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Pediatric Coding Alert

CPT 2004 Solves Your Critical Care Challenges
Experts reveal how 5 revamped instructions will simplify your 99289-99296 options ... Read more
14-Point Checklist Ensures Error-Free 99291-99292 Reporting
 Follow these do's and don'ts when you bill hourly critical care codesNot sure when y... Read more
Get Ready for 4 Changes That Will Ease Your Pediatric Coding
Stars deletion tops CPT 2004's simplification push If you were thinking that the n... Read more
Want to Increase Your ICD-9 Coding Accuracy?
Improve reimbursement with these tips Using the correct ICD9 Coding doesn't just e... Read more
Using V Codes to Your Best Advantage? Experts Tell How
V codes alone may not have the power to bring in reimbursement, but under certain circumst... Read more
You Be the Expert:
Don't Let Your Diagnoses Hurt Your E/M Pay
Question: When we report a level-three E/M service, one of our insurance companies alway... Read more
Reader Question:
Consider Alternative Codes for Unconfirmed ADD
Question: Which diagnosis should I use for a child who is unable to focus or is inattentiv... Read more
Reader Question:
Assign 24640, 9921x-57 for Difficult Insurers
Question: In the October 2003 Pediatric Coding Alert, you suggest using modifier -57 when ... Read more
Reader Question:
Patient's Status Drives E/M Component Coding
Question: During an office visit, my pediatrician performs an expanded problem-focused his... Read more
Reader Question:
Track E/M Services With New Category II Codes
Question: I heard that a new code section is coming in CPT Codes 2004. What is it and how... Read more
Reader Question:
Avoid Assigning Primary E Codes
Question: When should we report an E code as the primary diagnosis code?   ... Read more
You Be the Coder:
You Can Report Conference Time
Question: My pediatrician spends two and a half hours attending a hearing-impaired patient... Read more
You Can Get 'Courtesy' Visits Paid
Here's one practice's success story  If you want to offer expectant moth... Read more
How to Choose Among 6 Diagnostic Allergy Codes
4 ways you can tell 95004-95028 apart   Assigning the wrong allergy test code cou... Read more
Be a Confident 95004-95028 Coder
An allergy-test chart simplifies your choices Can't remember which allergy tests refer to... Read more
Case Study:
4 Answers You Need When Coding OM
This info will get you beyond 382.9 You can use a specific otitis media (OM) diagnosis to... Read more
Correction:
99440 Has More RVUs Than 99436
The October 2003 Pediatric Coding Alert contained a typographical error in the article &... Read more
Immunization Alert:
Iron-Clad Way to Report FluMist, Fluzone
Prepare for flu vaccines with this combo Wondering what to do about the new intranasal fl... Read more
Are You HIPAA-Compliant?
12 ways to minimize fax and e-mail risks If you want to stay out of the courthouse and the... Read more
Are You Hip? HIPAA FAQ
Everyone in your pediatric practice - coders and physicians included, not just the HIPAA p... Read more
3 Tips to Ensure HIPAA Compliance
Coding specialist, billing manager, and office manager alike - you're responsible for foll... Read more
Here's a HIPAA 'Cheat Sheet' for Billing/Coding Offices
For your pediatric practice to meet HIPAA compliance, all employees have to do their share... Read more
Reader Question:
Identify Hair Tourniquet With New E Code
Question: A mother gave birth to a neonate who had a hair wrapped around his finger. Whi... Read more
Reader Question:
How to Code a Stand-Alone Pelvic Exam
Question: What is the proper CPT Code for a routine adolescent pelvic and breast exam? F... Read more
Reader Question:
Use 99141-99142 for Pediatrician-Provided Sedation
Question: Insurance companies deny conscious sedation claims based on the fact that a pedi... Read more
Reader Question:
NPs Can Use Full E/M Range
Question: Which code should I use for a nurse practitioner (NP) visit when the pediatricia... Read more
Reader Question:
Learn 3 Ways to Bill EMLA
Question: We apply EMLA cream to numb the skin before giving penicillin injections. Insure... Read more
Reader Question:
Save Yourself Construction Costs
Question: Are physical barriers available to prevent patients and visitors from viewing co... Read more
You Be the Coder:
Parent Requests 'Consultation'
Question: An established patient's mother wants to consult with our pediatrician wit... Read more
2 Examples Help You Improve Your Neonatal Emergency Reimbursement
