CPT code 99205 refers to an extensive initial consultation with a healthcare provider for new patients.
Procedure Explanation:
This procedure involves a detailed meeting with a doctor in an office or clinic where the patient is new. It requires the doctor to review the patient’s medical history or conduct a thorough examination and make complex medical decisions. The consultation typically lasts an hour or more. It includes the entire evaluation process on the scheduled day but doesn’t cover treatment or follow-up visits.
Common Names:
- Comprehensive New Patient Visit
- New Patient Office Visit
- Initial Evaluation and Management
Relative Value Units (RVU):
The RVUs associated with this code are 3.5.
How This Procedure Appears:
- Operating Room Schedule Name: New Patient Consultation
- Surgical Consent Form Name: Detailed Patient Evaluation
Typical Patients and Diagnoses:
This type of appointment is often used for people who are seeing a healthcare provider for the first time or those who have complex medical issues needing a comprehensive evaluation. For example, a new patient with multiple health concerns such as diabetes and high blood pressure might require this kind of extensive consultation to create an effective treatment plan.
Associated ICD-10 Codes:
- Z00.00: General adult medical examination without abnormal findings
- E11.9: Type 2 diabetes mellitus without complications
- I10: Essential (primary) hypertension
Summary
In summary, code 99205 describes an in-depth evaluation of new patients, typically lasting at least 60 minutes. Typical ICD-10 codes associated with 99205 include Z00.00 (routine check-up) and E11.9 (uncomplicated type 2 diabetes).
Disclaimer
This post is for informational purposes only and is not a substitute for medical advice. “CPT” and CPT Codes are registered trademarks of the American Medical Association. HCPCS codes are managed by Medicare and are not subject to copyright.