Overhaul of Pediatric Critical Care Services With CPT 2003
Pediatricians who were just beginning to understand the subtlet... Read more
Get the Resources You Need for Coding in 2003
Make sure you have the proper resources to code pediatric services and procedures ... Read more
Make sure you have the proper resources to code pediatric services and procedures ... Read more
Modifier -63 Captures Increased Work for Procedures on Infants
CPT Codes 2003 creates a new modifier for the additional work involved in surgica... Read more
CPT Codes 2003 creates a new modifier for the additional work involved in surgica... Read more
Breathe Easier:
Revised Nebulizer Codes Top List of CPT Changes for 2003
Beginning Jan. 1, 2003, pediatricians can report nebulizer treatments and tr... Read more
Revised Nebulizer Codes Top List of CPT Changes for 2003
Beginning Jan. 1, 2003, pediatricians can report nebulizer treatments and tr... Read more
Reader Question:
Four Rules for Reporting Starred Procedures
Question: When we code an E/M with a starred procedure, the insurance company someti... Read more
Four Rules for Reporting Starred Procedures
Question: When we code an E/M with a starred procedure, the insurance company someti... Read more
You Be the Coder:
Stop Denials for Circumcision Bundling
Test your coding knowledge. Determine how you would code this situation before lookin... Read more
Stop Denials for Circumcision Bundling
Test your coding knowledge. Determine how you would code this situation before lookin... Read more
Stand Up to Observation Coding With Seven Scenarios
When a pediatrician admits a patient to observation status, keeping the nume... Read more
When a pediatrician admits a patient to observation status, keeping the nume... Read more
Documentation, Not Diagnosis, Is Crucial for Observation Billing
To avoid denials for observation services, pediatricians should concentrate on docum... Read more
To avoid denials for observation services, pediatricians should concentrate on docum... Read more
Wet Your Wallet With Six Tips on Infusion
To reap the full benefits of in-office hydration therapy, such as increased pati... Read more
To reap the full benefits of in-office hydration therapy, such as increased pati... Read more
Reader Question:
Modifier -25
Question: If a patient comes in and has an E/M visit (99213), blood count (85024) an... Read more
Modifier -25
Question: If a patient comes in and has an E/M visit (99213), blood count (85024) an... Read more
A Weighty Situation:
What 99298 Means Now
The anticipated definition change for 99298 (Subsequent neonatal intensive care, per... Read more
What 99298 Means Now
The anticipated definition change for 99298 (Subsequent neonatal intensive care, per... Read more
Clear the Way to Better Payment for Pre-Op Exams
When a pediatrician performs a preoperative examination, follow four t... Read more
When a pediatrician performs a preoperative examination, follow four t... Read more
CCI Update:
Version 8.3 Is Large but Not Alarming for Pediatricians
Although the latest version of the fourth-quarter Correct Coding Initiative (CCI) en... Read more
Version 8.3 Is Large but Not Alarming for Pediatricians
Although the latest version of the fourth-quarter Correct Coding Initiative (CCI) en... Read more
HCPCS Codes May Spell Relief for Undefined CPT Services
Although pediatricians aren't used to usin... Read more
Although pediatricians aren't used to usin... Read more
Reader Question:
New Versus Established Patient
Question: Our doctors see newborns in the hospital. Subsequently, the infants are ... Read more
New Versus Established Patient
Question: Our doctors see newborns in the hospital. Subsequently, the infants are ... Read more
Reader Question:
Contracting for After-Hours Visits
Question: In the September issue of Pediatric Coding Alert, you addressed billing ... Read more
Contracting for After-Hours Visits
Question: In the September issue of Pediatric Coding Alert, you addressed billing ... Read more
Reader Question:
Adoption Clearance
Question: How should we bill for patients who are under foster care and are being pu... Read more
Adoption Clearance
Question: How should we bill for patients who are under foster care and are being pu... Read more
You Be the Coder:
Serum Preparation and Administration
Test your coding knowledge. Determine how you would code this situation before l... Read more
Serum Preparation and Administration
Test your coding knowledge. Determine how you would code this situation before l... Read more
