decisionhealth Newsletters, Part B News - 2004 Issue 3 (March)
Billing 99387 for Preventive Exam
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Article Overview
This article explains how a Medicare reform provision was expected to add a new initial preventive exam for newly eligible beneficiaries, and why physician advocates were pressing CMS to recognize an existing CPT code rather than invent a new HCPCS code. It is relevant to coders, billers, compliance staff, and physicians tracking Medicare physician fee schedule implementation, coverage timing, and payment policy for preventive services.
Why This Topic Matters
The topic affects how a new Medicare preventive benefit could be represented on claims and how payment levels, deductible applicability, and beneficiary cost-sharing may be applied when the service is implemented.
What You Will Learn
- How the proposed Medicare preventive exam was being discussed in relation to coding and payment policy.
- Why physician groups were urging CMS to use an established CPT code instead of creating a new HCPCS code.
- What broad coverage and beneficiary timing issues were associated with the new Medicare benefit.
- What questions were being raised about reimbursement for the service.
Who Should Read This
- Medical coders
- Billers
- Compliance professionals
- Physicians
- Practice managers
- Revenue cycle staff
Codes Discussed
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