What does CPT code 99395 mean?

What does CPT code 99395 mean?

Periodic comprehensive preventive medicine reevaluation
CPT® Code 99395 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 the ordering of laboratory/diagnostic procedures, established …

What is included in CPT code 99397?

A: The commercial Health Maintenance visit codes (99381-99397) include a pelvic and breast exam. It is assuredly part of the ‘age and gender appropriate’ physical exam. Medicare, which doesn’t pay for the above codes, recognizes the G0101, Q0091 as their AWV visits. The G0439, etc.

What is procedure code 99480?

Code 99477 represents initial hospital care of the neonate (28 days or younger) who is not critically ill but requires intensive observation, frequent interventions, and other intensive care services….Caring for Sick Newborns.

99478 Present body weight less than 1500 grams
99480 Present body weight of 2501-5000 grams

What is the CPT code for wellness visit?

The two CPT codes used to report AWV services are: G0438 initial visit. G0439 subsequent visit.

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 is procedure code 99464?

attendance at delivery
Codes 99464 (attendance at delivery) and 99460 (initial hospital or birthing center care, per day, for the evaluation and management of normal newborn infant) are reported. Standby services are not reported per CPT guidelines.

What is the CPT code for a well baby/well child care visit?

There are no referral/preauthorization requirements for well baby/well child care visits when provided by a contracted FCHP primary care physician within the member’s product network. For new patients making a well baby/well child care visit: • For infants under age 1, use CPT code 99381.

What is the CPT code for newborn care?

Care of newborns who are not normal but do not require intensive services may be reported with codes for initial hospital care (99221-99223). Some infants may require intensive care services but do not meet the CPT definition of critically ill or injured required for reporting of critical care services.

What is the CPT code for routine child health examination?

Diagnosis code Z00.121 (encounter for routine child health examination with abnormal findings) and the appropriate problem diagnosis would be used. If a nurse visit is provided (e.g., weight screen only), code 99211 may be reported. If the nurse visit results in a visit with the physician, only the physician services would be reported.

What is the CPT code for preventive medicine visits for children?

• For children ages 12 to 17 (adolescent), use CPT code 99394. • For children age 18 (adolescent), use CPT code 99395. • Not all insurers pay for preventive medicine visits. For example, these visits are not covered by Medicare. If you suspect a patient does not have coverage, advise him or her of your billing policies.

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