What this is, in plain language
A visit with a clinician you have seen before, about 10–19 minutes of total provider time or straightforward decision-making.
Why a clinician orders it
Simple follow-ups, medication refills, or a single minor problem.
Medical necessity — what insurers usually look at
Usually covered with a copay or coinsurance and no prior authorization.
New to this? Read what medical necessity means and how to appeal a denial.
Documentation to ask about
- ✓Reason for the visit
- ✓Total time or MDM elements
Questions for your provider
- ?Is the provider in-network for my plan?
Why this code is in our seed set
High-volume established-patient E/M code in the CMS Top 200 Ranked by Services.
Validated against
- •AMA CPT code 99212 descriptor (2021 E/M revision)
- •CMS Top 200 Level I CPT Codes Ranked by Services
Important: AuraCode is an educational tool. It does not provide medical, legal, or insurance advice, claims decisions, or approval guarantees. Final coverage depends on your specific plan, eligibility, diagnosis, submitted documentation, and your insurer's review.