bluuebunny/crossref_metadata_2025 huggingface dataset:
Transitioning to ICD-10-CM (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Helping pediatricians make the transition to ICD-10-CM more painless by crosswalking Asthma and other Respiratory System codes
A Primer on the National Drug Code
Authors:   American Academy of Pediatrics
Published: April 2022

Product identifiers for drugs approved for human use to be reported in Box 24 of the CMMS 1500 form
Partial Code Freeze for ICD-9-CM and ICD-10-CM Finalized
Authors:   American Academy of Pediatrics
Published: April 2022

Partial freeze for updates to ICD-9-CM and ICD-10-CM for the October 1, 2013 implementation of ICD-10-CM
The Office of Inspector General 2011 Work Plan
Authors:   American Academy of Pediatrics
Published: April 2022

Areas of service being targeted for auditing and review: POS Errors, E/M Services During Medicare Global Periods, Payments for Diagnostic Radiology, E/M Services Coding and Payments, and Excessive Payments for Diagnostic Tests.
Point to Ponder: The Challenges of Getting Paid for Obesity-Related Services
Authors:   American Academy of Pediatrics
Published: April 2022

Most often reported E/M codes for obesity-related services and tips on their use.
You Code It! One Patient, 2 Visits
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting E/M services in concurrent care scenarios
CPT 2011 Errata
Authors:   American Academy of Pediatrics
Published: April 2022

Errata regarding prolonged physician service in the inpatient setting and updating influenza vaccine administration
Guide to Performing Chart Audits
Authors:   American Academy of Pediatrics
Published: April 2022

Routine audits to check that your practice is compliant and adhering to standards and guidelines, reporting appropriately, and verifying that documentation supports the coding
Medicare Covers Tobacco Cessation Counseling
Authors:   American Academy of Pediatrics
Published: April 2022

CMS covering tobacco cessation counseling as of August 25, 2010 for CPT codes 99406 and 99407 and HCPCS codes G0436 and G0437
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Coding services provided by a lactation consultant using 99215 for direct or 99213 for incident to the physician services
Denials to Dollars
Authors:   American Academy of Pediatrics
Published: April 2022

Denials resulting from incorrect coding edits as some payers adopt NCCI edits and others determine their own edits
Q&A (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Preparing an office for ICD-10-CM, parasacral dimple, Bicillin L-A, nasal swab, allowing one vaccine while refusing another, and teaching points for vaccine administration coding
Erratum: “National Correct Coding Initiative Update”
Authors:   American Academy of Pediatrics
Published: April 2022

Updated new vaccine coding edits
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

ED visit after a fall with admission for observation and urgent care center visit for a rash
Hospital Evaluation and Management Services Provided by Teaching Physicians (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

CMMS guidelines for reporting services provided by supervising and teaching physicians
Update: CPT Defines “Qualified Health Care Professional”
Authors:   American Academy of Pediatrics
Published: April 2022

Codes to report for services provided by physicians or clinical nurse practitioners as opposed to provided by physician assistants, registered nurse practitioners, and other professionals
New and Revised ICD-9-CM Codes for 2012
Authors:   American Academy of Pediatrics
Published: April 2022

New codes effective October 1, 2011, including expansion of codes for novel influenza A, Eschericia coli and thalassemia; more specific codes for pancytopenia; and new codes for pneumothorzs, nonspecific reactions to tuberculin skin tests, anaphylactic and serum reactions to vaccinations, and new personal history codes
The Ins and Outs of Reporting the Removal of a Foreign Body
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting for foreign body removel, consulting, incisions, forceps, E/M codes, and other procedures
What Can You Learn From This List?
Authors:   American Academy of Pediatrics
Published: April 2022

Top 25 diagnoses reported by pediatricians and the associated ICD-9-CM codes, and diagnosis coding basics
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

More than one diagnosis code at the same patient encounter, treatment at Boy Scouts camp, and autism counseling for wandering
The Dilemma: Split/Shared Neonatal and Pediatric Critical Care Services
Authors:   American Academy of Pediatrics
Published: April 2022

Interpretation of the physician directing inpatient care for codes 99468-99476 and 99478-99480
More Common Procedure Coding Faux Pas (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Common errors in coding for wound repair, abscess draining, and adhesion lysis
Transitioning to 10
Authors:   American Academy of Pediatrics
Published: April 2022

Introduction of timely column for 2012 dedicated to preparing readers for the transition to ICD-10-CM
Denials to Dollars: Billing Non-covered Services (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Payment for 99000 handling or conveyance of specimen for transfer when there is no payment for the service
Q&A (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Hearing screening services and Adacel for patients affected by flood conditions
You Code It! (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting for attending the delivery of a term neonate born in respiratory distress
Care of the Neonate: Your Questions Answered, Part 2
Authors:   American Academy of Pediatrics
Published: April 2022

