Coding references

Pediatrics: the codes and the rules.

Three tables for a pediatric practice, each one a coder can check against the 2025 CMS and ICD-10-CM files, and the notes that come up every week.

2025 files

Reference, not billing advice. The practice's coder confirms every code before a claim goes out.

The tables.

The notes a coder repeats.

  • A sick complaint addressed at a well visit is a separate E/M with modifier 25 when it is significant and documented separately.
  • Immunization administration with counseling (90460, 90461) is counted per component of each vaccine, through age 18, when the physician counsels the family.
  • Preventive visit codes have no listed work RVU here; the practice's fee schedule sets them, and Medicaid plans publish their own.

Other specialties.

A receptionist that knows pediatric calls.

Screening forms your clinicians approve, the on-call paged with answers, and every call booked or handed back as a task.