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ANNUAL GYN EXAMS AND ANNUAL PAP SMEARS BLUE CROSS / BLUE SHIELD MEDICARE & HAP MEDICAID & COMMERCIAL Billing Code Diagnosis Code Billing Code Diagnosis Code Billing Code Diagnosis Code Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Screen GYN Exam 010053 Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Preventive Medicine Age Appropriate CPT E/M Code New 99384 99387 or Established 99394 99397 V72.31 GYN Annual Exam No separate charges for GYN Exam or PAP Smear Complete Head to Toe Annual Exam and Annual PAP Smear Complete Head to Toe Annual Exam and Annual PAP Smear Complete Head to Toe Annual Exam and Annual PAP Smear Preventive Medicine Age Appropriate CPT E/M Code New 9938499387 or Established 99394 99397 V70.0 Routine Exam Preventive Medicine Age Appropriate CPT E/M Code New 99384 99387 or Established 99395 99397 V70.0 Routine Exam Preventive Medicine Age Appropriate CPT E/M Code New 99384 99387 or Established 99394 99397 V70.0 Routine Exam Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen No separate charges for GYN Exam or PAP Smear Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 OR CPT E/M Office Visit Code New 99202 99205 OR Established 99212 99215 Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen CPT E/M Office Visit Code New 99202 99205 OR Established 99212 99215 Appropriate diagnosis to specific chronic illness or problem Appropriate diagnosis to specific chronic illness or problem CPT E/M Office Visit Code New 99202 99205+ SE OR Established 99212 99215 + SE Appropriate diagnosis to specific chronic illness or problem No separate charges for GYN Exam or PAP Smear ANNUAL GYN EXAMS AND ANNUAL PAP SMEARS BLUE CROSS / BLUE SHIELD MEDICARE & HAP MEDICAID & COMMERCIAL Billing Code Diagnosis Code Billing Code Diagnosis Code Billing Code Diagnosis Code Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Screen GYN Exam 010053 Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Preventive Medicine Age Appropriate CPT E/M Code New 99384 99387 or Established 99394 99397 V72.31 GYN Annual Exam No separate charges for GYN Exam or PAP Smear Complete Head to Toe Annual Exam and Annual PAP Smear Complete Head to Toe Annual Exam and Annual PAP Smear Complete Head to Toe Annual Exam and Annual PAP Smear Preventive Medicine Age Appropriate CPT E/M Code New 9938499387 or Established 99394 99397 V70.0 Routine Exam Preventive Medicine Age Appropriate CPT E/M Code New 99384 99387 or Established 99395 99397 V70.0 Routine Exam Preventive Medicine Age Appropriate CPT E/M Code New 99384 99387 or Established 99394 99397 V70.0 Routine Exam Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen No separate charges for GYN Exam or PAP Smear Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 OR CPT E/M Office Visit Code New 99202 99205 OR Established 99212 99215 Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen CPT E/M Office Visit Code New 99202 99205 OR Established 99212 99215 Appropriate diagnosis to specific chronic illness or problem Appropriate diagnosis to specific chronic illness or problem CPT E/M Office Visit Code New 99202 99205+ SE OR Established 99212 99215 + SE Appropriate diagnosis to specific chronic illness or problem No separate charges for GYN Exam or PAP Smear ANNUAL GYN EXAMS AND ANNUAL PAP SMEARS BLUE CROSS / BLUE SHIELD MEDICARE & HAP MEDICAID & COMMERCIAL Billing Code Diagnosis Code Billing Code Diagnosis Code Billing Code Diagnosis Code Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Screen GYN Exam 010053 Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Preventive Medicine Age Appropriate CPT E/M Code New 99384 99387 or Established 99394 99397 V72.31 GYN Annual Exam No separate charges for GYN Exam or PAP Smear Complete Head to Toe Annual Exam and Annual PAP Smear Complete Head to Toe Annual Exam and Annual PAP Smear Complete Head to Toe Annual Exam and Annual PAP Smear Preventive Medicine Age Appropriate CPT E/M Code New 9938499387 or Established 99394 99397 V70.0 Routine Exam Preventive Medicine Age Appropriate CPT E/M Code New 99384 99387 or Established 99395 99397 V70.0 Routine Exam Preventive Medicine Age Appropriate CPT E/M Code New 99384 99387 or Established 99394 99397 V70.0 Routine Exam Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen No separate charges for GYN Exam or PAP Smear Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 OR CPT E/M Office Visit Code New 99202 99205 OR Established 99212 99215 Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen CPT E/M Office Visit Code New 99202 99205 OR Established 99212 99215 Appropriate diagnosis to specific chronic illness or problem Appropriate diagnosis to specific chronic illness or problem CPT E/M Office Visit Code New 99202 99205+ SE OR Established 99212 99215 + SE Appropriate diagnosis to specific chronic illness or problem No separate charges for GYN Exam or PAP Smear ANNUAL GYN EXAMS AND ANNUAL PAP SMEARS BLUE CROSS / BLUE SHIELD MEDICARE & HAP MEDICAID & COMMERCIAL Billing Code Diagnosis Code Billing Code Diagnosis Code Billing Code Diagnosis Code Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Screen GYN Exam 010053 Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Preventive Medicine Age Appropriate CPT E/M Code New 99384 99387 or Established 99394 99397 V72.31 GYN Annual Exam No separate charges for GYN Exam or PAP Smear Complete Head to Toe Annual Exam and Annual PAP Smear Complete Head to Toe Annual Exam and Annual PAP Smear Complete Head to Toe Annual Exam and Annual PAP Smear Preventive Medicine Age Appropriate CPT E/M Code New 9938499387 or Established 99394 99397 V70.0 Routine Exam Preventive Medicine Age Appropriate CPT E/M Code New 99384 99387 or Established 99395 99397 V70.0 Routine Exam Preventive Medicine Age Appropriate CPT E/M Code New 99384 99387 or Established 99394 99397 V70.0 Routine Exam Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen No separate charges for GYN Exam or PAP Smear Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 OR CPT E/M Office Visit Code New 99202 99205 OR Established 99212 99215 Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen CPT E/M Office Visit Code New 99202 99205 OR Established 99212 99215 Appropriate diagnosis to specific chronic illness or problem Appropriate diagnosis to specific chronic illness or problem CPT E/M Office Visit Code New 99202 99205+ SE OR Established 99212 99215 + SE Appropriate diagnosis to specific chronic illness or problem No separate charges for GYN Exam or PAP Smear

