Pediatric Coding Alert

Reader Question:

Not All AAP-Recommended Visits Are Payable All the Time

Question: Is it acceptable to offer (and charge for) 30-month visits? If so, how do we handle them?Michigan SubscriberAnswer: Unfortunately, payment and evidence based preventive medical standards are not the same thing. The Bright Futures/American Academy of Pediatrics "Recommendations for Pediatric Health Care" recommend a 30-month preventive medicine service (http://brightfutures.aap.org/pdfs/AAP%20Bright%20Futures%20Periodicity%20Sched%20101107.pdf). You should code these based on the patient's status as new or established.A patient is established if he has received face-to-face professional services from your pediatric group in the last three years (since he was born). For a 30-month preventive medicine new patient visit, use 99382 (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; early childhood [age 1 through 4 years]). Code an established patient preventive medicine service as 99392 (Periodic comprehensive preventive medicine reevaluation and [...]
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