CPT^® 99391, Under Established Patient

The Current Procedural Terminology (CPT^®) code 99391 as maintained by American Medical Association, is a medical procedural code under the range - Established Patient.

Additional/Related Information

Tabs

Summary

Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby visits, well–woman visits, and routine annual physical check–ups come under the purview of preventive medicine reevaluation and management services. These visits are different from other visits where the patient has a problem for which medical attention is sought. The age, gender, and associated risk factors of the person are important considerations while providing a preventive medicine service. The physician performs a comprehensive review of systems, comprehensive past family and social history (PFSH), and makes a thorough assessment of age and gender–related risk factors. The physician may order and obtain diagnostic/laboratory procedures and administer immunizations during the preventive service.

For clinical responsibility, terminology, tips and additional info
start codify free trial.

View any code changes for 2024 as well as historical information on code creation and revision.

Crosswalks

Tabs

Combat the #1 denial reason - mismatched CPT-ICD-9 codes - with top Medicare carrier and private payer accepted diagnoses for the chosen CPT® code.

View the CPT® code's corresponding procedural code and DRG. In a click, check the DRG's IPPS allowable, length of stay, and more. To plug inpatient facility revenue drains, subscribe to DRG Coder today.

Crosswalk to an anesthesia code and its base units, and calculate payments in a snap! Subscribe to Anesthesia Coder today.

View matching HCPCS Level II codes and their definitions.

Forum

Have a question about CPT Code 99391 ? Start a discussion here

99173 billed with E/M

Our practice seems to be having an issue with the visual acquity screening (99173) being billed with a E/M service(99391-99394). We append modifier 25 to the E/M service and on the 99173 we have tried... [ Read More ]

Well Child Visit and Mother's Postpartum (96161) together

How to bill for a newborn well child visit (ex: 99391) along with the mothers postpartum (ex: 96161) under the newborn. Does the CPT 96161 need a modifier?... [ Read More ]

CPT Practice Question

I am confused on this practice question : [B] 93. [/B]A two-month-old returns for a well check-up and several shots (Rota, DTaP-HepB-IPV, Pneumococcal PCV13) with her pediatrician. He offers sugges... [ Read More ]

99391 with GE Modifier

Does anyone have experience with appending the GE modifier to CPT 99391? We're getting a lot of denials with our Medicaid payers and I can't find any information on whether or not this modifier is app... [ Read More ]

code pairs found to be unbundled

[TABLE] [TR] [TD]90460[/TD] [TD]99391[/TD] [TD][/TD] [TD]20130101[/TD] [TD]*[/TD] [TD]1[/TD] [TD]CPT Manual or CMS manual coding instructions[/TD] [/TR] [TR] [TD]90460[/TD] [TD]99392[/TD] [TD][/TD] ... [ Read More ]

code pairs found to be unbundled

Can someone explain why i am getting this denial im linking the annual with the vaccine as well when i called the insurace they are saying the 99391 should not be billed with 90460 but arent we suppos... [ Read More ]

HOME VISITS DURING COVID 19

I have no experience billing for home visits and we have a provider (pediatrics) that would like to do well checks on our patients in their home during this pandemic. Do I still bill the well child co... [ Read More ]

Global modiifer

can we append 24 Modifier with 99391? 99391(Periodic comprehensive preventive medicine reevaluation and management ) hit under global period . Can we give 24 Modifier?... [ Read More ]

Foster Care Exam

Hello - I am trying to locate the correct coding for foster care exams for children being placed in new homes. We are able to bill Medicaid for these exams but I am unsure if it goes with a straight ... [ Read More ]

Pediatric Wellness Visits with Behavioral Screenings

We cannot append 59 Modifier for 96127 when performed with 99391 - 99393, Eventhough 96127 is allowed two times per visit and some payers may append 59 Modifier when billed two times in 1 line 96127 a... [ Read More ]

View All