Unlisted medicine services and procedures

Description

This code is utilized to report services or procedures in medicine that lack a specific code. It is essential for documenting unique or specialized interventions that do not fit into existing categories, ensuring accurate billing and record-keeping.

Medicare Hospital Outpatient Reimbursement (OPPS)

OPPS Payment Rate

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Patient Copayment / Coinsurance

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Top Modifiers

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HCPCS/CPT CCProcedure code change due to administrative or filing error(15.66%)

HCPCS/CPT 76Repeat procedure or service by same physician or qualified healthcare professional(3.91%)

HCPCS/CPT GYItem or service excluded from Medicare benefits(2.44%)

HCPCS/CPT GPOutpatient physical therapy service delivered by a physical therapist(1.11%)

HCPCS/CPT 95Telehealth service via real-time interactive audio and video telecommunications(1.03%)

HCPCS/CPT GAWaiver of liability statement issued per payer policy(1.03%)

HCPCS/CPT RTRight side procedure modifier(0.81%)

HCPCS/CPT GZItem or service expected to be denied as not reasonable and necessary(0.81%)

HCPCS/CPT 25Significant, separately identifiable evaluation and management service on the same day(0.81%)

HCPCS/CPT LTModifier for procedures performed on the left side of the body(0.66%)

Code Crosswalks

No crosswalks found.

Alternate Codes

No alternates found.

Billed With Codes

No codes found here.

Sources

We make no claims to ownership of the coding systems referenced on this platform. Codes and descriptions are produced from claims and chargemaster data available through the CMS-9915-F Transparency in Coverage Final Rule and via state or federal datasets. This service is provided solely as a reference to encourage use of these codes in our chargemaster review and automated billing tools, so that healthcare professionals can understand and correctly report these codes in their claims.

Federal and State Datasets

List of CPT/HCPCS Codes, Centers for Medicare & Medicaid Services (CMS)
I/OCE Quarterly Release Files, Centers for Medicare & Medicaid Services (CMS)
Physician Fee Schedule Relative Value Files, Centers for Medicare & Medicaid Services (CMS)
OPPS Addendum B, Centers for Medicare & Medicaid Services (CMS)
ASC Payment Addenda, Centers for Medicare & Medicaid Services (CMS)