Wiki Preventive Med Svcs 99381-99397

[prelljeama]

I work for a payer that states the vision, hearing, developmental services are inclusive to the CPT codes for Preventive Med; well child visit. Per 2009 CPT they can be separated out and charged. Are they inclusive?

 

[JodiLynn]

no they are not inclusive by CPT guidlines, but unfortunately commerical payers do not have to adhear to those guidlines.

 

[srw1970]

I have 99173 and 92551 that are being billed along with the preventative (99383 etc). Sometimes they get paid and sometimes they do not. Would you suggest that I bill them to all payers and see who will pay and who doesn't?

 

[hthompson]

My biller is asking if there is a need to append Modifier -51 and/or Modifier -25 to either of these codes?

Example:
99381-25
99173
92551-51