Coding for Pediatrics 2024

The AAP Committee on Coding and Nomenclature (COCN) is responsible for reviewing 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.

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. Non-preventive Outpatient Evaluation and Management Services in Outpatient Settings
Chapter 8. Preventive Services
Chapter 9. Telephone and Online Digital Evaluation and Management Services
Chapter 10. Indirect Management of Chronic and Complex Conditions
Chapter 11. Mental and Behavioral Health Services
Chapter 12. Common Testing and Therapeutic Services
Chapter 13. Qualified Nonphysician Health Care Professional Services
Chapter 14. Surgery, Infusion, and Sedation in the Outpatient Setting

PART 3. PRIMARILY FOR HOSPITAL SETTINGS
Chapter 15. Emergency Department Services
Chapter 16. Hospital Care of the Newborn
Chapter 17. Noncritical Hospital Evaluation and Management 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 2023 ICD-10-CM Pediatric Code Changes
II. Vaccine Products: Commonly Administered Pediatric Vaccines
III. Test Your Knowledge! Answer Key

INDEXES
Subject Index
Code Index
AAP/Bright Futures “Recommendations for Preventive Pediatric Health Care” (Periodicity Schedule)