The Record - for physicians and other health care providers to share with their office staffs
Forward to a friend  |  Subscribe  |  The Record Archive  |  Contacts  |  bcbsm.com  |  Print this article
December 2013

Reminder: Supporting documentation needed when billing unclassified or not-otherwise-classified procedure codes

Specific documentation is needed when you provide a service that is associated with an unclassified or not-otherwise-classified procedure code.

The supporting documentation is necessary to ensure that the claim can be reviewed in a timely manner to determine a procedure’s medical appropriateness and service payment amount. When the necessary documentation isn’t attached, claims will be denied.

Only services where an established Current Procedural Terminology or Health Care Procedure Coding System code doesn’t exist should be reported with a NOC code. NOC codes must include a description of the service performed as well as the specified supporting documentation.

For more information on supporting documentation, see the articles on Page 7 of the January 2009 Record and Page 3 of the September 2009 Record.

If you have additional questions about claims or payable services, see your online provider manual on web-DENIS.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2012 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.