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Pediatric Coding Alert

News You Can Use:
Spell Documentation Relief M-P-F-S in 2019
CMS reduces administrative burden, keeps current E/M guidelines — for now. There's a lo... Read more
Condition Spotlight:
Answer These 4 Questions to Master Food Allergy Coding
Hint: Approach codes for allergy, intolerance, and immunotherapy with caution. “As many... Read more
Clip and Save:
Use This Chart to Code Common Winter Conditions
And take these expert tips for flawless documentation. ‘Tis the season for sniffles and... Read more
Reader Question:
Think Twice Before Using This Sample Shipping Code
Question: When is it appropriate to bill 99000 for lab samples? Our office manager believe... Read more
Reader Question:
Deduce if Dx Dilemma Is Denial Defense
Question: A payer just denied a claim for a chemical cauterization of an umbilical granulo... Read more
Reader Question:
Know Recommended, Required, to Code This Supplement Encounter
Question: Our provider just prescribed a Vitamin D supplement to a 1-month-old breastfeedi... Read more
You Be the Coder:
Clarify Payer Guidelines to Avoid This Coding Headache
Question: We saw a patient on a Saturday morning during our regular Saturday hours for a p... Read more
News You Can Use:
Add These 7 Shiny New CPT® Codes to Your 2019 Coding Choices
Bring your E/M, vaccine coding up to date with this guide. The good news is that, with ju... Read more
ICD-10 Coding:
Clear Up Your Bronchitis Coding With This Expert Advice
Know when age does, does not, play a role in the Dx. Considering bronchitis is such a com... Read more
Practice Management:
Master Maternal Meet-and-Greets
Should you charge for this traditionally free service? The scene plays itself out through... Read more
Reader Question:
Remove Yourself from This OAE Coding Mistake
Question: We recently administered an otoacoustic emissions test (OAE) on a one-year-old p... Read more
Reader Question:
Read This Descriptor Closely for Dx Success
Question: Our pediatrician examined a young patient who presented with a sore throat, feve... Read more
You Be the Coder:
Heed the Global Warning in This Playground Accident Encounter
Question: A 3-year-old patient was playing on the monkey bars at a local park when he fell... Read more
ICD-10 Coding:
Take These 3 Tips to Document Pediatric Diabetes
Hint: pay attention to guidelines, additional code notes. Before the 1990s, the incidence... Read more
Coding Quiz:
Think You Know E/M Time Coding? Take This Quiz and Find Out
Keeping your eyes on the clock isn't the only rule to follow. When you code an evaluation... Read more
Practice Management:
Use These Codes for a Smooth Peds Patient Hand Off
And make sure you have a policy in place. “The only constant in life,” an ancient phi... Read more
Coding Quiz Answers:
Check Your Answers to Our E/M Time Coding Quiz
Once you've answered the quiz questions on page 75, compare your answers with the ones our... Read more
Reader Question:
Remember to Pack the Ice in This Muscle Strain Claim
Question: We had a patient report with a shoulder muscle strain that would not go away two... Read more
Reader Question:
Examine Modifier Use in This Medicaid Encounter
Question: We recently provided a preventive medicine evaluation and management (E/M) servi... Read more
You Be the Coder:
Code E/M Levels by Documentation, not Dx
Question: Which code should we report for evaluation of a cough, runny nose, and fever? We... Read more
News You Can Use:
Get More Specific With New Depression, Developmental Screen Codes
And add autism screening to your reporting choices. In the previous issue of Pediatric Co... Read more
E/M Coding:
Integrate These Codes Into Your Behavioral Health Reporting
And make sense of collaborative care documentation, too. Integrating behavioral health se... Read more
Case Study Corner:
Test Your Knowledge of This TB Coding Scenario
Can you correctly code this common pediatric encounter? It's a familiar coding situation ... Read more
Reader Question:
Take This Vital Advice to Find E/M Level
Question: A new patient presented in our office. Our pediatrician documented a comprehensi... Read more
Reader Question:
Use These Valid Guidelines for Virtual Visits
Question: How do we document email exchanges between a patient's guardian and our pediatri... Read more
Reader Question:
Manage Your Understanding of Care Management Bundling
Question: Our pediatrician reviewed a large medical chart prior to seeing a patient who is... Read more
You Be the Coder:
Calculate Tonsil Calculus Removal Reimbursement Correctly
Question: A patient reported to our office complaining of a sore throat and difficulty swa... Read more
News You Can Use:
Comprehend These New Codes for Cyberbullying, Abuse
ICD-10 addresses neglect and exploitation as well. The annual revisions to ICD-10 are upo... Read more
Know These New Neonatal Codes:
Report substance withdrawal and neonatal transitory disorders beginning Oct. 1.
