What are add-on CPT codes and when should they be used?

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Add-on CPT codes are supplementary codes used in medical billing to describe procedures or services that are performed in addition to a primary procedure. They are not reported alone and must always be billed with an appropriate primary CPT code.

Key Features of Add-on Codes:

• Always used with a primary code

• Cannot be billed as standalone services

• Typically describe:

  • Additional work (e.g. extra surgical steps)

  • Extended time (e.g. prolonged evaluation)

  • Bilateral or multiple instances of a procedure

How to Identify Add-on Codes:

• Found in the CPT code book with a “+” plus sign before the code.

• Example: +33225 (Insertion of pacing electrode, add-on to 33249)

Examples of Add-on Code Use:

1. Surgery:

   • Primary Code: 27447 – Total knee arthroplasty

   • Add-on Code: +27486 – Revision of total knee arthroplasty (if performed)

2. Anesthesia Time Units:

   • Add-on codes apply for prolonged anesthesia time.

3. Evaluation and Management (E/M):

   • +99354 for prolonged services beyond a typical E/M visit.

When to Use Add-on Codes:

• When the procedure is documented and medically necessary

• Only in combination with the correct primary CPT code

• Follow payer guidelines—some insurers may require special documentation

Tips:

• Do not report add-on codes by themselves.

• Ensure proper documentation to support the additional work.

• Use coding tools or CPT guidelines to verify correct code pairings.

In summary, add-on CPT codes capture extra services tied to a primary procedure, ensuring accurate billing and reimbursement.

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