Columbia University Medical Center - Billing Compliance Program
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Documentation Guidelines for CPT Evaluation and Management Services                         

Categories of Evaluation and Management Codes

OFFICE/OUTPATIENT
  • New pt. 99201 - 99205; 3 of 3 key elements
  • Est. pt. 99211 - 99215; 2 of 3 key elements
  • Consults 99241 - 99245; 3 of 3 key elements
INPATIENT
  • Initial in-pt. 99221 - 99223; 3 of 3 key elements
  • Subs. in-pt. 99231 - 99233; 2 of 3 key elements
  • Consults 99251 - 99255; 3 of 3 key elements
  • F/U consults 99261 - 99263; 2 of 3 key elements
Medicare Evaluation & Management Coding Teaching Regulations apply to:
  • Office consultations (99241-45)
  • Initial office visits (99201-05)
  • Hospital Consultations (99251-55)
  • Initial in-pt visits (99221-23)
  • Emergency room visits (99281-85)

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