bluuebunny/crossref_metadata_2025 huggingface dataset:
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting suspected diagnosis, alpha-1 antitrypsin deficiency, intramuscular injection, and unknown immunization status
Denial Den
Authors:   American Academy of Pediatrics
Published: April 2022

Vaccine counseling: when to use preventive medicine service codes and when to use immunization administration codes
Same Physician Work—But Lower Payment! Can You Explain That?
Authors:   American Academy of Pediatrics
Published: April 2022

Higher practice expense relative value units for services performed in a non-facility setting than in a facility
New and Revised 2009 CPT Medicine Codes
Authors:   American Academy of Pediatrics
Published: April 2022

Summary of select changes made to the medicine section of CPT for 2009
Wound Repair Codes Revised in 2009
Authors:   American Academy of Pediatrics
Published: April 2022

Revision to codes for intermediate wound repairs 12031-12056
Coding Conundrum
Authors:   American Academy of Pediatrics
Published: April 2022

How to report the diagnosis for a combination vaccine that does not have an established ICD-9-CM code
Point to Ponder
Authors:   American Academy of Pediatrics
Published: April 2022

Selection of the code when the same procedure or service has a CPT and a HCPCS code
The CMS Publishes the Medicare Medically Unlikely Edits
Authors:   American Academy of Pediatrics
Published: April 2022

Medically Unlikely Edit program to reduce payment errors
2009 Medicare Resource-Based Relative Value Scale: Good and Bad News
Authors:   American Academy of Pediatrics
Published: April 2022

2009 RBRVS for Medicaid and third-party payer payment
Hospital Discharge Day Management
Authors:   American Academy of Pediatrics
Published: April 2022

Appropriate reporting of normal newborn discharge day management services
Step 3: Determine the Level of Physical Examination Performed and Documented
Authors:   American Academy of Pediatrics
Published: April 2022

Physical examination level requirements
Point to Ponder
Authors:   American Academy of Pediatrics
Published: April 2022

Preventive medicine visits for patients with chronic conditions
Centers for Disease Control and Prevention Developmental Screening Flowchart
Authors:   American Academy of Pediatrics
Published: April 2022

Flowchart to justify code 96110 as separate from preventive medicine services
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Lidocaine injection prior to a surgical procedure, IV infusion for vomiting and dehydration, consultation for a pregnant mother, and removal of a foreign body
Coding Evaluation and Management and Patient Education Services for Obesity
Authors:   American Academy of Pediatrics
Published: April 2022

Coding for E/M services provided to children who are overweight or obese
A Sneak Peek: What’s to Come in CPT 2010
Authors:   American Academy of Pediatrics
Published: April 2022

Forthcoming changes to E/M Services, Surgery, Pathology and Laboratory, Medicine, and Category II Codes for 2010
Current Procedural Terminology® 2010
Authors:   American Academy of Pediatrics
Published: April 2022

Changes to CPT effective for reporting services provided after January 1, 2010, including more specific language differentiating consultation from transfer, reporting non-face-to-face prolonged services, integumentary system codes, pulmonary function tests, and new Category II codes for end-stage renal disease and HIV/AIDS
Denials to Dollars: American Academy of Pediatrics Advocates for Increased Payment for Combination Vaccines
Authors:   American Academy of Pediatrics
Published: April 2022

New CPT codes AAP has developed to more accurately reflect physician work administering combination vaccines
Your AAP at Work! Responses to the CMS Proposed Rules for Calendar Year 2010
Authors:   American Academy of Pediatrics
Published: April 2022

AAP Advocacy on Medicare & Medicaid proposed rules affecting pediatricians
Subspecialty Corner: Changes to the Surgical Section in CPT® 2010
Authors:   American Academy of Pediatrics
Published: April 2022

Surgical code changes for 2010
A Refresher Course: Understanding the Medicare National Correct Coding Initiative
Authors:   American Academy of Pediatrics
Published: April 2022

Updated summary of use of NCCI to determine Medicare payment policies
Interpreting Claim Adjustments on Your Remittance Advices or Explanations of Benefits (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs)
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Patient seen for croup with stridor, including performance of pulse oximetry and Decadron administration
Coding Quandary: Initial and Subsequent Hospital Care of the Sick Newborn
Authors:   American Academy of Pediatrics
Published: April 2022

Coding for progressive illness or increased level of service on the same calendar date, and reporting service when there is a transfer of care
Subsequent Hospital Care of the Sick Newborn (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Scenarios for 2 physicians from separate groups or specialties with condition changes and transfers of care
Coding for Children With Special Health Care Needs Part 3
Authors:   American Academy of Pediatrics
Published: April 2022

Coding guidelines for non-face-to-face E/M services such as telephone care time and care plan oversight
Coding Clarification
Authors:   American Academy of Pediatrics
Published: April 2022

Correction to April 2010 issue regarding initial observation care codes 99218-99220
Pitfalls of Electronic Health Record Coding
Authors:   American Academy of Pediatrics
Published: April 2022

