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June 20, 2025

Prevention and Screening

Prevention

Keeping patients healthy, providing advice about health risks and recommending screening tests and immunizations are the heart of primary care medicine. CPT uses one set of codes and Medicare another, and you’ll find coding information on both here, along with guidance on billing for split visits.

CPT codes for preventive services Expand
  • Coding Guide | Preventive Medicine Services
  • Billing for pap smear

 

Preventive services for Medicare patients Expand
  • Preventive Medicine Services | Medicare
  • Prolonged services codes for Medicare preventive medicine services: G0513, G0514
  • Age and wellness visits | Eligibility for Welcome to Medicare
  • G0101 Pelvic and Breast Exam
  • Wellness visits and care management in Rural Health Centers and Federally Qualified Health Centers (RHCs and FQHCs)
Screening and counseling Expand
  • Coding and reimbursement for lactation services
  • Smoking cessation coding, 99406 and 99407

HCPCS Screening Codes

  • National Coverage Determination: PrEP for HIV Prevention | HCPCS code G0011
  • HCPCS Code G0136 for Screening for the Social Determinants of Health (SDoH)
  • Screening for depression | HCPCS code G0444
  • Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse | HCPCS Code G0442
  • Screening for Other Sexually Transmitted Illnesses (STI)
  • Behavioral counseling for obesity, HCPCS code G0447
  • Intensive behavioral counseling for cardiovascular disease, HCPCS code G0446
  • ASCVD screening | HCPCS code G0537, G0538
  • High Intensity Behavioral Counseling to Prevent Sexually Transmitted Illnesses
  • Screening codes guide: G0442, G0443, G0444, G0446, G0447
Preventive and problem visits Expand
  • Billing Preventive Medicine Services and Problem Visit | Quick reference sheet
  • Reporting a problem-oriented visit on the same day as Welcome to Medicare (G0402) or Initial and Subsequent Wellness Visit (G0438, G0439)
  • Can we bill a new patient visit for preventive and E/M services on the same day?
  • Can I get paid for a problem oriented visit and wellness visit on the same day? | Video
  • Preventive Medicine, Wellness Visits and Problem-Oriented Visits | Webinar

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IRE Inpatient Determinations: Case Studiesoding for Prolonged Services | Webinar

Exclusively for members, this case-study focused webinar describes important ICD-10-CM Guidelines that establish the rules for these decisions.

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Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions.

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