PCC’s Billing Training Course

PCC offers a comprehensive course on using its software for pediatric billing and collections. Contact PCC at support@pcc.com or 802-846-8177 or 800-722-7708 to find out when the next course is.

Watch the most recent PCC Billing Training Course using the video links below. The complete course is about nine hours.

PCC’s Billing Training Course

Topic By Topic Videos: You can also choose specific topics and dive into more detail on the New Biller Training Outline page.

UC 2023 Videos and Course Materials

In 2023, PCC’s Users’ Conference was held in Burlington, Vermont. We celebrated PCC’s 40th anniversary with a 1980s theme.

Over 700 attendees participated both online and in-person in 63 courses, sessions, and round tables on issues of importance to pediatric practices.

Sessions were recorded, and where possible we’ve made them available on a PCC UC 2023 playlist, and using the links below. Attendees can access course and video information on the PCC Events app. Most materials will be available for at least one year following the conference.

You can review the UC 2023 Dashboard Awards, photo albums, and more at pcc.com’s UC 2023 page.

Course Descriptions, Slides, and Videos

Course Title Course Description Materials
2023 Coding Updates
Join PCC’s Jan Blanchard for a heads up on the new Pediatric ICD-10 and CPT coding changes for 2023.

Presented By: Jan Blanchard

2024 NCQA PCMH Annual Reporting Changes
Get insider knowledge of the 2024 NCQA PCMH Annual reporting changes and learn how to implement the changes with effective workflows.

Presented By: Kate Taylor, Amanda Ciadella

A Doctor and a Coder Walk into a Bar
The exact types of expertise needed to really nail documentation and E&M compliance are shared in this entertaining and interactive session. Krekamey Craig, MD shares real encounter examples from her experience as a practicing Pediatrician and Jan Blanchard highlights the coding guardrails around billing for these Primary Care Pediatric services. Come get the best guidance from both of the worlds you must navigate to be paid for all that you do and to *keep* that payment.

Presented By: Jan Blanchard, Krekamey Craig

A Practical Guide on Auditing Your Billing Department
Every office should have a strong understanding of their billing practices. Performing regular internal audits is an essential part to keeping your practice thriving and developing a plan that fits the needs of your organization is attainable. In this session you will learn the tools you need in areas such as correct modifiers, verifying large write-off balances, A/R follow-up and more.

Presented By: Heidi Chamberlin

Addressing Grief and Loss in Practice
Many of our children and families have experienced the loss of a loved one during the COVID-19 pandemic. However, pediatricians have not been traditionally trained in grief counseling and report discomfort in addressing this topic with patients. This session will discuss the basics in addressing grief and loss with and provide tips regarding how to comfort and partner with families during these most difficult experiences.

Presented By: Colleen Kraft

Advanced Reporting Workshop
Looking to gain a deeper understanding of how to build customized reports using PCC’s reporting tools including the Smart Report Suite (srs) and the EHR Report Library? Join us for this hands-on, interactive workshop to explore some of the advanced functionality within PCC’s reporting tools. Your PCC instructors will introduce you to report data sources and how to build customized report filters and output to meet your reporting needs. Come prepared with a laptop enabled with connectivity to your practice. One goal of this session is to create at least one new customized report on your own practice server.

Presented By: Tim Proctor, Jim Smith, Kate Taylor

Advancing Pediatrics 2023
Mark will discuss how the American Academy of Pediatrics (AAP) is working to solve the challenges currently facing pediatricians and pediatric medicine. Improvements are needed across the pediatric health care system to empower pediatricians to care for children and families.

Presented By: Mark Del Monte, JD

Allow Me to Introduce Myself: Professional Bios in 500 Words or Less
This workshop will cover the basics of what constitutes a great professional bio for websites, speaking events, professional networking, and more. Attendees will workshop their bios and compare with partners for half the session.

Presented By: Allie Squires

An Independent Pediatrician’s Journey to Ukraine
As news of the war in Ukraine escalated in 2022, Dr. Kent Kleppinger listened in with increasing concern from his practice in Laramie, Wyoming. When Dr. Kleppinger decided to step in to help physicians in Ukraine, he didn’t hesitate; he went all in.

Presented By: Kent Kleppinger, MD

Ask Chip
Bring your practice management questions and PCC’s resident practice management expert, Chip Hart, will answer them live.

Presented By: Chip Hart

Back to the Future A PCC Roadmap Review
A review of the past year of PCC changes and a preview of what’s to come. Come learn what PCC has in store for you!

Presented By: Scott Ploof

Billing Drop In Live from the UC!
Come meet all of your Pediatric Billing peers at this live, in person event modeled on our monthly virtual get togethers. No one knows your work like billing experts! Who better to offer solutions, time savers, shortcuts, tools, and resources than your fellow peers who are also using PCC? This is an opportunity to bring your questions and challenges to peers and experts in a low-key, casual, and friendly face-to-face environment.

Presented By: The Get Paid Team

Burnout: Or How I Stopped Worrying and Learned to Love the Job
Burnout has reached an all-time high among physicians in pediatrics. Using the latest information from positive psychology as well as proven stratgies from professional organizations, Dr. Trimble hopes to guide you through the best ways to understand and finally manage burnout. Don’t miss this opportunity to empower your people and bust through the chaos!

Presented By: Robert Trimble

CHADIS Workflow Roundtable (In-Person Only)
This is an opportunity for clients to get together and discuss CHADIS workflow challenges, best practices, and more. Learn from PCC’s CHADIS expert, Sasha Pavlovic, and others in a conversational setting.

Presented By: Sasha Pavlovic

Change Management for Managing Change
Every day in a busy pediatric practice you’re overwhelmed by the number of tactical decisions you need to make. This makes it difficult to think strategically for your practice. How can you ever evolve to become the practice you dreamed of being if you don’t have the time or organizational capacity to make the necessary changes. We will review a few simple guidelines that will help your practice make important changes to improve the quality of your care and the success of your practice.

Presented By: Chip Hart

Dark Side of the Moon
This is a class about how to use your practice as a tool to reach beyond the walls of your office. Vaccine clinics at local schools, mobile wellness visits at a homeless shelter, presence at the local farmer’s markets, and pairing with local vendors are all ways in which to explore other sides of the four walls of your office.

Presented By: Katie Schafer

Dashboard Awards Presentation
We’ll present this year’s dashboard awards at lunch!

Presented By: PCC

Disaster Preparedness for Solo and Small Practices: Lessons from My Journey with Cancer
I will use my personal journey with cancer to illustrate the kinds of planning and preparation that small and solo practice owners need to consider. We’ll discuss issues of continuity, insurance, communication and lessons learned for self-care to help ensure that when the unthinkable happens, the survival of one’s practice can take a back seat to returning to health.

Presented By: Seth Kaplan

Enneagram Magic: The Power of Self- Awareness
“Teamwork makes the dream work;” but first, one must look within themselves. Self-awareness helps us be fiercely present, have honest conversations, build trust and ultimately improve relationships, culture and productivity. The enneagram offers a self- awareness framework to better understand the “why” behind our actions AND inspires us to be curious about understanding the “whys” of those around us. During this session, we will do a deep dive into how to use the enneagram to promote self-discovery, provide feedback and improve teaming at work and at home. That is where the magic lies.

Presented By: Akshata Hopkins

Everybody Wants to Use New Forms (In-Person Only)
Join our Forms Development Team for a discussion of the migration process to PCC’s new forms solution and an opportunity to experiment with the product on your own. This hands-on workshop will include guided exercises allowing you to experience the Forms Configuration Tool within your own EHR system. Attendance at the prior “Sweet Forms O’ Mine” introductory session is recommended. This session will not be streamed for virtual attendees.

Presented By: Dan Gillette, Tim Proctor

Front Desk Best Practices
Explore front desk best practices related to scheduling, check-in, insurance verification and copay collection and what has changed as offices work within the pandemic. Understand the importance of the front desk when it comes to your practice’s workflow and collection process.

Presented By: Lynne Gratton

Get Ready to Dive Into Credit Card Processing: Let the Fun Begin!
We surveyed the PCC practices and the strong majority wanted a credit card processing workshop using CardPointe and/or BluePay with a strong emphasis on Credit Card on File (workflows, pros/cons etc), PCI Compliance, Patient Portal Marketing and setting up/maintaining payment plans.

Presented By: James & Sarah Estes

Grow Your Own EDI Superuser
Explore the lifecycle of electronic eligibility requests, claim submissions, and ERA responses. Along the way, you will learn about the underlying transactions (837P, 270 and 271, 835). By the end of this course, you’ll become the EDI superuser your practice needs: you’ll understand how to troubleshoot eligibility issues, decode confusing payor responses, and when to work with PCC.

Presented By: Ben Brandt

Hardware Petting Zoo (In-Person Only)
We will display and describe current and older equipment supplied by PCC, as well as allow participants to actually plug, click and manipulate equipment. This session is an intro to hardware for the techno-phobic.

Presented By: Tom Anderson,James Frei,Stephen Moore,Thomas Heller

Hardware Petting Zoo (In-Person Only)
We will display and describe current and older equipment supplied by PCC, as well as allow participants to actually plug, click and manipulate equipment. This session is an intro to hardware for the techno-phobic.

Presented By: Tom Anderson, James Frei, Stephen Moore, Thomas Heller

How To Assess Opportunities for Growing or Selling Your Practice
Do you have buyers knocking on your door? How do you know if selling is right for you? Should you hold on or sell out? There may be other options …

Presented By: Susanne Morgana Brennan, MBA

How To Market Your Practice With No Time, Talent, or Money
20 years ago, patients still found their pediatricians through a combination of word-of-mouth and the Yellow Pages. Although parent-to-parent marketing is still vital, 2023 is about Google, review sites, and cell phones. How can you, a pediatrician with no time, money, or social media talent, connect with these new millennial parents?

Presented By: Chip Hart

ImmTrac Roundtable (In-Person Only)
An opportunity for Texas clients to discuss workflows that impact immunization submissions to ImmTrac.

Presented By: Romni Palmer

Leave Behind the Dark Side: Post Charges, Payments, Submit Claims, and More in PCC EHR!
Complete your daily billing tasks in PCC EHR! From checking eligibility to working with personal payments, to submitting claims and posting insurance payments, PCC EHR has tools that will empower your billing lifecycle. Leave behind the text-based darkness of yesterday and learn about PCC EHR’s latest features.

Presented By: Brian Kennedy

Messaging to Patients
Learn the proper usage and best practices for PCC’s various messaging tools. Get up to date with all the recent changes, tips and tricks from patient engagement support specialists, Scarlett Tomlinson and Sasha Pavlovic

Presented By: Sasha Pavlovic,Scarlett Tomlinson

Monitoring your Immunization Submissions
This course covers the basics of using the Immunization Registry Response Viewer to check on your practice’s submissions to the state registry.

Presented By: Romni Palmer

PCC Benefits A Case Study
The benefit package provided by a company to its employees reflects the culture of the organization and provides the employer with the opportunity to demonstrate their commitment to the employer/employee relationship.

Presented By: Grace Kuzmin, Bill VanDeventer

PCC EHR Customizations & Workflow for Pediatric Medical Homes
Patient Centered Medical Home is not just a certificate, it’s actually a concept of care delivery. Learn from industry experts the most effective patient-facing workflows that affect your daily operations.

Presented By: Kate Taylor, Amanda Ciadella

PCC eRx Open Lab (In-Person Only)
New this year! Stop by our eRx-specific open lab for personalized answers to all your prescribing questions. Want help with your Favorites? Need a refresher on custom medications or other configuration options? Have an eRx bug you want squashed? Our eRx team is here to help.

Presented By: Morgan Ellixson Boyea, CPhT, CSPO

PCC Shortcuts For Faster Charting
This Advanced Beginner/Intermediate level workshop session reminds users how to configure snap text, auto-notes, Dx favorites, billing configuration, labs/orders, protocols, and tasking to reduce the time they spend charting. Bring your laptops for hands-on time at the end of the session.

Presented By: Sarah Bunning

Pre-Check-In Takes Flight!
Do you dream of greeting patients at the front desk with a just a smile, and NO paperwork? That’s the vision for a new feature in PCC development: Patient Pre-Check-In. In this session we will demonstrate the initial Pre-Check-In functionality and we will review designs for the remaining planned functionality. PCC will be seeking a few practices to pilot the feature and help us grow it to be ready for all practices. We will discuss the reality of what it means to pilot the first version, and we will provide opportunity for you to share your wishes for how this new feature should evolve to serve the needs of your practice and the patients and families you serve.

Presented By: Erica Greenwood, Amanda Smith

Preconference Morning Session
Live Stream the morning preconference sessions here!

Presented By: Nick Meunier, Tim Proctor, Morgan Ellixson Boyea, CPht, CSPO

Preconference: Introduction to Practice Vitals Dashboard
As a managing physician or practice administrator, have you ever wondered how your practice is performing with key clinical and financial indicators? This introductory session will provide an overview of PCC’s robust Dashboard reporting capabilities, focusing on measures that will allow you to keep your finger on the pulse of your practice.

Presented By: Tim Proctor

Preconference: PCC eRx 101: Prescribing Fundamentals
Are you brand new to prescribing with PCC eRx? Or simply want a review of the fundamentals? Join PCC’s Morgan Ellixson-Boyea, CPhT, CSPO for an in-depth tour of our prescribing software including dedicated time for questions. This course is designed for beginners, but anyone interested in learning more about PCC eRx is welcome to join us.

Presented By: Morgan Ellixson Boyea, CPhT, CSPO

Preconference: Tour of the EHR
This course begins with a run-through of appointment book, clinical workflows, where to find it, where to configure it, and what to do if you’re stumped. We will spend some time in protocols, scheduling templates, clinical alerts, and more.

Presented By: Nick Meunier

Proactively Manage Insurance A/R
In today’s challenging insurance environment, insurances are working overtime to limit reimbursement to providers. To get the most out of your contracted rates you first need to start with managing your insurance denials and the obstacles they throw your way in delaying payment. This session will touch on frequent denials, clearinghouse rejections, payer guidelines and so much more.

Presented By: Rebecca Lamb

Promoting a Vaccine Against Cancer: Increasing HPV Vaccination Rates in Your Practice
In the United States, high-risk HPV cause 3% of all cancers in women and 2% of all cancers in men. The HPV vaccine is extremely effective against preventing HPV related cancers yet only 54% of US teens are up to date on the vaccine and in many areas its as low as 30%. I will discuss how, through small yet effective interventions, Pelican Pediatrics increased our rates from 33% to 88% and how you can too.

Presented By: Eliza Varadi

Real Time Prescription Benefit Service: An Industry Perspective
Join PCC’s Dewey Howell, MD, PhD (the creator of PCC eRx!) for an in-depth review of an exciting change for PCC eRx: Real-Time Prescription Benefit Services. See a sneak peak of our upcoming changes and provide early feedback. Your input matters!

Presented By: Dewey Howell, MD, PhD

Reporting Drop-in Session (In-Person Only)
Join your peers and PCC’s reporting experts to discuss reporting needs at your practice in this part discussion, part workshop session. This is an opportunity to bring your reporting questions and challenges to peers and experts in a low-key, casual, and friendly environment.

Presented By: Tim Proctor, Jim Smith, Kate Taylor

Sailing Into The Wind: How To Survive In A Big Practice Market
How can a small, primary care practice survive in a health care market that appears to favor the larger groups? Learn how small practices can not only survive, but THRIVE, in big practice markets.

Presented By: Susan Kressly,Chip Hart

Sharing Clinical Records: DSM & CDE
This course will explore Direct Secure Messaging and Clinical Document Exchange, two solutions that allow your practice to share data more easily with third parties. Learn the difference between the solutions, how they complement each other, and how to onboard!

Presented By: Jennifer Marsala

Sweet Forms O’ Mine An Introduction to New PCC Forms
This introductory session will show you what it takes to convert to PCC’s new forms solution and the simple-to-use and powerful features that await you on the other side. Join PCC’s Forms development team as they walk you through creating new forms within the form configuration tool, highlighting how to insert variables, response prompts, headers, signatures, and much more.

Presented By: Dan Gillette

The Art of Delegation
In this session, Dr. Skinner will review the business case for delegation in the physician practice, uncover the typical roadblocks to delegation success, and share practical tips that help attendees improve their delegation skills in their offices.

Presented By: Katrina Skinner

The Next Generation Preparing Your Practice for a Long and Prosperous Future
Preparing to hand off a practice you’ve built is a daunting prospect. Taking over an existing practice is similarly daunting. In this course, you will learn how to prepare your practice to be handed off to the next generation. This course will cover structuring ownership and compensation to ease the transition as well as finding and preparing the right people to lead your practice into the future.

Presented By: Paul Vanchiere, MBA

The Pediatrician Experience: Participating in the AAP’s PROS Network Research
This session will provide background on PROS research, current projects, innovative approaches used with PCC, and will highlight the experience from the practitioner perspective of participating in PROS research

Presented By: Alexander Fiks

To the Right of Boom: What Happens After a Cyber-Security Incident Occurs
Learn about what happens after a cyber security incident occurs. Empower yourself by learning about post-event situational awareness and how to respond and recovery from a “boom”. We will review the 4 major actions every practice must take before a security incident is detected and after.

Presented By: Marissa Maldonado

Unstoppable. A Framework for Reaching Practice Goals.
In this session we will talk about how to align your entire team towards your practice goals to ensure they are met and celebrated by all. By the end of the session, participants should be able to define at least one practice goal and will have a framework that what will tell them exactly how to make sure that goal is accomplished not by them, but by their team.

Presented By: Emily Floyd

Using PCC Dashboard Data to Serve Your Community
Join us to hear how Dr. Seth Kaplan from TLC Pediatrics of Frisco, TX uses PCC’s Dashboard to make data-driven decisions for his practice. This session will provide an overview of PCC’s robust Dashboard reporting capabilities, focusing on financial and clinical measures that will allow you to keep your finger on the pulse of your practice.

