How To Use CPT Code 99072

CPT 99072 is a code used to report additional supplies, materials, and clinical staff time during a Public Health Emergency due to respiratory-transmitted infectious disease. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 99072.

1. What is CPT 99072?

CPT 99072 is a code used to report the additional supplies, materials, and clinical staff time required during a Public Health Emergency (PHE) due to respiratory-transmitted infectious disease. This code is applicable when the additional resources are necessary to ensure a safe in-person visit and reduce the risk of transmitting the infectious disease. The code is only applicable during a PHE as defined by law.

2. 99072 CPT code description

The official description of CPT code 99072 is: “Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service(s), when performed during a Public Health Emergency, as defined by law, due to respiratory-transmitted infectious disease.”

3. Procedure

The 99072 procedure involves the following steps:

1. Identifying the need for additional supplies, materials, or clinical staff time during a PHE due to respiratory-transmitted infectious disease.
2. Acquiring and utilizing the necessary additional resources, such as personal protective equipment (PPE), cleaning supplies, and staff time for pre-visit instructions and symptom checks.
3. Documenting the use of these additional resources and their purpose in mitigating the transmission of the infectious disease during the in-person visit.
4. Billing the CPT 99072 code in addition to the appropriate code for the service(s) rendered during the visit.

4. Qualifying circumstances

Eligibility for CPT code 99072 services is determined by the following criteria:

• The in-person visit must occur during a Public Health Emergency (PHE) as defined by law, due to a respiratory-transmitted infectious disease.
• The additional supplies, materials, or clinical staff time must be necessary to ensure a safe visit and reduce the risk of transmitting the infectious disease.
• The provider must document the use of these additional resources and their purpose in mitigating the transmission of the infectious disease during the in-person visit.

5. When to use CPT code 99072

It is appropriate to bill the 99072 CPT code when the following conditions are met:

• The in-person visit takes place during a Public Health Emergency (PHE) due to a respiratory-transmitted infectious disease.
• Additional supplies, materials, or clinical staff time are required to ensure a safe visit and reduce the risk of transmitting the infectious disease.
• The provider has documented the use of these additional resources and their purpose in mitigating the transmission of the infectious disease during the in-person visit.

6. Documentation requirements

To support a claim for CPT 99072, the following information must be documented:

• The date and time of the in-person visit.
• A description of the additional supplies, materials, or clinical staff time used during the visit.
• An explanation of how these additional resources were necessary to ensure a safe visit and reduce the risk of transmitting the infectious disease.
• Confirmation that the visit took place during a Public Health Emergency (PHE) due to a respiratory-transmitted infectious disease.

7. Billing guidelines

When billing for CPT code 99072, keep in mind the following guidelines and tips:

• Report 99072 only once per encounter per provider number, even if multiple services are performed.
• Bill the CPT 99072 code in addition to the appropriate code for the service(s) rendered during the visit.
• Ensure that the documentation requirements are met and properly recorded to support the claim for CPT 99072.

8. Historical information

CPT 99072 was added to the Current Procedural Terminology system on September 8, 2020. There have been no updates to the code since its addition.

9. Similar codes to CPT 99072

Five similar codes to CPT 99072 and how they differentiate are:

• CPT 99070: This code is used for reporting supplies and materials provided by the physician over and above those usually included in the office visit or other services rendered.
• CPT 99071: This code is used for reporting educational supplies provided by the physician, such as books, tapes, or pamphlets.
• CPT 99050: This code is used for reporting services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed.
• CPT 99051: This code is used for reporting services provided during regularly scheduled evening, weekend, or holiday office hours.
• CPT 99058: This code is used for reporting services provided on an emergency basis in the office, which disrupts other scheduled office services.

10. Examples

Here are 10 detailed examples of CPT code 99072 procedures:

1. A patient visits a provider during a PHE for a respiratory-transmitted infectious disease, and the provider uses additional PPE and cleaning supplies to ensure a safe visit.
2. A provider conducts a phone screening for symptoms before a patient’s in-person visit during a PHE for a respiratory-transmitted infectious disease.
3. A provider requires additional clinical staff time to educate patients on social distancing requirements during a PHE for a respiratory-transmitted infectious disease.
4. A provider uses additional cleaning supplies to sanitize the examination room between patients during a PHE for a respiratory-transmitted infectious disease.
5. A provider requires additional clinical staff time to check patients’ temperatures upon arrival during a PHE for a respiratory-transmitted infectious disease.
6. A provider uses additional PPE, such as face shields and gowns, during a PHE for a respiratory-transmitted infectious disease.
7. A provider requires additional clinical staff time to manage patient flow and maintain social distancing during a PHE for a respiratory-transmitted infectious disease.
8. A provider uses additional supplies, such as hand sanitizer and disinfectant wipes, during a PHE for a respiratory-transmitted infectious disease.
9. A provider requires additional clinical staff time to conduct contact tracing for patients who test positive for a respiratory-transmitted infectious disease during a PHE.
10. A provider uses additional supplies, such as air purifiers and HEPA filters, to reduce the risk of transmitting a respiratory-transmitted infectious disease during a PHE.