2025 CPT code 99383
(Active) Effective Date: N/A Revision Date: N/A Evaluation and Management - Preventive Medicine Services Feed
Initial comprehensive 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 appropriate laboratory/diagnostic procedures, new patient; late childhood (age 5 through 11 years).
Modifier 25 may be applicable if a significant, separately identifiable E/M service is provided on the same day.
The service is medically necessary for the preventive healthcare of a child within the specified age range who is a new patient to the practice.
The physician is responsible for performing an age and gender appropriate history and physical examination, providing counseling/anticipatory guidance/risk factor reduction interventions, and ordering appropriate immunizations/laboratory/diagnostic procedures based on the patient’s risk factors.
In simple words: This is a check-up visit for a child between 5 and 11 years old who hasn't seen this doctor or another doctor of the same specialty in the same practice for the past three years. The doctor will review the child's history, perform a physical exam, discuss health and safety tips, and order any necessary tests or vaccines.
This code represents the initial comprehensive preventive medicine evaluation and management service for a new patient in late childhood (age 5 through 11 years). It includes an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate laboratory/diagnostic procedures.
Example 1: A 6-year-old new patient presents for a well-child check-up, including a comprehensive history, physical examination, and age-appropriate counseling on nutrition and safety., A 9-year-old new patient with a family history of diabetes presents for a preventive visit. The physician performs a physical exam, reviews family history, and orders age-appropriate screening tests., An 11-year-old new patient presents for a pre-sports physical. The physician takes a detailed history, performs a physical exam tailored to sports participation, and discusses relevant health and safety guidelines.
Documentation should include a comprehensive history, age and gender appropriate examination, details of counseling/anticipatory guidance provided, risk factor reduction interventions discussed, and any laboratory/diagnostic procedures ordered. Documentation must support the medical necessity of the service.
- Specialties:Family Medicine, Pediatrics, Internal Medicine
- Place of Service:Office