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Pediatric Coding Alert

Get the Inside Scoop on Upcoming Circumcision Code Changes
Shocker: CPT 2007 ends your nerve block nonpayment woes When CPT 2007 takes effect Jan. 1... Read more
Reluctant to Charge for MD-Made Phone Calls? New Policy Will Make You Rethink Your Stance
Great news: The AAP supports payers reimbursing for 3 types of telephone care If you ... Read more
Create a Call Pay Plan in 5 Easy Steps
These AAP-endorsed measures will help you charge phone services ethically without causing ... Read more
READER QUESTION:
Use 4-5 Codes for HPV Vaccination
Question: How should I bill the administration of the second and third shot of Gardasil?... Read more
Capture 3 New Pulmonary Services With Set Rehaul
Outlying hospitals: Make sure you add 94610 to your encounter sheetThanks to CPT 2007, you... Read more
READER QUESTION:
Should You Give Referral on Overdues?
Question: A patient whom we have not seen since April and whose account is in collections ... Read more
READER QUESTION:
Rhinorrhea Dx Now Requires 5th Digit
Question: What diagnosis should I use for rhinorrhea?New York SubscriberAnswer: Effective ... Read more
READER QUESTION:
Bill 99238-99239 When Face-to-Face Occurs
Question: A pediatrician coded a newborn's hospital charges as an admit, two subsequent da... Read more
YOU BE THE CODER:
Buddy Tape--E/M or Procedure?
Question: A patient breaks one of his toes (826.0, Fracture of one or more phalanges of fo... Read more
Boost Payments by Reporting Foreign-Body Removal When You Take Out Splinter, Bead
These codes can net you $200+, and you probably already do these procedures One major ... Read more
Before You Code Another Consult, Look for These New Criteria
Your payments depend on updating the 3 R’s to 5 Consultation requirements have i... Read more
Modifier Mystery:
Tackle Sick-Visit Bundle Before Nonpayment Sidelines You
Tip: Dual-service entries should include customary fees, even if claim will result in de... Read more
Reader Questions ~ Identify This Component to Select Td Product Code
Question: When a patient receives a DECAVAC injection for immunization, should I use CPT 9... Read more
Reader Questions ~ Add V65.19 for Parent Conference Diagnosis
Question: What diagnoses apply when parents come in to discuss their child's health issues... Read more
Reader Questions ~ Don't Accept 51701-62270 Bundle
Question: A neonate came in with fever. We did a urine catheterization (CPT 51701 ) and a ... Read more
Reader Questions ~ Update RotaTeq Code by Dropping Indicator
Question: What does the lightening-bolt symbol next to CPT 90680 mean?Alabama SubscriberA... Read more
You Be the Coder ~ Should You Count 'By the Way' Service?
Question: While I was performing a scheduled preventive medicine service for a child, the ... Read more
Find Out if You Are Overlooking Opportunities To Collect $10+ for Developmental Screening
PEDS' creator shares 5 little-known facts about 96110If you don't realize the extent of te... Read more
Hone Your Modifier 25 Policy With These Guidelines
Private payers may drop the modifier requirement forj medicine/service claims You fin... Read more
Coding Checkup:
Take 5 Minutes to Nail Down The Fall ICD-9 Changes
Warning:  Pause before reporting bronchitis for a childSee if you're up to speed on t... Read more
READER QUESTIONS:
Current Clients Can Be Consultation Subjects
Question: Can I perform a consult on my own patient? Florida Subscriber Answer:... Read more
READER QUESTIONS:
Adhere to Inclusion/Exclusion Instructions
Question: When looking up codes in the tabular list of my ICD-9 manual, I often see &ldq... Read more
READER QUESTIONS:
Get Live Pediatric Coding Advice
Question: Do you know of any pediatric coding conferences coming up in the next year or tw... Read more
READER QUESTIONS:
Surgery Allows You to Specify Follow-Up Exam
Question: A child comes in for a penile lesion, and he is surgically treated and comes bac... Read more
You Be the Coder:
Which Modifiers Apply to Typical Birthing Care?
