Pediatric Coding Alert

Condition Spotlight:
Ask These 4 Questions, Find the Best Stomach Pain Code Quickly and Easily
Simply scrutinize for symptom, age, severity, and site. Few diagnosis codes get as much o... Read more
Coding Quiz:
Can You Pass This Year-in-Review Coding Quiz?
How many of these big 2021 changes do you recall? Can you remember the important coding ... Read more
Case Study Corner:
Follow Guidelines, Get Paid for Nothing!
Here's how to make sure your pediatrician gets credit when no problem is found. Here is a... Read more
Coding Quiz Answers:
Check Your Answers to Our End-of-Year Coding Quiz
How well do you know these major coding changes from 2021? Once you've answered the qui... Read more
Reader Questions:
Interpret This MDM Element Correctly for First-Rate Follow-up Reporting
Question: How should I code this follow-up visit? A patient returned to our pediatrician a... Read more
Reader Questions:
Sequence First Dx for Encounter Even When Not Definitive
Question: A patient with abdominal pain came to see our pediatrician. However, during the ... Read more
Reader Questions:
Take a Shot at Coding This Allergy Immunization Encounter When Serum not Provided
Question: If a patient comes to us asking to administer an allergy injection and brings he... Read more
You Be the Coder:
Check the Answer to This Lab Recheck Encounter
Question: As part of a patient well check, our pediatrician ordered a urinalysis, which ca... Read more
Condition Spotlight:
Take These 4 Tips for Flawless Winter Dx Coding
Here are all the instructions and guidelines you need to make it through the season. The ... Read more
News You Can Use:
Add to Your Flu Vaccine Coding Knowledge With This Update
AAP guidance gets some small but critical tweaks. The American Academy of Pediatrics (AA... Read more
Care Management:
Know These Differences, Update Your PCM/CCM/Complex CCM Understanding
Get ready for the code changes slated for Jan. 1, 2022. Last month, we told you about th... Read more
Reader Questions:
Delete These Debridement Codes for Verruca Destruction
Question: Our pediatrician documented “Skin lesion appearance consistent with verruca, n... Read more
Reader Questions:
Assign P Codes Past Perinatal Period in This Low Birthweight Encounter
Question: Our pediatrician just saw an infant who was born premature at 29 weeks and who w... Read more
You Be the Coder:
Ask These 3 Questions for Correct Inpatient Pediatric Critical Care Coding
Question: What is the difference between neonatal critical care (99468-99476) and intensiv... Read more
News You Can Use:
Note These 2022 CPT® Changes to 99211, COVID Coding
Experts weigh in on the latest revisions. The good news about the new and revised codes C... Read more
Care Management:
Stand by for RTM, PCM to Debut in 2022
New initiatives could increase your care management program options. In the Medicare Phys... Read more
Guidelines:
Get Right With These 2022 ICD-10 Laterality, COVID-19 Follow-Up Guideline Changes
And learn how to use new code Z71.85 safely. The Centers for Disease Control and Preventi... Read more
Reader Questions:
Use A, C, Y, W, and B to Spell Meningococcal Vaccine Coding Relief
Question: Can you explain when I should use 90619 or 90734 for a meningococcal A, C, Y, W ... Read more
Reader Questions:
Take This Advice for Newborn TCM
Question: Can we perform transitional care management (TCM) on newborns leaving the hospit... Read more
Reader Questions:
Know When Age Is, Is Not, a Factor in Umbilical Granuloma Code Choice
Question: An insurance company has just denied us for an umbilical granuloma, telling us t... Read more
You Be the Coder:
Answer This Question for Flawless 99211 Billing
Question: What are the minimum documentation requirements needed to bill 99211? What has t... Read more
2021 Reimbursement:
Get the Answers to Your CY 2022 Proposed Rule Questions
Vaccine administration payment, telehealth, under Medicare's microscope. Given the curren... Read more
2022 ICD-10 Revisions:
Bring These New Cough, Neonatal Screening Codes Onboard for 2022
ICD-10 adds immunization counseling, more specificity to feeding difficulties. Among the ... Read more
Social Determinants of Health:
Be More Specific With Your SDoH Documentation With These New ICD-10 Codes
Food and water insecurity and housing instability codes get a 2022 expansion. As a pediat... Read more
Reader Questions:
Know When Patient’s History Is a Thing of the Past
Question: Our provider documented that a patient had “childhood measles 10 years ago.... Read more
Reader Questions:
Use These Codes for Adverse COVID-19 Vaccine Reactions
Question: Our practice has been administering COVID-19 vaccines to our patients who are of... Read more
Reader Questions:
Use Skin Tag Code in These Extra Digit Encounters
Question: Occasionally, our pediatricians will remove a polydactylous digit from a newborn... Read more
You Be the Coder:
Manage Medications and Well Visits With This Useful Advice
Question: Is medication management included in a preventive medicine visit? And if it isn'... Read more
Preventive Care:
Get the Answers to Your Frequently Asked School Physical Questions
Are you ready for the back-to-school crew? School and athletic physicals are an annual r... Read more
