Practice Management Book

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E/M Established Outpatient VisitAka: E/M Established Office Visit, CPT 99211, CPT 99212, CPT 99213, CPT 99214, CPT 99215

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  1. Indication
    1. E/M Established Patient
  2. Established Outpatient: CPT Code 99211
    1. Key components not required
    2. Physician need not be present (only supervising)
    3. E/M Minimal Problem
    4. Staff Time: 5 minutes
  3. Established Outpatient: CPT Code 99212
    1. Key Components (2 of 3 meet or exceed requirements)
      1. E/M Problem Focused History
      2. E/M Problem Focused Exam
      3. E/M Straightforward Medical Decision
    2. E/M Self Limited or Minor Problem
    3. Physician Time: 10 minutes
  4. Established Outpatient: CPT Code 99213
    1. Key Components (2 of 3 meet or exceed requirements)
      1. E/M Expanded Problem Focused History
      2. E/M Expanded Problem Focused Exam
      3. E/M Low Complexity Medical Decision
    2. Problem severity
      1. E/M Low Severity Problem
      2. E/M Moderate Severity Problem
    3. Physician Time: 15 minutes
  5. Established Outpatient: CPT Code 99214
    1. Key Components (2 of 3 meet or exceed requirements)
      1. E/M Detailed History
      2. E/M Detailed Exam
      3. E/M Moderate Complexity Medical Decision
    2. Problem Severity
      1. E/M Moderate Severity Problem
      2. E/M High Severity Problem
    3. Physician Time: 25 minutes
  6. Established Outpatient: CPT Code 99215
    1. Key Components (2 of 3 meet or exceed requirements)
      1. E/M Comprehensive History
      2. E/M Comprehensive Exam
      3. E/M High Complexity Medical Decision
    2. Problem Severity
      1. E/M Moderate Severity Problem
      2. E/M High Severity Problem
    3. Physician Time: 40 minutes

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