# 99072 new code for PPE



## wynonna (Sep 17, 2020)

Has anyone heard of this code for additional PPE that can be billed with office visits?   
Are insurance companies reimbursing for it?
Are there any additional CPT and/or ICD10 codes to bill during COVID for supplies?
What are the documentation requirements for billing 99072?
Thanks


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## dstruve (Sep 17, 2020)

It is going to be like the 99070, just because they made the code doesn't mean any of the carriers will pay for it. I have not heard anything from any of the carriers at this point, just my speculation.


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## mgortega23 (Sep 17, 2020)

wynonna said:


> Has anyone heard of this code for additional PPE that can be billed with office visits?
> Are insurance companies reimbursing for it?
> Are there any additional CPT and/or ICD10 codes to bill during COVID for supplies?
> What are the documentation requirements for billing 99072?
> Thanks


We started billing this code and we have not seen reimbursement and do not expect it but Providers that I work for insist on having it on each claim except for labs. Here is something you can read on about the code. https://www.texmed.org/Template.aspx?id=54686&terms=99072


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## Billing500 (Sep 22, 2020)

What are you charging for this code @mgortega23


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## mgortega23 (Sep 23, 2020)

Billing500 said:


> What are you charging for this code @mgortega23


$20.00


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## mccoyheather (Sep 30, 2020)

Read this article: https://www.aapc.com/blog/51794-ama-approves-2-new-cpt-codes-for-covid-19/
cite link from article: Transmittal 10373, CMS Pub 100-04 Medicare Claims Processing Transmittal 10373: States new AMA codes released 9/8/2020 will be:
"EFFECTIVE DATE: October 1, 2020 *Unless otherwise specified, the effective date is the date of service. IMPLEMENTATION DATE: October 5, 2020" hope this helps. Our office has denied claims for 99072, applicable to any face to face encounter during PHE from 03/01/2020 to 12/31/2020 thus far. We are holding claims until 10/5. Good luck!


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## mgortega23 (Oct 22, 2020)

Billing500 said:


> What are you charging for this code @mgortega23


$20.00


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## ewilli (Nov 2, 2020)

My office has been billing the 99072 for $20.00, we do a lot of DOL billing. The Department of Labor is paying this code. The private insurance companies we deal with are not paying.


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## Partha45 (Nov 3, 2020)

We are billing this code and received payment from BCBS, Aetna & Cigna. 

But the BCBS & UHC guidelines stated as a bundled code not separately reimbursable code. It might get recoup in the future.



			https://www.uhcprovider.com/content/dam/provider/docs/public/policies/oxford/b-bundle-codes-ces-ohp.pdf
		



			https://www.floridablue.com/sites/floridablue.com/files/docs/Supplies_Payment_Policy_10-021_2020.pdf
		



			https://static.cigna.com/assets/chcp/resourceLibrary/medicalResourcesList/medicalDoingBusinessWithCigna/medicalDbwcCOVID-19.html


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## hhornsby (Nov 3, 2020)

How are your providers documenting for this CPT? Are they listing out everything used?


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## Partha45 (Nov 4, 2020)

hhornsby said:


> How are your providers documenting for this CPT? Are they listing out everything used?


"Patient presents to the office, requiring the care of an illness, ongoing treatment care. The encounter occurs during a Public Health Emergency (PHE), as defined by law, due to respiratory- transmitted infectious disease.

Apart from evaluation time, additional time spent by clinical staff to check patient symptoms upon arrival, provide instructions on social distancing, apply & remove PPE, and perform additional cleaning of the examination /procedure/imaging rooms, equipment, and supplies to prevent the spread of communicable disease."



			https://www.ama-assn.org/system/files/2020-09/cpt-assistant-guide-coronavirus-september-2020.pdf


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## tabytha (Nov 12, 2020)

Did you have to update your contracts to get paid for this code?


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## mgortega23 (Nov 17, 2020)

tabytha said:


> Did you have to update your contracts to get paid for this code?


No


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## TPeniston61 (Nov 20, 2020)

Medicare is  not paying for this code.


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