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Wiki billing preventative exam with 99213?

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avrilw

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Newport, WA
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Healthy Options Molina (Medicaid) is telling me that we are to bill a preventative visit for an adult using an office visit like 99213 with a dx indicating a preventative exam. That would be incorrect though right since those codes are only for problems?

Has anyone else billed Molina with a Preventative code (99396) for an adult and gotten paid?
 
Proper coding guidelines will tell you that is incorrect however each insurance plan has there own set of guidelines they follow. I would call the insurance and clarify what will they actually pay and inform them that is not correct. You can also report them to CMS.
 
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