Pub Date : 2024-06-01DOI: 10.1542/pcco_book242_document002
This article reviews key points from “Coding and Payment in Pediatrics: The A, B, Cs of Being Paid for the Care You Give,” an American Academy of Pediatrics (AAP) coding webinar presented by Shannon Fox-Levine, MD, FAAP, including the following: How payment affects patient access Appropriate coding and billing practices Contract terms Avoiding and fighting inappropriate denials Looking beyond fee-for-service payment State and national resources for addressing payment issues
{"title":"Coding and Payment in Pediatrics: The A, B, Cs of Being Paid for the Care You Give","authors":"","doi":"10.1542/pcco_book242_document002","DOIUrl":"https://doi.org/10.1542/pcco_book242_document002","url":null,"abstract":"This article reviews key points from “Coding and Payment in Pediatrics: The A, B, Cs of Being Paid for the Care You Give,” an American Academy of Pediatrics (AAP) coding webinar presented by Shannon Fox-Levine, MD, FAAP, including the following:\u0000 How payment affects patient access Appropriate coding and billing practices Contract terms Avoiding and fighting inappropriate denials Looking beyond fee-for-service payment State and national resources for addressing payment issues","PeriodicalId":490755,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"5 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141233925","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 : 2024-06-01DOI: 10.1542/pcco_book242_document005
This article reviews scheduled midyear coding changes to the following code sets: Current Procedural Terminology (CPT®) immunization code updatesOther CPT code implementation updatesHealthcare Common Procedure Coding System (HCPCS) updatesInternational Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) updates
{"title":"Stay Up to Date With Midyear Code Changes","authors":"","doi":"10.1542/pcco_book242_document005","DOIUrl":"https://doi.org/10.1542/pcco_book242_document005","url":null,"abstract":"This article reviews scheduled midyear coding changes to the following code sets: Current Procedural Terminology (CPT®) immunization code updatesOther CPT code implementation updatesHealthcare Common Procedure Coding System (HCPCS) updatesInternational Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) updates","PeriodicalId":490755,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"1 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141230759","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 : 2024-06-01DOI: 10.1542/pcco_book242_document001
This article dives into coverage of and codes for reporting services for HIV preexposure prophylaxis (PrEP), including the following: Coverage of HIV PrEP as a preventive service Diagnosis coding for HIV PrEP Procedure codes for HIV PrEP
本文深入探讨了艾滋病暴露前预防 (PrEP) 服务的覆盖范围和报告代码，包括以下内容：HIV PrEP 作为预防性服务的覆盖范围 HIV PrEP 的诊断编码 HIV PrEP 的程序编码
{"title":"Connecting Coding and Policy: HIV Preexposure Prophylaxis","authors":"","doi":"10.1542/pcco_book242_document001","DOIUrl":"https://doi.org/10.1542/pcco_book242_document001","url":null,"abstract":"This article dives into coverage of and codes for reporting services for HIV preexposure prophylaxis (PrEP), including the following:\u0000 Coverage of HIV PrEP as a preventive service Diagnosis coding for HIV PrEP Procedure codes for HIV PrEP","PeriodicalId":490755,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"15 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141233444","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 : 2024-06-01DOI: 10.1542/pcco_book242_document003
This article discusses how reporting codes in compliance with International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) guidelines can help physicians and other qualified health care professionals (QHPs) avoid denied claims. This includes the following: How ICD-10-CM codes affect claims adjudication Coding to the highest level of specificity Compliance with Excludes1 notes Compliance with “code first” notes Appropriately reporting codes for sequela Correct use of codes for external causes Proper linking of diagnosis to procedure codes
{"title":"Use Diagnosis Coding Conventions to Avoid Denied Claims","authors":"","doi":"10.1542/pcco_book242_document003","DOIUrl":"https://doi.org/10.1542/pcco_book242_document003","url":null,"abstract":"This article discusses how reporting codes in compliance with International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) guidelines can help physicians and other qualified health care professionals (QHPs) avoid denied claims. This includes the following:\u0000 How ICD-10-CM codes affect claims adjudication Coding to the highest level of specificity Compliance with Excludes1 notes Compliance with “code first” notes Appropriately reporting codes for sequela Correct use of codes for external causes Proper linking of diagnosis to procedure codes","PeriodicalId":490755,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"27 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141231999","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 : 2024-05-01DOI: 10.1542/pcco_book241_document004
In this You Code It! challenge, a nephrologist is consulted by a hospitalist to provide advice on diagnosis and management of a patient presenting with symptoms of dark urine, fatigue, and eye swelling. Did you assign the correct codes?
{"title":"You Code It! Answers: Stage 2 Hypertension, Hematuria, and Edema","authors":"","doi":"10.1542/pcco_book241_document004","DOIUrl":"https://doi.org/10.1542/pcco_book241_document004","url":null,"abstract":"In this You Code It! challenge, a nephrologist is consulted by a hospitalist to provide advice on diagnosis and management of a patient presenting with symptoms of dark urine, fatigue, and eye swelling. Did you assign the correct codes?","PeriodicalId":490755,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"2 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141023712","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 : 2024-05-01DOI: 10.1542/pcco_book241_document005
This article reviews examples of office and other outpatient evaluation and management (E/M) services for treatment of overweight and obesity, including the following.: Time-based code selectionCode selection based on medical decision-making (MDM)
{"title":"Coding Visits to Treat Overweight and Obesity","authors":"","doi":"10.1542/pcco_book241_document005","DOIUrl":"https://doi.org/10.1542/pcco_book241_document005","url":null,"abstract":"This article reviews examples of office and other outpatient evaluation and management (E/M) services for treatment of overweight and obesity, including the following.:\u0000 Time-based code selectionCode selection based on medical decision-making (MDM)","PeriodicalId":490755,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"53 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141042805","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 : 2024-05-01DOI: 10.1542/pcco_book241_document002
This challenge scenario involves a nephrology consultation with a 9-year-old boy who presented to the emergency department (ED) with dark urine, fatigue, and eye swelling. Can you assign the appropriate diagnosis and procedure codes for the consultation?
{"title":"You Code It! Stage 2 Hypertension, Hematuria, and Edema","authors":"","doi":"10.1542/pcco_book241_document002","DOIUrl":"https://doi.org/10.1542/pcco_book241_document002","url":null,"abstract":"This challenge scenario involves a nephrology consultation with a 9-year-old boy who presented to the emergency department (ED) with dark urine, fatigue, and eye swelling. Can you assign the appropriate diagnosis and procedure codes for the consultation?","PeriodicalId":490755,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"25 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141055193","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 : 2024-05-01DOI: 10.1542/pcco_book241_document001
This article reviews the amount and/or complexity of data to be reviewed and analyzed as an element of medical decisionmaking (MDM) performed during an evaluation and management (E/M) service. This includes the following: Review of results of tests ordered at a prior visitOrder for and independent interpretation of testsDocuments from a unique entityDiscussions about management or test interpretation
{"title":"Coding Review: Amount and/or Complexity of Data","authors":"","doi":"10.1542/pcco_book241_document001","DOIUrl":"https://doi.org/10.1542/pcco_book241_document001","url":null,"abstract":"This article reviews the amount and/or complexity of data to be reviewed and analyzed as an element of medical decisionmaking (MDM) performed during an evaluation and management (E/M) service. This includes the following:\u0000 Review of results of tests ordered at a prior visitOrder for and independent interpretation of testsDocuments from a unique entityDiscussions about management or test interpretation","PeriodicalId":490755,"journal":{"name":"AAP Pediatric Coding Newsletter","volume":"15 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141037712","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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