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2025 CPT code 90399

Unlisted immune globulin administration.

Use CPT code 90399 only when no other specific code accurately represents the administered immune globulin product. Submit a comprehensive explanation to the payer justifying the use of an unlisted procedure code, including the specific product administered, dosage, and medical necessity for the administration.

Modifiers may be applicable depending on the specific circumstances of the service provided. Consult payer guidelines for applicable modifiers.

The administration of the unlisted immune globulin must be medically necessary and supported by comprehensive documentation demonstrating the patient's need for the specific product administered. Documentation should explain why alternative, more commonly used immunoglobulins were insufficient.

The provider administers the immune globulin and documents the medical necessity for its administration.

IMPORTANT:Use only when no other more specific CPT code accurately reflects the administered immune globulin product.Consider using other codes (90396 etc.) if a more specific code exists.

In simple words: This code is used when a doctor gives you a type of immune globulin (a blood protein that helps fight infection) that doesn't have its own specific billing code.The doctor will need to provide extra details to explain why this code was used.

CPT code 90399 reports the administration of an immune globulin not specified by another, more specific CPT code.This code encompasses various serum or recombinant globulin products, including broad-spectrum anti-infective immune globulins, antitoxins, isoantibodies, and monoclonal antibodies.It is used when no other more appropriate code exists to accurately reflect the administered product and should be accompanied by detailed documentation justifying its use.

Example 1: A patient presents with a severe infection caused by a rare pathogen.No specific immunoglobulin product codes exist for this pathogen. The physician administers a broad-spectrum immunoglobulin product, and this code (90399) is used to bill for the administration., A patient with a known immunodeficiency receives a customized immunoglobulin preparation based on their specific antibody deficiencies. Since no other CPT code exists for this specific customized immunoglobulin preparation, code 90399 is used to bill for the administration., A patient is given an experimental immune globulin for a clinical trial.Because the drug is not yet FDA approved and therefore doesn't have an assigned CPT code, code 90399 is utilized for billing the administration, pending FDA approval and code assignment.

Detailed clinical notes explaining the medical necessity for the unlisted immune globulin, including the specific product name and dosage administered.Supporting lab results, treatment plan, and any other relevant documentation are required for justification.

** Always consult the most up-to-date CPT codebook and payer guidelines for accurate coding and billing of 90399. The use of this unlisted code requires strong supporting documentation to ensure claim reimbursement.

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