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Pediatric Coding Alert

Year in Review:
Remember 2023’s Biggest Coding Takeaways
How many of these changes can you recall? The world certainly has seen a lot in the last ... Read more
FAQ:
Conquer Congenital Condition Coding With the Answers to These FAQs
And see what to do when a child is exposed to COVID-19 in utero. It's not always clear wh... Read more
Practice Management:
Address Apathy and Burnout, Apply These Expert Tips
Also: learn how to extend the advice to remote workers. No matter the size of your practi... Read more
You Be The Coder:
Examine Whether Perinatal Coding Can Extend Beyond 28 Days
Question: One of our pediatricians saw a 10-year-old for a routine check-up. During t... Read more
Reader Question:
Clear Confusion Around This Multiple Location Question
Question: Our practice has multiple locations, and they don't all have the same equip... Read more
Reader Question:
Preview This New Physician Predicament
Question: Our practice recently hired a new pediatrician, but as of now that doctor ... Read more
Reader Question:
Make the Right Call in This Test Result Scenario
Question: My provider habitually calls patients to tell them about their lab results.... Read more
News You Can Use:
Find Your Way Through Flu Vax Coding with These Updates
Check out the handy chart to help you keep it all straight. Flu season is officially her... Read more
E/M Coding:
Cut Into Complex Concepts in the MDM Table
Learn the differences between words like “self-limited” and “acute.” While hand... Read more
Telemedicine:
Strengthen Your Telehealth Coding Game With These 4 Tips
Use the clip-and-save chart to help you select correct codes every time. As you may rec... Read more
Reader Questions:
Look to the Index to Answer This OM Coding Question
Question: My pediatrician documented otitis media with effusion (OME) for one patient, and... Read more
Reader Questions:
Look to Synonyms When Reporting This Cough Situation
Question: Our pediatrician documented that a patient had an “unexplained cough.” ... Read more
You Be the Coder:
See Whether This Screening is Separately Reportable
Question: During the history portion of a patient's evaluation and management (E/M) servic... Read more
News You Can Use:
See How CPT® Has Simplified COVID-19 Vax Coding
Check out which existing admin code survived the cut To streamline reporting, CPT® has c... Read more
Proposed Rule:
Know What to Watch For in the 2024 MPFS
See how the CF cut compares to previous years. Even though the COVID-19 public health ... Read more
Condition Spotlight:
Refresh Your Migraine Coding Game, Learn New ICD-10 Codes
Also find definitions of common terms. According to the Cleveland Clinic, up to 2 percen... Read more
Reader Questions:
Refer to This Medical Necessity Documentation Advice
Question: During a preventive visit, our provider noticed that the 2-year-old patient... Read more
Reader Questions:
See How Social Worker Counts as Clinician in This SDoH Scenario
Question: My provider counseled a 7-year-old patient and their father about adverse c... Read more
Reader Questions:
Lack of Localized Pain? No Problem
Question: My provider diagnosed gastroenteritis but didn't specify which quadrant the... Read more
Reader Questions:
Correctly Coding Hay Fever is Nothing to Sneeze At
Question: I am looking at a medical report that say the physician diagnosed the patie... Read more
You Be the Coder:
Solidify Your Understanding of Sequencing Asthma and its Triggers
Question: One of our patients came in experiencing exacerbation of their asthma due t... Read more
News You Can Use:
Take a Peek at ICD-10 2024’s Newest Z Codes
Plus: catch this updated verbiage in the section on SDoH. As a pediatric coder, you under... Read more
ICD-10 2024:
Reach Into ICD-10 2024 to Find 173 New Foreign Body Codes
Also: review the FBR codes to use with them. Kids love to explore the world around them, ... Read more
Condition Spotlight:
Brush Up On Your Coding as Strep Season Continues
Plus: Gain insight into the benefits of observing unusual trends in your practice Though ... Read more
Reader Questions:
Decipher This Diaper Rash Scenario
Question: We have an infant who came in with diaper rash caused by yeast. Do I code t... Read more
Reader Questions:
Adhere to Documentation to Accurately Assign Asthma with Rhinitis
Question: I'm frequently seeing denials when coding rhinitis or nasophar­yngitis wi... Read more
Reader Questions:
Know When Presenting Problems Don’t Equal Principal Diagnosis
Question: A patient presented with abdominal pain, nausea with vomiting, and diarrhe... Read more
