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Thread: Em/codes And Well Women Exam

  1. #1

    Default Em/codes And Well Women Exam

    AAPC: Back to School
    Are Dr Are Doing New Pt Office Visit's And Well Women Exams Also Established Pt's With Pap Smears Does Anyone Know How To Code These These Are Non Medicare Pt's.

  2. #2
    Join Date
    Apr 2007


    Can you re-write the question? I don't quite understand.

    If the patient is new and presents for a WWE then you would code v72.31 and 9938X, if the provider documents a "comprehensive" note (age/gender appropriate history/exam). See CPT assistant below. There is also a great article in this month's Coding edge about WWE that might answer your question, too.
    Preventive medicine services coding
    CPT Assistant, May 2002 Pages: 1,2 Category:
    Related Information
    Preventive Medicine Services

    The definition of "comprehensive" in relation to the preventive medicine services codes has been a source of some misunderstanding. For that reason, revisions were made in CPT 2002 to help clarify or differentiate the "comprehensive" nature of the examination associated with preventive medicine E/M services codes 99381-99397 from the "comprehensive" examination for other E/M services codes (eg, 99204, 99205, 99215).

    The preventive medicine services guidelines were revised in 2002 to clarify that the comprehensive nature of the examination associated with preventive medicine codes 99381-99397 reflects an age and gender appropriate history/exam, which is not synonymous with the "comprehensive" examination required by the problem-oriented E/M codes (eg, 99204, 99205, 99215).

    The descriptors of the preventive medicine codes 99381- 99397 were also revised to clarify that the preventive medicine services represent comprehensive (age and gender appropriate) history, examination, counseling/ anticipatory guidance/risk factor reduction interventions, and ordering of appropriate immunization(s) and laboratory/diagnostic procedures for recommended physician intervention standards, which are set and published by preventive medicine agencies. Note that the language "ordering of appropriate immunization(s)" was added to the code descriptor to specify that the ordering of immunization(s) is an inclusive component of the preventive medicine service. However, as noted in the guidelines preceding the preventive medicine services codes, the actual provision of immunizations should be reported separately. Therefore, the immunization administration codes 90471-90474 and the vaccine product codes 90476- 90748 should be additionally reported, when performed.

    The guidelines also state that ancillary studies involving laboratory, radiology, other procedures, or screening tests identified with a specific CPT code are reported separately. Therefore, tests identified with a specific CPT code (eg, 99173, Screening test of visual acuity, quantitative, bilateral) should also be reported separately.

    Please note that the guidelines preceding the preventive medicine codes specify how to report circumstances in which a problem or abnormality is encountered and addressed during the preventive medicine visit.

    Preventive medicine evaluation and management
    Preventive medicine services - vignettes

    CPT Assistant © Copyright 1990–2007 American Medical Association. All Rights Reserved

  3. #3


    can you code the office visit for example 99214 and the9938X or do you half to choose one ?

  4. #4
    Join Date
    Apr 2007
    Greeley, Colorado


    To code 99214 you must have documentation to support that separately from the 9938X. Read the guidelines under Preventive Medicine Services. It is possible to code both, but documentatioin MUST support both separately.
    Lisa Bledsoe, CPC, CPMA

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