AHA Coding Clinic® for HCPCS - 2009 Issue 1; FOR your INFORMATION

The reporting of unlisted services or procedures

When a separately reportable service has been performed and there is no HCPCS Level I (CPT, including Category I and Category III) codes or HCPCS Level II code which describes the service or procedure, an unlisted code is generally reported. In the CPT codebook the unlisted service/ procedure codes can be found at the end of a section or subsection. The long descriptors for these codes start with the term “Unlisted”. Unlisted codes should be reported only if no other specific HCPCS codes adequately describe the procedure or service. Under the outpatient prospective payment system (OPPS), the Centers...

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