Wiki definitions of coding

[den71ice]

Hello all my fellow coders,

I have a question that seems to be an issue in my clinic. From a coders, biller CPT and AMA perspective what is your definition or understanding of the word UNLISTED?

Thanks for all your help,

 

[Anna Weaver]

definition

Hello all my fellow coders,

I have a question that seems to be an issue in my clinic. From a coders, biller CPT and AMA perspective what is your definition or understanding of the word UNLISTED?

Thanks for all your help,

The word unlisted, to me, means that it's a procedure that isn't covered in any other code, with or without a modifier. It's something that is not done often enough to warrant it's own code. It's often not paid without appeal, due to that same reason. It causes me to shudder every time I use it, because I know, it's going to cause problems. Can't wait to see other responses!

 

[nc_coder]

In the AMA CPT 2009 Professional Edition pg xvi of the introduction it states:
It is recognized that there may be services or procedures performed by physicians that are not found in the CPT codebook. Therefore, a number of specific code numbers have been designnated for reporting unlisted procedures. When an unlisted procedure number is used, the service or procedure should be described. Each of these unlisted procedural code numbers (with the appropriate accompanying topical entry) relates to a specific section of the book and is presented in the guidelines of that section.

I, too, cringe when I have to use one of these and avoid them at all costs. But sometimes there is just no way around it.