What does CPT code 99904 mean?

The CPT (Current Procedural Terminology) code 99904 is used for reporting evaluation and management (E&M) services provided by a physician or other qualified health care professional to an established patient in a hospital or other outpatient setting. This code is typically used when the patient has a chronic or stable medical condition that is being managed or monitored, such as diabetes, hypertension, or asthma.

99904 is a code used for reporting an office visit for an established patient that requires a moderate level of medical decision making. This level of decision-making typically involves:

- A straightforward medical history

- A problem-focused examination

- Medical decision making of moderate complexity

Established patient visits are defined as visits with patients who have been seen by the physician or qualified healthcare professional within the past three years.

CPT code 99904 is part of a series of codes that range from 99201 to 99499, which are all used for reporting E&M services. Each code represents a different level of service, with higher codes indicating more complex medical decision making and/or patient care.

It's important to note that CPT codes are used for billing purposes and may vary depending on the specific circumstances of the patient's visit and the healthcare setting. For accurate billing and reimbursement, it is recommended to refer to the most up-to-date CPT codebook and guidelines.