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AMA Releases New Code for Use During the Public Health Emergency

On September 8, the American Medical Association (AMA) released a new code to report the additional practice expenses incurred during a public health emergency (PHE) that is over and above those usually included in a medical visit or service. The code accounts for the additional supplies, materials, and clinical staff time associated with evaluation, management and procedural services provided during the current PHE. 

 Code 99072 is effective immediately and reads:

Additional supplies, materials, and preparation time required and provided by the physician or other qualified health care professional and/or clinical staff over and above those usually included in an office visit or other service(s), when performed during a nationally declared public health emergency due to respiratory transmitted infectious disease.

This new code is intended to capture the following practice expense activities:

  • 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

The code should only be reported when the service is rendered in a non-facility place of service (POS) setting, such as a physician office, and in an area where the activities are required to lessen the transmission of the respiratory disease. The code should be reported only during a PHE due to a respiratory disease and only for additional items required to provide a safe in-person service. The code is to be reported once per in-person patient encounter regardless of the number of services provided at that encounter.

Currently, there are no relative value units (RVU) assigned to the code. The AMA has sent a request to the Centers for Medicare and Medicaid Services (CMS) to immediately implement the code and to assign practice expense RVUs based on input provided by the AMA. Practices can choose to assign a charge and submit the code to third-party payers however individual payer policies will dictate how the claim will be processed.

A special edition CPT Assistant article addressing this code and an additional COVID related laboratory code can be accessed here

Pain Management Codes Posted

The Coding and Reimbursement Committee has updated the coding information available on the AAPM website. New charts have been posted that include information concerning Medicare’s 2020 Relative Value Units (RVUs) for codes commonly reported by Pain Medicine Physicians. The title page provides links to CMS web pages that provide additional information and outlines the basis for the 2020 reimbursement rates.

The charts are organized according to the type of service (e.g. E/M, injections, radiology) with new and revised codes highlighted. As appropriate, some charts contain information indicating which codes include imaging guidance as well as which codes can be reported with the bilateral modifier. The Relative Value Units in the charts reflect the combined RVUs for physician work, practice expense and professional liability (total RVUs). RVUs in the “facility” column are used to calculate payments in the hospital or other facility setting. RVUs in the “non-facility” column are used for services provided in a physician office.

There is also a separate worksheet that lists all the new and revised codes for 2020. CPT 2020 introduces new codes for genicular and SI injections and makes significant changes to the instructions for reporting all somatic nerve injection codes. These changes are outlined in an AAPM E-News article, dated December 18, 2019.

Access the chart of common pain medicine codes online (login required).

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AAPM

American Academy of Pain Medicine