You Be the Coder:
Relieve Your Confusion Over Aspirin Allergy Coding
Question: I've been confused for a while about which ICD-10 code is appropriate for r... Read more
Documentation:
Focus on Communication to Improve Documentation
Here's a helpful acronym to take back to your provider. One of the biggest takeaways fro... Read more
Case Study Corner:
Get Into Gastroenteritis to Code This Case
Follow this case from initial visit to follow-up for clear coding guidance. As pediatric... Read more
Practice Management:
Know the Ins and Outs of Medical Necessity
Also: get expert advice on establishing a risk assessment. As a coder, you understand tha... Read more
Reader Questions:
Get to the Bottom of This Wound Repair Encounter
Question: Our provider saw a 7-year-old who cut their left foot on a broken wood shard whi... Read more
Reader Questions:
See the Subtle Differences That Affect this Colitis Case
Question: Our provider documented a 10-year-old patient as having both diarrhea and coliti... Read more
Reader Questions:
Assess This Category II Assessment Code Conundrum
Question: We are not able to get any payers to cover 3085F when billed with an office visi... Read more
You Be the Coder:
Know When to Lean on Laterality
Question: My provider performed two button removals for undescended testes surgery. The pr... Read more
Case Study Corner:
Consider Complete Picture, Correctly Code This Celiac Case
Also: See whether the encounter levels best with MDM or time. You've probably seen severa... Read more
Procedure Coding:
Tackle Tick-Removal Coding With These 3 Scenarios
Hint: Removal method dictates how to report the procedure. As temperatures continue to r... Read more
Artificial Intelligence:
Lean Into AI Learning With AMA’s AI Classifications
Know the nuances that will affect your code categorization. By now, you probably feel li... Read more
Reader Questions:
Get the Lowdown on Reporting Respiratory Conditions
Question: The pediatrician performs a thorough history and exam for a patient and doc... Read more
Reader Questions:
Understand Symptoms to Assign the Correct Asthma Code
Question: Our pediatrician diagnosed a patient with mild asthma and described the pat... Read more
Reader Questions:
See Why Simultaneous Siblings Signify Separate Encounters
Question: A parent brought in their two children with cold symptoms. The pediatrician... Read more
You Be the Coder:
Scratch Below the Surface of This Cellulitis Encounter
Question: Our provider saw an established 6-year-old patient who had been scratching ... Read more
Injury Coding:
Follow These Tips to Avoid Burn Coding Burnout
Remember to review the ICD-10-CM guideline that clarifies sequencing rules. When it come... Read more
Condition Spotlight:
Know the Depths to Which Documentation Dictates UTI Coding
And see which UTI code is specific to neonates. Coding for urinary tract infections (UTIs... Read more
Practice Management:
Appropriately Manage PHI to Maintain HIPAA Compliance
See how you may be violating privacy laws without realizing it. As technology continues t... Read more
Reader Questions:
Find the Right Code for This Dermatological Dilemma
Question: My provider diagnosed a teenaged patient with acne rosacea, which I've neve... Read more
Reader Questions:
Avoid Misinterpretation with This I&D Insight
Question: Our provider's notes say he “removed a 2.5 x 2 cm sebaceous cyst by incis... Read more
Reader Questions:
Test Your Understanding of the MDM Data Element
Question: If the pediatrician orders a test, does her review of that test during the... Read more
You Be the Coder:
Refresh Your Modifier Memory with This Postoperative Encounter
Question: Our provider saw a teenaged patient for a follow-up visit a week after remo... Read more
Virtual Visits:
Navigate Telehealth and E-Visits Post-PHE
Also, learn how to document each encounter. As the COVID-19 public health emergency (PHE)... Read more
Condition Spotlight:
Gain Insight Into Obesity Intervention Encounters
Understand counseling criteria that justifies each code set. Treating childhood obesity i... Read more
Denials:
Contest Claim Denials With These 5 Useful Tips
Seek out practice patterns that help you prevent denials. Appealing denials may not be ... Read more
Reader Questions:
Boost Awareness of New COVID Booster Code
Question: There is buzz around the office of a new COVID booster code for children, b... Read more
Reader Questions:
Review This New Patient E/M Rule
Question: I've been coding all nurse visits with 99211, but I'm being told that's not... Read more
You Be the Coder:
Learn About Laterality in This Cerumen Scenario