E/M guidelines for normal newborn care, sick newborns, and newborns requiring intensive or critical care
Denials to Dollars: Immunization Administration Documentation Issues
Authors:   American Academy of Pediatrics
Published: April 2022

Letter for guidance on appropriate documentation for immunization administration codes 90460 and 90461
Transitioning to 10: Coding for the Neonate
Authors:   American Academy of Pediatrics
Published: April 2022

Coding guidelines for crosswalking V30-V39 used as principal diagnosis assigned once to a newborn at the time of birth to category Z38
Did You Know? Medicare Change in Global Surgery Period for Simple Laceration Repair (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

How Medicare applies the global period designation to determine payment for 12001-12018 simple repair of superficial wound
Update: Medicare Primary Care Exception Rule Changes
Authors:   American Academy of Pediatrics
Published: April 2022

Clarification on requirements for teaching physicians submitting claims under PCER and Modifier GE
Transitioning to 10: The Basics
Authors:   American Academy of Pediatrics
Published: April 2022

Understanding ICD-10-CM codes to effectively work with software vendors, crosswalk ICD-9-CM codes, educate physicans and staff, and be prepared for the transition
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Intubation of a floppy neonate with transport
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Ibuprofen administration, partial removal of blanket fuzz, and reporting time spent that is between 2 typical times
Denials to Dollars: Coverage for Administration of an Injection and E/M Service on the Same Day
Authors:   American Academy of Pediatrics
Published: April 2022

Payment for code 96372 billed on the same day as E/M service
wRVUs increasing for well-child visits, inpatient well newborn services
Authors:   American Academy of Pediatrics
Published: April 2022

Positive change to pediatric practice bottom lines due to increases to work relative value units for well-child and well newborn visit preventive medicine service codes 99321-99384, 99391-99394, and 99460-99463
Good News: No Modifier Necessary When Reporting Neonatal Car Seat/Bed Testing and Evaluation and Management Services (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Codes 94780 and 94781 for car seat/bed testing for airway integrity
Denials to Dollars: Getting Paid for CPT Code 51701
Authors:   American Academy of Pediatrics
Published: April 2022

Response to denial for catheterization and urinalysis, checking modifier, global period, and appropriate bundling
A Refresher Course: Reporting Pelvic and Breast Examinations
Authors:   American Academy of Pediatrics
Published: April 2022

Correct reporting of breast and pelvic exams with and without Pap test, whether part of preventative or problem-oriented visit
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Transfer from community hospital to children’s hospital, obtaining blood from a catheter, congenital anomalies, and Marfan syndrome diagnosis
Transitioning to 10: ICD-10-CM Official Conventions (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Conventions, coding guidelines, abbreviations, punctuation, notes, definitions, and default codes
Point to Ponder: Reporting Correct Diagnoses for Obesity (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting BMI with obesity and other weight-related diagnoses
Denials to Dollars: More Coverage for Smoking Cessation Counseling
Authors:   American Academy of Pediatrics
Published: April 2022

Guidelines for HCPCS codes G0436 and G0437 and CPT codes 99406 and 99407 to bill for smoking cessation counseling
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Influenza antigen testing, toilet training problems, suture removal, and screenings performed during a preventive medicine visit
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Coding ED services for a fall and lost consciousness, including a neurology consultation
Taking the Mystery Out of the Application of Modifiers 52 and 53
Authors:   American Academy of Pediatrics
Published: April 2022

When to apply Modifier 52 (reduced service) and when to apply Modifier 53 (discontinued or terminated procedure)
Getting Paid for Lactation Counseling
Authors:   American Academy of Pediatrics
Published: April 2022

Questions and scenarios to determine how to report lactation counseling services
Transitioning to 10: Sprains and Strains
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting injuries in ICD-10-CM based on body regions
Good News for Physicians Caring for Children Covered by Medicaid
Authors:   American Academy of Pediatrics
Published: April 2022

Increased payment rates for specialists, subspecialists, and physicians with a claims history of 60% or more primary care services
Diagnosis Coding: Back to Basics With ICD-10-CM
Authors:   American Academy of Pediatrics
Published: April 2022

New rules for coding diagnoses, signs, symptoms, Z codes, and other factors
CPT 2013 Changes
Authors:   American Academy of Pediatrics
Published: April 2022

A heads-up on many of the major changes to CPT 2013, effective January 1, 2013
CPT 2013 Changes: Pediatric Vaccines and Administration
Authors:   American Academy of Pediatrics
Published: April 2022

Code changes and clarification for vaccine/toxoid administration
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

ICD codes for PFAPA, lip-licker dermatitis, and an abscess of the earlobe
Transitioning to 10: Screening for Alcohol and Substance Abuse (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

