In Coding
Jan 3rd, 2019
CPT® includes so-called “unlisted procedure codes” to report procedures or services for which there is no more specific code. Here are three tips to apply these codes, correctly. Tip 1: Unlisted Procedure Codes Are a Last Resort You should report unlisted procedure codes only when no other Category I or Category III CPT® code accurately ...
In Coding
May 5th, 2017
AMA’s Instructions for Use of the CPT® Codebook tell us, “do not select a CPT code that merely approximates the service provided. If no such specific code exists, then report the service using he appropriate unlisted procedure or service code.” The Instructions further note, “Each of these unlisted procedural code numbers (with the appropriate accompanying ...
In Billing
Dec 8th, 2014
You may claim unlisted procedure codes only if an existing CPT® Category I or Category III code does not describe the procedure you wish to report. Per Chapter 1 of the National Correct Coding Initiative Policy Manual for Medicare Services, “A physician should not report a CPT® code for a specific procedure if it does ...
Providers hear over and over again how important their documentation is to ensuring proper code selection and, ultimately, optimal compliant reimbursement. But the documentation stakes are even higher when there isn’t an appropriate code to describe the procedure or service performed.            You should never report a code that “almost” describes the procedure or service performed. ...
May 1st, 2013
ICD-10 is so specific that reporting unspecified codes will raise documentation red flags. By Shelly Cronin, CPC, CPMA, CPPM, CPC-I, CANPC, CGIC, CGSC Diagnosis coding is traditionally viewed as unessential to claims reimbursement; however, with ICD-10 that may change. Payers are going to great lengths to beef up their policies and to map their covered ...