How To Use CPT Code 19499

CPT code 19499 describes a procedure on the breast for which there is no specific code available. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 19499?

CPT 19499 is an unlisted procedure code that is used to report a procedure on the breast when there is no specific code available. It is important to note that this code should only be used when there is no other appropriate code that accurately represents the service provided.

2. Official Description

There is no official description available for CPT code 19499. However, it is important to consult the provider and ensure that proper documentation has been done before billing for an unlisted procedure.

3. Procedure

The procedure represented by CPT code 19499 can vary depending on the specific service provided on the breast. It is an unlisted procedure code, which means that it does not have a specific set of steps or guidelines associated with it. The provider will perform a procedure on the breast that is not represented by any of the standard and active CPT codes available.

4. Qualifying circumstances

There are no specific qualifying circumstances associated with CPT code 19499. It is used when there is no other appropriate code available to accurately represent the procedure performed on the breast.

5. When to use CPT code 19499

CPT code 19499 should only be used when there is no other specific code available that accurately represents the procedure performed on the breast. It is important to follow the CPT guidelines and not choose a code that merely approximates the service provided. If there is a Category III code available that represents the procedure, it should be used instead of an unlisted procedure code.

6. Documentation requirements

When reporting a procedure with CPT code 19499, it is crucial to provide proper documentation to support the claim. This includes a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. The documentation should also include one or more similar codes and compare the service to those codes to justify the claim amount being billed. Additionally, operative notes or other relevant documentation should be included to strengthen the claim and avoid possible denial.

7. Billing guidelines

When billing for CPT code 19499, it is important to follow the billing guidelines set forth by the payer. Each payer may have specific requirements or considerations for claims with unlisted procedure codes. It is crucial to include the necessary documentation and follow any additional guidelines provided by the payer to ensure proper reimbursement.

8. Historical information

CPT code 19499 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 19499

While there are no specific similar codes to CPT code 19499, it is important to consult the CPT guidelines and consider any other available codes that may more accurately represent the procedure performed on the breast. It is crucial to choose the most appropriate code that best describes the service provided.

9. Examples

Here are some examples of scenarios where CPT code 19499 may be used:

1. A provider performs a breast procedure that does not have a specific code available in the CPT system.
2. A patient undergoes a unique breast surgery that is not represented by any other existing CPT code.
3. A provider performs a specialized breast procedure that is not covered by any other specific code in the CPT system.
4. A patient receives a breast treatment or intervention that is not accurately described by any other available CPT code.
5. A provider performs a breast procedure that is not commonly performed and does not have a specific code assigned to it.
6. A patient undergoes a breast procedure that is not covered by any other existing CPT code due to its unique nature.
7. A provider performs a breast surgery that is not represented by any other specific code in the CPT system.
8. A patient receives a breast treatment or intervention that is not accurately described by any other available CPT code due to its complexity.
9. A provider performs a breast procedure that is not commonly performed and does not have a specific code assigned to it.
10. A patient undergoes a specialized breast surgery that is not covered by any other existing CPT code.