How To Use CPT Code 78699

CPT 78699 describes a diagnostic nuclear medicine procedure on the nervous system 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 78699?

CPT 78699 can be used to report a nervous system 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 the nervous system.

2. Official Description

The official description of CPT code 78699 is not available. However, it is important to note that CPT guidelines instruct that you should not choose a code that merely approximates the service provided. You should report the service using only the appropriate unlisted procedure code if no such specific procedure or service code exists. If a Category III code is available, it should be reported instead of an unlisted procedure code.

3. Procedure

1. The provider performs a diagnostic nuclear medicine procedure on the nervous system that does not have a specific code.
2. The procedure may involve the use of radioactive materials to visualize and evaluate the structure and function of the nervous system.
3. The specific steps and techniques used in the procedure may vary depending on the patient’s condition and the purpose of the examination.
4. The provider may administer the radioactive materials orally, intravenously, or through other routes of administration.
5. The provider may use imaging equipment, such as a gamma camera, to capture images of the nervous system.
6. The procedure may take a variable amount of time depending on the complexity of the examination.
7. The provider may interpret the images and prepare a report detailing the findings of the procedure.

4. Qualifying circumstances

CPT 78699 can be used when the provider performs a nervous system diagnostic nuclear medicine procedure that is not represented by any of the standard and active CPT codes available. This code should only be used when there is no specific procedure or service code that accurately describes the procedure performed.

5. When to use CPT code 78699

CPT code 78699 should be used when the provider performs a nervous system diagnostic nuclear medicine procedure that does not have a specific code available. It should only be used when there is no other appropriate code that accurately describes the procedure performed.

6. Documentation requirements

To support a claim for CPT 78699, the provider must document the following information:

• A detailed description of the procedure performed
• The reason for choosing the unlisted code instead of a defined, active code
• Comparison to similar codes to justify the claim amount
• Operative notes or other relevant documentation to strengthen the claim

7. Billing guidelines

When billing for CPT 78699, ensure that there is no specific code available that accurately describes the procedure performed. Submit a cover letter explaining the reason for choosing the unlisted code and include one or more similar codes to compare the service to. Provide operative notes or other relevant documentation to support the claim and avoid a possible denial. 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 78699 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 diagnostic nuclear medicine procedure on the nervous system to evaluate a patient with unexplained neurological symptoms.
2. A provider performs a diagnostic nuclear medicine procedure on the nervous system to assess the extent of a brain tumor.
3. A provider performs a diagnostic nuclear medicine procedure on the nervous system to evaluate a patient with suspected neurodegenerative disease.
4. A provider performs a diagnostic nuclear medicine procedure on the nervous system to assess the blood flow to a specific area of the brain.
5. A provider performs a diagnostic nuclear medicine procedure on the nervous system to evaluate a patient with suspected infection in the spinal cord.
6. A provider performs a diagnostic nuclear medicine procedure on the nervous system to assess the function of a patient’s neurotransmitters.
7. A provider performs a diagnostic nuclear medicine procedure on the nervous system to evaluate a patient with suspected nerve damage.
8. A provider performs a diagnostic nuclear medicine procedure on the nervous system to assess the response to a specific treatment.
9. A provider performs a diagnostic nuclear medicine procedure on the nervous system to evaluate a patient with suspected inflammation in the brain.
10. A provider performs a diagnostic nuclear medicine procedure on the nervous system to assess the blood-brain barrier integrity in a patient with a neurological disorder.