Question

question 12
a 10 - year - old girl is scheduled for her yearly physical with her pediatrician. at the time of the visit, the patient complains of watery eyes, scratchy throat and stuffy nose for the past two days. the provider performs the physical. he also performs a history and exam and treats the patient for a uri with low medical decision making. what cpt® coding is reported for this visit?
99213
99393 - 25, 99213
99393
99393, 99213 - 25

Explanation:

The patient is having a routine physical along with treatment for upper - respiratory infection (URI) symptoms. Code 99393 is for a 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 for a 10 - year - old (child age 4 - 11 years). Code 99213 is for an established patient office visit with a low level of medical decision - making. The 25 modifier is used to indicate a significant, separately identifiable E/M service by the same physician on the same day as a procedure or other service. Here, the preventive visit and the visit for the URI are both significant and separately identifiable.

Answer:

99393 - 25, 99213