10/02/2020

Correct Billing for CPT 99072

I just read that when we use the new CPT 99072, we have to add a modifier??? WHY weren't we told this last week when we attended a webinar about this new code? Thanks!!!

Based on coding guidance from CMS (https://www.cms.gov/files/document/mm11960.pdf) and other coding resources, there is no modifier that needs to be reported with this procedure code. CPT 99072 should be billed with any E&M code or procedures without any special modifiers as a condition for payment. Other insurance carriers such as commercial or Medicaid payers may require a modifier, but at this time, there are no published rules or conditions on payment of this code.