Mythbusters:
Bust These 4 Myths, Understand Food Allergy/Intolerance Dx
Keep your codes straight with a little clinical knowledge. If the difference between a fo... Read more
Procedure Coding:
Avoid Bundling Bloopers and Modifier Misunderstandings for Perfect Spirometry Coding
You'll be breathing a sigh of relief if you remember these 3 things. Pulmonary testing c... Read more
Reader Questions:
Follow the Instructions for CLIA-Compliant Testing
Question: Is there an age limit associated with a respiratory syncytial virus (RSV) test b... Read more
Reader Questions:
See the Difference Automatically Between These 2 Urinalysis Tests
Question: I am confused by the terms “automated” and “non-automated” when it comes... Read more
Reader Questions:
Check Your Calendar for Initial Hospital Care Date Billing
Question: A baby was born in the hospital on 6/1. On 6/2, our pediatrician performed the i... Read more
You Be the Coder:
Use This Code and MDM Level When Depression, Anxiety Linked
Question: How do you code a patient who has depression and anxiety? Do you code the two co... Read more
Guidelines:
Know Medical Necessity, Improve Your Coding Accuracy
But be prepared for provider-payer disagreements. Medical necessity is one of those term... Read more
Coding Quiz:
Ace This Quiz, Become a Z Code Expert
Know the correct codes to apply and why. You know that codes from Chapter 21 (Z00-Z99) of... Read more
Case Study Corner:
Refresh Your Repair Coding Knowledge With This Laceration Case Study
Sometimes, simple repairs require complicated coding solutions. Here's an all-too-familia... Read more
Coding Quiz Answers:
Check Your Answers to Our Z-Code Coding Quiz
How well do you know the Chapter 21 codes? Once you've answered the quiz questions on pag... Read more
Reader Questions:
Manage This Immunotherapy Monitoring Muddle
Question: We have a patient who reports for immunotherapy injections for a peanut allergy.... Read more
Reader Questions:
Query Payer for Depo Counseling and Administration
Question: If a patient comes in for family planning counseling, and our pediatrician admin... Read more
Reader Questions:
Take This Advice for Documenting Normal BMI
Question: If a patient's body mass index (BMI) is in the normal range, do you still assign... Read more
You Be the Coder:
Know Your Tests, Map to Correct Primary Dx
Question: We perform urine tests on our patients who have ADD (attention deficit disorder)... Read more
Telehealth:
Take This Advice for Current and Post-PHE Telehealth Success
These 6 big takeaways will help you move forward with your virtual services. The COVID-1... Read more
Procedure Coding:
Sharpen Your I&D Coding Precision With the Answers to These FAQs
Avoid costly coding errors by paying attention to answer 4. The incision and drainage (I&... Read more
Modifiers:
Mind This Modifier Masterclass, Boost Your Bottom Line
Learn from these 3 scenarios and make denials a thing of the past. Whether you append a ... Read more
Reader Questions:
See the Difference Between These Vision Screens
Question: Can you explain the difference between visual screening codes 99172, 99173, and ... Read more
Reader Questions:
Let This Guideline Govern Injury Code Choice
Question: An adolescent patient came in after turning his ankle playing soccer. Our pediat... Read more
Reader Questions:
Take This Submental Dx Coding Advice on the Chin
Question:  Our pediatrician documented a submental wound in a patient record. I can't... Read more
You Be the Coder:
Don’t Stop the Clock When the Patient Isn’t There
Question: The 2021 revisions to the office/outpatient evaluation and management (E/M) code... Read more
CPT® 2021 E/M Revisions:
Learn These 3 Big Takeaways From AMA’s Office/ Outpatient E/M Updates
MDM data points and risk redefined; sick/well visit coding dilemma addressed. The dust i... Read more
ICD-10 Coding:
Find Relief for Your Summertime Skin Condition Coding
Itching to code rashes correctly? This guide has you covered. Skin rashes in children are... Read more
Case Study Corner:
Can You Code This Repeat Nursemaid’s Elbow Encounter?
Hint: Don't code these similar encounters the same way twice. Your pediatrician may ref... Read more
Reader Questions:
Determine Line or Unit Payer Preference on Multiple Assessment Tools
Question: I am looking for guidance in billing for PHQ, Vanderbilt, ADHD and SCARED tools.... Read more
Reader Questions:
See the Answer to This Telehealth Video Problem
Question: Our pediatrician tried to conduct a telehealth evaluation and management (E/M) v... Read more
Reader Questions:
Secure Your Understanding of Unsecured Communications
Question: Our patients frequently ask if we can send them appointment reminders or bills ... Read more
You Be the Coder:
Repair Your Patient’s Bill in This Suture Removal Scenario
Question: Our pediatric practice is a part of a health system run by a local hospital. On... Read more
2021 Reimbursement:
Find Out What’s Going to Be in Your Practice’s Wallet This Year
Office and telephone E/M increases significantly offset preventive service decreases. For... Read more
Coding Quiz:
Do You Have What It Takes to Be a Mental Health Coding Maven?
