Wiki Preventive Counseling=99401-99404


Beechhurst, NY
Best answers
Hi All,
I need clarifications on when? how? and what are the documentations needed in order to bill these codes?
1.) When?
Is it true that we could add these codes with Preventive Visits- 99381-99397?

2.) How?
How many times that we could use these codes?

3.) What? Documentations needed?
a.) Does the provider needs to document that; " I spent mins? counseling on how to .....etc.
b.) Is it okay to bill for 99401 if the provider DON'T document the TIME spent counseling on...etc.

1) No, you cannot bill these with Preventative Visits (99381-99397) as they are items that are typically addressed in these type visits and therefore it would be considered "double dipping".

2) Check your payer guidelines.

3) They are time based codes, so the provider has to document the time spent, it must be face to face time and if they don't document time, it cannot be billed. The provider must also document what was discussed, and their recommendations. These codes are also not reported if they are in relation to an existing illness or injury. (ie: pt seen for knee arthritis, MD counsels patient on stair safety, etc. in relation to the arthritis, you can't bill the 99401-99404)

Hope this helps!
Hi Lisa,
Thank you so much for this clarification...
So it means that if the patient has established illnesses such as DM, HTN, AIDS..etc...and the provider provides COUNSELING for diet, exercise, etc.. using the V CODES DIAGNOSIS STILL IT IS NOT PERMISSIBLE TO ADD THE PREVENTIVE COUNSELING CODES?

Thanks again.