Pediatric Coding Alert

Question: Under ICD-10, can I still use the 99391-99395 with the Z00.129 along with the other diagnoses found during a well-child visit, or do I need to change it to 99213-99214 with a 33 modifier appended? This is how a seminar speaker recently told me to bill well baby visits once ICD-10 takes effect. 

Codify Subscriber

Answer: You can still use the 99391-99395 series as you do under ICD-9. The only difference is that you’ll use Z00.129 (Encounter for routine child health examination without abnormal findings) instead of V20.2. 

Adding modifier 33 (Preventive service) to a sick visit code does not automatically convert it to being equivalent to a well-child visit. Since CPT® already includes appropriate codes for preventive visits, you should continue reporting those as you have all along.

The belief that ICD-10 implementation will impact your CPT® coding is a commonly held opinion, but an incorrect one, said CMS’s Denesecia Green during a June 18 CMS presentation, “ICD-10: Preparing for Implementation and New ICD-10-PCS Section X.” 

“Outpatient and office procedure codes aren’t changing—that’s a common myth,” Green said. Payments will be based on CPT® codes, as they are now, even though ICD-10 codes may impact edits or medical necessity, she added.