Jonathan is a 12-year-old whose mother took him to his pediatrician for his annual exam. While examining him, his pediatrician discovered that he had an inguinal hernia and performed a problem-focused history, a problem-focused exam, and straightforward medical decision making. The pediatrician is referring Jonathan to a surgeon for the hernia repair, and Jonathan is to return to his pediatrician in 1 year. Choose the appropriate code(s) for Jonathan's visit:

Question

Quizplus · Accepted Answer

The correct codes are 99394 for the annual exam of an adolescent (age 12 through 17) and 99212-25 for a problem-focused visit with a separate, identifiable diagnosis (inguinal hernia) that required additional work beyond the preventive service. The modifier -25 indicates that the problem-focused visit was a separate and distinct service from the annual exam performed on the same day.

Jonathan Is a 12-Year-Old Whose Mother Took Him to His