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New CPT Code

  • 1.  New CPT Code

    Posted 09-15-2020 11:53
    Thought this might be of interest to those with office or imaging center operations.

    https://www.acr.org/Advocacy-and-Economics/Advocacy-News/Advocacy-News-Issues/In-the-Sept-12-2020-Issue/New-CPT-Code-to-Report-Additional-Costs-Incurred-Due-to-COVID-19

    First time I can remember a CPT code being added mid-year.  No idea whether insurance will pay, but maybe worth looking into.

    Cheers!

    ------------------------------
    David Smith FACMPE
    Executive Director
    United Imaging Consultants
    Mission
    (785) 393-8387
    ------------------------------


  • 2.  RE: New CPT Code

    Posted 09-17-2020 10:47
    Interesting:
    1.  So can we go back to the beginning of the PHE?
    2.  Any idea on the payment amount for this code?
    3.  Seems it's designed for POS 11, so any other issues in using for imaging center encounters?

    ------------------------------
    Douglas G. Kraus, CPA
    Chief Financial Officer
    South Texas Radiology Group, P.A.
    ------------------------------

    Original Message


  • 3.  RE: New CPT Code

    Posted 09-17-2020 10:58

    Hi Doug,

    The American Medical Association (AMA) published a new Current Procedural Terminology (CPT®) code on September 8 that accounts for extra provisions to ensure patient and provider safety during a public health emergency. APMA participated in the development of this code through its CPT Editorial Panel representation.

    The code is effective immediately:

    CPT 99072 - 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

    This new code does not yet have any dollar value associated with it, but APMA-supported efforts are underway to establish payment. 

    Our Clients are calculating the costs associated with their PPE for now.

    Barbara F. Rubel MBA, FRBMA

    Senior VP, Marketing & Client Services

    Immediate Past President, FRBMA

     

    brubel@msnllc.com

    904-657-2038 (Office) | 770-823-3597 (Cell)
    MSNLLC.com

     




    Original Message


  • 4.  RE: New CPT Code

    Posted 09-17-2020 11:00
    Hi Doug

    This link might be helpful:  https://www.ama-assn.org/system/files/2020-09/cpt-assistant-guide-coronavirus-september-2020.pdf

    My interpretation is that the new code is effective September 8, and is applicable in all non-facility settings, including imaging centers.

    Whether there will be insurance payment or in what amount I think is anybody's guess at this point.  Nine days isn't enough time for them to have digested, and most probably aren't aware and won't be until they start hearing from providers and seeing claims.  If no one bills for it, then there won't be any payment.  If many bill for it, then I think many third parties will ultimately pay.

    If I were running an imaging center or office based practice, I would review the article above, price out the cost of the items listed, and set a price as close as possible to that cost.  Then I would reach out to major payors to let them know we plan to use the new code, and urge them to cover it.

    I also think it's important to be mindful of the fact that many patients will probably have to pay out of pocket, at least until such time as the payors catch up with it.  That may be a reason for some not to use it.

    ------------------------------
    David Smith FACMPE
    Executive Director
    United Imaging Consultants
    Mission
    (785) 393-8387
    ------------------------------

    Original Message


  • 5.  RE: New CPT Code

    Posted 09-17-2020 11:08

    Thanks Dave.

    Yep had read that article. 

    Probably only wishful thinking on the part of commercial payers (actually processing it) but even if we get it covered for Medicare recipients, might be helpful depending on rate.

    Not even sure if any RVUs have been assigned, and likely not.

     

     

     

    Douglas G. Kraus, CPA

    Chief Financial Officer

    South Texas Radiology Group, P.A.

    (210) 616-7700

     




    Original Message


  • 6.  RE: New CPT Code

    Posted 09-29-2020 15:59
    We have reached out to a few carriers and are finding a few that will pay for the new code through November 1st.  However, at least one of them requires that information be included in the report to substantiate billing 99072.

    Has anyone else seen this or have any suggestions for the language to be included on the report?

    Stay well!