ICD-10-CM code distinction between Z13.89 for substance use and abuse counseling, and dependence on substances such as F10.920
Transitioning to 10: Bites, Bruises, and Other Superficial Injuries
Authors:   American Academy of Pediatrics
Published: April 2022

Changes to classification based on the body part and then the type of injury and helpful instructions
Coding for Cerumen Removal
Authors:   American Academy of Pediatrics
Published: April 2022

Scenarios to help determine correct codes for different methods of removing impacted or loose cerumen
Transitioning to 10: Well-Child Office Visits
Authors:   American Academy of Pediatrics
Published: April 2022

Description of the Z codes representing reasons for encounters or services set to replace V codes for services such as health examination
Coding of Integumentary Procedures: Simple or Complicated
Authors:   American Academy of Pediatrics
Published: April 2022

Current and accurate codes to make the most of performing minor intergumentary procedures in the office, such as acne surgery, abscess or cyst drainage, foreign body removal, laceration repair, wound repair, and lesion or wart destruction
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Well-child care provided by nurse practitioners and delivery of counseling through a video or recording
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Coding for E/M service, preservice work or repair, and repairs for lacerations and abrasions from a fall
Is This History? Coding Congenital Heart Disease
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting congenital anomalies at the time of diagnosis and until corrected, and as personal history when a patient has undergone correction in continued monitoring is required
Transitioning to 10: Congenital Malformations of the Circulatory System
Authors:   American Academy of Pediatrics
Published: April 2022

Mapping diagnosis codes for congenital malformations and for personal history of corrected malformations
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Diagnosis of implusive anger and 99460 for both a neonatologist and a pcp present at a birth,
Medical Decision-Making in Transitional Care Management
Authors:   American Academy of Pediatrics
Published: April 2022

Recognizing continuity of care in team approaches and the patient-centered medical home with TCM codes 99495 and 99496
Transitioning to 10: Finding Codes
Authors:   American Academy of Pediatrics
Published: April 2022

Reasons why and situations where the 0-9 and A-Z pattern may not be followed
Documentation Templates: Use With Caution
Authors:   American Academy of Pediatrics
Published: April 2022

Tips for effective templates so notes are individualized, appropriate space is left, review is clearly evident, and information is correctly captured
Transitioning to 10: You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Coding requirement changes relative to a preventive service visit, abnormal finding, and procedure codes
Getting Paid: Separately Reportable Preventive Services
Authors:   American Academy of Pediatrics
Published: April 2022

Contracting with payers based on bundling policies, pay rates, and other factors
Coding Quick Reference for Bright Futures Services (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

CPT and ICD codes for comprehensive preventive medicine E/M, problem E/M, laboratory testing, and ancillary services
Top 25 Pediatric Diagnoses Revisited
Authors:   American Academy of Pediatrics
Published: April 2022

Updated top 25 pediatric diagnoses based on 2008-2010 National Ambulatory Medical Care Survey, increased occurrence of asthma, contact dermatitis, influenza, acute otitis media, and influenza vaccination
Sporting the Correct Codes
Authors:   American Academy of Pediatrics
Published: April 2022

Coding for sports-related services, including heat exhaustion, concussion testing, cumulative trauma elbow pain, finger sprain, and a sports physical
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Procedure codes for influenza vaccine products
CPT 2014 Changes
Authors:   American Academy of Pediatrics
Published: April 2022

New E/M codes for interprofessional consultations and hypothermia treatment of a critically ill neonate, additional instruction for reporting of existing E/M services, clarifications for critical care transport and trnsitional care managment, and revisions for complex chronic care coordination
CPT 2014 Changes: Surgical and Medicine
Authors:   American Academy of Pediatrics
Published: April 2022

Changes for removal of impacted cerumen; quadrivalent influenza vaccine; evaluation of speech, language, and hearing; transcatheter closure; anogenital examination; visual evoked potential; and pupillometry
Clarification of External Cause Reporting With ICD-10-CM (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting codes for external cause of morbidity not nationally required, may be mandated by states or private payers
Denials to Dollars: AAP Advocacy Helps Reverse Edit Change
Authors:   American Academy of Pediatrics
Published: April 2022

Allowing use of an NCCI-associated modifier when physicians report newborn care on the same day as inpatient neonatal critical care
Is Your CMS-1500 Claim Form Version 02/12?
Authors:   American Academy of Pediatrics
Published: April 2022

Expansion of fields for diagnosis codes and other changes for the NUCC-developed claim form, effective April 1, 2014
Q&A (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Ultrasound guidance for vascular access and insertion of ear wicks
1500 Claim Form Example (ICD-10-CM) (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Example of the 1500 Health Insurance Claim Form
Subspecialty Corner: Surgery—The Package Deal
Authors:   American Academy of Pediatrics
Published: April 2022

