Eli's Rehab Report
Preventive Visit
New Jersey Subscriber
Answer: It is possible that the physician's actual visit met the criteria of a 99394 (... adolescent [age 12 through 17 years]), but his documentation does not substantiate the code, so it cannot be billed.
The physician seems to have provided a very brief visit in which he checked vital signs, asked about the patient's diet, and checked range of motion. Since the visit does not contain any problems or diagnoses, and yet does not fit the criteria for billing a preventive code, your best bet is to bill the unlisted evaluation and management code (99499). Medicare may not reimburse for this, but it wouldn't have paid for the preventive visit either, so you aren't losing money; you are merely making your documentation and codes match the first rule of coding.
Eli's Rehab Report
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