EHR limitations due to templates, inability to free text, and payer audits from changes in coding upon adoption of an EHR system
Examples: Using the Resource-Based Relative Value Scale Conversion Spreadsheet (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Medicare payments and conversion factors
You Code It! (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

E/M and critical care provided in the emergency department
Crosswalking ICD-9-CM to ICD-10-CM: Diseases of the Ear and Mastoid (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Increased specificity and new codes for ICD-10-CM
Payment Status for Newly Released Immunization Guidelines
Authors:   American Academy of Pediatrics
Published: April 2022

PCV13 and HPV vaccination coding and recommendations
Launching Your Career in Pediatrics
Authors:   American Academy of Pediatrics
Published: April 2022

Setting office hours based on desired style, market analysis, community needs, and other factors
New ICD-9-CM Codes for 2011
Authors:   American Academy of Pediatrics
Published: April 2022

New, revised, and deleted diagnosis codes becoming effective 10/01/10
Scenarios for New ICD-9-CM Codes
Authors:   American Academy of Pediatrics
Published: April 2022

8 scenarios to utilize 2011 codes 560.32, 799.51, 784.92, E007.3, V20.2, V13.65, 959.01, 780.33, 299.0, 787.62, 564.00, 787.63, 682.0, and V13.64
AAP to Lead Pediatric ICD-11 Efforts
Authors:   American Academy of Pediatrics
Published: April 2022

Pediatric Topic Advisory Group (TAG) to support the development of the 11th revision of ICD nomenclature
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

2-year-old with fever after 3 days of antibiotics for otitis media
Denials to Dollars: Payment for Limited Developmental Screening (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

List of payers and to-do list for 96110
AAP Pediatric Coding Newsletter™, Vol 5, No. 9 (June 2010), Clarification
Authors:   American Academy of Pediatrics
Published: April 2022

Clarification to Coding Conundrums regarding murmur referral to cardiologist and code V71.7
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Payment and documentation for tuberculosis skin test
New, Revised, and Deleted CPT Codes for 2011: Evaluation and Management Services
Authors:   American Academy of Pediatrics
Published: April 2022

Changes for time-based, service-level, hospital observation services, and critical care transport codes
The Effect of the Health Reform Laws on Coding and the Resource-Based Relative Value Scale
Authors:   American Academy of Pediatrics
Published: April 2022

Health Reform effects on Access to Care, Coverage, and Coding and Payment Rates
New, Revised, and Deleted CPT Codes for 2011: Medicine, Surgery, and Category III Codes
Authors:   American Academy of Pediatrics
Published: April 2022

Coding changes for vaccines, toxoids, neuro-cognitive, mental status, speech testing, gastroenterology, otorhinolaryngologic; cardiovascular; neurology, neuromuscular; chemotherapy; surgery, digestive system; aortic valve, automated audiometry, esophageal motility, gastrointestinal tract, and acoustic respiratory services
Denials to Dollars: Payment for Vision and Hearing Screening
Authors:   American Academy of Pediatrics
Published: April 2022

Appealing denial or bundling of 99173 and 92551
Point to Ponder: Actual Time Spent Falls Between 2 Typical Times
Authors:   American Academy of Pediatrics
Published: April 2022

When time spent is exactly halfway between two typical times for E/M codes
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

New or established patient reporting for physicians in a large group practice
Coding for Office Laboratory Procedures: Clearing the Confusion
Authors:   American Academy of Pediatrics
Published: April 2022

Selecting appropriate CPT laboratory codes 80000--89398
Subspecialty Corner: Pediatric CPT Category II Codes for Major Depressive Disorder (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Requirements and modifier descriptors for reporting CPT Category II codes for major depressive disorder (MDD) for patients aged 6 through 17 years
Crosswalking ICD-9-CM Codes to ICD-10-CM: Obesity and Related Codes
Authors:   American Academy of Pediatrics
Published: April 2022

Comparison of ICD-9-CM Codes/Descriptiors for Obesity and their ICD-10-CM conversions.
Q&A (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Management of ADHD provided over the telephone and immunization counseling performed with preventive medicine services compared to immunization administration codes.
Denials to Dollars
Authors:   American Academy of Pediatrics
Published: April 2022

Documenting cost savings for seeing patients in the office on an emergent bases over seeing them in the emergency department to ensure payment for special services codes 99050-99060
What Is Modifier 33?
Authors:   American Academy of Pediatrics
Published: April 2022

Preventive service modifier 33 for reporting preventive services that have been cited in preventive service mandates in response to PPACA and cost sharing imposition
Erratum: “A Primer on the National Drug Code”
Authors:   American Academy of Pediatrics
Published: April 2022

Code 90710 for Adacel
Important Update: Reporting Immunization Administration (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Payment of up to 7 additional vaccine components for combination vaccines, such as catch-up or admission
Pearls for the Primary Care Pediatrician and Specialist: Reporting Manual and Automated Audiometry Services
Authors:   American Academy of Pediatrics
Published: April 2022

