AAPC - Back to school
Results 1 to 3 of 3

Thread: Preventive Counseling 99401-99404

  1. #1

    Question Preventive Counseling 99401-99404

    AAPC: Back to School

    The preventive/counseling codes 99401-99404 are timed based codes 30 to 60 minutes. How do we determine on the record which is the appropriate code to use, does the physician have to state the time spent counseling the patient? I know the type of counseling has to be recorded. I have doctors who of course are choosing the 99404 (60 minutes) for the higher reimbursement. I do not have access to CPT Assistant to get more define rules on these CPT's, anyone who can send me any info., will be greatly appreciated.....
    Marilyn CPC, CPC-H, CEMC

  2. #2
    Join Date
    Apr 2007
    North Carolina


    Per CPT Assistant......

    These codes are time-based codes. The appropriate code is selected based on the approximate time spent providing the service. The extent of the counseling and/or risk factor reduction intervention must be documented in the medical record to qualify the service based on time.

    I've reviewed the CPT Assistants that applies to these codes and this is about as detailed as it gets...

    Hope this helps~

  3. #3


    Thank you, I was afraid of that... AMA comes up with these codes and then they are so grey.... a time based should always require the documentation of time spent along with the counseling.... Who am I to argue with a doctor after she/he chooses the 45min code and has written down the counseling and coordinating care, if indeed they spent 45 minutes with that patient..we all know that's far fetched.....

    Marilyn CPC, CPC-H, CEMC

Similar Threads

  1. Preventive counseling codes 99401-99404
    By STEPHENS1967 in forum Billing/Reimbursement
    Replies: 1
    Last Post: 05-15-2014, 08:38 PM
  2. Counseling Risk Codes 99401-99404
    By Sueedwards in forum Outpatient Facilities
    Replies: 0
    Last Post: 08-23-2013, 05:33 AM
  3. Preventive Counseling=99401-99404
    By veloso in forum E/M
    Replies: 2
    Last Post: 07-18-2012, 06:59 AM
  4. 99401 Preventive Counseling
    By jvaughn5 in forum Pediatrics
    Replies: 3
    Last Post: 09-09-2011, 07:21 AM
  5. Coding preventive medicine codes 99401-99404
    By 00023808 in forum OB/GYN
    Replies: 0
    Last Post: 06-21-2010, 01:07 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.