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New or Established Patient CPT® Code range 99242- 99245

The Current Procedural Terminology (CPT) code range for Office or Other Outpatient Consultations 99242-99245 is a medical code set maintained by the American Medical Association.

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CPT® Code Range 99242- 99245
Section 99242-99245
New or Established Patient
99242
99243
99244
99245
On a CPT® code's hierarchy page, you get to see a medical code's neighbors, including the CPT® codes' official long descriptors. Seeing related codes helps coders choose the correct code, improving their accuracy rate.
Click on a blue code to see a sample of a CPT® code's details page.
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CPT® 2024 Brings More E/M Changes
September 22, 2023
Code descriptor revisions are about time. After the extensive changes CPT made to the evaluation and management EM codes and guidelines over the last few years youll be relieved to know that the EM ch... [ Read More ]
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Lincare Holdings to Pay $29 Million for Medicare Overbilling
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Check Out These HCPCS Level II Code Changes in Effect Oct. 1
September 06, 2023
New codes may help providers get paid for emerging services and supplies. The Centers for Medicare 38 Medicaid Services CMS has posted the HCPCS Level II code set update for fourth quarter 2023 on its... [ Read More ]
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E/M Consultation - CPC exam prep question - help
[QUOTE="carrie.townsend@modahealth.com, post: 504265, member: 732844"] I am sitting for my CPC exam on Saturday. There is a question in the Study Guide that has me stumped (and my two CPC colleagues ... [ Read More ]
E/M Consultation - CPC exam prep question - help 99242 99244 consultation e/m
I am sitting for my CPC exam on Saturday. There is a question in the Study Guide that has me stumped (and my two CPC colleagues too). A 55-year-old patient is seen in an office visit by an otolaryng... [ Read More ]
E/M Changes in 2021
It appears that the E/M guidelines for outpatient consult codes (99242-99245) are remaining the same. Do others agree, or does anyone know something else about this?... [ Read More ]
Outpatient consultations
Hello and welcome to the forum REGINALD068! Per AMA CPT book, Consultations follow similar E/M guidelines as New Patients when it comes to History, Exam and Medical Decision Making components. In fac... [ Read More ]
Coding CONSULT when pt is a Preop clearance??? consults preop exam
Hi y'all, I am getting mixed answers to a question. If an ESTABLISHED patient comes into their family Dr and has to have a PREOP CLEARANCE is it ok to bill a consult code (99242--99245)??? I was alway... [ Read More ]
Crosswalking E&M Codes
Hello Fellow Coders I need some assistance with cross walking CPT codes. It was suggested that these codes below are ok to crosswalk one for one. However, I am not an expert in E&M coding. It was m... [ Read More ]
Emergency Department consults with Medicare as prime
Hi Leigh, Medicare no longer recognizes CPT 99242-99245 as of 2010. Can you give us the scenario?... [ Read More ]
Reimbursement for consult codes vs medicare new office/hospital eval codes
For the experienced billers, can you let me know what the difference in prices are for the new office consult codes 99241-99245 vs new office visit 99201-99205 along initial hospital care 99221-99223 ... [ Read More ]
Looking for Consult Rules
[b]Consults[/b] Karen, I hope the following helps. You are right about the physician cannot treat the patient in any way, including medications. Otherwise, it is no longer a consult. However, they... [ Read More ]
observation care
Hello, rmukkadan If the patient is in Observation Care, and was admitted by an Internal Medicine provider, the Gastroenterologist would need to bill the service under the office or other outpatient ... [ Read More ]
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