Wiki 99499 CPT code

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sarah_willham@yahoo.com

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Can someone give me their interpretation of this code? I am seeing it billed and then nothing in the record to indicate an unlisted E/M service…..

I then was asked about this code in regards to submitting it on a claim when the 12 dx codes are already filled to show additional codes were needed….. can someone provide me some clarification? The book doesn’t have any guidance……
 
They are saying it is used when you need to add additional codes to a claim…… I’m trying to find out where I can find the guidance that states that….. typically you can only add 12 dx codes to a claim…. I’ve never heard that 99499 is used to indicate more than 12 codes are needed on a claim…… there really isn’t any kind of guidance in the book for that code. I reached out to a colleague and she stated they use that code in surgery situations where the service provided, there is no code that matches so they use the 99499 and additionally a code that best represents the service provided along with additional documentation indicating why it was coded….. any help is greatly appreciated!
 
There is a very rare use for it.
Example: https://med.noridianmedicare.com/web/jeb/specialties/em/unlisted-em-service-cpt-code-99499 https://www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00100354

What you are talking about is when it is being used as a placeholder due to the diagnosis over 12 issue. There are times I have seen this. It is health plan specific and shouldn't be done unless they specifically tell you to do it.
Example: https://www.premera.com/documents/058270.pdf https://www.aetna.com/health-care-p...rt-and-the-importance-of-accurate-coding.html
 
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