Preventive services for obesity

Our office treats many patients with obesity and other co- morbid conditions. Can you comment or make a recommendation on the CPT® and CID codes we are using? Typically we'll use 99386 with modifier 33 (age based) with V70.0, V77.8 and a V code for the BMI, like V85.35. Many times we will diagnose htn, metabolic syndrome or hyperlipemia and add those diagnoses to the charge ticket. Do you see any reason why this shouldn't be paid?
We are also getting denied on 99411 with V65.3 and a BMI code such as V85.35. Any ideas?
Thank you.

re: Preventive services for obesity

I would not use preventive medicine codes for treatment of obesity. I would use an E/M service, based on time, for treatment of medical problems.

Some insurers may not pay for obesity treatment with any CPT® code, and may deny based on diagnosis. I know it doesn't make sense to us, but weight loss counseling is not a covered medical benefit for many payers.