Submitting Unlisted CPT or HCPCS Codes for Reimbursement

Effective for claims received on or after Jan. 1, 2019, UCare will deny the entire claim when any line on the claim is an unlisted HCPCS or CPT code submitted without supporting documentation. These denials will apply to all UCare products. 

• UCare will deny the line(s) that require(s) supporting documentation with the RARC code M127 – Missing patient medical record for this service. 
• The remaining lines on the claim will be denied using CARC 163 – Attachment/other documentation referenced on the claim was not received. 

Source: https://docs.ucare.org/filer_public/files/healthlines_2018_december.pdf?utm_source=December&utm_medium=health%20lines