Family medicine falls under the primary care medical profession category in the healthcare industry, which focuses solely on diagnosing and treating individuals, from infants to older adults. It is a branch of medicine that offers complete healthcare to people, families, and communities. It is distinguished by a long-term doctor-patient connection that ensures continuity of care.
It is a specialization in healthcare that focuses on offering comprehensive medical treatment to communities, families, and individuals. It’s defined as a doctor-patient trust relationship that preserves care. Family physicians address hypertension, diabetes, asthma, mental health issues, lifestyle changes, cancer screenings, immunizations, and many more.
Family practitioners get paid for their services through medical billing and coding, which requires a good understanding of CPT codes. Some of the most typical CPT codes in family medicine are listed below.
Family Medicine Common CPT Codes
- 99381-99387 and 99391-99397:
These codes charge patients from infancy through maturity for routine, comprehensive preventive medical examinations and management services. The codes differ depending on the patient’s age, with 99381-99387 billing for patients between 0 and 17 and 99391-99397 charging for patients 18 and over.
- 99215:
This code denotes the office-based evaluation and management services rendered by family doctors. The complexity of the patient’s examination and management is considered while assigning this code.
- 90791-90792:
These codes describe a psychiatric diagnostic examination, which is frequently used to identify and treat mental health conditions.
- 81002-81003:
These codes explain urinalysis, a test used to identify and track a number of medical disorders. These examinations assess various parameters, including protein, blood, glucose, and bacteria in the urine.
- 85025:
This code refers to a CBC test that detects cancer, infection, and anemia. The test requires a complete blood count, including all cell types (platelets, white blood cells, and red blood cells).
- 90471:
This code describes administering vaccinations or immunizations to prevent certain illnesses. These vaccines include chickenpox, hepatitis B, and the seasonal flu.
- 93000:
This code defines an electrocardiogram (ECG), which analyzes the heart’s electrical rhythm in detail. Heart rhythm problems and other illnesses connected to the heart are diagnosed and monitored using ECGs.
- 96372:
This code indicates the injection-based delivery of medication. Antibiotics, vaccinations, and other medicine may fall under this category.
- 99211:
A level one evaluation and management service rendered by a nurse or a healthcare professional is described by this code. Examples include gathering medical history, collecting vital signs, and talking with the patient about their problems.
- 36415:
This code describes a typical venipuncture, the procedure of drawing blood from a patient for analysis.
- 99204:
This code outlines a thorough evaluation and management service offered to new patients and those recently developed medical conditions or injuries that call for a comprehensive physical.
- 99212:
This code designates a level two evaluation and management service offered in an office setting. The service is often performed during follow-up visits and usually entails a quick examination and consultation.
- 93010:
This code designates an electrocardiogram (ECG) with at least 12 leads that capture activity in the heart’s chambers, valves, and walls from various perspectives.
- 99000:
This code denotes a patient-provided service that usually takes place in a laboratory, handling and procuring medical specimens.
- 81003, 81005, 81007, 81015, 81020, 81025:
These codes describe a microscopic urinalysis test that examines the urine’s characteristics and counts its cells.
- 99213:
This code describes existing patients who seek a simple consultation or assessment that may involve quick diagnostic procedures.
- 99358:
This code denotes extended evaluation and management services given to patients whose examination or treatment necessitates more time beyond the relative value units (RVUs) of the service generally offered and paid under the E/M codes.
- 99395-99396:
Using the codes 99395 and 99396 helps ensure patients receive the essential screenings and preventative care, identifying any health issues early and fostering general well-being.
These codes enable healthcare practitioners to be paid for their time and experience in providing preventative healthcare services, and they are frequently used during routine check-ups or wellness visits.
- 90460-90461:
These codes define the services that medical professionals give in administering vaccinations. These codes are frequently used when a doctor or licensed healthcare provider gives a patient a vaccine. The codes are unique depending on the patient’s age and how many vaccinations were given.
- 90785:
This code explicitly relates to the add-on code for “Interactive Complexity.” By using this code, healthcare professionals can record and bill for the extra effort required to handle complex interactions throughout a session.
This code ensures that healthcare practitioners are fairly rewarded for the extra time and knowledge needed to address these interactive challenges and offer excellent treatment to their patients.
- 99421-99423:
These codes are used to document and charge for medical services provided to established patients through remote means. Secure internet communication tools like email, videoconferencing, and secure messaging enable healthcare professionals to assess and monitor patients’ care.
These codes are established based on the provider’s total time on the encounter.
Conclusion:
Family physicians rely heavily on CPT codes to provide their patients with accurate billing and reimbursement. It is essential to comprehend the codes to ensure accurate invoicing and proper recording of patient services. To minimize billing problems and regulatory violations, healthcare providers must stay updated on code changes. To optimize patient care, practitioners must refresh their CPT code expertise as healthcare operations advance.