Adolescents may present to physicians and other qualified health care professionals (QHPs) with unique health care needs. (See “Coding, Billing, and Protecting an Adolescent’s Privacy” elsewhere in this issue for a discussion of protecting a patient’s request for privacy while appropriately coding and billing for services.)
From a coding perspective, it is important to differentiate preventive screening from diagnostic services. Screening is provided in the absence of signs or symptoms of illness. Tests and services provided in response to signs or symptoms of a problem (eg, amenorrhea, fatigue, urinary discomfort) or to monitor or reevaluate a previously diagnosed condition (eg, depression, attention-deficit/hyperactivity disorder) are diagnostic tests. Diagnostic tests are typically not paid as a preventive benefit and are subject to any deductible, coinsurance, or co-pay of the patient’s health benefit plan.
Certain preventive screening services are separately reported when provided in conjunction with a comprehensive preventive medicine evaluation and management...