Services that are included in the global surgical package or separately billable
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Hyperlipidemia screening performed at an outside laboratory, replacement of a gastronomy tube in the office, and repair of a congenital concealed penis
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Evacuating a subungual hematoma in the office.
Telehealth: Face-to-face Services From a Distance
Authors:   American Academy of Pediatrics
Published: April 2022

Telemedicine services considered through the face-to-face lens has unique concerns for coverage and definitions, all of which ultimately affect coding considerations.
What’s Your Policy? Same-Day Preventive and Other Medical Services
Authors:   American Academy of Pediatrics
Published: April 2022

Staff and patient/caregiver education and careful documentation for situations where preventive care visits lead to services that may incur cost-sharing expenses
Transitioning to 10: Documenting Dermatitis
Authors:   American Academy of Pediatrics
Published: April 2022

L20-L30 codes for dermatitis and eczema, from allergic, irritant, or unspecified contact; and H and L codes for non-contact elements of dermatitis
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Herpes simplex infection of the lip and antiviral medication
Documentation of Deep Sedation Services (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Documentation and coding guidelines associated with deep sedation services, including pre-, intra-, and post-service tasks
Coding for Behavioral Issues in Adolescence
Authors:   American Academy of Pediatrics
Published: April 2022

Scenarios to illustrate how primary care or ED physicians consulted on behavioral issues and how documented time of service is often the key for code selection
Encounters to Complete Administrative Forms
Authors:   American Academy of Pediatrics
Published: April 2022

Encounters and services related to completing forms for return to sports after an injury or illness is no longer an issue
New AAP Policy Statement: “Application of the Resource-Based Relative Value Scale System to Pediatrics”
Authors:   American Academy of Pediatrics
Published: April 2022

The newly published AAP policy dealing with RBRVS is reviewed and explained.
Transitioning to 10: Newborn and Infant Visits
Authors:   American Academy of Pediatrics
Published: April 2022

Common newborn and infant ICD-10 codes are covered, including birth weight and gestational age codes, and maternal health codes.
Your AAP at Work! Comments to CMS on Proposed Rule for 2015
Authors:   American Academy of Pediatrics
Published: April 2022

Review the AAPs comments to the proposed CMS rule change for 2015.
Transitioning to 10: Allergies
Authors:   American Academy of Pediatrics
Published: April 2022

Our ICD-10 subspecialty review continues. From allergic rhinitis to food allergies.
Changes to the National Correct Coding Initiative Manual for 2015
Authors:   American Academy of Pediatrics
Published: April 2022

Stay up-to-date with the latest changes to the Medicaid NCCI manual.
Chronic Care Management: Questions and Answers
Authors:   American Academy of Pediatrics
Published: April 2022

The complex ins and outs of chronic care management are explored and explained.
Transitioning to 10: Epilepsy
Authors:   American Academy of Pediatrics
Published: April 2022

Our in depth examination of ICD-10-CM continues with epilepsy as the focus.
Place of Service: Not Always Office
Authors:   American Academy of Pediatrics
Published: April 2022

Why the place of service codes shouldn't be taken for granted.
Newborn Resuscitation and the T-piece
Authors:   American Academy of Pediatrics
Published: April 2022

Delivery room attendeance and newborn resuscitation.
Reviewing the Review of Systems
Authors:   American Academy of Pediatrics
Published: April 2022

A long-time source of confusion and frustration, ROS and its guidelines are thoroughly examined.
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Coding for developmental screening when no significant concerns are found.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Intubation; Postoperative Care
Revenue Cycle Management in the Transition to ICD-10-CM
Authors:   American Academy of Pediatrics
Published: April 2022

Policies and procedures for unpaid claims will help in the transition and beyond.
A Refresher: The Conventions of ICD-10-CM
Authors:   American Academy of Pediatrics
Published: April 2022

The new conventions for ICD-10 plainly outlined.
CPT® 2016 Changes for Pediatrics
Authors:   American Academy of Pediatrics
Published: April 2022

Our yearly review of new changes coming to CPT on January 1, 2016.
CPT® 2016 Changes: Prolonged Clinical Staff Services
Authors:   American Academy of Pediatrics
Published: April 2022

An in depth view on prolonged services with direct supervision.
Subspecialty Corner: Transcatheter Pulmonary Valve Implantation (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

A highlight on the new Category I code for TPVI.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Mullerian developmental anomolies; Chief complaints in follow-up visits; Newborn discharge; Postural orthostatic tachycardia syndrome.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Fishhook removal, procedure and diagnosis.
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

A discharged NICU patient on home oxygen returns for an office visit.
Procedure Coding Guidance: 2016 Medicaid National Correct Coding Initiative Manual Updates
Authors:   American Academy of Pediatrics
Published: April 2022

Often, physicians and coders have questions on the services bundled by National Correct Coding Initiative edits and when it is appropriate to append a modifer that may override an NCCI edit…
Learn More About Value-Based Payment
Authors:   American Academy of Pediatrics
Published: April 2022

