Advanced Search

Pediatric Coding Alert

Let 3 Markers Guide Your Age-Restricted Diagnosis Coding or Risk MCE Edits
Prevent fussy-infant claim rejections by following payers' cycle definitions. ICD-9 2010 ... Read more
Greenlight 99211 With 9047x By Saying 'Yes' to These Questions
Don't code a nurse visit at a scheduled flu shot unless you can check off 4 items. Althou... Read more
Research 99211 Policies to Apply CCI Only When Necessary, Per AAP
Following the Correct Coding Initiative (CCI) edits across the board might save you time, ... Read more
Solving V60-V61 Dilemma? Look at Foster Care's Reason
One option can be only an additional diagnosis, not a primary. Now that you have four cod... Read more
READER QUESTIONS:
Check Cast Type to Determine Global, Itemization
Question: Our office has an after-hours facility that treats acute illnesses and non-comp... Read more
READER QUESTIONS:
Is 99231 x 40 OK?
Question: A patient with date of birth (DOB) 8/24/09 is now 47 days old. The baby was kep... Read more
READER QUESTIONS:
Here's When to Report Steroid Therapy History
Question: I see that ICD-9 2010 introduced new codes for personal history of inhaled ster... Read more
READER QUESTIONS:
Negative Urinalysis on Day 2: What V Code?
Question: A patient came in for a well check. The pediatrician ordered a urinalysis, whic... Read more
READER QUESTIONS:
Injured While Dancing: There's an E Code
Question: A patient fell at dance class and our pediatrician treated her for a concussion... Read more
You Be the Coder:
Parental Smoking Cessation Counseling
Question: At a problem-oriented visit, a pediatrician counsels a mother about how her sec... Read more
3-Prong Test Helps Support Your Time-Based Coding for Family Issues
AAP got you more family disruption, problem counseling, and foster care codes -- sta... Read more
Track Payer's Preferred H1N1 Admin Code -- or Risk Rejections
Code 488.1 does not = confirmed lab. Swine flu has made an early arrival in several state... Read more
4 Tactics Protect Your Cerumen Removal Pay
These tips tell you when to use 69210. You can rest assured that claims for 69210 (Remova... Read more
Correction:
Stay With V20.3x for Newborn Exam
Be careful that you still include the familiar 2 after the V code when using the newborn h... Read more
READER QUESTIONS:
Revise Your 'Hoarseness' ICD-9 Crosswalk
Question: In 2009, our ICD-9 cheat sheet lists 784.49 for hoarseness. Will the code chang... Read more
Reader Questions:
Splint on Day 2: Is It Reportable?
Question: Does the physician fee schedule assign global periods to the application of spl... Read more
Reader Questions:
Hx of Spider Bite: V15.06 Vs V15.09
Question: A patient has a history of allergic reactions to spider bites. When treatment o... Read more
Reader Questions:
Get 779.3x's 4th Digit With These Clues
Question: The expanded 779.3x subcategory codes seem so similar. Can you help me understa... Read more
Reader Questions:
Does 99000 Require Outside Lab, Urine Culture?
Question: I was under the impression the handling fee was only for labs that our office s... Read more
You Be the Coder:
Is 96110 OK With No Face-to-Face?
Question: A pediatrician receives a completed Teachers Vanderbilt ADHD rating scale in th... Read more
ICD-9 2010:
Good-Bye Nursemaid's Elbow,Transient Event Mysteries; Hello 4-Digit and 'ALTE' Codes
Not using 24640 -- a common error -- can cost your practice almost $70. You&... Read more
Termipedia:
What Is ALTE?
To get your head around new code 799.82, you've got to be up on the vocab. The National In... Read more
Seasonal Coding:
These Tactics Boost Your Flu Prevention Pay by $38
Avoid pitfalls that leave you footing vaccine costs. To ethically recoup all your deserve... Read more
Always Used V20.2? That's About to Change.
These codes explain atypical vaccine schedule, dad courtesy visit -- and more. Your ... Read more
READER QUESTIONS:
Does 'No SOB' Fall Under HPI or ROS?
Question: For a chart with a chief complaint of resolving pneumonia, a note indicates, "N... Read more
READER QUESTIONS:
Employer, Not You, Determines Surgery Co-Pays
Question: We are having an issue in our pediatric office regarding 56441. The patient had... Read more
READER QUESTIONS:
96110's Report Requires Recording Result
Question: Can you clarify what documentation needs to appear in the medical record when w... Read more
READER QUESTIONS:
Could Ending 99241-99255 Pay Help Your Practice?
Question: I'm hearing that consultation codes (99241-99255) will go away in 2010. How wil... Read more
READER QUESTIONS:
What Product Code for Swine Flu Vaccine?
