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CPT 99304

1st nf care sf/low mdm 25

CPT 99304 Evaluation and Management (E/M)

Description

1st nf care sf/low mdm 25

Common Specialties

Family Medicine, Internal Medicine

Documentation Requirements

  • Document clinical indications and clear medical necessity supporting the encounter or procedure.
  • Ensure complete provider signatures, credentials, date, and specific place of service (POS).
  • Verify documentation strictly supports code specificity to prevent downcoding or claim denials.

Billing & Coding Tips

  • Verify current payer fee schedules, NCCI edits, and Medically Unlikely Edits (MUEs).
  • Append correct modifiers (e.g., 25, 59, 26, TC) where distinct procedural services or components apply.
  • Confirm pre-authorization rules with Medicare, Medicaid, and commercial plans before submission.

Related Codes

99305 99306 99307 99308 99309 99310 99315 99316 99341 99342 99344 99345 99347 99348 99349

Quantum Health Services provides full-cycle revenue cycle management and medical billing services nationwide. This code reference is for educational purposes; always verify official payer policies. CPT© descriptors require proper AMA licensing.