Pediatric Coding Alert

Year in Review:
Remember 2023’s Biggest Coding Takeaways
How many of these changes can you recall? The world certainly has seen a lot in the last ... Read more
Conquer Congenital Condition Coding With the Answers to These FAQs
And see what to do when a child is exposed to COVID-19 in utero. It's not always clear wh... Read more
Practice Management:
Address Apathy and Burnout, Apply These Expert Tips
Also: learn how to extend the advice to remote workers. No matter the size of your practi... Read more
You Be The Coder:
Examine Whether Perinatal Coding Can Extend Beyond 28 Days
Question: One of our pediatricians saw a 10-year-old for a routine check-up. During t... Read more
Reader Question:
Clear Confusion Around This Multiple Location Question
Question: Our practice has multiple locations, and they don't all have the same equip... Read more
Reader Question:
Preview This New Physician Predicament
Question: Our practice recently hired a new pediatrician, but as of now that doctor ... Read more
Reader Question:
Make the Right Call in This Test Result Scenario
Question: My provider habitually calls patients to tell them about their lab results.... Read more
News You Can Use:
Find Your Way Through Flu Vax Coding with These Updates
Check out the handy chart to help you keep it all straight. Flu season is officially her... Read more
E/M Coding:
Cut Into Complex Concepts in the MDM Table
Learn the differences between words like “self-limited” and “acute.” While hand... Read more
Strengthen Your Telehealth Coding Game With These 4 Tips
Use the clip-and-save chart to help you select correct codes every time. As you may rec... Read more
You Be the Coder:
See Whether This Screening is Separately Reportable
Question: During the history portion of a patient's evaluation and management (E/M) servic... Read more
Reader Questions:
Look to the Index to Answer This OM Coding Question
Question: My pediatrician documented otitis media with effusion (OME) for one patient, and... Read more
Reader Questions:
Look to Synonyms When Reporting This Cough Situation
Question: Our pediatrician documented that a patient had an “unexplained cough.” ... Read more
News You Can Use:
See How CPT® Has Simplified COVID-19 Vax Coding
Check out which existing admin code survived the cut To streamline reporting, CPT® has c... Read more
Proposed Rule:
Know What to Watch For in the 2024 MPFS
See how the CF cut compares to previous years. Even though the COVID-19 public health ... Read more
Condition Spotlight:
Refresh Your Migraine Coding Game, Learn New ICD-10 Codes
Also find definitions of common terms. According to the Cleveland Clinic, up to 2 percen... Read more
Reader Questions:
Refer to This Medical Necessity Documentation Advice
Question: During a preventive visit, our provider noticed that the 2-year-old patient... Read more
Reader Questions:
See How Social Worker Counts as Clinician in This SDoH Scenario
Question: My provider counseled a 7-year-old patient and their father about adverse c... Read more
Reader Questions:
Lack of Localized Pain? No Problem
Question: My provider diagnosed gastroenteritis but didn't specify which quadrant the... Read more
Reader Questions:
Correctly Coding Hay Fever is Nothing to Sneeze At
Question: I am looking at a medical report that say the physician diagnosed the patie... Read more
You Be the Coder:
Solidify Your Understanding of Sequencing Asthma and its Triggers
Question: One of our patients came in experiencing exacerbation of their asthma due t... Read more
News You Can Use:
Take a Peek at ICD-10 2024’s Newest Z Codes
Plus: catch this updated verbiage in the section on SDoH. As a pediatric coder, you under... Read more
ICD-10 2024:
Reach Into ICD-10 2024 to Find 173 New Foreign Body Codes
Also: review the FBR codes to use with them. Kids love to explore the world around them, ... Read more
Condition Spotlight:
Brush Up On Your Coding as Strep Season Continues
Plus: Gain insight into the benefits of observing unusual trends in your practice Though ... Read more
Reader Questions:
Decipher This Diaper Rash Scenario
Question: We have an infant who came in with diaper rash caused by yeast. Do I code t... Read more
Reader Questions:
Adhere to Documentation to Accurately Assign Asthma with Rhinitis
Question: I'm frequently seeing denials when coding rhinitis or nasophar­yngitis wi... Read more
Reader Questions:
Know When Presenting Problems Don’t Equal Principal Diagnosis
Question: A patient presented with abdominal pain, nausea with vomiting, and diarrhe... Read more
You Be the Coder:
