How To Use CPT Code 99600

CPT 99600 describes a home visit service or procedure that does not have a specific code. 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 99600?

CPT 99600 can be used to report a home visit service or procedure that does not have a specific code. This code is used when the provider performs a service or procedure during a home visit that is not represented by any of the standard and active CPT codes available.

2. Official Description

The official description of CPT code 99600 is: ‘Unlisted home visit service or procedure.’

3. Procedure

1. During a home visit, the provider performs a service or procedure that does not have a specific code.
2. The provider carefully documents the details of the service or procedure performed, including the reason for choosing the unlisted code instead of a defined, active code.
3. A cover letter is submitted along with the claim, explaining the reason for using the unlisted code and comparing the service to similar codes to justify the claim amount.
4. Operative notes or other relevant documentation are included to strengthen the claim and avoid a possible denial.
5. Payers will consider claims with unlisted procedure codes on a case-by-case basis and determine payment based on the documentation provided.

4. Qualifying circumstances

CPT 99600 can be used when the provider performs a home visit service or procedure that is not represented by any of the standard and active CPT codes available. This code should only be used when there is no specific procedure or service code that accurately describes the service or procedure performed during the home visit.

5. When to use CPT code 99600

CPT code 99600 should be used when the provider performs a home visit service or procedure that does not have a specific code. It is important to note that this code should only be used when there is no other specific procedure or service code available that accurately describes the service or procedure performed during the home visit.

6. Documentation requirements

To support a claim for CPT 99600, the provider must document the following information:

• Details of the service or procedure performed during the home visit
• Reason for choosing the unlisted code instead of a defined, active code
• Comparison to similar codes to justify the claim amount
• Operative notes or other relevant documentation to strengthen the claim

7. Billing guidelines

When billing for CPT 99600, it is important to follow these guidelines:

• Submit a cover letter explaining the reason for choosing the unlisted code and comparing the service to similar codes
• Include operative notes or other relevant 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 99600 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a specialized wound care procedure during a home visit that does not have a specific code.
2. A provider conducts a comprehensive assessment of a patient’s home environment and provides recommendations for modifications to improve accessibility.
3. A provider performs a complex medical procedure that is not represented by any of the standard and active CPT codes during a home visit.
4. A provider delivers specialized palliative care services to a terminally ill patient during a home visit.
5. A provider performs a unique diagnostic procedure that does not have a specific code during a home visit.
6. A provider administers a specialized medication that is not covered by any of the standard and active CPT codes during a home visit.
7. A provider performs a complex physical therapy procedure that is not represented by any of the standard and active CPT codes during a home visit.
8. A provider conducts a specialized psychological evaluation that does not have a specific code during a home visit.
9. A provider performs a unique surgical procedure that is not covered by any of the standard and active CPT codes during a home visit.
10. A provider delivers specialized respiratory therapy services that do not have a specific code during a home visit.