preventative vs. E/M visits

If a patient comes into the office for pelvic pain and then decides that she would also like to have STD cultures done (unrelated to the pelvic pain) can I bill 99213 for the office visit as well as 99402 for the preventative visit and if so, what modifier would I have to use, if any? Thanks for the help.

Angie

Preventive vs problem focused

Preventive is usually codes 99381-99397 based on age and either new or est. Usually the pt comes for that (yearly physical exam). Then when a problem (pelvic pain) is encoutnered, you can document, code and bill a problem focused visit (99212-99215). ANd put the 25 modifier on the probelem focused visit

preventative vs. E/M

Thank you, Nonni! I think that I may have been misleading in my question...I was planning to use the 99401-99404 for preventative medicine counseling for the STD cultures and STD prevention services, no pap smear or yearly physical was done. Does this still fall under the same rule...and if so, which would get the modifier, the E/M for the original problem (pelvic pain) or the 99401?.

The E&M gets the -25

Be sure the note clearly separates the problem eval and management from the preventative counseling in case of audit. When you have a gyne problem and gyne counseling "they" may try to bundle the two together.

Counseling

Age-appropriate counseling that occurs during a preventive medicine encounter is part of the preventive medicine services codes, but preventive counseling and/or risk factor reduction interventions that are provided at a separate encounter should be reported with the preventive counseling codes.