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ANNUAL GYN EXAMS AND ANNUAL PAP SMEARS BLUE CROSS / BLUE SHIELD MEDICARE & HAP MEDICAID & COMMERCIAL

Billing Code Diagnosis Code Billing Code Diagnosis Code Billing Code Diagnosis Code Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Screen GYN Exam 010053 Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Preventive Medicine Age Appropriate CPT E/M Code New 99384 – 99387 or Established 99394 – 99397

V72.31 GYN Annual Exam

No separate charges for GYN Exam or PAP Smear

Complete Head to Toe Annual Exam and Annual PAP Smear

Complete Head to Toe Annual Exam and Annual PAP Smear

Complete Head to Toe Annual Exam and Annual PAP Smear

Preventive Medicine Age Appropriate CPT E/M Code New 99384– 99387 or Established 99394 – 99397

V70.0 Routine Exam

Preventive Medicine Age Appropriate CPT E/M Code New 99384 – 99387 or Established 99395 – 99397

V70.0 Routine Exam

Preventive Medicine Age Appropriate CPT E/M Code New 99384 – 99387 or Established 99394 – 99397

V70.0 Routine Exam

Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

No separate charges for GYN Exam or PAP Smear

Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem

Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem

Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem

Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 OR CPT E/M Office Visit Code New 99202 – 99205 OR Established 99212 – 99215 Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

CPT E/M Office Visit Code New 99202 – 99205 OR Established 99212 – 99215

Appropriate diagnosis to specific chronic illness or problem

Appropriate diagnosis to specific chronic illness or problem

CPT E/M Office Visit Code New 99202 – 99205+ SE OR Established 99212 – 99215 + SE

Appropriate diagnosis to specific chronic illness or problem

No separate charges for GYN Exam or PAP Smear

ANNUAL GYN EXAMS AND ANNUAL PAP SMEARS BLUE CROSS / BLUE SHIELD MEDICARE & HAP MEDICAID & COMMERCIAL

Billing Code Diagnosis Code Billing Code Diagnosis Code Billing Code Diagnosis Code Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Screen GYN Exam 010053 Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Preventive Medicine Age Appropriate CPT E/M Code New 99384 – 99387 or Established 99394 – 99397

