Pediatric Coding Alert

Practice Management:
Maximize All Services Rendered, Increase Your Bottom Line (Part 2)
Look for comprehensive payment information for each service. Last month we looked at two ... Read more
Mythbusters:
Bust These Myths, End Epistaxis Treatment Coding Errors
Learn which modifiers to append and when to append them. Children are widely known to res... Read more
E/M Coding:
Take These Hints for Accurate MDM Data Counting
Identify situations when it's best to not count data If you're like many coders and are c... Read more
Reader Question:
Count on the Descriptors to Consider Chronic Conditions
Question: We are just starting to bill for chronic care management time. Is a develo... Read more
Reader Questions:
Understand the Problem in This New Patient E/M Encounter
Question: When a new patient is scheduled for an initial physical exam and the pediat... Read more
Reader Questions:
Take Time to Evaluate This E/M Encounter
Question: My pediatrician spent 42 minutes with a patient who presented with a slight... Read more
You Be the Coder:
Try Your Hand at This Z Code Encounter
Question: Our pediatrician saw a 4-year-old whose mother said had been acting like he does... Read more
News You Can Use:
Familiarize Yourself with These CDC Updates to Flu Vaccinations
And reference the clip-and-save chart for quick coding. It's flu season again, which mean... Read more
Condition Spotlight:
Determine the Details to Correctly Code Conjunctivitis
Understand when to report from the B30.- versus the H10.- group. School is well underway,... Read more
Practice Management:
Maximize All Services Rendered, Increase Your Bottom Line (Part 1)
And learn how to overcome payment challenges. Periodically assessing how the practice is ... Read more
Reader Questions:
Understand What Codes to Add for Lesion Removal
Question: I billed 17003 along with 99213. I added the 25 modifier to the 99213 thinking t... Read more
Reader Questions:
Rely on This Rule for Respiratory System Coding
Question: I'm constantly coding respiratory system conditions incorrectly, and I can't und... Read more
Reader Questions:
Know the New Monkeypox Codes
Question: Are there monkeypox vaccine codes for children? We haven't seen any monkeypox at... Read more
You Be the Coder:
Recognize Whether This Visit Calls for Modifier 25
Question: Our pediatrician saw an existing 7-week-old patient for a routine checkup with i... Read more
Condition Spotlight:
Ditch Your Discomfort Coding These Skin Conditions
Look for these synonyms to aid in coding success. Skin conditions make up more than 12 mi... Read more
E/M Coding:
Avoid These Auditor Red Flags and Correctly Code for Time
Look for expert advice to take back to your practice. Using total time rather than couns... Read more
ICD-10 Coding:
Submit Clean Claims with Proper Sequencing
Check out the expert tips on how to paint the picture for the payer. Proper sequencing is... Read more
Reader Questions:
Decipher the Difference between a Referral and Consult
Question: What is the difference between a referral and a consultation and how does ... Read more
Reader Questions:
Defer to the Definitions for These Vax Admin Codes
Question: We have been using 90471, 90472, and 90473 or +90474 for vaccine administra... Read more
Reader Questions:
Refresh Your PCM Knowledge
Question: Who can provide principal care management (PCM) services, and what activiti... Read more
You Be the Coder:
Take Care to Capture to Correct Disorder in this Encounter
Question: Our pediatrician diagnosed a teenage patient with bipolar disorder and majo... Read more
News You Can Use:
Update Your COVID-19 Vax Know-How With 4 New Codes
Reference CPT® Appendix Q for help matching vaccines with their admin codes. COVID-19 is... Read more
E/M Update:
Jump Start Your Understanding of These 2023 E/M Updates
CPT® shakes up inpatient/observation care services coding. A revised set of observation... Read more
Proposed Rule:
Picture a Proposed Increase in Immunization Admin RVUs
It might offset proposed CF reductions. If you've looked at the 2023 Medicare Physician F... Read more
Reader Questions:
Digest the Differences Before Coding Allergy or Intolerance
Question: The doctor has diagnosed one of our patients as having a milk allergy. I used an... Read more
Reader Questions:
