Results 1 to 6 of 6

Unlisted codes

  1. Default Unlisted codes
    New Call-to-action
    We are having problems with unlisted codes. Our billing department is telling us that these codes do not get paid and we can not use them. I have explained that they need to be submitted along with the operative note. No one is listening to me. They are just taking the unlisted procedures off of the bill before it is submitted. Is anyone billing for unlisted codes and getting paid for them?

  2. #2
    North Carolina
    If the billing department is removing the unlisted code, what are they submitting in place? You are correct...If there isn't a CPT code to properly report the procedure, an unlisted code must be reported. Per CPT (front of your book)..."Select the name of the procedure or service that accuratley indentifies the service performed. Do not select a CPT code that merely approximates the service provided. If no such specific code exists, then report the service using the unlisted procedure or service code".

    Unlisted codes can become difficult when seeking reimbursement but submitting proper documentation and possibly an appeal is the correct course of action. I would present the citation from CPT to your billing department and take this to administration if all else fails.
    Rebecca CPC, CPMA, CEMC

    Your click COUNTS...

    CLICK to give FREE mammograms!

  3. Default
    In this case the unlisted codes was used along with 2 other codes that were not "unlisted" codes. so the biller just took the unlisted one off and billed the claim without it.

  4. #4
    North Carolina
    If it was appropriate to report the unlisted code also, it should have been submitted and worked on the back end. And if the billing department hasn't forgotten, that is their job. I strongly suspect that your providers and administration would be appalled if they knew the billing department took it upon themselves to remove those codes since this does have some financial impact. The provider performed the service, therefore he is entitled to that reimburement; however small it might be.
    Rebecca CPC, CPMA, CEMC

    Your click COUNTS...

    CLICK to give FREE mammograms!

  5. #5
    yes we bill unlisted codes and bill along with op notes and general description of procedure in box 19. we even get paid from medicare doing this.

  6. Default Unlisted code 47579

    Can you post unlisted codes 2 x's for a lap procedure if it's for the same area with different procedures done? There are open codes for them but not lap codes.

Similar Threads

  1. Unlisted Codes
    By in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 07-17-2015, 09:23 AM
  2. unlisted codes
    By cynthiabrown in forum Billing/Reimbursement
    Replies: 0
    Last Post: 11-06-2012, 05:04 PM
  3. unlisted codes
    By abevan in forum Medicare Regulations
    Replies: 6
    Last Post: 07-30-2012, 12:28 PM
  4. Unlisted Procedure Codes
    By Lyndapolk in forum General Surgery
    Replies: 0
    Last Post: 06-25-2009, 11:04 AM
  5. Unlisted cpt codes
    By georgie14 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 08-29-2008, 11:32 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.