Wiki preventative office visit

claudiapena

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If a 4 yr old pediatric patient had an annual preventative exam with no vaccines because the pt had a cold at the time, then returns for vaccines four months later where he only received his vaccines; a very brief HPI, MDM and ROS was done and documented can the provider bill the 99392 procedure code?
 
preventative visit

Did the provider bill the preventative code on the first visit? If so, you cannot bill it again. You could bill a 99211 with the vaccines because you have the ROS, etc on the follow up, but then you could not bill the 90471 with the vaccine codes.
 
If the intent of the visit was for the vaccines that were not given during the regularly scheduled well child check visit, then no you cannot bill another 99392. If the provider had to reassess the patient's cough to make sure the patient is healthy enough for the vaccines, an E&M (99212 - 99213) can be billed as long as documentation for the history exam and medical decision making matches the level of service.
 
The problem is with ICD-10 CM if the patient was symptomatic at the presentation for a preventive then it cannot be billed as a preventive. Z00 encounter for general exam without complaint, suspected or reported diagnosis. This is the category for all well adult and well child encounters.
 
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