This alphanumeric designation represents the Current Procedural Terminology (CPT) code used to identify a specific level of evaluation and management service provided to an established patient. It signifies a comprehensive encounter that demands a high level of complexity in medical decision making. Such encounters typically involve managing patients with multiple or significant conditions necessitating extensive data review and analysis. As an example, this could be used when a physician manages a patient with poorly controlled diabetes, hypertension, and early-stage heart failure during a single visit, requiring significant coordination of care and adjustment of multiple medications.
Its appropriate application ensures accurate billing and reimbursement for complex medical services rendered. This supports healthcare providers in offering thorough patient care, particularly for individuals with intricate health needs. Historically, the establishment of standardized coding systems such as CPT has streamlined communication and data collection within the healthcare industry, promoting efficient administration and quality improvement initiatives. Correct usage also helps prevent claim denials and potential audits, protecting the practice from unnecessary financial burdens.
