Pediatric Coding Alert

Question: Our office wants to start coding for transition planning and scoring, which involves the pediatrician's work setting up the transfer from our pediatric practice to an adult practice in town. How can we collect for these services?

New Jersey Subscriber

Answer: The answer depends upon the pediatrician's specific face-to-face work creating the transition. If you spend time during a patient visit working on the transition, you can use preventive medicine counseling codes 99401-99404 (Preventive medicine counseling and/or risk factor reduction interventions...), which you'll bill in 15-minute increments. 　If the patient's situation requires the physician to perform administration and interpretation of a health risk assessment during the transition, you might consider reporting 99420 (Administration and interpretation of health risk assessment instrument, eg, health hazard appraisal).

However, if the transition simply requires a letter to the new physician along with a copy of the patient's pediatric chart, most practices do not consider this a payable service and will not bill for it beyond a possible token copying fee billed to the patient.