Six Scenarios Sort Out Pediatric NICU Coding
When pediatricians provide services for newborns going in and out of the neonata... Read more
When pediatricians provide services for newborns going in and out of the neonata... Read more
Three Questions Resolve 99211 Conundrum
Knowing when to report CPT 99211 can confound the most experienced pediatric prac... Read more
Knowing when to report CPT 99211 can confound the most experienced pediatric prac... Read more
ICD-9 Codes for 2003:
New Diagnosis for Fussy Baby Tops List of Extensive Changes
Pediatricians will welcome the new and revised ICD9 codes for 2003, which add... Read more
New Diagnosis for Fussy Baby Tops List of Extensive Changes
Pediatricians will welcome the new and revised ICD9 codes for 2003, which add... Read more
Reader Question:
Modifier -21
Question: In the July issue of Pediatric Coding Alert, you recommended using... Read more
Modifier -21
Question: In the July issue of Pediatric Coding Alert, you recommended using... Read more
Reader Question:
Suture Removal by Different Doctor
Question: How should I report suture removal without anesthesia in the office when... Read more
Suture Removal by Different Doctor
Question: How should I report suture removal without anesthesia in the office when... Read more
Newborn Discharge Worries Should Drive Follow-Up Office Visit Coding
When evaluating a newborn after a hospital discharge, don't fall into the trap of codi... Read more
When evaluating a newborn after a hospital discharge, don't fall into the trap of codi... Read more
Wake Up to Better Conscious Sedation Reimbursement
Although many pediatric practices receive denials for conscious... Read more
Although many pediatric practices receive denials for conscious... Read more
CCI Edits Cause No Panic This Round
The Correct Coding Initiative (CCI) version 8.2 is now in effect, but expert... Read more
The Correct Coding Initiative (CCI) version 8.2 is now in effect, but expert... Read more
Stop Fretting Over Counseling Woes
Are difficult children or worried parents consuming your valuable time... Read more
Are difficult children or worried parents consuming your valuable time... Read more
Reader Question:
Requirements of 99211
Question: How do we get paid for nurse time (CPT 99211 ), such as weighing in-offi... Read more
Requirements of 99211
Question: How do we get paid for nurse time (CPT 99211 ), such as weighing in-offi... Read more
Reader Question:
Anaphylactic Reaction
Question: After a patient receives an allergy injection, she has an anaphylactic rea... Read more
Anaphylactic Reaction
Question: After a patient receives an allergy injection, she has an anaphylactic rea... Read more
You Be the Coder:
Foreign Body Versus E/M
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Foreign Body Versus E/M
Test your coding knowledge. Determine how you would code this situation before looking... Read more
A Seven-Step Guide to Neonatal Coding
When a neonate changes from a normal to sick, you risk overlooking opportunities to ... Read more
When a neonate changes from a normal to sick, you risk overlooking opportunities to ... Read more
Time Is of the Essence in ADD Evaluations
Four options exist to reap full reimbursement for the time you spend on evalua... Read more
Four options exist to reap full reimbursement for the time you spend on evalua... Read more
Correction:
Put V Codes in Primary Place for Preoperative Examinations
In the June 2002 Pediatric Coding Alert ("How to Modify a Diagnosis With a V Code"), t... Read more
Put V Codes in Primary Place for Preoperative Examinations
In the June 2002 Pediatric Coding Alert ("How to Modify a Diagnosis With a V Code"), t... Read more
Reader Question:
Adverse Reaction to Medication
Question: A diabetes patient who just started using insulin presented with blurred vis... Read more
Adverse Reaction to Medication
Question: A diabetes patient who just started using insulin presented with blurred vis... Read more
Reader Question:
Office Visit Leads to Hospital Care
Question: After examining a patient in the office and finding fecal impaction causing ... Read more
Office Visit Leads to Hospital Care
Question: After examining a patient in the office and finding fecal impaction causing ... Read more
You Be the Coder:
Nebulizer Treatments
Test your coding knowledge. Determine how you would code this situation before lookin... Read more
Nebulizer Treatments
Test your coding knowledge. Determine how you would code this situation before lookin... Read more
