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The CPT® Code 99060 refers to services that are rendered on an emergency basis outside of the standard office setting, which subsequently disrupts other scheduled office services. This code is utilized when a physician or other qualified healthcare professional provides essential medical procedures or services in response to an urgent situation. Such emergencies may arise unexpectedly and require immediate attention, thereby interrupting the normal flow of operations within the office. The use of this code indicates that the healthcare provider has prioritized the urgent needs of a patient, which may lead to delays or rescheduling of other appointments. It is important to note that this code is specifically for situations that occur outside of the office, distinguishing it from similar codes that apply to in-office emergencies. The application of CPT® Code 99060 underscores the necessity of flexibility in healthcare delivery, allowing providers to address urgent patient needs while managing the impact on their overall practice schedule.
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The use of CPT® Code 99060 is indicated in situations where emergency services are required outside of the office setting. This may include, but is not limited to, the following scenarios:
The procedural steps associated with CPT® Code 99060 involve the following:
After the emergency services have been rendered, the healthcare provider may need to follow up with the patient to ensure proper recovery and address any ongoing health concerns. Additionally, it is important to communicate with the office staff regarding the impact of the emergency on the schedule, including rescheduling any affected appointments. Proper documentation of the emergency service and its effects on the office routine is necessary for compliance and reimbursement purposes.
| Short Descr | OUT OF OFFICE EMERG MED SERV | Medium Descr | SVC PRV EMER OUT OFFICE DISRUPTS OFFICE SVC | Long Descr | Service(s) provided on an emergency basis, out of the office, which disrupts other scheduled office services, in addition to basic service | Status Code | Bundled Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x) | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | Y1 - Other - Medicare fee schedule | MUE | 0 | CCS Clinical Classification | 231 - Other therapeutic procedures |
| 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider |
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| 2006-01-01 | Added | First appearance in code book in 2006. |
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