New process: Unlisted codes on facility claims

Effective May 1, 2018, Priority Health will require a notation on facility claims submitted with unlisted CPT or HCPCS codes describing what item or service is being supplied.

Facility claims reported with unlisted CPT or HCPCS codes may be denied if this information is not supplied.  

This requirement is already in place for professional claims submitted for professional services reported with unlisted CPT or HCPCS codes.  

Where to include the note

On electronic claims: Use the note segment, NTE-Third party Organization Notes

On paper UB-04s: Use the remark section, FL80

Learn more

Go to: Billing & payment > Unlisted codes