To Ensure Proper Observation Coding, Consider Site of Service and Length of Stay
When selecting codes for short-stay hospital patients, pediatric coders should consi... Read more
When selecting codes for short-stay hospital patients, pediatric coders should consi... Read more
How to Modify a Diagnosis With a V Code
Certain V codes describe an encounter but may not be payable when used alone. But... Read more
Certain V codes describe an encounter but may not be payable when used alone. But... Read more
News Brief:
Still No Physician Work Value For Vaccine Administration
When CMS issued the fee schedule for 2002, it did not publish any work value for the v... Read more
Still No Physician Work Value For Vaccine Administration
When CMS issued the fee schedule for 2002, it did not publish any work value for the v... Read more
Reader Question:
Ring Block
Question: Should we use CPT 64450 in addition to the circumcision code if all we do i... Read more
Ring Block
Question: Should we use CPT 64450 in addition to the circumcision code if all we do i... Read more
Reader Question:
Pulse Oximetry
Question: Can a pediatrician bill separately for pulse oximetry? Florida Subscriber An... Read more
Pulse Oximetry
Question: Can a pediatrician bill separately for pulse oximetry? Florida Subscriber An... Read more
Reader Question:
Time Attending Delivery
Question: How can I bill for the time spent attending a delivery? The baby had Apgars ... Read more
Time Attending Delivery
Question: How can I bill for the time spent attending a delivery? The baby had Apgars ... Read more
You Be the Coder:
Hearing Screening and Testing
Test your coding knowledge. Determine how you would code this situation before lo... Read more
Hearing Screening and Testing
Test your coding knowledge. Determine how you would code this situation before lo... Read more
Use Modifier -25 to Properly Code For Visits Requiring Multiple Services
Pediatricians are familiar with the coding dilemma of the child who presents for ... Read more
Pediatricians are familiar with the coding dilemma of the child who presents for ... Read more
Use Accurate Diagnosis Code When Ordering Neonatal Tests
Pediatricians must order tests on newborns, and some of these tests may be esoteric. H... Read more
Pediatricians must order tests on newborns, and some of these tests may be esoteric. H... Read more
After-hours Codes Gain Acceptance
The after-hours and related codes (99050, Services requested after office hours in addit... Read more
The after-hours and related codes (99050, Services requested after office hours in addit... Read more
Two Minor Changes in CCI 8.1 Affect Pediatricians
The Correct Coding Initiative, version 8.1, includes some new bundling edits of inte... Read more
The Correct Coding Initiative, version 8.1, includes some new bundling edits of inte... Read more
Reader Question:
Newborn Exam and Treatment
Question: How should we bill if our pediatrician examines a newborn (premature) in the h... Read more
Newborn Exam and Treatment
Question: How should we bill if our pediatrician examines a newborn (premature) in the h... Read more
Reader Question:
Well Visit Before Vacation
Question: We recently had a patient who has had recurrent ear problems. The family is go... Read more
Well Visit Before Vacation
Question: We recently had a patient who has had recurrent ear problems. The family is go... Read more
Reader Question:
Billing for Urine Testing
Question: Should I use CPT 99211 for a patient if the parent just drops off a urine sam... Read more
Billing for Urine Testing
Question: Should I use CPT 99211 for a patient if the parent just drops off a urine sam... Read more
Reader Question:
Rapid Strep Test
Question: Should we use CPT 87880 for a rapid strep test performed in the office, fo... Read more
Rapid Strep Test
Question: Should we use CPT 87880 for a rapid strep test performed in the office, fo... Read more
You Be the Coder:
Behavior and Health Assessment
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Behavior and Health Assessment
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Infants Status Drives Coding Additional Services at Delivery
Many pediatricians and payers are confused about what additional services can be bill... Read more
Many pediatricians and payers are confused about what additional services can be bill... Read more
Report Condition for Mental/Behavioral Problems
Many private payers have mental-health restrictions for their managed care plans. Th... Read more
