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Thread: Unlisted codes

  1. #1

    Default Unlisted codes

    AAPC: Back to School
    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
    Join Date
    Apr 2007
    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.

  3. #3


    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
    Join Date
    Apr 2007
    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.

  5. #5
    Join Date
    Apr 2007


    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. #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.

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