2025 CPT code 99394
(Active) Effective Date: N/A Revision Date: N/A Preventive Medicine - Preventive Medicine Services Evaluation and Management Feed
Periodic comprehensive preventive medicine reevaluation and management of an established adolescent patient (age 12 through 17 years).
Modifier 25 can be appended if a significant, separately identifiable E/M service is performed on the same day.
Medical necessity is established by the need for age and gender-appropriate preventive services for adolescents.
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 necessary tests.
In simple words: This is a routine checkup for a teenager (12-17 years old) who has seen the doctor before. It includes a thorough check-up, advice on staying healthy, and any necessary tests.
This code encompasses a comprehensive history, examination tailored to the adolescent's age and gender, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate laboratory/diagnostic procedures for an established adolescent patient.
Example 1: A 15-year-old established patient presents for their annual well-child visit. The physician performs a comprehensive history and physical, discusses healthy lifestyle choices, and orders routine blood work., A 13-year-old established patient with a history of asthma presents for a preventive visit. The physician assesses their asthma control, provides education on asthma management, and orders pulmonary function tests., A 17-year-old established patient presents for a sports physical. The physician performs a physical exam, assesses their fitness for participation, and discusses injury prevention.
Documentation must include a comprehensive history and physical examination, details of counseling provided, risk factor reduction interventions discussed, and justification for any ordered tests or procedures.
- Revenue Code: M1B
- Payment Status: Active
- Specialties:Family Medicine, Pediatrics, Adolescent Medicine, Internal Medicine
- Place of Service:Office