You Be the Coder: Know the Ropes for Reporting Sick Evaluation During Well Visit

Question: When parents present with infants for regular health checkups at two, four, and six months, I spend a lot of time counseling and treating colic and GE reflux. Can I report 99212-25 with the ICD-9 code for colic (789.7) or gastroesophageal reflux (530.81) along with 99391 (linked to ICD-9 code v20.2 for a well baby visit)?

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Answer: According to CPT, you can bill a sick visit (Office or other outpatient services codes 99212-99215) in addition to a previously scheduled preventive medicine service (99381-99385 and 99391-99395) if the presenting problem "is significant enough to require additional work to perform the [...]

- Published on 2012-01-13