What is code 99213 used for?

CPT Code 99213: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and a low level of medical decision making.

Does Medicare cover code 99213?

The most common codes a doctor will use for follow up office visits are 99213 (follow up office visit, low complexity) and 99214 (follow up office visit, moderate complexity). A 99213 pays $83.08 in this region ($66.46 from Medicare and $16.62 from the patient).

What is the modifier for CPT code 99213?

modifier 59
If the circumstance calls for a Level 3 established patient visit (CPT code 99213) to be billed with psychological testing (such as CPT code 96101), modifier 59 would be appended to the testing code.

What is established patient level 3?

Level-III visits are considered to have a low level of risk. Patient encounters that involve two or more self-limited problems, one stable chronic illness or an acute uncomplicated illness would qualify.

Who can bill CPT code 99213?

CPT Code 99213 can be utilized for a mid-level outpatient or inpatient office visit. CPT Code 99213 is a level three code that should be used for an established patient. It cannot be used with a new patient who has no history.

What does CPT code 99213 stand for?

CPT Code 99213 Description CPT Code 99213: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and a low level of medical decision making.

Is the Medicare Code 99202 the same as 99204?

In other words, Medicare intended to pay the same rate for new patient codes 99202, 99203, and 99204, regardless of which code was reported. Medicare was going to pay another single rate for established patient codes 99212, 99213, and 99214.

When to use Procedure Code 99213 or 27447?

* Procedure code 27447 has a global surgery period of 90 days. * Procedure code 99213 is submitted with a date of service that is within the 90-day global period. * When a substantial diagnostic or therapeutic procedure is performed, the evaluation and management service is included in the global surgical period.

What’s the CPT code for an office visit?

A physician performed a visit that met the definition of an office visit CPT code 99213 and the total duration of the direct face-to-face services (including the visit) was 65 minutes. The physician bills CPT code 99213 and one unit of code 99354. EXAMPLE 2