Formatting Special Reports

When you report a CPT® “unlisted procedure” code, or one of the new technology (Category III) codes, you may be required to enclose a special report with your claim. Additionally, the CPT® codebook provides instruction regarding special reports in the Radiology Guidelines, which specify, “A service that is rarely provided, unusual, variable, or new may require a special report. Pertinent information should include an adequate definition or description of the nature extent, and need for the procedure; and the time effort, and equipment necessary to provide the service.”

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The special report should also provide information about the time, effort, and equipment necessary to provide the service. Additional information that may be helpful to the carrier includes: The complexity of symptoms, final diagnosis, pertinent physical findings, diagnostic and therapeutic procedures performed, concurrent problems, and planned follow-up care. This data gives the payer a better understanding of what the procedure is, what was required to perform it, and how it should be reimbursed.

One Response to “Formatting Special Reports”

  1. Harshad says:

    I agree. you have to be careful what you are cnrveoting to view on your ipod. I will try and get around to creating some screen shots of pages I have converted and put those here just to show what success I have had so far. I have had some success creating quizzes in the same way and when fully tested I will put some up so others can try them out.

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