Pub Date : 2023-03-01DOI: 10.1542/pcco_book227_document003
"This article focuses on codes associated with pathological neonatal hyperbilirubinemia. This includes the following: Diagnosis codes associated with identifying risk factors for significant hyperbilirubinemia Assignment of codes for tests used in screening, diagnosis, and/or monitoring hyperbilirubinemia Documenting to support the level of evaluation and management (E/M) service provided"
{"title":"Connecting Coding and Practice Guidelines: Hyperbilirubinemia","authors":"","doi":"10.1542/pcco_book227_document003","DOIUrl":"https://doi.org/10.1542/pcco_book227_document003","url":null,"abstract":"\"This article focuses on codes associated with pathological neonatal hyperbilirubinemia. This includes the following:\u0000 Diagnosis codes associated with identifying risk factors for significant hyperbilirubinemia Assignment of codes for tests used in screening, diagnosis, and/or monitoring hyperbilirubinemia Documenting to support the level of evaluation and management (E/M) service provided\"","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"572 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130616104","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 : 2023-03-01DOI: 10.1542/pcco_book227_document002
This article reviews differences in code categories and reporting instructions for point-of-care laboratory testing, including the following: Clinical Laboratory Improvement Amendments (CLIA) status Codes by test type Coding for related services
{"title":"Selecting the Right Codes for In-office Laboratory Testing","authors":"","doi":"10.1542/pcco_book227_document002","DOIUrl":"https://doi.org/10.1542/pcco_book227_document002","url":null,"abstract":"This article reviews differences in code categories and reporting instructions for point-of-care laboratory testing, including the following:\u0000 Clinical Laboratory Improvement Amendments (CLIA) status Codes by test type Coding for related services","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"152 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124207693","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 : 2023-03-01DOI: 10.1542/pcco_book227_document001
How do you know if you have been affected by down-coding? What is your risk? This article will review some of the risk factors, signs and symptoms, and potential treatment of down-coding as outlined by the American Academy of Pediatrics (AAP) “Prepayment Downcoding Checklist” (https://downloads.aap.org/AAP/PDF/Downcoding%20Checklist.pdf). Down-coding policies affect payment for evaluation and management (E/M) services. The risk of down-coding is higher for some physicians and other qualified health care professionals (QHPs). Underpayment caused by down-coding may pass through the billing office unnoticed. Treatment of down-coding depends on the level of coding accuracy identified in chart reviews.
{"title":"Is Your Practice Experiencing Down-coding?","authors":"","doi":"10.1542/pcco_book227_document001","DOIUrl":"https://doi.org/10.1542/pcco_book227_document001","url":null,"abstract":"How do you know if you have been affected by down-coding? What is your risk? This article will review some of the risk factors, signs and symptoms, and potential treatment of down-coding as outlined by the American Academy of Pediatrics (AAP) “Prepayment Downcoding Checklist” (https://downloads.aap.org/AAP/PDF/Downcoding%20Checklist.pdf).\u0000 Down-coding policies affect payment for evaluation and management (E/M) services. The risk of down-coding is higher for some physicians and other qualified health care professionals (QHPs). Underpayment caused by down-coding may pass through the billing office unnoticed. Treatment of down-coding depends on the level of coding accuracy identified in chart reviews.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127671194","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 : 2023-03-01DOI: 10.1542/pcco_book227_document006
The coding challenge presented elsewhere in this issue was based on a neonate born at approximately 37 weeks’ gestation who is found to have neonatal jaundice. The diagnosis and procedure codes for each of the examples appear here.
{"title":"You Code It! Answers: Management of Hyperbilirubinemia (Online Exclusive)","authors":"","doi":"10.1542/pcco_book227_document006","DOIUrl":"https://doi.org/10.1542/pcco_book227_document006","url":null,"abstract":"The coding challenge presented elsewhere in this issue was based on a neonate born at approximately 37 weeks’ gestation who is found to have neonatal jaundice. The diagnosis and procedure codes for each of the examples appear here.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133894614","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 : 2023-03-01DOI: 10.1542/pcco_book227_document005
Management of neonatal hyperbilirubinemia may require low to highly complex medical decision-making. The correct diagnosis code(s) must be reported to support the level of service provided. Can you identify the appropriate procedure and diagnosis codes for the following examples? Answers are elsewhere in this issue.