Codes for reporting manual and automated hearing testing 92550--92587 and 0298T--0212T
Common Diagnosis Coding Blunders: Reporting V Codes
Authors:   American Academy of Pediatrics
Published: April 2022

Specific guidelines for V01.0-V91.99 classification of factors influencing health status and contact with health services
Common Procedure Coding Faux Pas
Authors:   American Academy of Pediatrics
Published: April 2022

Common mistakes for Nasal Aspiration, Vision Screening, Eye Problem or Condition, Hair Tourniquets, Complete Blood Count, Peak Flow, and Removal of Cerumen
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Hospital care over several days, seeing a new patient but not performing minimal required key components for the category, and observation patient changed to inpatient
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Bronchiolitis in a 2-month-old boy admitted by a resident after history and evaluation
Q&A (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Early sexual development, V65.5 (feared complaint), and service provided to the parent without the child present
CPT 2012 Changes
Authors:   American Academy of Pediatrics
Published: April 2022

Changes effective January 1, 2012 to E/M Services, including Hospital Observation, Initial Observation Care, Prolonged Services with and without Direct Patient Contact, Critical Care, Intensive Care, and Transport
CPT 2012 Defines “Qualified Health Care Professional”
Authors:   American Academy of Pediatrics
Published: April 2022

Official definition of qualified health care professional as distinct from clinical staff
Changes in CPT Codes for 2012
Authors:   American Academy of Pediatrics
Published: April 2022

Changes for immunization administration, audiologic function tests, and pulmonary diagnostic testing and therapies, CNS tests, highly complex drug & biologic agent administration, etc.
Are You Hassled?
Authors:   American Academy of Pediatrics
Published: April 2022

If you have an issue with a third-party payer, submit a Hassle Factor Form from the AAP Member Center
Incident to and Reporting Split/Shared Evaluation and Management Services for Noncritical Care Services
Authors:   American Academy of Pediatrics
Published: April 2022

Billing for services provided directly, by another physician or NPP, and by another employee when provided within incident-to requirements
The A, B, C, and Es of Coding for Encounters Due to Catastrophic Events
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting guidelines for E codes reported as secondary diagnoses when the cause of an adverse effect is a catastrophic event
2012 Medicare Physician Fee Schedule: Good News and Bad News
Authors:   American Academy of Pediatrics
Published: April 2022

Summary of changes made to the 2012 CMS RBRVS, including Car Seat/Bed Testing, 5-Year Review Codes, Status Indicator, and Immunization Administration
Erratum: “Changes in CPT Codes for 2012”
Authors:   American Academy of Pediatrics
Published: April 2022

Update to code 90654 regarding FDA approval of the influenza virus vaccine
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting hemochromatosis, administering purified protein derivative, vaccine counseling by CNPs, and 37 minutes of face-to-face visit counseling
Transitioning to 10
Authors:   American Academy of Pediatrics
Published: April 2022

General Equivalence Mappings (GEMs) to crosswalk ICD-9-CM codes to ICD-10-CM codes with source code, target code, and flag
A Burning Question
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting for treatment of burns from heat and sun
Place of Service
Authors:   American Academy of Pediatrics
Published: April 2022

Place of Service errors in reporting and importance for payment systems
How Compliant Is Your Coding and Billing?
Authors:   American Academy of Pediatrics
Published: April 2022

Checklist to evaluate your practice’s coding and billing resources, procedures, and education
Coding for Anxiety and Bereavement
Authors:   American Academy of Pediatrics
Published: April 2022

Commonly used codes to report services provided in the office setting for children experiencing anxiety or bereavement, including evaluation, consultation, prolonged service, team conference, and DSM-PC
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting unrelated services provided to the same patient in multiple visits on the same calendar day
Common Modifier Coding Faux Pas
Authors:   American Academy of Pediatrics
Published: April 2022

Corrections to common mistakes practices make when reporting modifiers such 24, 25, 50, 51, and 59
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Removing an embedded earring with and without incision in ICD-9-CM
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Correcting claim or requesting review for low payment of EpiPen Jr, chemical cautery of umbilical granuloma, and diagnosing cellulitis
More CPT 2013 Changes
Authors:   American Academy of Pediatrics
Published: April 2022

Code changes for pharmacologic management, allergy testing, sleep medicine, infusion, vision screening, flaps and grafts, Denis Browne strapping, lungs and pleura, laboratory, and qualified health care professionals
Influenza Vaccination Reminder
Authors:   American Academy of Pediatrics
Published: April 2022

Influenza vaccination codes for the pediatric population for 2012-2013
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

ICU admission for possible drug overdose
Subspecialty Corner: CPT 2013 Psychiatry Codes (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Overview of the major changes and reporting guidelines including new code structure and terminology for diagnostic serivces, psychotherapy, and other psychiatric services provided in any setting by a physician or other qualified health care professional
Transitioning to 10: Health Risk Assessments
Authors:   American Academy of Pediatrics
Published: April 2022