V72.31 GYN Annual Exam

No separate charges for GYN Exam or PAP Smear

Complete Head to Toe Annual Exam and Annual PAP Smear

Complete Head to Toe Annual Exam and Annual PAP Smear

Complete Head to Toe Annual Exam and Annual PAP Smear

Preventive Medicine Age Appropriate CPT E/M Code New 99384– 99387 or Established 99394 – 99397

V70.0 Routine Exam

Preventive Medicine Age Appropriate CPT E/M Code New 99384 – 99387 or Established 99395 – 99397

V70.0 Routine Exam

Preventive Medicine Age Appropriate CPT E/M Code New 99384 – 99387 or Established 99394 – 99397

V70.0 Routine Exam

Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

No separate charges for GYN Exam or PAP Smear

Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem

Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem

Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem

Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 OR CPT E/M Office Visit Code New 99202 – 99205 OR Established 99212 – 99215 Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

CPT E/M Office Visit Code New 99202 – 99205 OR Established 99212 – 99215

Appropriate diagnosis to specific chronic illness or problem

Appropriate diagnosis to specific chronic illness or problem

CPT E/M Office Visit Code New 99202 – 99205+ SE OR Established 99212 – 99215 + SE

Appropriate diagnosis to specific chronic illness or problem

No separate charges for GYN Exam or PAP Smear

ANNUAL GYN EXAMS AND ANNUAL PAP SMEARS BLUE CROSS / BLUE SHIELD MEDICARE & HAP MEDICAID & COMMERCIAL

Billing Code Diagnosis Code Billing Code Diagnosis Code Billing Code Diagnosis Code Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Screen GYN Exam 010053 Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Preventive Medicine Age Appropriate CPT E/M Code New 99384 – 99387 or Established 99394 – 99397

V72.31 GYN Annual Exam

No separate charges for GYN Exam or PAP Smear

Complete Head to Toe Annual Exam and Annual PAP Smear

Complete Head to Toe Annual Exam and Annual PAP Smear

Complete Head to Toe Annual Exam and Annual PAP Smear

Preventive Medicine Age Appropriate CPT E/M Code New 99384– 99387 or Established 99394 – 99397

V70.0 Routine Exam

Preventive Medicine Age Appropriate CPT E/M Code New 99384 – 99387 or Established 99395 – 99397

V70.0 Routine Exam

Preventive Medicine Age Appropriate CPT E/M Code New 99384 – 99387 or Established 99394 – 99397

V70.0 Routine Exam

Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

No separate charges for GYN Exam or PAP Smear

Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem

Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem

Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem

Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 OR CPT E/M Office Visit Code New 99202 – 99205 OR Established 99212 – 99215 Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

CPT E/M Office Visit Code New 99202 – 99205 OR Established 99212 – 99215

Appropriate diagnosis to specific chronic illness or problem

Appropriate diagnosis to specific chronic illness or problem

CPT E/M Office Visit Code New 99202 – 99205+ SE OR Established 99212 – 99215 + SE

Appropriate diagnosis to specific chronic illness or problem

No separate charges for GYN Exam or PAP Smear

ANNUAL GYN EXAMS AND ANNUAL PAP SMEARS BLUE CROSS / BLUE SHIELD MEDICARE & HAP MEDICAID & COMMERCIAL

Billing Code Diagnosis Code Billing Code Diagnosis Code Billing Code Diagnosis Code Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Annual GYN Exam and PAP Smear ONLY Screen GYN Exam 010053 Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Preventive Medicine Age Appropriate CPT E/M Code New 99384 – 99387 or Established 99394 – 99397

V72.31 GYN Annual Exam

No separate charges for GYN Exam or PAP Smear

Complete Head to Toe Annual Exam and Annual PAP Smear

Complete Head to Toe Annual Exam and Annual PAP Smear

Complete Head to Toe Annual Exam and Annual PAP Smear

Preventive Medicine Age Appropriate CPT E/M Code New 99384– 99387 or Established 99394 – 99397

V70.0 Routine Exam

Preventive Medicine Age Appropriate CPT E/M Code New 99384 – 99387 or Established 99395 – 99397

V70.0 Routine Exam

Preventive Medicine Age Appropriate CPT E/M Code New 99384 – 99387 or Established 99394 – 99397