    ------------------------------
    Cindy Pittmon RCC, CHBME, FRBMA
    Founder, President, CEO
    Acclaim Radiology Management
    Longview TX
    (903) 663-4800
    ------------------------------

    Original Message


  • 7.  RE: New CPT Code

    Posted 09-30-2020 07:38

    Hi Cindy,

     

    I have suggested to our groups to add a sentence to their documentation stating something like:  "During this public health emergency we are using enhanced sterilization processes and PHE for your protection."

     

    Have a great day!

     

    Lori

     

    Lori M. Shore, CPC, RCC, RCCIR, FRBMA

    Vice President, Coding Education and Compliance

    MBMS, LLC

    111 Continental Drive, Suite 304

    Newark, DE  19713

    1-888-625-4753, ext. 311

    eFax 1 610 465 9481

    Cell - 484-832-6116

    www.mbms.net

     

     



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  • 8.  RE: New CPT Code

    Posted 09-30-2020 09:33

    Cindy, just wondering which carriers have said they will pay.  I haven't come across any as yet.

     

    Thanks,

    John

     

    ---

    John E. Pugh

    Pugh Healthcare Business Advisors

    P: 609-644-4479 F:609-503-2476

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    Original Message


  • 9.  RE: New CPT Code

    Posted 09-30-2020 10:38

    Hi John,

     

    We have been calling carriers and have found that Aetna and Premera BCBS say they will cover the charge.  We haven't actually received any payments as yet.

     

    Cindy

     




    Original Message


  • 10.  RE: New CPT Code

    Posted 09-30-2020 10:10
    Good morning

    We started to see the first payment by Aetna, they are paid 20.00, We are billing one unit per patient, all our reports include a note like this

    Service performed during Public Health Emergency. PPE supplies utilized according to CDC guidelines




    ------------------------------
    Cristina Arredondo MHA, FACHE, FACMPE
    Director Patient Financial Services
    Baptist M&S Imaging
    San Antonio TX
    (210) 785-2519
    ------------------------------

    Original Message


  • 11.  RE: New CPT Code

    Posted 10-19-2020 11:11

    Good Morning,

    Is anyone billing this CPT code for both their Imaging Centers and Hospital based claims?

     

    Thanks!

     

    Kim Smiley, CPC, RCC

    Coding Manager

    ph:  (317) 328-7256  |  fax: (317) 715-9955

    kim@northwestradiology.com

     

    Description: Description: Description: Description: NWR_50YR_Color_small

     

     

     




    Original Message


  • 12.  RE: New CPT Code

    Posted 10-19-2020 12:09

    Happy Monday  Kim,

     

    The last notification I recall seeing in September is that the 99072 is limited to non-facility POS.

     

    "This new code should only be reported when the service is rendered in a non-facility place of service (POS) setting, and in an area where it is required to mitigate the transmission of the respiratory disease for which the PHE was declared." CPT Assistant https://www.ama-assn.org/system/files/2020-09/cpt-assistant-guide-coronavirus-september-2020.pdf

     

    With that in mind some insurance companies are paying for the 99072 for non-facility settings.  It truly varies by insurance and the plan on whether to reimburse or not. 

     

    Unless there was a recent change, I have not seen that the 99072 has been added to the IDTF approved list. 

     

    If others have different information, please do share.

     

    Thanks,

    Sara

     


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  • 13.  RE: New CPT Code

    Posted 10-19-2020 12:13

    There was a through summary of this code on the Healthcare Administrative Partners blog last week.

    https://info.hapusa.com/blog-0/can-radiologists-effectively-bill-for-covid-related-costs

     

    John

     

    ---

    John E. Pugh
    Pugh Healthcare Business Advisors
    P: 609.644.4479 F: 609.503.2476

     




    Original Message


  • 14.  RE: New CPT Code

    Posted 11-10-2020 12:02
    Hi,

    Has anyone successfully billed this code to Medicare? I did see one previous post citing Aetna was paying. Any others payers anyone has come across?

    Thank you!

    ------------------------------
    Vicki Parikh
    Practice Administrator
    Mid-Delaware Imaging
    ------------------------------

    Original Message


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