There are a variety of screening instruments for development, behavior, and other health risk assessments. What is the proper code to use for which instrument?
||Health risk assessment
- Ages & Stages Questionnaire (ASQ)
- Parents’ Evaluation of Developmental Status (PEDS)
- Vanderbilt ADHD forms
- Conners Rating Scale
- Screen for Child Anxiety Related Disorders (SCARED)
- Edinburgh Postnatal Depression Screen (EPDS)
- Standardized Concussion Assessment Tool (SCAT)
- Asthma Control Test (ACT)
What constitutes a 99214? What does “moderate medical decision making” mean?
Here’s a handy guide.
The AAP’s Coding for Bright Futures resource.
VFC regional maximum caps for administration fees.
The law regarding regional caps is found here.
Chapter Pediatric Councils meet regularly with health plans to discuss access, quality and coverage issues impacted by health plan coverage and administration policies.
See blog post about which vaccines need what NDCs & NDC suffixes.
When a payer says, “We pay X% of Medicare” — what does Medicare pay?
How much revenue can a pediatrician expect to generate from his/her outpatient and inpatient work? Get some estimates using this spreadsheet tool.
The AAP has nurtured primary contacts with the largest private health plan carriers and each PPAAC member is assigned to specific carriers as a resource to assist AAP members having issues with the carrier.
- Aetna: Gene Hershorin, MD, FAAP: EHershorin@med.miami.edu
- Anthem: Mark Hudak, MD, FAAP: firstname.lastname@example.org
- CIGNA: Sue Kressly, MD, FAAP: email@example.com
- Humana: Gail Schonfeld, MD, FAAP: firstname.lastname@example.org
- United Healthcare: Richard Lander, MD, FAAP: email@example.com & Chip Harbaugh, MD, FAAP: firstname.lastname@example.org
- Blue Cross Blue Shield Association plans: Betsy Peterson, MD, FAAP: email@example.com
- Medical specialty and surgical specialty issues: Mary Brandt, MD, FAAP : firstname.lastname@example.org
The AAP’s Business Case for Vaccines lists how practices should think about appropriate payment for vaccines.