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Pediatric Coding Alert

Hospital Codes May Be Best:
Codes for Neonatal Intensive Care and Critical Care No Cure-all
The new definitions of critical care services (99291, 99292) and neonatal intensive care (... Read more
CPT 2000:
Four Key Changes in Critical Care Codes
There are four main ways the extensive new language in CPT 2000 regarding critical care se... Read more
Nurse Visit vs. Vaccine Administration:
Which Is Best?
Consider this common situation in pediatrics: Because one or more immunizations couldnt be... Read more
Pediatric Coders Should Be Aware of Other CPT 2000 Changes
Here are six additional code changes in CPT 2000 that will affect pediatricians (see also ... Read more
Reader Questions:
Prenatal Consult
Question: What should you code and/or charge for a prenatal consult? Anonymous Missis... Read more
Reader Questions:
Meconium and Intubation
Question: After suctioning the child for meconium (31515) at birth, the child goes on to h... Read more
Several Key Areas Are Affected by New CPT 2000 Codes for Pediatricians
There are some significant new codes and changes in coding language in CPT 2000 for pediat... Read more
Correct Coding Is Key to Getting Paid for Meetings with Adoptive Parents
There are some CPT and ICD-9 coding and reimbursement challenges inherent when meeting w... Read more
Can You Bill 99436 Twice for Twins?
Attendance at delivery (99436) is the code used by pediatricians who are requested to atte... Read more
Original Diagnosis and Procedure Codes Are Key to Getting Paid for Rechecks
Jennifer Bell, practice administrator for Baylor Pediatric Center in Dallas, TX, who alway... Read more
Reader Questions:
Intravenous Therapy
Question: Please advise on the correct use of 99354-99355 in conjunction with 90780-90781 ... Read more
Reader Questions:
Bundling
Question: Some insurance companies pay very low rates for E/M codes. I would like to do so... Read more
Reader Questions:
Trained Lactation Consultant
Question: Is there a code we can use for lactation counseling when the service is provided... Read more
Billing Alternatives for Crisis Hospital Visits on the Same Day
Sometimes a call comes in the early-morning hours. It is from the hospital; the pediatrici... Read more
How to Get Paid for Cerumen Removal and an Office Visit on Same Day
Removing impacted cerumen (69210) is a relatively common procedure in pediatrics, but unde... Read more
Use After-Hours Codes Appropriately to Receive Optimal Reimbursement
Pediatric practices are extending their hours to accommodate parents, make managed-care co... Read more
Correct Billing is Key for Hearing and Vision Srceening Tests
Hearing and vision tests are often conducted as part of preventive medical services. But d... Read more
Effectively Use E/M Services Codes To Bill for Psychological/Behavioral Problems
When a child has a psychosocial problem, depression, or Attention Deficit Hyperactivity Di... Read more
Diagnosis Coding Key When billing For Adolescent Pelvic Exam With Preventive Medicine Services
When pediatricians provide preventive-medicine services (well visits) for adolescents and ... Read more
Reader Questions:
Billing PKU
Question: If a PKU [test for phenylketonuria] is done in the office by nurses, and the vi... Read more
Reader Questions:
How to Code Sick and Well Visits on the Same Day
Question: Is it double-dipping to bill a new preventive-medicine services visit and a new ... Read more
Reader Questions:
Gastrostomy Tube Change
Question: When the nurse performs a gastrostomy tube change in our office we bill a CPT 99... Read more
Reader Question:
Procedure Code For Catheterization
Question: We perform catheterizations for urine specimen collection in our office. We want... Read more
What is the Age Limit?:
Correct Neonatal Intensive Care Coding Increases Pay-up
Coders for pediatric and neonatal practices frequently wonder what the age parameters ar... Read more
Coding Tactics for Catheterization During VUCG
Sometimes pediatricians must go to the hospital when a VUCG (voiding urethrocystography, C... Read more
Primary Care Pediatricians and Global Periods:
Getting Paid for Post-Surgery Problems
Scenario: A child who had ear tubes placed by an otolaryngologist (ENT)69436 (tympanostomy... Read more
Modifier -25:
How to Get Paid for Well and Sick Visits on the Same Day
The preventive-medicine services codes (99381-99397) are, by definition, asymptomatic or... Read more
Getting Paid for the Use of Albuterol and Rocephin
Albuterol, a bronchodilator added to saline and nebulized to treat asthma attacks, isnt ... Read more
National Pediatric Coding Conference Speaker Offers 4 Easy Reimbursement Tips
At last months Pediatric Coding & Management Survival Strategies conference, sponsored by ... Read more
Optimal Billing when Resident or ED Physician Admits Child for Observation
How should you handle billing when a child is admitted by a resident, but not seen by the ... Read more
Billing for Telehpone Calls When Some Carriers Pay and Some Don't
Pediatricians are often required to spend a great deal of time on the telephone answerin... Read more
Coding for Critically Ill Newborns Who Are Transported
When a newborn requires certain procedures to be performed by the pediatrician who is at... Read more
Reader Questions:
Coding Follow-up Visits
Question: Are there any diagnosis codes used when a child comes in for a re-check and the ... Read more
Reader Questions:
No-Trauma Auto Accidents
Question: What diagnosis code is appropriate to use when checking a child after a motor ve... Read more
Coding Solutions When Primary Care Pediatrician Visits Patient in the NICU
Sometimes parents request that their primary care pediatrician sees their new baby in the ... Read more
Proper Use of Neonatal Intensive Care Codes
When a sick or premature newborn becomes your patient, and you care for the baby but the... Read more
Neonatal Code Definitions
99295: Initial neonatal intensive care, per day, for critically ill neonate or infant (for... Read more
Follow-up:
Mix of Codes Solution for Newborn Problems Resolved on Second Day
In the April issue of PCA (page 30), we discussed how to code newborn days in the hospital... Read more
More on Solving RotaShield Payment Problems
Some pediatricians are being so poorly reimbursed for RotaShield, the rotavirus (RV) vac... Read more
Optimize Your Diagnosis Coding for Immunizations
There is rampant confusion about what diagnosis codes to use when you administer vaccines.... Read more
Reader Questions:
Counseling Codes
Question: Is it permissible to use CPT 90804 -90809 (psychotherapy) in conjunction with E... Read more
Reader Questions:
Exercise-Induced Asthma
Question: What is the code for exercise-induced asthma?Urmila Singh, MD, Indianapolis, IN ... Read more
Reader Questions:
Diagnosis Codes for Rechecks
Question: What diagnosis codes should be used for otitis media rechecks. Our doctors usual... Read more
Vaccine Administration Codes To Be Fixed for CPT 2000--But What Should You Do Now?
