CPT Code 99499: Unlisted Evaluation and Management Service

Procedure code 99499 is an unlisted Evaluation and Management (E/M) service code used in rare situations when a service does not meet the criteria of any specific CPT E/M code, typically when the visit does not reflect even the lowest level of E/M service. It requires detailed documentation explaining why no other code applies and a concise description of the service provided to support medical necessity and facilitate payer adjudication.

The CPT codes from 99202 to 99499 encompass a broad range of Evaluation and Management services provided by physicians and qualified healthcare professionals, including office visits, hospital care, consultations, emergency department services, critical care, nursing facility services, home health, prolonged services, and preventive medicine.

CPT code 99499 does not require a modifier; however, it must be billed with a brief service description and appropriate documentation. As per payer-specific guidelines, it is often used to submit supplemental diagnosis codes or unlisted services with a nominal charge.