NEW STANDARDIZED CPT CODES 2006
OFFICE - NEW PATIENT CPT CODES Evaluation & Management / Severity / Time
99201 LEVEL 1 Prob. Focus Hist. & Exam + Straight Forward Medical Decision making* / minor / 10 min
99202 LEVEL 2 Expanded Prob Focus Hist. & Exam + St. Forward Med Dec. making* / Lo-Mod. / 20 min
99203 LEVEL 3 Detailed Hist. & Exam Med. + Medical Decision making Low Complexity* / Mod. / 30 min
99204 LEVEL 4 Comprehensive Hist. & Exam + Med. Decision Moderate Complexity* / Mod-Hi / 45 min
99205 LEVEL 5 Comprehensive Hist. & Exam + Med. Decision making High Complexity* / Mod-Hi / 60 min
* All three key components
must be present.
OFFICE - ESTABLISHED PATIENT CPT CODES Evaluation & Management / Severity / Time
99211 LEVEL 1 Pt. Eval. Mgmt. (Physician presence may not be required.) / Minimal /5 min.
99212 LEVEL 2 Prob. Focus Hist. & Exam + Str. Forward Medical Decision** / Minor /10 min
99213 LEVEL 3 Expanded Prob. Focus Hist & Exam + Med. Dec. Low Complexity** / Lo-Mod / 15 min
99214 LEVEL 4 Detailed Hist. & Exam + Med. Decision Moderate Complexity** / Mod-H / 25 min
99215 LEVEL 5 Comprehensive Hist. & Exam + Med. Decision High Complexity** / Mod-Hi / 40 min
** Two of the three key
components must be present.
Modifiers for OFFICE VISIT Eval. and Mgmt Codes above: (Added to the end of the E/M codes)
--21 ADD. time for prolonged evaluation and patient management
--51 Multiple Services or procedures by same provider/same session
--52 REDUCED Services modifier
See modifiers --25. --32 and --59, --76, --77, --99 for relevancy + Other modifier codes in the AMA CPT Book
Required supervision by MD or DC in some states, unless Lic.Ac. primary care status.
97010 Hot or Cold Packs (supervised)
97014 Elect. Stim. (unattended) For acupuncture with electrical stimulation, see 97813, 97814.
97024 Diathermy (supervised)
97026 Infrared (supervised)
97028 Ultraviolet (supervised)
97032 Elect. Stim. Manual (constantly attended procedure) Each 15 min.
97035 Ultrasound each 15 min. (Constant attendance)
97039 Unlisted modality specify type and time _____________ if constant attendance, ie. moxa
97124 Massage Procedure (incl. stroking, compression, percussion)
97139 Unlisted Procedure, specify type and time _____________
97140 Manual Therapy techniques (eg myofascial release, mobilization, manipulation, manual lymphatic drainage, manual traction one or more regions each 15 min.
97530 Therapeutic activities, direct (one on one) pt. contact by provider. Use of dynamic activities to improve functional performance, each 15 min.
97532 Development of Cognitive skills to improve attention, memory, problem solving (including compensatory training) 1:1 contact.
97533 Sensory integrative techniques to enhance sensory processing & promote adaptive responses to environmental demands.
97780 Acupuncture code is deleted as of January 1, 2005. See 97810, 97811.
97781 Acupuncture code is deleted as of January 1, 2005. See 97813, 97814.
97802 Medical nutrition therapy. Initial assessment & Intervention with individual. 1:1 contact @ 15 minutes
97803 Medical nutrition therapy, Reassessment & intervention with individual, 1:1 contact @ 15 minutes.
97810 Acupuncture one or more needles without electrical stimulation with 1:1 contact. Initial 15 minutes.
97811 Acupuncture one or more needles without electrical stimulation with 1:1 contact. @ additional 15 minutes
97813 Acupuncture one or more needles with electrical stimulation, Initial 15 minutes of 1:1 contact.
97814 Acupuncture, reinsertion
of one or + needles with electrical stim. @ additional 15 minutes of
97799 Unlisted physical medicine/rehabilitaiton service or procedure
--22 ADD time for unusual procedural service
--51 Multiple Proced. other than E/M codes same session & provider: First procedure list as is. Other add'l codes, add --51 to those.
