Preventive Medicine Coding Guidelines — Preventive Medicine Codes

Ok everyone it looks like we made a mistake
on our webinar and one of our students actually brought
it to our attention so we ar re-recording the preventative medicine answer key. preventative medicine starts with a range of 99381 to 99429 These are codes set aside for such visits
when the patient is not really sick ,
they’re coming in for a check-up. Examples of that are going to be
well-baby clinics physicals prescription renewals sports physicals- anything that falls into that type of
the category. Preventive medicine
codes are again going be located in your evaluation and management section of
the front of your CPT manuals. There’s three divisions for preventative
medicine. You need to know is it a new patient, an established patient and the age of the patient . when you see a comprehensive history in an
exam it’s not the same thing when you’re dealing with regular E and M codes
for comprehensive becasue it’s not a multi system exam that usually do with E and M codes. This is what preventative medicine and it’s based solely on age whether a new
patient, established patient and the aged 0fthe patient. Now,
while you’re doing preventative medicine if there’s additional work that’s
involved the CPT guidelines are gonna state that if
there’s a trivial problem or an abnormality that the Doctor encounters-
you’re not going to report that. That’s going to be all going to be in the
regular preventative medicine code. On the other hand, if you have additional
work that’s called for like the removal of a lesion then you do get to report that. And you’re gonna use a modifier 25 that will be added to that. Therefore any
additional work that is done and you can use on a office visit uh… 99201 – 99215 and add the modifier25 When we did this earlier I know Laureen made
a comment about modifier 25 – to note that …when she went to conferences
they said if additional work is done it’s a good
idea to go ahead and create a separate report to be added that way when
the auditors come in they have no modifier 25 is a red flag for
auditors. It’s very over used and this can cause some problems so if your documentation
isn’t up to par you don’t wanna make used her fall into the trap of using modifier
24. That about sums up that preventative
medicine codes. They’re very easy to use once you get used to them it just takes a
little extra time to uh… make sure your documentation is accurate that your are
doing no additional work and to conclude: that you know the age of the
patient because it’s all based on age.

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