Presented By: Tim Proctor,Seth Kaplan

Welcome & Morning Announcements Presented By: PCC
What Retirement Taught Me About Retirement Planning
Retirement planning is not something that can be left to be taken care of when one decide that it’s time to retire. Rather, it is something that should be started as soon as one begins that first job. Planning takes different forms and addresses different topics as one moves through the stages of a career, but each choice sets the stage for future ones. While this talk will briefly discuss financial issues usually associated with retirement planning, the focus will be more on understanding one’s identity as a physician, and how that will shape the choices one makes throughout that career, especially those which will impact the timing, process, risks and benefits associated with retirement.

Presented By: Jesse Hackell

What’s Changed with Implementations?
Your office has been on PCC EHR for 5 years or more and your implementation process was 5 years ago. How do we do implementations now? What are the configurations we setup for new clients which you may not be taking advantage of? Learn how current implementations may change how you use PCC EHR.

Presented By: Lynne Gratton

What’s Next for PCC eRx
Join PCC’s Morgan Ellixson-Boyea, CPhT, CSPO for a sneak peek into the next year of development for PCC eRx. In addition, you’ll hear about recent bug fixes and improvements, learn new tips & tricks, as well as cast your vote for future enhancements of PCC eRx! Session will also include open Q&A.

Presented By: Morgan Ellixson Boyea, CPhT, CSPO

What’s Past is Prologue
We’ll share how the original vision for PCC–40 years ago!–designed to emphasize long-term relationships and empower our clients, continues to guide the company vision for today and the future.

Presented By: Erin Auer

Which Interfaces are Right for Your Practice?
Discover which PCC integration options best address specific data sharing use-cases, and which might be a good fit for your practice.

Presented By: Scott Kirby

Why You Need Data and Getting the Data You Need
At the conclusion of this presentation, participants should be able to: illustrate how to turn a “word problem into a math problem” just like in middle school, identify appropriate sources of the data required to make an Evidence Based Practice Management Decision, construct a plan and collect the data required to make an important assessment of the practice.

Presented By: Chip Hart

Writing Playbooks That Are Awesome
Playbooks are important for every pediatric practice: they explain how you want your schedulers to do your appointments; they describe the dress code and attendance policies for your staff in your employee handbook; they lay out steps to take in the case of vaccine temperature excursion. How can you write procedures that are clear, relevant, up-to-date, and don’t suck?

Presented By: Suzanne Berman

Patient Engagement Trainings and Drop-In Sessions

PCC’s Patient Engagement Team hosts regular drop-in sessions for PCC clients. Join us and other PCC users to have your questions answered by the Patient Engagement team, and to learn more about PCC’s patient communication, engagement, and clinical tools. You’ll even get occasional sneak peeks into upcoming PCC features and solutions.

Watch a Previous Drop-In Session

Click in the table below below to review the presentation video or any available accompanying materials for each web lab.

 

Date Topics Presentation Additional Links and Handouts
2025 February 24 Portal Self-Scheduling Drop-In Weblab Video Download a PDF of this session’s slides
2025 November 5  Portal Self-Scheduling New and Upcoming Features Training Video
2025 June 26  Portal Self-Scheduling Training Video Download a PDF of this session’s slides
2025 May 29  Portal Pre-Check-In Training Video Download a PDF of this session’s slides
2025 April 29  Portal Self-Scheduling Training Video Download a PDF of this session’s slides
2023 February 21  Patient Portal Messaging and Templates Video Download a PDF of this session’s slides
2022 October  Patient Communication Tools Video
2022 September Leveraging CHADIS’s Tools and Workflows
With Guests Hana Schwartz and Sharissa Epps from CHADIS
Video
2022 August Patient Engagement (Care for Patients) Inaugural Q&A Drop-In Session
Video

UC 2022 Videos and Course Materials

In 2022, PCC’s Users’ Conference returned to Burlington, Vermont. Our theme this year was Resilience and Rejuvenation! We recognize that you are in pediatrics because of your patients and their families. We want to honor that and help you make your practice a place that supports them through every phase of their journey with you.

Over 500 attendees participated both online and in-person in 46 courses, sessions, and round tables on issues of importance to pediatric practices.

Sessions were recorded, and where possible we’ve made them available on a PCC UC 2022 playlist, and using the links below. Attendees can access course and video information on the PCC UC 2022 app, which will be available for one year following the conference.

Learn more on PCC.com’s UC2022 wrap-up page.

Course Descriptions, Slides, and Videos

Course Title Course Description Materials
2022 Coding Updates
Join PCC’s Jan Blanchard for a review of the ICD and CPT changes in play this year. She’s not Donelle Holle, but she’s still awesome!

Presented By: Jan Blanchard

5 Security Policy Tips to Implement for a More Secure Practice
Learn what and how to implement 5 Security Policies today for your practice that will help ensure you are staying up to date with the evolving Cyber Security Landscape.

Presented By: Marissa Maldonado

AAP PROS Update
Join Alex Fiks of the AAP’s Pediatric Research in Office Settings (PROS) group to learn about PROS past, present, and future. He’ll highlight recent studies that PCC clients have collaborated on and preview some upcoming study opportunities.

Presented By: Alexander Fiks

Allow Me to Introduce Myself: Professional Bios in 500 Words or Less
This workshop will cover the basics of what constitutes a great professional bio for websites, speaking events, professional networking, and more. Attendees will workshop their bios and compare with partners for half the session.

Presented By: Allie Squires

Ask Chip
Practices can bring their questions to the session to have them answered live by Chip with helpful input from the audience.

Presented By: Chip Hart

Best Payment Processes: A Review Into Payment Workflows, Credit Card on File and PCI Compliance
How are you taking payments now? Are you employing the best payment processes for your practice? It’s a good idea to review your payment processes and ensure they grow along with you. There are various factors that can require a reassessment of these workflows, including security changes to reduce PCI scope, technology advancements and environmental obstacles, to name a few. We’ll provide examples of what other practices are doing and explain why they work. Payment acceptance methods PCC clients use include combinations of patient portal integration, hosted payment pages, virtual terminals and physical terminals. Like a lot of things, payment processes is not “one size fits all.” Seeing the ways other practices combine these methods in their offices will be useful in assessing the payment workflow of your own practice.

Presented By: James & Sarah Estes

Billing and Payment Workflows (Post 9.4 release)
This session will explore all the ways Billing and Collection tools may be accessed through PCC EHR.

Presented By: Ben Brandt

Billing Workflow Roundtable (in-person only)
Come hear about the tips and tricks your colleagues employ to make PCC work for them. We’ll explore shortcuts, pro tips, and words to the wise that will help you work smarter.

Presented By: Jan Blanchard

Budgeting For Pediatric Practices
Bring together all the financial data points to plan your future! Join Paulie Vanchiere from PMI as he walks you through the steps to create a budget for your practice. Leveraging practical experience, participants will learn what they need to know to properly plan your financial future.

Presented By: Paul Vanchiere

Clinical Oversight Reporting
As a managing physician or practice administrator, have you ever wondered which clinical reports you should be monitoring regularly to ensure the practice is operating successfully? This session will highlight PCC’s robust reporting capabilities, with a focus on clinical oversight reporting. You will learn how to report on clinical operations related to vaccine inventory, orders, and prescription activity. Discover how to use PCC’s Report Library for preventive and chronic care recall. We will also delve into high-level strategic reporting of clinical measures within PCC’s Dashboard including vaccine rates, well visit rates, screening rates, and more. Discover the numbers that really matter to your practice’s clinical health and how to find and track the information you need most.

Presented By: Tim Proctor

Compliance – You Don’t Know What You Don’t Know
Did you know as a Provider every time you credential with Medicaid or Medicaid HMO’s you are attesting that you have an effective Compliance Program? Yes, really. Do Your Practice Policies Meet Federal & State Regulations? Is Your Practice following OIG Guidelines? Are you familiar with Sec 1866? Did you Choose a Qualified Compliance Officer? Is Your Compliance Program Effective? Is Your Practice Utilizing Competencies Effectively? -Attendees will learn best practice risk assessment methodologies, how to define an audit scope, when to perform audits, what to look for, how to document and next steps when hazards or vulnerabilities are discovered.

Presented By: Michelle Richards

Creating Efficiencies within E&M Guidelines
In 2021 we focused on the newness of the guidelines, this year let’s focus on getting the guidelines right!

Presented By: Shannon Deconda

Delivering on Your Practice Culture
Are you running a practice where personal responsibility isn’t baked in? Do people leave shifts early? Do they wait for someone to tell them what to do? Are messes left for someone else (you!) to clean? Do your patients miss a lot of appointments? Is your clinical performance disappointing? How can you lead your practice to understand that they are part of a team with a common goal. You’ll also learn tips for honestly assessing BOTH of your practice’s cultures; the culture you aspire to and the culture you actually have.

Presented By: Chip Hart

Expanding Your Practice
This talk will focus on how to expand your practice and will address such topics as adding services to your existing location, opening an additional location, adding providers and/or partners, exploring and assessing joint ventures (with hospitals and other 3rd parties), and so on.

Presented By: Susanne Morgana Madden, MBA,Paul Vanchiere

Financial Oversight Reporting
As a managing physician or practice administrator, have you ever wondered which financial reports you should be monitoring regularly to ensure the practice is operating successfully? This session will highlight PCC’s robust reporting capabilities, with a focus on billing oversight and productivity reporting. You will learn how to do a pricing and payment analysis, and develop an understanding of high-level strategic reporting of financial measures within PCC’s Dashboard product. Discover the numbers that really matter to your practice’s financial health and how to find and track the information you need most.

Presented By: Tim Proctor

Forms with Benefits
Find out how PCC’s new forms solution can help you get more out of patient form letters. In the new way of doing things, your current forms get an upgrade and you can create new templates from scratch. Discover the benefits of switching up how you do forms, what it takes to convert to the new solution, and the simple, powerful tools that await you on the other side.

Presented By: Bastien Gliech,Dan Gillette,Kayla Robinson

Front Desk Best Practices
Explore front desk best practices related to scheduling, check-in, insurance verification and copay collection and what has changed as offices work within the pandemic. Understand the importance of the front desk when it comes to your practice’s workflow and collection process.

Presented By: Lynne Gratton

Get the most out of the CHADIS and PCC EHR integration
This session will offer practical insights, peer-tested ideas, and tips for getting the best return on your CHADIS integration. Some of the topics we’ll cover include: improving your patient portal usage rates, following up on outstanding questionnaires, modifying your CHADIS screening assignments, and many more. Bring your questions and ideas to this session. This course is primarily intended for existing users of the CHADIS-PCC integration, but the tips and tricks in this session will be beneficial to clients who are in the process of integration, or who would like to get started.

Presented By: Sasha Pavlovic

Healthcare Engagement and Experience
In 2022 and beyond, primary care must continue to adapt to Gen Y and Gen Z parents.This talk explores the ways in which healthcare professionals can connect and engage with patients/families.

Presented By: Todd Wolynn

How Much Should I Pay An Employed Clinician?
Hiring a new physician or nurse practitioner and wondering not only what you should pay, but what you can AFFORD to pay? This simple exercise will walk you through determining the maximum salary of your employed clinicians and review the non-salary drivers that motivate clinicians.

Presented By: Alex Meyer, MBA

How not to be a BWitch
Exploration of professional interactions among women, the negative impacts of the Queen Bee Syndrome, and how changes can be made for women to help uplift each other.

Presented By: Hiral Lavania

How the COVID Pandemic Permanently Changed How We Practice
Since the onset of COVID pediatric practices have had to change how we practice. Initially these changes seemed temporary but after 18 months many of the changes have actually improved many of our workflows and will likely stay. Some of the changes include or are related to : telemedicine, remote check-in, vaccine clinics, waiting rooms as well as addressing social and economic issues.

Presented By: Eliza Varadi

How To Effectively and Profitably Add Behavioral Health Services To Your Practice
This talk will focus on how to incorporate Behavioral Health services into your practice from a ‘line of service’ perspective: Who do you hire? What services do you offer? Do you outsource? How do you promote to patients? How can you ensure its profitable?

Presented By: Susanne Morgana Madden, MBA,Amanda Ciadella

How To Give Vaccines Without Giving Away The Farm
Do you know how much it really costs to administer vaccines? Are you properly billing for your vaccines? Learn how to measure your real product and administrative costs and discover practices ways to improve your delivery efficiency. Special appearance by Dr. Christoph Diasio to discuss vaccinating adults in the pediatric medical home.

Presented By: Christoph Diasio,Chip Hart

How To Maximize Your Preventive Care Clinical and Financial Workflow
We will discuss how to use different reports and PCC Dashboard information to maximize your well check recalls and minimize outstanding balances.

Presented By: Jim Leahy,Hiral Lavania

How to Organize and Run a Successful Drive-Thru Vaccination Clinic
Since the onset of the pandemic – we have turned our annual fluclinics into a drivethru – we have been able to perfect the technique – vaccinating 3 times the number of people while being socially distanced in their car. Once COVID vaccines rolled out we added those to our drivethru. Our last drivethrus included flu vaccines and COVID vaccines without any confusion and easy documentation. I would like to present the logistics and organization of the drivethru clinic

Presented By: Eliza Varadi

Humor in Medicine
You don’t need to be a shoulder specialist to find humor in medicine. Jim Smith’s comedic routine will teach how incorporating humor and levity into your practice can help you connect with and provide better care for your patients.

Presented By: Jim Smith

Impact Beyond The Exam Room
At the end of this presentation, attendees will understand that they can have impact beyond the exam room. They will also discover the different ways they can accomplish this.

Presented By: Dr. Unachukwu

Impact of COVID on Preventive Care
2020 was the first time in decades of measurement that most pediatric clinical benchmarks declined – well visit coverage, depression screening, even vaccines. What does the data tell us about the impact of COVID on the services pediatricians provided in 2020 and what should we be doing about it?

Presented By: Chip Hart

LIVE Pediatric Billing Drop In
Come meet all of your Pediatric Billing peers at this live, in person event modeled on our monthly virtual get togethers. No one knows your work like billing experts! Who better to offer solutions, time savers, shortcuts, tools, and resources than your fellow peers who are also using PCC? This is an opportunity to bring your questions and challenges to peers and experts in a low-key, casual, and friendly environment.

Presented By: Jan Blanchard,Douglas Brosseau

Oversight Reporting Workshop (in-person only)
Take what you’ve learned in the Financial and Clinical Oversight Reporting courses and start to put it into place in your practice. Bring your laptop, log into your system, and start working with your reports and your data today!

Presented By: Tim Proctor

Patient Recall Strategies
You know you have patients you haven’t seen in a while. How do you get them back in the office so they get the care they need? PCC’s Jim Smith will review recall strategies to bring your overdue patients back.

Presented By: Jim Smith

Preventive Care vs Sick Visit and Combo Care
Sometimes it’s not just a well child visit, and sometimes it’s not just a sick visit. The key is ensuring proper documentation to bill appropriately for services rendered.

Presented By: Shannon Deconda

Promoting Child Health Through Advocacy
Pediatricians are natural advocates and using these skills to advance and promote child health is impactful. This talk will review why advocacy is important, how to hone and develop those skills, as well as provide AAP examples of successful advocacy efforts.

Presented By: Sandy Chung

Refugee and Migrant Health and Your Pediatric Medical Home
The United States is seeing increases in the numbers of children and unaccompanied youth fleeing violence from countries in Central America, Haiti, and Afghanistan. This session will examine what these new populations of children mean to your community as well as highlight pediatric practices that are developing the capacity to care for these children.

Presented By: Colleen Kraft

Should You Run?
More women are needed to hold public office. Is it in your future? Hear from one female pediatrician who ran–and won!

Presented By: Katie Schafer

The Changing Nature of Malpractice Suits in Pediatrics
While the allegations of negligence in care have not changed much, the tactics and focus of plaintiff’s attorneys have evolved in concert with the changes in technology and documentation. This session will review several cases where the outcome depended not just on what the physician did or did not do, but on the technical processes of management and documentation.

Presented By: Jesse Hackell

The Five Biggest Mistakes Pediatricians Make
The 5 Biggest Business Mistakes Pediatricians Make Why do good independent pediatricians fail? Failure is an opportunity to reassess and learn from mistakes. While you’re good at your profession, it’s not enough to simply be a good pediatrician anymore. You also need to understand and excel at the business of pediatrics to make an independent practice truly thrive. It’s easy to develop habits over time that allow you to just get by, but not excel in your practice. With a few simple changes, you can improve your business, delight your patients, and create a better workplace culture. Take the opportunity of mistakes to make your practice stronger and more agile than ever.

Presented By: Chip Hart

The Magic of Tidying Up: Pediatric Executive Edit
Pediatricians frequently work in silos where their perfectionism and inability to say no leads to burnout and exhaustion. Many pediatricians have not cultivated their superpower of delegation or learned the art of automation to create more time for things that bring them joy. A pediatrician’s health, well-being, and personal development are crucial to the sustainability of their practice. In this thought-provoking and highly-motivating session, attendees will apply the principles of a popular decluttering movement to create more calendar space so they will have the emotional, mental, and physical bandwidth to care for their patients, families, and communities.

Presented By: Katrina Skinner

The Patient Centered Medical Home (PCMH) For Children With Special Healthcare Needs
It’s not a building! Family/Youth Leaders have an important role to play in a patient centered medical home. Learn what makes a medical practice a medical home, about the certification process and how family/youth leaders are integral to its success.

Presented By: Jan Blanchard,Amanda Ciadella

Time Tested Protocols for Personal Billing
Accounts receivable management is a constant battle for pediatricians. As the financial burden of healthcare shifts further towards the patient in the form of higher deductibles and copays, providers who have reliable and effective Personal Billing protocols will maintain a healthy cash flow and maximum revenue. This session will outline proven processes for efficient and effective Personal AR management. Target areas will include collections, front desk coordination, handling patient questions, managing aging balances.

