Primary Care Coding Alert

Reader Questions:

Follow-Up BC Visit? Choose From 99401-94404, 99211-99215

Question: Our physicians have our patients come back to our office after three months of putting them on birth control to make sure everything is fine. Most patients are on birth control for contraception. I have been using V25.01 or V25.41, but our payers have been denying the claims. What procedure and diagnosiscodes should I use?Minnesota SubscriberAnswer: If your physician is still doing preventive medicine counseling, use 99401-99404 (Preventive medicine counseling ...). Otherwise, you can only report the problem E/M codes (99211-99215, Office or other outpatient visit for the evaluation and management of an established patient ...) for these followup visits. CPT does not offer many good codes for less than comprehensive preventive care visits.Best advice: You need to ask your payers if they do, in fact, cover the follow-up visits and if so, how they want you to bill them, since they deny your claim when you use the [...]
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