tci E/M Coding Alert - 2021 Issue Q1

Reader Questions: Modify Your AWV Understanding in This Encounter

Question: Do I need to use a modifier when billing 87491 with an annual wellness visit? Maine Subscriber. Answer: Per National Correct Coding Initiative (NCCI) edits for the preventive medicine codes 99381-99397 (Initial/periodic comprehensive preventive medicine evaluation/reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new/established patient …), 87491 (Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique) is not a column 2 code for any of the preventive medicine visits. The same is true for 87491...

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