Presented By: Rebecca Lamb

Update on the 21st Century Cures Act and Data Segmentation
Discussion of progress made and pitfalls encountered in the process of learning how to segment data in the EHR to assure access to critical health information while also preserving confidentiality. Exploration of steps the pediatric provider should be prepared to take in view of our unique obligation to both children and their parents.

Presented By: Jesse Hackell

Welcome Session (Wed) and “Don’t Stop Believin’!” Presented By: PCC
Welcome and Morning Announcements (Thu) Presented By: PCC
Welcome and Morning Announcements (Fri) Presented By: PCC
What’s New?
We’ve released a ton of software in the last year. Come learn about all the new things at PCC since our virtual UC in 2021!

Presented By: Scott Ploof

What’s Next for PCC eRx
Join PCC’s Morgan Ellixson-Boyea, CPhT, CSPO for a sneak peek into the next year of development for PCC eRx. In addition, you’ll hear about recent bug fixes and improvements, learn new tips & tricks, as well as cast your vote for future enhancements of PCC eRx! Session will also include open Q&A.

Presented By: Morgan Ellixson Boyea

What’s Next?
During this session the PCC roadmap will be presented. The session will also include PCC’s planned release schedule.

Presented By: Megan Maddocks

Include Signable Policy Documents in Patient Portal Message Templates

Speed up your check-in process by including the Agreement field to a Patient Portal Messaging template, so patients can review and electronically sign policy documents before they arrive.

Create or Edit a Message Template

Open the Patient Portal Configuration tool from PCC EHR’s Configuration menu and open the Messaging Templates tab. Click “Add” to create a new message template, or “Edit” to add the Agreement field to an existing template.

Add The Agreement Field

From the field drop-down menu, select the Agreement Field and click “Add”.

Upload Documents

Click “Attach Document” to select a file. This file will be available for all Patient Portal users to review and sign when they select this message type. Select a document category for this document to be assigned in the chart’s documents.

Add a Label and Title

Once you’ve uploaded the document, give it a label and a title. The label will appear in the message template to indicate to the user what the document is, and the title will appear as the file name in the patient’s documents.


Add Additional Agreements

You can add multiple agreement fields, so if you need several documents signed, add an agreement field for each one, and upload each document.

Optional: Update Your Policy Documents

If you update or create a new policy document, you can replace the document in your Patient Portal Messaging Template and uploading a new one. To remove the document, edit the message template and click the X icon next to the document, then click “Attach Document” to upload a new version of the document.


Portal Users Sign and Send the Documents

When a portal user selects the new template, they’ll find each document waiting for them. They can review each document and click “Sign” to attach an electronic signature, along with a time and date stamp.

Once the user has signed the documents and sent the portal message, you’ll find it in the Messages Queue, the patient’s history and the patient’s documents.

If there are multiple documents in the message template, and the user elects to sign only one, no signed tag or timestamp will appear on the unsigned documents, but the user can send a new message to sign or resign any document.

Provide Good Faith Estimates for Pediatric Encounters

If a family does not have insurance, or the family won’t be using insurance for an encounter, then a pediatric practices needs to provide a “Good Faith Estimate” for the cost of care when an encounter is scheduled more than 3 days in advance.

This requirement came into effect on January 1st, 2022 as part of the “No Surprises Act”, and it aims to reduce the likelihood of a family receiving an unexpected medical bill.

Apply the Good Faith Estimate Rules for Pediatrics

Under what circumstances would a pediatric practice need to provide a Good Faith Estimate, and what should the estimate include?

Review the Types of Encounters You Schedule

Your practice schedules a variety of encounters, including physicals or “well visits”, next-day or same-day sick appointments, rechecks, and various consultations.

A typical pediatric practice should be prepared to offer Good Faith Estimates for their well visits, recheck visits, or consults—any appointment that would likely be scheduled more than three days in advance. It is unlikely you will need to provide a GFE for typical “sick” encounters, but you may wish to create one anyway for less-common circumstances.

Develop Estimates That Are Within $400

When you provide a Good Faith Estimate, it should declare the expected cost of services typically performed during the type of encounter, with an accuracy within $400.

For example, your Well Visit Good Faith Estimate might list expected amounts for a well visit and immunization administrations for each age, including amounts for common screenings.

While you are not required to detail the individual costs associated with an encounter, your practice may choose to list common procedures and prices to help the family understand what is included in the GFE.

Always Verify Payment Information When You Schedule

Medical professionals are not required to provide GFEs if the patient or family intends to bill insurance for the encounter, or if the practice will bill an insurance payer on behalf of the family.

Therefore, in addition to developing a GFE form for certain encounter types, your practice should review how you schedule appointments.

Whenever you schedule any encounter, your practice should:

  1. Ask the patient or family how the encounter’s charges will be paid
  2. Collect or update the patient’s insurance information
  3. Provide a GFE if the encounter will not be paid by insurance

PCC software includes customizable tools that can help your practice complete these tasks, such as Clinical Alerts which can appear during scheduling, the customizable Patient Details ribbon, and the ability to check insurance eligibility at any time (including a tool for reviewing eligibility for all scheduled patients). Contact PCC Support for help getting started with any of these tools.

No Insurance, Or Not Using Insurance For a Given Encounter: When a patient or family indicates that they do not have insurance, or that they do not intend to bill insurance for a specific encounter, and the appointment is scheduled three or more days in advance, you should provide a Good Faith Estimate that lists the expected charges with an accuracy within $400.

Develop a Workflow for Sending out GFEs

When your practice knows that a family will not be paying for an encounter with insurance, you should provide them with a Good Faith Estimate within three days of scheduling the appointment.

Your practice could use various methods to accomplish this. You can produce the required form immediately after you schedule the appointment, using the Forms component, and then deliver it using the patient portal.

If the family does not have a portal account, you can generate a PDF and use email or physical mail. You can work with PCC Support to adjust your forms and customize reports to meet this need.

Create Good Faith Estimate Forms

Your practice can develop quick Good Faith Estimate forms to help you provide a Good Faith Estimate whenever it is needed. For example, you could create a form letter that lists your GFEs for each type of encounter, and then send that form to families through the Patient Portal.

VFC and TOS Cash Discounts: If your practice administers VFC or other reduced-rate immunizations, you may wish to account for that difference in your GFEs. Similarly, if your practice offers a discount for payment received at time of service, you can include that information on your GFE forms.

While your practice is not required to provide an itemized charge list, many practices are choosing to do so in order to define the amounts included in the Good Faith Estimate.

Olney Pediatrics in Maryland and North Augusta Pediatrics has shared a sample Well Visit form (charge amounts have been removed for this image), which allows them to quickly create a GFE by checking off the details for a scheduled encounter and entering a total:


You can download a Microsoft Word file version for use at your practice.

The AAP has also created several sample forms:

In order to provide an accurate GFE for lab work that may occur outside of your practice, you may want to contact your lab companies. The AAP created a sample letter:

You can access the above AAP’s materials through the SOAPM website.

Contact PCC Support for help setting up your Good Faith Estimate forms.

Use a Billing Service with PCC

Some pediatric practices use a billing service instead of (or in addition to) in-house billing staff.

PCC maintains an index of billing services that have used PCC in the past, along with a quick “things to consider” Billing Service Shopping List for practices who are looking into using a billing service.

Billing Service List

Not a Recommendation or Endorsement: PCC makes no recommendation for particular billing services. Inclusion on this list means we know that the service has used PCC software at some point, and that they’ve shared their contact information with us.

Name Contact Email Phone Website Business Address
Altus Pediatric Billing Emily Floyd emily@altussolutionsgroup.com (972) 607-4130 https://altuspediatricbilling.com/ 7200 State Highway 161, Suite 350, Irving, TX 75039
AM Med Solutions Sunny Gazahi sg@ammedsol.com 888-811-5391 x100,
Fax: 1-646-292-5178
www.ammedsol.com 247 Prospect Ave, Suite 4C, Brooklyn, NY 11215;
1368 N US 1, Suite 404, Ormond Beach, FL 32174
Bookkeeping & Business Services, LCC (BBS) Diane Richards info@bbs1040.com, drichards@bbs1040.com (978) 794-1919 Bookkeeping & Business Services, LCC 302 Broadway, Methuen, MA, 01844
IPMSO Remote Biller Susanne Morgana Brennan brennan@ipmso.org (877) 774-7726 (877-771-PRCM) The Verden Group 48 Burd St Suite 104 Nyack, NY 10960
Medical Solutions Stephanie Dubert info@sotxbilling.com (956) 630-2225 Medical Solutions 612 Nolana, Suite 330, McAllen, TX 78504
PedsOne Tim Rushford tim@pedsone.com (866) 371-6118 PedsOne 10 East Allen Street, Suite 100 Winooski, Vermont 05404

Billing Service Shopping List

PCC created a Billing Service Shopping List guide in 2021. It includes questions to ask and things to consider when you research a billing service.

Contact PCC

Get in touch with PCC if you have questions about our policies and procedures for working with billing services. If you begin working with a billing service, let us know!

You can find other PCC clients who use billing services on PCC Community.

Share and Print Lab Results Through the Patient Portal

Your patients and families can download and print lab results from PCC’s Patient Portal, so there’s no need to upload COVID-19 and other test results manually. Portal users can access test results from their phone or computer, to print and share wherever they’re needed.

When you check “Include on Patient Reports” while ordering a lab in PCC EHR, the lab order automatically appears in the Patient Portal in the patient’s Labs section, and in the lab component of the visit itself.

The Download Lab Orders button generates a PDF file of the lab results. The PDF is very similar to the lab order details view in PCC EHR, though some minor items are changed to make the lab results clearer and easier to read.

Portal users can save the PDF to their phone or computer, or print it and have it in hand for schools, camps, and any other occasion where test results are needed.

Set Up a Brother ADS-2800W Scanner

Read the procedures below to set up and configure a Brother ADS-2800W scanner.

Prepare for Setup

You will need to take the following actions before you can set up your scanner.

Contact PCC Support to Set Up Scanner Bucket

If you do not have an existing scanner bucket, call or email PCC Support at (800)722-7708 or support@pcc.com to request a new scanner bucket.

Replacing an existing scanner?: If you are replacing an existing scanner you can use your old scanner’s bucket. To find your existing bucket number, log in to PCC EHR, select Documents from the Configuration menu, visit the Import Documents tab, and choose a bucket from the “File Source” column.

Find Your Wireless Information

Ask your Office Manager, Managing Provider, or local IT person for the name of your office wireless network and password.

Connect Your Scanner to Your Wireless Network

Follow the steps outlined here to connect your scanner to your wireless network.

Find Your Scanner’s IP address

Turn on your scanner and use your scanner’s control panel to follow the steps in this image. Choose WLAN for step 3 if you are using a wireless internet connection.

Find Your Scanner’s Default Login Password

The default password is either “initpass” or the password located on the back or bottom of the machine after “Pwd”.

Configure Your Scanner Settings

Access Your Scanner in a Browser Window

Open a web browser and type the IP address of your scanner. (Example: https://12.345.6.7) Log in with your Login Password if prompted.

Set Status

Select the “General” tab, then select “Status” and check the following:

  • Device status is set to “Sleep”.
  • Automatic Refresh is set to “Off”.
  • Web Language is set to “Auto”.
  • Device Location is blank.

Set Network to “Both”

Select the “Network” tab, then select “Interface” and check the following:

  • Interface is set to “Auto Switching (Enable Both Interfaces)”.
  • Wi-Fi Direct is Disabled.

Submit Network Selections

Click “Submit”.

Configure Wireless Settings

Open Wireless Setup Wizard

Select the “Network” tab and then select “Wireless (SetupWizard)”. Click “Start Wizard”.

Connect to Your Wireless Network

Choose your office’s wireless network from the dropdown. Enter your wireless password in the Network Key field, and click “Next”.

Enable Wireless Interface

Click “Yes”.

Configure Profile Settings

Set Profile to Network

Click on the “Scan” tab. Then click “Scan to FTP/SFTP/Network/SharePoint”. Set Profile 1 to “Network”.


Save Profile Settings

Click “Save” at the bottom of the page.

Confirm Profile Settings

Click on the “Scan” tab. Then click “Scan to FTP/SFTP/Network/SharePoint Profile” and confirm that Profile 1 is set to “Network”.

Set Profile Path

Click on “Profile 1” and set the following:

  • Profile Name: PCC EHR
  • Network Folder Path: \\acro\scanning\bucket### (Example: \\gkp\scanning\bucket001)
  • File Name: Use default
  • Quality: Color 200 dpi
  • File Type: PDF Multi-Page
  • Document Size: Letter

Continue Setting Profile Path

Scroll down and set the following:

  • Use PIN for Authentication: Off
  • Pin Code: 0000
  • Auth. Method: Auto
  • Enter the scanning username: nobody
  • Enter the scanning password: nobody
  • Reenter the scanning password: nobody

Click “Submit”.

Sync Date and Time With Server

Select the “Administrator” tab and then select “Date & Time”. Enter your current date, time, and time zone. Set Auto Daylight to “On”. Select Synchronize with SNTP server.

Click “Submit” or “Save” if prompted.

Test Your Scanner

Your scanner is now configured. Follow the instructions in your manual to run a test page. Upon completing a scan, your scanned document will appear in the Import Documents tool in PCC EHR. For more information, review this article: Attach a Document to a Patient’s Chart
Downloadable versions of Brother manuals and user guides can be found here.

Virtual Advanced Training Sessions

PCC offers online Virtual Advanced Training on topics designed to help your practice take better advantage of PCC’s features and tools. You’ve been using PCC EHR for a little while, and now you’re ready for a deep dive into how PCC can best intersect with your practice’s day-to-day workflow.

PCC hosts VAT sessions monthly, providing instruction followed by live discussion where you can ask questions, hear about what other practices are doing, and discuss implementation with PCC experts.

You can catch up on the recorded, instructional parts of these sessions any time using the links in the list below:

For more information, or to find out how to attend a live session, contact PCC Support at 802-846-8177 or 800-722-7708.

Also, for a self-guided overview based on roles, see Training for New PCC Users.

Update Your PCC Email Preferences

PCC reaches out to one or more folks at your office via email, and PCC services (like the online PCC Community) have optional email notifications.

If your practice has a new Office Manager, or you get a new email address, how do you update the ways that PCC contacts you? How do you set your preferences for different kinds of email communication from PCC?

Set Email Preferences for PCC Updates and Announcements

PCC sends information about software updates, disruptions to services, news about important issues facing pediatricians, and more to an email mailing list.

PCC recommends that at least one person at your practice sign up for these emails, such as an Office Manager or managing provider. We are careful to limit how many emails we send, and you can set which types of email messages you receive. These emails are sent from the pccmarketing@pcc.com address.

  • Subscribe: To subscribe to PCC updates and announcements, call 802-846-8177 or 800-722-7708 or send an email to support@pcc.com.

  • Change Your Email Address: To change the email address you use to read PCC communication, send an email to support@pcc.com to subscribe your new email address. Then, in your old email address account, use the Unsubscribe link from the bottom of an email from PCC.

  • Unsubscribe or Change What Messages You Receive: To change your email preferences or the address that you use, click on a link to “Manage Preferences” or “Update your email preferences” found at the bottom of an email from PCC.

You can find links to unsubscribe or change email preferences at the bottom of emails from PCC.


When you click a link to manage preferences, you can indicate whether you would still like to receive emails about PCC EHR and Company News, Pediatric Resources, the Pediatric Insights Blog, The Independent Pediatrician, Job Notifications, and emails from PCC Sales.


Click the “Update email preferences” button at the bottom to save your changes.

Set Email Preferences for PCC Community and PCC Talk

PCC Community is an online forum where you can ask questions of other pediatric practices and learn about important issues in pediatrics. It’s also a place where you can get caught up on PCC news, blogs, and announcements. Learn more by reading the PCC Community help article.

PCC Community can automatically send you email notifications about new posts, or digests collecting the new posts since you last visited.

  • Sign Up: To sign up for PCC Community, which can include email updates, see the instructions in the PCC Community help article.

  • Unsubscribe, Change Email Address or Change What Messages You Receive: To change your email preferences for PCC Community, see the instructions in the “How do I adjust my email settings and other user preferences?” and “Can I redirect PCC Community messages to a different email address?” questions in the PCC Community help article.

Change Email and Contact Information for Individual Communication from PCC

PCC Support sometimes needs to email your practice directly about support issues, software update migration, and other issues.

PCC keeps a list of contacts for your practice, with corresponding emails and phone numbers.

To change who PCC should contact, or to change the email address or phone number they should use, call 802-846-8177 or 800-722-7708 or email support@pcc.com.

Install a Fujitsu fi-7160 Scanner for PCC EHR

PCC recommends the Fujitsu fi-7160 scanner because of its reliability and performance. Older models of the fi series, like the 6110, are acceptable alternatives. All scan settings are controlled through the included PaperStream software.

Install a Fujitsu fi-7160 Scanner for PCC EHR on Windows

Follow the steps below to install and configure a Fujitsu fi-7160 on a Microsoft Windows PC for use with PCC EHR.

Download the Scanner Driver and Application

Unplug Your Scanner

Unplug your scanner from your workstation before software installation. Fujitsu fi-7160 scanners plug into workstations with a USB cable.

Visit Fujitsu’s Downloads Page

Open a web browser to Fujitsu’s fi Series downloads page (https://imagescanner.fujitsu.com/global/dl/).

Download the PaperStream IP Driver

Select your scanner’s series, scanner model, and your PC workstation’s operating system. Click “Display software list”.