What to bill when you transfer an infant Your pediatrician stabilizes a critically i... Read more
Gain $230 for In-House Radial Head Reduction
6 answers improve your nursemaid elbow payDid you know that you can bill an E/M with CPT ... Read more
A Chart Shows You How to Bill 99289-99292 Correctly
Infant and child transports require separate codes Looking for a code to use when the... Read more
3 Field-Tested Tips Boost Your Surgery Reimbursement
Opt for -59 with multiple procedures and avoid denials Are you having trouble decidin... Read more
Test Your Modifier -25/-59 Knowledge
This flow chart simplifies your optionsYou can avoid denials for second procedures, such a... Read more
Avoid OIG Scrutiny While Increasing Revenue by 15 Percent
How to turn 'incident-to' services from confusing to profitableThe U.S. Health and Human S... Read more
You Be The Expert:
Easily Identify Transfers of Care
Question: How do I know when a transfer of care has taken place?New York SubscriberAnswer:... Read more
Reader Question:
What Laceration Repair Codes Don't Include
Question: Should I bill for a suture/surgical tray or other supplies in addition to a lace... Read more
Reader Question:
A Simple Tool Combats Downcoding
Question: An insurer downcodes E/M visits because the diagnoses don't support the service ... Read more
Reader Question:
Compare 2 Screening Codes
Question: Texas law requires my pediatrician to perform five metabolic screening tests on ... Read more
Reader Question:
Research State Visual-Acuity Test Requirements
Question: When I report CPT 99173 with 99382-99383 or 99392-99393, Medicaid denies the sc... Read more
Reader Question:
Bill Locum Tenens With Modifier -Q6
Question: Another pediatrician is filling in at our practice while a physician goes on vac... Read more
Reader Question:
How to Bill an Allergy Shot
Question: A patient who requires immunotherapy due to hay fever brings in serum for his ... Read more
Reader Question:
Use 96151 for Nurse Nonmental Reassessments
Question: For children with congenital defects, our neurodevelopmental program initially p... Read more
You Be the Coder:
Different Doctor Removes Sutures
Question: An established patient presents to my pediatrician's office for removal of sutur... Read more
Are 'Get Acquainted' Visits Worth Your Pediatrician's Time?
Learn the benefits of V65.11 and other new ICD9 Codes You will finally have a diagnos... Read more
Pediatric ICD-9 Code Changes:
A Clip-n-Save Short List
Save yourself the hassle of sorting through the 2004 ICD-9 manual with this list of the m... Read more
Recoup an Extra $65 Per Circumcision
One coder shares her 64450 success story If you're not billing CPT 54150 and 64450 for... Read more
Get Better Reimbursement for Supplies and Services
AAP experts reveal how HCPCS Codes fill in CPT's gaps Demystify level-two coding... Read more
Code Consults and Referrals Correctly ...
... and Avoid OIG Scrutiny and Carrier Audits Even the most experienced coders have diffi... Read more
You Be the Expert:
Consults and Comanagement -Two Codes?
Question: Can I bill for a consultation if the physician is comanaging care of a patient... Read more
Reader Question:
Wood's Lamp Code Proves Elusive
Question: A mother brings her son in for a suspected corneal abrasion. The pediatrician ... Read more
Reader Question:
Get the Highest Payment for Scoring Connor's
Question: A pediatrician has parents complete a Connor's developmental screening evaluat... Read more
Reader Question:
Age Determines 99291 Versus 99293
Question: My pediatrician admits a 37-week-old child to a neonatal intensive care unit w... Read more
Reader Question:
A7005 Is for One-Time Use
Question: Our pediatricians think we should bill A7005 each time we use the nebulizer se... Read more
Reader Question:
Sort Out 95024-95027 Differences
Question: Should I use CPT 95024 or 95027 for allergy skin tests? Also, should I code b... Read more
Reader Question:
Find a Diagnosis for a Suspected-OM Visit
Question: Because her 3-month-old infant "is pulling on her ears," a mother presents wit... Read more
You Be the Coder:
Two Solutions Break Catheterization-E/M Bundle
Question: A child has a fever of unknown origin. The pediatrician performs a urine cathe... Read more
Wondering Which NCCI Edits to Adopt? Fracture/Splint Bundle Applies to All Payers
Fracture care coders, beware: If your pediatrician treats a fractured finger and appli... Read more
Stop Omitting Related Fracture Care Codes With This Clip-n-Save Chart
