The patient is seeing a new doctor in the same specialty group for an enlarged goiter and is undergoing a medically appropriate history and exam, along with a fine needle aspiration biopsy.
* Procedure Description:
* Medically appropriate history and exam.
* Review of TSH results and ultrasound.
* Ordering of fine needle aspiration biopsy.
* CPTCoding:
* 99202: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making.
Since it has been two years since the last visit and the patient is being seen by a new doctor in the same specialty group, the encounter is considered a new patient visit.
References:
* AMA's CPTProfessional Edition (current year).
* CPTAssistant for detailed coding guidelines on evaluation and management services.