knowledge/lexical/codes

Source: knowledge/lexical/codes.parquet. Source vintage: Package vintage 2026-10-01; source path partition not dated; inspect record and rule clocks separately. Grain: Packaged source record; inspect schema and linked world method before aggregation. Snapshot: 7a53af6a9beb58928d4a64dc92db09c9db65433f9909f1a10d16e302adaf86ba.

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99215
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99215 CBP denominator | Office visit established patient, high complexity Office o/p est hi 40 min criteria: If an E&M service on a catch-up/follow-up visit requires more than a problem focused history and examination and straightforward decision making, the codes 99213-99215 with an EP modifier should be used. disposition: payable disposition: payable-with-criteria medicaid-hi code-disposition criteria: If an E&M service on a catch-up/follow-up visit requires more than a problem focused history and examination and straightforward decision making, the codes 99213-99215 with an EP modifier should be used. medicaid-hi code-disposition disposition: payable-with-criteria medicaid-ri code-disposition disposition: prior-authorization-required medicaid-ri code-disposition payable-with-criteria: Massachusetts providers only may bill for this procedure. medicaid-ri code-disposition prior-authorization-required: true prior-authorization-required: true who may perform: Massachusetts providers only97

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