Part B Insider (Multispecialty) Coding Alert
Position Preventive Medicine Counseling Codes Correctly
Learn why a patient's illness negates using these codes
If the patient sees the physician just for counseling and does not have an established illness, you should use one of four codes, says Karen Green, CPC-H, OGS, coding specialist for Eau Claire Women's Care in Wisconsin. Depending on the session's duration, assign:
- 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.
According to CPT, counseling codes apply when a physician counsels on family problems, diet and exercise, substance abuse, sexual practices, injury prevention, dental health, and diagnostic and laboratory test results available at the time of the encounter.
Caution: In other words, the purpose of the visit must be promoting health and/or preventing illness or injury. If the patient is ill, you shouldn't use the preventive counseling codes. For example, use a counseling code when the doctor provides counseling on diet and exercise for a well patient who wants to lose weight, but not when the doctor provides the same services to a diabetic patient.
Part B Insider (Multispecialty) Coding Alert
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