Even though the switch from ICD-9 to ICD-10 is now three years old, the fallout from the t... Read more
Mythbusters:
Bust These Myths for Clear Contraceptive Service Coding
Experts weigh in on ways to report counseling, procedures. Providing contraceptive servic... Read more
Reader Question:
Factor Age into DTaP/Tdap Determination
Question:  Our pediatrician just saw a 7-year-old patient who was behind on his 6-yea... Read more
Reader Question:
Determine Purpose for Accurate Procedure Assignment
Question: We have recently begun performing in-and-out catheterization on children for uri... Read more
Reader Question:
Continue with This Modifier When Procedure Is Discontinued
Question: When our certified medical assistant (CMA) performs a hearing or vision screenin... Read more
You Be the Coder:
Separate Counseling by Dx in This E/M Encounter
Question: We are billing for an office visit for attention deficit hyperactivity disorder ... Read more
ICD-10-CM Coding:
Digest These Newborn Feeding Dx Codes
Look to guidelines and infant age for specificity in this scenario. The scenario may be f... Read more
E/M Coding:
Heed this Advice, Avoid Adolescent Preventive Medicine Coding Errors
These dos and don'ts will give your reporting a healthy outcome. An ounce of prevention, ... Read more
Procedure Coding:
Report E/M or Simple Incision for These Tick Encounters
Look to anatomical site, not creature, for Dx coding. If your patients live in, or will b... Read more
Reader Question:
Bill Single Code in This Spirometry Scenario
Question: When billing for two spirometries — a pre- and post-spirometry — during the ... Read more
Reader Question:
Determine Diaper Rash Dx, Tests, With These Codes
Question: How do I code for candidiasis diaper rash? I get mixed answers from physicians o... Read more
You Be the Coder:
Know Exclusive, Unlikely for CCI Edit Success
Question: What is the difference between mutually exclusive edits, and medically unlikely ... Read more
Practice Management:
Boost Your APPs Role, Boost Your Practice's Bottom Line
But understand federal and state regulations before you do. If, like many pediatric pract... Read more
Case Study Corner:
Simplify Your Simple Concussion Coding with This Advice
E/M level, testing codes, and Dx coding to seven digits are key. A six-year old girl fall... Read more
ICD-10 Coding:
Use This Guide to Find Physeal Fracture Codes Fast
And know with, without manipulation to find the right procedure. Salter-Harris fractures ... Read more
Reader Question:
Document Continued, not Completed, Care in This Follow-Up Encounter
Question: A patient we have been treating for a severe case of eczema came back to our pra... Read more
Reader Question:
Take the Sting out of Insect Bite Coding with This Scenario
Question: How do I code for multiple mosquito bites on an eight-year-old patient? Is there... Read more
You Be the Coder:
Breathe Deep, Code This Nebulizer Treatment with Caution
Question: A patient with a new diagnosis of asthma came to our practice to be educated on ... Read more
Mythbusters:
Bust These Multiple Myths to Master Milia Coding
And make sure you know your payer's rules for reimbursement. Common in newborns, milia ca... Read more
ICD-10 Coding:
Take These 3 Hints, Code Abdominal Pain with Precision
Use these simple solutions to support stomachache coding. It's a common complaint, but co... Read more
Case Study Corner:
Code Sunburn Scenario Correctly, Cure the Summertime Blues
You won't feel the burn if you follow our experts' advice. Summer is almost here, and you... Read more
Reader Question:
Time to Change Your Reporting with These New CCI Edits
Question: On April 1, the Centers for Medicare and Medicaid Services (CMS) made the next r... Read more
Reader Question:
Document Degree of Care in This Newborn Withdrawal Encounter
Question: My pediatrician was the primary care provider for a baby who was born to a mothe... Read more
Reader Question:
Link Screen Code with This Procedure to Avoid Denial
Question: We just got a denial for an X-ray performed on a 6-week-old patient. Our pediatr... Read more
You Be the Coder:
Go Deep to Code This Splinter Scenario
Question: Our pediatrician saw a patient who had been running barefoot on a wooden deck, w... Read more
ICD-10 Coding:
Hear This Advice, Code Otitis Media with Confidence
