Understanding CPT Code 99396 A Comprehensive Guide for Primary Care Physicians
                     Understanding CPT Code 
99396: A Comprehensive 
Guide for Primary Care 
Physicians
Key Insights into Preventive Care Billing
Website: www.imedclaims.com
Email: [email protected] 
Introduction to CPT Code 99396
 Definition:
 CPT 99396 is used for preventive medicine services for established patients aged 
40-64 years.
 Purpose:
 Covers routine health checkups and screenings.
 Helps in early disease detection and preventive care.
What’s Included in CPT 99396?
 Comprehensive Health Review:
 Medical history evaluation
 Risk factor assessment
 Physical Examination:
 Vital signs check
 General body system evaluation
 Preventive Guidance:
 Lifestyle counseling
 Age-appropriate screenings and immunizations
CPT 99396 Billing Guidelines
Key Billing Rules:
Only for established patients (ages 40-64).
Not applicable for problem-based visits – preventive care only.
Typically covered once per year under insurance.
Common Denials & Solutions:
Verify insurance coverage before billing.
Ensure correct ICD-10 codes for preventive care.
ICD-10 Codes Commonly Used with CPT 
99396
Examples of ICD-10 Codes:
Z00.00 – General adult medical exam without abnormalities
Z00.01 – General adult medical exam with abnormalities
Z13.6 – Screening for cardiovascular disorders
Key Tip: Always link diagnosis codes appropriately to avoid claim denials. 
Conclusion & Next Steps
 Key Takeaways:CPT 99396 is essential for preventive care visits for adults.
 Proper documentation ensures smooth reimbursements.
 Understanding ICD-10 codes helps in accurate claim submission.