Question

A 10-year-old girl is scheduled for her yearly physical with her pediatrician. At the time of the visit, the patient complains of watery eyes, scratchy throat and stuffy nose for the past two days. The provider performs the physical. He also performs an expanded problem history and exam and treats the patient for a URI. What CPT® code(s) is/are reported for this visit?

Answer 1

CPT 99213, Under Established Patient Office or Other Outpatient Services. The Current Procedural Terminology (CPT) code 99213 as maintained by American Medical Association, is a medical procedural code under the range - Established Patient Office or Other Outpatient Services.99393, 99213-25
CPT 99393, Under Established Patient Preventive Medicine Services. The Current Procedural Terminology (CPT) code 99393 as maintained by American Medical Association, is a medical procedural code under the range - Established Patient Preventive Medicine Services.
Modifier 25 (significant, separately identifiable evaluation and management [E/M] service by the same physician on the same day of the procedure or other service) is the most important modifier for pediatricians in Current Procedural Terminology (CPT®).