Another type of “consultation” for “clearance” occurs with travel medicine. A pre-travel consultation assesses the patient’s fitness for travel in the context of the anticipated risks. It may be utilized by international travelers for a variety of reasons, including business, tourism, humanitarian aid, or visiting friends and family. Mitigation often includes immunizations, prophylactic medications, and travel related information. Again, specifics on travel consultations is outside of the scope of this section, but many resources are available, such as the Center for Disease Control and Prevention (CDC)’s “Yellow Book”, which is available for free online, and the US Department of State’s website. Third party resources, such as Shoreland’s Travax, may provide additional guidance.
The ICD-10 codes are Z71.84 Encounter for health counseling related to travel. Most payers will cover routine vaccinations with Z23 Encounter for vaccination, but may refuse vaccines for travel-related destinations and the patient may need to pay out-of-pocket.
CPT coding typically involves a routine office visit. If the patient comes to the clinic only for counseling regarding immunizations required for foreign travel and preventive travel measures, and if the healthcare payer covers it (note that CMS does not), you could use general preventive medicine counseling CPT codes.
● 99401: Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes
● 99402: As above, approximately 30 minutes
● 99403: As above, approximately 45 minutes
● 99404: As above, approximately 60 minutes
Sometimes pre-travel consultations are billed to the patient directly as a flat-fee through dedicated specialty travel clinics, because healthcare payers can refuse payment. Since health insurance payers rarely cover travel-related visits, most patients are billed directly for any vaccines they receive in office. An example of how this is communicated to patients can be found at: https://health.uconn.edu/infectious-diseases/international-travelers-medical-service/important-information-for-travel-visits/.