In January 2015, the US Department of Health and Human Services administration set goals for value-based payments within the Medicare fee-for-service system and invited private sector payers to match or exceed them…
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Abnormal findings; Preoperative exam; RSV immunotherapy; Suspicious murmur …
Codes to Capture Vaccine Refusal
Authors:   American Academy of Pediatrics
Published: April 2022

A common concern for pediatricians is when parents or caregivers present a refusal to immunize their child. International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes can be used to report the reasons behind the underimmunization of children.
Denials to Dollars: Resubmissions and Appeals
Authors:   American Academy of Pediatrics
Published: April 2022

Everyday physician practices receive a mixture of payments and denials of charges from various payers. Prompt and effective attention to denied charges is important to avoid lost revenue.
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

A 22-month-old is seen as an established patient in the office for diarrhea and vomiting.
Current Procedural Terminology Updates, 2017
Authors:   American Academy of Pediatrics
Published: April 2022

This issue of AAP Pediatric Coding Newsletter™ includes an overview of the new and revised Current Procedural Terminology (CPT®) codes and instructions that most affect reporting of pediatric services in 2017. All CPT changes will be implemented on January 1, 2017.
ICD-10-CM Update
Authors:   American Academy of Pediatrics
Published: April 2022

In the July 2016 AAP Pediatric Coding Newsletter™, the changes to International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), were previewed. With the new codes now implemented on October 1, 2016, this article includes a few more updates.
COCN Member Commended
Authors:   American Academy of Pediatrics
Published: April 2022

Commendation from the Georgia Department of Community Health Medicaid Division for COCN member Jeffrey Linzer, Sr, MD, FAAP, FACEP.
ICD-10-CM: Reporting Suspected Conditions Ruled Out in Newborns
Authors:   American Academy of Pediatrics
Published: April 2022

The ICD-10-CM Official Guidelines for Coding and Reporting FY 2017 bring additional guidance on the use of codes in category Z05, encounter for observation and evaluation of a newborn for suspected diseases and conditions ruled out.
Encounters for General Medical Examinations With Abnormal Findings
Authors:   American Academy of Pediatrics
Published: April 2022

Since the implementation of International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), many questions have been posed about reporting of preventive evaluation and management (E/M) services that include abnormal findings. This article clarifies what an abnormal finding is with regard to reporting guidelines.
Coding Challenge Answers (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Answers to the questions posed in the Coding Challenge article.
Q&A (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Birth Injury; Newborn Affected by Group B Streptococcal Infection
ICD-10-CM: Common Illnesses of Winter and Spring
Authors:   American Academy of Pediatrics
Published: April 2022

This article is a quick reference on common pediatric illnesses during the winter and spring months and reporting guidelines from International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM).
Suspected Conditions in Infants and Children Other Than Neonates
Authors:   American Academy of Pediatrics
Published: April 2022

Accurate International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) code selection depends on the suspected condition and outcome of the examination. When reporting professional services, the key to reporting correctly is to code what is known at the end of that encounter.
What Does Your EHR Documentation Say?
Authors:   American Academy of Pediatrics
Published: April 2022

Electronic health records (EHRs) have great potential for capturing important health information and making that information readily available to providers of care. However, controversy abounds regarding the current features and uses of EHRs. This article discusses how to implement a compliance program to deter inappopriate use of EHR systems.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

CPT: 2 E/M Services on Same Date; CPT: Irrigation Removal of Foreign Body
More About Reporting Services That Include Non–face-to-face Time
Authors:   American Academy of Pediatrics
Published: April 2022

For more information on specific time-based services, refer to this list of articles in other issues of AAP Pediatric Coding Newsletter™.
You Code It! Chronic Care Management Services Answers (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Answers to the coding questions posed in the article "You Code It! Chronic Care Management Services".
ICD-10-CM: Biting Questions
Authors:   American Academy of Pediatrics
Published: April 2022

This article answers some common questions about bug bites and how to code them.
Subspecialty Corner: Negative Pressure Wound Therapy
Authors:   American Academy of Pediatrics
Published: April 2022

A brief discussion about negative pressure wound therapy and the applicable CPT codes.
ICD-10-CM: Sequela or Current Condition? (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

This article will assist physicians and coders experiencing confusion about reporting sequelae.
Sneak Preview: ICD-10-CM Changes Effective October 1, 2017
Authors:   American Academy of Pediatrics
Published: April 2022

This article previews the changes to International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) for the fiscal year 2018.
Verify Your Coding Compliance
Authors:   American Academy of Pediatrics
Published: April 2022

Establishing a compliance program is recommended to avoid issues of fraud and abuse. This article discusses elements of a compliance program for individual and small group practices.
Is It Fraud to Under-code Evaluation and Management Services?
Authors:   American Academy of Pediatrics
Published: April 2022

