In simple words: This code covers a complete checkup for a new patient 65 or older.The doctor will review your health history, conduct a physical exam, discuss health risks, and provide advice on prevention.Any tests or vaccines given are billed separately.

This CPT code, 99387, represents an initial comprehensive preventive medicine evaluation and management service for a new patient who is 65 years of age or older.The service includes an age- and gender-appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and ordering of appropriate immunizations and laboratory/diagnostic procedures.A new patient is defined as one who has not received care from the same physician or qualified healthcare professional in the same group practice within the past 36 months.Separate billing is required for any additional services such as immunizations and laboratory tests.

Example 1: A 72-year-old male presents for his first visit to a new primary care physician. The physician performs a complete history, physical exam, including age-appropriate screenings (e.g., prostate exam, colon cancer screening discussion), orders blood work and influenza vaccination. Code 99387 is reported., A 68-year-old female, new to the practice, comes in for an annual well-woman exam.The visit includes a comprehensive review of systems, a breast exam, pelvic exam, and discussion of preventative measures for osteoporosis and heart disease.Pap smear and mammogram are ordered. Code 99387 is reported.Additional codes for the Pap smear and mammogram will be reported separately., A 65-year-old male new patient presents for his first visit with complaints of mild fatigue and joint pain. The doctor performs a thorough history and physical exam, including addressing the fatigue and joint pain complaints. Because these complaints required additional work beyond the preventive visit the provider also reports an additional E/M code (e.g., 99203) with modifier -25.

Detailed documentation should include a comprehensive history (including past medical history, family history, social history, and review of systems), a complete physical examination (including age and gender-appropriate elements), documentation of counseling/anticipatory guidance/risk factor reduction interventions, orders for appropriate immunizations and laboratory/diagnostic tests, and any other relevant information.

** Always refer to the most current CPT® codebook and other relevant guidelines for accurate coding.Understanding the definition of a "new patient" is crucial for appropriate application of this code.