Ambulatory/ED Visit (1257)    NLM VALUE SETS (802.2)

Name Value
NAME Ambulatory/ED Visit
OID 2.16.840.1.113883.3.464.1003.101.12.1061
SHORT ID AV61
VERSION DATE 2017-01-06 00:00:00
CODE LIST
  • CODES:
    • CODE DESCRIPTION:   
      Subsequent hospital visit by physician (procedure)
      
    • CODE DESCRIPTION:   
      Patient-initiated encounter (procedure)
      
    • CODE DESCRIPTION:   
      Provider-initiated encounter (procedure)
      
    • CODE DESCRIPTION:   
      Patient encounter procedure (procedure)
      
    • CODE DESCRIPTION:   
      Follow-up encounter (procedure)
      
    • CODE DESCRIPTION:   
      Urgent follow-up (procedure)
      
    • CODE DESCRIPTION:   
      Home visit (procedure)
      
    • CODE DESCRIPTION:   
      Subsequent nursing facility visit (procedure)
      
    • CODE DESCRIPTION:   
      Nursing evaluation of patient and report (procedure)
      
    • CODE DESCRIPTION:   
      Follow-up inpatient consultation visit (procedure)
      
    • CODE DESCRIPTION:   
      Initial evaluation and management of healthy individual (procedure)
      
    • CODE DESCRIPTION:   
      Encounter for "check-up" (procedure)
      
    • CODE DESCRIPTION:   
      Visit out of hours (procedure)
      
    • CODE DESCRIPTION:   
      Weekend visit (procedure)
      
    • CODE DESCRIPTION:   
      History and physical examination with evaluation and management of nursing 
      facility patient (procedure)
      
  • CODES:
    • CODE DESCRIPTION:   
      Office or other outpatient visit for the evaluation and management of a 
      new patient, which requires these 3 key components: A problem focused history; 
      A problem focused examination; Straightforward medical decision making. 
      Counseling and/or coordination of care with other physicians, other qualified 
      health care professionals, or agencies are provided consistent with the 
      nature of the problem(s) and the patient's and/or family's needs. Usually, 
      the presenting problem(s) are self limited or minor. Typically, 10 minutes 
      are spent face-to-face with the patient and/or family.
      
    • CODE DESCRIPTION:   
      Observation care discharge day management (This code is to be utilized 
      to report all services provided to a patient on discharge from "observation 
      status" if the discharge is on other than the initial date of "observation 
      status." To report services to a patient designated as "observation status" 
      or "inpatient status" and discharged on the same date, use the codes for 
      Observation or Inpatient Care Services [including Admission and Discharge 
      Services, 99234-99236 as appropriate.])
      
    • CODE DESCRIPTION:   
      Initial observation care, per day, for the evaluation and management of 
      or unit.
      a patient which requires these 3 key components: A detailed or comprehensive 
      history; A detailed or comprehensive examination; and Medical decision 
      making that is straightforward or of low complexity. Counseling and/or 
      coordination of care with other physicians, other qualified health care 
      professionals, or agencies are provided consistent with the nature of the 
      problem(s) and the patient's and/or family's needs. Usually, the problem(s) 
      requiring admission to "observation status" are of low severity. Typically, 
      30 minutes are spent at the bedside and on the patient's hospital floor 
      
    • CODE DESCRIPTION:   
      Initial observation care, per day, for the evaluation and management of 
      a patient, which requires these 3 key components: A comprehensive history; 
      A comprehensive examination; and Medical decision making of moderate complexity. 
      Counseling and/or coordination of care with other physicians, other qualified 
      health care professionals, or agencies are provided consistent with the 
      nature of the problem(s) and the patient's and/or family's needs. Usually, 
      the problem(s) requiring admission to "observation status" are of moderate 
      severity. Typically, 50 minutes are spent at the bedside and on the patient's 
      hospital floor or unit.
      
    • CODE DESCRIPTION:   
      Initial observation care, per day, for the evaluation and management of 
      a patient, which requires these 3 key components: A comprehensive history; 
      A comprehensive examination; and Medical decision making of high complexity. 
      Counseling and/or coordination of care with other physicians, other qualified 
      health care professionals, or agencies are provided consistent with the 
      nature of the problem(s) and the patient's and/or family's needs. Usually, 
      the problem(s) requiring admission to "observation status" are of high 
      severity. Typically, 70 minutes are spent at the bedside and on the patient's 
      hospital floor or unit.
      