Click “Download” next to PaperStream IP (TWAIN)


If the download does not begin automatically, click the “Download” link called PSIPTWAIN(version number).exe


If prompted to run or save, select “Save”.

Download the PaperStream Capture Application

Click the “Back” button on your browser to view the previous page. In the applications section, click “Download” next to PaperStream Capture.


Enter your scanner’s serial number.


If the download does not begin automatically, click the “Download” link containing PSC(version number).exe. If prompted to run or save, select “Save”.

Install the Scanner Driver and Application

Launch the PaperStream IP Driver

Open your Downloads folder and launch the driver installer, PSIPTWAIN(version number).exe. If prompted to allow changes to this computer, select “Yes”. The installer will run a script to install necessary files, and then open a PaperStream IP Driver Setup window. Click “Next” to continue.

Install the PaperStream IP Driver

On the following screen, confirm that PaperStream IP and Scanner Central Admin are both checked, then click “Next”.


Read the agreement, check the “I accept…” box and click “Install”.


Installation may take several minutes. When complete, all three boxes (PaperStream, Software Panel and Scanner Agent) will be checked, and the “Stop” button will change to “Close”. Click “Close” to complete the driver installation.

Install PaperStream Application

Return to your Downloads folder and open the PaperStream application installer. You may be prompted to choose your language, and a PaperStream setup window will open.

  • Check “I accept the terms…”
  • Select “Basic (use basic functions with no limitations)”.
  • Uncheck “Display sample profiles”.
  • Uncheck “Show Welcome on startup”.



Click “Install”. When the installation is completed, click “Finish”. Click “OK” when prompted.

Configure Scanner Buttons

Plug in Your Scanner

PCC recommends that you plug your scanner into a USB 3.0 port for optimal speed.

Open the Windows Printers & Scanners Settings Panel

Find and open the Printers & Scanners settings window from your Windows Start menu. The fi-7160 should appear on the list of added devices.

Select Scanner and Properties

Click the device once, then click the “Manage” button.




Next, click “Properties”.

Configure the Scan Button to Launch PaperStream Capture

Select the Events tab.

  • Confirm that “Select an event:” is set to “Scan Button”.
  • Select “Start this program:”
  • Choose PaperStream Capture from the drop-down menu.

Now PaperStream Capture will run when the scan button is pressed on the physical scanner. Click “OK” to close this window.

Configure Scanner Profile and Destination

In this section you will configure the scanner’s settings and route the finished scans to PCC EHR.

Open the PaperStream Capture Application

Open the PaperStream Capture Application from the Start menu or desktop icon.

Create a Scanner Profile

Click the Lines menu next to the blue Scan button.


Select “Configure Profiles” from the drop-down options and click on the plus (+) button to add a scanner profile.


On the left menu select “1. Name” and add the Name “EHR”.

Confirm that PaperStream IP fi-7160 is in the Source Box

Select “2. Source” from the left menu. PaperStream IP fi-7160 should be visible in the “Source” box.


If the PaperStream IP fi-7160 is not in the “Source” box, there may be a problem with installation. Contact support at 1(800)722-7708 or support@pcc.com to troubleshoot the issue.

Configure Source Parameters

In the Source Parameters box, set the following:

  • Color Mode: Auto Color
  • Resolution: 200 dpi
  • Leave the Paper Size, Sides, and Continuous Scan as defaults.


Configure Display Options

In Display Options, set the following:

  • “Release After Scan”
  • “Minimize App. During Scan”
  • Do not select “Exit App After Scan”, as this can slow scanning time.

Leave Mark Options on the default settings.

Save and Name Your Profile

Click “Save As” under the Scanner Driver Profile drop-down. Name this driver profile “EHR” at the prompt.

Configure Your Scanner Profile Destination

Select “3. Destination” on the left menu. Change the default TIF to a PDF.

In the Folder field, type: \\acro\scanning\bucket###. Replace “acro” with your PCC practice acronym and “###” with your chosen bucket number (bucket001, for example). Use only lowercase for the acronym, and backslash “\” as opposed to “/” forward slash.

Which Bucket?: To pick a bucket number, log in to PCC EHR, select Documents from the Configuration menu, visit the Import Documents tab, and choose a bucket from the “File Source” column. For more information on buckets, visit Configure Document Categories, File Sources, and Default Behaviors.


Save You Scanner Configuration

Click “Save”. If a warning pops up, click “Yes” and “Close”.

Return to the Main Screen

Click the “Back” button to return to the main screen.

Map Your Scanner to the EHR Profile

Click the Lines menu and select the Administrator Tool. Select “Usability” from the left menu. Choose the “EHR” profile from the Scan drop-down.

Save Your Scanner Profile

Click “Save” and then “Close” to return to the main screen. Your EHR profile and rules are now set and you are ready to try a test scan.

Test Scanning a Document to PCC EHR

Follow the Fujitsu fi-7160 instructions to scan your first document. This first scan will be slow as the service is running for the first time.

When the scan completes, log into PCC EHR and navigate to Import Documents. The PaperStream application will flash orange on your toolbar as the scan is processed and the “Load New Files” button on the Import Documents screen will highlight yellow. Click the “Import Documents” button to load the scan into PCC EHR.



By default, you will see documents from all sources. You can change the File Source drop-down to select a specific bucket. Your scanner is now fully installed. For more information on importing documents, visit Attach a Document to a Patient’s Chart.

Configure Incoming CHADIS Questionnaire Results

When your patients, parents, and other users complete a CHADIS questionnaire, the results are automatically returned to PCC EHR, so you can review results quickly, without logging in to CHADIS at all.

To configure results, and ensure that incoming results are matched to the correct visit type, begin by linking questionnaires to orders through the Protocol tool in PCC EHR’s Configuration menu.

Open Protocol Configuration

In Protocol Configuration, select Component Builder, and open the Screening Orders component.

Any of these orders can be associated with a CHADIS questionnaire.

"

Open Questionnaires

Click “Add a Questionnaire” to open the full list of CHADIS questionnaires.

Select Questionnaire

Select one or more questionnaires to link it to the screening order selected above. You can use the search box in the upper right corner of the window to narrow the list of questionnaires and find exactly the questionnaire you need.

Each Questionnaire Can be Assigned Once: Each order can have multiple questionnaires assigned to it, but each questionnaire can only be associated with a single order. If a questionnaire is gray and cannot be selected, that questionnaire is already assigned to an order.

Some things to consider as you’re adding questionnaires to orders:

  • The simplest configuration is to add one order per questionnaire. For example, if you use CHADIS questionnaire #947, ADHD Developmental Intake Form, then create an order called “ADHD Developmental Intake Questionnaire” and assign the questionnaire to it.
  • For questionnaires that have different versions sorted by age, consider assigning all ages to a single order. Assigning all ages to one screening order, means you only need to configure billing for one order, rather than a separate order for each age.
  • Some questionnaires have different versions based on the respondent. For example, the Pediatric Symptom Checklist questionnaires include versions for both the parent and patient. Assigning both to the same order will group the results together in the visit, making it easier to compare the two without and closing two separate orders.
  • Consider the workflow for incoming results. If results require creating a task, such as manually updating medical history, assign those medical history questionnaires to a single order, and then assign one task from that order.

Decide If a Signature is Required

If a signature should be required on the results when they arrive, check the signature required box. Any questionnaire that requires a signature will appear on the signing queue when the result arrives.

Link LOINC codes to Screening Orders

To track CHADIS screening questionnaires for Clinical Quality Measures and PCMH, add matching tests to each Screening Order. Under the “Tests to Include” heading, click “Add a Test” and select the appropriate test. When tracking for Clinical Quality Measures, depression screenings require a result before they will appear in CQM reports.

Tasks are automatically assigned a due date the same day as the visit, so that tasks won’t appear on the task list before the patient arrives.

When a provider opens the visit, the results are available to review. New tasks can then be assigned and results entered.

Clicking “Details” opens the CHADIS results. If an order includes results from multiple respondents, each respondent’s results will have their own tab.

If a CHADIS result arrives that has not been assigned to a patient or portal user, results will appear unassigned in the messaging queue.

Unassigned results are similar to documents or lab results. Select them, search for the patient and assign them to a visit. Once results are assigned the patient and visit, they can be reviewed, signed and marked complete.

April 2021 SNOMED-CT Update

On April 11, 2021, PCC updated the SNOMED-CT diagnostic terms on your practice’s PCC system to the latest code set.

PCC regularly updates your system’s ICD-10, LOINC, SNOMED-CT, NDC, RVU, VIS, and other standardized lists so you won’t encounter challenges when you chart, order a lab, interface with a care provider, or bill for a visit. (Your practice’s local system automatically updates your practice’s procedure codes.)

Read below to learn about changes to preferred terms that may affect searching, new allergies, common diagnosis descriptions that were removed from SNOMED-CT, and new additions to your practice’s quick search Favorites.

Changes to the Preferred Term for Common Descriptions

The April 2021 SNOMED-CT update changes some terms that are used at pediatric practices. Clinicians may need to type a different search word to find these descriptions than what they used before. For example, the spelling of “weal” has been changed to “wheal”, and “Adverse reaction to vaccine product” is now “Vaccine adverse reaction”.

Here is a table of common SNOMED-CT diagnosis descriptions that have new preferred terms. PCC identifies these as possibly requiring a different search term, or just being useful to know for awareness.

New Preferred Term Old Preferred Term
Bilateral infantile esotropia of eyes Bilateral congenital esotropia of eyes
Bullous wheal Bullous weal
Childhood granulomatous periorificial dermatitis Facial Afro-Caribbean childhood eruption
Chronic irritant contact dermatitis of hands Cumulative irritant contact dermatitis of hands
Contact dermatitis caused by chlorinated hydrocarbon Contact dermatitis due to chlorocompound
Contact dermatitis caused by feces Feces-induced contact dermatitis
Contact dermatitis caused by fiberglass Fiberglass dermatitis
Contact dermatitis caused by poison primrose Contact dermatitis due to primrose
Contact dermatitis caused by ragweed Contact dermatitis due to ragweed
Contact dermatitis caused by saliva Saliva-induced contact dermatitis
Contact dermatitis caused by urine Urine induced contact dermatitis
Contact dermatitis of hand Contact hand eczema
Decreased body mass index Body mass index below normal parameters
Dermatosis in childhood Dermatosis in a child
Erythema multiforme due to viral disease Erythema multiforme caused by virus
Exanthem due to varicella Exanthem due to chicken pox
Fetal disorder due to disease in mother Fetal damage from disease in the mother
Increased body mass index Body mass index above normal parameters
Infantile esotropia Congenital esotropia
Infantile esotropia of left eye Congenital esotropia of left eye
Infantile esotropia of right eye Congenital esotropia of right eye
Infection caused by Paragonimus westermani Infection by Paragonimus westermanii
Irritant contact dermatitis caused by ring Ring dermatitis
Irritant contact dermatitis due to lip-licking Lip-licking eczema
Irritant contact dermatitis of hand Irritant contact hand eczema
Mass of head and/or neck Mass in head or neck
Normal body mass index Body mass index within normal parameters
Pervasive developmental disorder with disorder of intellectual development and absence of functional language with loss of previously acquired skills Pervasive developmental disorder with disorder of intellectual development and abscence of functional language with loss of previously acquired skills
Psoriasis of scalp Scalp psoriasis
Psoriasis with eczema Psoriasis-eczema overlap condition
Swelling of ear Swelling of ear structure
Vaccine adverse reaction Adverse reaction to vaccine product
Wheal Weal

New Allergies of Interest to Pediatrics

The April 2021 SNOMED-CT update adds 14 allergies which may be of interest to pediatric clinicians.

Acute allergic otitis media of left middle ear
Acute allergic otitis media of right middle ear
Allergic contact dermatitis caused by grease
Allergic contact dermatitis caused by oil
Allergic contact dermatitis caused by poison primrose
Allergic contact dermatitis caused by ragweed
Allergic contact dermatitis caused by soap
Allergic contact dermatitis caused by urushiol from Eastern poison ivy
Allergic contact dermatitis caused by urushiol from poison sumac
Allergic contact dermatitis due to jewelry
Allergic reaction caused by Hevea brasiliensis latex protein
Allergy to hair dye
Bilateral acute allergic otitis media of middle ears
Bilateral chronic allergic otitis media of middle ears

Deprecated SNOMED Diagnosis Descriptions

The April 2021 SNOMED-CT update removes or replaces many codes common to pediatric practices. Your practice may want to take special note of them.

Here are the top codes used by PCC’s pediatric practices that were removed from the international SNOMED-CT diagnosis library in 2021. When practices had these codes available for one-click selection on a chart note protocol, PCC added a replacement. For other diagnoses, your providers can find related descriptions with a search, but you may want to plan ahead.

Allergy to dairy food 425525006
Allergy to latex 300916003
Blood in feces symptom 249624003
C/O – cough 272039006
C/O – low back pain 161894002
C/O – postnasal drip 162382001
C/O nasal congestion 272034001
C/O: a rash 162415008
Fetal or neonatal effect of maternal problem unrelated to pregnancy 206001006
Knee pain 30989003
O/E – erythematous rash 135888007
O/E – expiratory wheeze 162894004
O/E – general eye examination 162806009
O/E – intoeing 275864001
O/E – itchy rash 304386008
O/E – pyrexia of unknown origin 164288004
O/E – rash present 268911002
O/E – rhinorrhea 164184005
O/E – speech delay 391099000
O/E-herpes labialis-cold sore 163139004
Tick bite without infection 443930005
Unilateral earache 162358006
Unilateral undescended testis 268227001

New Favorites Available in Diagnosis Quick Search

The SNOMED-CT update adds 1710 diagnosis descriptions to your system.

In preparation for the update, PCC’s certified coder, Jan Blanchard, assembled a list of 314 new SNOMED-CT descriptions of interest to pediatricians. The update added these diagnoses, which include the COVID-19 diagnosis, to your practice’s default Favorites list for quick searching, unless your practice has specifically requested otherwise.

What is a diagnosis 'Favorites' list?: As you type or search in any diagnosis field, PCC EHR automatically searches a customizable list of Favorites. Use the Diagnosis Configuration tool to adjust your practice’s list of Favorites. You can also right-click on any diagnosis field in PCC EHR to search your system’s full SNOMED-CT diagnosis library.

