Wiki 3085F

[lgirouard14]

Hello!
Can anyone help me with this code, 3085F? We are not able to get any insurances to cover this when billed with an office visit. Any insight is much appreciated!

 

[CBLENNIE]

3085F is a Category II CPT code which are informational codes are not intended to be used for billing/reimbursement purposes. Category II codes are typically optional, unless required by your payer contracts, and intended to be used for measuring performance on quality metrics such as HEDIS and/or PQRI.

Here is a bit of background on Category II codes from the AMA's website:
CPT Category II codes are supplemental tracking codes that can be used for performance measurement. The use of the tracking codes for performance measurement will decrease the need for record abstraction and chart review, and thereby minimize administrative burdens on physicians and other health care professionals.

These codes are intended to facilitate data collection about quality of care by coding certain services and/or test results that support performance measures and that have been agreed upon as contributing to good patient care. Some codes in this category may relate to compliance by the health care professional with state or federal law. Here is a link to this article on the AMA's website. Category II CPT codes: performance measurement

If you google CPT 3085F you will find that some payers do have 3085F listed on their fee schedules, but Medicare and most commercial payers will not reimburse 3085F or any other Category II CPT code. Do any of your insurance contracts/fee schedules list this code with a reimbursement amount for the code? You probably need to verify which, if any, of your contracts/fee schedules list this code with a reimbursement amount.