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By Brad Ericson, MPC, CPC-Ortho
Pediatricians provide preventive health care for healthy children and medical care for ill children. They are specially trained to assess the emotional needs and behavior of infants, children and adolescents. Earning your CPC-PEDST credentials will take you to a higher level of coding for these procedures and services. With CPC-PEDS credentials, you'll improve upon your CPCT coding skills while increasing the financial health of the medical institution you code for. Having the CPC-PEDS certification keeps you up-to-date on new and revised CPT® and ICD-9-CM coding structures and final physician work values for CPT codes used by pediatricians, pediatric medical subspecialists, and pediatric surgical specialists.
 You'll learn how to code everything from well-child visits and flu-shots to thrush and attention deficit disorder (ADD). CPC-PEDS ensures you receive all the reimbursement your pediatric practice rightfully deserves. You'll become an expert coder specifically for pediatrics, having greater insight into allergen immunotherapy, immunizations, office visits, inpatient services and newborns. And if you code for a practice that has after-hours appointments, you'll learn how to code those as well. You'll have a thorough understanding of what it means to be a pediatric coder. You'll learn vital coding insight specific to pediatric medicine, such as:
·      Why you should check a patient's age when assigning an intramuscular flu vaccine code
·      How to code if a child has been exposed to lead paint because of a toy recall
·      What the correct way to code is when a child comes in for a preventive medicine visit and symptoms are encountered during the visit
·      What codes to use when a teenager sees a nurse because of worsening asthma due to smoking and for counseling and intervention beginning a cessation program
Because many children with special health care needs and chronic medical conditions have their own set of reimbursement issues, obtaining CPC-PEDS credentials provide you added insight into coding and reimbursement problems related to their care. These codes encompass oversight of services such as work or school programs the child or adolescent may be attending where therapy is provided. When an issue arises with their care, you'll know how to negotiate with public and private insurers for compliant reimbursement.
Start by Studying
The American Academy of Professional Coders (AAPC) has developed a Study Guide to help you prepare for the pediatrics specialty credential examination. The Study Guide is designed to reflect the examination's structure, with extensive discussions regarding coding principles as they relate to anatomy and terminology, pathophysiology, procedures and services. The Study Guide is not an introduction to coding, but a review of coding concepts for the advanced pediatrics coder. Your long-term, day-to-day experience coupled with the Study Guide should prepare you to sit for the exam.
Put Your Knowledge to the Test
To take the Pediatric Specialty Exam, you must be an AAPC member and have at least one of the following credentials: CPCT, CPC-HT, CPC-PT, CCS, CCS-P, RHIT, MD. When you pass the exam, you will have earned the credential CPC-PEDS or AAPC-PEDST, depending on whether or not you earned your core credential through the AAPC.
Examinations are proctored through AAPC local chapter and Professional Medical Coding Curriculum (PMCC) sites. Each examination contains 75 questions and is administered in a 5-hour, proctored, open-book setting. Each examination contains 15 anatomy/medical terminology/pathophysiology questions, 15 ICD-9-CM questions and 45 coding scenarios.
Keep Your CPC-PEDS Credentials
Requirements to maintain your specialty certification include 16 continuing education units (CEUs) every 2 years; this is above and beyond the core credential CEU requirement. (The maximum number of CEUs is capped at 40 per year). For more information about the AAPC, to purchase a Study Guide or to register for the exam, go to www.aapc.com.
Brad Ericson is director of publications at AAPC and has been writing and editing coding publications for 16 years.
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