Pub Date : 2023-01-01DOI: 10.1542/pcco_book225_document003
This article provides information on changes to the criteria for reporting prolonged clinical staff services in office and other outpatient settings using codes 99415 and 99416. Time requirements for prolonged clinical staff service have changed for services provided in 2023. Prolonged service time is based on the amount of time spent by clinical staff that is beyond the typical clinical staff time for the related office or other outpatient evaluation and management (E/M) service. Prolonged clinical staff services may be reported for simultaneous services provided to 2 patients, but the time reported for each patient must have been devoted to the single patient. The following topics are discussed: – Defining prolonged clinical staff services – Changes to reporting in 2023 – Understanding time requirements for prolonged clinical staff services
{"title":"New Time Requirements for Prolonged Service by Clinical Staff","authors":"","doi":"10.1542/pcco_book225_document003","DOIUrl":"https://doi.org/10.1542/pcco_book225_document003","url":null,"abstract":"This article provides information on changes to the criteria for reporting prolonged clinical staff services in office and other outpatient settings using codes 99415 and 99416.\u0000 Time requirements for prolonged clinical staff service have changed for services provided in 2023. Prolonged service time is based on the amount of time spent by clinical staff that is beyond the typical clinical staff time for the related office or other outpatient evaluation and management (E/M) service. Prolonged clinical staff services may be reported for simultaneous services provided to 2 patients, but the time reported for each patient must have been devoted to the single patient. The following topics are discussed: – Defining prolonged clinical staff services – Changes to reporting in 2023 – Understanding time requirements for prolonged clinical staff services","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"7 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":"124045205","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_document001
This article answers questions related to the transition from 2022 to 2023 procedure codes and guidelines. Use and acceptance of new or revised codes and guidelines Payer acceptance of code revisions Compliance tools and activities
{"title":"2023 Code Changes: Preparation, Implementation, and Compliance","authors":"","doi":"10.1542/pcco_book225_document001","DOIUrl":"https://doi.org/10.1542/pcco_book225_document001","url":null,"abstract":"This article answers questions related to the transition from 2022 to 2023 procedure codes and guidelines.\u0000 Use and acceptance of new or revised codes and guidelines Payer acceptance of code revisions Compliance tools and activities","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"60 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":"134326178","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_document005
This month’s Coding Hotline addresses physician attendance at delivery and initial hospital care, pediatric critical care, and preventive medicine visits.
本月的编码热线涉及医生在分娩和初次住院护理、儿科重症护理和预防性就诊时的出勤情况。
{"title":"Coding Hotline","authors":"","doi":"10.1542/pcco_book225_document005","DOIUrl":"https://doi.org/10.1542/pcco_book225_document005","url":null,"abstract":"This month’s Coding Hotline addresses physician attendance at delivery and initial hospital care, pediatric critical care, and preventive medicine visits.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"65 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":"125054909","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_document004
Included in this article are tips for coding and reporting primary care services, including the following: Preventive medicine visits and other preventive services Office and other outpatient evaluation and management (E/M) services General tips for appropriate coding and documentation Please use your Current Procedural Terminology (CPT®) reference for full code descriptors and reporting instructions beyond those discussed in this article.
{"title":"Cracking Codes With Confidence: Coding for the Primary Care Pediatrician","authors":"","doi":"10.1542/pcco_book225_document004","DOIUrl":"https://doi.org/10.1542/pcco_book225_document004","url":null,"abstract":"Included in this article are tips for coding and reporting primary care services, including the following:\u0000 Preventive medicine visits and other preventive services Office and other outpatient evaluation and management (E/M) services General tips for appropriate coding and documentation\u0000 Please use your Current Procedural Terminology (CPT®) reference for full code descriptors and reporting instructions beyond those discussed in this article.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"23 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":"121183056","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 : 2022-12-01DOI: 10.1542/pcco_book224_document004
This article reviews the following topics related to interprofessional consultation services: Differentiating interprofessional consultation services Instructions for when to report or not report interprofessional consultation services Examples of interprofessional consultation services Reporting the time spent by the requesting physician or other qualified health care professional (QHP)
{"title":"Interprofessional Consultations: 99446–99449 Versus 99451","authors":"","doi":"10.1542/pcco_book224_document004","DOIUrl":"https://doi.org/10.1542/pcco_book224_document004","url":null,"abstract":"This article reviews the following topics related to interprofessional consultation services:\u0000 Differentiating interprofessional consultation services Instructions for when to report or not report interprofessional consultation services Examples of interprofessional consultation services Reporting the time spent by the requesting physician or other qualified health care professional (QHP)","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"156 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114058370","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 : 2022-12-01DOI: 10.1542/pcco_book224_document001
