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Level 3 Office Consult (99243)
This is the second most commonly used code used to bill for consults in the office. Internists selected the 99243 for 29.8% of these encounters in 2003. To get an idea of the frequency of use of this code among sub-specialists, nephrologists used this level of care for 15.9% of consults performed in the office during that same year (which added up to 25,238 visits). The 99243 ranked 53rd among the most frequently used CPT codes among all physicians in 2003. The reimbursement for this level of care is approximately $119.00. Usually the presenting problems are of moderate severity.
The documentation for this encounter requires THREE out of THREE of the following :
1) Detailed History
2) Detailed Exam
3) Low Complexity Medical Decision-Making
Or 40 minutes spent face-to-face
with the patient if coding based on time. The appropriate
documentation must be included.
Clinical
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