קוד CPT 99387: ביקור מונע, מטופל חדש, גיל 65 ומעלה

Learn how to effectively use the 99387 CPT code in your practice. Enhance your coding skills and improve patient care. Read our guide now!

Use Code

What is a new patient preventive exam (65+ years)?

99387 CPT code represents a comprehensive preventive medicine evaluation and management service for a new patient aged 65 years and older. This includes a complete age-appropriate history and physical, as well as anticipatory guidance and risk factor reduction counseling tailored to geriatric concerns.

In reporting a preventive medicine code like CPT 99387, remember that it does not cover evaluation of new or existing problems. If, during the visit, the patient expressed concern about a specific symptom, such as unusual pain or changes possibly linked to a family history of cancer reported, this may warrant a separate problem-focused service.

In such cases, healthcare providers may report an additional office visit code with modifier -25, if the evaluation is significant and separately identifiable from the preventive service. Documentation must clearly support the medical necessity of both services.

CPT code 99387 documentation requirements

Documentation must reflect:

Comprehensive personal and family medical history
Functional status, fall risk, sensory deficits, cognitive and mood screening
Review of systems and medication reconciliation
Physical exam: vitals, HEENT, cardiovascular, neuro, and musculoskeletal
Risk factor assessment and counseling (e.g., cancer screening, immunizations)
Advance care planning (optional but recommended)

Include preventive screening tools (e.g., PHQ-9, Mini-Cog) if administered.

CPT code 99387 billing guidelines

To avoid delays and denials during the billing process, here are some things to keep in mind:

Use only the cpde for new patients aged 65 or older.
Bill once per lifetime per provider group (unless patient has not been seen in 3+ years).
Add-on codes may be used for specific screening tests.
99387 does not include problem-specific diagnosis or treatment; if addressed, those issues must be documented separately and billed with an E/M code and modifier 25.

Always check and verify with payer policies regarding the coverage.

Other relevant CPT codes

99381: 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 laboratory/diagnostic procedures, new patient; infant (age younger than 1 year).
99382: Same as 99381; early childhood (ages 1–4 years).
99383: Same as 99381; late childhood (ages 5–11 years).
99384: Same as 99381; adolescent (ages 12–17 years).
99385: Same as 99381; adult (ages 18–39 years).
99386: Same as 99381; adult (ages 40–64 years).

These codes aren't applicable to established patients.

Frequently asked questions

Preventive medicine services focus on routine screenings and counseling for disease prevention, while office visits address specific health concerns or symptoms.

An annual wellness visit focuses on creating a personalized prevention plan and assessing health risks without a physical exam, while a preventive physical exam includes a full physical assessment and age-appropriate screenings.

CPT code 99387 is for an initial comprehensive preventive medicine evaluation and management of a new patient aged 65 years and older.