Preventive Medicine: Annual Wellness Visit

May 9th, 2018 - Find-A-Code™
Categories:   CPT® Coding   HCPCS Coding   Diagnosis Coding   Preventive Medicine Service  
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Annual Wellness Visit

Procedure Codes
G0438: Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit
G0439: Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
99385: Initial comprehensive preventive medicine evaluation 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, new patient; 18-39 years
99386: Initial comprehensive preventive medicine evaluation 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, new patient; 40-64 years
99387: Initial comprehensive preventive medicine evaluation 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, new patient; 65 years and older
59425: Antepartum care only; 4-6 visits
59426: Antepartum care only; 7 or more visits

ICD-10-CM
G0438, G0439: No specific diagnoses
99385-99387, 59425-59426: Z00.00, Z00.01, Z01.411, Z01.419

Frequency
G0439: Once annually
G0438, 99385-99387: Once in a lifetime
59425-59426: As appropriate

Additional Information

59425-59426

  • Only appropriate for expecting women close to her due date
  • May not be covered as preventive by Medicare, consult your payer

99385-99387, 59425-59426

  • These are well-woman visits, only covered as preventive for female patients
  • HHS Requirement: Well-woman preventive care visit annually for adult women to obtain the recommended preventive services that are age and developmentally appropriate, including preconception and prenatal care

99385-99387

  • Not covered by Medicare for preventative care, consider using G0438 instead, or G0439 for subsequent visits

Find-A-Code™ - Preventive Services - The information in this document does not guarantee payment or that included codes meet applicable qualifications as preventive services for all insurances and insurance plans, please consult your payer.


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