ICD-10-CM F, O, and Z codes for routine health examinations for children older than 28 days with or without abnormal findings
Denials to Dollars: Health Risk Assessment
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting diagnosis codes linked to 99420 to avoid denials
History of Medicare Conversion Factors Grid (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Medicare conversion factors 1992-2013
A Closer Look at Complex Chronic Care Coordination
Authors:   American Academy of Pediatrics
Published: April 2022

Capturing and documenting the coordinated activities of the physician-led care team for complex chronic care.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Congenital and acquired conditions of the toe and computer-based developmental training sessions.
Recovery Audit Contractors: Not Just for Medicare
Authors:   American Academy of Pediatrics
Published: April 2022

The expanding and evolving role of RACs from Medicare to Medicaid
Staying in Compliance With National Correct Coding Initiative Edits
Authors:   American Academy of Pediatrics
Published: April 2022

Integrating coding edits into a compliance program, modifiers, and quarterly review to avoid unexpected claim denials
Meaningful Use Incentives and Compliance
Authors:   American Academy of Pediatrics
Published: April 2022

Compliance elements for obtaining and keeping meaningful use incentive payments, including supporting documentation, state Medicaid program guidance, HIPAA compliance, and security risk analysis reviews
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

An 18-year-old male preventive service visit
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Application of fluoride varnish and Depo-Provera contraceptive injections
Compliance: Beyond Coding (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Reviews and updates to the underlying support system in conjunction with a coding compliance program: scheduling, service capture, reconciliation, and payment postings
Bright Futures in Coding
Authors:   American Academy of Pediatrics
Published: April 2022

Preparing the practice for increased delivery of recommended pediatric preventive health care and appropriate reporting of these and other services provided on the same date
Coding Physicals
Authors:   American Academy of Pediatrics
Published: April 2022

Appropriate coding for camp, school, sport, or other physicals requested after or in lieu of routine examinations
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

VFC for 18-year-old patients and rapid kits for influenza testing
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Applying obtaining a history from someone other than the patient in pediatrics for medical decision-making
CPT 2013 Errata
Authors:   American Academy of Pediatrics
Published: April 2022

Corrections to Evaluation and Management Table, added instruction for Pediatric Critical Care Transport, and Technical Corrections to Code Descriptors
Transitioning to 10: Back-to-School Bugs
Authors:   American Academy of Pediatrics
Published: April 2022

Diagnosis codes for common back-to-school bugs and ailments, including academic problems, backpack strain, fever, lice, nausea, and separation anxiety
Subspecialty Corner: Fetal Echocardiography and the Role of Same-Day Evaluation and Management
Authors:   American Academy of Pediatrics
Published: April 2022

Fetal heart imaging, referral, and counseling
Beyond Coding: Health Program Exclusion
Authors:   American Academy of Pediatrics
Published: April 2022

Guideance issued by the Office of Inspector General regarding screening potential employees and contractors for payment from federal health care programs
Diagnosis Coding of Known or Suspected Fetal Anomaly
Authors:   American Academy of Pediatrics
Published: April 2022

Diagnosis coding guidelines for maternal and fetal conditions
Q&A (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Newborn care E/M services for an abnormality, diagnosis codes for probable or suspected conditions,
More Than Code Changes: CPT 2014 Clarification of Appendix C
Authors:   American Academy of Pediatrics
Published: April 2022

Changes in clinical examples for E/M service codes by specialty
CMS Confirmation: Status of 3 Chronic Conditions
Authors:   American Academy of Pediatrics
Published: April 2022

Practical update to CMS guidance to use 1997 documentation guidelines for choosing level of examination
Non–face-to-face Care Options in 2014
Authors:   American Academy of Pediatrics
Published: April 2022

New CPT codes for complex chronic care coordination (CA), transitional care management (TCM), and interprofessional consultations for addressing overall complex health care needs
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Non--face-to-face inter-facility transport supervision and initial-day critical care of a neonate provided by the same physician, needle puncture to drain an abscess, type 2 national provider identifier (NPI) with a type 1 NPI nurse practitioner, and relative value unit (RVU) credit for remote consultation to physician by phone or Internet
Transitioning to 10: Documentation and Coding of Otitis Media
Authors:   American Academy of Pediatrics
Published: April 2022

Preparing for ICD-10-CM using common conditions, dual coding, and a table of documentation elements
Transitioning to 10: Documentation of Asthma
Authors:   American Academy of Pediatrics
Published: April 2022

Preparing for ICD-10-CM and the various changes to asthma classifications, with tips and a table of documentation elements.
AMA RUC Now Publishing Minutes and Vote Counts (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

An explanation of, and link to, the new AMA policy.
Well-Child Services Policy
Authors:   American Academy of Pediatrics
Published: April 2022

Policy to post to educate patients and caregivers about Bright Futures, the ACA, and payment terms and definitions
You Code It! (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Exacerbation of childhood asthma and a URI in an 8-year-old boy seen by a hospitalist with an interview, examination, and counseling
Professional Component Services: More Than Codes
Authors:   American Academy of Pediatrics
Published: April 2022

