Results 1 to 4 of 4

Preventive Counseling=99401-99404

  1. Default Preventive Counseling=99401-99404
    Exam Training Packages
    Hi All,
    I need clarifications on when? how? and what are the documentations needed in order to bill these codes?
    1.) When?
    Is it true that we could add these codes with Preventive Visits- 99381-99397?

    2.) How?
    How many times that we could use these codes?

    3.) What? Documentations needed?
    a.) Does the provider needs to document that; " I spent mins? counseling on how to .....etc.
    b.) Is it okay to bill for 99401 if the provider DON'T document the TIME spent counseling on...etc.

    Pls. HELP and THANKS

  2. #2
    Minneapolis, MN
    1) No, you cannot bill these with Preventative Visits (99381-99397) as they are items that are typically addressed in these type visits and therefore it would be considered "double dipping".

    2) Check your payer guidelines.

    3) They are time based codes, so the provider has to document the time spent, it must be face to face time and if they don't document time, it cannot be billed. The provider must also document what was discussed, and their recommendations. These codes are also not reported if they are in relation to an existing illness or injury. (ie: pt seen for knee arthritis, MD counsels patient on stair safety, etc. in relation to the arthritis, you can't bill the 99401-99404)

    Hope this helps!
    Lisa Gillstrom, CPC, CPBB, HUC
    National Compliance Manager

    himagine solutions inc.
    3109 W. Martin Luther King Blvd., Suite 650, Tampa, FL 33607
    P: 813-331-0645

  3. Default
    Hi Lisa,
    Thank you so much for this clarification...
    So it means that if the patient has established illnesses such as DM, HTN, AIDS..etc...and the provider provides COUNSELING for diet, exercise, etc.. using the V CODES DIAGNOSIS STILL IT IS NOT PERMISSIBLE TO ADD THE PREVENTIVE COUNSELING CODES?

    Thanks again.

  4. Default
    Can 99401-99404 be used with the diagnosis Z803 - Family History of Malignant Neoplasm of the Breast

Similar Threads

  1. Preventive counseling codes 99401-99404
    By STEPHENS1967 in forum Billing/Reimbursement
    Replies: 1
    Last Post: 05-15-2014, 09:38 PM
  2. Counseling Risk Codes 99401-99404
    By Sueedwards in forum Outpatient Facilities
    Replies: 0
    Last Post: 08-23-2013, 06:33 AM
  3. 99401 Preventive Counseling
    By jvaughn5 in forum Pediatrics
    Replies: 3
    Last Post: 09-09-2011, 08:21 AM
  4. Coding preventive medicine codes 99401-99404
    By 00023808 in forum OB/GYN
    Replies: 0
    Last Post: 06-21-2010, 02:07 PM
  5. Preventive Counseling 99401-99404
    By mmunoz21 in forum E/M
    Replies: 2
    Last Post: 05-28-2009, 07:59 AM

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.

Get OurFREE2017SalarySurvey.

We'll email you a link to our 2017 Healthcare Salary Survey when it is available so you can see your earning potential.