Acquired cryptorchidism Acquired cryptorchidism of left testis Acquired cryptorchidism of right testis Acquired structural abnormality of pharyngotympanic tube following procedure
Acute allergic otitis media of left middle ear Acute allergic otitis media of right middle ear Acute COVID-19 Acute mucoid otitis media of left middle ear
Adverse reaction to amoxicillin and/or clavulanic acid Adverse reaction to ampicillin and/or floxacillin Adverse reaction to COVID-19 antigen vaccine Adverse reaction to COVID-19 mRNA vaccine
Adverse reaction to COVID-19 vaccine Adverse reaction to sulfamethoxazole and/or trimethoprim Allergic contact dermatitis caused by grease Allergic contact dermatitis caused by oil
Allergic contact dermatitis caused by poison primrose Allergic contact dermatitis caused by ragweed Allergic contact dermatitis caused by soap Allergic contact dermatitis caused by urushiol from Eastern poison ivy
Allergic contact dermatitis caused by urushiol from poison sumac Allergic contact dermatitis due to jewelry Allergy to hair dye At increased risk of forced marriage
At increased risk of human trafficking At increased risk of institutional abuse At risk for medication error Bilateral acute allergic otitis media of middle ears
Bilateral adhesive otitis media of middle ears Bilateral cracked nipples Bilateral distortion of visual image of eyes Bilateral mucoid otitis media of middle ears
Bilateral swelling of ears Bilateral swelling of wrist joints Bilateral synovitis of joint of knees Bilateral talipes calcaneovarus
Bilateral talipes equinovarus Bilateral testicular agenesis Blount disease Body piercing
Breakthrough pain Bronchial irritation Bulimia nervosa in full remission Bulimia nervosa in partial remission
Bursitis of left wrist Bursitis of right wrist Carbuncle of left axilla Carbuncle of left lower limb
Carbuncle of left thigh Carbuncle of right axilla Carbuncle of right lower limb Carbuncle of right thigh
Carrier of Staphylococcus epidermidis Chronic papillomatous dermatitis due to contact with urine and/or feces Chronic perichondritis of left external ear Chronic perichondritis of right external ear
Chronic post-COVID-19 syndrome Chronic rhinosinusitis Chronic tubotympanic suppurative otitis media of left middle ear Chronic tubotympanic suppurative otitis media of right middle ear
Cleft of left hard palate Cleft of right hard palate Complete cleft of left hard and soft palate Complete cleft of right hard and soft palate
Conductive hearing loss of left ear Conductive hearing loss of left ear with normal hearing on right side Conductive hearing loss of right ear Conductive hearing loss of right ear with normal hearing on left side
Congenital clinodactyly of finger Congenital clinodactyly of little finger Congenital dislocation of bilateral elbows Congenital dislocation of joint
Congenital short ear Congenital stenosis of male external urethral orifice Congenital subluxation of left hip joint Congenital subluxation of right hip joint
Congenital torsion of left ovary Congenital torsion of right ovary Contusion of head and/or neck Dermatitis due to cat mite infestation
Dermatitis due to chicken mite infestation Dermatitis due to dog mite infestation Dermatitis due to exposure to man-made ultraviolet light Dermatitis due to mouse mite infestation
Dermatitis due to northern fowl mite infestation Dermatitis due to rabbit mite infestation Dermatitis due to rat mite infestation Developmental dysplasia of left hip
Developmental dysplasia of right hip Distortion of visual image of left eye Distortion of visual image of right eye Does participate in outdoor sporting activities
Domestic abuse victim in household Enlargement of left tonsil Enlargement of right tonsil Epidermal burn of left upper arm
Epidermal burn of right upper arm Epidermal nevus of left lower eyelid Epidermal nevus of left upper eyelid Epidermal nevus of right lower eyelid
Epidermal nevus of right upper eyelid Excessive intake of ascorbic acid Excessive intake of calcium Excessive intake of energy
Excessive intake of iron Excessive intake of niacin Excessive intake of phosphorus Excessive intake of plant fiber
Excessive intake of potassium Excessive intake of protein and protein derivative Excessive intake of riboflavin Excessive intake of thiamine
Excessive intake of zinc Female genital Trichomonas vaginalis infection Fissure of left nipple during lactation Fissure of right nipple during lactation
Food security Fracture of knee Frequent attender of emergency room Furuncle of left ankle
Furuncle of left forearm Furuncle of left hand Furuncle of left hip Furuncle of right ankle
Furuncle of right forearm Furuncle of right hand Furuncle of right hip Headache after cough
Hemiparesis of left side of face Hemiparesis of right side of face Hyperactive labyrinthine dysfunction of left inner ear Hyperactive labyrinthine dysfunction of right inner ear
Hypersensitivity to SARS-CoV-2 mRNA vaccine Immunization series incomplete Inadequate intake of ascorbic acid Inadequate intake of calcium
Inadequate intake of energy Inadequate intake of fat and oil Inadequate intake of iron Inadequate intake of niacin
Inadequate intake of plant fiber Inadequate intake of potassium Inadequate intake of protein and protein derivative Inadequate intake of riboflavin
Inadequate intake of thiamine Inadequate intake of zinc Indirect left inguinal hernia Indirect right inguinal hernia
Infection of left nipple during lactation Infection of right nipple during lactation Injury of head and/or neck Injury of muscle and tendon of lower leg
Injury of muscle of lower leg Injury of shoulder and/or upper arm Injury of tendon of lower leg Injury of wrist and/or hand
Irritant contact dermatitis caused by chlorine in swimming pool Irritant contact dermatitis caused by feces Irritant contact dermatitis caused by grease Irritant contact dermatitis caused by oil
Irritant contact dermatitis caused by saliva Irritant contact dermatitis caused by urine Irritant contact dermatitis due to concrete Irritant contact dermatitis due to jewelry
Irritant contact dermatitis due to stoma Irritant contact dermatitis of hand caused by grease Irritant contact dermatitis of hand caused by oil Irritant contact dermatitis of hand due to concrete
Itching of both hands Lack of support for smoking cessation Lesion of nasal cavity Localized swelling of toe of left foot
Localized swelling of toe of right foot Marfan syndrome type 1 Mass of left axillary region Mass of right axillary region
Middle ear effusion Multisystem inflammatory syndrome in children Neonatal conjunctivitis of left eye Neonatal conjunctivitis of right eye
Neonatal disorder due to abnormal maternal blood chemistry Neonatal disorder due to and following amniocentesis Neonatal disorder due to and following fetal blood sampling Neonatal disorder due to and following operative procedure on fetus
Neonatal disorder due to and following operative procedure on mother Neonatal disorder due to and following sampling of chorionic villus Neonatal disorder due to chronic maternal cardiovascular disease Neonatal disorder due to chronic maternal respiratory disease
Neonatal disorder due to disease in mother Neonatal disorder due to maternal disorder of urinary tract Neonatal disorder due to maternal gestational edema and proteinuria without hypertension Neonatal disorder due to maternal hypertension
Neonatal disorder due to maternal nutritional disorder Neonatal disorder due to maternal obesity Neonatal disorder due to maternal obesity with adult body mass index 30 or greater but less than 40 Neonatal disorder due to maternal obesity with adult body mass index equal to or greater than 40
Neonatal disorder due to maternal overweight Neonatal disorder due to maternal periodontal disease Neonatal disorder due to maternal renal disease Neonatal disorder due to maternal respiratory disease
Neonatal disorder due to maternal traumatic injury Neonatal spontaneous cerebellar hemorrhage Neonatal vitamin B12 deficiency due to maternal vitamin B12 deficiency Neural hearing loss of left ear
Neural hearing loss of right ear No cells seen in urine via microscopy Nondependent abuse of tobacco Nonvenomous insect bite of gum
Nonvenomous insect bite of nose Nonvenomous insect bite of scrotum Not entitled to social services assistance due to income above limit Onychia of finger of left hand
Onychia of finger of right hand Onychia of left thumb Onychia of right thumb Otalgia of left ear
Otalgia of right ear Pain in left abdominal lumbar region Pain in left lumbar region of back Pain in right abdominal lumbar region
Pain in right lumbar region of back Pain of joint of knee Pain of knee region Pain of left breast
Pain of right breast Performs social distancing Premature baby less than 26 weeks Rhinoconjunctivitis
Steroid-modified tinea infection of foot Steroid-modified tinea infection of lower limb Strain of muscle and tendon of lower leg Strain of muscle of lower leg
Strain of tendon of lower leg Superficial contusion of skin of thigh Superficial foreign body in abdominal wall Superficial foreign body in anus
Superficial foreign body in axilla Superficial foreign body in back Superficial foreign body in breast Superficial foreign body in buttock
Superficial foreign body in cheek Superficial foreign body in chest wall Superficial foreign body in ear Superficial foreign body in face
Superficial foreign body in flank Superficial foreign body in groin Superficial foreign body in gum Superficial foreign body in hand
Superficial foreign body in interscapular region Superficial foreign body in lip Superficial foreign body in neck Superficial foreign body in nose
Superficial foreign body in penis Superficial foreign body in perineum Superficial foreign body in scapular region Superficial foreign body in scrotum
Superficial foreign body in trunk Superficial foreign body in vagina Superficial foreign body in vulva Superficial foreign body of abdominal wall with infection
Superficial foreign body of ankle with infection Superficial foreign body of anus with infection Superficial foreign body of axilla with infection Superficial foreign body of back with infection
Superficial foreign body of breast with infection Superficial foreign body of buttock with infection Superficial foreign body of cheek with infection Superficial foreign body of chest wall with infection
Superficial foreign body of ear with infection Superficial foreign body of elbow with infection Superficial foreign body of face with infection Superficial foreign body of finger with infection
Superficial foreign body of flank with infection Superficial foreign body of foot with infection Superficial foreign body of forearm with infection Superficial foreign body of groin with infection
Superficial foreign body of gum with infection Superficial foreign body of hand with infection Superficial foreign body of hip with infection Superficial foreign body of interscapular region with infection
Superficial foreign body of lip with infection Superficial foreign body of lower limb with infection Superficial foreign body of neck with infection Superficial foreign body of nose with infection
Superficial foreign body of penis with infection Superficial foreign body of perineum with infection Superficial foreign body of scalp with infection Superficial foreign body of scapular region with infection
Superficial foreign body of scrotum with infection Superficial foreign body of shoulder with infection Superficial foreign body of testis with infection Superficial foreign body of thigh with infection
Superficial foreign body of toe with infection Superficial foreign body of trunk with infection Superficial foreign body of upper arm with infection Superficial foreign body of vagina with infection
Superficial foreign body of vulva with infection Superficial foreign body of wrist with infection Superficial foreign body with infection Superficial injury of gum
Superficial injury of scapular region Superficial injury of scrotum Superficial injury of skin of eyelid Sustained viral response
Tenderness of left abdominal lumbar region Tenderness of left lumbar region of back Tenderness of right abdominal lumbar region Tenderness of right lumbar region of back
Undescended left testicle Undescended right testicle Victim of forced sexual activity Viral load increased

SNOMED Codes Mapped to ICD-10 for Billing

The SNOMED-CT update includes new mappings to ICD-10 billing codes. Many previous mappings have been updated.

You may wish to review billing configuration for your diagnoses. You can open the Billing Configuration tool to configure which ICD-10 diagnoses are mapped to each SNOMED-CT description in PCC EHR. You can also use the snomedmap report to examine your practice’s diagnoses that may need updating.

Information Blocking in the 21st Century Cures Act FAQ

PCC created this FAQ to help pediatric practices learn about Information Blocking in the 21st Century Cures Act.

Watch PCC's Presentations on Information Blocking: To learn more, you can watch PCC’s Information Blocking presentation, or the April 2021 live Information Blocking Q&A session.

Consult Your Practice's Legal Counsel: PCC shares what we learn about pediatric industry issues and best practices, but we do not provide legal advice. For questions, consult your practice's legal counsel.

Contact PCC if you have questions about implementing solutions at your practice.

General Questions

What is Information Blocking?

Information blocking is defined in the 21st Century Cures Act. In summary, information blocking is “a practice that…is likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information,” unless such practice is required by law (e.g., HIPAA), or it meets an exception established through federal rulemaking (42 U.S.C. § 300jj-52(a)(1)).

Does information blocking apply to me?

Yes, information blocking applies to physicians and practitioners. Information blocking applies to three types of “actors”: Certified health IT vendors, HIN/HIEs and health care providers, regardless of whether or not they use a certified product or participate in federal or state quality incentive programs.

ONC uses the Public Health Service Act definition of a health care provider to further define what which health care providers information blocking applies to. The Public Health Service Act health care provider definition includes licensed physicians and practitioners (physician assistant, nurse practitioner, and clinical nurse specialist). For more information, please see this Fact Sheet published by the ONC: Cures Act Final Rule: 2015 Edition Cures Update Overview (healthit.gov)

When do the Information Blocking guidelines go into effect?

Information blocking guidelines go into effect on April 5, 2021. There are also several milestone due dates for the various “actors”; they are outlined here: New Applicability Dates included in ONC Interim Final Rule (healthit.gov)

Do I need to be using a Certified EHR?

No. The information blocking regulations do not require actors to have or use health IT certified under the ONC Health IT Certification Program.

How does the Cures Act handle paper charts?

While the intent of the Cures Act is to increase the electronic exchange of health data through various means of interoperability, paper charts are okay to use. At the same time, using paper charts does not exempt one from complying with the Cures Act. When patient health data is requested, it needs to be fulfilled in an alternate manner, likely via paper copy or fax. It is recommended to review the Infeasibility and Content and Manner exceptions to ensure compliance.

What is the United States Core Data for Interoperability?

USCDI stands for the United States Core Data for Interoperability. The USCDI replaces the Common Clinical Data Set (CCDS).
USCDI Definitions:

  • USCDI: a standardized set of health data classes and data elements for nationwide, interoperable health information exchange
  • USCDI Data Class: an aggregation of various data elements by a common theme or use case
  • USCDI Data Element: the most granular level at which a piece of data is represented in the USCDI for exchange

The USCDI will be updated through a transparent, collaborative process of public commenting and input on an annual basis.

What is Electronic Health Information (EHI) and am I required to provide to patients upon request?

Please see the ONC fact sheet that explains what Electronic Health Information (EHI) is, and the intent of its use: Understanding_EHI.pdf (healthit.gov). The Information Blocking regulation requires a response to fulfill requests, and EHI is the most common way to fulfill said requests. If you are unable to fulfill a request, please review the Information Blocking Exceptions.

When is Information Blocking allowed?

There are circumstances when information blocking is allowed. The ONC defined eight exceptions for information blocking. There are five exceptions for not fulfilling information and three exceptions that apply to information being fulfilled, but in a different, or certain way. Please see the Information Blocking Exceptions section for more information.

Exceptions for not fulfilling information:

  • Preventing Harm
  • Privacy
  • Security
  • Health IT Performance
  • Infeasibility

Exceptions applying to information fulfilled in a different (or certain) but still acceptable way:

  • Content and Manner
  • Fees
  • Licensing

Should I be updating my practice’s policies and procedures to address Information Blocking?

Yes. Three of the Information Blocking exceptions (preventing harm, privacy, and security) require a written policy. In addition to the required policies it is recommended to write and maintain an Information Blocking policy that includes protocols for sharing electronic and non-electronic health data.

PCC created a sample Electronic Health Information Access Policy. PCC does not provide legal advice. This policy is an example of what you may want to consider including in your own policy. Before you finalize a policy such as this, we recommend you consult your own legal counsel.

Should my practice have a written “data sharing” policy? What should it include?

Written policies are encouraged by the ONC, however a written policy is not automatically a safe harbor to prevent allegations of Information Blocking.

Information Blocking is a practice that is likely to “interfere with, prevent, or materially discourage access, exchange, or use of electronic health information.” Your practice’s policies should be written with this statement in mind.

For example, setting a standard 10 business day turnaround time to respond to requests for information (especially those that can be fulfilled electronically much faster) will likely constitute Information Blocking. Requests for patient data should be completed in an appropriate amount of time given the capabilities of the practice and the needs of the patient.

PCC created a sample Electronic Health Information Access Policy. PCC does not provide legal advice. This policy is an example of what you may want to consider including in your own policy. Before you finalize a policy such as this, we recommend you consult your own legal counsel.

What are examples of Information Blocking?

  • Provider has capability to provide same-day access to EHI but takes several days to respond
  • Provider organization charges a patient for their electronic data
  • Requiring patient consent to exchange electronic health information for treatment where it is not required by law
  • Certified health IT developer refuses to share technical information needed to export data
  • Health information network/health information exchange charges additional fees to exchange data or refuses to exchange data with non-members

Portal Access

Do we need to enable portal access to our patients if they request access?

Yes, if a patient requests portal access, it must be granted if you have the portal enabled. Additionally, if your practice does not have the portal enabled it is strongly recommended that you do so. If you do not have it enabled, you may choose to use the infeasibility exception, however it is not wise to use this exception for an extended period of time if you do have the ability to enable it and have chosen not to.

Can we charge patients for portal access?

No, charging patients to electronically access their electronic medication information is prohibited.

What exactly is being shared on the portal?

PCC practices have the ability to configure what they share in the patient portal, including the following information: allergies, care plans, clinical instructions, diagnoses, documents, future appointments and date of last physical, growth charts, immunizations, labs, medications, orders, race, ethnicity, preferred language, patient sex, problems, smoking status, vitals, and personal balances.

Practices may continue to share what they normally do. There are no specific requirements to share more or less information in this rule. If a patient requests additional PHI via the portal or otherwise, practices need to be prepared to respond to requests. The request for additional PHI should be provided electronically when that is feasible, otherwise it should be fulfilled in an alternative format (e.g. paper).

Interoperability

Does my practice have to connect to a HIE/HIN?

The Information Blocking rule does not require practices to connect to a HIE/HIN, however other incentive programs or payers may require it. HIE/HINs are actors subject to the requirements of the rule themselves.

Does my practice have to submit data to registries?

The Information Blocking rule does not require practices to connect data registries, however other incentive programs, local or state laws, or payers may require it.

Patient Confidentiality

Do we have to make all of our lab results accessible to patients in the portal?

It is not a requirement of the rule to make all lab results accessible to patients in the portal, it is your choice to do so or not. If a patient requests their lab results via the portal and you do not provide them, this is information blocking. You must acknowledge and respond to all requests for electronic health information. If you are unable to fulfill them in the manner they are requested, or have an additional reason for not fulfilling the request, please refer to the information blocking exceptions for additional guidance within the ONC Information Blocking exceptions Fact Sheet.

Our clinicians store confidential information in various places in PCC EHR. Do we need to make all of those notes available to patients?

The information blocking rule does not supersede the HIPAA privacy and security rules. It is not a requirement of the rule to release all confidential information available to patients (or their guardians). Please refer to the ONC information blocking exceptions to understand more about the circumstances to withhold information.

The ONC FAQ includes a question and answer regarding patient confidentiality when the patient is a minor: Information Blocking FAQs (healthit.gov)
For more information about patient privacy and making certain items confidential, read the Patient Privacy Features article.

If a parent requests their child’s entire health record to be shared (electronically or via paper), am I required to share clinical notes from specialists or hospitals that were included in the patient’s chart?

Providers and practices should share patient data that is clinically relevant and has been requested (e.g. HIPAA minimum necessary rule). If this includes data from other practitioners, then it should be shared. Conversely, if the provider believes there is a risk of harm or security when sharing the patient’s data, they should review and apply the appropriate Information Blocking exception given the specific circumstances.

Information Blocking Exceptions

What are the Information Blocking exception requirements? Read below to learn more.

Disclaimer: For the full regulatory language, please refer to §171.200 – .205 and §171.300 – 303 included in the 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Certification Program final rule located on the Federal Register here.

Preventing Harm

Objective: Blocking information is justified when it is in the public interest to protect a patient and other persons against unreasonable risks of harm.

Conditions:

  • The actor must hold a reasonable belief that withholding information will substantially reduce the risk of harm
  • The actor’s practice must be no broader than necessary
  • The actor’s practice must satisfy at least one condition from each of the following categories: type of risk, type of harm and implementation basis
  • The practice must satisfy the condition concerning a patient right to request review of an individualized determination of risk of harm

Examples:

  • Risk of corrupt or inaccurate data being recorded or incorporated in a patient’s electronic health record
  • Risk of misidentifying a patient or patient’s electronic health record
  • Determination by a licensed health care professional that the disclosure of EHI is reasonably likely to endanger life or physical safety
  • Reasonable belief that practice is necessary to directly and substantially reduce likelihood of harm

Privacy

Objective: This exception recognizes that if an actor is permitted to provide access, exchange or use of EHI under a privacy law, then the actor should provide that access, exchange or use. However, an actor should not be required to use or disclose EHI in a way that is prohibited under state or federal privacy laws.

Conditions: The actor must meet at least one of the following four sub-exceptions:

  • If patient consent or authorization is not in place, the rule refers to this as a pre-condition
  • If the health IT developer is not covered by HIPAA
  • If the data being requested is addressed by the HIPAA privacy exception; examples include psychotherapy notes and information for a court proceeding
  • If the patient requests to keep his or her information private

Examples:

  • Patient has not agreed to share her information with a certain other provider or has not yet signed a HIPAA consent form.

Security

Objective: This exception is intended to cover all legitimate security practices by actors but does not prescribe a maximum level of security or dictate a one-size-fits-all approach.

