Pub Date : 2023-05-01DOI: 10.1542/pcco_book229_document007
This month’s Coding Hotline includes questions on coding for a suspected neonatal infection, attention deficit-hyperactivity disorder, and a teaching physcian’s presence.
本月的编码热线包括关于疑似新生儿感染、注意力缺陷多动障碍的编码问题，以及一名教学医生的在场。
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Pub Date : 2023-05-01DOI: 10.1542/pcco_book229_document005
This article reviews how age ranges are applied for critical care and other services for which code descriptors include an age range.
本文回顾了年龄范围如何应用于重症监护和代码描述符中包含年龄范围的其他服务。
{"title":"Understanding Age Ranges in Current Procedural Terminology®","authors":"","doi":"10.1542/pcco_book229_document005","DOIUrl":"https://doi.org/10.1542/pcco_book229_document005","url":null,"abstract":"This article reviews how age ranges are applied for critical care and other services for which code descriptors include an age range.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124698402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.1542/pcco_book229_document006
The American Medical Association has updated “Errata and Technical Corrections—CPT® 2023.”
美国医学协会更新了“勘误表和技术更正- cpt®2023”。
{"title":"AMA Issues Errata and Technical Corrections for CPT 2023","authors":"","doi":"10.1542/pcco_book229_document006","DOIUrl":"https://doi.org/10.1542/pcco_book229_document006","url":null,"abstract":"The American Medical Association has updated “Errata and Technical Corrections—CPT® 2023.”","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"43 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127443010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.1542/pcco_book229_document004
Most payers specify a timely filing period for submitting claims for medical services (eg, 60 or 90 days). Claims that are denied for untimely filing are those for which the original submission to the payer occurred after the timely filing period has elapsed. However, there are opportunities to seek a reconsideration of the claim when a practice can provide evidence of timely filing.
{"title":"Did You Know? Responding to an Untimely Filing Denial","authors":"","doi":"10.1542/pcco_book229_document004","DOIUrl":"https://doi.org/10.1542/pcco_book229_document004","url":null,"abstract":"Most payers specify a timely filing period for submitting claims for medical services (eg, 60 or 90 days). Claims that are denied for untimely filing are those for which the original submission to the payer occurred after the timely filing period has elapsed. However, there are opportunities to seek a reconsideration of the claim when a practice can provide evidence of timely filing.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127934269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.1542/pcco_book229_document003
While physicians and other qualified health care professionals (QHPs) typically rely on administrative staff to oversee or conduct billing activities, a general understanding of the process may prove beneficial should issues like staff turnover or a problem with outsourced billing result in unpaid claims. This article reviews An initial step in claims management to verify that claims submitted electronically were accepted by the clearinghouse and/or payer How acknowledgment reports can provide evidence that claims were filed within a payer’s timely filing period (eg, within 60 or 90 days of the date of service)
{"title":"Beyond Codes: Electronic Claims Acknowledgment Reports","authors":"","doi":"10.1542/pcco_book229_document003","DOIUrl":"https://doi.org/10.1542/pcco_book229_document003","url":null,"abstract":"While physicians and other qualified health care professionals (QHPs) typically rely on administrative staff to oversee or conduct billing activities, a general understanding of the process may prove beneficial should issues like staff turnover or a problem with outsourced billing result in unpaid claims.\u0000 This article reviews\u0000 An initial step in claims management to verify that claims submitted electronically were accepted by the clearinghouse and/or payer How acknowledgment reports can provide evidence that claims were filed within a payer’s timely filing period (eg, within 60 or 90 days of the date of service)","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128849823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.1542/pcco_book229_document002
Interprofessional consultations are reported when a treating physician or other qualified health care professional (QHP) consults another physician or QHP for their recommendation on managing a patient’s specific condition or problem by telephone, internet, or other electronic communication technology.
{"title":"Interprofessional Consultations: Medicaid and Children’s Health Insurance Program Coverage","authors":"","doi":"10.1542/pcco_book229_document002","DOIUrl":"https://doi.org/10.1542/pcco_book229_document002","url":null,"abstract":"Interprofessional consultations are reported when a treating physician or other qualified health care professional (QHP) consults another physician or QHP for their recommendation on managing a patient’s specific condition or problem by telephone, internet, or other electronic communication technology.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"211 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116408620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1542/pcco_book228_document001
This article highlights some of the 42 new International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes (not all 42 are appropriate for pediatrics) as well as information on guidelines and instructions for reporting each of the code categories.
{"title":"ICD-10-CM Updates for April 1 Implementation","authors":"","doi":"10.1542/pcco_book228_document001","DOIUrl":"https://doi.org/10.1542/pcco_book228_document001","url":null,"abstract":"This article highlights some of the 42 new International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes (not all 42 are appropriate for pediatrics) as well as information on guidelines and instructions for reporting each of the code categories.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"52 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121484104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1542/pcco_book228_document002
This article provides tips for reviewing and “cleaning up” coding and billing practices. This includes the following topics: Appropriate adoption of new codes and guidelines Reviewing accounts receivable processes and outcomes Updating any outdated resources and exploring new options
{"title":"Spring Cleaning: Time to Tidy Up Coding and Billing Processes","authors":"","doi":"10.1542/pcco_book228_document002","DOIUrl":"https://doi.org/10.1542/pcco_book228_document002","url":null,"abstract":"This article provides tips for reviewing and “cleaning up” coding and billing practices. This includes the following topics:\u0000 Appropriate adoption of new codes and guidelines Reviewing accounts receivable processes and outcomes Updating any outdated resources and exploring new options","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131019760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1542/pcco_book228_document003
This article addresses the following topics: Current Procedural Terminology (CPT) codes for prolonged evaluation and management (E/M) service codes are reported based on the occurrence or absence of a face-to-face visit on the same date in addition to time requirements. The Centers for Medicare & Medicaid Services (CMS) created Healthcare Common Procedure Coding System (HCPCS) codes with guidelines that vary significantly from the CPT guidelines. CMS does not always limit the time attributed to prolonged service to time on the date of the encounter.
{"title":"Prolonged Services: CPT® Guidelines and Medicare/Medicaid Policy","authors":"","doi":"10.1542/pcco_book228_document003","DOIUrl":"https://doi.org/10.1542/pcco_book228_document003","url":null,"abstract":"This article addresses the following topics:\u0000 Current Procedural Terminology (CPT) codes for prolonged evaluation and management (E/M) service codes are reported based on the occurrence or absence of a face-to-face visit on the same date in addition to time requirements. The Centers for Medicare & Medicaid Services (CMS) created Healthcare Common Procedure Coding System (HCPCS) codes with guidelines that vary significantly from the CPT guidelines. CMS does not always limit the time attributed to prolonged service to time on the date of the encounter.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122019024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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