Is under-coding of evaluation and management services considered fraud, or is it just a mistake that can cost your practice money? This article offers tips for gaining coding confidence.
You Code It! Late Summer Fun With Coding
Authors:   American Academy of Pediatrics
Published: April 2022

Fill in the missing ICD-10-CM or CPT codes in this scenario.
New Codes for Psychiatric Collaborative Care Management
Authors:   American Academy of Pediatrics
Published: April 2022

Defining psychiatric collaborative care management.
You Code It Answers! Holiday Mishaps (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Answers to the coding scenario in the “You Code It! Holiday Mishaps” article are provided.
A Review of the Marshfield Clinic Medical Decision-making Tool
Authors:   American Academy of Pediatrics
Published: April 2022

This article offers tips on using the Marshfield Clinic Tool for determining the level of MDM.
You Code It! Injury With Nasal Hemorrhage
Authors:   American Academy of Pediatrics
Published: April 2022

An example scenario where a pediatrician is caring for a child with a nosebleed due to a fall.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

CPT®: Critical Care and Procedures; ICD-10-CM: Strain of Groin
Consultations: Aligning With Payer Guidelines (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

This article reviews Current Procedural Terminology (CPT®) instructions for consultation servies, and provides an overview of options for reporting to payers who no longer accept consultation codes or otherwise differ from CPT reporting instructions.
You Code It! Established Patient Evaluation and Management Visit
Authors:   American Academy of Pediatrics
Published: April 2022

An example scenario where a pediatrician is treating an established patient.
You Code It! Answers: Established Patient Evaluation and Management Visit (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Answers to the coding question posed in the You Code It! Established Patient Evaluation and Management Visit article.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

CPT®: Neonatal Critical Care and Oxygen Threshold; CPT: Maternal Depression Screening in Twins; CPT: Depression Screening
You Code It! Removal of Sutures (Answer) (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Answers to the coding question posed in the You Code It! Removal of Sutures article.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

HCPCS: Developmental Screening
You Code It! Continuous Glucose Monitoring (Answers) (Online Exclusives)
Authors:   American Academy of Pediatrics
Published: April 2022

Answers to the coding question posed in the You Code It! Continuous Glucose Monitoring article.
Evaluation and Management Coding in the Emergency Department
Authors:   American Academy of Pediatrics
Published: April 2022

Codes for reporting evaluation and management (E/M) services in the emergency department (ED) are similar to those for reporting other E/M services with a few exceptions. These exceptions and payer policies often result in questions about coding of ED services.
You Code It! Testing for Exercise-Induced Asthma
Authors:   American Academy of Pediatrics
Published: April 2022

Can you assign the appropriate diagnosis and procedure codes to the following scenarios in which the same patient receives care on 4 dates of service?
You Code It! Two Problems, One E/M Service (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Can you determine the level of established patient office or other outpatient evaluation and management service of the following clinical scenario in which a patient presents with 2 separate reasons for the visit?
New Chronic Care Management Code
Authors:   American Academy of Pediatrics
Published: April 2022

Effective January 1, 2019, there is a new code to capture chronic care management (CCM) services based only on the time spent by a physician or other qualified health care professional (QHP) who personally performs care management activities for at least 30 minutes in a calendar month.
CPT® 2019: Revision to Instructions
Authors:   American Academy of Pediatrics
Published: April 2022

In this article, Current Procedural Terminology (CPT®) 2019 changes to prefatory text and other instructions (without changes to code or code descriptors) are highlighted.
Subspecialty Coding News: 2019 Neurobehavioral Status Examination Codes
Authors:   American Academy of Pediatrics
Published: April 2022

The physician or qualified health care professional’s time of face-to-face testing and time interpreting test results and preparing a report are included in the time reported for neurobehavioral status examination, as detailed in this article.
Peripherally Inserted Central Venous Catheters and Midline Catheter Placement Coding in 2019
Authors:   American Academy of Pediatrics
Published: April 2022

Here are some quick tips on reporting PICCs and services not reported as PICC insertion.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

This month's Q & A scenario details the use of code 51701 for insertion of non-indwelling bladder catheter.
ICD-10-CM Update: Neonatal Conditions and Observation for Injury
Authors:   American Academy of Pediatrics
Published: April 2022

The following recent guidance from the most recent AHA Coding Clinic may be of particular value to pediatricians.
You Code It! Answers: Screening for Developmental Disorders at a Well-Child Visit
Authors:   American Academy of Pediatrics
Published: April 2022

Here are your You Code It! answers.
November 2018 Edition Errata
Authors:   American Academy of Pediatrics
Published: April 2022

An erratum for the November 2018 edition has been posted here.
Finding the Correct Codes in 2019
Authors:   American Academy of Pediatrics
Published: April 2022

It’s a new year with new codes and, likely, new payment policies from private and government payers. Is your practice up-to-date?
A New Year in Coding Crossword
Authors:   American Academy of Pediatrics
Published: April 2022

