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E/M Established Outpatient Visit

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E/M Established Outpatient Visit, E/M Established Office Visit, CPT 99211, CPT 99212, CPT 99213, CPT 99214, CPT 99215

  • See Also
  1. Evaluation and Management Coding (E/M Coding)
  2. E/M Patient Criteria (E/M New Patient, E/M Established Patient)
  3. E/M History Criteria
  4. E/M Examination Criteria
  5. E/M Medical Decision Making
  6. E/M Nature of Presenting Problem
  7. E/M New Outpatient Visit
  8. E/M Consultation Services
  9. E/M Emergency Services
  • Indication
  1. E/M Established Patient
  • Established Outpatient
  • CPT Code 99211
  1. Key components not required
  2. Physician need not be present (only supervising)
  3. E/M Minimal Problem
  4. Staff Time: 5 minutes
  • Established Outpatient
  • CPT Code 99212
  1. Key Components (2 of 3 meet or exceed requirements)
    1. E/M Problem Focused History
    2. E/M Problem Focused Exam
    3. E/M Straightforward Medical Decision
  2. E/M Self Limited or Minor Problem
  3. Physician Time: 10 minutes
  • Established Outpatient
  • CPT Code 99213
  1. Key Components (2 of 3 meet or exceed requirements)
    1. E/M Expanded Problem Focused History
    2. E/M Expanded Problem Focused Exam
    3. E/M Low Complexity Medical Decision
  2. Problem severity
    1. E/M Low Severity Problem
    2. E/M Moderate Severity Problem
  3. Physician Time: 15 minutes
  • Established Outpatient
  • CPT Code 99214
  1. Key Components (2 of 3 meet or exceed requirements)
    1. E/M Detailed History
    2. E/M Detailed Exam
    3. E/M Moderate Complexity Medical Decision
  2. Problem Severity
    1. E/M Moderate Severity Problem
    2. E/M High Severity Problem
  3. Physician Time: 25 minutes
  • Established Outpatient
  • CPT Code 99215
  1. Key Components (2 of 3 meet or exceed requirements)
    1. E/M Comprehensive History
    2. E/M Comprehensive Exam
    3. E/M High Complexity Medical Decision
  2. Problem Severity
    1. E/M Moderate Severity Problem
    2. E/M High Severity Problem
  3. Physician Time: 40 minutes