Relieve Your Confusion Over Aspirin Allergy Coding
Question: I've been confused for a while about which ICD-10 code is appropriate for r... Read more
Focus on Communication to Improve Documentation
Here's a helpful acronym to take back to your provider. One of the biggest takeaways fro... Read more
Case Study Corner:
Get Into Gastroenteritis to Code This Case
Follow this case from initial visit to follow-up for clear coding guidance. As pediatric... Read more
Practice Management:
Know the Ins and Outs of Medical Necessity
Also: get expert advice on establishing a risk assessment. As a coder, you understand tha... Read more
Reader Questions:
Get to the Bottom of This Wound Repair Encounter
Question: Our provider saw a 7-year-old who cut their left foot on a broken wood shard whi... Read more
Reader Questions:
See the Subtle Differences That Affect this Colitis Case
Question: Our provider documented a 10-year-old patient as having both diarrhea and coliti... Read more
Reader Questions:
Assess This Category II Assessment Code Conundrum
Question: We are not able to get any payers to cover 3085F when billed with an office visi... Read more
You Be the Coder:
Know When to Lean on Laterality
Question: My provider performed two button removals for undescended testes surgery. The pr... Read more
Case Study Corner:
Consider Complete Picture, Correctly Code This Celiac Case
Also: See whether the encounter levels best with MDM or time. You've probably seen severa... Read more
Procedure Coding:
Tackle Tick-Removal Coding With These 3 Scenarios
Hint: Removal method dictates how to report the procedure. As temperatures continue to r... Read more
Artificial Intelligence:
Lean Into AI Learning With AMA’s AI Classifications
Know the nuances that will affect your code categorization. By now, you probably feel li... Read more
Reader Questions:
Get the Lowdown on Reporting Respiratory Conditions
Question: The pediatrician performs a thorough history and exam for a patient and doc... Read more
Reader Questions:
Understand Symptoms to Assign the Correct Asthma Code
Question: Our pediatrician diagnosed a patient with mild asthma and described the pat... Read more
Reader Questions:
See Why Simultaneous Siblings Signify Separate Encounters
Question: A parent brought in their two children with cold symptoms. The pediatrician... Read more
You Be the Coder:
Scratch Below the Surface of This Cellulitis Encounter
Question: Our provider saw an established 6-year-old patient who had been scratching ... Read more
Injury Coding:
Follow These Tips to Avoid Burn Coding Burnout
Remember to review the ICD-10-CM guideline that clarifies sequencing rules. When it come... Read more
Condition Spotlight:
Know the Depths to Which Documentation Dictates UTI Coding
And see which UTI code is specific to neonates. Coding for urinary tract infections (UTIs... Read more
Practice Management:
Appropriately Manage PHI to Maintain HIPAA Compliance
See how you may be violating privacy laws without realizing it. As technology continues t... Read more
Reader Questions:
Find the Right Code for This Dermatological Dilemma
Question: My provider diagnosed a teenaged patient with acne rosacea, which I've neve... Read more
Reader Questions:
Avoid Misinterpretation with This I&D Insight
Question: Our provider's notes say he “removed a 2.5 x 2 cm sebaceous cyst by incis... Read more
Reader Questions:
Test Your Understanding of the MDM Data Element
Question: If the pediatrician orders a test, does her review of that test during the... Read more
You Be the Coder:
Refresh Your Modifier Memory with This Postoperative Encounter
Question: Our provider saw a teenaged patient for a follow-up visit a week after remo... Read more
Virtual Visits:
Navigate Telehealth and E-Visits Post-PHE
Also, learn how to document each encounter. As the COVID-19 public health emergency (PHE)... Read more
Condition Spotlight:
Gain Insight Into Obesity Intervention Encounters
Understand counseling criteria that justifies each code set. Treating childhood obesity i... Read more
Contest Claim Denials With These 5 Useful Tips
Seek out practice patterns that help you prevent denials. Appealing denials may not be ... Read more
Reader Questions:
Boost Awareness of New COVID Booster Code
Question: There is buzz around the office of a new COVID booster code for children, b... Read more
Reader Questions:
Review This New Patient E/M Rule
Question: I've been coding all nurse visits with 99211, but I'm being told that's not... Read more
You Be the Coder:
Learn About Laterality in This Cerumen Scenario
