tci Part B Insider - 2015 Issue 19

Physician Notes: This MAC Warns Against Vague Unlisted, NOC Claims

Plus: Wrong surgery on a patient? There’s a modifier for that. Sometimes it’s inevitable—your CPT® or ICD-9 manuals don’t include the right codes to reflect what’s in your physician’s documentation. In those instances, you have to turn to unlisted CPT® codes or NOC (not otherwise classified) diagnosis codes. However, payers have specific requirements for submitting these codes and one Part B MAC recently sent out a warning about what to include on the claims for them if you don’t want your payments denied. “When billing NOC or unlisted codes, providers shall...

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