Foreword
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The American Academy of Pediatrics (AAP) is pleased to publish this, the 22nd edition of Coding for Pediatrics—
an instructional manual and reference tool for use by primary care pediatricians, pediatric subspecialists, and
others involved in the provision of care to children. The purpose of this manual is to support the delivery of
quality care to children by providing the pediatric practitioner with the knowledge to best support appropriate
business practices. Many changes have been made to this edition, including updating the 2017 Current Procedural
Terminology (CPT®) and, for the first time since implementation, update of International Classification of Diseases,
10th Revision, Clinical Modification (ICD-10-CM) codes with guidelines for their application. New features are
the addition of chapters addressing care for children with chronic and complex conditions and services provided
by allied health and clinical staff in the physician practice. Readers will also find added emphasis on coding to
support quality initiatives and value-based payment. In addition, the AAP is pleased to continue to offer Coding
for Pediatrics, 2017, as an eBook.
Any corrections that may be necessary subsequent to the publication of the manual will be available to
readers of Coding for Pediatrics, 2017, by accessing www.aap.org/cfp. Coding for Pediatrics, 2017, does not replace
CPT, ICD-10-CM, or Healthcare Procedure Coding System (HCPCS); rather, it supplements those manuals.
Every effort has been made to include the 2017 codes and their respective guidelines; however, revised codes
and/or guidelines may have been published subsequent to the date of this printing. Updates to this manual
will be posted as appropriate on the Coding for Pediatrics Web site (www.aap.org/cfp).
The AAP actively works with the American Medical Association (AMA) CPT Editorial Panel and the AMA/
Specialty Society Relative Value Scale Update Committee (RUC) to develop pediatric specialty codes and assign
them appropriate relative value units. Since 1995, the AAP has contributed to the process that evaluates and
reviews changes to the Medicare Resource-Based Relative Value Scale (RBRVS). Pediatricians have been actively
involved in the AMA RUC Practice Expense Review Committee to review direct practice expenses for all existing
codes. As importantly, the AAP is represented on the AMA CPT Editorial Advisory Panel and on the ICD-10-CM
Editorial Advisory Board. The AAP continues to be involved in all areas of payment. The AAP Committee on
Coding and Nomenclature oversees all areas of coding as they relate to pediatrics, including CPT procedure
coding, ICD-10-CM diagnosis coding, and the valuation of CPT services through the Medicare RBRVS.
The AAP will continue to request new code changes and attempt to expeditiously notify membership of
changes through various means. AAP Pediatric Coding Newsletter™—a monthly newsletter available in print
and online—provides members and their office personnel with up-to-date coding and payment information.
The newsletter and other online resources can be accessed through the AAP newsletter Web site (http://coding.
aap.org). Other resources include coding seminars presented at the AAP National Conference & Exhibition;
webinars sponsored by the AAP (www.aap.org/webinars/coding); instructional materials in AAP News, includ-
ing the Coding Corner; Pediatric ICD-10-CM: A Manual for Provider-Based Coding; and various quick reference
cards. A list of these and other resources can be found in Appendix D of this manual. The use of these resources
should provide the membership with the skills needed to report their services appropriately. The Division of
Health Care Finance at the AAP headquarters stands ready to assist with problem areas not adequately covered
in this manual. The AAP Coding Hotline can be accessed through e-mail at aapcodinghotline@aap.org.
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