Review of the required elements in addition to codes for correct reporting and proper claim payment in relation to diagnosic services.
Transitioning to 10: Documenting Abdominal Pain or Tenderness
Authors:   American Academy of Pediatrics
Published: April 2022

Documentation requirement and ICD-10 code selection as pertaining to the commonly reported topic of abdominal pain.
Adaptive Behavior Assessments and Treatment
Authors:   American Academy of Pediatrics
Published: April 2022

A review of the current CPT Category III codes regarding adaptive behavior assesment and treatment.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

ICD-10 delay spurs ICD-11 query; and split/shared services in the office setting.
Oral Health Services Update
Authors:   American Academy of Pediatrics
Published: April 2022

New codes for oral health risk assessment as part of the universal preventative services recommendations.
You Code It! (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Split service of newborn visit, patient consultation, and circumcision.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Observation in the physician office; and an diagnosis codes for an automobile accident with no signs of injury.
Reporting the National Drug Code: A Refresher
Authors:   American Academy of Pediatrics
Published: April 2022

Answer lingering questions on the reporting of national drug codes for vaccines and drugs.
Newborn Preventive Care: Revisiting the 3- to 5-Day Visit
Authors:   American Academy of Pediatrics
Published: April 2022

Codes and guidelines for the initial newborn well-child visits are reviewed with examples and scenarios.
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Complications from constipation are explored along with phone consultation.
2015 ICD-10-CM: The Freeze Continues
Authors:   American Academy of Pediatrics
Published: April 2022

Update on the ICD-10-CM code freeze and implementation.
Denials to Dollars: Insurance Coverage of the 3- to 5-Day Visit (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Changes to payer coverage of newborn preventive well-child visits.
CPT 2015 Changes: Surgery and Medicine (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Further outlining and explanation of the 2015 CPT changes, focusing on the Surgery and Medicine sections of the code set.
New Policy Statement on Care Coordination & Free Access to Online Curriculum
Authors:   American Academy of Pediatrics
Published: April 2022

The new AAP policy statement and its intention is reviewed.
You Code It!
Authors:   American Academy of Pediatrics
Published: April 2022

Laceration injury with splinter and incision.
New Year, New Out-of-pocket Expenses
Authors:   American Academy of Pediatrics
Published: April 2022

Tips to minimize new year delays.
Coding Challenge: New and Revised CPT Codes
Authors:   American Academy of Pediatrics
Published: April 2022

Can you match the code to it's corresponding service?
New Year’s Resolution: Update Coding Resources
Authors:   American Academy of Pediatrics
Published: April 2022

Are your coding resources up to date?
Transitional Care Management: Questions and Answers (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Lingering questions to the recent revisions to chronic care codes are addressed.
Back to Basics: The National Correct Coding Initiative
Authors:   American Academy of Pediatrics
Published: April 2022

A refresher on NCCI with some basic questions and answers.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Fracture care after initial treatment.
Coding Challenge
Authors:   American Academy of Pediatrics
Published: April 2022

Test your knowledge of procedure codes and modifiers.
Transitioning to 10: Updating Resources
Authors:   American Academy of Pediatrics
Published: April 2022

Update your ICD-10 resources with our Coding Quick Reference for Bright Fugres Services (ICD-10-CM).
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Newborn care; Dog bite; Extracorporeal Membrane Oxygenation; Teaching hospital.
Alphabetic Reference to ICD-10-CM Guidelines
Authors:   American Academy of Pediatrics
Published: April 2022

The most relevant guidelines in an easy-to-access format.
CPT® 2016 Changes: Surgery, Radiology, and Medicine
Authors:   American Academy of Pediatrics
Published: April 2022

Changes to impacted cerumen, diagnostic x-ray, vaccines/toxoides, among others are examined in detail.
The Primary Care Exception: A Refresher
Authors:   American Academy of Pediatrics
Published: April 2022

PATH and PCER guidelines for teaching physicians.
Diagnosis Coding for Suspected or Confirmed Abuse
Authors:   American Academy of Pediatrics
Published: April 2022

ICD-10-CM may offer some clarification on diagnosing suspected or confirmed abuse.
Denials to Dollars: Revisiting Guidelines for Perinatal Conditions
Authors:   American Academy of Pediatrics
Published: April 2022

As denials on claims continue for reporting conditions that orginate in the perinatal period, this article will offer some guidance.
Coding for Advance Care Planning
Authors:   American Academy of Pediatrics
Published: April 2022

Coding for ACP and end-of-life discussions.
Documentation of Clinical Staff Visits
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting for E/M services as performed by clinical staff.
ICD-10-CM Coding for Open Wounds
Authors:   American Academy of Pediatrics
Published: April 2022

The significant ICD-10 changes to coding for open wounds is covered in depth.
Coding Challenge: When Is Modifier 25 Appropriate?
Authors:   American Academy of Pediatrics
Published: April 2022