Append Modifier 91 for Repeat Tests
Question: A young patient with type 1 diabetes described feeling weak and unsteady. The pe... Read more
Reader Questions:
Know Which Z Code to Use for These Neonatal Encounters
Question: Our pediatrician cared for a newborn at a local hospital for the duration of the... Read more
You Be the Coder:
Quantify Who Qualifies as a QHP
Question: If a patient tells the medical assistant (MA) who rooms the patient that they ar... Read more
News You Can Use:
Encounter These New SDoH and Noncompliance Codes
Also, take note of these related guideline changes. Documenting social determinants of he... Read more
ICD-10 Updates:
Update Your Understanding of Newborn Apnea and Personal History Codes
And find out which familiar codes now require an additional character. Of the almost 1,5... Read more
Practice Management:
Report This New ICD-10 Code to Round Out Peds Patient Handoff
Establish a policy to ensure a smooth transition. Change is inevitable, and for younger... Read more
Reader Questions:
Use Documentation to Determine MDM Level
Question: My provider saw an established child with an earache. The provider ordered ... Read more
Reader Questions:
Follow ICD-10 Guidelines to Mend This MRSA Mistake
Question: Our pediatrician saw a patient that was seen for left leg abscess. The pedi... Read more
Reader Questions:
Remove Incision Code From This FBR Encounter
Question: What would be the best code to use when a patient comes into the office wit... Read more
You Be the Coder:
Assess the Differences Between These 2 Assessment Codes
Question: I'm having difficulty choosing between 96127 and 96160. My provider suspect... Read more
Procedure Coding:
Go Deep With This Guide to Venipuncture Coding
Age, weight, technique, and provider qualifications key to correct code capture. If your ... Read more
Mythbusters:
Understand Clinical Concepts, Bust These Asthma Coding Myths
Understand severity levels for flawless J45.- assignment. The myths surrounding the J45.... Read more
Case Study Corner:
Study This Case, Learn 3 Different Ways to Code FBRs
See if your solution makes the cut. Active kids seem to be magnets for foreign bodies, wh... Read more
Reader Questions:
Stay on Point With This Pediatric COVID-19 Vaccine Update
Question: What is the current status of pediatric COVID-19 vaccines? I know the Pfize... Read more
Reader Questions:
Avoid Mixing Up These Acidosis Diagnoses and Diabetes Codes
Question: What is the correct diagnosis coding for a patient who has type 1 diabetes ... Read more
Reader Questions:
Bill for Family Counseling When Patient not Present
Question: A patient's family came in, and our pediatrician spoke to them about the ch... Read more
You Be the Coder:
Sample the Answer to This MDM Risk Riddle
Question: Our pediatrician gave a patient a trial/sample medication. She documented i... Read more
E/M Coding:
Get the Answers to All Your Frequently Asked MDM Questions
Hint: don't rush to the table before reading the definitions. If you still have a lot of ... Read more
Condition Spotlight:
Use This Guide, Stay in Shape With Your Eating Disorder Coding
Hot tip: remember to add BMI codes when appropriate “Fifty percent of girls and 30 per... Read more
Guidelines:
Know the Dos and Don’ts of Pediatric BMI Documentation
Here's how to assign the Z68.5- codes correctly. Whether you're documenting body mass in... Read more
Reader Questions:
Keep This Online Digital Service Documentation in the Pink
Question: One of our pediatricians has an established patient whose mother contacted ... Read more
Reader Questions:
Don’t Get Hyper About Using This Code for ADD
Question: Our pediatrician documented a patient with attention deficit hyperactivity ... Read more
Reader Questions:
Brush Up Your Understanding of Fluoride Varnish Applications
Question: Our providers are looking into offering fluoride varnish applications at t... Read more
You Be the Coder:
Consider This COVID-19 Immunization Counseling Advice
Question: We have been using 99401 when counseling for COVID vaccines, and when we al... Read more
ICD-10 Coding:
Don’t Be Immune to These ICD-10 Vaccination Encounter Codes
And take note of these new COVID-19 underimmunization codes. There's a lot more to using ... Read more
Test Yourself:
Will You Get Bugged Coding These Insect Bite Encounters?
