Office consultation, low complexity

CPT code 99243 signifies a high-level established patient office visit in the realm of Evaluation and Management (E/M) services. Tailored for complex cases, this code reflects the increased intensity and depth of medical encounters, highlighting the meticulous evaluation and decision-making involved.


CPT code:



Category I


Evaluation and Management (E/M)


Office or Other Outpatient Consultations


New or Established Patient

When medical practitioners encounter established patients with intricate health conditions, 99243 comes into play. This code is instrumental in accurately documenting the extensive effort invested in understanding and managing complex patient cases during office visits. It provides a nuanced representation of healthcare encounters that demand heightened attention and analysis.

Under what category does Office consultation, low complexity fall?

Category I

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

Per Encounter



Clinical use

Office or other outpatient consultation for a new or established patient, high complex decision making.


Higher MDM; expanded problem-focused history and examination.

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