How To Use CPT Code 38999

CPT 38999 describes a procedure in the hemic or lymphatic system that does not have a specific code. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 38999?

CPT 38999 can be used to report procedures in the lymphatic system that do not have a specific code. This code is used when there is no other available code that accurately represents the procedure performed on the lymphatic system. It is important to note that CPT guidelines advise against choosing a code that only approximates the service provided. Instead, the appropriate unlisted procedure code, such as 38999, should be used when no specific procedure or service code exists.

2. Official Description

The official description of CPT code 38999 is: ‘Unlisted procedure, hemic or lymphatic system.’

3. Procedure

1. The healthcare provider performs a procedure on the lymphatic system that is not represented by any of the standard and active CPT codes available.

4. Qualifying circumstances

CPT 38999 is used when there is no specific code available to accurately describe the procedure performed on the lymphatic system. This code is typically used in situations where the procedure is unique or does not fit into any existing code category. It is important to note that CPT guidelines recommend using a Category III code when available instead of an unlisted procedure code.

5. When to use CPT code 38999

CPT code 38999 should be used when there is no specific code available to accurately represent the procedure performed on the lymphatic system. It is important to ensure that no other appropriate code exists before reporting 38999. When reporting a procedure with an unlisted code, it is essential to submit a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. This letter should include one or more similar codes and compare the service to those codes to justify the claim amount being billed. Additionally, including operative notes or other relevant documentation can strengthen the claim and help avoid a possible denial.

6. Documentation requirements

To support a claim for CPT 38999, it is crucial to provide the following documentation:

• A cover letter explaining the reason for choosing the unlisted code
• One or more similar codes and a comparison of the service to those codes
• Operative notes or other relevant documentation

7. Billing guidelines

When billing for CPT 38999, it is important to follow these guidelines:

• Submit a cover letter explaining the reason for choosing the unlisted code
• Include one or more similar codes and compare the service to those codes
• Provide operative notes or other relevant documentation

8. Historical information

CPT 38999 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider performs a unique procedure on the lymphatic system that does not have a specific code.
2. A patient undergoes a procedure on the lymphatic system that does not fit into any existing code category.
3. A healthcare provider performs a specialized procedure on the lymphatic system that requires the use of an unlisted code.
4. A patient requires a procedure on the lymphatic system that is not accurately represented by any available CPT codes.
5. A healthcare provider performs a complex procedure on the lymphatic system that does not have a specific code.
6. A patient undergoes a procedure on the lymphatic system that is unique and does not fit into any existing code category.
7. A healthcare provider performs an innovative procedure on the lymphatic system that requires the use of an unlisted code.
8. A patient requires a procedure on the lymphatic system that is not accurately represented by any available CPT codes.
9. A healthcare provider performs a specialized procedure on the lymphatic system that does not have a specific code.
10. A patient undergoes a procedure on the lymphatic system that does not fit into any existing code category.