bluuebunny/crossref_metadata_2025 huggingface dataset:
Coding Pearls: Reporting Services Provided in the Emergency Department (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Emergency department E/M codes 99281-99285 reported when care is provided in an ED that is an organized hospital-based facility
Subspecialty Corner: “Supervised Procedure”: The Rules for Billing Procedures Under the Medicare Teaching Physician Guidelines (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Level of participation required by a teaching physician for reporting supervision for various procedures
A Refresher Course: Teaching Physician Guidelines for Supervising Residents in the Office or Clinic
Authors:   American Academy of Pediatrics
Published: April 2022

Primary care exception rule (PCER) of teaching physician rules for training, teaching, and supervision or residents training in primary care specialties
New CPT 2012 Codes for Neonatal Car Seat/Bed Testing for Airway Integrity
Authors:   American Academy of Pediatrics
Published: April 2022

Codes 94780 and 94781 for nursing observation, vital signs, and bundled with the global neonatal and pediatric initial and subsequent critical care initial and continuing intensive care codes
Prolonged Services Provided in the Observation Setting
Authors:   American Academy of Pediatrics
Published: April 2022

AMA reverted back to including 99356 and 99357 observation care codes for inpatient setting, requiring unit/floor time beyond the usual service
Erratum: “What Can You Learn From This List?” (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Corrections needed in the Table in “What Can You Learn From This List?” on page 7 of the September 2011 AAP Pediatric Coding Newsletter™ (volume 6, no. 12). The International Classification of Diseases, Ninth Revision, Clinical Modification codes have been corrected in lines 4, 10, 24, and 25.
Point to Ponder
Authors:   American Academy of Pediatrics
Published: April 2022

HIPAA Version 5010 standards compliance required by January 1, 2012 for software data handling
Subspecialty Corner: CPT 2012 Medicine, Surgery, and Category III Codes (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Additional changes that will affect pediatric subspecialists in Gastroenterology, Cardiology, Neurology, Chemotherapy, Dermatology, Surgery, Esophageal motility, catheter-delivered prosthetic pulmonary valve, and near infrared guidance
Clarification: Perinatal Period Definition
Authors: Pearlman Stephen , Martin Gilbert
Published: April 2022

Perinatal care codes affecting the period up to the 29th calendar day after birth, affecting codes 99468, 99469, 99471, 99472, and 99477
Reporting Postoperative Care
Authors:   American Academy of Pediatrics
Published: April 2022

Follow-ups for postoperative visits, discharge, management, and care
Changes to Category II (Pay-for-Performance) CPT Codes (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Revised asthma codes for assessment of control, tobacco use screening and intervention, pharmacologic therapy, risk assessment, and discharge plan
Care of the Neonate: Your Questions Answered, Part 1
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting perinatal consultations, attendance at delivery, resuscitation, and delivery/birthing room resuscitation
Coding Conundrum: Do You Use CPT or Medicare Guidelines When Reporting Consultations or Prolonged Care in the Observation or Inpatient Hospital Setting?
Authors:   American Academy of Pediatrics
Published: April 2022

August 2011 CMS policy changes for observation codes and prolonged care service codes
Evaluation and Management Decision Tree Reappears
Authors:   American Academy of Pediatrics
Published: April 2022

Decision tree to determine whether an E/M service should be assigned a new or an established patient designation
Errata: January 2012 AAP Pediatric Coding Newsletter™ (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Corrections to “Care of the Neonate” and “Coding Conundrum”
Why Did I Order This Test?
Authors:   American Academy of Pediatrics
Published: April 2022

Guidelines for reporting and requesting diagnostic tests including reporting diagnoses, reasons for tests, signs, and symptoms
Academy's developmental screening advocacy efforts a success (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Revision of code 96110 to more accurate “developmental screening”
Conjugates and Adjuvants, or Component of Vaccines?
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting vaccines with conjugates and adjuvants for codes 90460, 90461, and 90644
Handling More Than One Specimen?
Authors:   American Academy of Pediatrics
Published: April 2022

How to report code 99000 when handling multiple specimens
Modifier PD: Do You Need to Report It?
Authors:   American Academy of Pediatrics
Published: April 2022

3-day payment windo for hospitals and practices that are wholly owned or operated by a hospital
Point to Ponder: Be Aware of Payer Coverage Criteria
Authors:   American Academy of Pediatrics
Published: April 2022

MCD and LCD coverage information and other criteria for denials
Transitioning to 10 (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

CMS resources to assist physicians, including the ICD-10 Implementation Guides and the Small and Medium Practice Implementation Timeline Table
Transitioning to 10: Coding for Traumatic Fractures
Authors:   American Academy of Pediatrics
Published: April 2022

Details describing how to code fractures based on site, encounter type, and complications
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Admit to observation for wheezing with 2 partners of the same specialty seeing the child
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting concern of measles without signs or symptoms, hand-foot-and-mouth disease, and Helicobacter pylori infection
Transitioning to 10
Authors:   American Academy of Pediatrics
Published: April 2022

