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Thread: Question re: E&M

  1. #1

    Question Question re: E&M

    AAPC: Back to School
    I was wondering if a patient comes into the office for a routine Well Woman exam and a problem, can we bill 99395 as well as 99213? And if so, will re-embursement be at a reduced rate?

  2. #2
    Join Date
    Apr 2007
    Greeley, Colorado


    First, read the guidelines in CPT for Preventive Medicine Services. You can code an E/M if the problem is significant enough to require the key components of a problem oriented E/M. You would add modifier -25 to the E/M and use the problem dx. With Medicare, you must subtract the amount of the charge for the E/M from the charge for the preventive code so as not to go over the actual charge of your preventive code.
    Lisa Bledsoe, CPC, CPMA

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