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Preventive Medicine with a New Patient

By:  Find-A-Code
Published:  January 9th, 2018

When coding for preventive care, be sure to use the correct encounter code with the procedure as well as the appropriate modifier if required.

New Patient:  A patient that has not received any professional services i.e., E&M  or any other face to face service from the physician or group within the previous three years. Be sure you code as an encounter for health exam using the following Z-Codes:

99381 Infant (younger than 1 year) Z00.110 Health supervision for newborn under
8 days old or
Z00.111 Health supervision for newborns 8 to
28 days old or
Z00.121 Routine child health exam with abnormal
findings
Z00.129 Routine child health exam without
abnormal findings

99382 Early childhood (age 1–4 years)

99383 Late childhood (age 5–11 years)

99384 Adolescent (age 12–17 years)

Z00.121 Routine child health exam with abnormal
findings
Z00.129 Routine child health exam without
abnormal findings
99385 18 years or older Z00.00 General adult medical exam without
abnormal findings
Z00.01 General adult medical exam with
abnormal findings

Also remember to used modifier 33 if the service was initiated as a preventative service even if the visit required additional services. Be sure to code any abnormal findings as well. Read the attached article to verify the preventative service requires the use of modifier 33Modifier 33 for Preventive Care. As part of the Patient Protection and Affordable Care Act (PPACA), healthcare insurance companies are required to pay for some preventive services, and many have already deemed such services as immunizations, screenings, well-child examinations, and screening mammograms among others.  


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