You Be the Coder: Question Coding 99420 Separately From E/M

Why This Topic Matters

Health risk assessments are commonly used in preventive visits, but reporting them separately depends on payer rules and documentation. Understanding the article helps coders avoid inappropriate reporting and better support claims with the right records.

Article Sections

1. Question

   A reader asks how to report a health risk assessment performed during an annual wellness visit and whether any modifier is required. The scenario involves discussion of the assessment in the context of a preventive visit.

2. Answer

   The response addresses payer policy considerations, documentation expectations, and the relationship between the assessment and the associated evaluation and management service. It also points to a payer example and a reference for further review.

3. Background

   This section summarizes broader guidance on health risk assessments in the annual wellness visit setting, including general federal context and the kinds of topics such assessments are intended to address.