How To Use CPT Code 99387

CPT 99387 refers to the initial comprehensive preventive medicine evaluation and management for new patients aged 65 years and older. This article will discuss the description, procedure, qualifying circumstances, billing guidelines, documentation requirements, historical information, similar codes, and examples of CPT 99387.

1. What is CPT 99387?

CPT 99387 is a medical billing code used to report the initial comprehensive preventive medicine evaluation and management service provided to a new patient who is 65 years old or above. This code covers age and gender-appropriate history, examination, counseling, anticipatory guidance, risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures.

2. 99387 CPT code description

The official description of CPT code 99387 is: “Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and older.”

3. Procedure

The 99387 procedure involves the following steps:

1. Obtaining a comprehensive age and gender-appropriate history of the patient.
2. Performing a comprehensive examination tailored to the patient’s age and gender.
3. Providing counseling, anticipatory guidance, and risk factor reduction interventions based on the patient’s history and examination findings.
4. Ordering appropriate laboratory/diagnostic procedures to further assess the patient’s health status and identify potential health risks.

4. Qualifying circumstances

Patients eligible to receive CPT code 99387 services are those who:

• Are new patients, meaning they have not received any professional services from the provider or another provider of the same specialty within the past three years.
• Are 65 years old or older.
• Do not have any immediate medical concerns or problems requiring attention during the visit.
• Require periodic health checkups as a preventive measure to maintain their overall health and well-being.

5. When to use CPT code 99387

It is appropriate to bill the 99387 CPT code when a healthcare provider performs an initial comprehensive preventive medicine evaluation and management service for a new patient who is 65 years old or above. This code should be used for well-patient visits, such as routine annual physical check-ups, where the focus is on preventive care rather than addressing specific medical concerns or problems.

6. Documentation requirements

To support a claim for CPT 99387, the following information needs to be documented:

• A comprehensive age and gender-appropriate history, including past medical, family, and social history.
• A comprehensive examination tailored to the patient’s age and gender, covering all relevant body systems and areas.
• Details of counseling, anticipatory guidance, and risk factor reduction interventions provided during the visit.
• Orders for laboratory/diagnostic procedures, along with their results and any follow-up recommendations.
• Confirmation that the patient meets the criteria for a new patient and is 65 years old or older.

7. Billing guidelines

When billing for CPT code 99387, keep in mind the following guidelines and rules:

• Ensure that the patient meets the criteria for a new patient and is 65 years old or older.
• Document all required information to support the claim, as outlined in the documentation requirements section.
• If a distinct evaluation and management service for a problem is performed during the same encounter, it may be reported separately using the appropriate E/M code.
• Immunization services provided during the visit can be reported separately using the appropriate codes.

8. Historical information

CPT 99387 was added to the Current Procedural Terminology system on January 1, 1992. There have been several updates to the code description since then, with the most recent change occurring on January 1, 2009.

9. Similar codes to CPT 99387

Five similar codes to CPT 99387 and how they differ are:

• CPT 99381: Initial preventive medicine evaluation and management for new patients aged younger than 1 year.
• CPT 99382: Initial preventive medicine evaluation and management for new patients aged 1-4 years.
• CPT 99383: Initial preventive medicine evaluation and management for new patients aged 5-11 years.
• CPT 99384: Initial preventive medicine evaluation and management for new patients aged 12-17 years.
• CPT 99385: Initial preventive medicine evaluation and management for new patients aged 18-39 years.

10. Examples

Here are 10 detailed examples of CPT code 99387 procedures:

1. A 65-year-old new patient presents for a routine annual physical examination, including a comprehensive history, examination, counseling, and ordering of laboratory tests.
2. A 70-year-old new patient undergoes a comprehensive preventive medicine evaluation, including a detailed history, examination, and risk factor reduction interventions for age-related health concerns.
3. An 80-year-old new patient receives a comprehensive preventive medicine evaluation, including a thorough history, examination, counseling on fall prevention, and ordering of diagnostic imaging to assess bone density.
4. A 66-year-old new patient has a comprehensive preventive medicine evaluation, including a detailed history, examination, counseling on maintaining a healthy lifestyle, and ordering of laboratory tests to screen for common age-related conditions.
5. A 75-year-old new patient undergoes a comprehensive preventive medicine evaluation, including a thorough history, examination, anticipatory guidance on managing chronic conditions, and ordering of diagnostic tests to monitor disease progression.
6. An 85-year-old new patient receives a comprehensive preventive medicine evaluation, including a detailed history, examination, counseling on medication management, and ordering of laboratory tests to assess medication effectiveness and potential side effects.
7. A 68-year-old new patient has a comprehensive preventive medicine evaluation, including a thorough history, examination, risk factor reduction interventions for cardiovascular health, and ordering of diagnostic tests to assess heart function.
8. A 77-year-old new patient undergoes a comprehensive preventive medicine evaluation, including a detailed history, examination, counseling on mental health and cognitive function, and ordering of laboratory tests to screen for dementia and other neurological conditions.
9. An 89-year-old new patient receives a comprehensive preventive medicine evaluation, including a thorough history, examination, anticipatory guidance on end-of-life care planning, and ordering of diagnostic tests to assess overall health status.
10. A 72-year-old new patient has a comprehensive preventive medicine evaluation, including a detailed history, examination, counseling on cancer screening and prevention, and ordering of laboratory tests and diagnostic imaging to screen for various types of cancer.