Part B Insider - 2015 Issue 6
Reader Questions: Think 99395-99397 for a Periodic E/M
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Article Overview
This article addresses a reader question involving a yearly preventive visit and a same-day office procedure in an obstetric/gynecologic setting. It explains the broad coding context for reporting preventive medicine evaluation and management services together with a procedural service, and it notes the modifier considerations that may apply for separate reporting. The piece is aimed at medical coders, billers, and office staff who handle outpatient women’s health claims and same-day service reporting.
Why This Topic Matters
Same-day preventive and procedural services are common in outpatient practice, and correct reporting affects claim integrity and reimbursement. Understanding the general relationship between the preventive visit, the procedure, and modifier use helps reduce denials and support compliant billing.
Article Sections
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Question
A reader asks about coding a yearly examination when a procedure is performed during the same encounter.
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Answer
The response discusses the general reporting of a preventive medicine service with a separate procedure in the same visit and mentions modifier considerations for distinct services.
What You Will Learn
- How the article frames preventive medicine services in a same-day procedural scenario
- What general coding categories are discussed for a yearly gynecologic visit
- Why modifier-related guidance is relevant when multiple services occur on the same date
- How outpatient office coding questions are presented in a reader Q&A format
Who Should Read This
- Medical coders
- Medical billers
- OB-GYN office staff
- Revenue cycle personnel
- Compliance staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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