Outpatient Value Set CPT

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  "date" : "2019-01-29T01:00:02-05:00",
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  "purpose" : "(Clinical Focus: Denominator and Numerator criteria for Osteoporosis Management in Women STARSC12-HEDISOMW.),(Data Element Scope: CPT Codes),(Inclusion Criteria: As Defined within STARSC12-HEDISOMW.),(Exclusion Criteria: As Defined within STARSC12-HEDISOMW.)",
  "name" : "OutpatientValueSetCPT",
  "experimental" : false,
  "resourceType" : "ValueSet",
  "expansion" : {
    "contains" : [ {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99202",
      "display" : "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. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99203",
      "display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99204",
      "display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99205",
      "display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99211",
      "display" : "Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99212",
      "display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99213",
      "display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99214",
      "display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99215",
      "display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99242",
      "display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99243",
      "display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99244",
      "display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99245",
      "display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99341",
      "display" : "Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99342",
      "display" : "Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99344",
      "display" : "Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99345",
      "display" : "Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99347",
      "display" : "Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99348",
      "display" : "Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99349",
      "display" : "Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99350",
      "display" : "Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99381",
      "display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age younger than 1 year)",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99382",
      "display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood (age 1 through 4 years)",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99383",
      "display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (age 5 through 11 years)",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99384",
      "display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age 12 through 17 years)",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99385",
      "display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99386",
      "display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99387",
      "display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and older",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99391",
      "display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infant (age younger than 1 year)",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99392",
      "display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early childhood (age 1 through 4 years)",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99393",
      "display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late childhood (age 5 through 11 years)",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99394",
      "display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adolescent (age 12 through 17 years)",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99395",
      "display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39 years",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99396",
      "display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64 years",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99397",
      "display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 years and older",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99401",
      "display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99402",
      "display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99403",
      "display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99404",
      "display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99411",
      "display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99412",
      "display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99429",
      "display" : "Unlisted preventive medicine service",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99455",
      "display" : "Work related or medical disability examination by the treating physician that includes: Completion of a medical history commensurate with the patient's condition; Performance of an examination commensurate with the patient's condition; Formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; Development of future medical treatment plan; and Completion of necessary documentation/certificates and report.",
      "version" : "2024"
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      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99456",
      "display" : "Work related or medical disability examination by other than the treating physician that includes: Completion of a medical history commensurate with the patient's condition; Performance of an examination commensurate with the patient's condition; Formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; Development of future medical treatment plan; and Completion of necessary documentation/certificates and report.",
      "version" : "2024"
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    "timestamp" : "2024-06-14T13:11:11-04:00"
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  "title" : "Outpatient Value Set CPT",
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