# International Travel Exams



## kbeagles3 (Nov 8, 2011)

I am looking for the best CPT and Diagnostic code to be used when the physician provides a risk assessment for international travel.  This is not a problem visit, but a counseling visit.  Any suggestions?  Thanks!


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## ajs (Nov 8, 2011)

kbeagles3 said:


> I am looking for the best CPT and Diagnostic code to be used when the physician provides a risk assessment for international travel.  This is not a problem visit, but a counseling visit.  Any suggestions?  Thanks!



Well for CPT I would look at 99401-99404 codes and ICD-9 maybe V65.40 or V65.49?


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## dballard2004 (Nov 9, 2011)

My experience has always been that travel encounters are primarily counseling visits on disease and/or injury prevention in addition to the necessary vaccines and prophylactic medication is sometimes given.

I would recommend that you take a look at codes 99401-99404 for preventativie medicine counseling.  These codes are time based, so the time spent counseling will have to be documented and the extent of the counseling will also have to be documented. 

For ICD-9-CM codes, I would recommend you report V65.49 (other specified counseling). If prophylactic medication was given, I would also report V07.8 (other specified prophylactic or treatment measure). You would also report the V codes for any vaccines given.

If vaccines are given, append modifier 25 to the E/M code.

If the counseling is more focused on an established disease or signs/symptoms, and the provider spends greater than 50% of the visit in counseling, you would report the E/M level based on time.  If greater than 50% of the visit is not spent in counseling, then base the E/M level on the key components.

Hope this helps.


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## FTessaBartels (Nov 9, 2011)

*Self-pay*

Our department of travel medicine has found that virtually no payers cover this type of visit. Patients who wish an appointment are notified when they call to schedule that the cost is payable at the time of the visit by the patient. The cost of any vaccines required is separate and in addition to the cost of the consultation; and is ALSO payable at the time of the innoculation by the patient.  

Patients are free to file with their insurance company (or employer if it is work-related travel), and if they are reimbursed by that payer the money goes directly to the patient.  Our travel medicine department does *not* file any insurance claims.  

Hope that helps.

F Tessa Bartels, CPC, CEMC


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