Question: When a child is born, the hospital stay is only three days. Therefore, we do t... Read more
Sharpen Your Circumcision Coding With These 4 Pointers
Relief:  Recommendations on 54150, 64450-59 remain unchanged despite increased modi... Read more
Are These Locum Tenens Myths Clouding Your Compliance?
Obeying the 60-day limit may be trickier than you thinkYou may have some dangerous misconc... Read more
READER QUESTIONS:
Counting Chronic Conditions
Question: The 1997 audit guidelines state that I can reach an extended history by updating... Read more
READER QUESTIONS:
Look to V73.0-V82.9 for Well Check Screenings
Question: At a child's one- and five-year preventive medicine services, we perform a scree... Read more
You Be the Coder:
Consider These Diagnoses for Hyperbilirubinemia Evaluation
Question: Based on the American Academy of Pediatrics recommendation that pediatricians ... Read more
Get Ready for Expected Perinatal Diagnostic Changes
Surprise: You could benefit from a new V code The ICD-9 code additions that will most imp... Read more
Test Your Modifier 25, 59 Skills With 2 Scenarios
Comfort: You're not alone in your  pulse oximetry denials Correctly coded pulse ... Read more
Audits:
Can You Spot These 10 Red Flags in Your Charts?
Find the trouble signs before they turn into disasters When you're auditing your charts, w... Read more
Reader Questions:
Use Modifier 25 on E/M Code With 90772
Question: A pediatrician performs a significant, separately identifiable E/M service for a... Read more
Reader Questions:
Don't Leave Telephone Codes off the Hook
Question: Due to the large volume of non-emergent calls our pediatricians receive after 10... Read more
Reader Questions:
Count Readmission as Separate Service
Question: I discharged a patient from the hospital and readmitted him to the same hospital... Read more
Reader Questions:
Charging for PPD Reading Varies by Situation
Question: We charge for a PPD placement but historically have not billed for reading the t... Read more
Reader Questions:
Use Caution With Observation Codes
Question: My pediatrician saw a patient on Thursday night while he was the attending physi... Read more
Reader Questions:
You Can Get Paid for Nonphysician Catheter Placement
Question: Can we bill CPT 51701 if a nurse catheterizes a patient?Michigan Subscriber An... Read more
You Be the Coder:
Should You Stick With 99213 for Sunburn Care?
Question: A mother presents with her son whose back is red from what I diagnose as a first... Read more
A Fellow Pediatrician Unveils the New ICD-9 Codes Worth Adding to Your Superbill
Avoid these soon-to-be-taboo codes this October If you've been looking for a clearer way ... Read more
This Autumn, Add Another Digit to Aftercare Coding
BMI codes won't be for adults only When your office provides burn or laceration follow-up... Read more
Fewer Than 3 Components Doesn't Rule Out 99201-99205
Discover the factor that trumps new patient HEM criteria One rule supersedes 99201-99205'... Read more
Reader Questions:
Obtain Alternate V20.2 Age Guideline in Writing
Question: BlueCross National Capital Area (NCA) started applying claims containing V20.2 ... Read more
Reader Questions:
Stick With E/M Codes for Sports Exams
Question: Our practice has so much trouble getting reimbursed for sports physicals. Could ... Read more
Reader Questions:
1 Simple Answer Locks in Moderate Sedation Family
Question: A child comes in with a high fever, and the pediatrician suspects meningitis. Th... Read more
Reader Questions:
3 or 4 HPI Elements Play Big Role in Final E/M Level
Question: How does a brief history of present illness (HPI) differ from an extended HPI?Mi... Read more
You Be the Coder:
Does Developmental Questioning Warrant Reporting?
