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Pediatric Diagnosis Codes Made Easier

October 24, 2019

To: Family Physicians, Pediatricians

Billing the most specific diagnosis codes on claims is the best way to make sure you are reimbursed appropriately for your BlueCross BlueShield patients. ICD-10 codes let us know when you have patients with conditions that require more of your time.

BestPractice reimbursement will account for this additional time, but only if we know about your patients’ conditions.

For some conditions, there are many codes to choose from, so using the most specific diagnosis code can make a difference. For example, with numerous codes for asthma, billing J45.20 (mild intermittent, uncomplicated) or J45.51 (severe persistent with exacerbation) gives us important information, helping us better determine how to reimburse you for that patient.

We’ve developed a tip sheet with some of the most common pediatric ICD-10 diagnosis codes to help you quickly determine which code to put on a claim. Click below for a printable, downloadable PDF version of the tip sheet.

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