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Pediatric Coding Alert

E/M Coding:
Check Your Virtual Check-In Coding Comprehension
Use this FAQ, know when you can, cannot bill for telephone E/Ms. If your pediatrician is ... Read more
Guidelines:
Do These 4 Things to Keep Your PFSH Documentation Clean
Know your history by learning these pro tips. You may know all the elements that go into ... Read more
Procedure Coding:
Follow This Guide for Scrupulous Suture Removal Coding
And make sure these modifiers don't make a mess of your claim. It's a fact: kids get hurt... Read more
You Be the Coder:
Bring These Codes Onboard for Online Addiction
Question: A mother came in with her daughter concerned that she was spending too much time... Read more
Reader Question:
Know Congenital, Acquired for Laterality in Short Limb Dx
Question: Our pediatrician saw a patient and documented that the patient's left femur and ... Read more
Reader Question:
Seek This Modifier Substitution Solution
Question: We have been billing 94640 with 94664, using modifier 59 on the nebulizer d... Read more
Reader Question:
Look Past Index to Find Fungal Sinusitis Dx
Question: Our pediatrician diagnosed one of our patients with fungal sinusitis, but I can'... Read more
News You Can Use:
Stay on Top of These New ICD-10 Codes, Guidelines
Know what's going to affect your coding come October 1. While this year's changes to the ... Read more
Coding Quiz:
Answer These Questions, Master Modifier 25 Use
And sort out these scenarios to add to your understanding. You've used modifier 25 (Signi... Read more
Procedure Coding:
Follow These Steps to Strapping and Splinting Success
And solve this encounter to sharpen your skills. As simple as strapping and splinting pro... Read more
Coding Quiz Answers:
Check Your Answers to Our Modifier 25 Coding Quiz
Find out if you have what it takes to be a modifier master. Once you've answered the quiz... Read more
Reader Question:
Document BMI, Increase Knowledge
Question: If a patient's body mass index (BMI) is in the normal range, do we need to inclu... Read more
Reader Question:
Locate These Codes for Diaper Rash Relief
Question: Our pediatrician recently saw an infant that presented with a severe case o... Read more
You Be the Coder:
Don’t Take a Risk on Prescription Refill Reporting
Question: Can you count a routine prescription refill as a moderate level of risk whe... Read more
Condition Spotlight:
Add This Advice to Your Asthma Coding Armory
Use this guide to capture conditions correctly. You know that the J45.- (Asthma) codes ar... Read more
Guidelines:
Can You Solve These 4 Neonatal Transfer of Care Scenarios?
Get them wrong, and your bottom line could be in jeopardy. The days after a child is born... Read more
Clip & Save:
Use This Chart to Code Common Summer Conditions
And make sure you have your E/M, procedure coding ready to roll. Summer is the time for c... Read more
Reader Question:
Assess Modifier Use in This Multiple Test Claim
Question: I have a question regarding administering the Vanderbilt assessment. We typicall... Read more
Reader Question:
Stick to Specificity in This Dx Dilemma
Question: One of our pediatricians documented a patient's chief complaint as abdominal pai... Read more
You Be the Coder:
Beware of Procedure Type, Global Period, in This Neonate Encounter
Question: Our pediatrician just performed services for a newborn. On the first day, she pe... Read more
Practice Management:
Take These 4 Simple Steps, Perform Successful, Stress-Free Self-Audits, Part 2
Local analysis and education provide valuable lessons … literally. In last month's Pedi... Read more
E/M Coding:
Get All Your 99211 Questions Answered With This FAQ
Find out who should provide the service, and how and when it should be documented. Of all... Read more
Case Study Corner:
Know Acne Type, Procedures, to Ace This Case Study
And peek into payer policies to avoid cosmetic procedure problems. For many adolescents, ... Read more
Reader Question:
Document Key Factors to Avoid Immunization Denials
Question: Our pediatric practice is receiving denials on 90460/90461. What should we do to... Read more
Reader Question:
Factor Service Type Into This New vs. Established Calculation
Question: A patient came in for an evaluation and management (E/M) service on February 19,... Read more
You Be the Coder:
Enhance the E/M in this Epistaxis Encounter
Question: Our pediatrician just saw an established patient with a nosebleed. The patient's... Read more
Practice Management:
Take These 4 Steps to Perform Successful, Stress-Free Self-Audits: Part 1
Our experts offer insights, proven strategies for this important management tool. Self-au... Read more
Guidelines:
Make the Decision, Add Up the Points in This MDM Calculation
And know that numbers alone don't always equate to the correct E/M level. More than histo... Read more
Clip & Save:
Use This Chart for Accurate ADHD/ADD/Coexistent Condition Coding
Don't let subtle differences between conditions lead to coding errors. On the surface, di... Read more
Reader Question:
Keep Areas, Systems Separate for Accurate E/M Levels
