Primary care is a patient’s first healthcare encounter. The purpose is to teach optimal health skills. Primary care physicians understand their patients’ physical, psychological, and social issues. Some of the essential primary care-related CPT codes are highlighted with their definitions.
List of the CPT codes for Primary care
99202-99205: E/M codes are used for new patient office visits to describe evaluation and management
In an outpatient context, these codes document new patients’ evaluation and management services. A specific code is chosen depending on how complex the patient’s condition is and how much medical judgment is required.
99211-99215: Codes for evaluation and management (E/M) are used for routine patient office visits
These codes are employed for returning patients in a manner akin to those of initial patient visits. The particular code selected depends on the complexity of the patient’s condition and the degree of clinical judgment required.
99381-99397: Medical Services for Prevention
These codes are utilized for various preventative medicine treatments, such as regular check-ups, screenings, counseling, and risk assessment. The patient’s age determines the particular code selected, the complexity of the visit, and the services rendered.
90791-90792: Psychological Diagnostic Assessment
These codes are utilized when reporting a thorough evaluation and diagnosis of a patient’s mental health state. It entails conducting a detailed interview, assessing the symptoms, and creating a treatment plan.
99401-99404: Counseling for prevention and risk factor reduction
These codes document patient counseling and interventions that support preventive healthcare, address risk factors, and encourage healthy behavior.
93000-93010: Electrogram (EKG/ECG)
Electrocardiogram (ECG) testing, which gauges the heart’s electrical activity, is reported using these codes.
36416: Capillary Blood Drawing
In this process, the doctor uses a pointed device to prick the patient’s finger, heel, or ear, then presses the pricking site to collect a sample of blood droplets.
90471-90474: Administration codes for vaccinations
The administration of vaccinations to patients is reported using these codes. The selected code is based on variables like the delivery method and the total number of vaccinations administered.
81002-81003: Urinalysis
These codes document the results of tests done on urine samples to determine their contents, including glucose, pH, protein, etc.
93010: Cardiovascular procedures
An ordinary 12-lead (or more) ECG is interpreted, and the doctor reports the results.
96372: Chemical or drug injection subcutaneously or intramuscularly for therapeutic, preventive, or diagnostic purposes
The patient is injected with fluid, medication, or another therapeutic, preventative, or diagnostic agent. The physician, doctor’s assistant, or nurse performs the procedure. This code excludes the injection of toxoids or vaccination.
96361: Hydration by intravenous infusion; every additional hour
To treat more severe dehydration, the doctor continues to infuse intravenous, or IV, fluids with electrolytes through a pre-existing intravenous line every hour.
99281-99285: Emergency Room Services
From simple illnesses or injuries to urgent or life-threatening circumstances, these codes report services offered in the emergency room. The diagnosis code is determined by the intricacy and seriousness of the patient’s ailment.
90707-90749: Toxins, vaccines, and immunological globulins
These codes document the usage of particular vaccines, toxins, or immune globulins.
93015: Report and interpretation of a cardiovascular stress test
A cardiovascular stress test, such as a treadmill test or stress echocardiography, is reported using this code, along with its interpretation and report production.
94640: Nebulizer therapy
When using nebulizer equipment to administer medication for the treatment of respiratory diseases, this code is used to document the event.
99358-99359: Extended evaluation and management services, each lasting an additional 30 minutes beyond the usual period
These codes are used to document any extra-long-duration services that were rendered after the scheduled time for an evaluation and management visit.
10160: Abscess drainage and incision
This code documents the incision and drainage process for a localized infection or abscess.
96374: Injection for treatment, prevention, or diagnosis (name the substance or drug); intravenous push, single or initial substance/drug
This code is used to record the push intravenous medicine administration.
Primary Care’s Advantages and Drawbacks
When properly implemented, primary care is tremendously advantageous for patients’ health and less expensive for the public health care system. The decrease in hospitalizations and the requirement for secondary and tertiary healthcare services are two contributing factors.
Additional advantages of receiving primary medical care include:
- Higher availability of medical services
- Higher standard of medical care
- An emphasis on health prevention
- Early prevention of health disorders
- Better relationships with patients
- Less need for specialized treatment
- Several related vocations provide an economic advantage
But several obstacles prevent primary care from providing its benefits. The demand for new practitioners is expanding at a higher rate than the supply, which presents a serious concern due to the scarcity of primary care doctors. Furthermore, the standard of treatment varies among doctors, geographical areas, and nations. Typically, only half of primary care facilities offer after-hours service.
Conclusion
Improving patient results and offering cost-effective treatment rely on accurate documentation and coding for services delivered in primary care settings. To provide high-quality care and increase revenue, healthcare professionals must stay current on changes to CPT codes and recommendations.