Test Your Pediatric Coding Capabilities
How closely did you pay attention to the topics covered this year? Regardless of your coding skill level, it can be difficult to stay on top of the many articles and tips Revenue Cycle Insider produces each year. To refresh your memory, let’s revisit the key areas covered throughout pediatric coding in 2025. Test your knowledge, refresh your memory and sharpen your expertise before heading into 2026. Check Your Coding Skills Question 1: ___________ is typically caused by coxsackievirus A, a contagious virus that causes a very distinctive rash on the palms of the hands and soles of the feet. This can also appear in the diaper area, on the legs and arms, and around the mouth. To correctly code for this condition, you will report B08.4 (Enteroviral vesicular stomatitis with exanthem) caused by the coxsackievirus. What is the name of this disease? Question 2: When a patient presents bleeding from both nostrils and receives treatment, are nosebleed treatment codes per nostril, or for the whole nose? Question 3: If a patient is tested for a sexually transmitted infection (STI) but has no signs or symptoms, should the visit be coded as a screening? Question 4: True or False? Asthma has four different states of severity — intermittent, mild persistent, moderate persistent, and severe persistent — that correspond with the first four code subgroups in the J45.- group and the typical other and unspecified category. Question 5: Heat rash, also referred to as prickly heat, appears as small red bumps or tiny blisters filled with fluid and is intensely itchy. This condition is typically observed during times of intense heat and humidity. The most commonly affected areas are the upper chest and back, the neck fold around the hairline, or under the diaper, but can be found anywhere on the body. Limiting exposure to extended periods of heat or high-humidity environments can help lower the risk of developing a heat rash. What is the correct ICD-10-CM code for heat rash? Question 6: When a patient presents to your office with symptoms of lightheadedness, nausea, fatigue, and an elevated body temperature, these are all signs of heat stroke or heat exhaustion. You will not code the signs and symptoms separately because according to ICD-10-CM Official Guidelines, Section I.B.5, “Signs and symptoms that are associated routinely with a disease process should not be assigned as additional codes, unless otherwise instructed by the classification.” Because these are the signs related to heat stroke or heat exhaustion, you will simply look to codes T67.5- (Heat exhaustion, unspecified). What else will you need to code for payment? Question 7: When coding for conjunctivitis or “pink eye,” there are three sources it can be caused from: viral conjunctivitis, bacterial conjunctivitis, and _________ __________. Now Check Your Answers Answer 1: Hand, foot, and mouth disease is the name of the condition. Answer 2: Nosebleed treatment codes are unilateral. Codes 30901 (Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method) and 30903 (Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method) represent treatment on one nostril. You’ll see in the notes for both of these codes the directive “(To report bilateral procedure, use 30901 with modifier 50).” Answer 3: The answer is yes. If the patient is showing no signs or symptoms at the visit, you should consider the test a screening and assign Z11.3 (Encounter for screening for infections with a predominantly sexual mode of transmission) unless the provider was screening for human immunodeficiency virus (HIV) or human papillomavirus (HPV), which have their own separate encounter codes: Z11.4 (Encounter for screening for human immunodeficiency virus [HIV]) and Z11.51 (Encounter for screening for human papillomavirus (HPV)). Answer 4: This answer is true. The codes 4-character codes for different asthma levels are J45.2- (Mild intermittent asthma), J45.3- (Mild persistent asthma), J45.4- (Moderate persistent asthma), J45.5- (Severe persistent asthma), J45.9- (Other and unspecified asthma). Most of the codes in this group require that 5th character to communicate the patient’s state at the time of the encounter. Answer 5: The diagnosis code for heat rash is L74.0 (Miliaria rubra). Answer 6: You will need to code to the appropriate 7th character from the following: Answer 7: Allergic conjunctivitis is the possible third source of pink eye. In the ICD-10-CM book you will find these codes in the following sections: Refer to the B30.- Codes for Viral Conjunctivitis Use the H10.- Codes for Bacterial or Allergic Conjunctivitis Lindsey Bush, BA, MA, CPC, Production Editor, AAPC
