Preventive Medicine

This is an educational tool, not meant to be viewed as coding or billing guidelines.

Preventive Medicine Coding and Billing Info

Telehealth applicable codes will be indicated with a phone icon. 

Click on the topic you’re interested in below to view the information for it. You can also scroll down to review all topics. To see published recommendations according to population/grade per U.S. Preventive Services Task Force click here

Preventive Medicine Topics

Alcohol Misuse Screening & Counseling

Guidelines for Alcohol Misuse Screening & Counseling

Annual Wellness Visit

Guidelines for Annual Wellness Visits

Bone Mass Measurements

Guidelines for Bone Mass Measurements

Cardiovascular Disease Screening Tests

Guidelines for Cardiovascular Disease Screening Tests

Colorectal Cancer Screening

Guidelines for Colorectal Cancer Screenings

Counseling to Prevent Tobacco Use

Guidelines for Counseling to Prevent Tobacco Use

Depression Screening

Guidelines for Depression Screenings

Diabetes Screening

Guidelines for Diabetes Screenings

Diabetes Self-Management Training

Guidelines for Diabetes Self-Management Training

Glaucoma Screening

Guidelines for Glaucoma Screenings

Hepatitis B Virus Screening

Guidelines for Hepatitis B Virus Screening

HBV Vaccine & Administration

Guidelines for Hepatitis B Virus Vaccine & Administration

Hepatitis C Virus Screening

Guidelines for Hepatitis C Virus Screenings

HIV Screening

Guidelines for Human Immunodeficiency Virus Screenings

IBT for Obesity

Intensive Behavioral Therapy for Obesity

IBT for Cardiovascular Disease

Guidelines for Intensive Behavioral Therapy for Cardiovascular Disease

Influenza Virus Vaccine & Administration

Guidelines for Influenza Virus Vaccine & Administration

Initial Preventive Physical Examination

Guidelines for Initial Preventive Physical Examination

Lung Cancer Screening

Guidelines for Lung Cancer Screenings

Medical Nutrition Therapy

Guidelines for Medical Nutrition Therapy

Medicare Diabetes Prevention Program

Medicare Diabetes Prevention Program Expanded Model

Pneumococcal Vaccine & Administration

Guidelines for Pneumococcal Vaccine & Administration

Prolonged Preventive Services

Guidelines for Prolonged Preventive Services

Prostate Cancer Screening

Guidelines for Prostate Cancer Screenings

Screening for Cervical Cancer

Guidelines for Screening for Cervical Cancer

Screening for STIs and HIBC to Prevent STIs

Guidelines for Screening for STIs and High Intensity Behavioral Counseling to Prevent STIs

Screening Mammography

Guidelines for Screening Mammographies

Screening Pap Tests

Guidelines for Screening Pap Tests

Screening Pelvic Examination

Guidelines for Screening Pelvic Examination

Ultrasound Screening for AAA

Guidelines for Ultrasound Screening for Abdominal Aortic Aneurysm

Code Sets

CVX Vaccines Codes

CVX Vaccines Codes

Additional Links and Resources

Preventive and Screening Services

Ch. 18 Medicare Claims Processing Manual

Commonly Administered Pediatric Vaccines

American Academy of Pediatrics

CMS - Seasonal Influenza Vaccines Pricing

CMS - Seasonal Influenza Vaccines Pricing

Recommendations for Preventive Medicine

HRSA Recommended Preventive Services

Bright Futures Initiative

HRSA Recommended Preventive Services

Recommended Uniform Screening Panel

HRSA Recommended Preventive Services

Women’s Preventive Services Guidelines

US Preventive Services Task force

US Preventive Services Task force Recommendations

ACIP Recommendations

ACIP Recommendations

Select the title to see a summary and a link to the full article.

Preventive Medicine Versus E&M Codes: The Same-Day Coding Dilemma


Choosing a proper office visit code can become confusing unless one understands the rules separating preventive medicine and evaluation and management (E&M) coding. Problem-oriented E&M services, office, and other outpatient visit codes 99202-99215 (along with hospital, observation, and consultative encounters) are for patients who present with signs, symptoms,...

Preventive Services


In Today’s Take, let’s discuss the difference between preventive care. You might be thinking this is “101”. But it really isn’t. Oftentimes, when conducting chart audits, we not only we see issues with a lack of documentation criteria, especially with Medicare preventive services, but we also see confusion regarding...

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Proper Coding and Billing for Drugs, Biologicals and Injections

Proper Coding and Billing for Drugs, Biologicals and Injections

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Plan networks and government plans are required to cover preventive services as required by the Affordable Care Act (ACA) at no cost to the patient. This covers numerous screenings, counseling and well visits to prevent illness, disease and health problems. Services are based on age, gender, and other health factors. This does not include diagnostic testing as this is not considered preventive. Preventive services must be performed by a covered provider, in-network and may be used to develop a wellness plan to keep the patient healthy.

This page was created from a need to have all of the information in one place to accommodate Payers, Providers, Researchers, and others, suggestions and feedback are always welcome, please send it to us at The information covered on this page is informational only and not meant to be all-inclusive, always verify coverage with your payer.

For more information about the Affordable Care Act visit

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