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CPT 99381 (new patient well-child visit under 1 year) is one of the most-billed codes in pediatrics yet documentation gaps, new-vs-established patient errors, and missed same-day sick visits with Modifier 25 trigger denials and audits. This 2026 guide shows exactly what payers require, the 4 must-have documentation components, vaccine admin rules, and a pre-submission checklist that protects revenue and keeps claims clean.