How To Use CPT Code 59899

CPT 59899 describes a procedure in maternity care and delivery that does not have a specific code. This article will cover the description, official guidelines, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 59899?

CPT 59899 can be used to report procedures in maternity care and delivery that do not have a specific code. This code is used when the provider performs a procedure while the patient is pregnant or at the time of delivery that does not employ laparoscopy and is not represented by any of the standard and active CPT codes available.

2. Official Description

The official description of CPT code 59899 is: ‘Unlisted procedure, maternity care and delivery.’

3. Procedure

1. The provider performs a procedure while the patient is pregnant or at the time of delivery that does not employ laparoscopy.
2. The procedure is not represented by any of the standard and active CPT codes available.
3. CPT code 59899 is used to report the procedure when no specific code exists.

4. Qualifying circumstances

CPT 59899 is used when the provider performs a procedure in maternity care and delivery that does not have a specific code. This may occur when the procedure is unique or uncommon, and there is no existing code that accurately represents the service provided. It is important to note that laparoscopic procedures have their own specific code (CPT 59898) and should not be reported using CPT 59899.

5. When to use CPT code 59899

CPT code 59899 should be used when the provider performs a procedure in maternity care and delivery that does not have a specific code. It is important to ensure that there is no existing code that accurately represents the service provided before reporting CPT 59899. If a Category III code is available for the procedure, it should be reported instead of using an unlisted procedure code.

6. Documentation requirements

To support a claim for CPT 59899, it is important to provide thorough documentation. This should include a detailed description of the procedure performed, the reason for choosing the unlisted code, and a comparison to similar codes that do exist. Operative notes or other relevant documentation should also be included to strengthen the claim and avoid possible denial.

7. Billing guidelines

When billing for CPT 59899, it is important to follow the appropriate guidelines. Choose the unlisted procedure code only when no specific procedure or service code exists. If a Category III code is available, it should be reported instead of using CPT 59899. Include a cover letter explaining the reason for choosing the unlisted code and provide a comparison to similar codes to justify the claim amount. Payers will consider claims with unlisted procedure codes on a case-by-case basis and determine payment based on the documentation provided.

8. Historical information

CPT 59899 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 provider performs a unique procedure during a patient’s delivery that does not have a specific code.
2. A patient requires a specialized procedure during their pregnancy that is not represented by any existing CPT codes.
3. A provider performs a procedure at the time of delivery that is uncommon and does not have a specific code.
4. A patient undergoes a procedure during their pregnancy that is not accurately represented by any available CPT codes.
5. A provider performs a procedure during a patient’s delivery that is unique and does not have a specific code.
6. A patient requires a specialized procedure during their pregnancy that is not represented by any existing CPT codes.
7. A provider performs a procedure at the time of delivery that is uncommon and does not have a specific code.
8. A patient undergoes a procedure during their pregnancy that is not accurately represented by any available CPT codes.
9. A provider performs a procedure during a patient’s delivery that is unique and does not have a specific code.
10. A patient requires a specialized procedure during their pregnancy that is not represented by any existing CPT codes.