Question: At a 24-month established patient preventive medicine service, a mother describe... Read more
Get Set for Allergy Season by Matching Prep And Immunotherapy to Real-World Encounters
Surprise: Multi-dose prep deserves its own unit coding May flowers may bring allergy suff... Read more
Go In-Depth as 1 Coder Pinpoints a 95115-95117 Denial Hot Button
Diagnosis coding may not be as simple as you thinkIf you aren't getting paid for 95115-CPT... Read more
These Modifier 25 Do's Will Pass the OIG's Muster
Green-light E/M with vaccine, circ when documentation supports separate service Just beca... Read more
Random-Order Diagnostic Assignments Won't Cut It
 Implement this ICD-9 action plan to decide which diagnosis should go first Relyi... Read more
Reader Questions:
Don't Report 99051 as Stand-Alone Code
Question: Regarding CPT 2006's introduction of CPT 99051 , I have three questions: 1.... Read more
Reader Questions:
Are You Overcoding an E/M With 24640?
Question: In the February 2006 Pediatric Coding Alert, the "You Be the Coder" discusses mo... Read more
Reader Questions:
POS 12 Works With CPO, Not RH
Question: Are 99324-99337 and 99339-99340 for home care?Montana Subscriber Answer: You can... Read more
Reader Questions:
Surprise: Peak-Flow Denial May Be on Target
Question: An insurance company told me that the code I use for peak flow (CPT 94250 ) is i... Read more
You Be the Coder:
Follow This Rule to Prevent IA Double-Dipping
Question: A nurse administers Rotateq (rotavirus) along with other vaccines. Rotateq is th... Read more
You Can Separately Report Suture Removal--Experts Explain When and How
Hint:  Modifier 52 won't cure all of your coding woesYour suture-removal services can... Read more
Coding Online Services May Add $25 to Your Bottom Line
Your pediatrician can address simple issues on the Net--and get paid Your patients ma... Read more
Take 1 Step When Infusions Involve Multiple Substances
Be careful if you're reporting hydration therapy for drug administration fluid Yo... Read more
READER QUESTIONS:
Check Fee Schedule for Bilateral Options
Question: How can we use our insurer's Fee Schedule to determine when we can report modif... Read more
READER QUESTIONS:
Scratch 90788-There's a Better Choice
Question: We've received notice from our payers that 90788 is invalid after Dec. 31, 2005.... Read more
READER QUESTIONS:
Only 1 Code Available for TB Test
Question: I've heard conflicting information on coding tuberculosis skin tests. Should we ... Read more
READER QUESTIONS:
Don't Stop at E/M Code for Cerumen Removal
Question: Our pediatrician saw a patient for an ear infection, but the patient had such th... Read more
You Be the Coder:
Must Prolonged Services Occur the Same Day?
Question: Our group of pediatricians evaluates a patient on Monday. The following day, t... Read more
HCPCS 2006 Makes Albuterol Product Coding a Breeze
Key: Get your nebulizer claims on track and slash denials If your payers have started ... Read more
5 Steps Lead You to MNT Coding Perfection
Use this action plan so you won't miss out on reimbursement The number of diabetes cases ... Read more
Modifiers 59 and 25 Are Under the Microscope -- Are You Ready?
Tighten your documentation before you append, experts say Insurers will cast a spotlig... Read more
1 Simple Tool Can Make Your Consult Documentation Easy
Stymied by a lack of written consult requests? Fax this form to requesting physiciansIf yo... Read more
Reader Questions:
Physician Should Document HPI
Question: If a nurse documents the history of present illness (HPI) in her notes and the p... Read more
Reader Questions:
Look at 3 Options for Lactation Consults
Question: How can we bill for a lactation consultation that a registered nurse, who is a c... Read more
Reader Questions:
Avoid Coding 99440 and 99436 Together
Question: An ob-gyn called our pediatrician into the delivery room for a consult, and the ... Read more
Reader Questions:
Apply 691.0 for Diaper Rash
Question: Which diagnosis code should I report for a monilial diaper rash? New York... Read more
Reader Questions:
Rib X-Ray? Choose 71100 Instead of 71020
Question: We typically report CPT 71020 for two-view rib x-rays. An auditor we hired said... Read more
You Be the Coder:
Can We Report 30310 If We Don't Use Anesthesia?
