Wiki Obesity at Preventive Care Visit-I posted the following

[cbeste]

I posted the following question in the pediatric section a week ago and haven't had any responses, so I am hoping someone will see it here and help me out with this issue. Thanks!
I have a provider who coded a 99213 with a 99394 because he counseled the patient on his obesity during his well-child check. My feeling was that the obesity counseling should be included as part of the 99394. However, I did some research and it seems that if the obesity were addressed with counseling and/or risk factor reduction interventions for at least 15 minutes and if the provider had documented the time spent on this counseling, then a 99401 or a 99402 could be coded with the comprehensive preventive medicine code 99394. I couldn't find anywhere that said a 99213 would be appropriate in such a scenario. Does anyone have any experience coding for obesity at a preventive care visit? I would greatly appreciate any help.

 

[EricLam88]

I got this information from the Preventive Medicine Service Guideline in the CPT Book.

If the doctor believes that the obesity risk is a "significant" problem for the patient and he documents that, then he is allow to code 99394 with a 99213-25; I would advise sufficient documentation (what was discussed and time counseled)

If the doctor believes that the obesity risk is no a significant problem, then he should only code 99394.

However, you are also correct. You can also code 99401 along with 99394. Make sure you put Modifier 25 on the code so you can get paid for the services. The insurance company may want additional information.

 

[cbeste]

Great, thank you very much for the help.