Office consultation, high complexity

Reflecting a pinnacle in Evaluation and Management (E/M) services, CPT code 99245 designates an inpatient consultation with a comprehensive assessment and high-complexity decision-making. This code is reserved for medical encounters demanding an exhaustive evaluation and intricate decision-making processes.

Details

CPT code:

99245

Category:

Category I

Section:

Evaluation and Management (E/M)

Specialty:

Office or Other Outpatient Consultations

Type:

New or Established Patient

99245 comes into play when healthcare professionals conduct in-depth consultations with patients admitted to a hospital setting. The code signifies encounters that require a comprehensive assessment, involving an extensive examination and high-complexity decision-making. Its application ensures accurate documentation of the intensity and sophistication inherent in managing patients with severe and intricate health conditions.

Under what category does Office consultation, high complexity fall?

Category I

What is the billing unit for Office consultation, high complexity?

Per Encounter

Modifiers

-

Clinical use

Office or other outpatient consultation for a new or established patient, comprehensive assessment and management.

Documentation

Comprehensive history, examination, and high complexity MDM.

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