CPT code 99215 refers to a comprehensive office visit for someone who is already a patient.
Procedure Explanation:
This code is used for a doctor’s visit where the doctor takes an in-depth look at the patient’s health, reviews their history, might perform a physical exam, and makes important decisions about their treatment. It is for people who have been to this doctor before. There’s no surgery involved, and it doesn’t cover any tests done outside of the visit.
Common Names:
- Office Visit Level 5
- Detailed Follow-up
- Established Patient Visit
Relative Value Units (RVU):
The RVUs associated with this code are 2.8.
How This Procedure Appears:
- Operating Room Schedule Name: Not applicable, as this is an office visit
- Surgical Consent Form Name: Not applicable, as this is an office visit
Typical Patients and Diagnoses:
This type of visit is usually for patients who need a more thorough examination due to complex health conditions. For example, someone managing multiple chronic illnesses like diabetes and high blood pressure or a person who has a new, complicated health issue requiring significant time to assess would need this type of visit.
Associated ICD-10 Codes:
- E11.9: Represents Type 2 diabetes with no complications, often used when a patient is visiting for diabetes management
- I10: Represents high blood pressure, common when a patient is under evaluation for hypertension
- M54.5: Represents lower back pain, used for patients complaining about persistent back issues
Summary
In summary, code 99215 describes a detailed and comprehensive office visit for an established patient. Typical ICD-10 codes associated with 99215 include E11.9 (Type 2 diabetes) and I10 (High blood pressure).
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.