This article was written by Peter D. Rappo, MD, FAAP, and Melissa A. Rappo, BA. Dr Peter Rappo is a primary care pediatrician practicing in Brockton, MA. He is a former American Academy of Pediatrics (AAP) Massachusetts Chapter president, a former chair of the AAP Committee on Practice and Ambulatory Medicine, and an assistant clinical professor of pediatrics at Harvard University School of Medicine. His interest in coding stems from his interest in the care of children with special health care needs. Melissa Rappo has a BA from Boston University and works at the Center for Adolescent Substance Abuse Research at Children's Hospital Boston as a clinician and researcher.

A number of sources have indicated that the percentage of children in primary care settings with special health care needs ranges from 1% to 20%. At the extreme low end of this range are children with a variety of technology-dependent issues,...

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