What is a Well-Woman visit Current Procedural Terminology (CPT) code?

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From the Research

A Well Woman visit is typically billed using CPT codes 99385-99387 for new patients and 99395-99397 for established patients, which cover comprehensive annual gynecological examinations, including preventive screenings and counseling. These visits are crucial for maintaining women's health and include services such as breast examinations, pelvic examinations, Pap smears, and discussions on contraception and menopause management 1. The specific services included in a Well Woman visit may vary based on the patient's age, risk factors, and health history.

Key Components of a Well Woman Visit

  • Comprehensive health assessment
  • Preventive screenings, such as breast examinations and Pap smears
  • Counseling on women's health concerns, including contraception and menopause management
  • STI screenings
  • Discussion of healthy behaviors, such as not smoking and participating in physical activity, which are associated with higher percentages of screening for breast, cervical, and colorectal cancers 1

Importance of Well Woman Visits

Regular Well Woman visits are essential for early detection of health issues and maintaining overall wellness. They allow healthcare providers to identify potential problems before they become serious and provide personalized preventive care recommendations. Insurance plans, including Medicare and those under the Affordable Care Act, generally cover these preventive visits without cost-sharing.

Billing and Coding

The most common Well Woman CPT codes are 99385-99387 for new patients and 99395-99397 for established patients, varying by age group. These codes are used to bill for the preventive healthcare services provided during a Well Woman visit.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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