How To Use CPT Code 99060

CPT 99060 describes the provision of emergency services by a healthcare provider outside of their office, which disrupts other scheduled office services. 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 99060?

CPT 99060 can be used to describe emergency services provided by a healthcare provider outside of their office during regular office hours. These services are rendered without an appointment and ahead of other scheduled patients waiting in the office. The key words to remember when considering CPT 99060 are emergency and interruption. This code should only be reported if the patient arrives unexpectedly and other scheduled appointments need to be changed to accommodate the provider’s absence from the office.

2. Official Description

The official description of CPT code 99060 is: ‘Service(s) provided on an emergency basis, out of the office, which disrupts other scheduled office services, in addition to basic service.’

3. Procedure

1. The healthcare provider receives a call or notification about an emergency situation that requires their immediate attention.
2. The provider leaves their office and travels to the location where the emergency services are needed.
3. The provider assesses the patient’s condition and provides the necessary medical care or treatment.
4. The provider may need to reschedule or rearrange other appointments in their office to accommodate the emergency service.
5. After providing the emergency service, the provider may need to document the details of the encounter and any follow-up instructions or recommendations.

4. Qualifying circumstances

CPT 99060 is applicable when a healthcare provider renders emergency services to a patient outside of their office during regular office hours. The service must disrupt other scheduled office services, and the provider must have treated the patient for an emergent problem that required immediate attention. It is important to note that if the provider had an opening in their schedule and other appointments were not impacted, CPT 99060 should not be reported.

5. When to use CPT code 99060

CPT code 99060 should be used when a healthcare provider provides emergency services outside of their office during regular office hours, and other scheduled office services are disrupted as a result. This code should only be reported if the provider had to rearrange or reschedule other appointments to accommodate the emergency service.

6. Documentation requirements

To support a claim for CPT 99060, the healthcare provider must include adequate documentation in the patient’s record. The documentation should clearly indicate that the patient required emergency services and that other scheduled office services were disrupted as a result. Payers want to see that the provider treated the patient for an emergent problem and fit the patient into the schedule because of that problem.

7. Billing guidelines

When billing for CPT 99060, it is important to ensure that the service meets the qualifying circumstances described above. The provider should report this code in addition to the appropriate evaluation and management (E/M) code that describes the services rendered. It is also important to verify with the payer if any additional documentation or information is required to support the claim.

8. Historical information

CPT 99060 was added to the Current Procedural Terminology system on January 1, 2006. There have been no updates or changes to the code since its addition.

9. Examples

1. A physician providing emergency services to a patient who arrives unexpectedly in the emergency department, requiring other scheduled appointments to be changed to accommodate the provider’s absence from the office.
2. A dentist called to provide emergency dental care to a patient outside of their office, resulting in the rescheduling of other patients.
3. A psychiatrist providing emergency psychiatric services to a patient in crisis, causing other scheduled appointments to be rearranged.
4. A surgeon called to perform emergency surgery on a patient, resulting in the cancellation or postponement of other scheduled surgeries.
5. A pediatrician providing emergency care to a child with a severe illness, requiring other scheduled appointments to be rescheduled.
6. A cardiologist called to provide emergency cardiac care to a patient, disrupting other scheduled office services.
7. An ophthalmologist providing emergency eye care to a patient with a serious eye injury, causing other scheduled appointments to be rearranged.
8. An orthopedic surgeon called to provide emergency orthopedic care to a patient, resulting in the rescheduling of other patients.
9. A dermatologist providing emergency dermatological services to a patient with a severe allergic reaction, disrupting other scheduled office services.
10. A gynecologist called to provide emergency gynecological care to a patient, causing other scheduled appointments to be changed.