What is CPT code 99395 preventive visit?
Asked by: Francisco Sanford | Last update: August 6, 2025Score: 4.4/5 (70 votes)
What is CPT code 99395 preventive?
CPT code 99395 designates a comprehensive preventive medicine evaluation and management service for established patients, emphasizing the in-depth assessment involved in preventive care.
What needs to be documented for a preventive visit?
- A comprehensive history and physical exam findings;
- A description of the status of chronic, stable problems that are not “significant enough to require additional work,” according to CPT;
- Notes concerning the management of minor problems that do not require additional work;
What is the difference between 99396 and 99395?
adolescent (age 12 through 17 years) 99395 …18-39 years. 99396 … 40-64 years.
What is the CPT code for preventive visits?
The Current Procedural Terminology (CPT) code range for Preventive Medicine Services 99381-99429 is a medical code set maintained by the American Medical Association.
Ch # 4 | What is Preventive Care Services | What CPT and DX codes are used for Preventive Services
What is the CPT code for preventive gyn exam?
Preventive medicine codes (99381–99387 and 99391–99397) are used to report annual well-woman examinations and determined by the age of the patient and whether she is considered a new or established patient to the physician or practice.
What is covered in a preventive visit?
Counseling on such topics as quitting smoking, losing weight, eating healthfully, treating depression, and reducing alcohol use. Regular well-baby and well-child visits. Routine vaccinations against diseases such as measles, polio, or meningitis. Counseling, screening, and vaccines to ensure healthy pregnancies.
What is the difference between annual wellness visit and preventive visit?
The prevention plan includes a screening schedule for preventive services to help the patient maintain their health and prevent potential illnesses. An annual physical includes a wellness exam and a full physical exam including blood work, lab tests and vaccinations.
What is the age limit for CPT code 99395?
99395 – Preventive Service, est patient 18-39 years (Primary DX – Z00. 0 - annual exam)
What is the CPT for yearly wellness exam?
The CPT codes for Annual Wellness Visits are G0438 for the initial visit and G0439 for subsequent visits. These codes are used to bill Medicare for comprehensive wellness assessments and personalized prevention plans.
What is not covered under preventive care?
What's not considered preventive care? There are times when certain tests and screenings aren't considered preventive care. Things like diagnostic care, bloodwork and sexually transmitted infection (STI) testing may or may not be considered preventive.
What are the three words to remember for a Medicare wellness exam?
Word recollection (Banana, Sunrise, Chair) Have patient repeat the 3 words, tell them to remember them.
Can a dermatologist bill for preventive care?
It would NOT be appropriate for a dermatologist to report a code from the Preventive Medicine range (CPT 99381-99397) because a dermatologist is a specialist.
Can 99395 be billed as telehealth?
Comprehensive prevention family planning visits are also covered via telemedicine/telehealth, billed with an FP modifier: CPT® 99384, 99385, 99386, 99394, 99395, 99396, 99401. Comprehensive prevention family planning visits will continue to be limited to once every 365 days.
Can you bill 99213 and 99395 together?
can be used 99213 with 99395 at the same visit? Absolutely! You would use the modifier -25 on the 99213. Look at the Preventive Medicine section in CPT® and this is outlined in the narrative explanation prior to the actual listing of codes.
Is 99396 a physical?
CPT code 99396 refers to a preventive medicine evaluation and management (E/M) service for patients aged 65 years or older. It involves a comprehensive annual wellness visit (AWV), including personalized preventive medicine planning.
What does code 99395 mean?
The 99395 CPT code is used to describe a preventive (well-patient) outpatient office visit for an established patient between the ages of 18 and 39.
What is an example of preventive counseling?
Preventive Counseling is used to stop problems before they start or to prevent things from getting worse. Areas like “How to Keep Healthy,” “How to Prepare for Retirement,” or sessions in premarital counseling are examples of preventive counseling.
What is the CPT code for Pap smear?
Coding for a Pap Smear – Points to Note
The CPT codes for cytopathology screening of cervical or vaginal smears are: 88141-88155, 88164-88167, 88174-88175, P3000, P3001, G0123-G0124, and G0141, G0143-G0148 are. The code submitted should reflect the service provided.
What is considered a preventive doctor visit?
A medical preventive visit is a yearly doctor's appointment intended to prevent illnesses and detect health concerns early, before symptoms are noticeable. Preventive visits could be an annual physical, well-child exam, Medicare wellness exam or welcome to Medicare visit.
Why did I get a bill for a preventive care visit?
If you schedule a preventive care visit and ask your doctor about a specific health concern or condition, your clinic may code and bill the appointment as an office visit. If you want to know about costs, ask your doctor for an estimate of fees before you visit.
What is not covered in annual wellness visit?
Medicare does not cover Annual Wellness Visits if they are used to discuss, plan, or alter treatment for pre-diagnosed chronic illnesses, including high cholesterol, high blood pressure, or arthritis.
Is a dermatologist visit considered preventive care?
Answer: The visit to the dermatologist is not considered preventive care.
How do you code a preventive visit?
CPT® codes 99381-99397 are used for comprehensive preventive evaluations that are age-specific, beginning with infancy and ranging through patients 65 years and older, for both new and established patients.
What type of service is not considered to be a preventive medical service?
Alternative therapies: Services such as chiropractic, massage, acupuncture, and other alternative health services are not considered preventive care.