Re-examination/re-evaluation (short re-eval) of an established patient corresponds to which CPT code?

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Multiple Choice

Re-examination/re-evaluation (short re-eval) of an established patient corresponds to which CPT code?

The concept being tested is how to code a brief re-evaluation for an established patient. When a patient who is already in care comes in for a quick reassessment due to a change in condition, the visit is typically brief with minimal new data gathering and straightforward decision making. In CPT terms, this scenario fits an established-patient visit at the lowest level of complexity, which is coded as 99212. This code signals a brief, problem-focused history and exam with straightforward medical decision making, appropriate for a short re-eval. Why this fits best: the patient is established (not new) and the visit is a short re-evaluation, focusing on whether the plan should change based on the new information. The higher established-patient levels (99213 and 99214) imply more extensive history, exam, or medical decision making, which isn’t indicated by a short re-eval. The new-patient code (99202) would be used only if the patient were new to the practice, not for a re-evaluation of an established patient.

The concept being tested is how to code a brief re-evaluation for an established patient. When a patient who is already in care comes in for a quick reassessment due to a change in condition, the visit is typically brief with minimal new data gathering and straightforward decision making. In CPT terms, this scenario fits an established-patient visit at the lowest level of complexity, which is coded as 99212. This code signals a brief, problem-focused history and exam with straightforward medical decision making, appropriate for a short re-eval.

Why this fits best: the patient is established (not new) and the visit is a short re-evaluation, focusing on whether the plan should change based on the new information. The higher established-patient levels (99213 and 99214) imply more extensive history, exam, or medical decision making, which isn’t indicated by a short re-eval. The new-patient code (99202) would be used only if the patient were new to the practice, not for a re-evaluation of an established patient.

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