preventative medicine, age 40-64
preventative medicine, age 40-64
99396 is a CPT code, not an ICD9 code. The ICD9 code you use will depend on the condition or reason for the visit.
Yes.
99396
Periodic comprehensive preventive medicine
The medical code 99396 refers to a comprehensive preventive medicine evaluation and management service for an established patient aged 40 to 64 years. This service typically includes a thorough history, examination, and counseling on health maintenance and disease prevention. It is often used during routine check-ups to assess the patient's overall health and address any potential health concerns.
Ambetter typically covers preventive services, including certain evaluations and screenings, which may encompass medical code 99396 (a periodic comprehensive preventive medicine evaluation and management service for established patients). However, coverage can vary by plan and state, so it's essential to verify specific benefits with Ambetter directly or consult your healthcare provider for confirmation. Always check for any required prior authorizations or criteria that need to be met for coverage.
Yes, the CPT code 99396, which is used for a preventive medicine visit for established patients, requires a diagnosis code. Typically, this would be a code indicating the purpose of the visit, such as a routine check-up or other preventive care. It's important to ensure that the diagnosis code aligns with the services provided during the visit for proper billing and coding compliance.
99396
CPT code 99212 is used for an established patient office visit that requires a low level of medical decision-making, while CPT code 99396 is for a periodic comprehensive preventive medicine evaluation and management for an established patient. When documenting services, the order typically follows the nature of the visit, so if both codes are applicable, you would list the preventive visit (99396) first, followed by the problem-focused visit (99212), provided both services were performed during the same encounter. However, the specific order may depend on the context of billing and payer guidelines.
CPT Code 99396 -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; 40-64 years.
A CPT code for: 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; 40-64 years (of age).