Wiki Preventative Medicine in Oncology Practice

[sparkles1077]

Hello Fellow Coding Professionals,

Just wanted to get a feel on this scenario. Patient has history of cervical cancer and returns to their oncologist for surveillance. Provider considers this a well woman exam, performs an E and M and pap, and bills preventative.

Has anyone seen preventative care codes used in this fashion by oncologists?

Thank you

 

[OCD_coder]

I suppose it would depend on if the patient is a Medicare patient since preventative visits are not covered, but if the patient has a history of Ca the provider is no longer performing a preventative service, but surveillance. We bill surveillance visits with E&M codes 9921X.

Doing a Pap for cervical cancer might be indicated, see the attached article.

https://www.sgo.org/wp-content/uploads/2012/09/posttreatment-surveillance-paper_RESIZE.pdf

 

[sparkles1077]

Thanks again OCD-coder!

I did find this info in CPT Assistant:

Question: Can a specialist (ie, dermatologist, pulmonologist, etc) report the preventive medicine codes?

AMA Comment: The descriptors of the preventive medicine codes (99381-99397) were revised in CPT 2002 to clarify that the preventive medicine services represent comprehensive (age and gender appropriate) history; examination; counseling, anticipatory guidance, or risk factor reduction interventions; and ordering of appropriate immunization(s) and laboratory or diagnostic procedures for recommended physician intervention standards, which are set and published by preventive medicine agencies. Additionally, it is important to recognize that the listing of a service or procedure and its code number in a specific section of the CPT codebook does not restrict its use to a specific specialty group. Any procedure or service in any section of the codebook may be used to designate the services rendered by any qualified physician or other qualified health care professional.