tci Part B Insider - 2005 Issue 27

Part B Coding Coach: Afraid to Report Unlisted and Category III Codes? Capitalize on These 3 Tips

If you substitute Category III or unlisted-procedure codes with existing, but inexact, CPT codes for fear of inadequate reimbursement, beware: Failure to use the most accurate code, reimbursable or not, will result in denials and squelch all possibility for pay. Alternative: You can coach your carrier in developing reasonable RVUs  [relative value units] for unlisted-procedure and Category III codes with these three expert-approved steps. Category III codes are temporary codes for emerging technology, services, and procedures that allow the Centers for Medicare and Medicaid Services (CMS) to collect data on the use of these new services, an ability unlisted...

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