Removing an embedded earring with and without incision in ICD-10-CM
Care Plan Oversight: A Refresher on Payment for Non–face-to-face Planning, Coordination, and Communication
Authors:   American Academy of Pediatrics
Published: April 2022

Coding and tracking care plans, status reports, lab studies, communication, coordination, and integration to adjust therapy
CPT 2013 Changes: Evaluation and Management Services
Authors:   American Academy of Pediatrics
Published: April 2022

New and revised codes for supervision of emergency transport care, inpatient critical care, intensive care, observation, etc.
CPT 2013 Changes: Chronic Care Coordination and Transitional Care Management
Authors:   American Academy of Pediatrics
Published: April 2022

New codes recognizing complex care coordination for patients with chronic continuous or episodic health conditions, and transitional care management services
Denials to Dollars: Alcohol and Substance Abuse Screening With Brief Intervention (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Codes 99408 and 99409 for structured screening and brief intervention tools such as AUDIT, DAST, and CRAFFT
Denials to Dollars: Attention-Deficit/Hyperactivity Disorder
Authors:   American Academy of Pediatrics
Published: April 2022

Preventive footwork to identify policy guidelines in insurance plans to insure payment for ADHD services
Global Per Diem Critical Care Codes: Direct Supervision and Reporting Guidelines
Authors:   American Academy of Pediatrics
Published: April 2022

PATH guidelines for reporting services by the attending physician acting directly or supervising residents and fellows
Intensive and Critical Care Services: Initial or Subsequent?
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting multiple levels of pediatric hospital care in one stay for critical care, intensive care, and stepping between levels of care
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

E code for anaphylactic reaction and diagnosis coding for following a patient for possible residual or recurrent disease
Transitioning to 10: Sniffling, Coughing, Aching All Over
Authors:   American Academy of Pediatrics
Published: April 2022

ICD-10-CM range of codes for winter symptoms such as the common cold and influenza
Pulmonary Function Testing: Is Your CPT Coding Up to Date?
Authors:   American Academy of Pediatrics
Published: April 2022

Keeping up with CPT and NCCI changes for reporting and payment for spirometry, oximetry, ventilatory management, and other PFT
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Reevaluating the health status of a child in foster care for transition and suctioning to clear an infant’s airway or to obtain a specimen
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Codes for evening urgent care by nonphysician qualified health care professionals
Transitioning to 10: The Date Is Still October 1, 2014
Authors:   American Academy of Pediatrics
Published: April 2022

Preparation steps involving staff, vendors, budget, and other planning for ICD-10-CM
The Heat Is On: Coding for the Effects of Summer Fun
Authors:   American Academy of Pediatrics
Published: April 2022

Coding for maladies and minor injuries that commonly occur in summer, and related procedures and services such as sunburn, burns from fireworks, and splinting after a fall
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

11-year-old preventive medicine service with a cat bite, antibiotic prescription, and vaccine counseling
How Does Your Coding Compare? (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

How to benchmark code utilization with data from Medstat MarketScan that reflects the typical pediatric population.
You Code It! (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Ankle injury caused by a fall on a trampoline, with detailed history, x-ray interpretation, non-pneumatic CAM Walker boot application, and referral to an orthopedist
Transitioning to 10: Physician Reporting of Inpatient Services
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting conditions to the highest degree of certainty; using signs, symptoms, abnormal test results, or other reasons for encounters instead of an uncertain diagnosis
Incident-to Services by Auxiliary Staff
Authors:   American Academy of Pediatrics
Published: April 2022

Proposed changes to CMS incident-to policy amending the definition of auxiliary personnel
Transitioning to 10: 2014 ICD-10-CM Guidelines Published
Authors:   American Academy of Pediatrics
Published: April 2022

Clarification on use of parentheses for non-essential modifiers, new instructions addressing the use of signs, symptoms, and unspecified codes, external cause of morbidity codes, and rehabilitation services
AAP Pediatric Coding Newsletter™ Resources
Authors:   American Academy of Pediatrics
Published: April 2022

Subscriber benefits, including online exclusive articles, CEU quizzes, worksheets, templates, sample letters, and the coding calculator
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Weight-check visit and history in the first week of life
Subspecialty Corner: CPT 2014 Code Changes—Esophagoscopy
Authors:   American Academy of Pediatrics
Published: April 2022

CPT changes affecting endocopic procedures, including removal fo foreign body, balloon dilation, rigid trans-oral, and flexible trans-nasal esophagoscopy
When Pediatric Patients Have Medicare Coverage
Authors:   American Academy of Pediatrics
Published: April 2022

Preventive service benefits, immunizations, physical examinations, and other eligibility for children based on condition of the child or parent
Transitioning to 10: Resources for the Transition and Beyond
Authors:   American Academy of Pediatrics
Published: April 2022

