Pediatric Coding Alert
Coding Pain-Reduction Services
Louisiana Subscriber
Answer: You should report health behavior assessment intervention code CPT 96150 (Health and behavior assessment [e.g., health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires], each 15 minutes face-to-face with the patient; initial assessment) for the nurse's initial assessment. The health and behavior assessment/intervention codes (96150-96155) appropriately describe services that nonphysicians provide for patients with established illnesses, such as diabetes mellitus (for instance, 250.03, Diabetes mellitus without mention of complication; type I [insulin dependent type] [IDDM] [juvenile type], uncontrolled).
You should report 96150 for each 15-minute increment. If the nurse spends 30 minutes assessing the patient's behavior and teaching the child ways to ameliorate her disease-related problems, you should bill 96150 x 2.
For subsequent visits, you should use the reassessment (96151, ... re-assessment) or intervention (96152, Health and behavior intervention, each 15 minutes, face-to-face; individual) codes, which you also should report per 15 minute segment.
Pediatric Coding Alert
- 4 Rules Repair Your Laceration Coding
Experts reveal when to report intermediate repair codes If you resort to simple repair codes [...] - Test Your Laceration Coding Know-How
Determine how you would code these laceration repairs
If you're still unsure [...] - Don't Shy Away From Coding Same-Day Dialysis, Admission
3 steps boost your nephrology dollars' Pediatricians who perform dialysis services aren't receiving the reimbursement [...] - You Be the Coder:
Coding Pain-Reduction Services
Question: A 9-year-old diabetes patient refuses injections because of pain. Our diabetes nurse performs an [...] - 6 Suggestions for Foolproof Modifier -25 Coding
Who knew that one little modifier could cause so many headaches? Put modifier -25 on [...] - Reader Question:
You Can Code for Giving Synagis Without Supply
Question: What CPT Code should I use for a Synagis injection when the patient's parent [...] - Reader Question:
Differentiate NEC from NOS
Question: What do "NEC" and "NOS" mean in ICD9 coding? How should I select between [...] - Reader Question:
Stick With E/M Codes for Sports Physicals
Question: Our practice has so much trouble getting reimbursed for sports physicals. I just discovered [...] - Reader Question:
E/M Includes Peak Flow
Question: I never know when to charge for peak flow separately or when the visit [...] - Reader Question:
Bill for Multiple Foreign-Body Removal
Question: A pediatrician removes a bead from each of a child's ears without anesthesia. Should [...] - Reader Question:
What Counts as ROS Versus PFSH
Question: A grandmother brings her granddaughter in for a swollen and sore wrist. The woman [...] - Restructure Appeals With These 6 Steps
Get organized for easier, more productive appeals When your practice receives a denial on a [...] - Read EOBs Before Responding to Denials
What 'noncovered service' really means to your office You can't streamline your appeals process unless [...] - You Be the Expert:
What Makes a Clean Claim?
Question: We are having problems in our family practice with the number of claims we [...] - Reader Question:
Bridge the Communication Gap ASAP
Question: The physicians and billers in my office don't practice open communication, and it's leading [...]
