Preventive Medicine
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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 TopicsAlcohol Misuse Screening & Counseling Guidelines for Alcohol Misuse Screening & Counseling Annual Wellness Visit Guidelines for Annual Wellness Visits Bone Mass MeasurementsGuidelines for Bone Mass Measurements Cardiovascular Disease Screening TestsGuidelines for Cardiovascular Disease Screening Tests Colorectal Cancer ScreeningGuidelines for Colorectal Cancer Screenings Counseling to Prevent Tobacco Use Guidelines for Counseling to Prevent Tobacco Use Depression Screening Guidelines for Depression Screenings Diabetes ScreeningGuidelines for Diabetes Screenings Diabetes Self-Management Training Guidelines for Diabetes Self-Management Training Glaucoma ScreeningGuidelines for Glaucoma Screenings Hepatitis B Virus ScreeningGuidelines for Hepatitis B Virus Screening HBV Vaccine & AdministrationGuidelines for Hepatitis B Virus Vaccine & Administration Hepatitis C Virus ScreeningGuidelines for Hepatitis C Virus Screenings HIV ScreeningGuidelines 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 & AdministrationGuidelines for Influenza Virus Vaccine & Administration Initial Preventive Physical ExaminationGuidelines for Initial Preventive Physical Examination Lung Cancer ScreeningGuidelines for Lung Cancer Screenings Medical Nutrition Therapy Guidelines for Medical Nutrition Therapy Medicare Diabetes Prevention ProgramMedicare Diabetes Prevention Program Expanded Model Pneumococcal Vaccine & AdministrationGuidelines for Pneumococcal Vaccine & Administration Prolonged Preventive Services Guidelines for Prolonged Preventive Services Prostate Cancer ScreeningGuidelines for Prostate Cancer Screenings Screening for Cervical CancerGuidelines for Screening for Cervical Cancer Screening for STIs and HIBC to Prevent STIsGuidelines for Screening for STIs and High Intensity Behavioral Counseling to Prevent STIs Screening MammographyGuidelines for Screening Mammographies Screening Pap TestsGuidelines for Screening Pap Tests Screening Pelvic ExaminationGuidelines for Screening Pelvic Examination Ultrasound Screening for AAAGuidelines for Ultrasound Screening for Abdominal Aortic Aneurysm Additional Links and ResourcesPreventive and Screening ServicesCh. 18 Medicare Claims Processing Manual Commonly Administered Pediatric VaccinesAmerican Academy of Pediatrics Code SetsCVX Vaccines CodesCVX Vaccines Codes Additional Links and ResourcesCMS - Seasonal Influenza Vaccines PricingCMS - Seasonal Influenza Vaccines Pricing Select the title to see a summary and a link to the full article. September 30th, 2019 Vaccine Administration - When The Right Vaccine Code is Not Enough| Published September 30th, 2019 Understanding how to apply immunization administration codes properly will support correct reimbursement for vaccinations. Reporting the right vaccine code alone is not enough to guarantee proper billing. The majority of the time, providers can charge for the vaccine/product as well as the administration of the vaccine; always consult your payer ... November 1st, 2018 CMS: Medicare Diabetes Prevention Program Expanded Model| Published November 1st, 2018 CMS announces the Medicare Diabetes prevention program is now a new covered service. Per a recent MLN news release. Medicare Beneficiaries will be notified in 2019 in a Medicare handout. Diabetes affects more than 25 percent of Americans aged 65 or older, and its prevalence is projected to increase approximately... July 17th, 2018 Understanding the Level of Preventative Services (Grades and Suggestions)| Published July 17th, 2018 It is essential for providers, clinicians, and other users to understand the importance of providing preventative services. The U.S. Preventative Services Task Force (USPSTF) has recommendations and has applied Grade Definitions as a suggested resource to imply the significance and strength of preventative services. The following definitions apply to recommendations ... May 22nd, 2018 AMA vs Medicare rules and the use of the PT modifier| Published May 22nd, 2018 Be sure to review the specific payer policy you are submitting claims to. Medicare’s policy requires the use of a different code when a screening colonoscopy becomes a diagnostic procedure requiring you to bill with CPT code 00811 when treating a Medicare Beneficiary. The use of the PT modifier is ... May 9th, 2018 Preventive Medicine: Breastfeeding Supplies| Published May 9th, 2018 - Last Review/Update August 1st, 2018 Preventive Medicine Topics Page
Breastfeeding Supplies
Procedure Codes A4286: Locking ring for breast pump, replacement E0602: Breast pump, manual, any type E0603: Breast pump, electric (ac and/or dc), any type E0604: Breast pump, hospital grade, electric (ac and / or dc), any type S9443: Lactation classes, non-physician provider, per session
ICD-10-CM ... May 9th, 2018 Preventive Medicine: Counseling to Prevent Tobacco Use| Published May 9th, 2018 - Last Review/Update August 1st, 2018 Preventive Medicine Topics Page
Counseling to Prevent Tobacco Use
Procedure Codes 99406: Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes 99407: Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes
ICD-10-CM 99406-99407: No specific diagnoses
Frequency 99406-99407: 2 attempts a year, ... May 9th, 2018 Preventive Medicine: Depression Screening| Published May 9th, 2018 - Last Review/Update August 1st, 2018 Preventive Medicine Topics Page
Depression Screening
Procedure Codes G0444: Annual depression screening, 15 minutes 96127: Brief emotional/behavioral assessment (eg, depression inventory, attention-deficit/hyperactivity disorder [ADHD] scale), with scoring and documentation, per standardized instrument
ICD-10-CM G0444, 96127: No specific diagnoses
Frequency G0444:Once annually 96127: No specific frequency guidelines
Additional Information 96127
Only covered for ages ... February 1st, 2018 How to Code Screening and Diagnostic Colonoscopy| Published February 1st, 2018 The following information is from BC Advantage.
Colonoscopy is a common procedure performed byGastroenterologists. CPT defines a colonoscopy examination as "the examination of the entire colon, from the rectum to the cecum or colon-small intestine anastomosis, and may include examination of the terminal ileum or small intestine proximal to an anastomosis" ... January 9th, 2018 Preventive Medicine with a New Patient| Published January 9th, 2018 When coding for preventive care, be sure to use the correct encounter code with the procedure as well as the appropriate modifier if required.
New Patient: A patient that has not received any professional services i.e., E&M or any other face to face service from the physician or group within the ... There are more articles. View all articles... View articles for the current subject by subtopic: (There are no webinars at this time, please check back later.) ADA - Caries Risk Assessment FormAMA-Preventive services coding guidesScreening Pap Tests and Pelvic Examinations (There are no podcasts at this time, please check back later.)
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 Support@Findacode.com. 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 HHS.gov |
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