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99401 Preventive Counseling

  1. #1
    Default 99401 Preventive Counseling
    Medical Coding Books
    Does anyone bill for 99401 in addition to an E/M (not a well visit) if the patient comes in for one problem and the pediatrician also discusses/counsels the patient on diet, sexual practices, or family issues if the topic arises? If so, are you getting reimbursed for it? Thanks.

  2. #2
    Kansas City Chapter
    I have tried it about three or four times and only been denied once, by Humana. We are still fighting them on that claim.

  3. #3
    Default 99401
    We have had some success. But we are very careful to code as specifically as possible.

    There are counseling opportunities for alcohol, tobacco use, family planning counseling, depression are only a few.

    In order to do this, we have sat down with our providers and indicated the level of documentation necessary and appropriate for preventative counseling. This helps with coding, reimbursement, and respnding to denials.

  4. #4
    Thanks for the info!

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