ICD-10-CM coding and documentation resources from AAP, AAPC, AMA, and CMS
A Refresher on Moderate (Conscious) Sedation Services (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Increasing coding and documentation requirements with increasing depth of sedation and intensity of monitoring for sedation, analgesia, and anesthesia 99143-99150, includes decision tree
Beyond Moderate Sedation: Coding for Anesthesia Services
Authors:   American Academy of Pediatrics
Published: April 2022

The second in a series of coding articles on the deepening levels of anethesia services. Age, special circumstances, modifers, and the documentation needed are covered, as well as payment examples.
Q&A (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Glucose level finger stick as billable service?
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Anemia in an infant and evaluation and management for a neonate born to a diabetic mother who does not have related symptoms or complications
Technical Correction to Critical Care Codes (99468–99476)
Authors:   American Academy of Pediatrics
Published: April 2022

CPT errata correcting prefatory language for neonatal and pediatric critical care services regarding same day or same stay
Transitioning to 10: Documentation of Sinusitis
Authors:   American Academy of Pediatrics
Published: April 2022

Documentation elements necessary to support specific code selection for acute or chronic sinusitis and when to report additional codes for identified infectious agents
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Critical care services for a pediatric patient in observation status, a transthoracic echocardiogram with no defect found, and the enuresis code for a bed-wetting visit
The Problem With Problem Lists
Authors:   American Academy of Pediatrics
Published: April 2022

Conditions appearing on a problem list that are not currently being treated by the health care professional performing the visit
Observation Care Services: CPT or Medicare
Authors:   American Academy of Pediatrics
Published: April 2022

The differences between CPT instructions and Medicare policy confuse many who report on observational care services. This in-depth article starts to unravel some of the confusion.
Transitioning to 10: Documenting Diabetes Mellitus (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

As instances of diabetes mellitus rise, be ready to capture and report accurately on this condition in light of the upcoming switch to ICD-10.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Athma ventilation; CPT codes for influenza vaccines
Chronic Care Management 2015: Recognizing the Intent
Authors:   American Academy of Pediatrics
Published: April 2022

2015 CPT changes continue with a review of chronic care mangagement.
Breaking Out Emotional/Behavioral Assessments
Authors:   American Academy of Pediatrics
Published: April 2022

Examination of the role for the new CPT code which breaks out emotional/behaviorial assessments from the developmental screening.
CPT Incorporates ACIP Vaccine Abbreviations
Authors:   American Academy of Pediatrics
Published: April 2022

January 2015 brings more changes to CPT.
Applying the 2015 ICD-10-CM Guidelines for Initial Encounters
Authors:   American Academy of Pediatrics
Published: April 2022

Dive deeper into the revised ICD-10 guidelines for initial encoutners.
CPT 2015: New Codes for ECMO/ECLS Services
Authors:   American Academy of Pediatrics
Published: April 2022

A new subsection of CPT codes, a new (and thorough) review from the Newsletter.
Transitioning to 10: Infection
Authors:   American Academy of Pediatrics
Published: April 2022

Our T10 series continues with a focus on ICD-10-CM coding for infectious and parasitic diseases.
New Vaccine Code Implementation on February 1, 2015 (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

A new code approval process allows for a new vaccine code release.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

HCPCS code for obesity counceling; Sibling exposure and treatment.
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Cesarean delivery attendence and subsequent coding in ICD-9-CM versus ICD-10-CM.
Do You Know Your History? (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Test your knowledge and match patient statements with the correct history element.
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Sports physical with obecity counceling.
Subspecialty Corner: Endoscopy Coding Update (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

CPT 2015 and the changes it brings to this procedure.
History in the Preventive Service
Authors:   American Academy of Pediatrics
Published: April 2022

Supporting well-child visits through accurate level of history documentation.
Transitioning to 10: A Look Into the Eyes
Authors:   American Academy of Pediatrics
Published: April 2022

Differences from ICD-9 to ICD-10 in terms of conditions of the eye are explored.
Modifier Challenge
Authors:   American Academy of Pediatrics
Published: April 2022

Secure correct payments with knowledge of correct modifier use.
Split/Shared Evaluation and Management Services: Place of Service Matters
Authors:   American Academy of Pediatrics
Published: April 2022

Team-based care and how to code for it.
Transitioning to 10: Codes for Recommended Pediatric Influenza Vaccines, 2015–2016 (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

An influenza vaccine walk-through for the changes in light of the ICD-10 change.
Transitioning to 10: The Time Has Come
Authors:   American Academy of Pediatrics
Published: April 2022

Put the transistion in perspective with these key elements.
CPT® 2016 Changes: Evaluation and Management Coding
Authors:   American Academy of Pediatrics
Published: April 2022

Changes to prolonged services with direct patient contact, and behavior change interventions.
Coding Challenge: CPT® 2016 in Practice (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Test your CPT knowledge.
Coding for Bedside Ultrasound: No Hocus POCUS
Authors:   American Academy of Pediatrics
Published: April 2022

Guidelines and scenarios for Point-of-Care Ultrasound.
Coding Challenge:
Authors:   American Academy of Pediatrics
Published: April 2022