Deciding whether to code for fracture care or an application can be frustrat... Read more
5 Tips Help You Combat 90471-90472 Bundling
To get reimbursed for vaccine administration, you will have to educate your insurers on wh... Read more
Save Hundreds of Dollars per Week With Time-Based Billing
How can you boost that low-level to a higher-level E/M visit and recoup more than an ext... Read more
ICD-9 2004 Will End Pre-Birth Counseling, Synagis Dilemmas
You cant code to the highest specificity unless a diagnosis exists for the patients condit... Read more
6 Field-Tested Steps That Will Dramatically Improve Your Laceration Repair Billing
Are you having trouble piecing together the information you need to report laceration repa... Read more
You Be the Expert:
Laceration Repair Codes Include Anesthesia
Question: How should we code to get reimbursed for anesthetic administration when performi... Read more
Reader Question:
Sort Out Premature Birth Services
Question: My pediatrician attends the birth of a 30-week gestation baby born in a small ho... Read more
Reader Question:
Know the Pros and Cons of a Forms Code
Question: Does a code exist for reporting forms, such as sports or school forms? Will in... Read more
Reader Question:
Scrutinize New Versus Established Patient Rules
Question: A pediatrician recently joined our group practice. Several patients are transf... Read more
Reader Question:
Partial Ear-Plug Removal Deserves Credit
Question: A child presents with a foreign body in his ear. An ear plug had broken off in... Read more
Reader Question:
99354 Requires 30 Minutes Past E/M-Defined Time
Question: My pediatrician sees a 10-year-old boy for an asthmatic attack. She spends 30 mi... Read more
You Be The Coder:
Patient Reveals Problem During Well Check
Question: A 16-year-old established female patient comes in for her annual checkup. Althou... Read more
6 Simple Steps Help You Pin Down Reimbursement for Screening Tests
Don't let frequent denials stop you from coding a vision acuity screening test (99173)... Read more
Should You Always Fight for 99173 Coverage? Get the Lowdown on Which Denials You Should Appeal
When billing CPT 99173 , 99382-99383 and 99392-99393, knowing what to expect from payers... Read more
Stuck in an Under-Reimbursement Rut? Try These 3 Urgent-Care Coding Tips
Failing to report CPT 99058 when your pediatrician interrupts her schedule to provide eme... Read more
Using 99381-99397-52 for Sports Exams? CPT Rules May Surprise You
Before lack of coverage for sports physicals pushes you into using creative coding strateg... Read more
Think Youve Made Your Case for Modifier -22? Not if You Havent Done These 5 Things
If you're submitting a claim for modifier -22 (Unusual procedural services) w... Read more
You Be the Expert:
Choose Your Coding Poison Based on Documentation
Question: How should I decide whether managing excessive bleeding that requires extra ph... Read more
Reader Question:
Identify Changing Anatomy
Question: Which ICD9 Codes should I use for increased or decreased head circumference in... Read more
Reader Question:
Take Off With 99289-99290 Road Rules
Question: When a nurse practitioner (NP) without a physician present accompanies a critica... Read more
Reader Question:
Roll Ear-Wick Placement Into E/M Service
Question: Which code should I assign for inserting a wick in a childs ear?Georgia Subscrib... Read more
Reader Question:
Know the Ins of Foreign-Body Removal
Question: A pediatrician sees a patient in the office and removes a belly-button ring th... Read more
Reader Question:
Keep Billing E/M With 90471-90474
Question: In a pediatric office, is it correct to code CPT 99211 -25 with a vaccine CPT co... Read more
Reader Question:
Fussy-Baby Code Allows Accurate Reporting
Question: How should we code for a fussy baby?Colorado Subscriber Answer: You should repo... Read more
You Be the Coder:
Tissue Adhesive Code Depends on Insurer
Question: My pediatrician used Dermabond to close a superficial 2.0-cm laceration on a c... Read more
4 Clever Ways to Take the Sting out of Coding Allergic Reactions
Capitalizing on reimbursement for treating bee-venom-triggered anaphylaxis in the ... Read more
Dos and Donts for Diagnosing Multisystem Reactions:
Why Most Practices Get It Wrong
If you want to receive full reimbursement for anaphylaxis from bee stings, y... Read more
Are You Dripping Injection Fraud?:
Take This Quick Test to Tell
In an effort to infuse their offices with added reimbursement, many pediatric coders a... Read more
