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2010 Guide for Medicare Consultation Code Reporting

For example, instead of using criteria for consultation CPT codes 99241-99245, physicians will need to follow AMA CPT coding guidelines for CPT codes 99201-99205 and 99211-99215 to determine the appropriate level of care (new or established) provided to the patient.

Office or Other Outpatient Services (99201-99215)

Office or Other Outpatient Services (99201-99215) The following codes are used to report evaluation and management services provided in the physician's office or in an outpatient or other ambulatory facility.

Bulletin Number: xxxxxx

Implementation Date: January 3, 2006 Payment for Office/Outpatient E/M Visits (Codes 99201-99215) Note: This article was revised to contain Web addresses that conform to the new CMS website and to show they are now MLN Matters articles.

CPT Definition Sheet

CPT Code Sheet.xls. CPT Definition Sheet CPT Code Description CPT Code New or Established Patient History Physical Exam (#of Body Systems) Medical Decistion Making New-Problem Focused, 10 min) 99201 New Problem Focused Problem Focused Straight Forward New-Expanded (Problem Focused, 20 min) 99202 ...

Bulletin Number: xxxxxx

GO - What You Need to Do GO - What You Need to Do Hospitals, including critical access hospitals (CAHs), billing for these facility charges must bill them on bill types 13x or 85x with revenue code 0510 (clinic visit) when an E & M code in the range of 99201-99245 is Disclaimer This article was prepared ...

CPT code 99203 includes a Detailed History:

CPT Code Amount of Required Findings 99201 1-5 99202 6 99203 12 99204 & 99205 All elements within the shaded boxes and at least 1 element within the unshaded boxes.

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Anthem Midwest Clinical Claims Edit

99201-99205 (Office or other outpatient visit, for the evaluation and management of a new patient) and 99211-99215 (Office or other outpatient visit, for the evaluation and management of an established