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CPT 99393 | Preventive Medicine For Established Patients Ages 5-11

CPT 99393 is used to report a preventive medicine reevaluation and management service for an established patient between the ages of 5 and 11.

What Is CPT Code 99393?

CPT code 99393 is a Current Procedural Terminology (CPT) code used to report a preventive medicine reevaluation and management service provided to a child who is an established patient and is between the ages of 5 and 11 years old.

This service includes a comprehensive history and examination appropriate for the child’s age and gender and counseling and guidance to prevent risk factors.

In addition, the service may include the ordering of laboratory and diagnostic procedures, as well as the administration of immunizations.

When billing for this service, the medical coding professional should use CPT code 99393 to report the preventive medicine reevaluation and management service. Any additional laboratory, diagnostic tests, or immunization services provided during the visit should be reported separately.

Description

The CPT book describes CPT code 99393 as: “Periodic comprehensive preventive medicine reevaluation 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, established patient; late childhood (age 5 through 11 years).”

Procedure

This procedure involves a preventive medicine reevaluation and management service provided to a child who is an established patient and is 5-11 years old.

The service includes a comprehensive history and examination appropriate for the child’s age and gender.

During the visit, the healthcare provider will also provide counseling and guidance to the child and their parent(s) or guardian(s) to prevent risk factors that could affect the child’s health.

In addition to the preventive medicine reevaluation and management service, the healthcare provider may perform laboratory or diagnostic tests and provide immunization services during the visit. These additional services can be separately reported.

How To Use CPT 99393

Preventive medicine reevaluation and management services such as CPT 99393 are provided to individuals who are not experiencing any current health issues but need periodic check-ups as a preventative measure, such as well-baby, well-woman, and routine annual physicals.

These services consider the age, gender, and associated risk factors of the patient to guide the taking of patient history, performing an examination, and assessing age and gender-related risk factors.

The provider may also order diagnostic/laboratory procedures and administer immunizations during the preventive service. These visits are distinct from patients with a specific health issue requiring medical attention.

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