Conditions:

  • The practice must be directly related to safeguarding the confidentiality, integrity and availability of the EHI. It must be tailored to specific security risks, and it must be implemented in a consistent and non-discriminatory manner.
  • The healthcare provider/organization must document its security policy

Examples:

  • There is an active or known virus or ransomware attack
  • An individual has been unable to prove their identity
  • Request for EHI from a patient-facing application or website causes actor’s system to raise a malicious software detection alert

Infeasibility

Objective: This exception recognizes practical challenges to comply with a request for EHI.

Conditions: The actor must meet one of the following
Conditions:

  • There is an event beyond the actor’s control, such as a natural or human-made disaster (public health emergency, public safety incident, war, terrorist attack, civil unrest such as a labor strike, telecommunication or internet service being unavailable, or act of military or government authority)
  • A request cannot be technically met as requested (via a certain format)
  • The actor is not able to understand the request because of patients’ requests to keep it private or to keep them safe
  • The current circumstance makes fulfilling the request not possible
  • The actor must provide a written response to the requestor within 10 business days of receipt of the request with the reason(s) why the request is infeasible

Examples:

  • A natural disaster occurs such as a hurricane, earthquake, or tornado affects electricity and internet availability in an area for a week.
  • A small physician practice with limited financial and technical resources may find it burdensome to accommodate requests from other providers to establish and maintain outbound interfaces from the practice’s EHR system that it neither needs for its own health care activities nor to comply with any regulatory requirements

Health IT Performance

Objective: This exception recognizes the need for health IT to be taken offline for system maintenance and improvements.

Conditions:

  • Unavailability of health IT must be for no longer than necessary to achieve the maintenance or improvements (e.g. upgrade)
  • Unavailability of health IT for maintenance or improvements must be implemented in a consistent and non-discriminatory manner
  • Unavailability of health IT for maintenance or improvements must be agreed (e.g., advanced notice of system downtime for maintenance)
  • An actor may take action against a third-party app that is negatively affecting the health IT’s performance
  • For a period of time that is no longer than necessary
  • Implemented in a non-discriminatory manner
  • Consistent with existing service-level agreements, where applicable

Examples:

  • Planned maintenance or improvements such as routine repairs, updates, or new releases
  • Unplanned maintenance or improvements to respond to urgent or time-sensitive issues, which cannot wait for the occurrence of a pre-planned time period to implement the required maintenance or improvements

Content and Manner

Objective: This exception provides clarity and flexibility to actors concerning the required content (scope of EHI) of an actor’s response to a request to access, exchange or use EHI and the manner in which the actor may fulfill the request. Content is the what. Manner is the how.

Conditions:

  • Content: Establishes the content an actor must provide in response to a request to access, exchange or use EHI in order to satisfy the exception.
    • Until October 6, 2022, the EHI data must be provided (at minimum) represented in the United States Core Data for Interoperability (USCDI) standard
    • On and after October 6, 2022 , the EHI definition is no longer limited to the EHI identified by the data elements represented in the USCDI
  • Manner: Establishes the manner in which an actor must fulfill a request to access, exchange or use EHI in order to satisfy this exception. An actor may need to fulfill a request in an alternative manner when the actor is either:
    • Technically unable to fulfill the request in any manner requested
    • Cannot reach agreeable terms with the requestor to fulfill the request
    • If an actor fulfills a request in an alternative manner, such fulfillment must satisfy the Fees Exception and Licensing Exception, as applicable.

Examples:

  • Client requests connection to Commonwell; vendor is not connected to Commonwell, but can offer connection to CareQuality
  • Request for EHI that is not able to be fulfilled electronically, therefore it is send using a PDF (or other) format

Fees

Objective: This exception allows actors to charge fees related to the development of technologies and services that enhance interoperability.

Conditions:

  • Fees charged must:
    • Be consistent
    • Be reasonable related to the cost to us to provide access, enable exchange or use EHI
    • Be nondiscriminatory
  • This exception does not allow:
    • A fee based on the electronic access by an individual patient, his or her personal representative, or another person or entity designated by that individual to access the individual’s EHI
    • A fee to perform an electronic health information export for a patient or a client looking to change to a different EHR unless a fee has been already agreed upon

Examples:

  • Provider or practice charging a fee for patient access to their health information electronically (is prohibited)
  • Health care provider or practice imposing fees to exchange data with a hospital system they are not affiliated with, but does not charge fees for affiliated facilities (and vice versa)

Licensing

Objective: This exception allows actors to protect the value of their innovations and charge reasonable royalties

Conditions:

  • Scope of Rights: The license must provide all rights to enable the access, exchange, or use of EHI and achieve the intended access, exchange or use of EHI via the interoperability elements
  • Reasonable royalties are permissible
  • Non-discriminatory terms: The terms and conditions must be based on objectively verifiable and uniformly applied criteria
  • Non-disclosure agreement safeguards

Configure Which PCC EHR Queues Appear for Each User

Your practice can define which PCC EHR queues will appear when a user logs in. For example, a staff member at the front desk may not need to see prescription renewals or signing. Their PCC EHR screen could look like this:

And a biller may only need to review today’s schedule and messages in order to post charges:

By fine-tuning which queues appear for each user role in your practice, you can make PCC EHR easier to use and you can control who has access to different functions in PCC EHR.

Configure User Roles to Display PCC EHR Queues

To adjust which queues are visible for each user at your practice, first open the User Administration tool and edit a user role.


Use one of your existing roles or create a new one. Double-click on the role to adjust permission settings.

First, select “Queues” to make queues visible to the user role. Then select each queue that users with this role should have access to. Repeat this process for each role at your practice. If a user role should only have limited access, you can deselect all queues. Then the user will see a blank PCC EHR window.

As you design roles, remember that users can be assigned more than one. Each user will see all the queues available for any of their assigned roles. Also, note that the eRx Tasks queue only appears for users who have both a role with the queue permission and an enabled PCC eRx account.

Next, edit each user’s account and adjust their assigned roles.

By fine-tuning which queues appear for each user role in your practice, you can make PCC EHR easier to use and you can control who has access to different functions in PCC EHR.

For a complete guide to defining and assigning Roles in the User Administration tool, read the main Set User Roles for Permissions and Security article.

COVID-19 Vaccines: Plan, Configure, Order, Administer, and Bill

You can use PCC EHR to order, administer, and track COVID-19 vaccines, either for pediatric patients or as part of a COVID-19 vaccine clinic for older patients. Read below to learn how to sign your practice up, plan for a vaccine clinic, configure your PCC system, and how to order, administer, and track COVID-19 vaccination.

Procedure Code Guidance: The procedure codes discussed in this article are intended only as examples. You should consult the AMA’s current CPT Coding Guide and work with your insurance payers to verify what codes you should report on claims. Your practice updates and maintains your billable procedure list, codes, and prices in the Procedures table in the Tables configuration tool on your PCC system.

Get Signed Up and Plan for COVID-19 Vaccinations

As of June 2022, pediatric practices are administering COVID-19 vaccines to adults, patients age 12 and up, patients age 5-11, as well as younger children. The Federal Government and President Biden have repeatedly announced that pediatric practices shall play a key role in the vaccination of young patients.

In 2021, PCC prepared this list of links for help “getting started”. While the situation has changed many time since, these resources may still be helpful!

  • Register to Administer COVID-19 Vaccines: If you haven’t already registered to administer the COVID-19 vaccine, you can find your state specific registration details at the AAP’s State COVID-19 Vaccine Provider Registration Resources page.

  • Evaluate Your Active Patient Population for Target Age Groups: Use PCC’s Report Library to estimate patient populations. For example, how many 5-11 year olds have visited your practice in the past three years? When planning a shot clinic, for example, don’t forget to consider children with birthdays in the upcoming months. Consider also contacting older patients who visit your practice: while families may receive vaccination elsewhere, your practice can help fill in the gaps.

  • Plan Your Practice's Vaccine Clinic: Develop a plan to administer the vaccine with your practice. Consider holding a vaccine clinic and also offering COVID-19 vaccination during regularly scheduled visits. PCC has documentation and a blog article about running mass vaccine clinics.

  • Communicate With Families: Use Broadcast Messaging to communicate your plan early to your patient families. This will help reduce phone calls to your office and encourage families to plan how and when they will get their children vaccinated.

  • Add Immunization Billing Codes and Orders to Your PCC System: Use the links and the procedures below to add billing procedures to your system and set up orders and chart note protocols for quick and easy administration. Once you have added your procedures with prices and names and adjusted your orders in PCC EHR, you can immediately begin ordering, administering, and billing for the vaccines. PCC Support can help you with every step of the process.

  • Contact PCC to Update Vaccine Tracking: Whenever you add a new immunization, contact PCC Support to configure new immunizations so they will track on a patient’s immunization record.

  • Create or Obtain a Consent Form: Your practice can create your own consent form, or there may be a standard one available from your state. PCC has heard from pediatricians who use the new Massachusetts COVID-19 Vaccine for 5-17 Years form and Oregon’s Pfizer Minor Consent Form.

  • Obtain VIS Forms (EUA Fact Sheets) at CDC.gov or through FDA: For COVID-19 vaccines in 2020-2023, there is no formal VIS form. Instead, manufacturers work with the CDC to provide Emergency Use Authorization Fact Sheets, or EUA. For example, in November of 2021, the FDA released Pfizer 12+ Fact Sheets and Pfizer 5-11 Fact Sheets. With each new vaccine approved for emergency use, there is an adjustment to the available EUA fact sheets.

Understand the Details and Codes for Each Vaccine

Before you set up any new vaccine in PCC’s system, you should review the details of the immunization. For example, you will need to know the manufacturer and their MVX code (such as PFR, for Pfizer), the dose amount, the CVX Code for the vaccine, the National Drug Code (NDC) for the vial, along with the CPT codes your practice will use for billing both the immunization and the administration. Your clinical staff will also want to review diluent information for administration and obtain VIS forms or “EUA” forms.

PCC's COVID-19 Vaccine Table: When the first COVID-19 vaccines rolled out, PCC created a table of available vaccines for each age group which included the information a pediatric practice needed to get started. From 2021 to April of 2023, we kept this table up-to-date when new vaccines were approved. We published this table on a short-term basis due to the importance of the issue and the rapid changes occurring. We’ve now removed it, and instead we recommend practices check codes, dosing amounts, NDC, and other details with official sources.

You can obtain more information from these resources:

Configure PCC EHR for COVID-19 Vaccines

Read below to learn how to add a COVID-19 vaccine to your PCC system. Contact PCC Support for assistance with any of these steps.

In addition to adding a vaccine that you will administer, you can use the steps below to add vaccines that your practice will track but will never administer.

See More About Adding an Immunization: For more screenshots and help with these configuration tools, see the main Add and Configure Immunizations in PCC reference article.

Create Immunization Entries in Your Practice’s Procedures Table

First, create procedure entries for the vaccine in the Proceduress table found in the Tables tool in the Configuration menu. If you’ve never done this before, contact PCC Support and we will walk you through the process.

For a complete guide, read the main Add and Configure Immunizations in PCC EHR article.

  • Procedure Name: You can name procedures anything that will be useful for your practice. As there will be several different COVID-19 vaccines coming into use in 2021, PCC recommends a naming convention that identifies the manufacturer of the vaccine. If you will be administering two different dosages of the Pfizer vaccine (for example, 0.3ml for older patients), you may want to incorporate the dosage or age range into the title of the procedure.

  • Accounting Type: Billable procedures you perform in your practice should have an accounting type of “Revenue”.

  • Procedure Group: The Procedure Group field is a customizable value used for reporting purposes; it does not affect billing or how a procedure is ordered or completed. Select an appropriate Procedure Group, such as “Immunizations”.

  • TOS: The Type of Service should read “Medical Care” for all immunizations or medications you administer.

  • Units: Enter one (1) unit. The Procedures table lists the smallest, standard administered value for the vaccine.

  • NDC: Enter the National Drug Code for the COVID-19 vaccine. You can use the CDC’s informational table, but you should check the labeling on the vaccine vial itself when it arrives at your practice. You can also cross-reference the National Drug Code Library.

    11 Digits From the Vial, Not the Box: You should enter the NDC code printed on the smallest administered dose, such as the specific tube, vial, or pouch that contains the vaccine or medication. This is sometimes referred to as the “Use” NDC. Do not use the NDC code printed on a box or carton that contains more than one dose, often referred to as the “Sale” NDC. The NDC code standard supports both 10 and 11 digit NDCs, and PCC recommends you use the 11 digit version.

  • Dose Amount and Dose Units: Enter the dose amount and dose units found on the vial, pouch, or tube that you administer. For example, the Pfizer COVID-19 vaccine is administered as 0.3 mL for older patients, so you would enter “0.3” and “mL”. The 5-11 vaccine is a 0.2mL dose. If you are administering different doses, you should set up different entries in your Procedures table.

  • Procedure Code or CPT: Use the CDC or AMA links to locate the billing procedure code and enter it in all schedules. PCC does not provide or distribute CPT codes, and cannot add this information to your system. Enter the same code for all schedules. If your practice has a schedule specifically configured for Medicaid billing, and your state Medicaid program requires a modifier, you can enter the full code + modifier in the code field for that schedule.

  • Price: Enter a price for the procedure in the fields for each schedule. In 2021, PCC expected most practices should enter a $0.00 price for COVID-19 vaccines, though your situation may vary. For example, CMS publishes a $0.01 price, and some payers may not be able to process $0.00 charges on claims. In general, procedure prices should be identical in all fields, though a practice can use different fee schedules for TOS payment or Medicaid vaccines (VFC). The examples in the image above are for illustration only and are not fee suggestions.

Add the New Immunization Administration Procedures to Your Procedures Table

Use the Procedures table in the Tables tool to clone an existing immunization administration procedure. Adjust the description and code for administration of the COVID-19 vaccine. Each administration for some COVID-19 vaccines have a unique code! Refer to the CDC or AMA resources to know the correct codes to add.

As of 2022, PCC expects most pediatric practices will need to track at least five or six different administration billing codes, including the first and second dose of the expected Pfizer 5-11 vaccine and administration and followup shots for the 12+ vaccine.

What should I charge for COVID-19 immunization administration?: We recommend you check with your payers to determine expected payment for COVID-19 vaccine administration codes. Note that Medicare presently pays $40 for each administration and some private payers or individual states may be paying more. The pediatric benchmark for procedure pricing in the U.S. is to charge above 180% of Medicare reimbursement amounts, which are publicly available per-relative value unit for each region.

Add Any Needed Immunization Manufacturers

Your system relies on an internal table to identify the manufacturers of each immunization. Prior to 2021, this table was relatively static as there were only a few major immunization manufacturers. Pfizers new vaccines changed this.

If you are administering vaccines from a new manufacturer, contact PCC Support and we can update your system’s internal table of manufacturers.

Create Entries in the Immunization and Disease Table

PCC Support will complete this step for you. Contact them at support@pcc.com or 1-800-722-1082.

The Immunization and Disease table handles how specific immunization procedures in your Procedures table align with vaccination and/or diseases. Contact PCC Support for assistance.

Configure Your System to Display the Vaccine and to Print It on Immunization School Forms

PCC Support will complete this step for you. Contact them at support@pcc.com or 1-800-722-1082.

Your Client Advocate or other PCC support team member will add the new vaccine to four “under-the-hood” configuration tables, work with you to make adjustments to your printable immunization school form(s), and work with you to test the configuration and make sure that the new vaccine appears correctly in PCC EHR.

Add a COVID-19 Immunization Order to Specific Chart Note Protocols

Use the Protocol Configuration tool to add the COVID-19 vaccine to the Immunizations component for specific chart note protocols.

A clinician can always search and find any immunization order. You can save clinicians’ time by putting specific immunizations right on your practice’s chart notes, so they will be available with a single click.

Add Catch-Up Imms, Flu Shots, and More: The AAP recommends practices take advantage of every encounter to get patients caught up on immunizations and offer flu shots. As you adjust your protocols for a COVID-19 vaccine clinic, consider other components and immunizations you can add to help your clinicians during the visit.

Map Z23 and Billing Procedures to the COVID-19 Immunization Order

When a clinician clicks “Order” next to a COVID-19 vaccine, PCC EHR can automatically place diagnosis and procedure billing codes onto the encounter for billing. Whenever you add a new vaccine, use the Billing Configuration tool to map precisely which codes should be triggered by that order.

In the example above, the practice has mapped the COVID-19 (Pfizer, 5-11) immunization order to a Z23 diagnosis, a billing CPT code, and two specific immunization administration codes.

Customize How the Immunization Appears in the Patient’s Chart

Use the Immunization Configuration tool in PCC EHR to configure the order that immunizations appear in a patient’s Immunization History. Use the same tool to set whether or not the immunization will always appear in a patient’s chart or will only appear if they have had a dose.

Click and drag to rearrange how immunizations appear in a patient’s chart. Click the “Display” checkbox next to all immunizations you would like to appear in a patient’s Immunization History, even if they have never received a dose.

Always Display: In a patient’s chart, the Immunization History will display all immunizations that a patient has received. You can also configure an immunization to appear on every patient’s record, even if they have never received a dose. For example, since all patients should receive an IPV, most practices select “Display” next to “IPV” in the Immunization Configuration tool. In contrast, a practice might sometimes administer a cholera vaccine, but would only need it to appear in the patient’s record if a patient received it. They therefore would not check “Display” next to Cholera.

Create a COVID-19 Vaccination Pre-Registration Form in the Patient Portal

Your practice can create a pre-registration template in the patient portal, so parents can answer COVID-19 vaccine registration questions quickly and easily on their smart phone. You can use these forms to gather information ahead of a vaccine clinic, or send the form to families after they’ve schedule their appointment.


To learn about patient portal templates, read Configure Your Patient Portal Message Templates.

To see what other practices have done, download Portal Message Template – 5-11yr COVID Shot Pre-registration.

