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LEVEL 3 ESTaBLISHED
OFFICE PATIENT
 

 

Level 3 Office Visit (99213)

This level of care is located “in the middle’ of the coding spectrum for office visits with established patients.  Not surprisingly, the 99213 is the most popular choice for internists who select this level of care for 48.5% of these encounters.  This code also has the distinction of being the most widely used CPT code on the planet.  Usually the presenting problems are of low to moderate severity.  The reimbursement for this level of care is approximately $66. This code is most likely over-used because many physicians do level-4 work without really knowing it. To see why, take the web-course.

The documentation for this encounter requires TWO out of THREE of the following :

1)  Expanded Problem Focused History
2)  Expanded Problem Focused Exam
3)  Low Complexity Medical Decision-Making

Or 15 minutes spent face-to-face with the patient if coding based on time.  The appropriate documentation must be included.

Clinical Example...

This topic is covered in detail in of one of our web-based E/M coding courses.
 

Established Office Patients

Established Office Visits   Related Topics
 

 

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These are the most common patient encounters on the planet, so it's important to code correctly for these visits. Knowing the difference between a level 3 and level 4 established office patient can make a huge difference in your remibursement and income.  
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