Question: When reporting H61.21 or H61.22, do I still have to append a laterality mod... Read more
CPT® Coding:
Stay Sharp With This Urinalysis Review
Also, understand which modifiers apply to which situations. Urinalyses are common and re... Read more
Bust These Myths to Become a Sequela Scholar
See which guidelines can help you with proper sequencing. Since kids are prone to illnes... Read more
Discern Documentation Dos and Don’ts, Query Confidently
And learn how to scour a record to avoid duplicate queries. The difference between a cl... Read more
You Be the Coder:
Venture Into Pediatric Venipuncture Territory With This Scenario
Question: How do I code venipuncture for a 3 kg infant under 1 year? I thought I shou... Read more
Reader Questions:
Stay Awake for These 2023 Sleep Apnea Codes
Question: The pediatrician evaluated a 5-day-old patient who was born prematurely. Af... Read more
Reader Questions:
Differentiate Between Suppurative and Nonsuppurative in This OM Case
Question: A patient came in recently with a bad ear infection. Our pediatrician docum... Read more
Reader Questions:
Prepare Your Practice for a Post-PHE Environment
Question: What can our practice do to prepare for the public health emergency (PHE) e... Read more
Case Study Corner:
Code This New Patient Encounter From Start to Finish
Stay on top of opportunities to report SDoH. As a peds coder, you're used to coding new p... Read more
Knowledge Check:
Secure Your Skills With These Newborn FAQs
Learn when to use Chapter 16 codes for newborns older than 28 days. Newborn encounters, ... Read more
Clarify Correct Usage of Modifier 25 (Part 2)
Hint: A new problem doesn't always mean a billable E/M service.  Last month, we us... Read more
Reader Questions:
Digest the ifferences Among These Eating Disorder Codes
Question: I'm seeing three different codes for binging and purging conditions in ICD... Read more
Reader Questions:
Check Payer Policy in This Wastage Situation
Question: One of our physicians treated a patient with a nebulizer, but the patient w... Read more
Reader Questions:
Be on the Lookout for More Info Re: PHE
Question: I read that there's been another PHE extension, but I've also heard this m... Read more
You Be the Coder:
Know When to Report Z23 as Primary
Question: Can I use Z23 as the primary code for a flu vaccination encounter? Codify ... Read more
Condition Spotlight:
Review These Tips for Correct Constipation Coding
Learn when and when not to report constipation. Constipation is a common pediatric condit... Read more
ICD-10 Coding:
Expand Your Understanding of These Common Infant Care Codes
See how an infant's age can affect which code you select. Whether you're new to pediatr... Read more
Clarify Correct Usage of Modifier 25 (Part 1)
Hint: Detailed documentation is key. Few modifiers are as wily as 25 (Significant, separa... Read more
Reader Question:
Know When Patient Age Carries Weight for Reporting BMI
Question: An obese patient with gastrointestinal issues came in to see the pediatrician th... Read more
Reader Question:
Account for Each Vaccine Component With This Add-On Code
Question: We have a 7-week-old patient who presented for a DTaP-IPV/ Hib vaccine. The pedi... Read more
Reader Question:
Up Your Coding Credibility by Decoding This Depression Scenario
Question: A 13-year-old patient reported feeling depressed for the last month. They ... Read more
You Be the Coder:
Report This Common Occurrence With Confidence
Question: A parent brings their infant to see the pediatrician, saying the baby had b... Read more
News You Can Use:
Tune In to These 3 2023 Final Rule Highlights
Find out why CMS changed its mind on split/shared visits. The Center for Medicare & M... Read more
Condition Spotlight:
Can Your Coding Keep Up With RSV Cases?
And recognize when RSV is the culprit behind other problems. Respiratory syncytial virus ... Read more
Practice Management:
Maximize All Services Rendered, Increase Your Bottom Line (Part 3)
See what the total revenue increase could be for all 7 services. Over the last two months... Read more
Reader Question:
Report E/M When I&D Codes Won’t Do
Question: I'm familiar with the incision and drainage (I&D) codes, but I don't th... Read more
Reader Question:
Deflect the Default in This Tonsillitis Encounter
Question: A patient came in with swollen glands and inflamed tonsils, and my pediatri... Read more
You Be the Coder:
Learn When and When not to Use Chapter 16 Codes
Question: We had a 2-week-old newborn contract bacterial pneumonia due to strep B, bu... Read more
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