Ring in the New Year with this coding crossword!
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

This month’s Q&A pertains to coordination of care in evaluation and management.
Conducting a Coding Compliance Audit
Authors:   American Academy of Pediatrics
Published: April 2022

A key factor in compliance auditing is selection of charts for review. This article tells you how.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

This month’s Q&A addresses clinical staff evaluation and management services, as well as neonatal critical care.
Why Include a Certified Professional Coder in Your Practice?
Authors:   American Academy of Pediatrics
Published: April 2022

Many practices do not include a certified professional coder on their staff. However, there are benefits to allowing certified coders to monitor changes to codes and payer policies, provide answers to coding questions and assist a practice in capturing appropriate revenue for services rendered.
AAP Pediatric Coding Newsletter™ March 2019 Quiz (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Quiz for AAPC Continuing Education Units
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

How are units of medication reported using the Healthcare Common Procedure Coding System (HCPCS)?
Coding Challenge: Immunization Administration Coding Answer Key
Authors:   American Academy of Pediatrics
Published: April 2022

The answers to this month’s You Code It! scenario are presented here.
You Code It! Well-Baby Examination With Maternal Depression Screening
Authors:   American Academy of Pediatrics
Published: April 2022

Can you correctly assign diagnosis and procedure codes to this scenario?
You Code It! Request for Immunization
Authors:   American Academy of Pediatrics
Published: April 2022

A 15-year-old male presents as a new patient requesting immunization against human papillomavirus (HPV). What are the appropriate codes for this visit?
Get-to-Know-You Visits: Coding Begins With Scheduling
Authors:   American Academy of Pediatrics
Published: April 2022

Parents and other caregivers often contact a pediatric practice for a visit to meet a prospective pediatrician for their children or to "establish care." Proactive planning and formal policies and procedures can help practices avoid coding issues with these visits.
The Role of the AAP in the Official ICD-10-CM Process
Authors:   American Academy of Pediatrics
Published: April 2022

As coders prepare for another round of International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) updates on October 1, it is important to understand what goes into the revisions and how the American Academy of Pediatrics (AAP) is involved. The AAP has played an active role in proposing codes, being part of discussions with other groups, and offering expert comments when issues affect pediatrics.
Subspecialty Coding: CPT® 2020—Long-term Electroencephalogram Codes
Authors:   American Academy of Pediatrics
Published: April 2022

New codes have been added for long-term continuous recording electroencephalograms (EEGs), along with new definitions and reporting instructions
Coding Hotline
Authors:   American Academy of Pediatrics
Published: April 2022

This month's coding question relates to an acute on chronic medial meniscus injury.
CPT 2020: Hernia Repair and Orchiopexy
Authors:   American Academy of Pediatrics
Published: April 2022

The 2020 updates to Current Procedural Terminology (CPT ®) bring good news to pediatric surgeons and urologists who perform orchiopexy. The code descriptor for code 54640 has been revised in 2 important ways.
Office E/M 2021: An Overview of Medical Decision-making
Authors:   American Academy of Pediatrics
Published: April 2022

This article provides an overview of the upcoming planned changes related to selection of the level of medical decision-making for services.
Coding for Ingestion Challenge
Authors:   American Academy of Pediatrics
Published: April 2022

Ingestion challenge is used to confirm or rule out an allergy or to determine if a patient has outgrown an allergy. This article provides information on relevant codes.
You Code It! Answers: Travel Counseling
Authors:   American Academy of Pediatrics
Published: April 2022

Did you assign the appropriate codes to each scenario? Find out here.
History Mix and Match (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Can you match the letter for each term with its description in the “History Term Descriptions” Table?
New Diagnosis Code for Vaping-Related Disorder Also Brings New Chapter to ICD-10-CM
Authors:   American Academy of Pediatrics
Published: April 2022

The US Centers for Disease Control and Prevention has added a midyear change to ICD-10-CM. A new chapter is in place for the provisional assignment of codes for new diseases of uncertain etiology and a code for vaping-related lung injury.
Coding Hotline
Authors:   American Academy of Pediatrics
Published: April 2022

This installment of the Coding Hotline takes a look at coding for prolonged service.
Coding Hotline
Authors:   American Academy of Pediatrics
Published: April 2022

This month's Coding Hotline questions address pigtail catheter placement, consultation in the NICU, and discharge time documentation.
Don’t Get Bitten When Coding Injuries!
Authors:   American Academy of Pediatrics
Published: April 2022

When coding for injury-related services, an accurate understanding of International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) instructions and how ICD-10-CM codes are linked to procedure codes is important to avoid claim denials.
New Category III Code Introduced for Humeral Osteotomy With Intramedullary Lengthening Device
Authors:   American Academy of Pediatrics
Published: April 2022

