The alphanumeric designation “99243” represents a specific medical billing code within the Current Procedural Terminology (CPT) system. This code describes an evaluation and management (E/M) service provided to a patient by a physician or other qualified healthcare professional in a consultation setting. Specifically, it denotes a level three outpatient consultation, generally involving a comprehensive history, examination, and moderate complexity medical decision making. An example scenario would be a specialist assessing a patient with a complex medical condition referred by their primary care physician for expert opinion.
Accurate application of this coding system is vital for appropriate reimbursement from payers and for maintaining standardized communication regarding medical services. Precise use of codes like this ensures healthcare providers are compensated fairly for the cognitive effort and resources expended during patient care. Furthermore, it facilitates tracking of healthcare trends and allows for meaningful data analysis in the realm of population health management. Historically, these codes have evolved to reflect changes in medical practice and technological advancements within the healthcare industry.