Question: Some patients' parents are requesting that their children receive the H1N1 flu ... Read more
You Be the Coder:
Check for System Gaming After I&D Global Ends
Question: Codes 10060 and 10061 have a 10-day global fee, which means you cannot bill an ... Read more
Prevent Infant Problem Visit Autorejections With These Must Have ICD-9 2010 Updates
This step-by-step guide makes adding colic, newborn feeding problems a breeze. Sticking w... Read more
Neonatologists:
Don't Miss These Hospital Newborn Code Changes
HIE, blood codes specify type, baby. You'll want to update neonatologists on encephalopat... Read more
Avoid Same Date Admission, Discharge Denials By Checking Admit View
Your 99463 view might need tightening. You may never say hello to the $75 for 99463 unles... Read more
Protect Deserved Hospital Well Care Pay With EOB Check
Are you receiving one-third less for 99460- 99465? Here's what to do. You know insurers a... Read more
Head Off ECG, Unrelated Procedure Bundles to Save $21
Your 93000 pay could depend on using this tool. For insurers that follow Correct Coding I... Read more
Correction:
RLQ Goes to 789.03, LLQ Goes to 789.04
Go online for your updated abdominal pain diagram. In Pediatric Coding Alert, vol. 12, no... Read more
Reader Questions:
Is 51701 + E/M-25 OK?
Question: A patient required an in/out cath for residual urine. Can I report an office vi... Read more
Reader Questions:
Does 99239 Require All or Some Items?
Question: Our state Medicaid denied 99239 on the last day of the hospitalization because ... Read more
Reader Questions:
Weigh Your MD Diabetes Education Options
Question: A pediatrician and PA are educating some parents on diabetes, exercise, and nut... Read more
Reader Questions:
Count Pain Reliever in E/M
Question: Is there a code that I can use for the administration of Tylenol or Motrin? The... Read more
You Be the Coder:
Office Visit Versus Preventive Medicine Service
Question: A pediatrician submitted the following chart note, which appears as written (no... Read more
Does 96110 Have an Age Limit? It Depends on Who You Ask
Your developmental testing pay hinges on plan awareness. Not screening your major payers'... Read more
488 for H1N1? Watch Your Date, Final Digit
These updates keep your swine flu coding on track -- now and in the fall. Before you... Read more
Verify FBR Requirements to Gain $100-$200 for Procedure
Your 'incision' interpretation could be unnecessarily limiting your 10120s. If your remov... Read more
Take Advantage of Removal Codes' Pay Without Causing Sticker Shock
You won't overcharge for FBR's follow-up care, thanks to this chart. Prep parents that yo... Read more
Auditing Corner:
4 Tips Help You Give Credit for All Allowed History Elements
Time saver: Strike a balance between bean counting and example-driven coding. After circl... Read more
READER QUESTIONS :
Stop 'Too Many Diagnoses' Denials With 1 V Code
Question: Medical Assistance (MA) started denying Minnesota's preventive medicine service... Read more
READER QUESTIONS :
Before Using Repair Code, Check for 1 of 2 Items
Question: A new patient presents to our office with a 2.0 cm cut on her chin from falling... Read more
READER QUESTIONS :
Parent Requested Consult Goes Here
Question: After a mom had seen three other physicians for a patient's unresolved thrush a... Read more
READER QUESTIONS :
Dual 87804 Results: AMA Issues Modifier Directive
Question: When reporting 87804 to describe testing for rapid influenza virus A&B, sho... Read more
You Be the Coder :
Travel Clinic: 1 ICD-9, 2 CPT Options
Question: An 18-year-old established patient met with our pediatrician to discuss an upco... Read more
Bust 4 Myths That Could SinkYour Critical Care Services Payments
Surprise: Codes 99291, +99292 apply to infants, young pediatric patients in th... Read more
Stop Mixing Up Critical Care Services By Answering These Questions
This flow chart solves location, transport, age dilemmas to land you on the ri... Read more
Seasonal Coding:
Snag Summer Tick-Related Case DxsWith Insect Fast Facts
Injury code hinges on your venomous, nonvenomous savvy -- and more. Think a tick ... Read more
Don't Sell Yourself Short on Problem Camp Exams
Tip:Time-based E/M might be in line when managing diabetes, asthma, ADHD. ... Read more
READER QUESTIONS :
Give Device Reason on Removal
Question: Our pediatrician saw a little boy with what she called retained tymp... Read more
READER QUESTIONS :
Can NP Report Breastfeeding Consult?
Question: We have a nurse practitioner (NP) who has specialized education in l... Read more
READER QUESTIONS :
Postvaccine Knot: Adverse Effect or NEC?
