The effect of COVID-19 worldwide is unprecedented and multidimensional. The American Medical Association (AMA) Current Procedural Terminology (CPT®) Editorial Panel is tasked with ensuring that CPT codes remain up to date and reflect the latest medical care available to patients. To achieve this, the CPT Editorial Panel has set a precedent for rapidly releasing CPT codes during the pandemic to address this emergent issue. In keeping with this practice, the CPT Editorial Panel approved two new Category I codes and expedited the publication of these new codes to the AMA website on September 8, 2020.
Special Services, Procedures and Reports
● 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.
Discussion
This new code is established in response to the significant additional practice expenses related to activities required to safely provide medical services to patients in person during a PHE over and above those usually included in a medical visit or service. This new code should only be reported when the service is rendered in a non-facility place of service (POS) setting.
This new code is designed to capture the following practice expense factors such as:
Time over what is included in the primary service of clinical staff time (registered nurse [RN]/ licensed practical nurse [LPN]/ medical technical assistant [MTA]) to conduct a pre-visit phone call to screen the patient (symptom check), provide instructions on social distancing during the visit, check patients for symptoms upon arrival, apply and remove PPE, and perform additional cleaning of the examination/procedure/imaging rooms, equipment, and supplies
Three surgical masks
Cleaning supplies, including additional quantities of hand sanitizer and disinfecting wipes, sprays, and cleansers
Code 99072 is to be reported only once per in-person patient encounter per provider identification number (PIN), regardless of the number of services rendered at that encounter. In the instance in which the noted clinical staff activities are performed by a physician or other qualified health care professional (eg, in practice environments without clinical staff or a shortage of available staff), the activity requirements of this code would be considered as having been met; however, the time spent should not be counted in any other time-based visit or service reported during the same encounter.
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