Get ready for the warm weather with these summertime scenarios. When an insect bites or s... Read more
Modifiers:
Follow This Advice to Unbundle Same-Day Services
There's more to separating services than using modifier 59. Whenever your pediatrician pe... Read more
Reader Questions:
Take This Advice for Documenting Different Counseling Services Together
Question: Is it possible to report preventive medicine counseling and a preventive medicin... Read more
Reader Questions:
Pass This Threshold to Get Prolonged Service Time on Your Side
Question: Our provider performed an office evaluation and management (E/M) service for a n... Read more
Reader Questions:
Stick to This Code for PKU Heel Pokes
Question: Our provider office performs second and third newborn phenyl­ketonuria (PK... Read more
You Be the Coder:
Know When to Add E/M Without Destroying Wart Removal Claims
Question: Our office manager wants to charge for an office/outpatient evaluation and manag... Read more
ICD-10 Coding:
Use This Guide to Code Pediatric Skin Rashes
Don't dig too deep for these common integumentary diagnoses. “There are more than 12 mi... Read more
Coding Quiz:
Code These Scenarios Correctly, Prevent Newborn Well-Visit Coding Errors
Can you provide the correct ICD-10 and CPT® codes for these 2 scenarios? Time to test yo... Read more
Guidelines:
Rule in This Guideline When Ruling Out Abuse Dx
Here's what to do when ICD-10 guidelines seem to contradict. Since the beginning of your ... Read more
Coding Quiz Answers:
Check Your Answers to Our Preventive E/M Coding Quiz
How well do you know the well-visit rules? Once you've reviewed the scenarios on page 3, ... Read more
Reader Questions:
Determine This Laterality Dx on DOS
Question: I'm looking for some clarity regarding the new ICD-10 guideline that allows... Read more
Reader Questions:
Don’t Complicate This Congenital COVID Conundrum
Question: A mom gave birth to single live newborn vaginally. During the pregnancy, th... Read more
Reader Questions:
Document Different Services in Discharge/Surgery Scenarios
Question: Our pediatrician performed a frenotomy on a newborn, then discharged the ch... Read more
You Be the Coder:
Drive This E/M Level With Documentation Detail
Question: How would you level this office/outpatient evaluation and management (E/M) ... Read more
Condition Spotlight:
Delve Into These Details for Depression Dx
Quickly arrive at the correct code choice and stay ahead of the pandemic curve. Has the p... Read more
Procedure Coding:
Take These 4 Tips for Accurate Lesion Removal Coding
Know the why, what, and where, and let your code choice measure up. Skin conditions make ... Read more
Reader Questions:
Boost Your Pfizer COVID Vaccine Third Dose Administration Understanding
Question: I am confused about the correct administration code to use for the third pediatr... Read more
Reader Questions:
Separate These Outpatient and Inpatient Encounters for Correct Billing
Question: If a pediatrician sees a patient earlier in the day at our practice, then admits... Read more
Reader Questions:
Unspecify the Relationship in This Neonatal Jaundice Case
Question: Our pediatrician documented that a neonate had jaundice; the baby had been ... Read more
You Be the Coder:
Answer This Question, Assign Z79 Codes Correctly
Question: I always thought you billed Z79.899 whenever a patient was taking a long-term me... Read more
Procedure Coding:
Take These 6 Steps, Code Therapeutic Drug Encounters Easily
Concentrate on the dose and you won't waste time. Coding for therapeutic injections can ... Read more
Mythbusters:
Bust These Myths, Code Special Services Correctly
Differences between after-hours and emergency services codes are subtle but important. C... Read more
ICD-10 Coding:
Get the Answers to All Your Neonatal Dx Coding Questions
Here's what you need to know about when and how to apply the perinatal period codes. Abou... Read more
Reader Questions:
Capture Conditions Affecting Patient Care and Treatment Only
Question: When I am levelling an office/outpatient evaluation and management (E/M) service... Read more
Reader Questions:
Be Specific Questioning This COVID-Related Counseling Denial
Question: One of our pediatricians provided telemedicine counseling for parents who had qu... Read more
Reader Questions:
Bill This Normal Newborn Care Code Once Per Provider
Question: One of our pediatricians examined a newborn for the first time on the date ... Read more
You Be the Coder:
Need to Code for COVID Vaccine Safety Counseling? Here’s How
Question: I know that there is a new ICD-10 code, Z71.85, that ICD-10 introduced last year... Read more
News You Can Use:
Will Your Practice Go in the Red or the Black This Year?
Vaccine, CCM increases are offset by a CF reduction that may not even come to pass. For p... Read more
COVID-19 Coding:
Want to Code COVID Vaccines Correctly? Here Are 4 Things You Need to Know
Narrow down your choices and pick the right code for the right patient. On November 2, 20... Read more
ICD-10 Coding:
Hear These 4 Hacks for Pain-Free OM Coding
Understanding clinical terms, laterality, and instructions will steer you in the right dir... Read more
Reader Questions:
Look to Payer Guidelines for Age-Specific Dx Coding Rules
Question: Are there any ICD-10 guidelines for when to use a code that is specific to a ped... Read more
Reader Questions:
Know Which Codes Expose Need in This Drug Test Encounter
Question: A father came to us asking for blood work to be done on a child that was exposed... Read more
Reader Questions:
Use These Codes to Report Preterm Newborns After 37 Weeks
Question: What ICD-10 code can I use for a newborn that a provider documents as born prema... Read more
You Be the Coder:
Know How to Add Up These CT Scans for MDM Credit
Question: How would you count the amount/complexity of data in the following scenario? On... Read more
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