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Level 3 New Patient Office Visit (99203)

Perhaps because it is located “in the middle”, the 99203 is the second most frequently used code for new office patients.   Internists used this code for 29.66% of these encounters in 2015. The Medicare allowable reimbursement (2017) for this visit is $109.46 and it is worth 1.42 work RVUs.  Usually the presenting problems are of mild to moderate severity. 

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

1)  Detailed History
2)  Detailed Exam
3)  Low Complexity Medical Decision-Making

Or 30 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 more detail in our web-based E/M coding courses.

New Office Patients

New Office Patients
  Related Topics


Basic Course Preview
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Now that the consult codes have been eliminated for Medicare patients, the new office patient visit has become the most common outpatient initial encounter. Learn exactly what needs to be documented for each level of care for these visits. All levels of care are discussed.  
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