Question: We are performing a voluntary self-audit of our evaluation and management (E/M) ... Read more
Reader Question:
Test Your Understanding of This Inclusive Dx
Question: We just got denied on a claim billed for strep and influenza A and B test using ... Read more
You Be the Coder:
Follow This Advice, Calculate Risk Level With Confidence
Question: I'm trying to determine the level of risk in the following encounter: a patient ... Read more
Practice Management:
Follow This Advice, Keep Your Practice’s Future Bright
Bright Futures guidelines can benefit your practice while helping your patients. Now in i... Read more
Procedure Coding:
Answer These 4 Questions, Enhance Your Cerumen Removal Coding
Don't let familiarity with this common procedure breed contempt. Cerumen removal is one o... Read more
Mythbusters:
Bust These 4 Myths for Clear Respiratory Reporting
Don't let bundling, modifier use obstruct your documentation. With all their confusing te... Read more
Reader Question:
Take Time to Report Travel Counseling Encounter
Question: One of our high-school-age patients is preparing for a monthlong trip to Kenya. ... Read more
Reader Question:
Separate Services, Mend This Modifier Mess
Question: We were denied payment on 99214-25, B07.8, and 17110 for removal of a verruca pl... Read more
Reader Question:
Establish These Details for Clean Trach Tube Removal Documentation
Question: Our pediatrician recently changed a trach tube in our office. How should we bill... Read more
You Be the Coder:
Dial in Location for Telemedicine Success
Question: We would like to start using telehealth in our pediatric practice — we think i... Read more
News You Can Use:
Know Which Peds Services CMS Devalued in 2019
Many commonly used codes will negatively impact this year's bottom line. As we reach the ... Read more
Guidelines:
Reduce Prolonged Coding Agony With These 4 Hints
Go beyond reporting time to claim additional service time successfully. You've probably c... Read more
ICD-10 Coding:
Take This Advice for Flawless Worried Well Coding
Hint: Knowing your encounter code options and ICD-10 guidelines pays. The scenario is all... Read more
Reader Question:
Improve Your Coding Health with This New Flu Vaccine
Question: Our dietician reviews electronic food logs sent in remotely on a weekly or month... Read more
Reader Question:
Assign Additional MDM Point Only if Supplemental Information Provided
Question: We recently took on a new patient who is deaf. The patient came with a family me... Read more
You Be the Coder:
Distinguish Distinct, Multiple Modifiers in This Separate Procedure Scenario
Question: Our provider administered an ear lavage to remove impacted cerumen in one o... Read more
ICD-10 Guidelines:
Let These 3 Tips Guide You to Accurate Neonate Dx
Hint: P-code guidelines, age provide the key. Using codes from ICD-10 Chapter 16: Certain... Read more
Coding Quiz:
Take This Quiz, Review Your ROS Knowledge
Let these answers provide you with the who, what, how, and why of system review recording.... Read more
Case Study Corner:
Code by the Numbers for HPV Vaccination Success
Know patient age, dose schedule for precision immunization coding. Since 2006, the preval... Read more
Coding Quiz Answers:
Check Your Answers to Our ROS Coding Quiz
Once you've answered the quiz questions on page 11, compare your answers with the ones pro... Read more
Reader Question:
Explore Modifier Use, E/M, When Foreign Body not Found
Question: Our pediatrician just saw a young patient who complained of a sliver in his fing... Read more
Reader Question:
Documentation Key to Patient I&D
Question: Our provider recently drained an abscess on one of our patients. What documentat... Read more
Reader Question:
Use This New Z Code for Maternal Depression Screens
Question: As a part of the Medicare Meaningful Use program, we routinely screen mothers of... Read more
You Be the Coder:
Know When Age Is, is Not, a Factor in This Immunization Encounter
Question: We have a physician in our practice who orders nurses to administer 90696 to kid... Read more
Mythbusters:
Bust These 3 Myths to Start the New Year Right
Know what to mark up, and what to leave alone, in your old coding books. Even though 2018... Read more
E/M Coding:
Add to Your Understanding of New vs. Established
The 3-year rule isn't the only guideline you need to apply. On the surface, if you know t... Read more
Condition Spotlight:
Got Lactation Service Questions? We've Got Answers
Provider credentials key to accurate billing. Giving Mom the best possible advice about b... Read more
Reader Question:
Report Opened Vial Dose in This Vaccine Administration
Question: We did not have a children's dose of the flu vaccine in stock, so our provider a... Read more
Reader Question:
Modify Your Understanding of 'Distinct Service'
Question: We just got a denial from Blue Cross Blue Shield (BCBS) for using modifier 59 on... Read more
You Be the Coder:
Use Abnormal Finding Code With Mixed Well-Child Results
Question: Our provider saw a 6-year-old patient for a 99393 well-child check. At the encou... Read more