Test your knowledge of Modifier 25.
Physician or Qualified Health Care Professional Face-to-face and Unit/Floor Time
Authors:   American Academy of Pediatrics
Published: April 2022

Are you capatalizing on specific E/M services which may be separately reportable?
Transitioning to 10: Questions and Answers
Authors:   American Academy of Pediatrics
Published: April 2022

The Q&A on the most frequent queries of the past 6 months.
Transitioning to 10: Abnormalities Ruled Out
Authors:   American Academy of Pediatrics
Published: April 2022

Although familiarity can breed a more precise dislike, it can also ease the burden of change. Six months after the implementation…
Evaluation and Management: A Closer Look at Examination Guidelines
Authors:   American Academy of Pediatrics
Published: April 2022

Physicians (and other qualified health care professionals) who provide evaluation and management (E/M) services have the choice of using the 1995 or 1997 version of documentation guidelines published by the Centers for Medicare & Medicaid Services (CMS)…
Coding Challenge: Units of Service (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Correct reporting of units of service (UOS) is a key component of medical billing. Many code descriptors provide the basis for determining UOS for a service or supply…
Preventive and Problem-Oriented Care on the Same Date
Authors:   American Academy of Pediatrics
Published: April 2022

One of the most frequently asked questions we hear from physicians and coders is how to appropriately report a problem-oriented office or other outpatient evaluation and management service on the same date as a preventative medicine service…
Skin Lacerations: Complexity, Location, and Size
Authors:   American Academy of Pediatrics
Published: April 2022

Reporting repair of skin lacerations can seem complicated by the number of codes and length of prefatory language appearing with Current Procedural Terminology (CPT®) codes for wound repair. However, most lacerations only require consideration of 3 factors…
HIPAA Update: Release of Records
Authors:   American Academy of Pediatrics
Published: April 2022

Physician practices should be aware of recent guidance from the US Department of Health and Human Services (HHS) on an individual’s right to see and receive copies (on request) of the information in his or her medical or other health records.
You Code It: Breakdown of Key Components (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

This article breaks down the key components used to select the level of service for the patient scenario in “You Code It!”
Q&;A (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

PICC lines and critical/intensive care; Local reaction to vaccination
Coding for Services Related to Breastfeeding
Authors:   American Academy of Pediatrics
Published: April 2022

When addressing issues with breastfeeding, it is important to determine if the problem is one of the baby or the mother because most health insurance plans require reporting of problems addressed for the mother to the mother’s health plan.
Modify Your Telemedicine Services in 2017!
Authors:   American Academy of Pediatrics
Published: April 2022

Telemedicine has been a growing area of interest in recent years. Coverage and reporting requirements have varied not only by payer but by plan, requiring verification not only of coverage but reporting instructions. This article offers guidance on how to implement the new CPT® modifier used to indicate that services were provided via real-time audio/video telecommunications.
Q&A
Authors:   American Academy of Pediatrics
Published: April 2022

Electronic cigarette exposure; Congenital nevus
When Are Modifiers Necessary?
Authors:   American Academy of Pediatrics
Published: April 2022

The correct use of modifiers is a constant source of questions. This article offers guidance on CPT modifier use, provides common indications for using modifiers, and tips on when modifiers are not necessary.
Coding Challenge: Incident-to Reporting (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Can you identify which of the following scenarios meet the standard requirements for reporting services as incident to a physician’s or qualified health care professional’s services? Answers and rationale follow each scenario.
New Guidelines for Diagnosis Coding
Authors:   American Academy of Pediatrics
Published: April 2022

The fiscal year 2017 guidelines for use of International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) apply to all services from October 1, 2016, through September 30, 2017. Revisions to these guidelines bring new guidance on reporting conditions and reasons for encounters that may be commonly reported in pediatric practice.
Your AAP at Work! AAP Responds to Denial of Immunization Administration
Authors:   American Academy of Pediatrics
Published: April 2022

This article reports on efforts by the AAP to seek an increase in the number of units allowed per day for immunization administration through 18 years of age.
ICD-10-CM: Influenza and Its Manifestations
Authors:   American Academy of Pediatrics
Published: April 2022

This article discusses influenza and related conditions reporting guidelines from International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM).
Coding Challenge: Bilateral Services Answers
Authors:   American Academy of Pediatrics
Published: April 2022

Answers to the questions posed in the Coding Challenge article.
Coverage May Be Contagious: Watch What Medicare Does
Authors:   American Academy of Pediatrics
Published: April 2022

Each year, the Centers for Medicare & Medicaid Services (CMS) publishes proposed and final rules for changes to the Medicare Physician Fee Schedule (MPFS). This issue of AAP Pediatric Coding Newsletter™ highlights some of the MPFS changes for 2017.
Non–face-to-face Prolonged Services: Are You Missing Out on Payment?
Authors:   American Academy of Pediatrics
Published: April 2022

