• Revenue Cycle Management
  • COVID-19
  • Reimbursement
  • Diabetes Awareness Month
  • Risk Management
  • Patient Retention
  • Staffing
  • Medical Economics® 100th Anniversary
  • Coding and documentation
  • Business of Endocrinology
  • Telehealth
  • Physicians Financial News
  • Cybersecurity
  • Cardiovascular Clinical Consult
  • Locum Tenens, brought to you by LocumLife®
  • Weight Management
  • Business of Women's Health
  • Practice Efficiency
  • Finance and Wealth
  • EHRs
  • Remote Patient Monitoring
  • Sponsored Webinars
  • Medical Technology
  • Billing and collections
  • Acute Pain Management
  • Exclusive Content
  • Value-based Care
  • Business of Pediatrics
  • Concierge Medicine 2.0 by Castle Connolly Private Health Partners
  • Practice Growth
  • Concierge Medicine
  • Business of Cardiology
  • Implementing the Topcon Ocular Telehealth Platform
  • Malpractice
  • Influenza
  • Sexual Health
  • Chronic Conditions
  • Technology
  • Legal and Policy
  • Money
  • Opinion
  • Vaccines
  • Practice Management
  • Patient Relations
  • Careers

Q&A: Billing for services that don't have CPT codes

Article

The AMA has implemented numerous changes to Category III codes, and some of them have transitioned to Level I CPT codes.

Q: We have been receiving rejections on claims for unlisted services that do not fit the description of any Current Procedural Terminology code, even though we submit a letter and the op report. We are confused because they keep asking us to submit the correct code. What do we need to do?

A: First, contact the insurer and find out specifically what is being requested. It may be the temporary Category III codes that exist for services that have not yet been assigned a CPT code. The American Medical Association has implemented numerous changes to Category III codes, and some of them have transitioned to Level I CPT codes. You may not submit an unlisted procedure if there is a Category III code that describes the service. If it is a Medicare claim, this may be the basis for your denials.

Related Videos
Robert E. Oshel, PhD
Gary Price, MD, MBA
Victor J. Dzau, MD, gives expert advice
Ron Holder, MHA, gives expert advice
remote patient monitoring
referral
no shows
effective meetings
phone
© 2023 MJH Life Sciences

All rights reserved.