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Wiki Is this a well baby visit?

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LINDA

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We have a Developmental Pediatrician in our office who sees patients in the NICU to assess for potential developmental delays (due to prematurity or other complications as a newborn). She will then see some of these babies after they are discharged to continue to monitor for developmental problems.
We currently bill for the office visits using the standard E/M codes but I'm wondering if the 99391 (follow up preventative visit i.e. well baby) would be more appropriate? My doctor says since she's a Developmental Pediatrician her visits are more comprehensive than the standard well baby visit. We don't do immunizations -- the baby does continue to see their regular pediatrician for those. Just wanting to get another coders perspective. Thanks!!
 
No, I would not code these specialist visits as preventative. The babies are being seen because of their previous and/or specific issues, so an appropriate E/M level should be used.

Also, assuming her regular pediatrician bills with the preventative codes, you (or they) would be denied reimbursement if each of you submitted the same code within the same time frame.
 
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