Jamie Posted Sat 04th of January, 2020 19:27:54 PM
Here at our office we see a lot of patients for their overseas travel before going to a diff country. During the travel consultation the provider reviews medical necessity for possible immunizations and prophylactic measures needed and sometimes required for travel based on the specific area/country the patient is traveling to. They review prior medical history and any limitations the patient may have that would prevent them from traveling safely. Sometimes prescription is written for travelers symptoms (ex: Travelers diarrhea) and patients are provided with literature for prevention while overseas as well. In order to charge patients for their travel consult to include all the above information provide/given...would it be appropriate to bill an E/M 99201-99215 or appropriate to bill 99401-99404? and why? Thank you
SuperCoder Answered Mon 06th of January, 2020 07:00:46 AM
As per guidelines, the following codes (99401-99404) are used to report the preventive medicine evaluation and management of infants, children, adolescents, and adults. The extent and focus of the services will largely depend on the age of the patient. If an abnormality is encountered or a preexisting problem is addressed in the process of performing this preventive medicine evaluation and management service, and if the problem or abnormality is significant enough to require additional work to perform the key components of a problem-oriented E/M service, then the appropriate Office/Outpatient code 99201-99215 should also be reported.
Also, Modifier 25 should be added to the Office/Outpatient code to indicate that a significant, separately identifiable evaluation and management service was provided on the same day as the preventive medicine service. The appropriate preventive medicine service is additionally reported.
Hope this helps!