Pediatric Coding Alert

Question: A parent brought in their two children with cold symptoms. The pediatrician diagnosed one sibling with acute sinusitis and the other with acute bronchitis. Do I report this as one encounter or two?

Texas Subscriber

Answer: Report this as two separate encounters. Each patient receives individual evaluation, treatment, and care based on their specific needs. In this case, each child’s evaluation resulted in different diagnoses. Even though both children were in the same room during the same time, you will need to report each child’s evaluation and management (E/M) service separately in order to accurately reflect the provider’s care and ensure proper reimbursement.