A physician who is part of a medical group practice saw a patient today who had not been treated by the practice for 7 years. The patient presented with a persistent cough and some congestion. The physician performed a comprehensive history and detailed exam. The patient is diabetic, which is controlled with diet and medication. The physician ordered lab work and a CXR. The physician prescribed medication for the cough and congestion and gave the patient a new prescription for his diabetic medication. The patient was asked to return in 1 week. Choose the appropriate evaluation and management code for today's encounter:

Question

Quizplus · Accepted Answer

The correct choice is 99203, which is for a new patient office or other outpatient visit that requires a detailed history and examination, and the decision making of low complexity. Since the patient had not been treated by the practice for 7 years, they are considered a new patient according to most guidelines, which typically define a new patient as someone who has not received any professional services from the physician or another physician of the same specialty and in the same group practice within the past three years.

A Physician Who Is Part of a Medical Group Practice