Question: The day after a patient received vaccine shots, the mother brought t... Read more
READER QUESTIONS :
2 Details Make Lesion Adhesion Codeable
Question: Our pediatricians often perform lysis of penile adhesions post circu... Read more
READER QUESTIONS :
Does Prednisone Make Dermatitis a 99214?
Question: Since prescription management involves moderate risk on the CMS standard docum... Read more
You Be the Coder :
What Code for Possible Swine Flu?
Question: A parent brings in a child with fever of 102.2°F, diarrhea, sore... Read more
No Code for Camp Exam? Here's How You Handle Pay
Outside this time frame, consider filling out forms with well check. ... Read more
Policy Update:
Gather Solid Modifier 25, 59 Info Before Reporting to CIGNA
You now have clear-cut policies to apply, including 1 on 96110 pay. ... Read more
Auditing Corner:
Check Out 2 Roles a Peds Coder Can Play in Diagnoses
ICD-9 code overlap and unspecified code default slow claims processing. ... Read more
Test Yourself:
Sidestep 789.00 Safety Zone When You Spot 'Q' Abbreviations
This speed sheet keeps your abdominal pain claims ICD-9 compliant. ... Read more
READER QUESTIONS:
$100 Hinges on Boil Note's CPT Codes
Question: For the following chart note (which appears exactly as written without grammat... Read more
READER QUESTIONS:
Get Modifier 25 Scoop on Well Check + Shots
Question: Staff sometimes includes modifier 25 on a preventive medicine servic... Read more
READER QUESTIONS:
Does DDST Count as 96110?
Question: Can the DDST code be used for annual well exams if the questionnaire... Read more
READER QUESTIONS:
Is a 'Greenstick Fracture' Open or Closed?
Question: A physicians note indicates a greenstick fracture. Should I use the ... Read more
READER QUESTIONS:
Stereopsis Testing: It's a Vision Screen Portion
Question: Medicaid is now requiring a stereopsis exam (for depth perception) w... Read more
You Be the Coder:
Do 95115, 95117 Require Physician Injection?
Question: A parent brings allergy serum to our office. The patient comes in once... Read more
Capture Giving Vaccinations Without Charging Products
These VFC FAQs help you report the seemingly impossible. Sure, you ... Read more
Easily Identify Which Patients UHC's Immunization Policy Affects
Purchased product pay remains the same. If a recent bulletins got y... Read more
Asthma Attack:
Find Out if Prolonged or High-Level E/M Represents Your Work
This checklist deters payback requests for insufficient +99354 time. ... Read more
3 Truths Set You Straight on Supersized CCI
Bonus:You may be able to resubmit bundled resuscitation claims. Unl... Read more
Auditing Corner:
Get 411 on Allergy, Cyanosis Terms to Up These Counts
NKDA and C/C/E wont trip you up thanks to quick quiz. Even an audit... Read more
READER QUESTIONS:
Circumcision With EMLA Requires Modifier
Question: Documentation indicates the following: PREOPERATIVE DIAGNOSIS(ES)/IN... Read more
READER QUESTIONS :
Check Final Dx, Counseling Time, on Lab FU Visit
Question: When a patient returns to the office for review of her lab results, ... Read more
READER QUESTIONS :
Are There Any Childhood Oral Vaccines?
Question: The active polio virus is no longer being used. With what products w... Read more
READER QUESTIONS :
Developmental Testing:Which Modifier Is Better?
Question: Some coders suggest using modifier 25 on the well visit code when al... Read more
You Be the Coder:
Ask This to Determine 25-Service
Question: At an 11-year-old girls preventive medicine service, a pediatrician ... Read more
Support Higher-Level Family Counseling Sessions Using 7 V Codes
This series helps show why $55 more for a 99214 could be in order. Still don't have V61.0... Read more
5 Answers Capture Suture Removal and Related Work
Tip: Your E/M usually requires 2 components --" which means more than problem focused. ... Read more
Extend 99000 to Specimen Prep, Regardless of Shipping Fee
Think you can use 99000 only when your practice incurs a transportation charge? Truth: St... Read more
READER QUESTIONS:
99202 -- History Type + 1 Component = 99213
Question: Are new-patient office visit codes a step down from established-patient office... Read more
READER QUESTIONS:
Check for Face-to-Face Before Discharge
Question: Sometimes our pediatricians tell a new mom she can take her baby home the next ... Read more
READER QUESTIONS:
Have Policyholders Check 99381, 99391 Coverage
Question: Is there a limit or a set criteria for how many preventive visits can be billed... Read more
READER QUESTIONS:
CNS = NP = PA for CPT, but Check State Law
Question: Does a certified nurse specialist (CNS) count as a nurse practitioner (NP) for ... Read more
READER QUESTIONS :
Asthmatic Croup Versus Regular Croup
Question: Documentation indicates a six-month-old patient has croup. The mom describes th... Read more
READER QUESTIONS:
Use 82272 When Child Needs Hemocult Test
Question: A patient came in with abdominal pain, and the pediatrician checked for blood i... Read more
You Be the Coder:
Check Treatment Before Reporting Splinting
Question: A 3-year-old child comes in with a history of falling off a chair and injuring ... Read more
Report Only Legitimate 96110s to Preserve Code's Integrity
These 4 characteristics signal $13 screening is appropriate. Do you circle 96110 for aski... Read more
3 Intensive Care Coding Mistakes Most Coders Make
When weighing an infant is too risky, support 99478-99480 with these steps. If you're bun... Read more
Check Destruction Method Before Assuming 17110
You could gain $30 if a shave is also performed. Treating 17110 as your office's catch-al... Read more
Reader Questions:
CCI Continues Renumbered 90772 Edits
Question: A pediatrician admitted a patient to the hospital and ordered a penicillin inje... Read more
Reader Questions:
Known Condition Voids Screening
Question: If a physician knows that a patient has a condition, can you bill a lab screeni... Read more
Reader Questions:
Check After-Hours Reason to Add 99050
Question: What are the parameters for charging for extended hours visits? Do the patients... Read more
Reader Questions:
Problem Status: Focus on Examiner
Question: When is a problem a new problem? Example: A patient is seen in the emergency de... Read more
Reader Questions:
Which ICD-9 for Monitoring Ritalin Use?
