For which type of care would a consultation code like 99255 be appropriate?

For which type of care would a consultation code like 99255 be appropriate?

• A. Routine check-ups
• B. Complex patient evaluations
• C. Annual assessments
• D. Preventative care visits

Answer: (B)

Consultation code 99255 is specifically intended for complex patient evaluations. This code is used when a physician provides a detailed consultation, which usually involves a thorough assessment of a patient's medical history, a comprehensive examination, and the development of a detailed plan of care. The complexity of the evaluation necessitates a significant amount of time and expertise and typically involves multiple medical issues or a particularly challenging diagnosis. Complex patient evaluations may include situations where the patient's condition is complicated by comorbidities, requires input from multiple specialists, or needs significant decision-making and management. Utilizing this code ensures that the complexity and comprehensiveness of the care provided are appropriately captured for billing and clinical documentation purposes. In contrast, routine check-ups, annual assessments, or preventative care visits usually do not meet the criteria for this higher-level consultation code as they do not typically involve the same level of complexity or detailed evaluation.

Consultation code 99255 is specifically intended for complex patient evaluations. This code is used when a physician provides a detailed consultation, which usually involves a thorough assessment of a patient's medical history, a comprehensive examination, and the development of a detailed plan of care. The complexity of the evaluation necessitates a significant amount of time and expertise and typically involves multiple medical issues or a particularly challenging diagnosis.

Complex patient evaluations may include situations where the patient's condition is complicated by comorbidities, requires input from multiple specialists, or needs significant decision-making and management. Utilizing this code ensures that the complexity and comprehensiveness of the care provided are appropriately captured for billing and clinical documentation purposes. In contrast, routine check-ups, annual assessments, or preventative care visits usually do not meet the criteria for this higher-level consultation code as they do not typically involve the same level of complexity or detailed evaluation.