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Level 2 Hospital Consult (99252)
This is the second lowest level of care for hospital consultations. Internists used this code for 8.1% of these encounters in 2003. To get an idea of the frequency of use of this code among sub-specialists, nephrologists used the 99252 for only 4.2% of consults performed in the hospital during that same year (which added up to 24,587 visits in the entire country). The 99252 ranked 174th among the most frequently used CPT codes in 2003 by all physicians combined. Usually the presenting problems are of low severity. The reimbursement for this level of care is approximately $71.70.
The documentation for this encounter requires THREE out of THREE of the following :
1) Expanded Problem Focused History
2) Expanded Problem Focused Exam
3) Straightforward Medical Decision-Making
Or 40 minutes spent face-to-face
with the patient if coding based on time. The appropriate
documentation must be included.
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