Practice Quiz

Medical Coding

Category - Coding Guidelines

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When you include an unlisted service procedure code on a claim, what else must you also include on the claim?
  1. A Category III code
  2. A Category II code
  3. A special report
  4. All diagnostic studies
Explanation
Answer: C - When you include an unlisted service procedure code on a claim, you must also include a special report. This special report needs to include a precise description of the service or procedure and the nature of and need for the service. The special report should also include the time, effort, and equipment used to complete the service.
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