A well-child visit is coded as a preventative maintenance examination.
Well-child exams or check-ups can be coded and submitted to the insurance company on a yearly basis, except in the case of infants. Infants are seen more often in the first year of life. A well-child exam typically consists of taking the patient's vital signs such as height, weight , temperature, pulse and blood pressure. Then the physician performs an assessment of the patient and asks questions regarding any issues the patient may be experiencing. At least two codes will be needed for a well-child visit, one for the diagnosis and one for the CPT encounter, or physician office visit.
Instructions
1. Look up the well-child exam in the International Classification of Diseases, 9th revision (ICD-9) code book's alphabetical section. This is located in volume two. You must have a diagnosis code to show the insurance company medical necessity for the physician encounter. To look up the visit in the ICD-9 code book, first look under exam, then well baby. Note the code where you are referred.
2. Check the code in the tabular (numeric) section of the ICD-9 code book located in volume one. The ICD-9 code for a well-child examination is V20.2, which is a routine infant or child health check. All examination codes are found in the V-code section of the ICD-9 handbook.
3. Assign a code from the Evaluation and Management (E&M) section of the CPT code book. This code identifies the type and place of visit, whether the patient was new or established, and how extensive the exam by the physician was.
4. Submit the claim to the insurance company via electronic or paper claim form.
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