Billing Unlisted CPT Procedure Codes to Medicare

Recently many claims and supporting documentation have been submitted containing unlisted CPT® code(s) for which a separate, payable procedure cannot be identified. When this occurs, the unlisted CPT® code is denied.

To best facilitate payment for an unlisted CPT® code, please include in the claim’s narrative section what specific procedure is being linked to the unlisted code. When possible, include the CPT® code that the provider thinks most closely approximates the procedure. By doing so, CIGNA Government Services can process your claim quicker and more accurately. If you forget to place the information in the original claim, be sure to address it when you submit the required documentation.

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