Question: Our insurer's fee schedule amounts for 30300 and 30310 seem very high, and patie... Read more
Use These Tried-and-True Tips to Turn Office Visit Denials Into 9921x + 69210 Payments
Experts reveal the diagnoses and modifiers insurers want on cerumen removal, E/M service... Read more
Master New Chemotherapy Coding Method in 4 Easy Steps
Real-world case study teaches you to apply CPT 2006 guidelinesIf you provide outpatient pe... Read more
Capture Asthma, Diabetes Education a Whole New Way
Your practice could benefit from patient self-management codes Because your plate is ... Read more
READER QUESTIONS:
Include Oxygen Administration in E/M Service
Question: When an office patient requires oxygen, what CPT Codes should I use for admini... Read more
READER QUESTIONS:
Indicate Incomplete Screen With Modifier 53
Question: When a pediatrician spends time attempting a hearing and vision screen but can... Read more
READER QUESTIONS:
Protect Consult Pay With Request Verification
Question: To use a consultation code, a coworker thinks we should make sure the requesting... Read more
READER QUESTIONS:
Use Itemization to Avoid Vaccine Admin Denials
Question: When we bill 90466 or 90472 more than once, insurers deny the additional submiss... Read more
You Be the Coder:
How to Code After-Hours Emergency
Question: I returned to the office at midnight to see an asthmatic patient. Because I pr... Read more
There's a New Way to Break Down IV Infusions In 2006--Here's How
Replace hydration therapy's '8' with a '6' You can seamlessly tra... Read more
Reap 3 Benefits of New and Revised Special Service Codes
CPT Codes 2006 opens the door to capturing posted evening-hour surcharges Because old... Read more
Payment Potential Should Lure You Into 99050-99060 Update Lesson
More special service specifics may yield greater coverageDon't be so quick to brush off le... Read more
READER QUESTIONS:
Break Down Newborn Care With Encounter Chart
Question: The January 2006 Pediatric Coding Alert indicates that w... Read more
READER QUESTIONS:
Apply Flat Fee to Sedation Codes
Question: When a pediatrician provides moderate sedation, how should I capture the charge ... Read more
READER QUESTIONS:
Learn How to Compare Annual Payment Rates
Question: How can I determine if a service's value has changed from last year?Ohio Subscri... Read more
You Be the Coder:
Modifier 25 vs. 57--Expect Some Policy Changes
Question: A mother brings her son in for elbow pain after she yanked him out of the way of... Read more
Update Neonatal Care Continuum With New High-Paying SIC Code
CPT 2006 expands subsequent care codes to include normal-weight newbornKnowing the new 200... Read more
Crucial Action Plan Avoids Injection Admin Denials in 2006
Use new code 90772 for Synagis and Rocephin shot You can keep payment for therapeutic... Read more
Code 90772 Versus 99211:
Ask 3 Questions When Nonphysician Performs IM Injection
Revert to a nurse visit in absence of direct supervision, CPT statesCPT 2006 injection adm... Read more
Get All the Pediatric Changes You Need to Know in 1 Place
E-mail for your free CPT Codes 2006 guideStaff can easily learn the top CPT 2006 changes ... Read more
READER QUESTIONS:
Look at Method to Choose Circ Code
Question: Should I assign CPT 54150 or 54160 for newborn circumcision? I use a Bell clamp... Read more
READER QUESTION:
Opt for E/M Code Instead of Med Management
Question: For a Ritalin follow-up visit for a child who has attention deficit disorder (AD... Read more
READER QUESTIONS:
3 Methods Substantiate Modifier 25 Claim
Question: A consultant suggests that we use two-entry documentation for encounters that in... Read more
READER QUESTIONS:
Wait 3 Years Before Recoding New Patient
Question: A child stopped treatment with our office two years ago. May I report another ne... Read more
You Be the Coder:
Learn Home CPO Service Criteria
Question: A pediatrician reviews labs over the phone with a patient’s parent and p... Read more
Available Years:  2006  2005  2004  2003  2002  2001  2000  1999  1998