Report CPT code 99080 if a provider used a form or made a report (in addition to standard documentation) about the patient’s situation or status.
1. What Is CPT Code 99080?
CPT 99080 covers a report or form for documenting the situation or status of a patient. This code is an addition to standard documentation.
The CPT book describes CPT 99080 as: “Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form.”
The 99080 CPT code procedure begins with a provider acquiring the information about the patient to complete a special form or document a patient’s condition. It can also be used to prove the medical necessity for a procedure.
Then, the provider fills in the form or files the report and ends this procedure.
4. Billing Guidelines
Do not use CPT 99080 for routine forms (for example, hospital discharge summaries). This code can only be used if the provider completes a form or document other than a standard form (for example, paperwork related to the Family and Medical Leave Act).
The 99080 CPT code can not be reported in combination with evaluation services for medical disability or other work-related services.
CPT 99080 does not apply to standard records review because E/M codes already include this service. Time spent reviewing medical records during a transfer of a patient is included.
The provider should document this by documenting their record review and including a summary. Medical-decision making for the data component can be increased this way and can allow for a higher service level if the exam or history supports it.