Effective for dates of service on and after July 1, 2020, new Current Procedural Terminology® Category III code 0594T may be reported for implantation of an externally controlled intramedullary lengthening nail via osteotomy of the humerus.
Did COVID-19 Reveal Your Practice Needs a Checkup?
Authors:   American Academy of Pediatrics
Published: April 2022

The COVID-19 pandemic has had a lasting effect on physicians. With all that has taken place, how is your practice’s financial health?
Office E/M 2021: Evaluation and Management Codes: A Work in Progress
Authors:   American Academy of Pediatrics
Published: April 2022

It’s important to keep in mind that additional modifications to the 2021 office E/M guidelines are possible prior to the publication of CPT 2021.
Office E/M 2021: Level 2 Visits
Authors:   American Academy of Pediatrics
Published: April 2022

This article provides information and examples of the changes that will be implemented for office and other outpatient evaluation and management (E/M) codes on January 1, 2020.
Coding for Back to School and Preparticipation Physical Evaluations
Authors:   American Academy of Pediatrics
Published: April 2022

As children return to school in the midst of the COVID-19 pandemic, it is expected that pediatricians will see an increased number of children who require routine preventive services or are experiencing difficulty in returning to school. This article provides codes for some of the potential reasons for visits and procedure codes for the services to address those reasons.
Influenza Immunization Coding
Authors:   American Academy of Pediatrics
Published: April 2022

It is once again time to promote immunization against influenza for all patients older than 6 months. Practices should be prepared to accurately report the immunization administration and influenza vaccine product codes.
CPT®: Quantitative SARS-CoV-2 Test and Public Health Emergency Practice Expense
Authors:   American Academy of Pediatrics
Published: April 2022

CPT codes 86413 and 99072 were added effective September 8, 2020.
Claim Denials: Write Off or Recapture the Revenue?
Authors:   American Academy of Pediatrics
Published: April 2022

If your practice has experienced financial downturns in 2020 (as many have due to the coronavirus disease 2019 pandemic), it might be worthwhile to ask what happens in your practice when claims are denied.
General Documentation Requirements for Digital and Telephone Evaluation and Management Services
Authors:   American Academy of Pediatrics
Published: April 2022

Provision of and payment for digital and telephone evaluation and management (E/M) services has expanded in 2020 due to the coronavirus disease 2019 public health emergency. However, questions abound about the required documentation for these services.
Coding Hotline
Authors:   American Academy of Pediatrics
Published: April 2022

This month’s Coding Hotline takes a look at resubmitting unpaid claims.
Tips: Office Evaluation and Management Documentation
Authors:   American Academy of Pediatrics
Published: April 2022

This article includes tips to help pediatricians document office evaluation and management (E/M) services and support code selection for the problems addressed, data reviewed and analyzed, risk of further management or treatment, and time spent on the date of the encounter.
Initial Fracture Care: Musculoskeletal or Evaluation and Management
Authors:   American Academy of Pediatrics
Published: April 2022

When pediatricians provide care for a patient with a fracture, coding is based on the care provided and the intent to provide ongoing care versus refer to another physician for care. Most codes for fracture care are assigned values that include 90 days of care following the date of initial fracture care. It is important to assign codes only for the services provided.
CPT Codes Released for COVID-19 Vaccines
Authors:   American Academy of Pediatrics
Published: April 2022

The Current Procedural Terminology® Editorial Panel has developed several new COVID-19 vaccine product and immunization administration codes.
Observation Evaluation and Management Services
Authors:   American Academy of Pediatrics
Published: April 2022

Observation services are frequently provided in lieu of or prior to inpatient hospital services, but determining when to report codes for these services is not always a straightforward decision.
Coding Hotline
Authors:   American Academy of Pediatrics
Published: April 2022

This month’s Coding Hotline takes a look at coding for newborn care as well as preoperative COVID-19 testing.
Coding Challenge Answers: Evaluation and Management Services
Authors:   American Academy of Pediatrics
Published: April 2022

The answers to the Coding Challenge are presented.
Retroactive Evaluation and Management Guideline Corrections Published
Authors:   American Academy of Pediatrics
Published: April 2022

On March 9, 2021, updates were made to Current Procedural Terminology® (CPT®) evaluation and management (E/M) services guidelines via a technical correction. This correction is retroactive to January 1, 2021. This article highlights the changes that were made along with some American Academy of Pediatrics (AAP) guidance for adhering to the revised guidelines.
Coding Hotline
Authors:   American Academy of Pediatrics
Published: April 2022

This month, the Coding Hotline addresses coding for fluoride application as well as immunization counseling and telemedicine.
Discontinued or Reduced Services: Modifier 52 or 53
Authors:   American Academy of Pediatrics
Published: April 2022

How is a service reported by a pediatrician when not performed in its entirety? That question pops up periodically, and the answer depends on the reason the service was halted.