Question: When reporting H61.21 or H61.22, do I still have to append a laterality mod... Read more
CPT® Coding:
Stay Sharp With This Urinalysis Review
Also, understand which modifiers apply to which situations. Urinalyses are common and re... Read more
Mythbusters:
Bust These Myths to Become a Sequela Scholar
See which guidelines can help you with proper sequencing. Since kids are prone to illnes... Read more
Documentation:
Discern Documentation Dos and Don’ts, Query Confidently
And learn how to scour a record to avoid duplicate queries. The difference between a cl... Read more
You Be the Coder:
Venture Into Pediatric Venipuncture Territory With This Scenario
Question: How do I code venipuncture for a 3 kg infant under 1 year? I thought I shou... Read more
Reader Questions:
Stay Awake for These 2023 Sleep Apnea Codes
Question: The pediatrician evaluated a 5-day-old patient who was born prematurely. Af... Read more
Reader Questions:
Differentiate Between Suppurative and Nonsuppurative in This OM Case
Question: A patient came in recently with a bad ear infection. Our pediatrician docum... Read more
Reader Questions:
Prepare Your Practice for a Post-PHE Environment
Question: What can our practice do to prepare for the public health emergency (PHE) e... Read more
Case Study Corner:
Code This New Patient Encounter From Start to Finish
Stay on top of opportunities to report SDoH. As a peds coder, you're used to coding new p... Read more
Knowledge Check:
Secure Your Skills With These Newborn FAQs
Learn when to use Chapter 16 codes for newborns older than 28 days. Newborn encounters, ... Read more
Modifiers:
Clarify Correct Usage of Modifier 25 (Part 2)
Hint: A new problem doesn't always mean a billable E/M service.  Last month, we us... Read more
Reader Questions:
Digest the ifferences Among These Eating Disorder Codes
Question: I'm seeing three different codes for binging and purging conditions in ICD... Read more
Reader Questions:
Check Payer Policy in This Wastage Situation
Question: One of our physicians treated a patient with a nebulizer, but the patient w... Read more
Reader Questions:
Be on the Lookout for More Info Re: PHE
Question: I read that there's been another PHE extension, but I've also heard this m... Read more
You Be the Coder:
Know When to Report Z23 as Primary
Question: Can I use Z23 as the primary code for a flu vaccination encounter? Codify ... Read more
Condition Spotlight:
Review These Tips for Correct Constipation Coding
Learn when and when not to report constipation. Constipation is a common pediatric condit... Read more
ICD-10 Coding:
Expand Your Understanding of These Common Infant Care Codes
See how an infant's age can affect which code you select. Whether you're new to pediatr... Read more
Modifiers:
Clarify Correct Usage of Modifier 25 (Part 1)
Hint: Detailed documentation is key. Few modifiers are as wily as 25 (Significant, separa... Read more
Reader Question:
Know When Patient Age Carries Weight for Reporting BMI
Question: An obese patient with gastrointestinal issues came in to see the pediatrician th... Read more
Reader Question:
Account for Each Vaccine Component With This Add-On Code
Question: We have a 7-week-old patient who presented for a DTaP-IPV/ Hib vaccine. The pedi... Read more
Reader Question:
Up Your Coding Credibility by Decoding This Depression Scenario
Question: A 13-year-old patient reported feeling depressed for the last month. They ... Read more
You Be the Coder:
Report This Common Occurrence With Confidence
Question: A parent brings their infant to see the pediatrician, saying the baby had b... Read more
News You Can Use:
Tune In to These 3 2023 Final Rule Highlights
Find out why CMS changed its mind on split/shared visits. The Center for Medicare & M... Read more
Condition Spotlight:
Can Your Coding Keep Up With RSV Cases?
And recognize when RSV is the culprit behind other problems. Respiratory syncytial virus ... Read more
Practice Management:
Maximize All Services Rendered, Increase Your Bottom Line (Part 3)
See what the total revenue increase could be for all 7 services. Over the last two months... Read more
Reader Question:
Report E/M When I&D Codes Won’t Do
Question: I'm familiar with the incision and drainage (I&D) codes, but I don't th... Read more
Reader Question:
Deflect the Default in This Tonsillitis Encounter
Question: A patient came in with swollen glands and inflamed tonsils, and my pediatri... Read more
You Be the Coder:
Learn When and When not to Use Chapter 16 Codes
Question: We had a 2-week-old newborn contract bacterial pneumonia due to strep B, bu... Read more
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