CPT Code 99215- Office or other outpatient visit for the evaluation and management of an established patient.
99215
99211, 99212, 99213, 99214, or 99215
The CPT code for evaluation and management of deltoid muscle pain and swelling would typically fall under an office or outpatient visit code, such as CPT code 99202-99205 for new patient visits or 99212-99215 for established patient visits, depending on the complexity of the evaluation and management provided by the healthcare provider.
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Level 5 Office Visit (99215)The 99215 represents the highest level of care for established patients being seen in the office. Rather surprisingly, this is the least popular code used to bill for these encounters. Internists used the 99215 to bill for only 4.1% of established office patients in 2003. The reimbursement for this level of care is approximately $117.00. Usually the problems are of moderate to high severity. The 99215 ranked 31st among the most frequently used CPT codes among all physicians in 2003.The documentation for this encounter requires TWO out of THREE of the following :1) Comprehensive History2) Comprehensive Exam3) High Complexity Medical Decision-MakingOr 40 minutes spent face-to-face with the patient if coding based on time. The appropriate documentation must be included.
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