Coding Chronic Conditions Got You Down? Try These 7 Tips for Better Pay
It sounds simple, but it's easier said than done: If you... Read more
Reader Question:
Sedation Payment Is as Elusive asTwilight Sleep
Question: Our pediatric group typically bills 99214-25, 93000 and 99141 for services a... Read more
Reader Question:
Compare Home to Office Coding
Question: We provide early childhood intervention services and have 12 pediatricians w... Read more
Reader Question:
Clear the Way to 92567 Reimbursement
Question: Our pediatric office just began providing tympanometry. Do insurers require ... Read more
Reader Question:
Sew Up Added Supply Concerns
Question: When a physician at another facility, such as the emergency room, places sut... Read more
Reader Question:
Standard or Confirmatory Consult Code for Second Opinion
Question: I recently saw a patient who'd been seen six months before by another member... Read more
You Be the Coder:
Inject Some Coding Know-How
Test your coding knowledge. Determine how you would code this situation before looking... Read more
A Refreshing Treatment Soothes R&R Jealousy
Don't let your practice pay the price for children who took in some rays over spring... Read more
Emblaze Your Superbill With 4 Codes
Pediatricians may not report sunburn care if they don't have the appropriate ... Read more
Add a Helping of MNT to Your Practices Plate
Since CPT Codes introduced a trio of new codes in 2001 to medical nutr... Read more
Got the Right Type? Take the Guesswork Out of Diabetes Diagnosis Coding
Don't overlook digits four and five when assigning ICD9 codes for diabetes diag... Read more
Test Yourself:
A Diabetes Diagnosis Checkup
How much have you learned about three critical aspects of diabetes mellitus (DM) diagn... Read more
Reader Question:
A Drop of Blood Goes a Long Way
Question: In addition to performing a PKU newborn screen, my pediatricians administer ... Read more
Reader Question:
Evaluate Multiple Hospital Visit Rules
Question: If I see an ill child in the hospital in the morning and my partner sees t... Read more
Reader Question:
Bladder Procedure Involves Pediatrician
Question: Our doctor ordered a voiding cystourethrogram (VCUG) for a 2-year-old female... Read more
Reader Question:
Cutdown Venipuncture Confusion
Question: What is the difference between the pediatric venipuncture CPT 36420 -36425 a... Read more
Reader Question:
Use Modifier -91 to Report Multiple Diagnostic Tests
Question: A 15-year-old diabetic patient came in complaining of weakness, tremors an... Read more
You Be the Coder:
Test Your Film Knowledge
Test your coding knowledge. Determine how you would code this situation befo... Read more
Crossover Guidelines Ease Neonatal Critical Care Nightmares
Many neonatologists and pediatricians struggle with the nuances of switching... Read more
Cut Off Pediatric Critical Care At 24+
You conquered neonatal-to-pediatric transitional coding, but one great divid... Read more
Tune Into 92552s Increasing Intensity
Pediatricians and pediatric coders who incorrectly discriminate between in-office hear... Read more
2 Tools Battle Health Exam, Hearing Test Denials
An ounce of prevention and the right diagnosis can spell victory when you report a wel... Read more
Keep an Eye on the Spectrum of Neonatal Coding for Full Reimbursement
A newborn's condition can change from normal to sick to normal aga... Read more
Test Yourself:
A Newborn Spectrum-of-Care Quiz
How much have you learned about three critical aspects of coding for newborns whose co... Read more
Reader Question:
Payers Disagree Over Turning Yellow
Question: If I report 99431 and 99433 to Blue Cross Blue Shield of Illinois for a norm... Read more
Reader Question:
Cough Up Post-86580 Services
Question: Should I bill CPT 99211 for tuberculosis (PPD) reading? New Jersey Subscri... Read more
Reader Question:
Dont Forget Aphasia Diagnosis
Question: Which ICD9 Code should I use for Landau-Kleffner syndrome? Vermon... Read more
Reader Question:
Cut Out Extra Procedure Confusion
Question: Our pediatrician saw a newborn in the hospital on day 1 and excised a cyst f... Read more
Reader Question:
Feel Better About Well Visit Combos
Question: Should I append a modifier to a preventive medicine service code? For instan... Read more
Reader Question:
Bill for Consultations Postresuscitation
Question: A neonatologist was called into the delivery room for a consult and had to r... Read more
You Be the Coder:
Accept the Solitude of Absent Children