Here's your chance to prove you know your way around the F01-F99 codes. Do your anxiety l... Read more
Procedure Coding:
Get the Answers to Your Frequently Asked HRA Questions
Here's your guide to risk-free screening and assessment coding. Because health risk ass... Read more
Coding Quiz Answers:
Check Your Answers to Our Mental Health Coding Quiz
Time to find out if you're a Chapter 5 ace. Once you've answered the quiz questions on pa... Read more
Reader Questions:
Choose These Codes for Post-COVID Sports Clearance
Question: Our pediatric office wants to put together a procedure for clearing patient... Read more
Reader Questions:
Know These Requirements Before Billing Non-Face-to-Face Prolonged Services
Question: I know that 99358 is a standalone code that requires at least 30 minutes of prol... Read more
Reader Questions:
Rule in These Codes When Suspected Substance Symptoms Ruled Out
Question: If Mom smoked tobacco or abused substances during pregnancy, and the newborn doe... Read more
You Be the Coder:
Test Your Understanding of This MDM Element
Question: In the answer to question 2 in “Take This Quiz, See if Your 2021 MDM Knowledge... Read more
Guidelines:
Know These Guidelines for Trouble-Free Type 1 Coding
Hint: It's not quite as simple as knowing E10 from E11. As a peds coder, you're fully aw... Read more
Modifiers:
Test Your Modifier 24 Understanding With These 2 Scenarios
And know whether the 2021 office/outpatient E/M changes will affect its use. If you're ... Read more
Procedure Coding:
Use These Tips to Improve Your Urinalysis Understanding
These 4 simple pointers will sharpen your testing savvy. Urinalysis tests are so common ... Read more
You Be the Coder:
Document Drug, Dose, and Decision for MDM Credit
Question: Our pediatrician told a patient to continue taking a given medication at the sam... Read more
Reader Questions:
Add This COVID-19 Code to Your Vaccination List
Question: I know we now have CPT® vaccine and vaccine administration codes for the curren... Read more
Reader Questions:
Remove Paring Code in This Lesion Destruction Encounter
Question: Our pediatrician recently removed a wart from a patient's hand. She began by par... Read more
Reader Questions:
View the Correct Way to Code This Corneal Abrasion Encounter
Question: Our pediatrician examined a patient's eye using a Wood's lamp. She placed a drop... Read more
News You Can Use:
Know These 4 Big Takeaways from the 2021 Final Rule
Prolonged service confusion, telehealth expansion, and a bottom line increase for 2021. ... Read more
Preventive Care:
Follow These 5 Recommendations for Preventive Medicine Documentation Success
Go beyond 99381-99396 descriptors and CPT® guidelines, say experts. Preventive medicine ... Read more
ICD-10 Coding:
Keep Your Eyes on These ICD-10 Codes for Successful Vision Coding
You haven't seen it all till you've seen these codes. Pediatricians are often called upo... Read more
You Be the Coder:
Update Your Knowledge of COVID-19 Vaccine, Treatment, Dx Codes
Question: The news is full of stories about COVID-19 vaccinations now becoming available, ... Read more
Reader Questions:
Review Your Understanding of This MDM Data Guideline
Question: If a provider is billing based on medical decision making (MDM), not on time, c... Read more
Reader Questions:
Make the Right Modifier Choice in This Flu Test Scenario
Question: We often do double flu tests, one for flu A and one for flu B. We bill code 8780... Read more
Reader Questions:
Apply These Guidelines Before Appending These Modifiers
Question: Occasionally, our pediatrician has to stop a vision or hearing screening because... Read more
Preventive Care:
Develop Your Screening and Testing Coding Knowledge With These 4 Tips
Don't forget to heed AAP's advice and guidance. Age-appropriate screens or tests that ass... Read more
Coding Quiz:
Take This Quiz, See if Your 2021 MDM Knowledge Is on the Level
How well do your answers match up with those of our expert? Now that your office/outpatie... Read more
ICD-10 Coding:
Ask These Questions, Improve Your Musculoskeletal Dx Coding
Time to make choosing the right M00-M99 code pain-free. You know all too well that even t... Read more
Coding Quiz Answers:
Check Your Answers to Our MDM Coding Quiz
Time to find out how well you're dealing with the 2021 office or outpatient E/M changes. ... Read more
Reader Questions:
Depend on Parent History for E/M Data Element
Question:Under the 2021 office/outpatient evaluation and management (E/M) guidelines, can ... Read more
Reader Questions:
Follow These Guidelines for Correct Immunization, Well Visit Dx Sequencing
Question: I know that Z23 is the primary diagnosis code for immunizations, but does it get... Read more
Reader Questions:
Know These Terms for Correct Z79 Use
Question: When would I use Z79.899? And what do the terms “long term” and “current... Read more
You Be the Coder:
No Dx? No Certification? Use This Code for Nutrition Counseling
Question: Our pediatrician saw a patient who is putting on weight but whose body mass inde... Read more
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