Pediatric Coding Alert
Reader Questions:
Look for V20.2 Alternative
Published on Mon Mar 23, 2015
Question: One of our insurers just denied a claim for a 12 day-old child’s preventive medicine visit. The EOB stated that V20.2 (Routine infant or child health check) was not valid, but we always use this for our wellness visits. Which code should we use instead?
South Carolina Subscriber
Answer: You should use V20.32 (Health supervision for newborn 8 to 28 days old) for a child that is 12 days old. Payers have recognized this code since 2010, but it appears that some insurers have just recently started instituting edits that prefer V20.32 over V20.2 for patients in this age bracket.
Other Articles in this issue of
Pediatric Coding Alert
- E/M Coding:
Know How to Carve Out Time for Preventive/ Sick Split Visit
Tip: Keep an eye on the clock to ensure you’re billing accurately for time spent. - Chronic Care Management:
Include These 9 Musts into Your CCM Routine
Referring doc isn’t online? You may not be able to collect for CCM. Although you’ve [...] - What Are Private Payers Saying About CCM?
If your payer follows CMS rules, then Marshall’s advice during the agency’s webinar can help [...] - Who Can Provide Chronic Care Management?
If you’re wondering which of your practitioners can provide chronic care management (CCM) services, Marshall [...] - Incident To:
Determine Whether Patient's Medical Condition Qualifies As 'New' to Heed Incident To Rules
Hint: Texas Medicaid recently changed its incident to rules. A new condition to you may [...] - Reader Questions:
Look for V20.2 Alternative
Question: One of our insurers just denied a claim for a 12 day-old child’s preventive [...] - Reader Question:
Look to State Guidelines for 90-Day Supplies
Question: We have patients who have instructions from their employers to get a 90-day drug [...] - You Be the Coder:
Same Day Hospitalization Only Bundled With Same Doc
Question: My colleague said that if a child is admitted to the hospital on the same [...]
View All
