What is the primary role of established patient codes such as 9921?

The primary role of established patient codes, such as 99211, is to describe ongoing healthcare services provided to patients who have already received care from the provider or practice. These codes reflect the nature of interactions that occur between the healthcare provider and the patient over time, focusing on continuity of care.

Established patient codes are designed for situations where a clinician is managing an ongoing health condition, following up on previous treatments, or addressing new concerns in a previously established relationship. They help bill for services rendered that require less time and complexity than codes for new patients, reflecting the rapport and historical context built in the patient-provider relationship.

In contrast, the other options pertain to different scenarios. New patient consultations are represented by different coding, as they describe encounters with patients who have not been seen by the provider before. Emergency room visits have dedicated codes that indicate the acute nature and immediacy of care required. Preventive care assessments also have specific coding distinct from established patient codes, focusing on wellness and prevention rather than ongoing treatment.