CPT^® 99242, Under New or Established Patient

The Current Procedural Terminology (CPT^®) code 99242 as maintained by American Medical Association, is a medical procedural code under the range - New or Established Patient.

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Summary

The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a straightforward level of medical decision making or the provider spends at least 20 minutes of total time on the encounter on a single date.

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E/M Consultation - CPC exam prep question - help

[QUOTE="carrie.townsend@modahealth.com, post: 504276, member: 732844"] In this instance, the CPC book says "...which required these 3 key components" for selecting the E/M. So if all three are not me... [ Read More ]

E/M Consultation - CPC exam prep question - help

You have to [B][I][B][I]meet or exceed[/I][/B][/I][/B][I] [/I][B][I]each[/I][/B][I][B] of the 3 key components[/B][/I] for consultation codes. Side note - same applies to initial inpatient visits 9922... [ Read More ]

E/M Consultation - CPC exam prep question - help

[QUOTE="AaPe12, post: 504272, member: 78116"] Hi. Let me restate the answers to the question with letters, to minimize confusion: A. 99204 B. 99252 C. 99244 D. 99242 We can eliminate A because, as y... [ Read More ]

E/M Consultation - CPC exam prep question - help

Hi. Let me restate the answers to the question with letters, to minimize confusion: A. 99204 B. 99252 C. 99244 D. 99242 We can eliminate A because, as you said it is a consultation service that meet... [ Read More ]

E/M Consultation - CPC exam prep question - help

[QUOTE="carrie.townsend@modahealth.com, post: 504265, member: 732844"] I am sitting for my CPC exam on Saturday. There is a question in the Study Guide that has me stumped (and my two CPC colleagues ... [ Read More ]

E/M Consultation - CPC exam prep question - help 99242 99244 consultation e/m

I am sitting for my CPC exam on Saturday. There is a question in the Study Guide that has me stumped (and my two CPC colleagues too). A 55-year-old patient is seen in an office visit by an otolaryng... [ Read More ]

Preop consult with routine well exam

Can the provider perform and bill to the insurnace a pre-op consult (i.e. 99242) and a routine well exam (i.e. cpt code 99396) on the same date of service? Provided documentation supports the service.... [ Read More ]

E/M Changes in 2021

It appears that the E/M guidelines for outpatient consult codes (99242-99245) are remaining the same. Do others agree, or does anyone know something else about this?... [ Read More ]

Consult for Pre op and E/M level for office visit

Can a provider who is seeing a patient for a pre-op evaluation for surgery (i.e. 99242 visit) also charge an E/M level office visit (i.e. 99214) for problems or chronic conditions addressed/treated on... [ Read More ]

Modifier 25 same day as minor procedure

[B]Hello, I am in a dispute with my Pears and Physician on whether this consult 99242 should be billed with this procedure with a modifier 25. Below I have included the report for review. Any help w... [ Read More ]

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