||||||||||| VII Foreword |||||||||| The American Academy of Pediatrics (AAP) is pleased to publish the 26th edition of Coding for Pediatrics—an instructional manual and reference tool for use by primary care pediatricians, pediatric subspecialists, and others involved in the provi- sion of care to children. This manual supports the delivery of quality care to children by providing the pediatric practitio- ner with the knowledge to best support appropriate business practices. This edition includes the 2021 Current Procedural Terminology (CPT®) and International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) code changes with guidelines for their application. Most significantly, this manual provides pediatric-specific guidance to coding for all evaluation and management (E/M) services by providing guidance and examples of documentation and code selection using the 1995 and 1997 E/M documen- tation guidelines and the new and distinctly different guidelines for office and other outpatient E/M services. With a focus on creating ease of reference, Coding for Pediatrics 2021 is divided into the following parts: Part 1: Coding Basics and Business Essentials includes information on code sets, compliance, and business topics such as billing and payment methodologies. Part 2: Primarily for the Office and Other Outpatient Settings includes information on coding and billing of ser- vices such as office visits, outpatient consultations, and preventive services. Part 3: Primarily for Hospital Settings includes information on coding for inpatient and observation services, includ- ing newborn care and surgical procedures. Part 4: Digital Medicine Services includes discussion of the evolving codes for reporting telemedicine services, remote monitoring and interpretation, and other services provided via digital technology. Quick references to CPT and ICD-10-CM code changes applicable to pediatrics are provided in Appendixes I and II. A table of pediatric vaccine product codes can be found in Appendix III, and direct supervision and reporting guide- lines can be found in Appendix IV. A continuing education quiz to earn 4.0 continuing education units from the American Academy of Professional Coders is available online at www.aap.org/cfp. Supplemental material can be found on the Coding for Pediatrics website (www.aap.org/cfp) for a wealth of ­information, including a documentation checklist and tracking worksheets for care management and care plan oversight services. Each chapter includes “Test Your Knowledge!” questions (answers can be located in Appendix V). Additionally, resources for more information on each chapter’s contents can be located at the end of chapter. As in previous years, the AAP is also pleased to also offer Coding for Pediatrics 2021 as an eBook. Coding for Pediatrics 2021 does not replace CPT, ICD-10-CM, or the Healthcare Common Procedure Coding System rather, it supplements those manuals. Every effort has been made to include the 2021 codes and their respective guidelines however, revised codes and/or guidelines may have been published subsequent to the date of this printing. Errata to this manual will be posted as appropriate on the Coding for Pediatrics website (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 up-to-date coding and payment information. The newsletter and other online resources can be accessed through the AAP newsletter website (https://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, including the Coding Corner Pediatric ICD-10-CM: A Manual for Provider-Based Coding Pediatric Office- Based Evaluation and Management Coding: 2021 Revisions Pediatric Coding Basics: An Introduction to Medical Coding and various quick reference cards. The use of these resources should provide pediatricians with the skills needed to report Coding_2021.indb 7 Coding_2021.indb 7 9/15/20 2:23 PM 9/15/20 2:23 PM
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