mr. flintstone is seen by his oncologist just two days after undergoing extensive testing for a sudden onset…
mr. flintstone is seen by his oncologist just two days after undergoing extensive testing for a sudden onset of petechiae, night sweats, swollen glands and weakness. after a brief review of history, dr. b. marrow re - examines mr. flintstone. the exam is documented and the medical decision making is of moderate complexity and takes 11 minutes. the oncologist spends an additional 45 minutes discussing mr. flintstones new diagnosis of hodgkins lymphoma, treatment options and prognosis. what cpt® coding is reported?\no 99253\no 99215, 99417\no 99204, 99354\no 99215, 99354
Answer
Explanation:
Step1: Identify key - time and complexity
The oncologist spends 11 minutes on the exam and 45 minutes discussing treatment and prognosis for a moderate - complexity case.
Step2: Refer to CPT coding rules
For a new patient visit with a significant amount of time spent on counseling and coordination of care (more than 50% of the total encounter time), the code is selected based on the total time. Total time = 11+45 = 56 minutes. For a new patient office visit with moderate complexity and significant counseling/coordination of care, the appropriate CPT code is 99204 for 30 - 44 minutes of total face - to - face time and 99205 for 45 - 59 minutes of total face - to - face time. Here, the total time is 56 minutes, so the code is 99205.