Add Incoming COVID-19 Vaccine Lots in the Lot Manager

When a vaccine arrives at your practice, add it to the Lot Manager in PCC EHR.

You can use a barcode scanner to enter information, or enter it manually. Use the documentation that accompanies the vaccine and/or the CDC links at the top of this article to learn more about dosage, diluent, and NDC code information for each vaccine. Note that cartons and vials have different NDC codes.

Order and Administer a COVID-19 Vaccine

Prior or during an encounter, use the Immunizations component on the chart note to order a vaccine.


You can complete the order on the chart note, from the patient’s Outstanding Tasks component, or from the convenient orange orders indicator found on PCC EHR’s main schedule screen.

When you chart the administration of any immunization, you can select a lot, select which VIS/EUA Fact Sheet you provided, and then indicate that you administered the shot or that it was canceled or refused. PCC EHR will enter your practice’s default or most recent shot information for some fields.

Provide an EAU Fact Sheet Instead of a Vaccine Information Sheet (VIS)

In PCC EHR, you can indicate which VIS you provided to a patient. There are currently no VISs for COVID-19 vaccines. Instead, the CDC and FDA are working with vaccine manufacturers to prepare and share Emergency Use Authorization Fact Sheets to recipients. In PCC EHR, the EUAs will appear in the drop-down menu instead of the VIS.

The CDC's COVID-19 Vaccine Handout: In addition to the EUA Fact Sheet, your practice may choose to distribute your own materials or the CDC’s What to Expect after Getting a COVID-19 Vaccine document. You can find this document on the CDC’s information pages for COVID-19 vaccines approved in the United States.

Bill for COVID-19 Vaccines

When your practice clicks “Order” next to a COVID-19 vaccine, your practice’s configured billing diagnoses and procedure codes will appear on the Bill screen automatically.

A clinician will see the codes when they prepare the encounter for billing.



You can make any adjustments needed. (Note that the above example does not include a visit code or other billing codes that might be part of a typical encounter.)

After the clinician has made the encounter ready for billing, the biller can post the charges from the Schedule screen in PCC EHR.


As they post charges, the biller can review and adjust patient information, along with the diagnosis and procedure codes.

What Billing Diagnoses and Procedures Do I Use for a COVID-19 Related Encounter?: While circumstances will vary, PCC has an overview of Coding and Billing for a COVID-19 Related Encounter.

Review and Understand COVID-19 Immunization Forecasting Details

As of 2022, PCC has observed that automated immunization forecasting for COVID-19 is inconsistent. There are numerous vaccines in play, each with different dosage rules. Federal and State governments may decide to advise clinicians to ignore some periodicity requirements, and those requirements are changing rapidly.

PCC is working with our immunization forecasting vendor to deliver updated forecasting as the schedules change. In the meantime, you may only see a COVID-19 line in the Immunization Forecasting component if a patient has (for example) received a first dose of a multi-dose vaccine. Long term, our immunization forecasting vendor plans to support all dose schedules for each approved vaccine.

Immunization Forecasting in PCC EHR

Can My Pediatric Practice Become a COVID-19 Vaccine Site for Adult Patients?

Many pediatric practices are working with their local health department in order to administer COVID-19 vaccines to both children and adults.

PCC has worked with practices to help them get set up, and you can read more at COVID-19 Vaccine: What Pediatricians Need to Know.

Become a Medicare Provider

If you plan to administer the COVID-19 vaccine to Medicare patients, or see Medicare patients for other reasons, you may decide to register as a Medicare provider.

The Federal Government is working to expedite the Medicare enrollment process in order to make sure more clinicians are able to see Medicare patients for COVID-19 related needs and/or to administer the COVID-19 vaccine. Clinicians need to enroll in Medicare in order to bill for encounters with Medicare patients.

You can learn about the expedited enrollment process here: CMS (https://www.cms.gov/files/document/provider-enrollment-relief-faqs-covid-19.pdf). Once a clinician is enrolled, they can see Medicare patients and administer the COVID-19 vaccine. After the pandemic, a clinician would have to complete the full enrollment process.

Medicare does not accept paper claims, and signing up for electronic claim submission with Medicare is a separate process. PCC’s EDI experts can assist you with setting up claim submission. This process has not been expedited in the same way as enrollment, and PCC anticipates initial claim submission could take up to a month.

Report on COVID-19 Vaccination at Your Practice

As of PCC EHR 9.4, coming to all practices in the third quarter of 2022, you can review your COVID-19 vaccination rates in the Practice Vitals Dashboard.

You can also use PCC EHR’s Report Library to create custom immunization and charge-based reports, and perform recalls to patients.

PCC EHR Report Library

Submit COVID-19 Vaccines to Your State’s Immunization Registries

In all states and regions where PCC offers immunization registry connections, COVID-19 immunization data is included in your practice’s immunization registry submissions.

If you have a bidirectional connection with your immunization registry, COVID-19 vaccine information is included when you look up and import patients’ state immunization records.

If you are experiencing problems with your state registry and COVID-19 vaccine lookups, contact your state’s immunization registry vendor.

Submit Immunization Records to Registries

Look Up and Import Patient Records from Your Local Immunization Registry

Fall 2020 SNOMED-CT and ICD-10 Updates Add COVID-19-Related Issues and Other Diagnoses

On September 20th of 2020, PCC updated the SNOMED-CT diagnostic terms and the ICD-10 diagnosis billing codes on your practice’s system.

PCC regularly updates your system’s ICD-10, LOINC, SNOMED-CT, NDC, RVU, VIS, and other standardized lists so you won’t encounter challenges when you chart, order a lab, interface with a care provider, or bill for a visit. (Your practice’s local system automatically updates your practice’s procedure code validation, as well.)

In PCC EHR, clinicians enter diagnoses using SNOMED, which maps to ICD-10 billing codes for claims. We updated both of these codesets in order to provide you with the most up-to-date diagnostic language in the chart, and to support the 2021 edition of ICD-10, which takes effect for dates of service after 2020-10-01.

Read the sections below to learn about the updates, educational opportunities, and diagnosis codes and descriptions of particular interest to pediatricians.

Use 2021 ICD-10 Diagnosis Billing Codes, Including New COVID-Related Codes

The 2021 ICD-10 update includes new sections for COVID-19-related infections and vaping-related disorders. You can review the complete, updated guidelines in the CDC’s ICD-10-CM Official Guidelines for Coding and Reporting.

The new codes and guidelines take effect for dates of service starting on 10/1/2020. You can learn about the updates that are of most interest to pediatric practices by attending PCC Web labs held by Jan Blanchard (CPC, CPEDC). Missed a web lab? You can watch a recorded session as well.

In addition to COVID-19 and vaping-related guidelines and codes, Jan notes that the 2021 ICD-10 update includes more specificity for substance abuse codes, several adjustments to influenza coding, and new codes for reflux, headaches/face pain, and more. In the “curiosities” bucket, the update includes “Pedestrian on electric scooter and standing micro-mobility pedestrian conveyance (hoverboard, segway)” added to V00-V06.

Chart Diagnoses Mapped to Deprecated ICD-10 Billing Codes: Were there any 2021 code changes for items that your practice frequently bills? You can review your system configuration using the snomedmap report. While there were no major disruptions in the 2021 ICD-10 update, it’s always worth taking a look at your code mapping reports to head off any billing challenges.

Use the Latest SNOMED Diagnoses, Including New COVID-Related Descriptions

The SNOMED-CT update includes thousands of new descriptions for diagnoses, allergies, therapies, and procedures. It also updates thousands of text descriptions for diagnoses and their mapped ICD-10 billing codes. You can review information about the update on the National Library of Medicine website.

Review Your COVID-19 SNOMED to ICD-10 Mapping: As codesets continue to change in response to COVID-19, PCC recommends you review the diagnoses you use to chart and bill for COVID-19 issues. For example, this update includes a new recommended mapping of the Exposure to SARS-CoV-2 SNOMED description to the Z20.828 ICD-10 code. This mapping was not included by default in the previous SNOMED standard. You can double-check your practice’s diagnosis billing configuration in the Billing Configuration tool.

New COVID-19-Related Diagnosis Descriptions

The update includes 22 new diagnoses for the use of identifying when an issue is related to COVID-19. For example, there are new descriptions for otitis media and several new descriptions for respiratory distress and infections, pneumonia, bronchitis, and similar. For a complete guide to COVID-19-related descriptions, you can read the COVID-19 section of the SNOMED-CT International Release Notes.

Acute bronchitis caused by SARS-CoV-2
Asymptomatic SARS-CoV-2
Acute hypoxemic respiratory failure due to disease caused by Severe acute respiratory syndrome coronavirus 2
Acute kidney injury due to disease caused by Severe acute respiratory syndrome coronavirus 2
Acute respiratory distress syndrome due to disease caused by Severe acute respiratory syndrome coronavirus 2
At increased risk of exposure to Severe acute respiratory syndrome coronavirus 2
Cardiomyopathy due to disease caused by Severe acute respiratory syndrome coronavirus 2
Conjunctivitis due to disease caused by Severe acute respiratory syndrome coronavirus 2
Dyspnea caused by Severe acute respiratory syndrome coronavirus 2
Encephalopathy due to disease caused by Severe acute respiratory syndrome coronavirus 2
Fever caused by Severe acute respiratory syndrome coronavirus 2
Infection of upper respiratory tract caused by Severe acute respiratory syndrome coronavirus 2
Lower respiratory infection caused by SARS-CoV-2
Lymphocytopenia due to Severe acute respiratory syndrome coronavirus 2
Myocarditis due to disease caused by Severe acute respiratory syndrome coronavirus 2
Pneumonia caused by SARS-CoV-2
Otitis media due to disease caused by Severe acute respiratory syndrome coronavirus 2
Rhabdomyolysis due to disease caused by Severe acute respiratory syndrome coronavirus 2
Sepsis due to disease caused by Severe acute respiratory syndrome coronavirus 2
Severe acute respiratory syndrome coronavirus 2 detected
Severe acute respiratory syndrome coronavirus 2 not detected
Thrombocytopenia due to Severe acute respiratory syndrome coronavirus 2

New Favorites Available in Diagnosis Quick Search

The update adds 2043 diagnosis descriptions to your system. PCC added 245 of them to the “Favorites” quick search feature of all diagnosis fields in PCC EHR.

In preparation for the update, PCC’s certified coder, Jan Blanchard, assembled a list of 245 new SNOMED-CT descriptions of interest to pediatricians. The update added these diagnoses to your practice’s default Favorites list for quick searching, unless your practice has specifically requested otherwise.

What is a diagnosis 'Favorites' list?: As you type or search in any diagnosis field, PCC EHR automatically searches a customizable list of Favorites. Use the Diagnosis Configuration tool to adjust your practice’s list of Favorites. You can also right-click on any diagnosis field in PCC EHR to search your system’s full SNOMED-CT diagnosis library.

You can review the list of 245 new Favorite descriptions. Attend PCC’s monthly coding weblabs to learn more about the new descriptions and other coding topics.

Deprecated SNOMED Diagnosis Descriptions

The Fall 2020 SNOMED-CT update removes or replaces many codes common to pediatric practices. Your practice may want to take special note of them.

Here are the top 25 codes from PCC’s pediatric practices that have been removed from the SNOMED-CT diagnosis library in 2020. When these codes appeared for selection on a chart note protocol, PCC added a replacement if available. For other diagnoses, your providers can usually find new appropriate descriptions with a search, but you may want to plan ahead.

Allergy to edible egg 91930004
Seborrhea 86708008
Sprain, ankle joint, lateral 209532000
Allergic reaction to insect bite 213024000
Dermoid cyst of skin 276729007
Hearing loss in right ear 1091501000119106
Pilonidal cyst with abscess 85224001
Allergic reaction, due to correct medicinal substance properly administered 57302007
Toxic erythema 58767000
Infective hepatitis immunization 275849001
Sprained finger/thumb 287097007
Adverse effect, due to correct medicinal substance properly administered 45376003
Pilonidal cyst without abscess 76545008
Adverse reaction to vaccine properly administered 699017007
Allergic reaction to bite and/or sting 418484009
Gastrointestinal allergy to food 414314005
Photosensitization due to sun 258155009
Sprain of toe joint 262998001
Angioedema of eyelids 402405007
Angioedema of lips 402406008
Adverse drug reaction resulting from treatment of disorder 708809007
Discharge of eye 18628002
Allergic reaction to systemically administered drug affecting oral mucosa 702559001
Facial seborrheic dermatitis 402210009

SNOMED Codes Mapped to ICD-10 for Billing

The SNOMED-CT update includes new mappings to ICD-10 billing codes. Many previous mappings have been updated.

You may wish to review billing configuration for your diagnoses. You can open the Billing Configuration tool to configure which ICD-10 diagnoses are mapped to each SNOMED-CT description in PCC EHR. You can also use the snomedmap report tool to examine your practice’s diagnoses that may need updating.

Run a Pediatric Drive-Up Flu or COVID-19 Shot Clinic

Your practice can use PCC EHR to perform a shot clinic while also meeting COVID-19 safety protocols.

PCC has worked with several practices who are running “drive through” or “curb side” flu clinics. In addition to providing your families and communities with a vital service, by running a drive through flu shot clinic, you can prepare your practice for for participation in other vaccine clinics, such as expected upcoming vaccinations for COVID-19.

Learn More From the Experts: PCC spoke with several practices to draw together the ideas and tips below. We especially learned a lot from Dr. Jeanne Marconi, who delivered a seminar sharing her experience and expertise in running this kind of flu clinic. You can watch a recording of her seminar.

Check Out PCC's Blog Post: PCC posted a great guide to How to Open a Drive Thru Flu Clinic at a Pediatric Practice! It includes our notes below and so much more. Take a look!

Watch PCC Pediatric Flu Clinic Roundtable: In September of 2020, PCC hosted a Flu Clinic roundtable, talking about drive-thru strategies and more!

Pick a Location

If you’re reading this article, then your practice wants to run a vaccine clinic, but (especially during COVID-19), you do not want to do so in your physical office space. Where can you hold an outdoor, drive-thru flu shot clinic?

You may have a parking lot or other large enough area near your practice to support a drive-through clinic, or you may not. A local business might. Consider reaching out to banks, stores, and/or your local municipality to find a location.

If your practice does not own your parking lot, you may wish to take additional precautions or seek permission.

You may want to double-check your location’s general liability policy. It usually covers things that happen in your parking lot, even if you rent or lease your property. You may want to share your policy with your landlord, or connect with your insurance company to discuss the issue.

Prepare Things You Will Need

How will you maintain the cold-chain for your vaccines? Do you need traffic cones? What additional PPE will you need? And can you buy a tent from Walmart?

Some practices erect pop-up tents for checkin and administration stations. You’ll need to plan time for erecting and disassembling your tents. If there’s no rain, you might decide to skip the tent that day.

The CDC website hosts an excellent preparation checklist that covers the more serious issues, like vaccine storage, supplies, and rules around administration.

Plan for Safety

Your practice should plan the drive-up visit workflow to ensure safety. Ask yourself how you will “shepherd” cars, and where do they will wait when they pull in. Your location may have specific safety needs, and you will need to plan for traffic flow.

You should also make safety parameters clear to your families and all attendees. For example, instructing families that they should always stay in their car, and instruct staff to not approach a car until it has been placed in park.

You may need additional staff to help monitor and direct traffic so you are not blocking a major roadway.

Set Expectations and Get Your Staff On Board

You can hold a full, all-hands meeting: our practice is going to do a drive-thru flu clinic! Explain how this will help your families and your community. Every staff member plays a part, even if its just promoting the clinic at each contact point.

Dr. Marconi recommends having a “champion” on staff to be the point person, to help clarify and handle questions that come up. Offer food and other encouragement to your staff!

Pick a Date(s)

When will you host your drive-through flu shot clinic? You’ll need a date with adequate staff, and you’ll need to calculate how many patients or families you are likely going to be able to see.

Since you are looking for low traffic and wide open parking lots, a weekend date may work best.

Promote Your Drive-Thru Flu Shot Clinic

How will you get the word out?

Talk to families, use PCC’s Broadcast Messaging, and provide verbal reminders at every point of contact. Dig into social media, update your practice’s home page, Facebook, your phone hold announcement, and consider sending a press release to publications in your community.

Are you the first one in your community to offer this valuable service? Local media might help you promote the flu clinic, and/or report on it, which helps build your practice which in turn means you are better able to support your community.

Schedule Patients

How will you communicate your flu clinic “slot” availability to all patients and families? And how will they Schedule?

High volume visits mean that scheduling has to be easy. You can have families use of PCC’s portal message scheduling template so that families can pick a time or slot. You could also use a service like FullSlate, Calendly, or Acuity. These services create an online website for you so parents can easily sign up for an open slot.

Perform Pre-Visit Patient and Family Preparation

Your flu clinic will run best if you’ve worked with every family before the actual clinic. Send them the VIS beforehand, do pre-visit COVID-19 questions. When you speak with a family, always take the opportunity to do wellness questions, update information about patient chronic problem and care plan maintenance, and review their medications.

You can send the Influenza Vaccine VIS through PCC’s patient portal. You can also laminate a copy and hand it into the car at the time of service.

You can ask COVID-19 screenings ahead of time, or tell the family to expect them at the clinic. Remember to screen all occupants of the car at the time of service. Practices have developed alternative ways of asking kids COVID-19 screening tests, such as asking what they ate for breakfast and what it tasted like.

Use the Opportunity: You’ve got the family or patient on the phone? Use that opportunity to check in on all recall topics. Chronic disease management, updated immunizations, and more. You can schedule Telehealth and Well visits based on what you learn. You should also review and update demographics, verify insurance, and plan how they will pay! (Get credit card on file, for example.)

