Final answer:
A. 99203 The correct CPT code for a new patient outpatient visit with a detailed history, expanded problem-focused exam, and moderate MDM is 99203. Additional tests such as chest X-ray and CBC are warranted, and the doctor should provide a recommendation that considers both acute and chronic conditions.
Step-by-step explanation:
The subject of this question is determining the appropriate Current Procedural Terminology (CPT) code for a medical service provided in a healthcare setting, specifically for a new patient outpatient visit.A detailed history and expanded problem-focused examination with moderate Medical Decision Making (MDM) are key components described in the question. The CPT code that best fits this scenario is 99203. Code 99203 is used for a new patient visit that requires these levels of care according to the American Medical Association's guidelines for outpatient/office visits.
The presence of headache, chest pain, coughing, and shortness of breath, combined with nausea, diarrhea, and a high fever, suggests the need for immediate additional tests, such as a chest X-ray, complete blood count (CBC), and possibly tests for respiratory infections. Considering John's underlying conditions of asthma and type 2 diabetes, the doctor's recommendation should be tailored to address both the acute symptoms and his chronic illnesses.