Coding for Pediatrics 2025: A Manual for Pediatric Documentation and Payment

by Aap Committee on Coding and Nomenclature (Editor)

Overview

This updated 30th edition of Coding for Pediatrics includes all changes in Current Procedural Terminology (CPT®) codes—complete with expert guidance for their application. The book’s recently updated vignettes and examples, as well as the many coding pearls throughout, provide added guidance needed to ensure accuracy and payment.

Key updates

• CTP 2025 code updates
• This edition introduces a range of new codes and guidelines, including:
  • New chapter discussing telemedicine code changes
  • Immunization coding updates
  • Addition of codes for reporting contraception services
  • Update to coding for skin substitute grafts

Coding for Pediatrics 2025 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 services such as office visits, outpatient consultations, and preventive services.
• Part 3: Primarily for Hospital Settings includes information on coding for inpatient and observation services, including newborn care and surgical procedures.
• Part 4: Digital Medicine Services includes discussion of the evolving codes for reporting telemedicine services and remote monitoring and interpretation of patient data.

 Appendices include
          o   A table of pediatric vaccine product codes
          o   Test Your Knowledge! answer key
  Supplemental material is provided online, accessible with an access code, including a general documentation checklist, tracking worksheets for chronic care management, and care plan oversight services. A continuing education quiz to earn 4.0 continuing education units from the American Academy of Professional Coders is also available online.
 

Product Details

ISBN-13:	9781610027496
Publisher:	American Academy of Pediatrics
Publication date:	11/19/2024
Edition description:	30th ed.
Pages:	565
Product dimensions:	8.82(w) x 10.87(h) x 1.18(d)

About the Author

The AAP Committee on Coding and Nomenclature (COCN) is responsible for reviewing of all proposed changes to Current Procedural Terminology (CPT) and International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding structures to determine whether the Academy will endorse the proposal; participates in the American Medical Association/Specialty Society Relative Value Scale Update Committee (RUC) survey process by validating clinical vignettes, evaluating survey data and deciding on physician work and practice expense relative value units (RVUs) to recommend to the RUC; and serves as a review panel regarding other activities such as identifying Academy positions on the Medicare Resource-Based Relative Value Scale (RBRVS). 

Table of Contents

Foreword
Acknowledgments
Quick Reference to 2025 CPT Pediatric Code Changes
How to Use This Manual
CFP 2025 Road Map

PART 1: CODING BASICS AND BUSINESS ESSENTIALS
Chapter 1: The Basics of Coding
Chapter 2: Coding Edits and Modifiers
Chapter 3: Coding to Demonstrate Quality and Value
Chapter 4: The Business of Medicine: Working With Current and Emerging Payment Systems
Chapter 5: Preventing Fraud and Abuse: Compliance, Audits, and Paybacks
Chapter 6: Evaluation and Management Documentation Guidelines

PART 2: PRIMARILY FOR THE OFFICE AND OTHER OUTPATIENT SETTINGS
Chapter 7: Non-Preventive Evaluation and Management Services in Outpatient Settings
Chapter 8: Preventive Services
Chapter 9: Indirect Management of Chronic and Complex Conditions
Chapter 10: Mental and Behavioral Health Services
Chapter 11: Common Testing and Therapeutic Services
Chapter 12: Qualified Nonphysician Health Care Professional Services
Chapter 13: Surgery, Infusion, and Sedation in the Outpatient Setting

PART 3: PRIMARILY FOR HOSPITAL SETTINGS
Chapter 14: Emergency Department Services
Chapter 15: Hospital Care of the Newborn
Chapter 16: Noncritical Hospital Evaluation and Management Services
Chapter 17: Critical and Intensive Care
Chapter 18: Common Surgical Procedures and Sedation in Facility Settings

PART 4: DIGITAL MEDICINE SERVICES
Chapter 20: Telemedicine Coding and Documentation Concepts
Chapter 21: Remote Data Collection and Monitoring Services

APPENDIXES
I. Vaccine Products: Commonly Administered Pediatric Vaccines
II. Test Your Knowledge! Answer Key

INDEXES
Subject Index
Code Index
AAP/Bright Futures “Recommendations for Preventive Pediatric Health Care” (Periodicity Schedule)