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Primary Care Coding Alert

You Be the Coder:

Preventive Exam with Vision Screening

Published on Mon Apr 01, 2002

Test your coding knowledge.  Determine how you would code this situation before looking at the box below for the answer.

Question: When a patient comes in for a preventive exam and the doctor performs a vision screening as well, can we bill separately for both?

Georgia Subscriber

Answer: The answer depends on your carrier. CPT states under the Preventive Medicine section, "Immunizations and ancillary studies involving laboratory, radiology, other procedures, or screening tests identified with a specific CPT code are reported separately." Because vision screening now has its own code (99173, Screening test of visual acuity, quantitative, bilateral), you can report it in addition to the preventive exam (99381-99397).
 
Before 2000, vision screening did not have its own code and therefore was not separately billable from the preventive service. However, some carriers are still not reimbursing these services separately. Certain carriers consider the vision screening as inclusive in the preventive exam and will only reimburse for the E/M. Check with your local carrier to determine billing.

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