Medicare Compliance & Reimbursement - 2017 Issue 9
Reader Question: Avoid Reporting Both 99385 and 99402
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Article Overview
This reader Q&A discusses CPT preventive medicine and counseling coding for a new adult patient visit that included contraceptive management and significant counseling time. It is relevant to coders, billers, and clinicians who need to understand how preventive medicine services, counseling services, and possible E/M alternatives are framed in the source guidance.
Why This Topic Matters
The article helps distinguish when counseling is considered part of a preventive medicine service versus when a separate counseling service may be considered, which can affect code selection and claim handling.
Article Sections
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Question
The submitting scenario describes an adult female preventive visit, counseling time, and a question about whether two services may be billed together.
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Answer
The response addresses the preventive medicine service at issue, references the relevant CPT framework, and notes when a separate counseling service may be considered. It also mentions an alternative E/M approach in a different documentation scenario.
What You Will Learn
- How the article frames preventive medicine services in relation to counseling time
- When the source discusses a separate counseling service versus counseling included in a preventive visit
- Why documentation context may affect consideration of a preventive versus E/M approach
- What general payer implications may be associated with an alternate visit type
Who Should Read This
- Medical coders
- Medical billers
- Compliance staff
- Physicians and clinicians
- Revenue cycle professionals
Codes Discussed
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