Patient Appointments Flashcards
Time required for a new patient
60 mins
Time required for an established patient
15 minutes
Time required for a comprehensive appointment
45 to 60 minutes
Time required for preventative care
45 to 60 minutes
Time required for an urgent appointment
20 minutes
Time required for other entities
30 minutes
What is the purpose of a new patient appointment?
Has not received services from the provider or same group/specialty within 3 years
What is the purpose of an established patient appointment?
Received services from the same provider or same group within the 3 years
What is the purpose of a comprehensive appointment?
New or established patient for a specified complaint at the highest coding level, multiple complaints, injuries, or worsening chronic conditions
What is the purpose of a preventative care appointment?
Thorough review of body systems including preventative care and screenings
What is the purpose of an urgent appointment?
Medically necessary within 24 hours
What is the purpose of an appointment that falls under other entities?
Non-patient related such as depositions, sales, representatives, staff meetings, training
What are the CPT coding guidelines numbers for new patients?
99201-99205
Coding guideline for 99201
Problem focused history/exam
straightforward decision making
Coding guideline for 99202
expanded-problem focused history/exam
straightforward decision making
Coding guideline for 99203
detailed history/exam
low complexity decision making
Coding guideline for 99204
comprehensive history/exam
moderate complexity decision making
Coding guideline for 99205
comprehensive history/exam
high complexity decision making
Problem focused examination
Limited examination of the affected body area or organ system
Expanded problem focused examination
limited examination of the affected body area or organ system
and any other symptomatic or related body area(s) or organ system(s)
detailed examination
extended examination of the affected body area(s) or organ system(s) and any other symptomatic or related body area(s) or organ system(s)
comprehensive examination
general multi-system examination or complete examination of a single organ system and other symptomatic or related body areas or organ systems
