Neurology, coded right.

99204 is the default code for most new-patient outpatient encounters in primary care and outpatient subspecialty practice. Use it for a new patient with at least one of: two or more chronic problems with progression or treatment changes; one undiagnosed new problem with uncertain prognosis; prescription drug management. Common patterns: new patient establishing primary care with multiple chronic comorbidities; new endocrinology consult for poorly controlled T2DM; new cardiology consult for chest pain and an abnormal stress test result. Prescription drug management satisfies moderate risk on its own, which makes 99204 the right code for the vast majority of new-patient continuity encounters. Time-based alternative is 45 to 59 minutes of total time on the date of the encounter.

Use 99205 for a new patient with severe, decompensated, or high-acuity disease, or for complex consult-style new-patient encounters where decisions about hospitalization, major surgery, drug therapy requiring intensive monitoring, or de-escalation of care are made. Real examples: a new patient referred for severe pulmonary hypertension where right-heart catheterization is planned; a new oncology consult for newly-diagnosed metastatic disease where systemic therapy is initiated; a new patient with decompensated heart failure where admission is considered. Time-based alternative is 60 to 74 minutes of total time on the date of the encounter. Beyond 75 minutes, add 99417 (commercial) or G0316 (Medicare) in 15-minute increments.

99214 is the workhorse of primary care and most outpatient subspecialties. Use it when at least one of these is true: two or more chronic problems with progression, treatment changes, or side effects; one undiagnosed new problem with uncertain prognosis; one acute illness with systemic symptoms; or prescription drug management at any complexity. Prescription drug management on its own satisfies the moderate-risk element, which is why straightforward chronic disease follow-ups with a med adjustment routinely clear the 99214 bar. Time-based alternative is 30 to 39 minutes of total time on the date of the encounter. Pick the method that supports the strongest note: encounters with prescription changes are usually cleaner under MDM; encounters with extensive counseling or care coordination are usually cleaner under time.

Use 99215 when the encounter genuinely required high-complexity decision-making: severe exacerbation or decompensation of a chronic illness, an acute or chronic illness or injury that poses a threat to life or bodily function, decision regarding hospitalization, drug therapy requiring intensive monitoring for toxicity, or extensive comorbidity management driving a high-risk decision. Real examples: a CHF patient with new bilateral leg edema and dyspnea where you considered emergency admission; a new-onset AFib with RVR you elected to manage outpatient with same-day rate-control titration; an oncology patient with febrile neutropenia. Time-based alternative is 40 to 54 minutes of total time on the date of the encounter.

G2211 is the continuity add-on. Append it to an office E/M (99202 through 99215) under one of two conditions: you are the continuing focal point for all of the patient's health care (the primary-care framing), OR you are the ongoing care provider for a patient's single serious condition or a complex condition (the subspecialty framing). Common eligible scenarios: a routine primary care follow-up for chronic disease management; an endocrinology continuity visit for diabetes; an oncology survivorship visit; a rheumatology disease-modifying-medication monitoring visit; a nephrology follow-up for CKD progression. Ineligible scenarios: one-time consults, urgent care visits, hospital follow-up where you are not the longitudinal provider, and visits where modifier 25 is appended to the primary E/M (explicitly prohibited).

99483 is the Medicare-recognized service for a comprehensive cognitive assessment with care plan, billed in patients with mild cognitive impairment, dementia (any stage and any cause), or strong clinical suspicion of cognitive impairment. Use it when you are establishing or revisiting a comprehensive care plan: an initial assessment for memory complaints in a 75-year-old, an annual re-evaluation for a known Alzheimer's patient, or a post-hospital cognitive assessment in a patient with new functional decline. The visit must cover 10 required elements and result in a written care plan shared with the patient and caregiver. Once per 180 days per beneficiary; you cannot stack two 99483 visits within the same six-month window. Qualifying diagnoses include G30.x (Alzheimer's), G31.84 (mild cognitive impairment), F01.x (vascular dementia), F03.x (unspecified dementia), G31.83 (dementia with Lewy bodies), and G31.09 (frontotemporal dementia). The 60-minute benchmark is typical but the code is not strictly time-based; the 10 structural elements drive billability.

Extended routine EEG, 41-60 minute recording.

Routine outpatient awake + drowsy EEG.

NCS evaluation, 9-10 individual studies. 95912 for 11-12, 95913 for 13+.

NCS evaluation with 13+ individual studies (extensive workup, e.g. polyneuropathy).