How To Use CPT Code 78599

CPT 78599 describes a respiratory diagnostic nuclear medicine procedure that does not have a specific code. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 78599?

CPT 78599 can be used to report a respiratory diagnostic nuclear medicine procedure that does not have a specific code. This code is used when the provider performs a procedure that is not represented by any of the standard and active CPT codes available for respiratory diagnostic nuclear medicine.

2. Official Description

The official description of CPT code 78599 is: ‘Use to report a respiratory diagnostic nuclear medicine procedure that does not have a specific code.’

3. Procedure

1. The provider performs a respiratory diagnostic nuclear medicine procedure that is not represented by any of the standard and active CPT codes available.

4. Qualifying circumstances

Qualifying circumstances for CPT 78599 include situations where there is no specific code available to accurately describe the respiratory diagnostic nuclear medicine procedure performed by the provider. This code should only be used when there is no other appropriate code that can be used to report the procedure.

5. When to use CPT code 78599

CPT code 78599 should be used when there is no specific code available to accurately describe the respiratory diagnostic nuclear medicine procedure performed by the provider. It should not be used if there is a specific code that can be used to report the procedure.

6. Documentation requirements

To support a claim for CPT 78599, 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 78599, 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 the claim on a case-by-case basis and determine payment based on the documentation provided.

8. Historical information

CPT 78599 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 respiratory diagnostic nuclear medicine procedure to assess lung function in a patient with suspected pulmonary disease.
2. A provider performs a respiratory diagnostic nuclear medicine procedure to evaluate the effectiveness of a patient’s asthma treatment.
3. A provider performs a respiratory diagnostic nuclear medicine procedure to detect the presence of a pulmonary embolism in a patient with symptoms of shortness of breath.
4. A provider performs a respiratory diagnostic nuclear medicine procedure to assess the severity of a patient’s chronic obstructive pulmonary disease (COPD).
5. A provider performs a respiratory diagnostic nuclear medicine procedure to evaluate the ventilation and perfusion of a patient’s lungs prior to surgery.
6. A provider performs a respiratory diagnostic nuclear medicine procedure to assess the response of a patient’s lungs to a specific treatment.
7. A provider performs a respiratory diagnostic nuclear medicine procedure to detect the presence of a lung infection in a patient with a persistent cough.
8. A provider performs a respiratory diagnostic nuclear medicine procedure to evaluate the effectiveness of a patient’s smoking cessation program.
9. A provider performs a respiratory diagnostic nuclear medicine procedure to assess the lung function of a patient with a history of exposure to occupational hazards.
10. A provider performs a respiratory diagnostic nuclear medicine procedure to evaluate the response of a patient’s lungs to exercise.