Practice Management Book

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E/M Examination CriteriaAka: E/M Problem Focused Exam, E/M Expanded Problem Focused Exam, E/M Detailed Exam, E/M Comprehensive Exam

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  1. Examination Type: Problem Focused
    1. Criteria
      1. Limited to affected body area or organ system
    2. Related Codes
      1. E/M New Outpatient Visit
        1. CPT 99201
      2. E/M Established Outpatient Visit
        1. CPT 99212
      3. E/M Emergency Services
        1. CPT 99281
      4. E/M Consultation Services
        1. CPT 99241
  2. Examination Type: Expanded Problem Focused
    1. Criteria
      1. Affected body area or organ system
      2. Other symptomatic or related organ systems
    2. Related Codes
      1. E/M New Outpatient Visit
        1. CPT 99202
      2. E/M Established Outpatient Visit
        1. CPT 99213
      3. E/M Emergency Services
        1. CPT 99282
        2. CPT 99283
      4. E/M Consultation Services
        1. CPT 99242
  3. Examination Type: Detailed
    1. Criteria
      1. Extended examination of affected body areas
      2. Other symptomatic or related organ systems
    2. Related Codes
      1. E/M New Outpatient Visit
        1. CPT 99203
      2. E/M Established Outpatient Visit
        1. CPT 99214
      3. E/M Emergency Services
        1. CPT 99284
      4. E/M Consultation Services
        1. CPT 99243
  4. Examination Type: Comprehensive
    1. Criteria
      1. Complete single system specialty examination or
      2. Complete multi-system examination
    2. Related Codes
      1. E/M New Outpatient Visit
        1. CPT 99204
        2. CPT 99205
      2. E/M Established Outpatient Visit
        1. CPT 99215
      3. E/M Emergency Services
        1. CPT 99285
      4. E/M Consultation Services
        1. CPT 99244
        2. CPT 99245

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