{"title":"You Code It! Management of Hyperbilirubinemia (Online Exclusive)","authors":"","doi":"10.1542/pcco_book227_document005","DOIUrl":"https://doi.org/10.1542/pcco_book227_document005","url":null,"abstract":"Management of neonatal hyperbilirubinemia may require low to highly complex medical decision-making. The correct diagnosis code(s) must be reported to support the level of service provided. Can you identify the appropriate procedure and diagnosis codes for the following examples? Answers are elsewhere in this issue.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116662176","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 : 2023-02-01DOI: 10.1542/pcco_book226_document002
The problems addressed and types of services provided to adolescent patients often raise questions about coding and billing. This article discusses a few of the topics that frequently result in coding questions. Preventive screening services Counseling and prescription of contraceptives Services to transgender and gender-diverse patients
{"title":"Coding for Adolescent Health Care Services","authors":"","doi":"10.1542/pcco_book226_document002","DOIUrl":"https://doi.org/10.1542/pcco_book226_document002","url":null,"abstract":"The problems addressed and types of services provided to adolescent patients often raise questions about coding and billing. This article discusses a few of the topics that frequently result in coding questions.\u0000 Preventive screening services Counseling and prescription of contraceptives Services to transgender and gender-diverse patients","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124845537","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 : 2023-02-01DOI: 10.1542/pcco_book226_document003
This article reviews the codes and reporting guidelines for initial newborn care services, including the following: Attendance at delivery and newborn resuscitation Initial care of the normal newborn Initial hospital care of a sick newborn Initial neonatal intensive care Initial neonatal critical care A brief discussion of how code edits used by many payers affect reporting and payment is also provided.
{"title":"Coding for Initial Newborn Care","authors":"","doi":"10.1542/pcco_book226_document003","DOIUrl":"https://doi.org/10.1542/pcco_book226_document003","url":null,"abstract":"This article reviews the codes and reporting guidelines for initial newborn care services, including the following:\u0000 Attendance at delivery and newborn resuscitation Initial care of the normal newborn Initial hospital care of a sick newborn Initial neonatal intensive care Initial neonatal critical care A brief discussion of how code edits used by many payers affect reporting and payment is also provided.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127007638","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 : 2023-02-01DOI: 10.1542/pcco_book226_document001
This article provides a high-level discussion of privacy as it affects billing and coding, including the following topics: Rights and accommodations for privacy Privacy in the context of coding
本文对影响计费和编码的隐私进行了高级讨论，包括以下主题:隐私的权利和适应编码上下文中的隐私
{"title":"Coding, Billing, and Protecting an Adolescent’s Privacy","authors":"","doi":"10.1542/pcco_book226_document001","DOIUrl":"https://doi.org/10.1542/pcco_book226_document001","url":null,"abstract":"This article provides a high-level discussion of privacy as it affects billing and coding, including the following topics:\u0000 Rights and accommodations for privacy Privacy in the context of coding","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127443829","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 : 2023-01-01DOI: 10.1542/pcco_book225_document002
When the office and other outpatient evaluation and management (E/M) code changes were implemented in early 2021, American Academy of Pediatrics coding staff answered many frequently asked questions about the changes to the E/M codes and guidelines. This article revisits a few of those questions with inclusion of 2023 changes, where applicable. The following topics are addressed: Use of face-to-face and non–face-to-face time Problem types described in the Current Procedural Terminology (CPT®) “Levels of Medical Decision Making” table Counting test results in the amount and/or complexity of data to be reviewed and analyzed Problem risk and management risk Documentation and coding tips are also provided for some topics.
{"title":"Answers to Questions About Evaluation and Management Code Selection in 2023","authors":"","doi":"10.1542/pcco_book225_document002","DOIUrl":"https://doi.org/10.1542/pcco_book225_document002","url":null,"abstract":"When the office and other outpatient evaluation and management (E/M) code changes were implemented in early 2021, American Academy of Pediatrics coding staff answered many frequently asked questions about the changes to the E/M codes and guidelines. This article revisits a few of those questions with inclusion of 2023 changes, where applicable. The following topics are addressed:\u0000 Use of face-to-face and non–face-to-face time Problem types described in the Current Procedural Terminology (CPT®) “Levels of Medical Decision Making” table Counting test results in the amount and/or complexity of data to be reviewed and analyzed Problem risk and management risk\u0000 Documentation and coding tips are also provided for some topics.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133289328","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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