Pediatric Coding Q&a: Expert Advice from the AAP Coding Hotline

The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. The AAP is the largest pediatric publisher in the world, with a diverse list of resources that includes essential clinical and practice management titles and award-winning books for parents.

• Introduction  Administrative Examinations (including sports physicals) and FormsSports PhysicalsExaminations Required For Overseas TransferFoster Care or Protective Services Check-upCompletion of FormsCoding Completion of Court DocumentsAfter-hours, Emergency, Weekend or Holiday Services Services Provided on HolidaysOffering After-hours Preventive VisitsAfter-hours Telephone ServiceNurse Visits During Regularly Scheduled Weekend Hours Allergy and Immunologic Services Epinephrine Injector DemonstrationEvaluation and Management and Allergy TestingCoding a Discontinued Ingestion ChallengeAdministration of Oral DiphenhydramineAsthma Asthma – Prescription Drug ManagementDiagnosing Asthma at Preventive VisitCoding the Asthma Control TestRefill of Asthma Medications During Preventive VisitInhalation Treatment and Demonstration of NebulizerInhalation Treatment via Metered-dose InhalerAttention-deficit Hyperactivity Disorder (ADHD) ADHD Rating ScalesDate of Service for ADHD Rating ScalesAssessment for ADHD Without DiagnosisADHD Follow-up VisitRating Scales as Data ElementsADHD as a Moderate Complexity ProblemDiagnosis Codes for ADHDPatient Not Present for ADHD Visit  Autism and Developmental PediatricsDiagnosis Coding for AutismAdding a Developmental PediatricianAutism Screening and TestingDevelopmental Testing TimeDevelopmental Testing and Evaluation and Management Services  Behavioral HealthChildhood GriefHealth Behavior Assessment and InterventionInterprofessional Consultations with Mental Health Professionals.Discussion of management with Behavioral Health ProfessionalCounseling for Alcohol or Substance UseService Provided Without Patient PresentBehavioral Health Service to ParentPsychiatric Services by a Pediatrician Billing and Claims CompletionDowncoding of ClaimsUsing ModifiersNational Provider Identifiers (NPIs) on ClaimsBilling for Locum TenensSpeaking with Child’s Guardian Ad Litem  Breastfeeding and Lactation CounselingCodes for Breastfeeding Support and Lactation CounselingPayer Policies for Reporting Breastfeeding Support and Lactation ConsultationsLactation Counseling as a Split or Shared ServiceMedical Decision-making: Discussion with Lactation Consultant  BurnsEvaluation and Management of BurnSunburnFollow-up of Minor Burn InjuryFollow-up of Burn Injury Requiring TreatmentTelephone or Telemedicine Visit for Burn InjuryDebridement of Non-thermal Burn  Cerumen RemovalCerumen Removal with Irrigation and InstrumentationCerumen Impaction Partially RemovedCerumen RemovalCerumen Removal with an Evaluation and Management Service  Cardiac ConditionsMultisystem Inflammatory Syndrome in Children (MIS-C) Follow-upElectrocardiography with Purchased Professional ComponentPericardiocentesisOffice Visit for Family History of Ventricular Tachycardia  CircumcisionCircumcision with Evaluation and Management ServiceCircumcision with Lysis of AdhesionCircumcision with ComplicationPost-circumcision CellulitisCircumcision With Physician Supervision  Clinical Staff/Nurse ServicesDevelopment Screening by Clinical StaffTuberculin Skin TestReading a Tuberculin Skin TestNurse Care CoordinatorTelemedicine 99211  ConcussionComplexity of Problem for ConcussionDiagnosis Coding: Concussion Follow-upElectronically-administered Concussion Test  Congenital ConditionsLigature of Accessory DigitsNeonatal Ear MoldingUltrasound for Congenital Hip Dysplasia  ContraceptionComplexity of Problem for Contraception ServicesContraceptive InjectionContraceptive Prescription at Preventive Medicine VisitContraceptive Prescribed as Treatment  DepressionComplexity of Problems: Depression and AnxietyReporting a Positive Depression ScreeningFollow-up of Depression and Other Chronic ConditionDepression and Complexity of Problem  Eating Disorders and Medical Nutrition TherapyManaging Eating Disorders in Complex IllnessesNutritional Counseling at a Preventive Medicine VisitInitial or Subsequent Medical Nutrition Therapy  FeverFebrile InfantsFever and Streptococcal Sore