Pediatric Coding Alert

Question: We are a very busy pediatric office with four staff pediatricians, three of whom do not speak Spanish. We use our front office staff, who are not professional licensed translators, to translate when necessary. When a pediatrician uses one of them to interpret during a visit, can we code a higher level of care? Virginia Subscriber


Answer: Yes, you can. Because there is no specific code for interpretive services, no rules exist regarding who counts as an interpreter. The pediatrician may instead select a higher-level service based on: 1. the history and medical decision-making's added complexity. Additional history questions relating to cultural and family issues, as well as more complex medical decision-making related to the same cultural, family and language issues, could justify using a higher-level office visit code. 2. time. You could use time to support a higher-level service if counseling and/or coordination of care dominates (more than 50 percent of the time) the face-to-face encounter.