    • CODE DESCRIPTION:   
      Office consultation for a new or established patient, which requires these 
      3 key components: A problem focused history; A problem focused examination; 
      and Straightforward medical decision making. Counseling and/or coordination 
      of care with other physicians, other qualified health care professionals, 
      or agencies are provided consistent with the nature of the problem(s) and 
      the patient's and/or family's needs. Usually, the presenting problem(s) 
      are self limited or minor. Typically, 15 minutes are spent face-to-face 
      with the patient and/or family.
      
    • CODE DESCRIPTION:   
      Office consultation for a new or established patient, which requires these 
      3 key components: An expanded problem focused history; An expanded problem 
      focused examination; and Straightforward medical decision making. Counseling 
      and/or coordination of care with other physicians, other qualified health 
      care professionals, or agencies are provided consistent with the nature 
      of the problem(s) and the patient's and/or family's needs. Usually, the 
      presenting problem(s) are of low severity. Typically, 30 minutes are spent 
      face-to-face with the patient and/or family.
      
    • CODE DESCRIPTION:   
      Office consultation for a new or established patient, which requires these 
      3 key components: A detailed history; A detailed examination; and Medical 
      decision making of low complexity. Counseling and/or coordination of care 
      with other physicians, other qualified health care professionals, or agencies 
      are provided consistent with the nature of the problem(s) and the patient's 
      and/or family's needs. Usually, the presenting problem(s) are of moderate 
      severity. Typically, 40 minutes are spent face-to-face with the patient 
      and/or family.
      
    • CODE DESCRIPTION:   
      Office consultation for a new or established patient, which requires these 
      3 key components: A comprehensive history; A comprehensive examination; 
      and Medical decision making of moderate complexity. Counseling and/or coordination 
      of care with other physicians, other qualified health care professionals, 
      or agencies are provided consistent with the nature of the problem(s) and 
      the patient's and/or family's needs. Usually, the presenting problem(s) 
      are of moderate to high severity. Typically, 60 minutes are spent face-to-face 
      with the patient and/or family.
      
    • CODE DESCRIPTION:   
      Office consultation for a new or established patient, which requires these 
      3 key components: A comprehensive history; A comprehensive examination; 
      and Medical decision making of high complexity. Counseling and/or coordination 
      of care with other physicians, other qualified health care professionals, 
      or agencies are provided consistent with the nature of the problem(s) and 
      the patient's and/or family's needs. Usually, the presenting problem(s) 
      are of moderate to high severity. Typically, 80 minutes are spent face-to-face 
      with the patient and/or family.
      
    • CODE DESCRIPTION:   
      Emergency department visit for the evaluation and management of a patient, 
      which requires these 3 key components: A problem focused history; A problem 
      focused examination; and Straightforward medical decision making. Counseling 
      and/or coordination of care with other physicians, other qualified health 
      care professionals, or agencies are provided consistent with the nature 
      of the problem(s) and the patient's and/or family's needs. Usually, the 
      presenting problem(s) are self limited or minor.
      
    • CODE DESCRIPTION:   
      Office or other outpatient visit for the evaluation and management of a 
      new patient, which requires these 3 key components: An expanded problem 
      focused history; An expanded problem focused examination; Straightforward 
      medical decision making. Counseling and/or coordination of care with other 
      physicians, other qualified health care professionals, or agencies are 
      provided consistent with the nature of the problem(s) and the patient's 
      and/or family's needs. Usually, the presenting problem(s) are of low to 
      moderate severity. Typically, 20 minutes are spent face-to-face with the 
      patient and/or family.
      
    • CODE DESCRIPTION:   
      Emergency department visit for the evaluation and management of a patient, 
      which requires these 3 key components: An expanded problem focused history; 
      An expanded problem focused examination; and Medical decision making of 
      low complexity. Counseling and/or coordination of care with other physicians, 
      other qualified health care professionals, or agencies are provided consistent 
      with the nature of the problem(s) and the patient's and/or family's needs. 
      Usually, the presenting problem(s) are of low to moderate severity.
      
