How To Use CPT Code 88099

CPT 88099 describes a postmortem examination procedure that is not represented by any of the standard and active codes available. 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 88099?

CPT 88099 can be used to report postmortem examination procedures that do not have a specific code available. This code is used when the provider performs a procedure that is not represented by any of the standard and active codes. It is important to note that this code should only be used when there is no other specific procedure or service code that accurately describes the service provided.

2. Official Description

The official description of CPT code 88099 is: ‘Unlisted necropsy (autopsy) procedure.’

3. Procedure

1. The provider performs a postmortem examination procedure that is not represented by any of the standard and active codes available.
2. The procedure may involve various steps and techniques depending on the specific circumstances and requirements of the examination.
3. The provider carefully examines the deceased individual’s body and collects relevant data and samples for further analysis.
4. The procedure may include dissection, organ examination, tissue sampling, and other necessary steps to determine the cause of death or gather additional information.
5. The provider documents their findings and prepares a comprehensive report detailing the examination procedure and results.

4. Qualifying circumstances

CPT 88099 is used when the provider performs a postmortem examination procedure that is not represented by any of the standard and active codes. This code should only be used when there is no other specific code available that accurately describes the service provided. It is important to note that code guidelines instruct against choosing a code that merely approximates the service. Instead, the appropriate unlisted procedure code should be reported.

5. When to use CPT code 88099

CPT code 88099 should be used when the provider performs a postmortem examination procedure that is not represented by any of the standard and active codes. It is important to ensure that there is no other specific code available that accurately describes the service provided before reporting CPT 88099. If a Category III code is available for the procedure, it should be reported instead of using an unlisted procedure code.

6. Documentation requirements

To support a claim for CPT 88099, the provider must ensure proper documentation of the following:

• A detailed description of the postmortem examination procedure performed
• Explanation of why the procedure is not represented by any of the standard and active codes
• Comparison to similar codes, if available, to justify the use of an unlisted procedure code
• Relevant notes or other documentation to strengthen the claim and avoid possible denial

7. Billing guidelines

When billing for CPT 88099, it is important to follow the specific guidelines to ensure accurate reporting and reimbursement. The provider should submit 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, including relevant notes or other documentation can strengthen the claim and avoid 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 88099 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 pathologist performing a postmortem examination procedure to determine the cause of death in a deceased individual.
2. A forensic scientist conducting a postmortem examination procedure to gather evidence and determine the circumstances surrounding a suspicious death.
3. A medical examiner performing a postmortem examination procedure to investigate the cause of death in a deceased individual involved in a traffic accident.
4. A coroner conducting a postmortem examination procedure to determine the cause of death in a deceased individual found under suspicious circumstances.
5. A research institution conducting a postmortem examination procedure to study the effects of a specific disease on the human body.
6. A geneticist performing a postmortem examination procedure to analyze the genetic makeup of a deceased individual.
7. A hospital conducting a postmortem examination procedure to identify any medical errors or complications that may have contributed to a patient’s death.
8. A forensic anthropologist performing a postmortem examination procedure to identify human remains and determine the cause of death.
9. A medical examiner conducting a postmortem examination procedure to investigate the cause of death in a deceased individual involved in a criminal case.
10. A pathologist performing a postmortem examination procedure to study the progression of a disease in a deceased individual.