National Correct Coding Initiative add-on codes

CMS has provided contractors with guidelines regarding the use of add-on codes, which may result in new denials not previously received. An add-on code is a HCPCS/CPT code that describes a service that is always performed in conjunction with another primary service. An add-on code is eligible for payment only if it is reported with an appropriate primary procedure performed by the same practitioner. An add-on code is never eligible for payment if it is the only procedure reported by a practitioner.

Add-on codes may be identified in three ways:

• The code is listed as a Type I, Type II, or Type III, add-on code.
• An add-on code generally has a global surgery period of “ZZZ” on the Medicare physician fee schedule database.
• An add-on code is designated by the symbol “+” in the Current Procedural Terminology® (CPT®) Manual.