Table of Contents
What is the difference between CPT code 99213 and 99212?
CPT Code 99212 is a level two code. For CPT Code 992213, an outpatient or inpatient office visit that is considered to be a mid-level visit can be billed with this code. CPT Code 99213 can only be used for an already established patient. It is a level 3 code.
Is 99212 a valid CPT code?
CPT® 99212, Under Established Patient Office or Other Outpatient Services. The Current Procedural Terminology (CPT®) code 99212 as maintained by American Medical Association, is a medical procedural code under the range – Established Patient Office or Other Outpatient Services.
How many minutes is 99212?
Time
| CPT Code | Total Time |
|---|---|
| 99212 | 10-19 mins |
| 99213 | 20-29 mins |
| 99214 | 30-39 mins |
| 99215 | 40-54 mins |
What is the difference between 99211 and 99212?
Unlike other office visit E/M codes – such as 99212, which requires at least two of three key components (problem-focused history, problem-focused examination and straightforward medical decision making) – the documentation of a 99211 visit does not have any specific key-component requirements.
How much is a 99212 visit?
Prices for Standard Primary Care Services
| CPT Code | Cost | Description |
|---|---|---|
| 99212 | $70 | Standard 5-10 Minute Office Visit |
| 99213 | $95 | Standard 10-15 Minute Office Visit |
| 99214 | $130 | Standard 20-25 Minute Office Visit |
| 99215 | $180 | Standard 30-45 Minute Office Visit |
Does 99212 need a modifier?
Remember, the 25 modifier is added to the E/M code (99201-99205, 99212-99215), not the CMT code (98940-98943) and BOTH must be performed during the same visit. If only an E/M service is billed, the 25 modifier is not required.
When should I use 99212?
99212 CPT Code: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making.
How long is a 99212 visit?
10 minutes
Typical times for established patient office visits
| CPT code | Typical time |
|---|---|
| 99212 | 10 minutes |
| 99213 | 15 minutes |
| 99214 | 25 minutes |
| 99215 | 40 minutes |
What modifier goes with 99212?
25 modifier
Remember, the 25 modifier is added to the E/M code (99201-99205, 99212-99215), not the CMT code (98940-98943) and BOTH must be performed during the same visit. If only an E/M service is billed, the 25 modifier is not required.
What is a 91 modifier used for?
Modifier 91 This modifier is used for laboratory test(s) performed more than once on the same day on the same patient. Tests are paid under the clinical laboratory fee schedule.
When should modifier Xu be used?
You may report modifier 59 or –XU for a diagnostic procedure performed before a therapeutic procedure only when the diagnostic procedure is the basis for performing the therapeutic procedure.
What is a 26 modifier used for?
Generally, Modifier 26 is appended to a procedure code to indicate that the service provided was the reading and interpreting of the results of a diagnostic and/or laboratory service.
What does the medical code 99212 stand for?
CPT Code 99212: Evaluation and Management Definition An evaluation and management appointment for an established patient in an office or outpatient setting.
What does Procedure Code 99212 mean?
Code 99212, the Level 2 office/outpatient E/M code for established patients, is used in the internal medicine practice setting when a patient comes in with a minor illness or problem that requires the physicians input.
What does 99212 mean?
Internal Medicine Coding Alert. Code 99212, the Level 2 office/outpatient E/M code for established patients, is used in the internal medicine practice setting when a patient comes in with a minor illness or problem that requires the physicians input. These are usually patients with conditions of low severity such as the flu, sore throat,…
What constitutes a 99212 visit?
99212 is a CPT code for: Office or other outpatient visit for the evaluation and management of an established patient with a problem focused history and examination, and straightforward medical decision making.