Test you coding procedural service skills.
A Look at ICD-10-CM Conventions for Neonatal Conditions
Authors:   American Academy of Pediatrics
Published: April 2022

Nonessential modifiers, notes in the tablular list, include and exclude notes, are all explored in this article on ICD-10 conventions for Neonatal conditions.
ICD-10-CM for Necrotizing Enterocolitis: Neonatal or Not?
Authors:   American Academy of Pediatrics
Published: April 2022

Current and possible future reporting standards for NEC.
A Big Year Is Ending: What’s Next?
Authors:   American Academy of Pediatrics
Published: April 2022

2015 brought ICD-10, new services. What else might be coming in 2016.
ICD-10-CM: Reporting Borderline Diagnoses
Authors:   American Academy of Pediatrics
Published: April 2022

Borderline type 2 diabetes and borderline hypertension serve as examples for how to approach other borderline scenarios.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Interpretation of radiographs; Ear canal drainage; Use of scribes.
Time-Based Reporting, 2016
Authors:   American Academy of Pediatrics
Published: April 2022

Explore the services that include physician time.
Understanding Medicaid Medically Unlikely Edits
Authors:   American Academy of Pediatrics
Published: April 2022

The Centers for Medicare & Medicaid Services (CMS) maintains 2 types of Medicaid National Correct Coding Initiative (NCCI) edits: procedure-to-procedure edits and Medically Unlikely Edits (MUEs). Physicians may be most familiar with procedureto-procedure edits…
Coding for Mental/Behavioral Health Professionals in the Medical Home
Authors:   American Academy of Pediatrics
Published: April 2022

As pediatricians seek to provide comprehensive care, allied health professionals and services outside the typical scope of primary care pediatrics are increasingly integrated into practice…
Maximizing 10: Initial, Subsequent, and Sequela Confusion
Authors:   American Academy of Pediatrics
Published: April 2022

Although reports indicate much of the transition to ICD-10 has gone well, there are still some areas that continue to raise questions…
Parental Rights and HIPAA
Authors:   American Academy of Pediatrics
Published: April 2022

Key questions for pediatrics about health information privacy and release of protected health information (PHI) under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) often relate to parental rights to access the health information of their children.
Newborn Care or Hospital Care
Authors:   American Academy of Pediatrics
Published: April 2022

Selecting the appropriate procedure codes for care of the newborn requires a decision between care that was significantly beyond normal newborn care and standard care of a newborn.
Starting Over With Moderate Sedation
Authors:   American Academy of Pediatrics
Published: April 2022

For those who provide moderate (conscious) sedation, there are substantial changes coming. All CPT® instructions and codes change for dates of service on and after January 1, 2017. This article shows which codes will be deleted in 2017, and compares 2016 instructions and 2017 instructions for reporting moderate sedation.
Influenza Vaccine Codes, 2017 (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Among the CPT® code changes effective January 1, 2017, the influenza vaccine codes will no longer include an age designation but instead will include dosage amounts. By including only the dosage, the codes are more easily matched to the trivalent and quadrivalent vaccine products based on the prescribing information for the individual product.
Modifier Resources From AAP Pediatric Coding Newsletter™ (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Online resources for information about modifiers and The National Correct Coding Initiative.
ICD-10-CM Exclusion Notes: New Guidelines
Authors:   American Academy of Pediatrics
Published: April 2022

International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) exclusion notes have been a source of questions and controversy since the code set was implemented in 2015. This article discusses a reporting exception that has now been approved and implemented.
Immunization Coding Review
Authors:   American Academy of Pediatrics
Published: April 2022

Because immunizations are an important component of pediatric care, proper coding for immunization administration and the associated vaccine products is an important component of pediatric practice. This article discusses common concerns related to immunization coding.
You Code It! Asthma Care and Preventive Service Answers (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Answers to the coding question posed in the scenario in the “You Code It! Asthma Care and Preventive Services” article.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Lip Tie; Prescription Drug Management
You Code It! ADHD Follow-up Visit (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

An example scenario intended to illustrate documentation and coding for a patient with ADHD who is presenting for a follow-up visit.
You Code It! Reaction to an Apple
Authors:   American Academy of Pediatrics
Published: April 2022

An example scenario where a 14 year-old-girl eats and apple and experiences itching and swelling in her mouth.
You Code It! Reaction to an Apple Answer
Authors:   American Academy of Pediatrics
Published: April 2022

Answers to the coding question posed in the scenario in the “You Code It! Reaction to an Apple” article.
Getting Paid More for Complex Chronic Care Management
Authors:   American Academy of Pediatrics
Published: April 2022

For years, Medicare and other payers have paid for chronic care management (CCM) services, but, as of January 2017, the Medicare Physician Fee Schedule (MPFS) has been expanded to include complex chronic care (CCCM) services. This article notes the similarities and differences in the descriptors for CCM and CCCM.
Behavioral Health Integration in the Medical Home
Authors:   American Academy of Pediatrics
Published: April 2022

