The American Academy of Pediatrics (AAP) is pleased to publish this, the 23rd edition of Coding for
Pediatrics—an instructional manual and reference tool for use by primary care pediatricians, pediatric sub­
specialists, 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 sup-
port ­ appropriate business practices. Many changes have been made to this edition, including updating the 2018
Current Procedural Terminology (CPT®) codes and 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 a chapter addressing telemedicine and new chapters separately addressing common surgical procedures and
sedation and common testing and therapeutic services. Readers will also find several chapters reorganized and
enhanced with more detail on appropriate coding and documentation. In addition, the AAP is pleased to con-
tinue  to offer Coding for Pediatrics 2018 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 2018 by accessing Coding for Pediatrics 2018 does not replace
CPT, ICD-10-CM, or Healthcare Common Procedure Coding System; rather, it supplements those manuals. Every
effort has been made to include the 2018 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 (
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. Other resources include coding seminars presented at the AAP National Conference & Exhibition;
webinars sponsored by the AAP (; 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. 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 ­
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