CPT^® 99392, Under Established Patient

The Current Procedural Terminology (CPT^®) code 99392 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 99392 ? Start a discussion here

Required modifier for cpt code 87491

A modifier should not be necessary on the AWV -- 87491 is not a column 2 code for 99392, and CPT guidelines state that tests with a specific CPT code are reported separately from AWVs.... [ Read More ]

Required modifier for cpt code 87491

It’s being billed with an office visit 99392... [ Read More ]

If you are coding a Pediatric Well visit 99392 and you also do a vision a 3yr old occular vision screen 99174, do you only apply the -59 on 99174?

You do not need to add modifier -25 to the 99392. Only -59 to 99174.... [ Read More ]

If you are coding a Pediatric Well visit 99392 and you also do a vision a 3yr old occular vision screen 99174, do you only apply the -59 on 99174?

If a payer requires a modifier, 25 would be more appropriate because you have an E/M service (99392) and a non-E/M service (99174). If you get a denial, it is important to look first at the payer's po... [ Read More ]

If you are coding a Pediatric Well visit 99392 and you also do a vision a 3yr old occular vision screen 99174, do you only apply the -59 on 99174?

If we are doing a Pediatric's Wll visit 99392 and we also do a 3yr old ocular vision screen 99174, do you only apply the -59 modifier? Has something changed and you also need to add the -25 modier t... [ 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 ]

Can you bill 99392-25 with 96110-59?

Good Afternoon, I am billing for 99392-25 with 96110-59 and the payor is bundling the 96110. I ran EnCoder Pro and there is no CCI edits for these two codes, they can be billed together. Is this payor... [ Read More ]

Preventative Visit and E/M e/m with modifier 25 preventative

Listed in the chief complaint is "cough and wellness check" there is an HPI for the cough and an Exam and ROS. There is a brief "wellness HPI" and mention of vaccines and nutritional guidance my... [ Read More ]

Fee schedule for Preventive visits

[b]Does this copy and paste from the RVU file help?[/b] STATUS WORK NON-F FAC MP NON-F FACILITY HCPCS CODE DESCRIPTION RVU PE PE ... [ Read More ]

99173 need a modifier? 99173 mod 59

Hi Everyone. I am hoping someone can help me. I am trying to figure out if when billing 99382-99384 or 99392-99394 (prev med visit new/est pt) with 99173 (vision screening) if the vision screening ne... [ Read More ]

View All