Many private payers have mental-health restrictions for their managed care plans. Th... Read more
Use Four Steps to Accurately Select Laceration Repair Codes
When you repair a laceration, four elements determine the correct code: 1. Classification:... Read more
When you repair a laceration, four elements determine the correct code: 1. Classification:... Read more
Clarification:
Casting and Strapping Include Application, Not Supplies
In the January article "Ethically Maximize Reimbursement for Fracture Treatment ... Read more
Casting and Strapping Include Application, Not Supplies
In the January article "Ethically Maximize Reimbursement for Fracture Treatment ... Read more
Reader Question:
Reporting Chronic Conditions
Question: Some of our patients have chronic conditions that consume a lot of the p... Read more
Reporting Chronic Conditions
Question: Some of our patients have chronic conditions that consume a lot of the p... Read more
Reader Question:
Processing Special Reports
Question: Which code should we use for filling out forms? Will it be paid? Connecticu... Read more
Processing Special Reports
Question: Which code should we use for filling out forms? Will it be paid? Connecticu... Read more
Reader Question:
Suture Removal
Question: Should we charge for removing sutures? What if they were placed in the emer... Read more
Suture Removal
Question: Should we charge for removing sutures? What if they were placed in the emer... Read more
You Be the Coder:
Pelvic Examinations
Test your coding knowledge. Determine how you would code this situation before lo... Read more
Pelvic Examinations
Test your coding knowledge. Determine how you would code this situation before lo... Read more
Select E/M Level Based on New Documentation Guidelines
The AAP has proposed guidelines that are relevant to pediatrics. These guidelines ar... Read more
The AAP has proposed guidelines that are relevant to pediatrics. These guidelines ar... Read more
Correction:
Outpatient Consultation Codes for Observation Unit
In the December 2001 issue of Pediatric Coding Alert on page 96, in a reader question ... Read more
Outpatient Consultation Codes for Observation Unit
In the December 2001 issue of Pediatric Coding Alert on page 96, in a reader question ... Read more
News Brief:
Changes for Neonatal, Pediatric Intensive Care Codes for 2003
The neonatal intensive care codes (99295-99298) will be altered and added to in 2003.... Read more
Changes for Neonatal, Pediatric Intensive Care Codes for 2003
The neonatal intensive care codes (99295-99298) will be altered and added to in 2003.... Read more
Reader Question:
Billing for Prescription Writing
Question: Writing triplicate prescriptions for Ritalin takes a lot of time. Can you sugg... Read more
Billing for Prescription Writing
Question: Writing triplicate prescriptions for Ritalin takes a lot of time. Can you sugg... Read more
Reader Question:
Newborn Examination
Question: If a baby is not seen until the day after it is born, how should the pediatric... Read more
Newborn Examination
Question: If a baby is not seen until the day after it is born, how should the pediatric... Read more
Reader Question:
Failed In-Office Hydration
Question: We recently treated a child with gastroenteritis in the office. The visit requ... Read more
Failed In-Office Hydration
Question: We recently treated a child with gastroenteritis in the office. The visit requ... Read more
Reader Question:
Telephone Admission to ED
Question: How should I bill for a patient admitted by telephone and discharged the next ... Read more
Telephone Admission to ED
Question: How should I bill for a patient admitted by telephone and discharged the next ... Read more
Reader Question:
Coding for the Bili Chek
Question: How should I bill for the new transcutaneous bilirubin machine?Arizona Subscri... Read more
Coding for the Bili Chek
Question: How should I bill for the new transcutaneous bilirubin machine?Arizona Subscri... Read more
Reader Question:
Preauthorizing Synagis
Question: How can I streamline the process of preauthorizing Synagis?Texas Subscriber &... Read more
Preauthorizing Synagis
Question: How can I streamline the process of preauthorizing Synagis?Texas Subscriber &... Read more
Reader Question:
Multiple Nebulizer Training
Question: We often perform numerous nebulizer treatments on a patient on the same day. H... Read more
Multiple Nebulizer Training
Question: We often perform numerous nebulizer treatments on a patient on the same day. H... Read more
Reader Question:
Dorsal Penile Nerve Block
