In medical billing, an unlisted code is used to report a service or procedure that does not have a specific Current Procedural Terminology (CPT) code. Reimbursement for these services can be nuanced and complex, but can be navigated with some basic understanding.
Explore this issue:September 2018
“There are specific reasons why the procedure you want to perform may not have its own code,” said R. Peter Manes, MD, coordinator of health policy and chair of the Physician Payment Policy Workgroup for the American Academy of Otolaryngology–Head and Neck Surgery (AAO/HNS). “The most common of these are low volume and newer technology.”
Don’t Use CPT Codes That Are Similar
While you need to be careful when working with unlisted codes, there is no need to fear them. Because of payment concerns, there may be a temptation to use an established code for a similar procedure.