preventive service

Hi,

A patient of 2 1/2-month-old born on 08/26/2013 was seen by a doctor on 10/22/2013 an office visit and again 10/28/2013 baby was brought here for preventive care services, so what shall I bill for the visit 10/28/2013 i.e., either Initial comprehensive preventive medicine evaluation and management - 99381 or Periodic comprehensive preventive medicine reevaluation and management - 99391

Thanks in advance for cooperation

Mike S.

re: preventive service

At the 10/28 well baby visit, the patient is considered established, therefore 99391 is the appropriate code.

re: preventive service

Hi,

Thank you very much for your response.

For my understanding, patient was seen by the doctor for office visit on 10/22/2013. But doctor saw the patient for the preventive services first time on 10/28/2013, so still you want me to use 99391 as periodic preventive services.

Please correct me if I am wrong.

Thanks,
Mike S.

re: preventive service

Hi Mike -

The rule is that a patient can only be "New" once. Assuming you billed the initial office visit on 10/22 as a "New" patient, then the well baby visit should be the established code 99391, NOT 99381.

The exception to the rule is if, and only if, more than three years has passed since the patient was last seen by the practice. In that case you could charge an appropriate new patient code.

Hope this helps :o)

re: preventive service

Hi,

I understood. Thank you very much for your valuable response

Mike S.