How To Use CPT Code 68899

CPT 68899 describes a procedure on the lacrimal system that does not have an assigned code. This article will cover the description, official terminology, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 68899?

CPT 68899 is used to report new or unusual procedures on the lacrimal system that do not have an assigned code. This code is used when the provider performs a procedure on the tear ducts that is not represented by any of the standard and active CPT codes available.

2. Official Description

The official description of CPT code 68899 is: ‘Use 68899 to report new or unusual procedures on the lacrimal system that do not have an assigned code.’

3. Procedure

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

4. Qualifying circumstances

CPT 68899 can be used when the provider performs a procedure on the tear ducts that does not have a specific code assigned to it. This code is used when there is no other appropriate code available to accurately describe the procedure performed.

5. When to use CPT code 68899

CPT code 68899 should be used when the provider performs a procedure on the lacrimal system that does not have an assigned code. This code should only be used when there is no other specific procedure or service code available to accurately describe the service provided.

6. Documentation requirements

To support a claim for CPT 68899, the provider must include a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. The cover letter should also include one or more similar codes and compare the service to those codes to justify the claim amount being billed. Additionally, the provider should include the operative notes or other relevant documentation to strengthen the claim and avoid a possible denial.

7. Billing guidelines

When billing for CPT 68899, the provider should submit a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. The cover letter should also include one or more similar codes and compare the service to those codes to justify the claim amount being billed. The payer 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 68899 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 procedure on the lacrimal system to repair a tear duct that is not represented by any of the standard and active CPT codes available.
2. A patient undergoes a unique procedure on the tear ducts that does not have a specific code assigned to it.
3. A provider performs a specialized procedure on the lacrimal system that requires the use of CPT code 68899.
4. A patient requires a procedure on the tear ducts that is not accurately described by any other available CPT code.
5. A provider performs an innovative procedure on the lacrimal system that does not have an assigned code.
6. A patient undergoes a complex procedure on the tear ducts that requires the use of CPT code 68899.
7. A provider performs a rare procedure on the lacrimal system that is not represented by any existing CPT code.
8. A patient requires a procedure on the tear ducts that cannot be accurately described by any other available code.
9. A provider performs an uncommon procedure on the lacrimal system that necessitates the use of CPT code 68899.
10. A patient undergoes a specialized procedure on the tear ducts that does not have a specific code assigned to it.