    • CODE DESCRIPTION:   
      Emergency department visit for the evaluation and management of a patient, 
      which requires these 3 key components: An expanded problem focused history; 
      An expanded problem focused examination; and Medical decision making of 
      moderate complexity. Counseling and/or coordination of care with other 
      physicians, other qualified health care professionals, or agencies are 
      provided consistent with the nature of the problem(s) and the patient's 
      and/or family's needs. Usually, the presenting problem(s) are of moderate 
      severity.
      
    • CODE DESCRIPTION:   
      Emergency department visit for the evaluation and management of a patient, 
      which requires these 3 key components: A detailed history; A detailed examination; 
      and Medical decision making of moderate complexity. Counseling and/or coordination 
      of care with other physicians, other qualified health care professionals, 
      or agencies are provided consistent with the nature of the problem(s) and 
      the patient's and/or family's needs. Usually, the presenting problem(s) 
      are of high severity, and require urgent evaluation by the physician, or 
      other qualified health care professionals but do not pose an immediate 
      significant threat to life or physiologic function.
      
    • CODE DESCRIPTION:   
      Emergency department visit for the evaluation and management of a patient, 
      which requires these 3 key components within the constraints imposed by 
      the urgency of the patient's clinical condition and/or mental status: A 
      comprehensive history; A comprehensive examination; and Medical decision 
      making of high complexity. Counseling and/or coordination of care with 
      other physicians, other qualified health care professionals, or agencies 
      are provided consistent with the nature of the problem(s) and the patient's 
      and/or family's needs. Usually, the presenting problem(s) are of high severity 
      and pose an immediate significant threat to life or physiologic function.
      
    • CODE DESCRIPTION:   
      Home visit for the evaluation and management of a new patient, which requires 
      these 3 key components: A problem focused history; A problem focused examination; 
      and Straightforward medical decision making. Counseling and/or coordination 
      of care with other physicians, other qualified health care professionals, 
      or agencies are provided consistent with the nature of the problem(s) and 
      the patient's and/or family's needs. Usually, the presenting problem(s) 
      are of low severity. Typically, 20 minutes are spent face-to-face with 
      the patient and/or family.
      
    • CODE DESCRIPTION:   
      Home visit for the evaluation and management of a new patient, which requires 
      these 3 key components: An expanded problem focused history; An expanded 
      problem focused examination; and Medical decision making of low complexity. 
      Counseling and/or coordination of care with other physicians, other qualified 
      health care professionals, or agencies are provided consistent with the 
      nature of the problem(s) and the patient's and/or family's needs. Usually, 
      the presenting problem(s) are of moderate severity. Typically, 30 minutes 
      are spent face-to-face with the patient and/or family.
      
    • CODE DESCRIPTION:   
      Home visit for the evaluation and management of a new patient, which requires 
      these 3 key components: A detailed history; A detailed examination; and 
      Medical decision making of moderate complexity. Counseling and/or coordination 
      of care with other physicians, other qualified health care professionals, 
      or agencies are provided consistent with the nature of the problem(s) and 
      the patient's and/or family's needs. Usually, the presenting problem(s) 
      are of moderate to high severity. Typically, 45 minutes are spent face-to-face 
      with the patient and/or family.
      
    • CODE DESCRIPTION:   
      Home visit for the evaluation and management of a new patient, which requires 
      these 3 key components: A comprehensive history; A comprehensive examination; 
      and Medical decision making of moderate complexity. Counseling and/or coordination 
      of care with other physicians, other qualified health care professionals, 
      or agencies are provided consistent with the nature of the problem(s) and 
      the patient's and/or family's needs. Usually, the presenting problem(s) 
      are of high severity. Typically, 60 minutes are spent face-to-face with 
      the patient and/or family.
      
    • CODE DESCRIPTION:   
      Home visit for the evaluation and management of a new patient, which requires 
      these 3 key components: A comprehensive history; A comprehensive examination; 
      and Medical decision making of high complexity. Counseling and/or coordination 
      of care with other physicians, other qualified health care professionals, 
      or agencies are provided consistent with the nature of the problem(s) and 
      the patient's and/or family's needs. Usually, the patient is unstable or 
      has developed a significant new problem requiring immediate physician attention. 
      Typically, 75 minutes are spent face-to-face with the patient and/or family.
      
