tci E/M Coding Alert - 2017 Issue 9

Reader Question: Avoid Reporting Both 99385 and 99402

Question: The physician saw a 21-year-old female patient for a general adult exam and contraceptive management. The physician spent 50 minutes face-to-face with the patient, and about 30 minutes of that was spent on counseling. I originally chose 99385, but I am being asked if we can also bill 99402? Iowa Subscriber Answer: The correct choice in this case is 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). Code 99385includes "counseling/anticipatory guidance/risk factor...

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