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The CPT® Code 99072 is designated for reporting additional supplies, materials, and clinical staff time that exceed what is typically included in an office visit or other non-facility services. This code is specifically applicable during a Public Health Emergency (PHE) as defined by law, particularly in the context of respiratory-transmitted infectious diseases. The use of this code is limited to situations where the office visit or service is directly related to a respiratory infectious disease that is part of the PHE. The additional supplies and materials that can be reported under this code are essential for preventing the transmission of the infectious disease associated with the PHE. These items may include, but are not limited to, face masks, cleaning products, point of care tests, and other necessary supplies that contribute to the safety and health of both patients and healthcare providers. Furthermore, the clinical staff time that is accounted for under this code reflects the extra effort required to ensure safe evaluation, medical treatment, or procedural services during the PHE. This may encompass activities such as providing pre-visit instructions to patients, assessing symptoms, taking vital signs upon patient arrival, and delivering education on measures to mitigate the spread of the disease, either before or after treatment. Overall, CPT® Code 99072 serves to capture the additional resources and efforts required to maintain safety and compliance during a public health crisis.
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The CPT® Code 99072 is indicated for use during an office visit or non-facility service that occurs in the context of a Public Health Emergency (PHE) due to a respiratory-transmitted infectious disease. The following conditions warrant the application of this code:
The procedure associated with CPT® Code 99072 involves several key steps that ensure the safe delivery of healthcare services during a PHE. Each step is crucial for maintaining patient safety and preventing the spread of infectious diseases.
Following the procedure associated with CPT® Code 99072, it is essential to ensure that patients receive appropriate post-visit care and education. This includes advising patients on any necessary follow-up appointments, monitoring for symptoms related to the respiratory infectious disease, and reinforcing the importance of hygiene practices to prevent further transmission. Additionally, healthcare facilities should continue to evaluate their supply levels and readiness to respond to ongoing public health concerns, ensuring that they are equipped to provide safe and effective care in future visits.
| Short Descr | ADDL SUPL MATRL&STAF TM PHE | Medium Descr | ADDL SUPL MATRL&STAF TM DRG PHE RES-TR NFCT DS | Long Descr | 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 | 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) | Berenson-Eggers TOS (BETOS) | none | MUE | 3 |
| 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. | GP | Services delivered under an outpatient physical therapy plan of care | CS | Cost-sharing waived for specified covid-19 testing-related services that result in and order for or administration of a covid-19 test and/or used for cost-sharing waived preventive services furnished via telehealth in rural health clinics and federally qualified health centers during the covid-19 public health emergency | AT | Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942) | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | KX | Requirements specified in the medical policy have been met | GW | Service not related to the hospice patient's terminal condition | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | GO | Services delivered under an outpatient occupational therapy plan of care | CO | Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant | GA | Waiver of liability statement issued as required by payer policy, individual case | CQ | Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant | Q5 | Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | 24 | Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period: the physician or other qualified health care professional may need to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) unrelated to the original procedure. this circumstance may be reported by adding modifier 24 to the appropriate level of e/m service. | 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. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 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. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GX | Notice of liability issued, voluntary under payer policy | LT | Left side (used to identify procedures performed on the left side of the body) | MG | The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional | QW | Clia waived test | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2022-01-01 | Added | First appearance in code book. |
| 2022-01-01 | Changed | Grammar correction |
| 2020-09-08 | Added | Code added. |
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