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LEVEL 5 ESTABLISHED
OFFICE PATIENT |
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Level 5 Office Visit (99215)
The 99215 represents the highest level of care for established patients being seen in the office. Rather surprisingly, this is the least popular code used to bill for these encounters. Internists used the 99215 to bill for only 4.1% of established office patients in 2003. The reimbursement for this level of care is approximately $117.00. Usually the problems are of moderate to high severity. The 99215 ranked 31st among the most frequently used CPT codes among all physicians in 2003.
The documentation for this encounter requires TWO out of THREE of the following :
1) Comprehensive History
2) Comprehensive Exam
3) High 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
Example |
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