How To Use CPT Code 99001

CPT 99001 refers to the handling and conveyance of a specimen for transfer from a patient in a non-office setting to a laboratory. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 99001.

1. What is CPT 99001?

CPT 99001 is a code used to describe the handling and conveyance of a specimen for transfer from a patient in a location other than the provider’s office, such as the patient’s home or a nursing facility, to a laboratory for analysis. This code is used by medical coders and billers to accurately document and bill for the services provided by healthcare professionals in these specific situations.

2. 99001 CPT code description

The official description of CPT code 99001 is: “Handling and/or conveyance of specimen for transfer from the patient in other than an office to a laboratory (distance may be indicated)”.

3. Procedure

The 99001 procedure involves the following steps:

1. Collection of the specimen from the patient in a non-office setting, such as their home or a nursing facility.
2. Proper labeling and packaging of the specimen for transport.
3. Completion of necessary requisition and/or shipping forms.
4. Transportation of the specimen to the laboratory via an appropriate carrier.

4. Qualifying circumstances

Healthcare providers are eligible to bill for CPT 99001 services when the following circumstances apply:

• The specimen is collected from the patient in a location other than the provider’s office, such as the patient’s home or a nursing facility.
• The provider is responsible for the handling and conveyance of the specimen to the laboratory for analysis.
• The distance between the patient’s location and the laboratory may be indicated, as it can impact the handling and conveyance process.

5. When to use CPT code 99001

It is appropriate to bill the 99001 CPT code when a healthcare provider collects a specimen from a patient in a non-office setting and is responsible for the handling and conveyance of the specimen to a laboratory for analysis. This code should not be used for specimens collected in the provider’s office or when the provider is not responsible for the handling and conveyance of the specimen.

6. Documentation requirements

To support a claim for CPT 99001, the following information should be documented:

• The patient’s location at the time of specimen collection (e.g., home, nursing facility).
• The type of specimen collected.
• The date and time of specimen collection.
• Details of the handling and conveyance process, including labeling, packaging, and transportation method.
• Any relevant distance information between the patient’s location and the laboratory.

7. Billing guidelines

When billing for CPT code 99001, it is important to be aware of the following guidelines and tips:

• Some payers may not cover handling or conveyance fees for specimens, so it is essential to check specific payer guidelines regarding 99001.
• Some insurance companies may bundle any handling fee or conveyance fees with the lab test, so it is crucial to verify specific payer guidelines in these cases as well.

8. Historical information

CPT 99001 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2013, with the previous descriptor being “Handling and/or conveyance of specimen for transfer from the patient in other than a physician’s office to a laboratory (distance may be indicated)”.

9. Similar codes to CPT 99001

Five similar codes to CPT 99001 and how they differentiate are:

1. CPT 99002: This code is used for handling and conveyance of a specimen for transfer from a patient in an office setting to a laboratory.
2. CPT 99003: This code is used for handling and conveyance of a specimen for transfer from a patient in a hospital setting to a laboratory.
3. CPT 99004: This code is used for handling and conveyance of a specimen for transfer from a patient in an ambulatory surgical center to a laboratory.
4. CPT 99005: This code is used for handling and conveyance of a specimen for transfer from a patient in a skilled nursing facility to a laboratory.
5. CPT 99006: This code is used for handling and conveyance of a specimen for transfer from a patient in an assisted living facility to a laboratory.

10. Examples

Here are 10 detailed examples of CPT code 99001 procedures:

1. A nurse visits a patient’s home to collect a blood sample for laboratory testing and prepares the specimen for transport to the lab.
2. A healthcare provider collects a urine sample from a patient in a nursing facility and sends it to a laboratory for analysis.
3. A home health aide collects a sputum sample from a patient at their residence and arranges for the specimen to be transported to a laboratory for testing.
4. A healthcare provider visits a patient’s home to collect a stool sample for laboratory analysis and prepares the specimen for shipment to the lab.
5. A nurse collects a throat swab from a patient in a nursing facility and sends the specimen to a laboratory for testing.
6. A healthcare provider visits a patient’s home to collect a wound culture and prepares the specimen for transport to a laboratory for analysis.
7. A nurse collects a cerebrospinal fluid sample from a patient in a non-office setting and sends the specimen to a laboratory for testing.
8. A healthcare provider collects a synovial fluid sample from a patient in a nursing facility and prepares the specimen for shipment to a laboratory for analysis.
9. A home health aide collects a saliva sample from a patient at their residence and arranges for the specimen to be transported to a laboratory for testing.
10. A healthcare provider visits a patient’s home to collect a skin biopsy and sends the specimen to a laboratory for analysis.