And know what to do when the condition has been resolved. As a peds coder, your ICD-10 ma... Read more
E/M Coding:
Choose Codes Carefully in This Sick Neonate Scenario
Level of care key when documenting newborn illness. If you've been a peds coder for any l... Read more
Case Study Corner:
Know Circumstances to Report Underdosing Accurately
ICD-10 even includes choices for hard times. Introduced to ICD-10 in 2015, the term "unde... Read more
Reader Question:
Determine Site for Definitive Debridement Documentation
Question: One of our patients was recently involved in a skateboard accident, which result... Read more
Reader Question:
Know Where to Look for WARI Codes
Question: Our provider recently diagnosed a patient with wheezing associated respiratory i... Read more
Reader Question:
Use This Code for Benign Wart Removal
Question: A patient reported to our office with several plantar warts on the sole of his r... Read more
You Be the Coder:
Know Care Level, Understand Bundled Procedures
Question: A patient reported to our pediatrician with congestion, wheezing, and coughing. ... Read more
E/M Coding:
Manage Your Knowledge of Chronic, Complex Care Management
Hint: eligibility, care plans, timing, and guidelines form the foundations. On the surfac... Read more
Coding Quiz:
Can You Ace This ENT Quiz?
Test your knowledge of these 5 common peds problems. In your peds practice, you deal with... Read more
Case Study Corner:
Go Beyond E66 Codes for Complete Obesity Reporting
BMI key to coding the condition. Obesity, the Centers for Disease Control and Prevention ... Read more
Coding Quiz Answers:
Check Your Responses to Our ENT Coding Quiz
Grab your answers and see if you can call yourself an expert. Answer 1: "This would depen... Read more
Reader Question:
Assess These Behavioral and Developmental Screening Codes
Question: Can you explain the difference between 96127 and 96110? Which assessment instrum... Read more
Reader Question:
Track Time for This Treatment Scenario
Question: Our provider administered an albuterol treatment to an asthmatic patient that la... Read more
You Be the Coder:
Understand Lab Techniques, Pass This Influenza Test
Question: Our provider wants to start performing influenza testing in our office. Can you ... Read more
ICD-10 Coding:
Paint the Whole Picture with Chapter 20 Codes
External cause reporting lets you go the extra mile. Yes, it's true you don't have to rep... Read more
Procedure Coding:
Hear This Advice, Code These Tests Clearly
Know which ones can be used as screening tools, and why. Whether your pediatrician perfor... Read more
E/M Coding:
Follow These Steps to Code Baby's First Few Days
Look to definitions for definitive documentation. The birth of a child, and the days that... Read more
Reader Question:
Limit Modifier 55 Use in This Minor Injury Encounter
Question: An established patient reported to our practice and asked our physician to remov... Read more
Reader Question:
Report Units, not Modifier, in This Multiple Injection Scenario
Question: A patient reported to our office with bacterial pneumonia, and our pediatrician ... Read more
You Be the Coder:
Code for Risk Assessment, Education in This Asthma E/M Scenario
Question: Our pediatrician just saw a 13-year-old female patient who had recently been to ... Read more
News You Can Use:
Know How the 2018 PFS Will Impact Your Practice's Bottom Line
Your most-used codes and location could spell lower revenues. In November, the Centers fo... Read more
Mythbusters:
Bust These 4 Myths for Flawless E/M Reporting
Get philosophical with these HPI pointers. The guidelines are both lengthy and complex. S... Read more
ICD-10-CM Coding:
Ask These Questions for Clear Pink Eye Coding
Know cause, location to find the specific Dx. You know it as conjunctivitis, though it's ... Read more
Reader Question:
Code Routine Exam Based on Dx When Definitive
Question: When is it appropriate to code a routine child health exam "with abnormal findin... Read more
Reader Question:
Unbundle Separate Service During Global With This Modifier
Question: Our pediatrician recently removed a number of skin tags from one of our adolesce... Read more
You Be the Coder:
Know These Numbers to Add Up Vaccine Reimbursement
Question: We have been getting numerous National Drug Code (NDC) denials for administering... Read more
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