Clear the Confusion about New Patient CPT Code Range (2024)

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Clear the Confusion about New Patient CPT Code Range? ›

The CPT codes ranging from 99202 to 99205 are designated for documenting the initial encounters between healthcare providers and new patients. These codes were updated in 2021 by the American Medical Association (AMA) to more accurately reflect the complexity and the requisite time for patient visits.

New Patient CPT^® Code range 99202- 99205.

For a level-4 visit to be a 99204 CPT code, not only must the patient be new, but the encounter needs to include a comprehensive history as well as a physical exam. A comprehensive history should include: Patient's present illness. Past medical history.

99205 Description: Office or other outpatient visit for the evaluation and management of a new patient which requires a medically appropriate history and/or examination and high medical decision making.

99331 - a problem focused interval history; - a problem focused examination; and - medical decision making that is straightforward or of low complexity. Usually, the patient is stable, recovering or improving.

Codes range from 00100–99499 and are generally ordered into sub-categories based on procedure/service type and anatomy. Category II: These alphanumeric tracking codes are supplemental codes used for performance measurement.

CPT® code 99203: New patient office visit, 30-44 minutes | American Medical Association.

According to CPT, 99214 is indicated for an “office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: a detailed history, a detailed examination and medical decision making of moderate complexity.” [For more detailed ...

CPT® code 99204: New patient office visit, 45-59 minutes | American Medical Association.

CPT Code 90792 description: Psychiatric Diagnosis Interview Examination (PDE) performed by a licensed mental health provider. According to CMS.gov, CPT Code 90792 requires: Elicitation of complete medical and psychiatric history (including past, family, social)

What is 99205 or 99204? ›

Code 99204 requires a minimum of 45 minutes of face-to-face time with the patient and Code 99205 requires a minimum of 60 minutes face-to-face time with the patient. For both services, at least 50% of the face-to-face time must be spent providing counseling and/or coordination of care.

CPT® code 99213: Established patient office or other outpatient visit, 20-29 minutes.

99253 comes into play for subsequent inpatient hospital care, focusing on cases with low complexity. The code is utilized when healthcare providers continue to oversee patients admitted to the hospital, ensuring that ongoing management aligns with the simplicity of the health concerns.

Domiciliary, Rest Home, or Custodial Care Services

CPT Codes 99334, 99335, 99336, 99337 for Established patient assisted living facility have been deleted. Alternate codes would be home or residence services codes 99347, 99348, 99349, 99350.

13152 - CPT® Code in category: Repair, complex, eyelids, nose, ears and/or lips...

CPT® Code 13151 in section: Repair, complex, eyelids, nose, ears and/or lips.

9789.12. 11. Evaluation and Management: Coding - New Patient; Documentation.

Three-year rule: The general rule to determine if a patient is new” is that a previous, face-to-face service (if any) must have occurred at least three years from the date of service. Some payers may have different guidelines, such as using the month of their previous visit, instead of the day.

Initial Hospital Inpatient or Observation Care CPT^® Code range 99221- 99223. The Current Procedural Terminology (CPT) code range for Initial Hospital Inpatient or Observation Care 99221-99223 is a medical code set maintained by the American Medical Association.

CPT Code 99202

This code describes a level 2 new patient visit that requires a low level of medical decision-making. The typical time for this visit is 20 minutes.