Expanding on the discussion of coding for mental/behavioral health services from a previous issue, this article reviews codes introduced in the Medicare Physician Fee Schedule for 2017 for reporting the physician supervision of integrated mental and behavioral health services, which is referred to as behavioral health integration (BHI).
Sports and Camp Physicals
Authors:   American Academy of Pediatrics
Published: April 2022

This article discusses coding for services associated with clearing children for sports or other activities where a specific form is required from the pediatrician.
You Code It! Preventive Counseling Answer
Authors:   American Academy of Pediatrics
Published: April 2022

Answers to the coding question posed in the scenario in the “You Code It! Preventive Counseling” article.
Distinguishing Modifiers: Distinct Procedure or Separate Evaluation and Management Service
Authors:   American Academy of Pediatrics
Published: April 2022

This article explains the different purposes of 2 key Current Prodcedural Terminology (CPT) modifiers that are often confused not only by physicians and coders, but also by payers and claims administrators.
Conducting Internal Chart Reviews
Authors:   American Academy of Pediatrics
Published: April 2022

Implementing internal chart reviews are an important aspect of coding compliance. Resources for conducting chart reviews and documentation elements that may be included in reviews are discussed.
You Code It! Late Summer Fun With Coding Answers (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Answers to the coding scenario in the “You Code It! Late Summer Fun With Coding” article are provided.
General Behavioral Health Care Management
Authors:   American Academy of Pediatrics
Published: April 2022

Update on coding for general behavioral health care management in 2018.
CPT® 2018 Changes: Laboratory and Pulmonary Diagnostic Procedures
Authors:   American Academy of Pediatrics
Published: April 2022

Update on code changes for laboratory and pulmonary diagnostic procedures for 2018.
You Code It! Road Rash—Answers (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Answers to the coding questions posed in the scenario in the “You Code It! Road Rash” article.
Choose the Right Code: Audiometry (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Tips on coding for audiometry screening, which is recommended to be performed as part of preventive medicine (well-child) visits.
E/M Coding: Benefit or Burden? Payer guidelines have created a beast and it’s time to advocate for change (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Discussing some of the challenges experienced when coding for E/M services.
National Drug Code Unit Errors Prompt Refund Requests
Authors:   American Academy of Pediatrics
Published: April 2022

This article discusses the need to recognize the difference in claims processing based on the number of units per National Drug Code (NDC) versus per Current Procedural Terminology (CPT®) code units.
You Code It! Holiday Mishaps
Authors:   American Academy of Pediatrics
Published: April 2022

Fill in the missing ICD-10-CM or CPT codes in this scenario.
Documenting Medical Decision-making
Authors:   American Academy of Pediatrics
Published: April 2022

Continued discussion of the issue on updating the Centers for Medicare & Medicaid Services (CMS) E/M coding requirements.
Getting the Most From AAP Pediatric Coding Newsletter™
Authors:   American Academy of Pediatrics
Published: April 2022

Discussion of the resources available on the AAP Pediatric Coding Newsletter™ Web site.
You Code It Answers! Injury With Nasal Hemorrhage
Authors:   American Academy of Pediatrics
Published: April 2022

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

CPT®: Extremity X-ray; CPT: Scoliosis Study; CPT: Destruction Codes; ICD-10-CM: Loss of Consciousness
Minor Procedures: Documentation and Coding
Authors:   American Academy of Pediatrics
Published: April 2022

Examples of minor procedures commonly performed in pediatric practice are used to illustrate the documentation necessary to support the services, supplies, and work included in each, as well as the appropriate procedure coding.
Therapeutic Intervention: 2018 HCPCS Codes
Authors:   American Academy of Pediatrics
Published: April 2022

As of January 1, 2018, payers may accept a Healthcare Common Procedure Coding System or Current Procedural Terminology (CPT®) code for therapeutic services aimed at development of cognitive skills.
The Surgical Package and Related Services
Authors:   American Academy of Pediatrics
Published: April 2022

The surgical package definition in Current Procedural Terminology (CPT®) differs from that of Medicare. It is important to know if the payer uses the Medicare surgical package, aligns with CPT, or has its own definition of the surgical package and related global periods.
Coding Challenge: Modifiers and Procedural Services (Answers) (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

The answers to this month’s Coding Challenge!
ICD-10-CM Coding Confusion: Care During the Birth Admission
Authors:   American Academy of Pediatrics
Published: April 2022

The Coding Clinic guidance regarding reporting of Z38 codes should be viewed as official guidance clarifying the intent of the guidelines, and the appropriate Z38 code should be the attending physician’s first-listed diagnosis for all care provided during the birth admission.
Coding Challenge: Match Codes to Consultation Services (Answers)
Authors:   American Academy of Pediatrics
Published: April 2022

Answers to this month's Coding Challenge!
You Code It! Testing for Exercise-Induced Asthma (Answers) (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Did you assign the appropriate diagnosis and procedure codes to the following scenario in which the same patient receives care on 4 dates of service?
Q&A (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

This month's Q&A features guidance on self-limited or minor problems, the number of diagnoses submitted, and payer guidelines for incident-to services.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