Question: Should I code a ring block the same as a dorsal penile nerve block?New Jersey ... Read more
Dorsal Penile Nerve Block
Question: Should I code a ring block the same as a dorsal penile nerve block?New Jersey ... Read more
You Be the Coder:
Car Crash without Injury
Test your coding knowledge. Determine how you would code this situation before l... Read more
Car Crash without Injury
Test your coding knowledge. Determine how you would code this situation before l... Read more
Common In-Office Waived Tests:
A Guide to Reporting the Plethora of New Tests
Pediatricians perform many "lab" tests in the office such as rapid tests to denote whe... Read more
A Guide to Reporting the Plethora of New Tests
Pediatricians perform many "lab" tests in the office such as rapid tests to denote whe... Read more
Drum-in Otitis Media Diagnosis with Five Scenarios
In pediatrics, the most typical otitis diagnosis is related to the middle ear and is ... Read more
In pediatrics, the most typical otitis diagnosis is related to the middle ear and is ... Read more
Select Symptom, Definitive Diagnosis Based on Encounter
In pediatrics, often there is no definitive diagnosis. In these cases, use a signs and... Read more
In pediatrics, often there is no definitive diagnosis. In these cases, use a signs and... Read more
Reader Question:
The Benefits of E Codes
Question: Should I use E codes for accidents?Illinois Subscriber Answer: Although E... Read more
The Benefits of E Codes
Question: Should I use E codes for accidents?Illinois Subscriber Answer: Although E... Read more
Reader Question:
Asthma Services
Question: When an asthma patient comes in for a checkup, should I code a sick visit or p... Read more
Asthma Services
Question: When an asthma patient comes in for a checkup, should I code a sick visit or p... Read more
Reader Question:
E/M without History
Question: When a nanny brings a patient in and I cant obtain a comprehensive history, how ... Read more
E/M without History
Question: When a nanny brings a patient in and I cant obtain a comprehensive history, how ... Read more
You Be the Coder:
Hospital Accompaniment
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Hospital Accompaniment
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Ethically Maximize Reimbursement for Fracture Treatment in a Primary Care Setting
When primary care pediatricians provide fracture care and laceration repair a commo... Read more
When primary care pediatricians provide fracture care and laceration repair a commo... Read more
New Asthma Diagnosis Codes Create Choices and Confusion
" Expanded and refined diagnosis coding for respiratory problems (491-496)... Read more
" Expanded and refined diagnosis coding for respiratory problems (491-496)... Read more
Treat Dehydration in the Office for a Wetter Bottom Line
When a child is dehydrated due to gastroenteritis, many pediatricians send the patient t... Read more
When a child is dehydrated due to gastroenteritis, many pediatricians send the patient t... Read more
Free Anthrax Coding Report on Web
Physicians and other healthcare professionals who provide services to any patients with ac... Read more
Physicians and other healthcare professionals who provide services to any patients with ac... Read more
Reader Question:
Medicaid and Vaccines
Question: How can I tell if Medicaid will pay for vaccine administration codes?Michigan Su... Read more
Medicaid and Vaccines
Question: How can I tell if Medicaid will pay for vaccine administration codes?Michigan Su... Read more
Reader Question:
Downcoding Office Visits
Question: One insurance company downcodes all of our CPT 99213 s (established patient of... Read more
Downcoding Office Visits
Question: One insurance company downcodes all of our CPT 99213 s (established patient of... Read more
Reader Question:
Pulmonary Function Testing
Question: My practice is interested in doing pulmonary function testing on asthma patients... Read more
Pulmonary Function Testing
Question: My practice is interested in doing pulmonary function testing on asthma patients... Read more
Reader Question:
Dx for Immunization
Question: Should I use individual diagnosis codes for each vaccination, or should I lump... Read more
Dx for Immunization
Question: Should I use individual diagnosis codes for each vaccination, or should I lump... Read more
You Be the Coder:
Allergy Shots
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Allergy Shots
Test your coding knowledge. Determine how you would code this situation before loo... Read more