How To Use CPT Code 85999

CPT 85999 describes an unlisted hematology and coagulation procedure that does not have a specific code. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 85999?

CPT 85999 can be used to report hematology and coagulation procedures that do not have a specific code. It is an unlisted procedure code that is used when there is no other specific code available to accurately describe the service provided.

2. Official Description

The official description of CPT code 85999 is: ‘Unlisted hematology and coagulation procedure.’

3. Procedure

1. When performing a hematology and coagulation procedure that does not have a specific code, CPT 85999 should be used.
2. It is important to provide a detailed description of the procedure performed, including any relevant information about the patient’s condition and the specific techniques used.
3. Include any additional documentation or supporting materials that may be necessary to justify the use of the unlisted code.

4. Qualifying circumstances

CPT 85999 can be used when there is no other specific code available to accurately describe the hematology and coagulation procedure performed. This may occur when a new procedure is developed or when an existing procedure does not have a specific code assigned to it.

5. When to use CPT code 85999

CPT code 85999 should be used when there is no other specific code available to accurately describe the hematology and coagulation procedure performed. It is important to ensure that there is no other code that closely approximates the service provided before using the unlisted code.

6. Documentation requirements

To support a claim for CPT 85999, it is important to provide a detailed explanation of the procedure performed, including any relevant information about the patient’s condition and the specific techniques used. Additionally, include any additional documentation or supporting materials that may be necessary to justify the use of the unlisted code.

7. Billing guidelines

When billing for CPT 85999, it is important to include a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. Include one or more similar codes and compare the service provided to those codes to justify the claim amount being billed. Additionally, include any relevant documentation to strengthen 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 85999 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 hematologist performing a specialized coagulation procedure for a patient with a rare bleeding disorder.
2. A laboratory technician conducting a hematology procedure to analyze a patient’s blood sample for abnormalities.
3. A coagulation specialist performing a complex procedure to assess a patient’s clotting factors.
4. A pathologist conducting a hematology procedure to diagnose a patient’s blood disorder.
5. A medical technologist performing a coagulation procedure to monitor a patient’s anticoagulant therapy.
6. A hematologist conducting a specialized procedure to evaluate a patient’s bone marrow for abnormalities.
7. A laboratory technician performing a hematology procedure to determine a patient’s blood type.
8. A coagulation specialist conducting a complex procedure to assess a patient’s risk of developing blood clots.
9. A pathologist performing a hematology procedure to evaluate a patient’s red blood cell count and morphology.
10. A medical technologist conducting a coagulation procedure to assess a patient’s ability to form blood clots.