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Dont Miss Out on Reimbursement For Nebulizer Medications and Materials
You may scoff at taking the time to bill for nebulizer supply codes th... Read more
How Many Pennies Will I Get?:
Check Out the Nebulizer Supplies Coding Cheat Sheets
Faced with small payouts on nebulizer drugs and equipment, coders can't consume precio... Read more
Watch Your Lesions and Blood Counts With NCCI 9.0
Pediatricians should be aware that providing and billing for procedures is a... Read more
News Brief:
CMS Rejects New Hepatitis B Codes,Accepts Old Versions
Just when you thought you had grasped the CPT Codes 2003 changes that affect pedi... Read more
Fee Schedule Update:
Bush Signs Bill to Correct Medicare Payment Rates
With a single flourish, President George W. Bush lessened the blow of the anticipated ... Read more
Dont Let Your Mind Wander:
Focus on Evaluation Time in ADHD Coding
Keeping track of time spent diagnosing, developing treatment plans and providing f... Read more
Test Yourself:
An ADHD Coding Checkup
How much have you learned about three crucial aspects of coding attention de... Read more
Reader Question:
Care, Age and Status Drive NICU/PICU Coding
Question: When a critically ill infant remains critical past 30 days of life, do w... Read more
Reader Question:
54150 + 64450 = a Hard Time
  Question: The December 2002 Pediatric Coding Alert states that we should f... Read more
Reader Question:
ADHD Phone Calls Gratis?
Question: Should pediatricians bill for telephone calls they make during attention def... Read more
You Be the Coder:
Dont Get Sore Over 87880
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Is Your Office Sacrificing Training and E/Ms? Get What You Deserve with 94664 and 9921X
The next time your practice drops everything to treat an unscheduled patient for wheez... Read more
Did You Code the Session Correctly?
The pediatrician and nurse perform seven procedures (coding options follow each proced... Read more
Peds Receives Double Whammy:
Fee Schedule for 2003 Slashes RVU Reimbursement,Amount
Medicare not only cut relative value unit (RVU) reimbursement for 2003 by 4.4 percent ... Read more
Chart:
Chart:
... Read more
Dont Let the Interim Fee Schedule Filing Rules Drive You Crazy
Juggling two fee schedules for one calendar year could drive the most patient pediatri... Read more
Keep an Eye on Follow-Up Care When Coding Extended Hospital Stays
To report care complexity and medical decision-making accurately for pediatric and n... Read more
Reader Question:
Dont Charge Extra for 69210 on Both Ears
Question: For CPT 69210 , should I charge one price if both ears are irrigated? Illin... Read more
Reader Question:
On-Call Codes Describe Patient-Specific Attendance
Question: How do the new on-call codes apply? Insurers will likely not pay for the t... Read more
Reader Question:
New Orders Accompany 99232
Question: The distinction between the documentation requirements for CPT 99231 and 99... Read more
Reader Question:
Team Conferences Require Case Management Codes
Question: How should we code for a team conference? Several providers are meeting regu... Read more
You Be the Coder:
To Append an Attempt or Not?
Test your coding knowledge. Determine how you would code this situation before lookin... Read more
You Be the Coder:
Readmission to ICU for Asthma Complications
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Dont Fall Into Generation Gaps When Coding Adolescent Wellness Exams
Adolescent preventive medicine exams for patients 12 to 17 years old can include anc... Read more
Break Down Nebulizer Session to Capture Allowable Services and Procedures
Although CPT 2003 clarified the nebulizer training codes, pediatricians are still aski... Read more
Five Tips Sort Out E/M with Minor Procedure
Coding an E/M service with a minor procedure never ceases to stump even the most con... Read more
Reader Question:
Use Related Codes When Billing for Adolescent Obesity
Question: We frequently see adolescent patients who are obese. Were using 278.00 (Obesi... Read more
Reader Question:
Screening During Teen Wellness Checks
Question: How should we code hearing screening and testing for adolescent patients? What... Read more
You Be the Coder:
E/M Office Visit Codes Capture Gynecological Services
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
You Be the Coder:
Report Problem for Follow-Up Newborn Exams
Test your coding skill. Determine how you would code this situation be... Read more
Available Years:  2003  2002  2001  2000  1999  1998