choosing the correct CPT code for an office visit is based on the complexity of the visit. If you choose 99214, the medical documentation must provide
CPT CODE 99214 FAQs: 1. What determines the level of an E/M code under Medicare? The level is based on the medically necessary services for the patient’s condition, not the overall length of the visit. 2. How should the History of Present Illness (HPI) be documented? Document a detail...
Medical necessity of a service is the overarching criterion for payment in addition to the individual requirements of a CPT code. It would not be medically necessary or appropriate to bill a higher level of evaluation and management service when a lower level of service is warranted. The volume ...