Unlisted code
Listed in CPT book used when no other code accurately describes the procedure or service a special report must always accompany
Category II
...
Largest to smallest
Section, subsection, subheading, category
Low birth weight subheading
Continuing intensive care
21899
Unlisted procedure neck or thorax
99205
A new patient presents to the physician's office at which time the physician provides a comprehensive history and exam with a high-complexity MDM
99460
History and exam of the normal newborn infant born in a hospital setting
00834 - P1
Assign a CPT anesthesia code and applicable modifier for anesthesia services for a nine month old normal child who received anesthesia for hernia repair in the lower abdomen
99201
This is a 15 year old girl never seen at this Clinic. During a problem-focused history, she states that she noticed a lump on the back of her right wrist yesterday. Space there is a 2 centimeter freely movable rubbery round swelling on the dorsal surface of the right wrist. Space distal nerve or vascular and tendon exam intact. Space this is not a painful to palpitation. The MDM was of straightforward complexity impression semicolon ganglion cyst, right wrist treatment semicolon refer to dr. Andrews for further treatment
99396
A 40 year old patient presents to the office for a preventive care exam
Modifier 59
Distinct procedural service its reported to indicate that services that are usually bundled into one payment were provided as separate services it can be found under appendix a under certain circumstances it may be necessary to indicate that a procedure or service was distinct or independent from other non e/m Services performed on the same day modifier 59 is used to identify procedure Services other than e/m services that are not normally reported together but are appropriate under the circumstances documentation must support a different session a different procedure or surgery a different site or organ system separate incision excision separate lesion or separate injury used modifier 59 when there is no other appropriate modifier used with secondary additional or lesser procedure
Inpatient
One who has been formally admitted to a healthcare facility
Outpatient
One who has not been formally admitted to a healthcare facility or a patient admitted for observation
New patient
One who has not received Professional Services from The Physician or another physician of the same exact to Specialty and subspecialty in the same group within the last 3 years
Established patient
One who has received Professional Services from The Physician or another physician of the exact specialty within the past 3 years
New patient
A physician must spend more time with the new patient obtaining history cost of a new patient is higher
Established
Code 99211 report Services provided in the office and for which The Physician may not be present during the service but is in the office and available the employee providing the service must have the credentials and necessary to provide the service and the service must be part of a document to treatment plan that position should sign the documentation of the service