CPT code 99245 refers to a detailed consultation with a doctor, typically taking place in an office or clinic setting, for either new patients or those who have been seen before.
Procedure Explanation:
This medical procedure involves a thorough discussion with a doctor who explores the patient’s medical history and conducts an examination. The doctor uses this information to make complex medical decisions. This visit usually takes about 55 minutes or more. It does not cover any tests or treatments that the patient might undergo; it is focused on the consultation itself.
Common Names:
- Office Consultation
- Outpatient Consultation
- Detailed Evaluation
Relative Value Units (RVU):
The RVUs associated with this code are 3.75.
How This Procedure Appears:
- Operating Room Schedule Name: Comprehensive Office Consultation
- Surgical Consent Form Name: Detailed Patient Evaluation and Consultation
Typical Patients and Diagnoses:
This consultation is primarily used for patients who have complex or serious medical conditions that require in-depth assessment by a specialist or a primary care physician. For example, someone with unexplained symptoms wanting to understand their cause, or a person who has multiple medical conditions needing coordination of care, will typically undergo this procedure.
Associated ICD-10 Codes:
- Z00.00: Routine general health check with no complaints
- I10: High blood pressure without additional symptoms
- E11.9: Type 2 diabetes without complications
Summary
In summary, code 99245 describes a comprehensive medical consultation focused on understanding a patient’s health through detailed evaluation. Typical ICD-10 codes associated with 99245 include Z00.00 (general check-up) and I10 (uncomplicated 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.