CPT Code 99212- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components:
A problem focused history;
A problem focused examination;
Straightforward medical decision making.
Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs.
Usually, the presenting problem(s) are self limited or minor. Physicians typically spend 10 minutes face-to-face with the patient and/or family
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.
A medical assistant visit cannot be billed as a 99212, which is a code for an established patient office visit that requires a physician's or qualified healthcare provider's evaluation and management. Medical assistants typically do not perform the level of service that qualifies for this billing code, as it requires a physician's decision-making and clinical judgment. Only the provider who performs the evaluation can bill for the 99212 code.
I believe 99201 is for a new patient, and 99212 is for an established patient.
This is the code used by providers to identify an Established Patient Visit with a problem-focused where the medical decision making was straightforward and the average face-to-face time was approximately 10 minutes.
99212 99213 99214
Office/outpatient E & M of established patient, requiring 2 of 3 components: problem focused history/examination/straightforward decision making
CPT code 99212 is used for an established office or other outpatient visit that typically requires a problem-focused evaluation and management (E/M) service. It is typically billed for a visit that lasts about 15 minutes and involves a straightforward medical decision-making process. This code is often used for follow-up visits where the patient's condition is stable or improving and does not require extensive evaluation or intervention.
CPT Code 99212- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components:A problem focused history;A problem focused examination;Straightforward medical decision making.Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs.Usually, the presenting problem(s) are self limited or minor. Physicians typically spend 10 minutes face-to-face with the patient and/or family
CPT code 99212 is used for an established patient office visit that requires a low level of medical decision-making, while CPT code 99396 is for a periodic comprehensive preventive medicine evaluation and management for an established patient. When documenting services, the order typically follows the nature of the visit, so if both codes are applicable, you would list the preventive visit (99396) first, followed by the problem-focused visit (99212), provided both services were performed during the same encounter. However, the specific order may depend on the context of billing and payer guidelines.
Procedure code 99212 with a modifier of 25 refers to an established patient office visit in which a healthcare provider performs a medically appropriate evaluation and management service that is distinct from any other services provided on the same day. It typically indicates a low-level visit, requiring a problem-focused examination and typically involving a straightforward medical decision-making process. The modifier 25 signifies that the visit was significant enough to warrant separate billing from other procedures performed that day.
10
Office/outpatient E & M of established patient, requiring 2 of 3 components: problem focused history/examination/straightforward decision making