For adolescents, sports and school physicals, injuries, and acute illnesses are often the reasons that warrant a visit to the pediatrician. However, the world is full of temptations for the adolescent as he or she tries to assert independence, fit in, and deal with the responsibilities that come with each step toward adulthood (eg, cigarettes, alcohol, drugs). Although complex problems may require a referral for specialized care, it is often the primary care or emergency department (ED) physician who is first consulted on these issues. When reporting related services, the documented time of service is often the key for code selection.

A couple of scenarios help to illustrate this. Both scenarios are followed by procedure codes and diagnosis codes from International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM).

Tommy is a 14-year-old who is admitted to the ED for...

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