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CPT 99402

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CPT 99402 Evaluation and Management (E/M)

Description

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Common Specialties

Emergency 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

99401 99403 99404 99406 99407 99408 99409 99411 99412 99415 99416 99417 99418 99421 99422

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.