Did you know? The 99213 CPT Code is one of the most frequently used codes in medical billing for office or outpatient visits, and it is specifically used for established patients. Healthcare professionals must understand this CPT code for accurate billing and ensure proper reimbursement.
As many healthcare policies and billing practices have recently changed, it’s become more important to know the updated 99213. So, if you want to learn about CPT Code 99213 in detail, we’ve got you covered.
What Is CPT Code 99213?
CPT Code 99213 is an evaluation and management (E/M) code that healthcare professionals commonly use for billing a specific type of outpatient medical visit. However, it especially applies to established patients.
This means those patients who have been seen before by the healthcare provider and now come for their next visit in an office for moderate care because the CPT Code 99213 is associated with a moderate level of complexity and its used office visits, which require modern medical care and management of patient’s conditions.
This code 99213 is described as a “Level 3 Established Patient Office Visit”, which means this visit usually involves:
A detailed history
A detailed physical examination
Medical decision-making of moderate complexity
These visits usually last around 20-29 minutes, where a patient requires moderate attention, such as managing chronic conditions or discussing new health concerns that require some medical decision-making. For healthcare professionals, this code is essential for reimbursement failure after the care they provide.
Key Features of CPT Code 99213
Code Type | Description |
CPT Code | 99213 |
Code Level | Level Three |
Complexity Level | Moderate |
Visit Duration | 20-29 minutes |
Services | Evaluation and management, diagnosis, treatment, counseling and education |
One of the crucial reasons for using the 99213 carefully is to ensure healthcare providers get reimbursement properly for the care they provide. Plus, staying updated with recent CPT codes is also important to know what needs to be documented, and getting expert advice can help them handle the challenges of medical billing and coding easily.
What does the 99213 CPT Code cover?
The 99213 CPT Code represents evaluation and management (E/M) services provided by healthcare professionals. This code is used to document and bill level three office visits, which include face-to-face encounters with patients and treatment of new or existing problems. This code is appropriate when the healthcare provider spends 20-29 minutes with face-to-face interaction with the patient.
Here are some key components of the 99213:
1. Evaluation: The medical visit includes an analysis of the patient’s medical history, current symptoms, and physical examination to find a diagnosis and treatment plan.
2. Complexity: The 99213 CPT Code is used for a moderate level of decision-making. This means this code is appropriate for those patients who have moderate symptoms or stable chronic conditions that require regular monitoring and management.
3. Time: The typical time spent on a medical visit between 20-29 minutes leads to 99213.
4. Management: Healthcare professionals mainly focus on managing a patient’s health condition, including prescribing medications, ordering tests, providing education, counselling, and coordinating care with other providers.
5. Documentation: Accurate documentation is essential when using the CPT 99213 Code. Which describes the reason for the visit, examination, treatment provided, and patient’s response to the treatment.
Pro Tip: Healthcare professionals make sure the visit’s complexity and time align with the 99213 requirement for accurate documentation, billing, and reimbursement.
Original Blog Source: https://www.vcdoctor.com/blog/99213-cpt-code
0 Comments