    • CODE DESCRIPTION:   
      Home visit for the evaluation and management of an established patient, 
      which requires at least 2 of these 3 key components: A problem focused 
      interval history; A problem focused examination; Straightforward medical 
      decision making. Counseling and/or coordination of care with other physicians, 
      other qualified health care professionals, or agencies are provided consistent 
      with the nature of the problem(s) and the patient's and/or family's needs. 
      Usually, the presenting problem(s) are self limited or minor. Typically, 
      15 minutes are spent face-to-face with the patient and/or family.
      
    • CODE DESCRIPTION:   
      Office or other outpatient visit for the evaluation and management of a 
      new patient, which requires these 3 key components: A detailed history; 
      A detailed examination; Medical decision making of low complexity. Counseling 
      and/or coordination of care with other physicians, other qualified health 
      care professionals, or agencies are provided consistent with the nature 
      of the problem(s) and the patient's and/or family's needs. Usually, the 
      presenting problem(s) are of moderate severity. Typically, 30 minutes are 
      spent face-to-face with the patient and/or family.
      
    • CODE DESCRIPTION:   
      Home visit for the evaluation and management of an established patient, 
      which requires at least 2 of these 3 key components: An expanded problem 
      focused interval history; An expanded problem focused examination; Medical 
      decision making of low complexity. Counseling and/or coordination of care 
      with other physicians, other qualified health care professionals, or agencies 
      are provided consistent with the nature of the problem(s) and the patient's 
      and/or family's needs. Usually, the presenting problem(s) are of low to 
      moderate severity. Typically, 25 minutes are spent face-to-face with the 
      patient and/or family.
      
    • CODE DESCRIPTION:   
      Home visit for the evaluation and management of an established patient, 
      which requires at least 2 of these 3 key components: A detailed interval 
      history; A detailed examination; Medical decision making of moderate complexity. 
      Counseling and/or coordination of care with other physicians, other qualified 
      health care professionals, or agencies are provided consistent with the 
      nature of the problem(s) and the patient's and/or family's needs. Usually, 
      the presenting problem(s) are moderate to high severity. Typically, 40 
      minutes are spent face-to-face with the patient and/or family.
      
    • CODE DESCRIPTION:   
      Home visit for the evaluation and management of an established patient, 
      face-to-face with the patient and/or family.
      which requires at least 2 of these 3 key components: A comprehensive interval 
      history; A comprehensive examination; Medical decision making of moderate 
      to high complexity. Counseling and/or coordination of care with other physicians, 
      other qualified health care professionals, or agencies are provided consistent 
      with the nature of the problem(s) and the patient's and/or family's needs. 
      Usually, the presenting problem(s) are of moderate to high severity. The 
      patient may be unstable or may have developed a significant new problem 
      requiring immediate physician attention. Typically, 60 minutes are spent 
      
    • CODE DESCRIPTION:   
      Initial comprehensive preventive medicine evaluation and management of 
      an individual including an age and gender appropriate history, examination, 
      counseling/anticipatory guidance/risk factor reduction interventions, and 
      the ordering of laboratory/diagnostic procedures, new patient; infant (age 
      younger than 1 year)
      
    • CODE DESCRIPTION:   
      Initial comprehensive preventive medicine evaluation and management of 
      an individual including an age and gender appropriate history, examination, 
      counseling/anticipatory guidance/risk factor reduction interventions, and 
      the ordering of laboratory/diagnostic procedures, new patient; early childhood 
      (age 1 through 4 years)
      
    • CODE DESCRIPTION:   
      Initial comprehensive preventive medicine evaluation and management of 
      an individual including an age and gender appropriate history, examination, 
      counseling/anticipatory guidance/risk factor reduction interventions, and 
      the ordering of laboratory/diagnostic procedures, new patient; late childhood 
      (age 5 through 11 years)
      
    • CODE DESCRIPTION:   
      Initial comprehensive preventive medicine evaluation and management of 
      an individual including an age and gender appropriate history, examination, 
      counseling/anticipatory guidance/risk factor reduction interventions, and 
      the ordering of laboratory/diagnostic procedures, new patient; adolescent 
      (age 12 through 17 years)
      
    • CODE DESCRIPTION:   
      Initial comprehensive preventive medicine evaluation and management of 
      an individual including an age and gender appropriate history, examination, 
      counseling/anticipatory guidance/risk factor reduction interventions, and 
      the ordering of laboratory/diagnostic procedures, new patient; 18-39 years
      
