CPT 99382: Preventive Visit, New Patient, Age 1-4
Initial comprehensive preventive medicine evaluation and management of a new patient, age 1 through 4 years. Includes comprehensive history, examination, counseling, and risk factor reduction.
Why CPT 99382 Claims Get Denied
Claims billed under CPT 99382 are frequently denied or downcoded for the following reasons. Understanding these patterns helps your practice reduce denial rates and recover revenue faster.
Benefit limit for preventive visits already reached
Billed too soon after a prior preventive visit
Missing preventive diagnosis code
Bundled with same-day sick visit without modifier 25
Billing Tips for CPT 99382
Bill with Z00.129 (routine child health examination without abnormal findings) or Z00.121 (with abnormal findings). Verify payer-specific well-child visit frequency limits. Document any separate problems that warrant an additional E/M code with modifier 25.
Documentation Requirements
To support a clean claim for CPT 99382, your clinical documentation should include:
Comprehensive age-appropriate history
Complete physical examination
Developmental milestones assessment
Immunization review
Anticipatory guidance
Vision and hearing screening
Common Modifiers for CPT 99382
Reduce CPT 99382 Denials by 60%
RediClaim's pre-submission scrubber catches documentation gaps and coding errors before you submit, while the appeal generator handles denials that slip through.