The American Medical Association® (AMA) brought a new CPT® code, 99072, on September 8, 2020, for revealing the use of the extra cost of personal protective equipment (PPE) supplies, components, and duration to securely care for patients during a COVID-19 Public Health Emergency (PHE).
Don’t know what 99072 is or how to bill for extra PPE costs? Here are a few things to remember when billing this new CPT code.
What is the significance of CPT® Code 99072?
The American Medical Association (AMA) describes the 99072 CPT® code as additional procedures, equipment, and clinical staff time above and beyond those usually used in an initial appointment or other non-facility service(s), when conducted during a Public Health Emergency as defined by law, due to cardiac infectious disease.
What Are Practice Expenses Included in CPT® 99072?
The new 99072 code, according to the AMA CPT® Assistant (Special Edition September Update), includes the following practice expenses:
- Pre-visit phone calls to monitor the patient (symptom checks), social distancing directions during the visit, verifying patients for symptoms when they arrive at your office (taking temperatures and asking questions), putting on and taking off PPE, and cleaning and disinfection rooms.
- Three different surgical masks.
- Cleaning materials (hand sanitizer, disinfecting wipes, sprays, and cleansers).
What Are the Dos and Don’ts of CPT® 99072?
- The American Medical Association (AMA) advises against using CPT® 99070 to notify the increased expense of PPE supplies during the Public Health Emergency (PHE) but instead to use code 99072, as this new code accurately represents the additional costs with PPE supplies during COVID-19. If the PHE has concluded, do not use code 99072 because it is no longer valid.
- Irrespective of the number of services you offer during the medical encounter, you should report code 99072 once per in-person patient encounter/per provider identification number (PIN).
- To notify code 99072, the patient does not need a COVID-19 test or diagnosis.
- Nursing facility visits should not be reported as 99072 because they are regarded as facility services.
- Not all insurance companies cover additional PPE costs and recognize 99072 on claims. For example, the Centers for Medicare & Medicaid Services (CMS) and the
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