In the past, benefits were provided for direct prolonged physician services, but payment for indirect (non–face-to-face) prolonged services was rare. The Centers for Medicare & Medicaid Services (CMS) has indicated that Medicare will now pay 2 codes which describe prolonged services without direct patient contact. This article offers reporting instructions for utilizing those codes.
You Code It! Chronic Care Management Services (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Example scenarios for reporting chronic care management services.
New Vaccine Codes Effective July 1, 2017
Authors:   American Academy of Pediatrics
Published: April 2022

The American Medical Association (AMA) Current Procedural Terminology (CPT®) Editorial Panel approved changes to vaccine codes for publication online January 1, 2017, and implementation on July 1, 2017. This article provides an overview of the changes.
Coding Challenge: Inhalation Treatments
Authors:   American Academy of Pediatrics
Published: April 2022

Test your knowledge to determine the correct procedure codes based on instruction from either Current Procedural Terminology (CPT®) or Medicaid National Correct Coding Initiative (NCCI).
Coding Challenge Answers: Inhalation Treatments
Authors:   American Academy of Pediatrics
Published: April 2022

Answers to the questions posed in the Coding Challenge article.
Inhalation Treatments: Understanding CPT® and Medicaid Instructions (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Inhalation treatments for acute airway obstruction are an important element of care for patients with asthma and other respiratory conditions. Coding for these services appears straightforward based on Current Procedural Terminology (CPT®) instruction. However, changes to the National Correct Coding Initiative (NCCI) Policy Manual for Medicaid Services for 2017 remind us that these services must be reported based on payer guidelines when these differ from CPT.
Subspecialty Corner: Coding for Complications of Neonatal Circumcision
Authors:   American Academy of Pediatrics
Published: April 2022

Neonatal circumcision is a relatively simple procedure, but complications can arise. This article discusses how to report services associated with addressing complications and related procedural services.
You Code It! Preventive Counseling
Authors:   American Academy of Pediatrics
Published: April 2022

An example scenario where a pediatrician counsels a family on precautions to take before traveling to South America.
ICD-10-CM Codes and Claim Form
Authors:   American Academy of Pediatrics
Published: April 2022

Coding is complex; it is so much more than simple code selection. There are many pieces of the puzzle that must come together on a claim form in order to ensure proper payment of services. This article reviews documentation of the diagnoses for services rendered and the appropriate linking of diagnoses to services.
Influenza Immunization Coding 2017–2018
Authors:   American Academy of Pediatrics
Published: April 2022

It’s time again to refresh your influenza vaccine coding. This article includes the codes for the vaccine products that are specific to the pediatric population and are indicated as available for the 2017–2018 influenza season at the time of publication.
Q&A (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

ICD-10-CM: Conditions Originating in the Neonatal Period; CPT®: Modifier 50; CPT: Omalizumab Administration
2018 Updates in Evaluation and Management Coding
Authors:   American Academy of Pediatrics
Published: April 2022

Update on evaluation and management coding changes for 2018.
New Modifiers for Habilitative and Rehabilitative Services
Authors:   American Academy of Pediatrics
Published: April 2022

Update on new modifiers for habilitative and rehabilitative serices for 2018.
AAP Comments on Documentation Guidelines for E/M Services
Authors:   American Academy of Pediatrics
Published: April 2022

Overview of the issue and comments from the AAP on updating the Centers for Medicare & Medicaid Services (CMS) E/M coding requirements.
Sorting Out Care Management in 2018
Authors:   American Academy of Pediatrics
Published: April 2022

Discussion and tips on how to report different levels and types of care management services.
Commentary: A Call to Modernize CMS Evaluation and Management Coding Requirements (Online Exclusive)
Authors:   American Academy of Pediatrics, Lehmann Christoph U. , Kressly Susan J.
Published: April 2022

A call for CMS to update documentation requirements for E/M coding to allow for further integration and utilization of electronic health records.
Coding Dietary Counseling: Weigh Your Options
Authors:   American Academy of Pediatrics
Published: April 2022

Pediatricians may spend a good deal of time and resources addressing weight and growth concerns often including counseling for diet and/or exercise. It’s important to know which codes apply to these services and which health care professionals may report each service.
Global Period Chart: Common Pediatric Procedures
Authors:   American Academy of Pediatrics
Published: April 2022

A quick reference to the global periods of some of the most common pediatric procedures.
You Code It! Removal of Sutures
Authors:   American Academy of Pediatrics
Published: April 2022

An example scenario in which a pediatrician is treating an established patient.
Evaluation and Management Coding: Feeding Problems
Authors:   American Academy of Pediatrics
Published: April 2022

Although coding for feeding problems based on the key components of history, physical examination, and medical decision-making is often sufficient to capture the physician work of the encounter, billing based on the time spent in counseling and/or coordination of care should also be a consideration.
Coding Challenge: Modifiers and Procedural Services (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Can you identify the correct modifiers for each of the following scenarios?
Procedure Coding: Removal of Impacted Cerumen
Authors:   American Academy of Pediatrics
Published: April 2022

