2017 CPT Codes Changes for Pediatrics – How These Will Affect Your Practice

Current Procedural Terminology (CPT) changes are going to come into effect on January 1, 2017. This will mark the introduction of the 22nd edition of CPT code changes that will see several additions, deletions as well as modifications made to the existing list. Many of these changes in the codes are meant for use by Pediatrics too. This makes it essential for pediatric practices to update themselves with the code changes which will come into effect in the beginning of the next year. In all, over 700 code changes will come into effect from day one of 2017.

Pediatric coding and billing usually are meant to bill for services rendered to infants as well as children and adults aged 21 years or younger. While Medicaid covers most of the pediatric patients, outpatient pediatrics Medicaid billing can pose a challenge. The new updates for pediatrics include examples as well as guidance for implementing the new codes. Some of these changes will include codes related to:

  • Patient health risk assessment
  • New Telehealth modifier
  • Parent/caregiver health risk assessment
  • Review of pediatric surgical procedures updated
  • Moderate Sedation Services
  • New Appendix in CPT related to telehealth services

One of the prime ideas behind coding changes is to make sure that the physicians are able to choose the right code, which helps them lower the risks of payment delays or claim denials. Have a look at some of the upcoming CPT revised codes for Pediatrics which will come into effect by
Jan 1, 2017:

Revised 90644 Meningococcal conjugate vaccine, serogroups C & Y and Haemophilus influenza type b vaccine (Hib-MenCY), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use
Revised 90655 Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.25 mL dosage, for intramuscular use
Revised 90656 Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use
Revised 90657 Influenza virus vaccine, trivalent (IIV3), split virus, 0.25 mL dosage, for intramuscular use
Revised 90658 Influenza virus vaccine, trivalent (IIV3), split virus, 0.5 mL dosage, for intramuscular use
Revised 90661 Influenza virus vaccine, trivalent (ccIIV3), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use
Revised 90685 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.25 mL dosage, for intramuscular use
Revised 90686 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use
Revised 90687 Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL dosage, for intramuscular use
Revised 90688 Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use
Revised 90698 Diphtheria, tetanus toxoids, acellular pertussis vaccine, Haemophilus influenza type b, and inactivated poliovirus vaccine, (DTaP-IPV/Hib), for intramuscular use
Revised 90734 Meningococcal conjugate vaccine, serogroups A, C, Y and W-135, quadrivalent (MCV4 or MenACWY), for intramuscular use

For more on CPT code changes in 2017 for pediatrics, join Donelle Holle for a live webinar on Thursday, Dec 01, 2016, titled ‘2017 Updates to CPT® and Review for Pediatrics‘. Donelle will use the session time to give you the latest information regarding 2017 coding changes, highlighting the ones that are essential in Pediatrics, and how you put them to best use.

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