Summary & Overview
CPT 99389: Comprehensive Preventive Medicine Reevaluation for Seniors
CPT code 99389 represents a periodic comprehensive preventive medicine reevaluation and management service for individuals aged 65 years and older. This code is significant in the national healthcare landscape as it supports preventive care for seniors, a population with increasing healthcare needs. The service is typically delivered in an office setting and is designed to promote wellness, identify risk factors, and facilitate early detection of health issues through regular, thorough assessments.
Blue Cross Blue Shield is a key payer covering this code, reflecting its importance in commercial insurance plans. Readers will gain insights into clinical benchmarks, relevant policy updates, and the broader context of preventive medicine for older adults. The publication also addresses common billing modifiers, associated provider taxonomies, and ICD-10 diagnoses relevant to this service. Additionally, related CPT codes are discussed to provide a comprehensive understanding of preventive and counseling services for seniors. This summary offers a clear overview of the code's clinical purpose, payer coverage, and its role in supporting preventive healthcare nationwide.
CPT Code Overview
CPT code 99389 is used for a periodic comprehensive preventive medicine reevaluation and management of an individual aged 65 years and older. This service is classified as preventive medicine and is typically provided in an office setting (Place of Service 11). The code encompasses a thorough assessment aimed at maintaining health and preventing disease in older adults, including a review of medical history, risk factors, and a physical examination.
Clinical & Coding Specifications
Clinical Context
A typical scenario involves a patient aged 65 years or older presenting to a physician's office for a scheduled periodic preventive medicine reevaluation. The visit is comprehensive, focusing on health maintenance, risk assessment, and screening for common age-related conditions. The physician reviews the patient's medical history, performs a physical examination, updates immunizations, and orders appropriate screening tests such as for diabetes, lipoid disorders, and cardiovascular conditions. The workflow includes documentation of findings, counseling on preventive health measures, and coordination of follow-up care as needed.
Coding Specifications
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Modifiers:
- Modifier
25: Used when a significant, separately identifiable evaluation and management service is performed by the same physician on the same day as another procedure or service. - Modifier
33: Indicates that the service provided is a preventive service.
- Modifier
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Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
207Q00000X |