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HCPCS Editorial Notations
CPT Editorial Notations
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24E by Line 30 Minutes 45 Minutes 60 Minutes AUTHORIZED PERSON's benefits effer certify CITY TATE Class/Section codebook complete item 9a-d Counsel/Coordination CTHER DATE OF BIRTH DD 1 YY DD YY DOC FORM Dyes EMPLOYER's EXAMINATION Problem Focused Exp/Prob Focused 99202 Explain Unusual circumstances express written permission FECA FEDERAL Tax I.D. Fist Name government benefits HCPCS HEALTH INSURANCE CLAIM HISTORY Problem Focused include Area Code INJURY Relate items inst Instruction Manual available INSURANCE CLAIM FORM INSURED's NAME LastName item 24E Low Complexity MAME MedBooks medical benefits MEDICALDECISIONMAKING Straightforward MEDICARE Middle initial NUCC Instruction Manual ote:D party who accepts Patient Name PATIENT'S OR AUTHORIZED payment of government payment of medical Physician Signature physkian or supplier Pica PREGNANCYLMP Problem Focused 992.01 procedure process this claim Program QTHER READ Back request payment Sponsors SSW street surgery TELEPHONE include Area THER thereof TRICARE www.nucc.org