Current Procedural Terminology (CPT®) includes a myriad of codes for preventive medicine. Among those are codes for counseling and/or risk factor reduction interventions provided to individuals (99401–99404) and groups (99411, 99412). The following is a review of the complex issues surrounding the coding for this form of counseling when it is offered at the same time as other evaluation and management (E/M) services.

These codes are reported based on time in accordance with CPT instruction that a unit of time is attained when the midpoint is passed (eg, 8 minutes or more of preventive medicine counseling may be reported with code 99401).

The descriptions of codes 99401–99404 and 99411–99412 include “separate procedure,” meaning these services may not be additionally reported when performed as an integral component of another procedure or service. So when would codes 99401–99404 or 99411–99412 be separately reportable...

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