V70.0 Routine Exam

Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

No separate charges for GYN Exam or PAP Smear

Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem

Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem

Annual GYN Exam , Annual PAP Smear, PLUS Mgmt Chronic Illness or Problem

Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091 OR CPT E/M Office Visit Code New 99202 – 99205 OR Established 99212 – 99215 Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

Screen GYN Exam 010053-XX Screen Pap Obtain PQ0091

V76.2 Screen Low Risk V15.89 Screen High Risk V76.47 Vaginal CA Screen

CPT E/M Office Visit Code New 99202 – 99205 OR Established 99212 – 99215

Appropriate diagnosis to specific chronic illness or problem

Appropriate diagnosis to specific chronic illness or problem

CPT E/M Office Visit Code New 99202 – 99205+ SE OR Established 99212 – 99215 + SE

Appropriate diagnosis to specific chronic illness or problem

No separate charges for GYN Exam or PAP Smear

SAMPLE

E/M CODING CHART NEW PATIENT ESTABLISHED PATIENT

Has not been seen by HFH OB/GYN in past 3 years Seen by HFH OB/GYN in past 3 years Must meet all 3 components Must meet 2 of 3 components 99201 – 10 minutes face to face Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Problem Focused Exam – 1 – 5 areas Straightforward Decision Making

99211 – 5 minutes face to face Physicians – do not use this code Does not require a physician presence Minimal presenting problem

99202 – 20 minutes face to face Expanded Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Expanded Problem Focused Exam – 6 – 11 areas Straightforward Decision Making

99212 – 10 minutes face to face Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Problem Focused Exam – 1 – 5 areas Straightforward Decision Making

99203 – 30 minutes face to face Detailed History

HPI – Extended – 4 or more ROS – Extended – System + Additional PFSH – Pertinent – Directly Related

Detailed Exam - 12 or more areas Low Complexity Decision Making

99213– 15 minutes face to face Expanded Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Expanded Problem Focused Exam – 6 – 11 areas Low Complexity Decision Making

99204 – 45 minutes face to face Comprehensive History

HPI – Extended 4 or more ROS – Complete – All Systems PFSH – Complete – 2 or 3

Comprehensive Exam – All elements Moderate Complexity Decision Making

99214 – 25 minutes face to face Detailed History

HPI – Extended – 4 or more ROS – Extended – System + Additional PFSH – Pertinent – Directly Related

Detailed Exam - 12 or more areas Moderate Complexity Decision Making

99205 – 60 minutes face to face Comprehensive History

HPI - Extended – 4 or more ROS – Complete – All Systems PFSH – Complete 2 or 3

Comprehensive Exam – All elements High Complexity Decision Making

99215 – 40 minutes face to face Comprehensive History

HPI - Extended – 4 or more ROS – Complete – All Systems PFSH – Complete 2 or 3

Comprehensive Exam – All elements High Complexity Decision Making

E/M CODING CHART NEW PATIENT ESTABLISHED PATIENT

Has not been seen by HFH OB/GYN in past 3 years Seen by HFH OB/GYN in past 3 years Must meet all 3 components Must meet 2 of 3 components 99201 – 10 minutes face to face Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Problem Focused Exam – 1 – 5 areas Straightforward Decision Making

99211 – 5 minutes face to face Physicians – do not use this code Does not require a physician presence Minimal presenting problem

99202 – 20 minutes face to face Expanded Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Expanded Problem Focused Exam – 6 – 11 areas Straightforward Decision Making

99212 – 10 minutes face to face Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Problem Focused Exam – 1 – 5 areas Straightforward Decision Making

99203 – 30 minutes face to face Detailed History

HPI – Extended – 4 or more ROS – Extended – System + Additional PFSH – Pertinent – Directly Related

Detailed Exam - 12 or more areas Low Complexity Decision Making

99213– 15 minutes face to face Expanded Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Expanded Problem Focused Exam – 6 – 11 areas Low Complexity Decision Making

99204 – 45 minutes face to face Comprehensive History

HPI – Extended 4 or more ROS – Complete – All Systems PFSH – Complete – 2 or 3

Comprehensive Exam – All elements Moderate Complexity Decision Making

99214 – 25 minutes face to face Detailed History

HPI – Extended – 4 or more ROS – Extended – System + Additional PFSH – Pertinent – Directly Related

