Coding and Billing Pediatric Services - AAPC

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11Coding and Billing Pediatric ServicesAAPCLisa Jensen, MHBL, FACMPE, CPC8/4/20102About the Presenter Manager of the Special Investigations Unit at Providence Health Plans in Beaverton, Oregon 18 Years Healthcare Experience 14 Years of Management Experience 11 Years of Pediatric Experience National Speaker on Management, Coding & Compliance Topics Master s Degree in Healthcare Business Leadership (MHBL) Fellow in the American College of medical Practice Executives (FACMPE) Certified Professional Coder in AAPC (CPC) Services Face-to-Face Services Missed Procedures Pediatric Reimbursed for What You Do4Selecting Appropriate E/M Codes E/M codes represent largest portion of codes reported and income for non-procedural based practices. Guidelines can be vague and complex Approach from clinical perspective Start with the elements of medical -decision making The nature of the presenting problem, severity of illness35Coding Compliance Not every visit is a 99213 Seek appropriate training in the E/M guidelines Use electronic templates wisely Choose either the 1995 or 1997 guidelines for each encounter, do not mix Choose to code by key components (history, exam and medical decision making) or time carefully6E/M Based on Time 99201-99215 Typically related to child behavioral issues No

Coding Compliance • Not every visit is a 99213 • Seek appropriate training in the E/M guidelines • Use electronic templates wisely • Choose either the 1995 or 1997 guidelines for each encounter, do not mix • Choose to code by key components (history, exam and medical decision making) or time carefully 6 E/M Based on Time • 99201-99215

  Training, Coding, Medical, Pediatric