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 99397
Related Codes Table
| Code | Description |
|---|---|
| 99387 | 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. |
| 99395 | 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. |
| 99406 | Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes. |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (PPPS), subsequent visit. |
Commonly Billed With
CPT code 99397 is commonly billed with codes such as 36415 (Routine venipuncture) and 85025 (Complete blood count).
Clinical Scenarios
Scenario 1: Annual Wellness Visit
In this scenario, CPT code 99397 can be used in conjunction with G0439 for an annual wellness visit for a patient aged 65 years or older.
Scenario 2: Smoking Cessation Counseling
If the patient requires smoking cessation counseling along with the preventive medicine reevaluation, CPT code 99406 can be billed alongside 99397.
Scenario 3: Laboratory Tests
If additional laboratory tests are ordered during the preventive medicine reevaluation, codes such as 80061 (Lipid panel) may be billed along with CPT code 99397.
FAQ Section
Can CPT code 99397 be used for new patients?
No, CPT code 99397 is specifically for established patients aged 65 years or older.
Is there a time requirement for billing CPT code 99397?
Yes, CPT code 99397 requires a minimum total time of at least 30 minutes spent face-to-face with the patient.
Can additional counseling services be billed along with CPT code 99397?
Yes, additional counseling services related to risk factor reduction interventions can be billed separately if performed during the same encounter.
What is the frequency limitation for billing CPT code 99397?
CPT code 99397 can be billed once every year per patient to ensure comprehensive preventive care for elderly patients.
Are there specific documentation requirements for reporting CPT code 99397?
Providers must document a comprehensive history, examination, medical decision making, risk factor assessment, and any interventions provided during the encounter to support billing for CPT code 99397.
Add CPT Lookup to Your Desktop
Install this free AI tool on your desktop for quick access to accurate CPT codes anytime.