CPT^® 99252, Under New or Established Patient

The Current Procedural Terminology (CPT^®) code 99252 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 inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a straightforward level of medical decision making or the provider spends at least 35 minutes of total time on the encounter on a single date.

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View matching HCPCS Level II codes and their definitions.

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Modifier 51?

[QUOTE="amyjph, post: 505875, member: 172045"] If you are reporting unlisted codes, modifiers are not appended to unlisted codes. Modifiers are used to report or indicate a procedure performed has bee... [ Read More ]

Modifier 51?

If you are reporting unlisted codes, modifiers are not appended to unlisted codes. Modifiers are used to report or indicate a procedure performed has been altered but not changed in its definition or ... [ 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 ]

Modifiers for unlisted codes

I would not use modifiers such as -22, -52, -53 on an unlisted, as you should be comparing the unlisted to a similar value code. In a situation of an assistant surgeon, then I think -80 would certai... [ Read More ]

Orthopedic consults

I disagree. Whether or not 99221-99223 is appropriate can depend on the carrier. When CMS eliminated consult codes, their official advice is the admitting bills 99221-99223 with -AI. Physicians who ... [ Read More ]

inpatient CPT ?

I have not billed for an inpatient visit before. It was a consult by a dermatologist. I have a detailed history, expanded problem focus exam, and moderate medical decision making. The code I came u... [ Read More ]

Anthem Commercial Policy of Wisconsin Consultation Codes

Most Recently our office has been sent several recoupment notification from Anthem Blue Cross Blue Shield. The notices state an overpayment exists and Anthem is requesting a refund. The reason for th... [ Read More ]

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