New CPT Code 99072

We have already seen payers start adding 99072 as a bundled (non-reimbursable) code to their policies.

Aloha,

Thank you for your feedback. It’s nice to see another Island physician affiliated with PMI. We will start to code 99072 as well and hope they start to reimburse use for it.

Sincerely,

Danielle P., RMA

Practice Manager

Wee Pediatrics, Inc./Theresa Y. Wee, M.D.

Wee Wellness Center

94-1388 Moaniani Street, Suite 207

Waipahu, Hawaii 96797

Phone: (808)677-9988 Extension: 103

Fax: (808)671-5559

www.weewellnesscenter.com

Live Long, Laugh often, Love strong…

Are you still getting payments for code 99072? Please let me know so I can prove to our local insurers that there are other payers that are not ignoring this CPT code. It just burns me up to see insurance companies bundling this code when it is specific to the pandemic and we are spending extra money to provide services to patients. What can we do about this situation?

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Hi. Thank you for sending out information about your use of the 99072 code. When using that code, which diagnosis / diagnoses do you use? All diagnoses attached to the visit?

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Hi, I have been using this code (99072) since around 9/24 even though during the last Chip & Paulie on 10/21 - they said insurance company were paying including Tricare- all our claims have not been so lucky

No reimbursement/payment to date as viewed an an invalid code. Entire claim kicked out. We have to remove CPT and rebill as a corrected claim to get the remaining CPTs on claim paid.

99072-
UHC, Anthem BCBS/Carefirst & most Medicaid plans are not paying for this.

Cigna & Aetna started to pay initially, but now they are dropping to PR. Humana Military mostly pays but sometimes they drop to PR.

We are in AZ and being paid for 99072 by most Aetna plans, BC/BS, and Cigna. We are not using a modifier.

Sorry for the late reply. Yes, I use all the codes associated with the reason for the visit to the office. Had a few Tricare payments and Aetna, but the payments are not consistent or frequent. But the payment at least covers for a box of masks :slight_smile: