Office consultation, straightforward complexity

Evaluation and Management (E/M) services are fundamental in healthcare, providing a structured approach to patient assessment. CPT code 99242 represents a mid-level established patient office visit, emphasizing a balance between complexity and routine care.

Details

CPT code:

99242

Category:

Category I

Section:

Evaluation and Management (E/M)

Specialty:

Office or Other Outpatient Consultations

Type:

New or Established Patient

This code is employed when physicians engage with established patients in an office setting, requiring a moderate depth of evaluation. It covers scenarios where a patient's condition demands more attention than a basic encounter but does not involve the intricacies of high-level consultations. Physicians utilize this code to accurately document their efforts in managing patients with a nuanced approach.

Under what category does Office consultation, straightforward complexity fall?

Category I

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

Per Encounter

Modifiers

-

Clinical use

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

Documentation

Moderate MDM; detailed history and examination.

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