Level 3 Visits 115 Level 3 Visits Level 3 Visits This article provides information and examples of the changes that will be implemented for office and other outpatient evaluation and manage- ment (E/M) codes on January 1, 2021. In this article, we review example scenarios that might be reported with codes at level 3 of the office E/M services (99203 and 99213) for dates of service on and after January 1, 2021. ★▲99203 Office or other outpatient visit for the evaluation and ­ management of a new patient, which requires a medically history and/or examination and low level of ­appropriate medical decision making. When using time for code selection, 30–44 minutes of total time is spent on the date of the encounter. ★▲99213 Office or other outpatient visit for the evaluation and manage- ment of an established patient, which requires a medically history and/or examination and low level of ­appropriate medical decision making. When using time for code selection, 20–29 minutes of total time is spent on the date of the encounter. As previously noted, for each level of office E/M service, the MDM is the same for new or established patients. For level 3 codes selected based on MDM, low-complexity MDM is required. The Table shows the elements of MDM that support low-complexity MDM. Two of 3 elements must be met or exceeded to support a level of MDM. When selecting a code based on the physician’s or QHP’s total time spent on care of the individual patient, on the date of the encounter, minimum required times are 30 minutes to report 99203 and 20 minutes to support 99213. Total time includes face-to-face and non–face-to-face time directed to the care of the individual patient on the date of a visit. Ped Office-based EM Coding booklet interior.indd 115 Ped Office-based EM Coding booklet interior.indd 115 9/14/20 12:02 PM 9/14/20 12:02 PM
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