Ophthalmic Coding Specialist Practice Test

Which CPT code corresponds to a new patient exam with a detailed history, detailed exam, and low complexity medical decision-making?

1. CPT code 99202

2. CPT code 99203

3. CPT code 99204

4. CPT code 99205

The correct answer is: CPT code 99203

The CPT code that aligns with a new patient exam characterized by a detailed history, a detailed examination, and low complexity medical decision-making is 99203. This particular code is specifically designated for outpatient visits that include these components. In the context of CPT coding, a new patient is defined as someone who has not received professional services from the physician or another physician of the same specialty within the past three years. The components of the exam include: - A detailed history, which encompasses the patient's present illness and other relevant medical history. - A detailed examination that provides thorough documentation of the physical assessment. - Low complexity medical decision-making, which indicates that the physician is dealing with straightforward problems that require minimal effort. In contrast to the other codes, 99202 describes a visit with a problem-focused or expanded problem-focused exam and straightforward decision-making, while 99204 and 99205 denote higher levels of complexity in medical decision-making and require more comprehensive components in the examination and history taken. The nuances in the levels of complexity determine the appropriate CPT code to reflect the services rendered accurately. Thus, 99203 is the correct choice for this scenario.