CPT Code Lookup Tool
Use this free CPT Lookup Tool to search for Current Procedural Terminology (CPT) codes, descriptions, and related details — designed to help streamline and simplify your medical billing process.
Enter a CPT code or keyword to search
Search Results
Office or other outpatient visit
Evaluation and management of an established patient...
Information
This code is for use in medical billing and coding.
Information
This code is part of the section of CPT codes.
Office or other outpatient visit for the evaluation and management...
Note
This description reflects the 2021 E/M coding guidelines.
Information
codes are used to report evaluation and management services provided in various settings.
Information
RVUs are used to determine the fee for a service under the Medicare Physician Fee Schedule.
Information
This code is commonly used by primary care providers, but may be used by any specialty providing office visits.
Significant, separately identifiable E/M service
Information
Modifiers provide additional information about the service provided.
Detail About CPT 99391
Related CPT Codes
CPT Code | Description |
---|---|
99392 | Periodic comprehensive preventive medicine reevaluation and management of an individual (1-4 years) |
99393 | Periodic comprehensive preventive medicine reevaluation and management of an individual (5-11 years) |
99394 | Periodic comprehensive preventive medicine reevaluation and management of an individual (12-17 years) |
99395 | Periodic comprehensive preventive medicine reevaluation and management of an individual (18-39 years) |
99396 | Periodic comprehensive preventive medicine reevaluation and management of an individual (40-64 years) |
Commonly Billed With
- CPT 99392 - Periodic comprehensive preventive medicine reevaluation and management (1-4 years)
Often billed together for continued preventive care across different age groups.
- CPT 36415 - Routine venipuncture
Commonly performed in conjunction with preventive care visits for lab work.
Clinical Scenarios
Scenario 1
A 6-month-old infant comes in for a routine well-child visit, including vaccinations and developmental screening.
Scenario 2
A 9-year-old child presents for a yearly physical exam, growth assessment, and counseling on healthy lifestyle habits.
Scenario 3
A 16-year-old adolescent visits for a sports physical, discussion on risk behaviors, and mental health screening.
Scenario 4
A 35-year-old patient schedules a preventive care appointment for chronic disease risk assessment and personalized health goals.
Frequently Asked Questions
Q1: When should I use CPT 99391?
CPT 99391 is used for the periodic comprehensive preventive medicine reevaluation and management of an individual under 1 year of age.
Q2: What documentation is required for CPT 99391?
Documentation should include age-appropriate history, examination, counseling, anticipatory guidance, and risk factor reduction interventions.
Q3: What are common modifiers used with CPT 99391?
Commonly used modifiers include 25 for significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure, and 59 for distinct procedural service.
i clas = "fas fa-question me - 2" > Q4: What are common denial reasons for CPT 99391?
/ h >
p clas = "mb - 0 ps - 4" > Shortage of appropriate documentation supporting the medical necessity of the service or incorrect coding/billing information can lead to denials for CPT 99391. / p >
/ div >
/ div >
hr clas = "my - 3" >
div clas = "mb - 4" >
h clas = "text-secondary mb - 2" >
i clas = "fas fa-question me - 2" > Q5: How does CPT 99391 differ from similar codes?
/ h >
p clas = "mb - 0 ps - 4" > CPT code 99391 specifically applies to patients under 1 year of age, while related codes like CPT 99392 to CPT 99396 cover different age ranges for periodic comprehensive preventive care. / p >
/ div >
/ div >
/ div >
Add CPT Lookup to Your Desktop
Install this free AI tool on your desktop for quick access to accurate CPT codes anytime.