This article reviews the use of total time in code selection for services provided in 2023, including the following: Evaluation and management (E/M) categories to which selection based on total time is applicable Defining total time—inclusions and exclusions Reporting prolonged service by a physician or other qualified health care professional (QHP)
{"title":"Preparing for 2023: Evaluation and Management Total Time and Prolonged Service","authors":"","doi":"10.1542/pcco_book224_document001","DOIUrl":"https://doi.org/10.1542/pcco_book224_document001","url":null,"abstract":"This article reviews the use of total time in code selection for services provided in 2023, including the following:\u0000 Evaluation and management (E/M) categories to which selection based on total time is applicable Defining total time—inclusions and exclusions Reporting prolonged service by a physician or other qualified health care professional (QHP)","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127399890","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 : 2022-12-01DOI: 10.1542/pcco_book224_document002
This article reviews the following regarding Category III code updates: Publication and implementation dates of Category III codes Reporting services that are described by Category III codes New Category III codes – Virtual reality (VR) technology to assist therapy – VR procedural dissociation services – Mechanical hypothermic management for mild traumatic brain injury
{"title":"Category III Procedure Code Updates for January 2023","authors":"","doi":"10.1542/pcco_book224_document002","DOIUrl":"https://doi.org/10.1542/pcco_book224_document002","url":null,"abstract":"This article reviews the following regarding Category III code updates:\u0000 Publication and implementation dates of Category III codes Reporting services that are described by Category III codes New Category III codes – Virtual reality (VR) technology to assist therapy – VR procedural dissociation services – Mechanical hypothermic management for mild traumatic brain injury","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128292668","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 : 2022-12-01DOI: 10.1542/pcco_book224_document003
This article reviews the following: Changes to evaluation and management (E/M) code categories for visits provided in residential settings. Codes will be selected based on either the level of medical decision-making (MDM) or on the physician or other qualified health care professional’s (QHP’s) total time on the date of the encounter. Changes to reporting care plan oversight for a patient who resides in a home or residential setting.
{"title":"Preparing for 2023: Home and Residence Services","authors":"","doi":"10.1542/pcco_book224_document003","DOIUrl":"https://doi.org/10.1542/pcco_book224_document003","url":null,"abstract":"This article reviews the following:\u0000 Changes to evaluation and management (E/M) code categories for visits provided in residential settings. Codes will be selected based on either the level of medical decision-making (MDM) or on the physician or other qualified health care professional’s (QHP’s) total time on the date of the encounter. Changes to reporting care plan oversight for a patient who resides in a home or residential setting.","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122117323","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 : 2022-11-01DOI: 10.1542/pcco_book223_document005
This article introduces code changes that will be effective for services provided on and after January 1, 2023. It also includes a review of how the removal of sutures and staples are reported in 2022 when these services take place outside of a global period/surgical package. The following topics will be discussed: Reporting removal that requires anesthesia −Code changes−When removal is not separately reported−Relative value units (RVUs)Reporting removal when anesthesia is not required −New codes−When removal is not separately reported−Separately reported services−RVUs
{"title":"2023 Code Changes: Suture Removal","authors":"","doi":"10.1542/pcco_book223_document005","DOIUrl":"https://doi.org/10.1542/pcco_book223_document005","url":null,"abstract":"This article introduces code changes that will be effective for services provided on and after January 1, 2023. It also includes a review of how the removal of sutures and staples are reported in 2022 when these services take place outside of a global period/surgical package. The following topics will be discussed: Reporting removal that requires anesthesia −Code changes−When removal is not separately reported−Relative value units (RVUs)Reporting removal when anesthesia is not required −New codes−When removal is not separately reported−Separately reported services−RVUs","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128841124","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 : 2022-11-01DOI: 10.1542/pcco_book223_document003
This article reviews changes to codes and guidelines for reporting evaluation and management (E/M) services provided to patients in an emergency department (ED), including the following: How codes are changingCode selection based on medical decision-making (MDM) aloneReporting ED E/M and critical care services on the same dateObservation services provided in the ED
{"title":"Preparing for 2023: Emergency Department Visits","authors":"","doi":"10.1542/pcco_book223_document003","DOIUrl":"https://doi.org/10.1542/pcco_book223_document003","url":null,"abstract":"This article reviews changes to codes and guidelines for reporting evaluation and management (E/M) services provided to patients in an emergency department (ED), including the following: How codes are changingCode selection based on medical decision-making (MDM) aloneReporting ED E/M and critical care services on the same dateObservation services provided in the ED","PeriodicalId":370754,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130733938","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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