12.  Getting Paid!

Summary

Getting Paid!

In episode 12 of Building Better Workflows titled “Getting Paid,” Dr. Lia addresses essential pediatric coding guidelines and mental health billing strategies aimed at improving reimbursement for pediatric healthcare services. She begins by recommending the American Academy of Pediatrics’ latest *Coding for Pediatrics* manual as a vital resource for staying current with coding practices, emphasizing the chapters dealing with mental and behavioral health coding. Dr. Lia highlights the significance of accurate E/M coding, suggesting specific codes like 99213 to 99215 for established patients and 99203 to 99205 for new patients to ensure providers are compensated properly for their time. 

 

She also delves into behavioral health reimbursement by explaining the inclusion of communication with other healthcare professionals and the application of modifier 25 for visits that address additional mental health concerns. Other important codes mentioned include 99408 and 99409 for substance use interventions, 99484 for chronic behavioral health condition management, and codes 96127 and 96110 for mental health and developmental screenings, underscoring their role in coding for pediatric mental health. Dr. Lia concludes emphasizing the need for advocacy for better reimbursement policies, directing listeners to resources and collaborative efforts that tackle these ongoing challenges in healthcare payments. This episode is a robust guide for healthcare professionals seeking to navigate the complexities of mental health billing effectively.



 

Bullet points of key topics 

  • Dr. Lia discusses crucial coding practices and guidelines to optimize billing for pediatric mental and behavioral health services.
  • Recommendation of resources like the AAP coding manual and the Building Better Workflows workbook to aid in effective coding and billing.
  • Emphasizes the importance of advocacy for appropriate compensation for mental health services in pediatric care.

 

 

List of resources mentioned in the episod



 

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Dr Lia Gaggino

Dr Lia Gaggino Host of the Pediatric Meltdown Podcast

Dr. Lia Gaggino has worked as a pediatrician for over 30 years on the west side of Michigan. During her career as a primary care physician, she has been privileged to care for children and adolescents, and know that their success is closely tied to mental wellness.

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Dr. Lia Gaggino has worked as a pediatrician for over 30 years on the west side of Michigan. During her career as a primary care physician, she has been privileged to care for children and adolescents, and know that their success is closely tied to mental wellness.

Recent Episodes

  • All Post
  • ADHD
  • Advocacy
  • Aggression and Disruptive Behaviors
  • Anxiety
  • Autism
  • Building Better Workflows
  • Depression
  • Genetics
  • healthcare disparities and inequalities
  • LGBTQIA+
  • Medications
  • Mental Health
  • OCD
  • Other
  • Pain
  • Parent/child
  • Physician Well-Being
  • Schizophrenia
  • Sleep
  • Social Media
  • Substance Abuse
  • Suicide Prevention
  • Trauma

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