A guide to the new office evaluation and management codes for 1992

The new office evaluation and management codes require an understanding of definitions that have been recently created by the Current Procedural Terminology (CPT) Editorial Panel. Code selection is based on seven components; the three key components are the history, the physical examination and medical decision making. Office visit codes are divided into five levels of visits, based on service. New-patient office visits require all three key components for any level visit; established-patient office visits require only two of the three components. The new office code descriptions were created to assist physicians in code selections. Only when counseling or coordination of care dominates the visit (e.g., more than 50 percent) is time to be considered a controlling factor. Physicians are urged not to code only from time descriptors. The 1992 CPT book will list only the new evaluation and management codes, deleting the old level-of-service codes. Physicians are encouraged to contact local insurance carriers to ensure that they will also be using the new codes in 1992.