This month’s Q & A features coding for automated eye examinations.
Anticipated Changes: 2019 ICD-10-CM
Authors:   American Academy of Pediatrics
Published: April 2022

New and revised codes are coming soon to International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). This article highlights some changes that affect coding for pediatric care.
Anticipated New ICD-10-CM Code Tables (not for use prior to October 1, 2018)
Authors:   American Academy of Pediatrics
Published: April 2022

Tables of anticipated new ICD-10-CM codes are featured here.
Audits Are Inevitable: Are You Limiting Your Risk?
Authors:   American Academy of Pediatrics
Published: April 2022

Regardless of the reason for an audit or chart review, how your practice responds is important. This article contains tips for preparing your practice to properly respond to payer audits.
Critical Care: Goodbye Telemedicine Codes 0188T and 0189T
Authors:   American Academy of Pediatrics
Published: April 2022

Pediatric physicians providing critical care via telemedicine will change the way these services are reported in 2019.
Getting Paid in 2019: Relative Value Units and Conversion Factors
Authors:   American Academy of Pediatrics
Published: April 2022

This article discusses the RVU assignments for codes that are new or revised in 2019. Knowing the RVUs assigned to a service can provide a source for estimating payments for services you may add and the effects of changes to codes for services you already provide.
CPT® 2019: Psychological and Neuropsychological Testing
Authors:   American Academy of Pediatrics
Published: April 2022

Codes for psychological and neuropsychological testing services are undergoing multiple changes in Current Procedural Terminology (CPT) 2019. Find out what's new!
ICD-10-CM Reporting Guideline Updates for Pediatrics
Authors:   American Academy of Pediatrics
Published: April 2022

In this article, new ICD-10-CM guideline changes that may affect reporting of pediatric diagnoses are reviewed.
Coding Challenge: 2019 Coding Guidelines and Instructions
Authors:   American Academy of Pediatrics
Published: April 2022

See if you can tackle this month’s Coding Challenge on 2019 guidelines and instructions.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

This month’s Q & A features guidance on neonatal critical care after transport.
Influenza: Coding for Related Tests and Services
Authors:   American Academy of Pediatrics
Published: April 2022

As the typical peak of influenza season nears, it is important to be ready to report services provided to evaluate and manage influenza and influenza-like illnesses. This article provides a refresher for reporting the related diagnoses and procedural services.
Evaluation and Management: Time Is Not Always an Option
Authors:   American Academy of Pediatrics
Published: April 2022

There are very few evaluation and management service codes for which typical time is never a factor in reporting the service. Other criteria are used for the selection of the specific codes (eg, defined components, services reported per day).
Learning Your ADS
Authors:   American Academy of Pediatrics
Published: April 2022

Learn how to report injury codes that require a seventh character choice!
Audit Tools: What You Need to Perform and Document Chart Audits
Authors:   American Academy of Pediatrics
Published: April 2022

To perform in-house chart audits, a practice must have the tools to verify that documentation is adequate, codes are correctly assigned, and results and corrective actions are documented.
Hospital Discharge Day Management: Are You Coding Correctly?
Authors:   American Academy of Pediatrics
Published: April 2022

CPT provides codes for reporting discharge day management services for inpatient and observation stays. These codes take into account work such as final examination of the patient, review and discussion of the hospital stay, coordination and instruction for ongoing care with caregiving agencies, preparation of final discharge records, prescriptions, and referral forms.
You Code It! Answers: What’s Wrong With These Claims?
Authors:   American Academy of Pediatrics
Published: April 2022

The answer to this month’s You Code It! scenario is presented here.
Office and Other Outpatient Evaluation and Management: Big Changes May Be Coming
Authors:   American Academy of Pediatrics
Published: April 2022

The Centers for Medicare & Medicaid Services (CMS) is showing serious intent to reduce the burden of documentation to support code selection in compliance with the 1995 and 1997 Documentation Guidelines for Evaluation and Management Services.
What Coding Might Look Like Under Centers for Medicare & Medicaid Services 2021 Proposals
Authors:   American Academy of Pediatrics
Published: April 2022

The Centers for Medicare & Medicaid Services (CMS) and the Current Procedural Terminology (CPT®) Editorial Panel are considering changes to coding of office and other outpatient evaluation and management (E/M) services starting January 1, 2021. This article provides examples of what the CMS has proposed.
You Code It! Answers: Evaluation and Management With Preventive Counseling
Authors:   American Academy of Pediatrics
Published: April 2022

The answer to this month’s You Code It! scenario is presented here.
National Correct Coding Initiative Policy Change
Authors:   American Academy of Pediatrics
Published: April 2022

The Centers for Medicare & Medicaid Services (CMS) has made a significant change to the policy for using distinct service modifiers to override Medicare National Correct Coding Initiative (NCCI) edits. The change will be implemented July 1, 2019.
You Code It! Answers: Well-Baby Examination With Maternal Depression Screening
Authors:   American Academy of Pediatrics
Published: April 2022

