Unlisted/Non-specific HCPCS/CPT Codes - Paramount …

PG0097 05/03/2021 Unlisted/Non-specific HCPCS/CPT Codes Policy Number: PG0097 Last Review: 05/03/2021 GUIDELINES This policy does not certify benefits or authorization of benefits, which is designated by each individual policyholder contract. Paramount applies coding edits to all medical claims through coding logic software to evaluate the accuracy and adherence to accepted national standards. This guideline is solely for explaining correct procedure reporting and does not imply coverage and reimbursement. SCOPE X Professional X Facility DESCRIPTION Healthcare Common Procedure Coding System ( hcpcs ) are billing Codes developed by the Centers of medicare and Medicaid services (CMS). They are assigned to every task and service a medical practitioner may provide to a patient including medical, surgical and diagnostic services . Current Procedural Terminology (CPT) are billing Codes developed by the American Medical Association (AMA) that describes the range of services that can be billed for by a physician, hospital, or outpatient facility that provides medical services .

Dec 01, 2007 · whether or not the procedure is covered, was medically necessary, and if separate service is warranted or is a bundled service. Product code S5199 is non-covered. COVERAGE CRITERIA HMO, PPO, Individual Marketplace, Elite/ProMedica Medicare Plan, Advantage Paramount reimburses medically necessary unlisted procedures and services.

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  Services, Code, Medicare, Specific, Hcpcs, Covered, Unlisted, Unlisted non specific hcpcs cpt codes

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