Question: For an electrocardiogram (ECG) (93000-93010, Electrocardiogram, routine ECG wit... Read more
You Be the Coder:
DTaP-IPV Booster Receives Own Code
Question: What is the CPT code for Kinrix? Arizona Subscriber Answer: You should use new... Read more
Give Your Newborn Coding Skills a Check Up With 2 Scenarios
This directive stops the sending physician from committing an $860 global critical care er... Read more
Bust Well Check-Related Bundles Using Improved Appeals Packet
You've now got clear backing that screenings are separately reportable.You no longer have ... Read more
CPT 2009:
Prevent Shot, Hydration, IVIG Code Denials With This Update Guide
Overlooking Synagis treatment change will delay $21 per claim.You can save countless hours... Read more
Differentiate CR, Monitoring By Focusing on 2 Details
Code 94777 can stand alone in the office.Zoom in on length and purpose to avoid stumbling ... Read more
Reader Questions:
Zero In on Nail Procedure
Question: A child who slammed his finger in the garage door came in with an injured hand a... Read more
Reader Questions:
Check Date(s) Before Coding Observation
Question: I billed an observation stay with face-to-face admission on day 1, continued obs... Read more
Reader Questions:
Stick With E/M for Suture Removal
Question: A patient came to our practice for suture removal. Our group did not perform the... Read more
Reader Questions:
Arm Pain at Well Check: How Many E/Ms?
Question: A 2-year-old established patient presented for a preventive medicine service. Th... Read more
Reader Questions:
3 Items Separate 2 Venipuncture Codes
Question: What is the difference between 36400 and 36410? Is it necessary to do a femoral ... Read more
You Be the Coder:
94010 Versus 94060: Look for Bronchodilation
Question: When billing for two spirometries during the same visit, a pre- and post-spirome... Read more
Sort Out Your ADHD Follow-Up Options to Capture Visit Pay
V code, time, 99211, 90862, and modifier 25 could all come into play -- here's when.W... Read more
Get Out a Red Pen to Revise Delivery Room Mgt Instruction
This top errata relieves a major concern. Before you panic about a CPT 2009 resuscitation ... Read more
Rejoice in Pay Boost for Vaccine Administration in 2009
Nurse ensuring vaccine quality could add $1,000 to your bottom line.You no longer have to ... Read more
CPT 2009:
4 Updates You Need to Correctly Code Extended Time
Same-day inpatient E/Ms are perfect opportunity to use revised code +99356.To avoid landin... Read more
Reader Questions:
Years, F2F Steer Choosing Status
Question: A regional pediatrician who works in urgent care on a Saturday night sees a pa... Read more
Reader Questions; OM, URI Exam + MDM = 9921?
Question: Documentation for an established patient visit includes these items:Chief compla... Read more
Reader Questions:
Get the Facts on Fighting for Standby Pay
Question: When billing 99360 (1-30 minute total duration time for physician requested serv... Read more
Reader Questions:
Check If Payer Accepts V20.2 Until Age 18
Question: Where can I find the official guidelines on when to use V20.2 versus V70.3? Shou... Read more
You Be the Coder:
Can You Capture HPV Counseling?
Question: The physician counsels the patient and family on the human papillomavirus (HPV) ... Read more
Available Years:  2009  2008  2007  2006  2005  2004  2003  2002  2001  2000  1999  1998