The answer to this month's You Code It! scenario is presented here.
ICD-10-CM Fill in the Blanks: Hazards of Summer Fun
Authors:   American Academy of Pediatrics
Published: April 2022

Can you complete the sentences using the diagnosis codes provided?
AAP Pediatric Coding Newsletter™ June 2019 Quiz (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Quiz for AAPC Continuing Education Units
Codes Assigned by Payers: CARCs and RARCs
Authors:   American Academy of Pediatrics
Published: April 2022

Claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs) are used to provide information on how a claim was processed. We define and provide examples of CARCs and RARCs.
Coding Hotline
Authors:   American Academy of Pediatrics
Published: April 2022

This month, the Coding Hotline answers questions on newborn same-date admission and discharge, extracorporeal membrane oxygenation, and two E/M services performed on the same date.
Hierarchical Condition Categories: What They Are and Why They Matter to Pediatricians
Authors:   American Academy of Pediatrics
Published: April 2022

You might not have heard of hierarchical condition categories, but your practice and patients are likely affected by them. We'll break down the concept and explain how they can have a significant effect on revenue.
What Is CLIA?
Authors:   American Academy of Pediatrics
Published: April 2022

The Clinical Laboratory Improvement Amendments (CLIA) were passed in 1988 by Congress to establish quality standards for all laboratory testing and to ensure the accuracy, reliability, and timeliness of patient test results regardless of where the test was performed. This article highlights waived tests and practice considerations.
You Code It! Answers: Request for Immunization
Authors:   American Academy of Pediatrics
Published: April 2022

The answer to this month’s You Code It! scenario is presented here.
Coding for Digital Medicine
Authors:   American Academy of Pediatrics
Published: April 2022

Technology is everywhere in our lives. People are connected at all times and expect instant results, even when it comes to health care. Digital medicine and its telehealth component are helping to make that possible.
You Code It! Focus on Medical Decision-making
Authors:   American Academy of Pediatrics
Published: April 2022

Increasingly, physicians and health plans are moving toward the use of medical decision-making (MDM) as the key component for selecting a level of evaluation and management (E/M) services. You will be challenged to recognize the MDM elements in 2 scenarios.
CPT® 2020: Radiologic Gastrointestinal Examination
Authors:   American Academy of Pediatrics
Published: April 2022

Current Procedural Terminology (CPT®) codes in the 74210–74280 range are significantly changed for 2020. This article provides an overview of what to expect.
Chronic Care Management: Current Coding Options
Authors:   American Academy of Pediatrics
Published: April 2022

There have been significant changes to CCM codes since the original complex CCM codes were introduced in 2013. This article will quickly get you up to speed.
AAP Updates Policy on Pediatric Application of Coding, Valuation Systems
Authors:   American Academy of Pediatrics
Published: April 2022

The American Academy of Pediatrics Committee on Coding and Nomenclature and Private Payer Advocacy Advisory Committee have updated the 2014 policy statement, “Application of the Resource-Based Relative Value Scale System to Pediatrics.” The revised policy statement, along with an accompanying technical report, is titled, “Pediatric Application of Coding and Valuation Systems.”
Example: My Plan of Care (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Creating templates for plans of care and tracking the time and activities of chronic care management (CCM) services require time and effort but are essential to providing and documenting these services.
Office E/M 2021: An Overview of Evaluation and Management Changes for 2021
Authors:   American Academy of Pediatrics
Published: April 2022

This article provides a preview and an initial step in learning to use the revised codes and coding guidelines that will be implemented for services on and after January 1, 2021.
You Code It! Assigning Appropriate Codes for Hospital Care of Newborns
Authors:   American Academy of Pediatrics
Published: April 2022

A variety of evaluation and management (E/M) codes are used to report hospital services provided to newborns. Can you assign them correctly?
You Code It! Two Consultations in One Admission
Authors:   American Academy of Pediatrics
Published: April 2022

Are you familiar with Current Procedural Technology (CPT®) instructions for reporting inpatient consultations? Test your knowledge by assigning codes to this scenario.
Coding Hotline
Authors:   American Academy of Pediatrics
Published: April 2022

In this edition of Coding Hotline, our team addresses coding questions related to post-circumcision adhesions and resolved conditions.
Aftercare, Follow-up, Status, and History
Authors:   American Academy of Pediatrics
Published: April 2022

Often, a patient’s condition requires surveillance after initial treatment or continued care during a healing phase. Follow-up care and aftercare codes describe these reasons for encounters.
You Code It! Answers
Authors:   American Academy of Pediatrics
Published: April 2022

Did you assign the appropriate codes? Find out here.
You Code It! Integumentary Repair
Authors:   American Academy of Pediatrics
Published: April 2022

An 11-year-old presents to the ED with wounds caused by hitting his leg against a stack of medical siding while riding his bicycle. Can you assign the correct codes to this scenario?
Code Comparison: Remote Evaluation and Management Services
Authors:   American Academy of Pediatrics
Published: April 2022

