Wiki Auditing for Pediatrics


Manhattan New York Chapter
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Is there anyone knowledgeable in auditing Pediatrics? Specifically, auditing Well Child visits. What are the criteria that must be met? Is it the same as E/M coding?

Thanks for the help!
well child visits

When I worked for pediatrics we used age specific forms from the american academy of pediatrics. I think if your provider is a member you might be able to download these forms. The AAP website also has a great tool at this link:

I would probably audit based on AAP recommendations.........and you want to make sure the vaccine records are appropriately documented. Hope this helps. Auditing preventive care is difficult b/c there are not clear cut guidelines for what is required in a well visit. It really depends on the pt's age, gender, and what the provider feels is appropriate. Per the CPT guidelines "The comprehensive nature of Preventive Medicine reflects an age/gender appropriate history/exam and is NOT synonymous with the "comprehensive" exam required for E/M codes 99201-99350"