What does the CPT code 9921 represent?

The CPT code 99212 is specifically designated for an established patient visit. This code is part of the range that addresses evaluation and management services, which distinguish between new and established patients based on their prior relationship with the healthcare provider.

For established patients, the documentation requirements are generally less intense since the provider has already collected and reviewed the patient's medical history in previous visits. Established patient visits are typically for routine follow-ups or management of ongoing conditions, and the CPT description notes that these visits focus on relatively stable or improving conditions, allowing providers to assess changes in health status based on historical data.

In contrast, a new patient visit would utilize a different CPT code, as it requires more extensive documentation due to the need to gather a complete medical history and perform comprehensive evaluations. Similarly, terms like "routine check-up" and "follow-up appointment" may imply different scopes or levels of care and documentation requirements that differ from the specificity of what code 99212 covers. Thus, recognizing 99212 as indicative of an established patient visit is key to accurate coding and billing within healthcare practices.