Throat  Foreign BodiesEar Tube or Foreign Body RemovalForeign Body Removal by IrrigationForeign Body Removal from FootForeign Body Removal Using a NeedleAttempted Foreign Body RemovalRemoval of Multiple Foreign Bodies of EarRemoval of Earring  FracturesNursemaid ElbowGlobal Care for Radial FractureInfluenza Immunization During the Global PeriodCodes for Supply of Splints  Genitourinary ServicesLysis of Adhesions as a Planned ProcedureLabial Adhesion  Hearing and VisionEar Pulling without Diagnosed ProblemEye Examination with Fluorescein DyePreventive Medicine Visit with Hearing and Vision ScreeningFailed Hearing Screening at SchoolDiagnosis of Failed Newborn Hearing ScreeningVision and Hearing Tests in Evaluation of Underachievement in SchoolOtoacoustic Emissions  Hyperbilirubinemia and JaundiceOffice Visit for JaundiceJaundice Suspected at Preventive VisitPreventive Visit and Office Visit for JaundiceLevel of Care for HyperbilirubinemiaOffice Visit Resulting in Readmission for Phototherapy  Immunization AdministrationImmunization Administration with Health Risk AssessmentImmunization Without Physician CounselingReporting Immunization Administrations with and without CounselingReporting Immunization Counseling without AdministrationVaccines for Children and Medical Cost Sharing PlansDocumentation of Immunization Counseling with Administration  IntegumentaryWorsening ImpetigoStye of Eyelid with Other Skin InfectionRaynaud’s Phenomenon – Nailfold CapillaroscopyIncision and Drainage of Multiple AbscessesCryotherapy of Warts and Evaluation and Management Service  Interpretation and Translation ServicesCode for Use of Interpreter ServiceExtended Service Time Due to Interpreter or Translator  Laboratory ServicesLaboratory Tests and Medical Decision-makingVisit to Provide Results of TestingInfluenza A/B TestingLipid Testing for Patient on Atypical AntipsychoticDiagnosis Code for Lead ScreeningDiagnosis Code for Titers Order at School Admission Examination  Maternal Depression ScreeningProcedure Code for Maternal Depression ScreeningReporting Positive Maternal Depression ScreeningMaternal Depression Screening and Preventive Service  Newborn Attendance at DeliveryMedical Necessity of Attendance at DeliveryAttendance Subsequent to BirthAttendance at Delivery and Newborn Hospital Care  Newborn – Hospital CareExtended Normal Newborn CareNormal Newborn Care Throughout AdmissionNewborn Same Date Admission and DischargeNormal Care Versus Hospital CareNewborn Suspected to be Affected by Maternal ConditionNewborn – Transfer from NICUSplit or Shared Visits  Newborn – Critical or Intensive CareNeonatal DefinitionGestational Age and Birth WeightNormal Newborn and Neonatal Intensive/Critical Care on the Same DateNewborn Critical or Intensive CareTransfer Back to Birth HospitalInterfacility Transfer in Same Group PracticeSplit or Shared Neonatal Critical or Intensive Care ServicesNewborn Interfacility Transport  Newborn Care – Office or Outpatient CareNewborn Visit – New or Established PatientNewborn Preventive CareNewborn Follow-up Weight CheckUnder-Immunization of Parents of NewbornNewborn Code for Screening for Hip DysplasiaNewborn Umbilical GranulomaUmbilical GranulomaNewborns and Transitional Care Management  ObesityLaboratory Testing for Obesity-related ConditionsPreventive and Problem-Oriented ServicesEvaluation and Management of Obesity  Oral HealthFluoride Varnish and Evaluation and ManagementConsultation for Preoperative Clearance  Preventive ServicesPreventive Medicine Evaluation and Management ServicePreventive Medicine Services by ResidentsCodes for Screening InstrumentsMultiple Standardized Screening InstrumentsPreventive Screenings and Work Relative Value Units  Respiratory ConditionsRespiratory Syncytial Virus Diagnosis CodeRespiratory Syncytial Virus ProphylaxisOffice Emergency Care for Respiratory DistressDiagnosis Coding for Influenza AUnits for Infectious Agent Detection of COVID-19 and Influenza A and BSame-date Administration of Palivizumab and Influenza VaccineNasopharyngeal/Tracheal SuctioningTelephone Service for Worsening Respiratory InfectionTelephone Service Regarding Multiple Siblings  Social Determinants of Health (SDOH)SDOH and Medical Decision-makingFamily History of Domestic ViolenceIdentified Need for Childcare Assistance  Index