How To Use CPT Code 68399

CPT 68399 describes a procedure on the conjunctiva that does not have a specific code. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 68399?

CPT 68399 refers to a procedure performed on the conjunctiva that does not have a specific code. It is used when there is no existing CPT code that accurately represents the service provided by the healthcare professional.

2. Official Description

The official description of CPT code 68399 is not available. However, it is important to note that CPT guidelines state that an unlisted procedure code should only be used when there is no specific procedure or service code available to accurately describe the service provided.

3. Procedure

1. The healthcare professional performs a procedure on the conjunctiva that does not have a specific code.
2. The procedure may involve various techniques or interventions specific to the patient’s condition.
3. The healthcare professional carefully documents the details of the procedure, including the specific steps taken and any instruments or equipment used.
4. The operative notes or other relevant documentation should be included to support the claim and justify the use of the unlisted procedure code.

4. Qualifying circumstances

CPT 68399 can be used when the healthcare professional performs a procedure on the conjunctiva that is not represented by any of the standard and active CPT codes available. This may occur when the procedure is unique or uncommon, and there is no specific code that accurately describes it.

5. When to use CPT code 68399

CPT code 68399 should be used when there is no specific CPT code available to accurately represent the procedure performed on the conjunctiva. It is important to note that this code should not be used if there is a specific code that closely approximates the service provided.

6. Documentation requirements

To support a claim for CPT 68399, the healthcare professional must provide a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. The letter should include one or more similar codes and compare the service to those codes to justify the claim amount. Additionally, the operative notes or other relevant documentation should be included to strengthen the claim and avoid a possible denial.

7. Billing guidelines

When billing for CPT 68399, it is important to follow the specific guidelines provided by the payer. The healthcare professional should ensure that the documentation supports the use of the unlisted procedure code and justifies the claim amount. It is also important to include a cover letter explaining the reason for choosing the unlisted code and comparing it to similar codes.

8. Historical information

CPT 68399 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 professional performs a unique procedure on the conjunctiva to address a specific condition that does not have a specific CPT code.
2. A patient requires a specialized intervention on the conjunctiva that is not covered by any existing CPT codes.
3. A healthcare professional performs a complex procedure on the conjunctiva that is not accurately represented by any available CPT codes.
4. A patient undergoes a rare procedure on the conjunctiva that does not have a specific code in the CPT system.
5. A healthcare professional performs an innovative procedure on the conjunctiva that is not covered by any existing CPT codes.
6. A patient requires a customized intervention on the conjunctiva that is not accurately described by any available CPT codes.
7. A healthcare professional performs a novel procedure on the conjunctiva that is not represented by any specific CPT code.
8. A patient undergoes an uncommon procedure on the conjunctiva that does not have a specific code in the CPT system.
9. A healthcare professional performs a specialized intervention on the conjunctiva that is not covered by any existing CPT codes.
10. A patient requires an innovative procedure on the conjunctiva that is not accurately described by any available CPT codes.