vii Welcome and Overview Welcome to Pediatric Coding Basics: An Introduction to Medical Coding! If you are ready to learn about coding for professional services in the practice of pediatric medicine, Pediatric Coding Basics is a great place to start. This introduction to the code sets and the reporting method used by physicians to bill health plans and other payers for services is a first step in learning to appropriately assign and report codes. This book addresses gaps often seen by pediatricians and other health care professionals as they begin practicing and billing for their professional services. Too often pediatricians and other health care professionals were provided with paper or electronic lists from which they were to select codes without the benefit of Understanding where these codes come from How code selection affects payment for services Risks associated with incorrect code assignment With that in mind, the American Academy of Pediatrics (AAP) and its Committee on Coding and Nomenclature developed this publication to provide background and basic information necessary to support appropriate code selection for specific conditions and services. Pediatric Coding Basics begins with an overview of medical coding, followed by a more detailed review of the different types of codes commonly used in pediatrics. It then discusses how to effectively use the different types of codes together for billing purposes before exploring health plan policies and coding compliance. Each chapter includes Coding Challenge questions with the answers appearing in Appendix A. Appendix B is a glossary of commonly used acronyms and Appendix C includes a brief history of coding. Upon completion of this book, refer to Appendix D to learn how to take an online assessment and earn a Certificate of Completion from the AAP. When you are ready to learn more about coding for pediatric services, we hope that you will take advantage of all the award-winning AAP coding products. These products empower pediatricians to code their work correctly with excellent explanations in addition to multiple helpful pediatric vignettes for general pediatricians as well as for subspecialists. All Current Procedural Terminology (CPT®) and International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes included in this publication are for educational purposes to understand the code sets. As of 2020 these codes are current however, refer to the most current code-specific publication for up-to-date coding information.
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