2025 CPT code 99070
(Active) Effective Date: N/A Revision Date: N/A Medicine - Special Services, Procedures and Reports Medicine Services and Procedures Feed
Supplies and materials (excluding spectacles) provided by the physician exceeding those typically included in an office visit or other service; requires itemized list.
Modifiers are generally not used with this code.
Medical necessity is established by demonstrating that the additional supplies were clinically required to treat the patient's condition effectively and safely beyond the usual supplies incorporated into the primary procedure or visit.
The provider's clinical responsibility involves determining the necessity of providing additional supplies beyond the standard amounts included in other services. They must document the rationale and list the specific supplies provided.
In simple words: This code is used when a doctor gives you more supplies or materials than usual during your visit, like extra bandages or medication.The doctor must list everything extra they gave you.
CPT code 99070 reports supplies and materials furnished by the physician or other qualified healthcare professional that go beyond what's typically included in an office visit or other services.This code is for items exceeding the usual amount, and an itemized list of drugs, trays, supplies, or materials provided must accompany the claim.Spectacles are excluded. For additional supplies, materials, and clinical staff time needed during a public health emergency (as legally defined) due to respiratory-transmitted infectious disease, use code 99072.
Example 1: A patient presents for a laceration repair.The laceration is extensive requiring more suture material, antiseptic solution, and dressing supplies than typically used for a simple repair. Code 99070 is reported in addition to the laceration repair code and each supply item must be listed., A patient with a complex wound requires numerous dressings, special wound care products, and topical antibiotics exceeding the usual amount for basic wound care. The physician documents the type and amount of each supply and reports 99070 along with the wound care codes., During an office visit for an acute illness, a physician provides the patient with multiple medications and syringes exceeding those typically given for standard treatment.The physician itemizes each medication and related supply. This code is reported in addition to the EM code for the office visit.
Detailed documentation is crucial, including an itemized list of all supplies provided (drugs, trays, materials), along with the quantity of each.Supporting clinical documentation justifying the medical necessity for the excess supplies is required.
** This code is intended for situations where supplies exceed those normally included with the primary service.It is important to differentiate between supplies typically included in a procedure and those that are truly excess and separately billable. Documentation supporting the need for the excess supplies is essential.
- Revenue Code: Y1 (OTHER - MEDICARE FEE SCHEDULE)
- RVU: Work RVU – 0.00; Malpractice RVU – 0.00; Facility RVU – 0.00; Non-Facility RVU – 0.00; Facility Total RVU – 0.00; Non-Facility Total RVU – 0.00; Medicare National Facility Total Payment – $0; Medicare National Non-Facility Total Payment – $0
- Global Days: The global concept does not apply to this code.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Data unavailable.Consult Medicare fee schedules and other relevant payer information for historical fee data.
- Specialties:All specialties may use this code when appropriate.
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center