    • CODE DESCRIPTION:   
      Initial comprehensive preventive medicine evaluation and management of 
      an individual including an age and gender appropriate history, examination, 
      counseling/anticipatory guidance/risk factor reduction interventions, and 
      the ordering of laboratory/diagnostic procedures, new patient; 40-64 years
      
    • CODE DESCRIPTION:   
      Initial comprehensive preventive medicine evaluation and management of 
      an individual including an age and gender appropriate history, examination, 
      counseling/anticipatory guidance/risk factor reduction interventions, and 
      the ordering of laboratory/diagnostic procedures, new patient; 65 years 
      and older
      
    • CODE DESCRIPTION:   
      Office or other outpatient visit for the evaluation and management of a 
      new patient, which requires these 3 key components: A comprehensive history; 
      A comprehensive examination; Medical decision making of moderate complexity. 
      Counseling and/or coordination of care with other physicians, other qualified 
      health care professionals, or agencies are provided consistent with the 
      nature of the problem(s) and the patient's and/or family's needs. Usually, 
      the presenting problem(s) are of moderate to high severity. Typically, 
      45 minutes are spent face-to-face with the patient and/or family.
      
    • CODE DESCRIPTION:   
      Periodic comprehensive preventive medicine reevaluation and management 
      of an individual including an age and gender appropriate history, examination, 
      counseling/anticipatory guidance/risk factor reduction interventions, and 
      the ordering of laboratory/diagnostic procedures, established patient; 
      infant (age younger than 1 year)
      
    • CODE DESCRIPTION:   
      Periodic comprehensive preventive medicine reevaluation and management 
      of an individual including an age and gender appropriate history, examination, 
      counseling/anticipatory guidance/risk factor reduction interventions, and 
      the ordering of laboratory/diagnostic procedures, established patient; 
      early childhood (age 1 through 4 years)
      
    • CODE DESCRIPTION:   
      Periodic comprehensive preventive medicine reevaluation and management 
      of an individual including an age and gender appropriate history, examination, 
      counseling/anticipatory guidance/risk factor reduction interventions, and 
      the ordering of laboratory/diagnostic procedures, established patient; 
      late childhood (age 5 through 11 years)
      
    • CODE DESCRIPTION:   
      Periodic comprehensive preventive medicine reevaluation and management 
      of an individual including an age and gender appropriate history, examination, 
      counseling/anticipatory guidance/risk factor reduction interventions, and 
      the ordering of laboratory/diagnostic procedures, established patient; 
      adolescent (age 12 through 17 years)
      
    • CODE DESCRIPTION:   
      Periodic comprehensive preventive medicine reevaluation and management 
      of an individual including an age and gender appropriate history, examination, 
      counseling/anticipatory guidance/risk factor reduction interventions, and 
      the ordering of laboratory/diagnostic procedures, established patient; 
      18-39 years
      
    • CODE DESCRIPTION:   
      Periodic comprehensive preventive medicine reevaluation and management 
      of an individual including an age and gender appropriate history, examination, 
      counseling/anticipatory guidance/risk factor reduction interventions, and 
      the ordering of laboratory/diagnostic procedures, established patient; 
      40-64 years
      
    • CODE DESCRIPTION:   
      Periodic comprehensive preventive medicine reevaluation and management 
      of an individual including an age and gender appropriate history, examination, 
      counseling/anticipatory guidance/risk factor reduction interventions, and 
      the ordering of laboratory/diagnostic procedures, established patient; 
      65 years and older
      
    • CODE DESCRIPTION:   
      Preventive medicine counseling and/or risk factor reduction intervention(s) 
      provided to an individual (separate procedure); approximately 15 minutes
      
    • CODE DESCRIPTION:   
      Preventive medicine counseling and/or risk factor reduction intervention(s) 
      provided to an individual (separate procedure); approximately 30 minutes
      
    • CODE DESCRIPTION:   
      Preventive medicine counseling and/or risk factor reduction intervention(s) 
      provided to an individual (separate procedure); approximately 45 minutes
      
    • CODE DESCRIPTION:   
      Office or other outpatient visit for the evaluation and management of a 
      new patient, which requires these 3 key components: A comprehensive history; 
      A comprehensive examination; Medical decision making of high complexity. 
      Counseling and/or coordination of care with other physicians, other qualified 
      health care professionals, or agencies are provided consistent with the 
      nature of the problem(s) and the patient's and/or family's needs. Usually, 
      the presenting problem(s) are of moderate to high severity. Typically, 
      60 minutes are spent face-to-face with the patient and/or family.
      