It is clear that the new vaccine administration codes (90471 for one vaccine, and 90472 fo... Read more
CLIA License Key:
Update on Rapid Strep Test Coding
In the February issue of PCA, we discussed coding for rapid strep tests. The AMA had rec... Read more
Optimal Coding for Removing Multiple Splinters
Removing even one splinter from a child isnt easyand removing more than one is that much... Read more
Clarification:
E/M Codes With Fracture Care
In the February issue of PCA, we covered how to code properly when a fractured finger ne... Read more
Persistence and Payer
It happens often enough in pediatrics: A child comes in for a well visit, and turns out ... Read more
Optimal Coding for Same-Day Multiple Visits
Its not unusual in pediatrics for an infant or child to come in in the morning with a pr... Read more
How to Code Well Visit Done on First Sick Visit
Often, the first time a child is seen in a pediatric practice is when he or she is sick. S... Read more
First-Visit Coding for Normal Newborns:
Use of 99432 Clarified
In the February issue of PCA, we discussed the use of 99432 (normal newborn care in other ... Read more
99431 or Hospital Admission Codes?:
Coding for Newborns, Not Normal, But Not Sick Enough for NICU Codes
When a baby is born with some kind of a problem, but the problem isnt severe enough to use... Read more
Avoid Pitfalls of New Vaccine Codes with Updated Superbills and Reimbursement Strategies
In CPT 1999, there are 24 new codes and 30 revised codes for vaccines. In addition, ther... Read more
Coding for School Sports Physicals Revisited:
Preventive Services, Consultation Codes and Contract Arrangements
Coding for school, sports, or camp physicals presents several problems for pediatricians. ... Read more
Use Modifier - 25 to Get Paid for Otoacoustic Emission Tests and Well Visits
Carol Jacobs, MD, FAAP, of Livingston, TX, was having problems getting reimbursed for otoa... Read more
Reimbursement for Pre-Diagnosis ADHD Evaluations
Its a very common scenario: A child is referred to you by the school for behavioral proble... Read more
Follow--Up on Correct Coding and Billing for Prolonged Services
In last months issue of PCA, we discussed how to code for treating an anaphylactic react... Read more
Why Pediatricians Should Follow Medicare E/M Guidelines
These rules for billing levels of service may actually increase your reimbursement,and put... Read more
Dont Use 99432 for First-Month Office Visits
We have learned that some pediatric practices are using 99432 for office visits of newborn... Read more
How to Code Treatment of Anaphlactic Reactions to Allergy Shots
If you give allergy shots, you have to be prepared for an anaphylactic reaction. And as Ju... Read more
Correct Coding for Finger Splint Applications
Reviewed on April 23, 2015; no changes to content Coping with fractured fingers is n... Read more
Optimal Billing for Vision and Audio Screening
Some insurers ardently believe that vision screening and audio screening are included in w... Read more
Get Paid for Monitoring Home Bilirubin Therapy
More and more patients are getting treated at home instead of in the hospital, and newborn... Read more
Update on Coding for Dermabond Tissue Adhesive
Several readers have written to us in the past two weeks questioning our recommendation ... Read more
87880 is the Right Code for Rapid Strep Tests
Reviewed on April 23, 2015 Latest on CPT Code 87880 for Rapid Strep ... Read more
Get Paid for Time Spent in ER When Patient is Admitted on the Same Day
Pediatricians are often called to the emergency room to see patients. They can spend an ex... Read more
One Practice's Success Story:
Collect Co-Pays and Bill for 99211
Sometimes called a nurse visit, 99211 is a valuable code for pediatrics. Its the lowest le... Read more
90862 Not Recommended for Primary Care Pediatricians
Many pediatric coders have scratched their heads trying to figure out if they can use 9086... Read more
Optimal Diagnosis Coding for Rule-Outs and Screening
If a pediatrician orders a test to rule out a certain condition, what kind of diagnosis ... Read more
Pediatric Coding Roundup
Editors Note: Coding advice and strategies offered in this section are verified by various... Read more
Available Years:  1999  1998