What does CPT code 99397 mean? (2023)

What does CPT code 99397 mean?

CPT® Code 99397 - Established Patient Preventive Medicine Services - Codify by AAPC.

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What is the CPT code for preventive exam?

Physical Exam CPT Codes For New Patients

CPT 99381: New patient annual preventive exam (younger than 1 year). CPT 99382: New patient annual preventive exam (1-4 years). CPT 99383: New patient annual preventive exam (5-11 years). CPT 99384: New patient annual preventive exam (12-17 years).

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What does code 99395 mean?

99395- 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, and the ordering of laboratory/diagnostic procedures, established patient; 18-39 years.

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Can g0439 be billed with 99397?

No you cannot bill the AWV with the preventive visit. You can bill the AWV with a separate E/M.

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How often can you bill 99397?

*The Annual Preventive Exam (99397) cannot be billed with the AWV or Welcome to Medicare Visit Can be billed as stand-alone: 99381-99387, 99391-99397 None. None. None. Once in a lifetime.

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Does Medicare cover CPT code 99397?

A full physical 99397 or 99387 is NOT covered by Medicare and patients are responsible for the cost and can be billed. Some secondary insurance companies may cover the full physical exam, which helps beneficiaries.

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What is included in a preventive physical exam?

Since the focus of this appointment is prevention, your doctor may do the following: Ask about your current health status and medical history, lifestyle, and family medical history.
...
For example:
  • Female: breast exam, pelvic exam including Pap smear.
  • Male: testicular, hernia and prostate exam.
  • Child: well-child exam.

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Can you bill a preventive visit with an office visit?

Physicians are not prohibited from coding and billing for both preventive and problem-focused E/M services when they are performed during the same appointment.

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What is CPT code for well woman exam?

Well Women Exam CPT Code

CPT G0101 may be used to report Well Woman Exam. The description of the CPT code for Well woman is as follows: “Cervical or vaginal cancer screening; pelvic and clinical breast exam.”

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Does CPT code 99397 need a modifier?

When a preventative exam is performed, 99381-99397 and a person gets an immunization/hearing test/eye exam/etc... then a modifier 25 is put on the preventative exam code.

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What is not covered in Medicare Annual Wellness visit?

The annual wellness visit generally doesn't include a physical exam, except to check routine measurements such as height, weight and blood pressure." The UNC School of Medicine notes, "Medicare wellness visits … are designed to improve your overall health care by providing a more detailed look at your health risks ...

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How do I code a Medicare Annual Wellness visit?

CPT G0439 is used to code all subsequent Annual Wellness Visits that occur after the initial Annual Wellness Visit (G0438).

What does CPT code 99397 mean? (2023)
What does CPT code 99411 mean?

CPT® Code 99411 in section: Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure)

Can you bill a preventive visit with an office visit?

Physicians are not prohibited from coding and billing for both preventive and problem-focused E/M services when they are performed during the same appointment.

What is the CPT code for annual wellness exam?

The two CPT codes used to report AWV services are: G0438 initial visit. G0439 subsequent visit.

What is the CPT code 99401?

For example, the time element of code 99401, “Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes,” is met when the physician spends at least eight minutes of face-to-face time counseling the patient.

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