Well Child Visits

irma011

Contributor
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18
Location
Marshall, TX
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Can anyone advise me on whether or not we can bill CPT codes 97802/97803 and 96110 with wellness visit E/M codes? Or would that be considered unbundling components of the well visit? What about the vision & hearing screenings as well? Are those also inclusive with the well visit & shouldn't be reported separately? Thanks in advance!
 

rthomas@impcna.com

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I am in Mississippi and majority of insurance payers follow the Bright Futures Guidelines (recommendations for preventive pediatric health care) put out by the American Academy of Pediatrics. I attached the periodicity schedule. 96110 is covered as part of a wellness visit during an 18 month & 24 month visit. We use the MCHAT assessment for this. We bill it with the well E/M and it is paid. The other 2 codes are not considered wellness to my knowledge. You might want to look at 99401, Preventive medicine counseling, which includes diet. This code isn't covered by many payers though, it's usually rolled into the E/M. Hope this helps.
 

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irma011

Contributor
Messages
18
Location
Marshall, TX
Best answers
0
I am in Mississippi and majority of insurance payers follow the Bright Futures Guidelines (recommendations for preventive pediatric health care) put out by the American Academy of Pediatrics. I attached the periodicity schedule. 96110 is covered as part of a wellness visit during an 18 month & 24 month visit. We use the MCHAT assessment for this. We bill it with the well E/M and it is paid. The other 2 codes are not considered wellness to my knowledge. You might want to look at 99401, Preventive medicine counseling, which includes diet. This code isn't covered by many payers though, it's usually rolled into the E/M. Hope this helps.
Thank you so much!!
 
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