Since Current Procedural Terminology® provides separate codes for removal of impacted cerumen with and without instrumentation, we must look at 2 different ways of providing and documenting these services.
Health Examination for Newborns Younger Than 8 Days
Authors:   American Academy of Pediatrics
Published: April 2022

This article contains the appropriate first-listed codes for the attending physician’s care during the birth admission and for post-discharge newborn health examinations.
Medicare Changes the Rule: Medical Student Documentation
Authors:   American Academy of Pediatrics
Published: April 2022

Documentation of an evaluation and management (E/M) service by a medical student can be used to support the teaching physician’s billing of the E/M service provided the documentation shows the teaching physician verified the history and personally performed the physical examination and medical decision-making (MDM).
You Code It! Newborn Care (Answers) (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Did you assign the appropriate International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) and Current Procedural Terminology® codes for the scenario?
Preparing for Preparticipation Physical Evaluations
Authors:   American Academy of Pediatrics
Published: April 2022

What codes will be reported for preparticipation physical evaluations depend on the extent of service provided, the patient’s benefit plan, and your practice’s proactive handling of requests for sports physicals and other common encounters for evaluation and approval for participation.
The Value of Codes
Authors:   American Academy of Pediatrics
Published: April 2022

It is important to have some understanding of how the value of codes affects your practice. Even as payment shifts toward a quality and cost basis, it is likely that the values assigned under the fee-for-service methodology will still affect payment.
You Code It! Injury and Illness Managed at the Same Encounter
Authors:   American Academy of Pediatrics
Published: April 2022

This month’s You Code It! features cases of injury and illness managed at the same encounter.
Evaluation and Management Crossword
Authors:   American Academy of Pediatrics
Published: April 2022

See if you can complete the Evaluation and Management Crossword puzzle!
Evaluation and Management Crossword (Answer Key) (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

Answers to the Evaluation and Management Crossword puzzle are provided.
Responding to Payer Audits: Have a Policy and Procedure
Authors:   American Academy of Pediatrics
Published: April 2022

Each practice should have policies explaining how requests for medical records and chart reviews and audits will be handled, as well as the process for handling requests. This article presents tips for creating policies and procedures to help your practice identify and respond appropriately to the increasing demand for chart reviews and audits.
Evaluation and Management: A Continuum of Pharyngitis/Strep Throat
Authors:   American Academy of Pediatrics
Published: April 2022

In this article, we present a new continuum model for pharyngitis, including streptococcal infection.
You Code It! Two Problems, One E/M Service (Answers) (Online Exclusive)
Authors:   American Academy of Pediatrics
Published: April 2022

The answer to this month's You Code It! scenario is presented here.
Current Procedural Terminology (CPT®) 2019: Code Changes
Authors:   American Academy of Pediatrics
Published: April 2022

This article provides an overview of some of the Current Procedural Terminology code changes that may affect reporting of pediatric services on and after January 1, 2019.
Digitally Stored Data Services/Remote Physiologic Monitoring
Authors:   American Academy of Pediatrics
Published: April 2022

In expanding recognition of the value of remote physiologic monitoring and collection and interpretation of physiologic data, 3 new codes and a revised code are included in the evaluation and management (E/M) section of Current Procedural Terminology 2019 in the non–face-to-face E/M services category.
Interprofessional Assessment and Management 2019: Reporting Referring and Consulting Services
Authors:   American Academy of Pediatrics
Published: April 2022

Codes for interprofessional telephone and Internet  consultation are changed in Current Procedural Terminology (CPT®) 2019 to include communication via EHR but still include verbal and written reports from the consultant to the referring provider. Get all the details here.
Office Evaluation and Management Services: Don’t Forget to Document Time
Authors:   American Academy of Pediatrics
Published: April 2022

Time-based billing of evaluation and management (E/M) codes has been a beneficial but underused option to physicians when billing for E/M services that are predominantly spent in counseling and/or coordination of care. Current Procedural Terminology (CPT®) allows selection of the code with the time nearest the actual time of service.
You Code It! Screening for Developmental Disorders at a Well-Child Visit
Authors:   American Academy of Pediatrics
Published: April 2022

What are the appropriate procedure and diagnosis codes for this month’s encounter?
Coding Challenge Answers: 2019 Coding Guidelines and Instructions
Authors:   American Academy of Pediatrics
Published: April 2022

The answers to this month’s Coding Challenge can be found here.
New Year’s Resolution: Give Your Billing Practices a Checkup
Authors:   American Academy of Pediatrics
Published: April 2022

A great way to start off the new year is to evaluate how well your practice functions in activities that support practice revenue. Are your coding and billing tools and processes effective?
You Code It! Use of Multiple Questionnaires in an Evaluation and Management Service
Authors:   American Academy of Pediatrics
Published: April 2022

This month’s You Code It! relates to the use of multiple questionnaires in an evaluation and management service.
You Code It! Answers: Use of Multiple Questionnaires in an Evaluation and Management Service
Authors:   American Academy of Pediatrics
Published: April 2022

This month’s You Code It! answers are given here.