Wiki What constitutes a Well Child Check with Abnormal Findings?

julieordway

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Hello!
I'm new to Pediatric coding and was wondering if anyone could provide a few scenarios of what constitutes a routine child health examination "with abnormal findings".
At a 15 month WCC, the provider finds a heart murmur documented as follows:
Grade 2/6 systolic ejection murmur heard along the left sternal border.
Provider refers to Children's Cardiology Hospital.
Would this qualify as abnormal finding?
Thanks!
 
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