Detailed Exam - 12 or more areas Moderate Complexity Decision Making

99205 – 60 minutes face to face Comprehensive History

HPI - Extended – 4 or more ROS – Complete – All Systems PFSH – Complete 2 or 3

Comprehensive Exam – All elements High Complexity Decision Making

99215 – 40 minutes face to face Comprehensive History

HPI - Extended – 4 or more ROS – Complete – All Systems PFSH – Complete 2 or 3

Comprehensive Exam – All elements High Complexity Decision Making

E/M CODING CHART NEW PATIENT ESTABLISHED PATIENT

Has not been seen by HFH OB/GYN in past 3 years Seen by HFH OB/GYN in past 3 years Must meet all 3 components Must meet 2 of 3 components 99201 – 10 minutes face to face Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Problem Focused Exam – 1 – 5 areas Straightforward Decision Making

99211 – 5 minutes face to face Physicians – do not use this code Does not require a physician presence Minimal presenting problem

99202 – 20 minutes face to face Expanded Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Expanded Problem Focused Exam – 6 – 11 areas Straightforward Decision Making

99212 – 10 minutes face to face Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Problem Focused Exam – 1 – 5 areas Straightforward Decision Making

99203 – 30 minutes face to face Detailed History

HPI – Extended – 4 or more ROS – Extended – System + Additional PFSH – Pertinent – Directly Related

Detailed Exam - 12 or more areas Low Complexity Decision Making

99213– 15 minutes face to face Expanded Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Expanded Problem Focused Exam – 6 – 11 areas Low Complexity Decision Making

99204 – 45 minutes face to face Comprehensive History

HPI – Extended 4 or more ROS – Complete – All Systems PFSH – Complete – 2 or 3

Comprehensive Exam – All elements Moderate Complexity Decision Making

99214 – 25 minutes face to face Detailed History

HPI – Extended – 4 or more ROS – Extended – System + Additional PFSH – Pertinent – Directly Related

Detailed Exam - 12 or more areas Moderate Complexity Decision Making

99205 – 60 minutes face to face Comprehensive History

HPI - Extended – 4 or more ROS – Complete – All Systems PFSH – Complete 2 or 3

Comprehensive Exam – All elements High Complexity Decision Making

99215 – 40 minutes face to face Comprehensive History

HPI - Extended – 4 or more ROS – Complete – All Systems PFSH – Complete 2 or 3

Comprehensive Exam – All elements High Complexity Decision Making

E/M CODING CHART NEW PATIENT ESTABLISHED PATIENT

Has not been seen by HFH OB/GYN in past 3 years Seen by HFH OB/GYN in past 3 years Must meet all 3 components Must meet 2 of 3 components 99201 – 10 minutes face to face Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Problem Focused Exam – 1 – 5 areas Straightforward Decision Making

99211 – 5 minutes face to face Physicians – do not use this code Does not require a physician presence Minimal presenting problem

99202 – 20 minutes face to face Expanded Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Expanded Problem Focused Exam – 6 – 11 areas Straightforward Decision Making

99212 – 10 minutes face to face Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Problem Focused Exam – 1 – 5 areas Straightforward Decision Making

99203 – 30 minutes face to face Detailed History

HPI – Extended – 4 or more ROS – Extended – System + Additional PFSH – Pertinent – Directly Related

Detailed Exam - 12 or more areas Low Complexity Decision Making

99213– 15 minutes face to face Expanded Problem Focused History

HPI – Brief 1 - 3 ROS – Problem Pertinent – 1 system PFSH – N/A

Expanded Problem Focused Exam – 6 – 11 areas Low Complexity Decision Making

99204 – 45 minutes face to face Comprehensive History

HPI – Extended 4 or more ROS – Complete – All Systems PFSH – Complete – 2 or 3

Comprehensive Exam – All elements Moderate Complexity Decision Making

99214 – 25 minutes face to face Detailed History

HPI – Extended – 4 or more ROS – Extended – System + Additional PFSH – Pertinent – Directly Related

Detailed Exam - 12 or more areas Moderate Complexity Decision Making

99205 – 60 minutes face to face Comprehensive History

HPI - Extended – 4 or more ROS – Complete – All Systems PFSH – Complete 2 or 3

Comprehensive Exam – All elements High Complexity Decision Making

99215 – 40 minutes face to face Comprehensive History

HPI - Extended – 4 or more ROS – Complete – All Systems PFSH – Complete 2 or 3

Comprehensive Exam – All elements High Complexity Decision Making

SAMPLE