Question

This established 10yo patient presents with a sore throat, a fever of 101.4, swollen glands of the neck and a red blotchy rash over her neck, face, chest and back. She has significant nausea and has vomited three times since this morning and is complaining of severe pain when swallowing. A medically appropriate history and physical exam are documented with medical decision making of moderate complexity. The physician ordered a rapid strep test which was performed in the office by the nurse on staff. Because of the significant nausea and questionable antibiotic compliance in the past, the physician administers 1.2 million units of Bicillin LA (Long acting Penicillin G Benzathine) via deep intramuscular injection. The patient will be seen again in five days. The patient was diagnosed with Strep throat. Code for the appropriate CPT and HCPCS codes only.'

Answer 1

The CPT codes are 99214, 87880, 96372 and HCPCS code is J0561 X 12.

What are Evolution and Management codes for office visits?

• Depending on the patient category, there are two sets of E/M codes used for office or other outpatient services.
• The E/M codes for brand-new patients fall between 99201 and 99205.
• The E/M codes for established patients vary from 99211 to 99215.
• Three factors that determine how the codes within each range differ from one another.
• The depth of the history gathered, the depth of the physical examination conducted, and the complexity of the medical decision making are the factors.
• Three different sorts of codes must be reported for office visits:

• CPT codes (including the E/M codes) for the procedures carried out,
• ICD-10 codes for diagnoses,
• and medical supplies utilized during the visit are coded with HCPCS.

What are the CPT codes?

99214 - Evaluation and care of an established patient during an office or other outpatient visit that calls for at least two of the following three essential elements:

• A thorough history;

• A thorough investigation;

• Moderately complicated medical decision-making.

87880 - Streptococcus, group A; immunoassay for the identification of infectious agent antigens with direct optical observation (This is the code for the rapid strep test)

96372 - Subcutaneous or intramuscular injection of a chemical or medication for therapeutic, preventative, or diagnostic purposes

What are the HCPCS code?

J0561 X 12 - Penicillin G benzathine injection, 100,000 units, J0561 (This is the code for the Bicillin L-A administered).

Learn more  E/M codes here:

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