Plan For Payment

Many practices simply ask for “cash” payment for flu shots: for a non-office visit, occurring as fast as possible, billing insurance may not make sense for you.

Either way, your practice should work to make payment as touch-less and efficient as possible.

You can work with your financial services vendor to set up secure credit card on file, for example.

Set Up Your Intake Station and Your Shot Administration Station

To see patients quickly, you can have each car stop at two stations. First, an intake station for COVID-19 screening and prep, to help the family get ready (loosen clothes, set expectations), and to collect any forms. Next, the shot station, where the clinician should double-check the child’s age and consent, confirm the vaccine they believe they are receiving, administer the vaccine, confirm the patient appears well, and document that the vaccine was administered.

At each station, you’ll want signs (or hand-held posters) with “Stop Here” and “Put your Car in “P”ark!”. Someone should individually verify that a car is in park as they approach.

Have an Emergency Plan

Your practice already knows your emergency procedures when seeing patients at your practice. Take some time to review and update that plan for your drive-thru flu clinic.

If something goes wrong, or the patient has an emergency, everyone should know the plan. Who will call 911?

How Did It Go?

As with all new initiatives, things will go wrong. You’ll learn how to improve, what to do differently next time.

Send a survey to some patients or check in with families. Did it work? And ask your staff: They helped a huge number of patients in a short period of time! Congratulate and reward them for doing this.

Other Things We’ve Heard

Dr. Marconi shared that with practice and experience her staff can now manage to see 10 cars an hour. She uses a pre-check station, with 1 MA, followed by a shot station, with 1 staff. You can create multiple lanes as well.

We also learned from many PCC practices that a drive-thru clinic has a surprising bonus: kids are in their car seats, in familiar surroundings, and ready for what’s coming. Some administrations are harder in a car, but some are actually easier!

Your practice may also want to have a plan for “guest” flu shot customers. If someone is not a patient at your practice, how will you handle them? Schedule them for a new patient visit?

There are a number of great online resources for flu clinics and drive-thru flu clinics! Check out Sanofi’s resources, or the CPP Buying Group’s resources.

Code and Bill for E&M Office Visits

Upon completion of a sick visit encounter, a clinician selects an “Evaluation and Management” or E&M code. This is sometimes called the “office visit” level. E&M level selection is based on the clinician’s medical decision making or the amount of time spent on care for that patient on the calendar date of the encounter.

Procedure Code Guidance: The procedure codes discussed in this article are intended only as examples. You should consult the AMA’s current CPT Coding Guide and work with your insurance payers to verify what codes you should report on claims. Your practice updates and maintains your billable procedure list, codes, and prices in the Procedures table in the Tables configuration tool on your PCC system.

Why is E&M Code Selection Important to a Pediatric Practice?

E&M services make up a large percentage of the work you do as a pediatrician. They represent the cognitive work, information gathering, and decision making that goes into patient care. Because so much of the work you do falls under the umbrella of E&M, it’s vital that you code those services correctly. Many pediatricians under-code their encounters, resulting in significant lost revenue for their practice.

Documenting your encounters is not only important for continuity of care. It also supports collecting and retaining the revenue those services generate.

PCC’s E&M Coding Tool

PCC’s Jan Blanchard (CPC, CPEDC) developed a printable guide for E&M Coding.

2021 Transition Resources Archive

On January 1st, 2021, the guidelines for coding and billing an office visit changed significantly. PCC collected resources, created tutorials, and managed an FAQ at that time.

2021 Resource Guide: Some of the details below have changed since 2021. You should consult the current AMA CPT Coding Guide for the most up to date requirements and guidance. Reach out to PCC Support or attend a live PCC Billing Drop-In session to learn more.

How Do I Select an E&M Code for 2021 and Beyond?

For encounters that occur after December 31st, 2020, a clinician no longer uses history or physical exam performed during the encounter as criteria for code selection. Instead, they select a code based on either medical decision making or time spent practicing care for the patient on the day of the visit.

Here’s a brief explanation of how you select a billing code level for an “evaluation and management” or “Office Visit” after January 1st, 2021. These guidelines apply to common visit billing codes, such as 99212, 99213, 99214, or 99215, as well as to the selection of codes 99202 through 99205.

Select a Code Based on Medical Decision Making

You can base your visit level code on medical decision making, which is comprised of three elements:

  • Problems Addressed: The number of problems you addressed for the patient during the day of the encounter.

  • Items Reviewed: The tests, chart information, and other data you reviewed in relation to the problems addressed today.

  • Risk: The level of risk presented to the patient.

  • Select a Code Based on Time

    You can base your visit level code selection on the total time that the rendering clinician spent on the patient that day. That can include the time the pediatrician spent before, during, and after the actual encounter.

    Watch PCC 2021 E&M Coding Videos

    These 2021 videos provide examples of how to level your E&M visits:

    Configure PCC EHR to Support Your Clinicians and Billers for E&M Level Selection in 2021

    Your practice can add fields to your chart note protocols in order to track time spent before, during, and after the encounter by the clinician. You can also track the number of problems addressed, items reviewed for the problems, and the level of risk present.

    As an example, this sample chart note protocol includes components designed to quickly note problems, time and risk.

    For help customizing your protocols, check out Configure Chart Note Protocols, and get in touch with PCC Support for assistance.

    2021 Additional Resources and Guides

    In the lead up to the 2021 transition, PCC published blog posts and other organizations published guides and online tools.

    • PCC Resources
    • Other Resources
      • AAP FAQ: E&M 2021 coding questions and answers by the American Academy of Pediatrics.
      • AAP MDM Grid: A direct link to the AAP’s chart which illustrates levels of medical decision making. It includes several useful examples. (AAP hosts this file here.)
      • MDM Tracker: An online tool for selecting visit level based on medical decision making in 2021.

    2021 Questions and Answers on Interpreting E&M Guidelines

    PCC’s Jan Blanchard works with pediatric practices to help them interpret coding guidelines. Read below to see a selection of the 2021 E&M questions received at the time of the transition. These Q&As were last updated on 2021-01-08, so you should consult your AMA CPT Guide for more recent details.

    Questions and Answers

    • Where can I find PCC’s 2021 MDM Tool?
    • Where can I find the online MDM calculator Chip Hart shared?
      You can find it on the Confessions of a Pediatric Practice Management Consultant blog post entitled “Free E&M Medical Decision Making Calculator”.
    • Is fever a systemic symptom which can elevate a visit’s level?
      Sometimes. It depends on the patient’s presentation, and only when paired with an acute illness.

      CPT defines systemic symptoms this way:
      “Acute illness with systemic symptoms: An illness that causes systemic symptoms and has a high risk of morbidity without treatment. For systemic general symptoms, such as fever, body aches, or fatigue in a minor illness that may be treated to alleviate symptoms, shorten the course of illness, or to prevent complications, see the definitions for self-limited or minor problem or acute, uncomplicated illness or injury. Systemic symptoms may not be general but may be single system. Examples may include pyelonephritis, pneumonitis, or colitis.” (p12-14 2021 CPT Manual)

      Fever had become a mainstay of complexity expression in E&M documentation. In 2021, not all fevers meet the definition of a systemic symptom. AMA says that in cases where the fever is a “general symptom in a minor illness”, it is *not* systemic. So using it to express visit complexity becomes a case-by-case determination for 2021. Things like age and other risks will be determining factors that clinicians will have to consider when they decide this point.

    • Can we get points for both ordering and reviewing tests and labs in our MDM leveling?
      No. For any one test or lab, you may include *either* the ordering or reviewing done on the service date. To include both points would be “double dipping”.

      Furthermore, the AAP has interpreted the AMA’s position to be that you may not consider tests performed in your office in your MDM level determination. This interpretation is under review.

    • Will documenting multiple diagnoses lead to a higher level of MDM?

      Maybe. “Problems” are the units of determination for MDM. So, if you treat three problems in a visit, but there are five ICDs listed, the ICDs do not inherently support higher complexity leveling. Some ICDs are reported because they represent circumstances and/or problems which complicate care but which are not specifically addressed at that visit. Documenting the role that those existing problems play in your thinking could support assigning higher Problem values to what *is* addressed.

    • Can I really get credit every time a parent or guardian contributes history to a visit?
      Maybe. If you feel confident that the contribution they made is required for appropriate care to be rendered, yes. Document the reason for their perspective being necessary if it is not obvious. For example, little ones who can’t speak for themselves obviously require someone to give their history. But for teens, the necessity of another perspective in, say, behavioral or social concerns where objective input is valuable, document a statement to that effect and take the independent historian point(s).
    • If I spend time reviewing records from a different practice, even if they’re from a practice where I formerly practiced medicine, can I count that time toward my day’s total?
      Technically, I would say yes. If the patient is familiar to you, the review would likely not take very long, necessarily.

      Follow Up Question: What if I am reviewing records at my practice that are “old”, say, greater than 3 yrs?
      Answer: No, not the way requirements are currently written: “Review of prior external note(s) from each unique source.” Only records from sources outside your own organization can be considered external and valid for those points.

    • How do Social Determinants of Health (SDoH) count toward MDM?
      Per CPT 2021, SDoHs are “Economic and social conditions that influence the health of people and communities. Examples may include food or housing insecurity.”

      Per the Elements of Medical Decision Making grid published by AMA in CPT® Evaluation and Management (E/M) Office or Other Outpatient (99202-99215) and Prolonged Services (99354, 99355, 99356, 99XXX) Code and Guideline Changes, an example of Moderate risk of morbidity from additional diagnostic testing or treatment is “Diagnosis or treatment significantly limited by social determinants of health”. I interpret these references to suggest that any SDoH which significantly limits the patient’s ability to carry out the clinician’s plan meets the Level 4 risk requirement.

      According to the U.S. Department of Health, Social Determinants of Health are economic and social conditions that influence the health of people and communities. Their examples include:

      • Safe housing, transportation, and neighborhoods
      • Racism, discrimination, and violence
      • Education, job opportunities, and income
      • Access to nutritious foods and physical activity opportunities
      • Polluted air and water
      • Language and literacy skills

      Some of these may be reported using ICD codes found in “Persons with potential health hazards related to socioeconomic and psychosocial circumstances Z55-Z65”

      • Z55 Problems related to education and literacy
      • Z56 Problems related to employment and unemployment
      • Z57 Occupational exposure to risk factors
      • Z59 Problems related to housing and economic circumstances
      • Z60 Problems related to social environment
      • Z62 Problems related to upbringing
      • Z63 Other problems related to primary support group, including family circumstances
      • Z64 Problems related to certain psychosocial circumstances
      • Z65 Problems related to other psychosocial circumstances
    • How will billing sick care that was rendered during a well visit be affected by the 2021 E&M changes?
      As a physical exam is not a consideration in leveling 2021 E&M visits, clinicians can now capture sick care for New Patient well visits, and can more easily level any visit that includes both sick and well care.

      The new MDM focus on visit leveling represents less subjectivity in discerning which parts of a service were part of the well care and which were part of the sick care.

    • Do I need to document in the note the exact amount of time spent on each activity, or is it ok to just document total time?
      Full day totals are permissible, but I would feel better seeing at least time segments. Rough estimates for segments would do, but to expect that human brains can recreate a day’s worth of timed detail accurately for work that gets interrupted and broken up and then wrapped up after everyone else has gone home is a stretch which can be avoided.

    • Is there still a Level 1 visit for nurse-only visits?
      Yes, for established patients only, a Level 1 nurse visit can be reported using 99211. New patient level 1 code 99201 expires on 12/31/20 and is not reportable thereafter. This is due to the identical MDM requirements for both 99201 and 99202. By 2021 standards, 99201 becomes redundant to 99202.
    • If I continue to chart after hours, can I add that time for the purposes of leveling the visit?
      Yes. Caveat: The only after hours charting time (or any other clinical activity time) you may include in your billed time is the time spent *on the date of service*. If you chart any part of yesterday’s visit today, you may bill by time but you cannot include the time you spent today in the total you use for choosing your level. For example, if on Monday you see an established patient and spend 5 minutes reviewing records, 10 minutes in a visit, 5 minutes on a results call Monday night and 10 minutes charting on Tuesday morning, you may only bill a level 3 visit using Monday time: 5+10+5=20 minutes; Tuesday’s 10 minutes cannot count toward the leveling.
    • Will I get MDM data points for tests like rapid flu or rapid strep for which I also charge?
      Currently, no. The current interpretation of the relationship between awarding data points for tests and labs and paying for tests and labs is that they are mutually exclusive.

      Discussions around this continue, but currently you should not expect to level using data points for test and labs you bill.

    • Are a CBC and differential counted as more than 1 lab? Or for example COVID-19/Flu/RSV combo - is that 1 test or 4 tests?
      It depends on the number of CPTs. If CBC and differential are one CPT, it is one data point for either ordering or reviewing. If the COVID-19/Flu/RSV combo is one CPT, one point is its data value.
    • Could I count one of several screenings towards data reviewed and bill for the other and not be double-dipping?
      This is not in the spirit of the requirement, but is still under discussion. Billing effects are impossible to explore here. The sheer variety of payers and policies means the outcome can not be predicted. Furthermore, carrier behavior makes predictions of future claim determinations little more than a guessing game.
    • Do I get credit if some historians are in office and others participate over facetime, phone, etc., for the same visit?
      Yes. There is no cumulative credit for historians, but if someone other than the patient is required to participate that requirement is met.
    • If you use a formal screen for SDoH that is scored and payable, then you can’t count that screening towards MDM, correct?
      Currently, that is correct.
    • Does pulse oximetry give a data point?
      I don’t know, and this question is more complex than it looks. The debate between clinicians about whether pulse ox is a vital sign is a factor. If you consider it a vital, it is not a test, and counting it as a data point is questionable. However, pulse ox has a billable CPT, so some may consider it a test.

      Also, the question of whether in-house tests and labs may be used for data credit remains unanswered. I am undecided on this as yet and will count on the clinicians with whom I review encounters to help me arrive at a position on this point in future.

    • We do our huddle and "run the schedule" (i.e. review referrals, lab results, vaccines, and consult notes) the day *before*, not the day of! Can we count that time when leveling each of those encounters?
      No. Currently, the only “billable” time is that spent by the clinician for that patient on the service date.
    • Does 'undiagnosed new problem with uncertain prognosis' relate to when we don’t yet have a diagnosis, or does it mean a new previously undiagnosed problem that you identified at the visit?
      This phrase comes from a MDM requirement. Our interpretation is that it means a new problem for the patient that you have never seen before, and for which you are uncertain of the outcome.

      CPT 2021 is light on guidance on this point. “Undiagnosed new problem with uncertain prognosis: A problem in the differential diagnosis that represents a condition likely to result in a high risk of morbidity without treatment. An example may be a lump in the breast…” The AAP offered an additional example of a potentially malignant lesion in the Feb 2020 issue of the Coding Newsletter.

    • If we bill for one Vanderbilt, could we then claim MDM credit for the ones from other sources?
      My sense of this is that doing so is *not* in the spirit of the guideline. Additionally, performing a service and not billing for it will run afoul of many insurance contracts. Also, please see above for information about Data credit for in-house labs and tests.
    • What about the hand-on-the-doorknob minor things that parents like to bring up? If there are enough of these, or significant ones, can I document them in a manner that might bump MDM up a level?

      Example: Rash (insect bite) + been a little constipated (give some prune juice), been having stomach aches (few questions to make sure it’s nothing worrisome, asked to schedule another visit to evaluate further)…

      Yes, but MDM is based on significance, not the number of problems. The total number of problems does not necessarily increase the credit you can claim for complexity in the Number and Complexity of Problems Addressed element. Rather, the most complex problem addressed (Minimal, Low, Moderate, High) in a given encounter typically represents the level of “problems addressed” which should be used for leveling. Exceptions include self-limited, minor problems (1 = Minimal while 2 = Low) and stable chronic illnesses (1 = Low, 2 = Moderate).

    • Can concussion be considered an acute complicated injury - a head injury that gave other systemic symptoms?
      Described that way, absolutely. Be sure to familiarize yourself with the AMA’s definition of Systemic Symptoms.
    • What is meant by 'risk'? The guideline only lists examples. Is there a way to determine risk on MDM without these examples? Is that purely a judgment call?
      Yes, this is a clinical judgment.

      From the AMA: “Trained clinicians apply common language usage meanings to terms such as high, medium, low, or minimal risk and do not require quantification for these definitions (though quantification may be provided when evidence-based medicine has established probabilities). For the purposes of MDM, level of risk is based upon consequences of the problem(s) addressed at the encounter when appropriately treated. Risk also includes MDM related to the need to initiate or forego further testing, treatment, and/or hospitalization.”

    • If you send a kid to the Emergency Department, or for testing due to concern for appendectomy, does that discussion get you to a higher level of risk? Does discussion of a possible ER visit count?
      Not usually. If the decision is purely for testing consideration, meaning the tests could be done in another care setting without ready access to acute or surgical or inpatient care, I would *not* say that meets the spirit of the requirement.

      From the AMA: “… decision about hospitalization includes consideration of alternative levels of care…Examples may include a psychiatric patient with a sufficient degree of support in the outpatient setting or the decision to not hospitalize a patient with advanced dementia with an acute condition that would generally warrant inpatient care, but for whom the goal is palliative treatment.”

    • Will PCC develop a software timer to capture clinician charting time?
      PCC is not currently developing a timer in PCC EHR. Our research mid-2020 about this feature found that users did not see enough value in having to activate a timer whenever they turned their attention to a particular chart.

      For example, if PCC EHR automatically records your time with a chart open, you would be required to close and reopen every chart every time you were interrupted while charting in order for it to be accurate. If you had to actively click a button to stop and start a timer, it would be an ever-present timer that required their attention. Users shared this would be distracting at best and annoying at worst. Most users were happier to state their own estimates of how much time was spent, either in total or in segments to be used for totaling when they were sure services were complete for the whole day.