    • CODE DESCRIPTION:   
      Preventive medicine counseling and/or risk factor reduction intervention(s) 
      provided to an individual (separate procedure); approximately 60 minutes
      
    • CODE DESCRIPTION:   
      Preventive medicine counseling and/or risk factor reduction intervention(s) 
      provided to individuals in a group setting (separate procedure); approximately 
      30 minutes
      
    • CODE DESCRIPTION:   
      Preventive medicine counseling and/or risk factor reduction intervention(s) 
      provided to individuals in a group setting (separate procedure); approximately 
      60 minutes
      
    • CODE DESCRIPTION:   
      Administration and interpretation of health risk assessment instrument 
      (eg, health hazard appraisal)
      
    • CODE DESCRIPTION:   
      Unlisted preventive medicine service
      
    • CODE DESCRIPTION:   
      Work related or medical disability examination by the treating physician 
      that includes: Completion of a medical history commensurate with the patient's 
      condition; Performance of an examination commensurate with the patient's 
      condition; Formulation of a diagnosis, assessment of capabilities and stability, 
      and calculation of impairment; Development of future medical treatment 
      plan; and Completion of necessary documentation/certificates and report.
      
    • CODE DESCRIPTION:   
      Work related or medical disability examination by other than the treating 
      physician that includes: Completion of a medical history commensurate with 
      the patient's condition; Performance of an examination commensurate with 
      the patient's condition; Formulation of a diagnosis, assessment of capabilities 
      and stability, and calculation of impairment; Development of future medical 
      treatment plan; and Completion of necessary documentation/certificates 
      and report.
      
    • CODE DESCRIPTION:   
      Office or other outpatient visit for the evaluation and management of an 
      established patient, which requires at least 2 of these 3 key components: 
      A problem focused history; A problem focused examination; Straightforward 
      medical decision making. Counseling and/or coordination of care with other 
      physicians, other qualified health care professionals, or agencies are 
      provided consistent with the nature of the problem(s) and the patient's 
      and/or family's needs. Usually, the presenting problem(s) are self limited 
      or minor. Typically, 10 minutes are spent face-to-face with the patient 
      and/or family.
      
    • CODE DESCRIPTION:   
      Office or other outpatient visit for the evaluation and management of an 
      established patient, which requires at least 2 of these 3 key components: 
      An expanded problem focused history; An expanded problem focused examination; 
      Medical decision making of low complexity. Counseling and coordination 
      of care with other physicians, other qualified health care professionals, 
      or agencies are provided consistent with the nature of the problem(s) and 
      the patient's and/or family's needs. Usually, the presenting problem(s) 
      are of low to moderate severity. Typically, 15 minutes are spent face-to-face 
      with the patient and/or family.
      
    • CODE DESCRIPTION:   
      Office or other outpatient visit for the evaluation and management of an 
      established patient, which requires at least 2 of these 3 key components: 
      A detailed history; A detailed examination; Medical decision making of 
      moderate complexity. Counseling and/or coordination of care with other 
      physicians, other qualified health care professionals, or agencies are 
      provided consistent with the nature of the problem(s) and the patient's 
      and/or family's needs. Usually, the presenting problem(s) are of moderate 
      to high severity. Typically, 25 minutes are spent face-to-face with the 
      patient and/or family.
      
    • CODE DESCRIPTION:   
      Office or other outpatient visit for the evaluation and management of an 
      established patient, which requires at least 2 of these 3 key components: 
      A comprehensive history; A comprehensive examination; Medical decision 
      making of high complexity. Counseling and/or coordination of care with 
      other physicians, other qualified health care professionals, or agencies 
      are provided consistent with the nature of the problem(s) and the patient's 
      and/or family's needs. Usually, the presenting problem(s) are of moderate 
      to high severity. Typically, 40 minutes are spent face-to-face with the 
      patient and/or family.
      
MEASURE LIST