When to use 99401-99404 codes

atomasek

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I work for a high risk obstetrics office and one of our other coders thinks we should use the 99401-99404 codes for pre-pregnancy consults instead of regular consult codes 99241 etc. However, in the CPT book the codes are used for preventive medicine counseling. Which would be correct for a pre-pregnancy consult.

Help would be greatly appreciated.:eek:
 

Kris Cuddy

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I, too, have an OBGYN practice and unless there is a problem, like infertility, we don't bill consultation codes for patient's who want pre-pregnancy counseling.

I'm wondering if these are truly consults, eg, are they being sent by another provider for an examination and advice and opinion to be returned to the other provider?


Kris
 
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According to CPT®, counseling codes apply when a physician counsels on family problems, diet and exercise, substance abuse, sexual practices, injury prevention, dental health, and diagnostic and laboratory test results available at the time of the encounter.
 
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