Definition:
CPT® 99080 describes special reports or documentation required by third parties that are not included in standard services. This code is commonly used for completion of forms, letters, or reports needed for insurance, legal, or administrative purposes.
When to Use:
- For completing insurance forms, disability evaluations, or school/occupational reports.
- When documentation goes beyond routine patient care notes, including extra time for data gathering or explanation.
- Appropriate for situations where the provider’s work is requested by an external entity and not part of standard office visits.
Documentation Requirements:
To support billing for CPT® 99080, clinicians should document:
- Type of report or form requested.
- Date of service and time spent preparing the report.
- Information provided, including summary of patient status or clinical findings.
- Any additional communication with third parties as part of the report.
Key Notes:
- CPT® 99080 is an add-on service and is billed in addition to other patient encounter codes when applicable.
- Accurate documentation ensures compliance and proper reimbursement for administrative work.
- Use discretion to avoid overbilling; the service must be separate from routine office visits.
How OptiMantra Supports 99080:
OptiMantra’s EMR and practice management platform helps providers track and document special reports efficiently, organize necessary patient information, and generate clean, compliant claims. This streamlines administrative work while maintaining accurate records for billing and compliance.
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