Preventive Medicine Services [Current Procedural Terminology (CPT®) codes 99381-99387, 99391-99397, Healthcare Common Procedure Coding System (HCPCS) code G0402] are comprehensive in nature, reflect an age and gender appropriate history and examination, and include counseling, anticipatory guidance, and risk factor

What are preventive services in medical billing?

Preventive care is a cornerstone of family medicine. Routine visits for patients of all ages are scheduled to promote wellness and disease prevention. These visits can also include additional services, such as vaccinations, screening laboratory services, counseling and even management of medical problems.

What is the CPT code 99397?

CPT® 99397 in section: Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and more.

What are common CPT codes?

According to About.com, the following are the most commonly used CPT codes (Evaluation and Management): 99201-05: New Patient Office Visit 99211-15: Established Patient Office Visit 99221-23: Initial Hospital Care for New or Established Patient 99231-23: Subsequent Hospital Care 99281-85: Emergency Department Visits

What is the difference between G0439 and 99397?

A full physical exam, 99397, is different than an Annual Wellness Visit, G0438/G0439, or “Welcome to Medicare Exam”, G0402. A full physical 99397 or 99387 is NOT covered by Medicare and patients are responsible for the cost and can be billed.

What are some examples of preventive care?

Preventive Care

• Blood pressure, diabetes, and cholesterol tests.
• Many cancer screenings, including mammograms and colonoscopies.
• Counseling on such topics as quitting smoking, losing weight, eating healthfully, treating depression, and reducing alcohol use.
• Regular well-baby and well-child visits, from birth to age 21.

What is preventive method?

Primary prevention. Methods to avoid occurrence of disease either through eliminating disease agents or increasing resistance to disease. Examples include immunization against disease, maintaining a healthy diet and exercise regimen, and avoiding smoking.

What is the CPT code 93000?

For example, CPT code 93000 denotes a routine electrocardiogram (ECG) with at least 12 leads, including the tracing, interpretation, and report.

What is CPT code G0438?

G0438 is the HCPCS code you should use when coding a patient’s first annual wellness visit. Its long descriptor is “Annual wellness visit, includes a personalized prevention plan of service (PPPS), first visit,” while its short descriptor is “Annual wellness first.”

What is CPT code 99213 used for?

CPT Code 99213: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and a low level of medical decision making.

What are the 3 categories of CPT codes?

There are three categories of CPT Codes: Category I, Category II, and Category III.

What are the most commonly used CPT code modifiers?

Categories of CPT Modifiers The most widely used CPTs in an office setting are the E/M Codes 99201-99215; however, very few modifiers can be associated with these services. CPT modifier 25 can only be used for E/M CPTs, and under certain circumstances modifier 52 can be used as well.

What are the new CPT codes for 2021?

For 2021, two new CPT codes ( 33995 and 33997 ) and four revised CPT codes (33990-33993) reflect insertion, removal, and repositioning of right and left percutaneous ventricular assist devices (VADs).

When should modifier 33 be used?

If you provide multiple preventive medical services to the same non-Medicare patient on the same day, append modifier 33 to the codes describing each preventive service rendered on that day. You may also apply modifier 33 when a preventive service must be converted to a therapeutic service.

How often can CPT 99397 be billed?

*The Annual Preventive Exam (99397) cannot be billed with the AWV or Welcome to Medicare Visit Can be billed as stand-alone: 99381-99387, 99391-99397 None. None. None. Once in a lifetime.

Can you bill 99213 and G0439 together?

Medicare does discourage this and says there is too much ‘crossover’ between these two preventive services. We usually see a 99213 or 99214 with a G0438 or G0439 to represent the problem management outside the AWV.