How To Use CPT Code 91299

CPT 91299 describes a diagnostic procedure in the gastrointestinal system that does not have a specific code. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 91299?

CPT 91299 can be used to report a diagnostic procedure performed on the gastrointestinal system when there is no specific code available. This code is used when the procedure performed does not have a designated code in the Current Procedural Terminology system.

2. Official Description

The official description of CPT code 91299 is: ‘Use 91299 to report diagnostic procedures in the gastrointestinal system that do not have a specific code.’

3. Procedure

1. The healthcare provider performs a diagnostic procedure on the gastrointestinal system.
2. This procedure is used to examine the cause of abnormal signs and symptoms.
3. Since there is no specific code available for this procedure, CPT 91299 is used to report it.

4. Qualifying circumstances

CPT 91299 is used when the healthcare provider performs a diagnostic procedure on the gastrointestinal system that is not represented by any of the standard and active CPT codes available. This code is used when there is no specific code that accurately describes the procedure performed.

5. When to use CPT code 91299

CPT code 91299 should be used when there is no specific code available to accurately report a diagnostic procedure performed on the gastrointestinal system. It is important to note that this code should only be used when there is no other appropriate code that can be used to describe the procedure.

6. Documentation requirements

To support a claim for CPT 91299, the healthcare provider must provide a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. The cover letter should include one or more similar codes and compare the service to those codes to justify the claim amount being billed. Additionally, the operative notes or other relevant documentation should be included to strengthen the claim and avoid a possible denial.

7. Billing guidelines

When billing for CPT 91299, it is important to submit a cover letter explaining the reason for using the unlisted code. The cover letter should compare the service to similar codes and provide documentation to support the claim. 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 91299 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 healthcare provider performs a diagnostic procedure on the gastrointestinal system to investigate the cause of unexplained abdominal pain.
2. During the procedure, the healthcare provider examines the gastrointestinal tract for any abnormalities or signs of disease.
3. Since there is no specific code available to accurately report this procedure, CPT 91299 is used.
4. The healthcare provider submits a cover letter explaining the reason for using the unlisted code and includes documentation supporting the claim.
5. The payer reviews the claim and determines payment based on the documentation provided.
6. Another healthcare provider performs a diagnostic procedure on the gastrointestinal system to evaluate a patient with chronic diarrhea.
7. The procedure involves various tests and examinations to identify the underlying cause of the patient’s symptoms.
8. Since there is no specific code that accurately describes this procedure, CPT 91299 is used to report it.
9. The healthcare provider includes a cover letter comparing the service to similar codes and provides supporting documentation.
10. The payer reviews the claim and makes a payment determination based on the documentation provided.