Please note that this article contains information that is only relevant to American clinics.

 

As you know, all of the treatment and service charges that you submit to Medicare insurance carriers are based on the American Medical Association’s (AMA) set of CPT codes. Among these codes is CPT code 97799—unlisted medicine/rehabilitation service or procedure. But as you can undoubtedly see, the CPT code’s description is rather vague, and open to interpretation. In this article, we’ll be clarifying CPT code 97799 and providing some examples of when you might need to use it.

 

Click here to learn more about billing Medicare patients for home exercise programs and patient education.

 

CPT code 97799 should be used when the therapy service or procedure that you’re providing is not described by a more specific CPT code. A recent article from Gawenda Seminars and Consulting cited dry needling (acupuncture) and hippotherapy (horseback riding) as examples.

 

The article then goes on to cite the AMA’s 1999 CPT Assistant, stating “when reporting an unlisted code to describe a procedure or service, it will be necessary to submit supporting documentation n along with the claim to provide an adequate description of the nature of the [procedure or service].”

 

As a reminder, Practice Perfect EMR comes preloaded with an entire library of CPT codes so that there’s no need to manually enter your clinic’s commonly used treatment and service charges. By providing you with the entire list, you’re able to handpick the CPT codes that are relevant to your practice, and discard the rest.

 

We hope you found this article helpful. For more great information about Medicare and the proper use of CPT codes, check out the Gawenda Seminars and Consulting website and learn more about the benefits of becoming a Gold Member.

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