Gastroenterology Coding Alert

Question: I did some paperwork for a patient in my practice. Can I bill for it?

Tennessee Subscriber

Answer: A code exists which generally describes this kind of work. CPT 99080 is for "special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form."

To answer your question, yes, you can bill for it. However, the question of whether it's covered is another thing. Many insurers do not pay for this code, and you may have to go outside coverage to get paid for it. Just as its descriptor says, 99080 is intended to be used when a physician fills out something other than a standard reporting form, such as paperwork related to the Family and

Medical Leave Act. You shouldn't use it to report the completion of routine forms, such as hospital-discharge summaries.

Note: It would not be appropriate to submit 99080 in conjunction with 99455 or 99456, which are the codes for work-related or medical disability evaluation services. The descriptors for these codes explicitly state that they include "completion of necessary documentation/certificates and reports."