Can be used 99213 with 99395 at the same visit?

can be used 99213 with 99395 at the same visit?

Absolutely! You would use the modifier -25 on the 99213.

Look at the Preventive Medicine section in CPT® and this is outlined in the narrative explanation prior to the actual listing of codes.

Charlene Endre-Burgett, MS, CMA (AAMA), CPM-MCS, CPC, CMSCS
Administrator, North Scottsdale Family Medicine
Blog: www.charleneburgett.wordpress.com
LinkedIn: www.linkedin.com/in/charleneburgett

re: CAN BE USED 99213 WITH 99395 AT THE SAME VISIT?

I did same 99213- 25 and 99395 but 99395 denied as lack of info.
What to do next?

re: CAN BE USED 99213 WITH 99395 AT THE SAME VISIT?

I am OPS/OBV coder for a facility and don't code E/M but I checked this for you and there are numerous CPT® Assistant references ( in the CPT® book) on these codes including 99395. Do you have access to CPT® Assistant? I can't publish it here due to copyright laws, but if u can access CPT® Assistant you might find the answers.

re: CAN BE USED 99213 WITH 99395 AT THE SAME VISIT?

see CPT® Assistant Aug 97 for a vignette. Basically u will need a separate dx for each CPT® code that is different explaining for.... 1.) why a preventive med visit is necessary and also a... 2.) problem-focused office visit is being billed on the same DOS. Your dxs should match the CPT® codes (in other words show medical necessity) for each portion of this visit with a different CPT® code. Hopefully that helps you & doesn't violate copyright laws, because I have tried to tell you the answer in my own words, and I cited the source. I am new to this forum today, & trying to follow the rules. Best of luck to you. If you don't already have access to CPT® Assist, I suggest you ask your employer to provide it for you. It is a very helpful resource to answer questions you may have.