The COVID-19 pandemic heightened the focus on provision of evaluation and management (E/M) services without a face-to-face (in-person) visit with a patient and/or caregiver. With multiple ways of providing care from a distance, it is important to know which codes apply to each type of service
AAP COVID-19 Coding Resources
Authors:   American Academy of Pediatrics
Published: April 2022

The American Academy of Pediatrics is here to support you as you implement new policies and practices related to COVID-19.
CPT® Modifiers
Authors:   American Academy of Pediatrics
Published: April 2022

Did you assign the appropriate codes? Find out here.
COVID-19 Coding Update
Authors:   American Academy of Pediatrics
Published: April 2022

The AAP continues to monitor the COVID-19 outbreak in the United States and provide members with tools and support to navigate this public health emergency.
Tricare Now Paying for Vision Screenings
Authors:   American Academy of Pediatrics
Published: April 2022

Tricare has removed Current Procedural Terminology® vision screening codes 99174 and 99177 from the No Government Pay Procedure Code List for children aged 1 to 6 years.
Office E/M 2021: Examples of Risk in Determination of Overall Medical Decision-making
Authors:   American Academy of Pediatrics
Published: April 2022

The risk of complications and/or morbidity or mortality of patient management is 1 of 3 elements of medical decision-making (MDM) that may be used in determining the level of service for office and other outpatient evaluation and management (E/M) services on and after January 1, 2021. Two of 3 elements of MDM must support a level of service.
General Pediatrics: Care of Newborn Who Becomes Ill
Authors:   American Academy of Pediatrics
Published: April 2022

When reporting hospital care of the ill newborn, it is important to understand which codes are applicable.
Modifiers: Do You Use 59 or XE, XP, XS, XU?
Authors:   American Academy of Pediatrics
Published: April 2022

In 2015, the Centers for Medicare & Medicaid Services (CMS) introduced 4 new modifiers intended to replace modifier 59 (distinct procedural service).
AAP Pediatric Coding Newsletter™ June 2020 Quiz (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Quiz for AAPC Continuing Education Units
2020 Versus 2021: When Is 99211 Reported?
Authors:   American Academy of Pediatrics
Published: April 2022

In 2021, code 99201 (level 1, new patient visit) will be deleted (due to lack of differentiation from 99202), but what happens with 99211 (level 1, established patient visit)? The answer is that the changes make the intended use of 99211 clearer.
New Category III Code: Eye Movement Analysis
Authors:   American Academy of Pediatrics
Published: April 2022

Category III (new or emerging technology) code 0615T was implemented on July 1, 2020 (prior to inclusion in CPT 2021) for reporting eye movement testing in patients who have a head injury that may be a traumatic brain injury or concussion.
Coding Challenge Answers: Name That Modifier!
Authors:   American Academy of Pediatrics
Published: April 2022

Check your answers to this issue's Coding Challenge.
AAP Pediatric Coding Newsletter™ August 2020 Quiz (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Quiz for AAPC Continuing Education Units
Coding Hotline
Authors:   American Academy of Pediatrics
Published: April 2022

This month’s Coding Hotline addresses questions related to Lyme disease testing and urinary catheterization.
New ICD-10-CM Guidelines: COVID-19–Related Services
Authors:   American Academy of Pediatrics
Published: April 2022

Recently released official guidelines provide new instructions for reporting diagnoses associated with coronavirus disease 2019 (COVID-19) testing and treatment.
Coding Hotline
Authors:   American Academy of Pediatrics
Published: April 2022

This month’s Coding Hotline answers a question regarding coding for subsequent hospital care.
Coding Hotline
Authors:   American Academy of Pediatrics
Published: April 2022

This month's Coding Hotline takes a look at modifier 25.
Office E/M 2021: Examples of Pediatric Medical Decision-making for Office Evaluation and Management Services
Authors:   American Academy of Pediatrics
Published: April 2022

In the coming months, there will undoubtedly be uncertainty about the levels of medical decision-making (MDM) for specific encounters. Each encounter must be evaluated based on the MDM elements of the number and complexity of problems addressed, amount and/or complexity of data to be reviewed and analyzed, and risk of complications and/or morbidity or mortality of patient management.
You Code It! Evaluation and Management of Enuresis
Authors:   American Academy of Pediatrics
Published: April 2022

Can you assign the correct procedure and diagnosis codes for these scenarios?
Coding Hotline
Authors:   American Academy of Pediatrics
Published: April 2022

This month’s Coding Hotline takes a look at coding for office evaluation and management, prescription drug management, data reviewed and analyzed, and risk.
You Code It! Answers: Evaluation and Management of Enuresis
Authors:   American Academy of Pediatrics
Published: April 2022

The answers to this month’s You Code It! scenarios are presented.
AAP Pediatric Coding Newsletter™ February 2021 Quiz (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Quiz for AAPC Continuing Education Units
Coding Challenge: Evaluation and Management Services
Authors:   American Academy of Pediatrics
Published: April 2022

Can you identify which statements are true and which are false?