Ob-Gyn Coding Alert

Tip: Avoid using 99401-99404 if the patient is ill. If youre not reporting preventive medicine counseling codes 99401-99404 on the same day as a problem-based E/M visit when your ob-gyn counsels the patient on an unrelated issue, you could be missing out on reimbursement up to $109. First, Study Preventive Medicine Codes If the patient sees an ob-gyn just for counseling and does not have an established illness, you should use one of three codes, depending on the counseling sessions duration: " 99401 -- Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes " 99402 -- ... approximately 30 minutes " 99403 -- ... approximately 45 minutes " 99404 -- ... approximately 60 minutes. Note: Based on the Medicare conversion factor of $36.0666 per RVU, 99401 pays about $35, while 99404 pays about $109. According to CPT, counseling codes apply when a physician counsels on family [...]