CodeMap® Compliance Briefing: 02/01/2008
When a provider is unable to find either a specific analyte code or a method code for a particular test or procedure, the provider may identify the test with an unlisted procedure code. However, providers should use these codes only as a last resort since many payers, in particular Medicare, require additional development or explanation of why the test was performed. In addition, typically Medicare sets reimbursement amounts for these codes at $0.00. Despite these drawbacks, some providers of esoteric procedures have found a way to use these codes to their advantage. Today’s CodeMap® Compliance Briefing will discuss unlisted CPT codes, the associated rules, and recent developments concerning how these codes are used.
Gregory Root, Esq.
Using Unlisted CPT Codes<....
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