Pediatric Coding

Pediatric medical coding involves well-check and healthcare services provided to children of all ages from infants to adolescents. A majority percentage of pediatric patients are covered by Medicaid; each state having a unique Medicaid program. Medial coding for pediatrics can be complex and extremely challenging.

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The American Academy of Pediatrics (AAP) notes that “Pediatricians focus on the physical, emotional, and social health of infants, children, adolescents, and young adults from birth to age 21.”

Pediatric specialties include: General pediatrics, pediatric cardiology, pediatric endocrinology, pediatric infectious disease, nutrition services, pediatric neurology, pediatric gastroenterology, pediatric pulmonology, pediatric oncology, pediatric nephrology, genetics, and behavioral psychology.

General pediatric responsibilities:

  • Pediatricians provide health supervision and preventive maintenance for children that promotes good health and fosters healthy lifestyles.
  • Working to reduce overall infant and child mortality
  • Controlling infectious disease in children and adolescents and provide medical care for seriously or chronically ill patients.
  • Maintaining consultative partnerships that include other providers in terms of caring for the physical, emotional, and mental health of children. Pediatricians diagnose and provide treatment for injuries, infections, genetic defects, and other types of acute and chronic organic disease and dysfunction.
  • Offering advice and education to parents in preparation for developmental challenges.
  • Age-appropriate testing and screening.
  • Health exams and participatory determinations with regard to community-based activities, school sports activities, and public health.

The American Medical Association (AMA) states that “Physicians trained in pediatrics are experts in emotional and behavioral assessment and can be powerful advocates for troubled children and adolescents. Pediatricians are often the first and best advocates for children who suffer the consequences of increasingly prevalent psychosocial morbidities, such as homelessness, family violence, and substance abuse.”

As detailed above, pediatric care encompasses a vast expanse of services and responsibilities that demand a high degree of extensive familiarization with pediatric procedures, anatomy and physiology, and relevant ICD-10 codes and modifiers that are comprehensive in nature and very complex. In these ways, professional medical coding services are a supportive and highly effective advocate for any pediatric practice.

Certified, professional medical coders consistently provide the highest and best coding services which are your best protection against audits and penalties resulting from improper coding practices. Outsourcing pediatric coding needs allow practitioners to invest valuable time providing the high level of patient care that their practice depends upon, affords increased revenues, remedies backlogs, reduces office expenses, as well as educational and training demands, and boosts staff, patient, and physician satisfaction.