Diabetes Visit (1413)    NLM VALUE SETS (802.2)

Emergency department patient visit (procedure)

Initial evaluation and management of healthy individual (procedure)

Encounter for "check-up" (procedure)

Visit out of hours (procedure)

Weekend visit (procedure)

History and physical examination with evaluation and management of nursing 
facility patient (procedure)

Observing eye during eye care (procedure)

Extended tonometry (procedure)

Extended tonometry - office hours (procedure)

Extended tonometry - 24 hours (procedure)

Visual testing (procedure)

Subsequent hospital visit by physician (procedure)

Patient-initiated encounter (procedure)

Provider-initiated encounter (procedure)

Patient encounter procedure (procedure)

Follow-up encounter (procedure)

Visual field examination for driving (procedure)

Eye examination for driving (procedure)

Urgent follow-up (procedure)

Home visit (procedure)

Subsequent nursing facility visit (procedure)

Nursing evaluation of patient and report (procedure)

Limited eye examination (procedure)

Ophthalmic examination and evaluation (procedure)

Ophthalmic examination and evaluation, follow-up (procedure)

Comprehensive eye examination (procedure)

Follow-up inpatient consultation visit (procedure)

Ophthalmological services: medical examination and evaluation with initiation 
of diagnostic and treatment program; intermediate, new patient

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.

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.

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.

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.

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.])

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 

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.

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.

Initial hospital care, per day, for the evaluation and management of 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 are of low severity. Typically, 30 minutes are spent 
at the bedside and on the patient's hospital floor or unit.

Initial hospital 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 are of moderate severity. Typically, 
50 minutes are spent at the bedside and on the patient's hospital floor 
or unit.

Ophthalmological services: medical examination and evaluation with initiation 
of diagnostic and treatment program; comprehensive, new patient, 1 or more 
visits

Initial hospital 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 are of high severity. Typically, 70 
minutes are spent at the bedside and on the patient's hospital floor or 
unit.

Subsequent hospital care, per day, for the evaluation and management of 
a patient, which requires at least 2 of these 3 key components: A problem 
focused interval history; A problem focused examination; 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 patient 
is stable, recovering or improving. Typically, 15 minutes are spent at 
the bedside and on the patient's hospital floor or unit.

Subsequent hospital care, per day, for the evaluation and management of 
or unit.
a 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 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 patient is responding 
inadequately to therapy or has developed a minor complication. Typically, 
25 minutes are spent at the bedside and on the patient's hospital floor 

Subsequent hospital care, per day, for the evaluation and management of 
a patient, which requires at least 2 of these 3 key components: A detailed 
interval history; A detailed 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 patient is unstable or has developed a significant complication 
or a significant new problem. Typically, 35 minutes are spent at the bedside 
and on the patient's hospital floor or unit.

Hospital discharge day management; 30 minutes or less

Hospital discharge day management; more than 30 minutes

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.

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.

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.

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.

Ophthalmological services: medical examination and evaluation, with initiation 
or continuation of diagnostic and treatment program; intermediate, established 
patient

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.

Inpatient 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, 20 minutes are spent at the bedside 
and on the patient's hospital floor or unit.

Inpatient 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, 40 minutes are 
spent at the bedside and on the patient's hospital floor or unit.

Inpatient 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, 55 minutes are spent at the bedside 
and on the patient's hospital floor or unit.

Inpatient 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, 80 minutes are spent at the 
bedside and on the patient's hospital floor or unit.

Inpatient 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, 110 minutes are spent at the 
bedside and on the patient's hospital floor or unit.

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.

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.

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.

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 physicians, 
or other qualified health care professionals but do not pose an immediate 
significant threat to life or physiologic function.

Ophthalmological services: medical examination and evaluation, with initiation 
or continuation of diagnostic and treatment program; comprehensive, established 
patient, 1 or more visits

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.

Critical care, evaluation and management of the critically ill or critically 
injured patient; first 30-74 minutes

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 

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)

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)

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)

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)

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)

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)

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)

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)

Preventive medicine counseling and/or risk factor reduction intervention(s) 
provided to an individual (separate procedure); approximately 15 minutes

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.

Preventive medicine counseling and/or risk factor reduction intervention(s) 
provided to an individual (separate procedure); approximately 30 minutes

Preventive medicine counseling and/or risk factor reduction intervention(s) 
provided to an individual (separate procedure); approximately 45 minutes

Preventive medicine counseling and/or risk factor reduction intervention(s) 
provided to an individual (separate procedure); approximately 60 minutes

Administration and interpretation of health risk assessment instrument 
(eg, health hazard appraisal)

Unlisted preventive medicine service

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.

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.

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.