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Pediatric Coding Alert

Preventive Services:

Separately Report These 5 Services When Performed With Well Visits

Don't write off payment for injections, screenings, and other services during preventive exams. When a patient presents to your practice for a preventive medicine visit, you'll simply report a code from the 99381-99397 range and move on, right? Not so fast. You could be writing off hundreds of dollars in reimbursement for the additional services you provide at checkups. Find out what you can separately report by reading the following five tips. Note: Although CPT® does not recommend modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) on the preventive medicine E/M codes for any of these services, some payers may require this for separate recognition and payment. The following discussions and examples may require you to append modifier 25 to the preventive medicine codes. 1. Problems Discovered During Well Visit. If you encounter a significant [...]