Coding for Pediatrics 2022. A Manual for Pediatric Documentation and Payment

Foreword
Acknowledgments
How to Use this Manual

Part 1: Coding Basics and Business Essentials
Chapter 1. The Basics of Coding
Chapter 2. Coding Edits and Modifiers
Chapter 3. Coding to Demonstrate Quality and Value
Chapter 4. The Business of Medicine: Working With Current and Emerging Payment Systems
Chapter 5. Preventing Fraud and Abuse: Compliance, Audits, and Paybacks
Chapter 6. Evaluation and Management Documentation Guidelines

Part 2: Primarily for the Office and Other Outpatient Settings
Chapter 7. Office and Other Outpatient Evaluation and Management Services
Chapter 8. Preventive Services
Chapter 9. Consultation, Residential, and Non-Face-to-Face Evaluation and Management Services
Chapter 10. Surgery, Infusion, and Sedation in the Outpatient Setting
Chapter 11. Common Non-facility Testing and Therapeutic Services
Chapter 12. Management of Chronic and Complex Conditions
Chapter 13. Qualified Nonphysician Health Care Professional Services
Chapter 14. Mental and Behavioral Health Services

Part 3: Primarily for Hospital Settings
Chapter 15. Hospital Care of the Newborn
Chapter 16. Noncritical Hospital Evaluation and Management Services
Chapter 17. Emergency Department Services
Chapter 18. Critical and Intensive Care
Chapter 19. Common Surgical Procedures and Sedation in Facility Settings

Part 4: Digital Medicine Services
Chapter 20. Telemedicine Services
Chapter 21. Remote Data Collection and Monitoring Services

Appendixes
I. Quick Reference to 2022 ICD-10-CM Pediatric Code Changes
II. Quick Reference to 2022 CPT® Pediatric Code Changes
III. Vaccine Products: Commonly Administered Pediatric Vaccines
IV. Global Per Diem Critical Care Codes: Direct Supervision and Reporting Guidelines
V. Test Your Knowledge! Answer Key

This year's completely updated 27th edition of Coding for Pediatrics includes all changes in Current Procedural Terminology (CPT®) codes–complete with expert guidance for their application. Also included are the new office and outpatient evaluation and management coding changes. The book's many clinical vignettes and examples, as well as the many coding pearls throughout, provide added guidance needed to ensure accuracy and payment.

• New chapters dedicated to telemedicine and remote physiological data services
• New codes for single-disease care management
• New codes for congenital cardiac catheterization
• Clarifications to outpatient E/M requirements
• Coding changes in the following areas:
  
  • Updates to musculoskeletal system
  • Cardiovascular
  • Male genital system
  • Face to face medicine
  • COVID vaccines
• More than 80 new and revised coding examples
• Revised organization for more efficient and and easier content access
• Additional online-only content added

AUTHOR INFORMATION

The AAP Committee on Coding and Nomenclature (COCN) is responsible for reviewing of all proposed changes to CPT and ICD-10-CM coding structures to determine whether the Academy will endorse the proposal; participates in the American Medical Association/Specialty Society Relative Value Scale Update Committee's (RUC) survey process by validating clinical vignettes, evaluating survey data, and deciding on physician work and practice expense relative value units (RVUs) to recommend to the RUC; and serves as a review panel regarding other activities such as identifying Academy positions on the RBRVS. The COCN also monitors the Medicare RBRVS physician fee schedule and its adoption by private and public payers.

To update pediatricians on its activities, including the formal publication of new and revised CPT and ICD-10-CM coding structures and final values for CPT codes used by pediatricians, pediatric medical subspecialists, and pediatric surgical specialists, the COCN publishes periodic articles in AAP News along with a monthly coding column called Coding Corner.