Pediatric Coding Alert

Question: Our Medicaid carrier denies 99391 when we bill it with diagnosis code V20.32. Is there another diagnosis code we can use to bill preventive care?

Pediatric Coding Listserv Subscriber

Answer: Code V20.32 (Health supervision for newborn 8 to 28 days old) is a new addition to ICD-9 2010, so it might not be in your carrier's system yet; try reporting the more general code V20.2 (Routine infant or child health check) instead.

Good news: You're on the right track with reporting 99391 (Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infant, [age younger than one year]) for the preventive care because of the patient's age associated with V20.32. Choose other options from the code family 99392-99395 for older patients.