PREVENTIVE CODES THAT SHOULD GENERALLY BE …

1 PREVENTIVE CODES that SHOULD GENERALLY BE COVERED AT NO OUT OF POCKET COST FOR BCBSIL HMO MEMBERS Note that this list does not contain every possible code that might be used for PREVENTIVE services addressed by ACA12/6/2010 Physican educational services rendered to patients in a group setting 99078 - Physican educational services rendered to patients in a group setting (eg. prenatal, obesity, or diabetic instructions) PREVENTIVE Medicine, Individual Counseling 99401- approximately 15 minutes99402 -approximately 30 minutes99403 -approximately 45 minutes99404 -approximately 60 minutesAlcohol and/or substance abused structured screening and brief intervention99408 - 15-30 minutes99409 - greater than 30 minutes PREVENTIVE Medicine, Group Counseling 99411 -approximately 30 minutes99412 - approximately 60 minutesMedical Nutrition Therapy97802 = Medical nutrition therapy, initial assessment and intervention, individual.

2 Face-to-face with the patient, each 15 mins 97803 = Medical nutrition therapy, re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes97804 = Medical nutrition therapy, group (2 or more individuals) each 30 minutesG0270 = Medical nutrition therapy and reassessment and subsequent intervention, individualG0271 = Medical nutrition therapy and reassessment and subsequent intervention, groupS9470 - nutritional counseling/dietician visitS9452 - nutrition classes/non-physicianPhysical ExaminationS0613 - Annual gynecological examination; clinical breast examination without pelvic evaluationG0102 - Prostate cancer screening.

3 Digital rectal examinationImmunizationsAll Vaccine CODES 90476 - 90749 except 90675 (rabies vaccine, intramuscular) and 90676 (rabies vaccine, intradermal)All CODES 90465 - 90468, 90471 - 90474, G0008-G0010 PREVENTIVE Medicine services - AdultNew Patient: 99384 - adolescent (age 12-17)99385 - 18-39 years99386 - 40-64 years99387 - 65 years and olderEstablished Patient:99394 - adolescent (12-17)99395 - 18-39 years99396 - 40-64 years99397 - 65 years and older PREVENTIVE Medicine services - PediatricNew Patient 99381 - age younger than 1 year99382 - age 1-4 years99383 - 5-11 yearsEstablished patient.

4 99391 - age younger than 1 year 99392 - age 1-4 years99393 - age 5-11 years Smoking Cessation99406 - Smoking and tobacco use cessation counseling99407 - Smoking and tobacco cessation, intensiveG9016 - Smoking Cessation counselingS9075 - Smoking cessation treatmentS9453 - Smoking cessation classes, non-physicianMedical Genetics and Genetic Counseling Services96040 Colorectal cancer screening Note: a flexible sigmoidoscopy or colonoscopy may be a PREVENTIVE service or may be diagnostic or therapeuticFlexible sigmoidoscopy45330-45345 ICD 9 Procedure code 9 Procedure code Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Associatio