tci Medicare Compliance & Reimbursement - 2013 Issue 13

Reimbursement: Boost Your Bottom Line By Billing Services In Addition To Preventive Care

Appropriate modifier use could help break bundling of services. Normally you’ll code preventive wellness visits by choosing the best option based on the patient’s age and whether she is a new or established patient. Your code choices are: 99381-99387 (Initial comprehensive preventive medicine evaluation 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 patient …) or 99391-99397 (Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions...

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