Medicare AdvantageApril 30, 2020
Reimbursement Policy Update: Unlisted, Unspecified or Miscellaneous Codes
Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.
Effective August 1, 2020, Empire BlueCross BlueShield will continue to allow reimbursement for unlisted, unspecified or miscellaneous codes. Unlisted, unspecified or miscellaneous codes should only be used when an established code does not exist to describe the service, procedure or item rendered.
Reimbursement is based on review of the unlisted, unspecified or miscellaneous codes on an individual claim basis. Claims submitted with unlisted, unspecified or miscellaneous codes must contain specific information and/or documentation for consideration during review.
For additional information, please review the Unlisted, Unspecified or Miscellaneous Codes reimbursement policy here.
PUBLICATIONS: May 2020 Empire Provider News
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