CPT Code 99214: Definition, Billing Guidelines, and Compliance Tips
CPT Code 99214 is one of the most frequently used Evaluation and Management (E/M) codes for established patient visits in outpatient settings. This comprehensive guide explains everything you need to know about the 99214 CPT code—from its definition and proper documentation requirements to pre- and post-2021 E/M guideline changes. Learn how to apply the code based on medical decision-making or total time spent, avoid common coding pitfalls, and ensure compliance to maximize revenue.
We also explore practical use cases such as chronic condition management, post-operative complications, and mental health follow-ups. By understanding the nuances of moderate complexity, correct documentation standards, and proper use of modifiers, your practice can avoid audits, reduce claim denials, and stay compliant with CMS and AMA standards. Whether you’re a provider, coder, or billing manager, mastering CPT 99214 is essential for success in today’s healthcare reimbursement landscape.
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