--52 REDUCED Services or cancellation of procedure modifier (add to existing Procedure CPT code)
64550 TNS surface (transcutaneous) neurostimulator.
99070 Supplies and materials over & above those usually included with office visit.
99070 Supplements (list) Herbs and Nutrition, other
99070 Orthopedic support/ pillows _________
99080 Special Report such as insurance forms, more than the info conveyed in the usual medical communications or stardard reporting form. (Do not use in conjunction with 99455, 99456 for completion of Work. Comp. forms)
99199 Unlisted special
services, procedure or report.
CONSULTATION--OFFICE OR OTHER OUTPATIENT FACILITY CPT
New or Established Patient --Evaluation & Managment / Severity / Time
99241 Level 1 Prob. Focus Hist.& Exam + Straight Forward Med. Decision making / Minor/ 15min
99242 Level 2 Expanded Prob Focus Hist & Exam + Str. Forward Decision making / Low / 30 min
99243 Level 3 Detailed Hist. & Exam + Medical Decision making Low Complexity / Mod./ 40 min
99244 Level 4 Comprehensive Hist. & Exam + Med. Dec. Moderate Complexity / Mod-Hi / 60 min
99245 Level 5 Comprehensive Hist. & Exam + Med. Dec. making High Complexity / Mod-Hi / 80 min
Follow-up visits in consultant's office or other outpatient facility that are initiated by the physician consultant are reported using office visit codes for established patients (5 levels respectively 99211-99215)
99341-99345 New Patients Levels (See CPT code book.)
99347-99350 Established Patients (See CPT code book.)
99600 Unlisted Home visit, service, or procedure (physician or non physician health care professional.
OTHER SPECIAL CPT SERVICES CODES
99050 Services requested after office hours in addition to basic service
99052 Services requested between 10 PM and 8 AM in addition to basic service
99054 Services requested on Sundays and holidays in addition to basic service
99056 Services provided at request of patient in a location other than physician's office which are normally provided in the office
99058 Office services provided on a emergency basis
99070 Supplies and materials
99071 Educational supplies, such as books, tapes and pamphlets, provided by the physician for the patient's education at cost to the physician
99075 Medical Testimony
99078 Physician educational services rendered to patients in a group setting (e.g. health care class, obesity or drug rehabilitative instruction)
99080 Special reports such as insurance forms, or the review of medical data to clarify a patient's status --more than the information conveyed in the usual medical communication standard reporting form
99082 Unusual Travel (e.g. transportation and escort of patient)
99090 Analysis of information data stored in computers (e.g. tests, ECGs, blood pressures, etc.). Do not report 99090 if other more specific CPT codes exist, ie. 97750 for muscular skeletal function testing.
99091 Collection & Interpretation of physiologic data digitally stored and/or transmitted by patient or caregiver to physician or qualified health care professional requiring minimum of 30 minutes of time. Don't report this code as separate item when patient presents on same day as the E/M code used. Services described by 99091 would be considered part of the E/M visit in that case.
99199 Unlisted special service, proedcure or report
98925 OMT 1-2 body regions involved
98926 OMT three to four body regions involved
98927 OMT five to six body regions involved
98928 OMT seven to eight body regions involved
98929 OMT nine to ten body regions involved
98940 CMT spinal, 1-2 regions
98941 CMT spinal, 3-4 regions
98942 CMT spinal, 5 regions
98943 CMT extraspinal, one or more regions
95831 Muscle testing, manual (separate procedure) with report; extremity (excluding hand) or trunk
95832 Muscle testing, hand, with or without comparison with
95833 Muscle testing, total evaluation of body, excluding hands
95834 Muscle testing, total evaluation of body, including hands
95851 Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section (spine)
95852 ROM etc. hand with or without comparison with normal side
95857 Tensilon test for myasthenia gravis
95858 Tensilon test for myasthenia gravis w/ electromyographic recording
See CPT book from AMA for other related codes
17001, 17002 have been deleted. To report see 17003, 17004. Do not report 17004 in conjunction with codes 17000-17003. 17010 has been deleted. To report see specific anatomical site code. 17100-17105 have been deleted. To report see 17000, 17003, 17004. See 17106-17250 for additional related codes.
____ STATE AID CODES Check with your state regulatory board for codes or changes
____ WORK COMP. RVS CODES Check with your state regulatory board for codes or changes
TREATMENT RVS CODES (check with your state)
*CMT Codes include pre-manipulation patient assessment.
*Acupuncture, Chiropractic and osteopathy: Use --25 above with the E/M service codes beyond normal E/M service when warranted
This is a Free supplement from
From Tao to Earth
See website: http://taotoearthpmpubs.com
Original Design by Claire Flint / Webmaster