Oncology & Hematology Coding Alert

Question: Our oncology nurses asked me to investigate 99060. Should I report this code for emergency services outside the office that disrupt our schedule?

Nevada Subscriber

Answer: Although that is the AMA's general intent in providing this code, few payers will reimburse you for 99060 (Service[s] provided on an emergency basis, out of the office, which disrupts other scheduled office services, in addition to basic service).

The clinical example AMA's CPT Assistant (August 2006) offers is that a patient with increasingly worse abdominal pain -requires immediate treatment out of the office, which disrupts other scheduled office services.- As the descriptor states, you should report 99060 in addition to a basic service, such as an E/M code.

But Medicare does not price the code on its fee schedule, and you-ll find many (but not all) other payers following suit. Some experts recommend including the code as -nonpayable- in your payer contracts so that you may charge the patient for the service.