Practice Management Book

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E/M Established Outpatient Visit

Aka: E/M Established Outpatient Visit, E/M Established Office Visit, CPT 99211, CPT 99212, CPT 99213, CPT 99214, CPT 99215
  1. See Also
    1. Evaluation and Management Coding (E/M Coding)
    2. E/M Patient Criteria (E/M New Patient, E/M Established Patient)
    3. E/M History Criteria
    4. E/M Examination Criteria
    5. E/M Medical Decision Making
    6. E/M Nature of Presenting Problem
    7. E/M New Outpatient Visit
    8. E/M Consultation Services
    9. E/M Emergency Services
  2. Indication
    1. E/M Established Patient
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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

Established Patient Office or Other Outpatient Services (C0695211)

Concepts Therapeutic or Preventive Procedure (T061)
CPT 1013638
English Established Patient Office or Other Outpatient Services
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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