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PAP226

Category II CPT Codes


Provider Administrative Policy

Section
Claims Submission
Policy Date
November 2007
Status/Date
Reviewed/September 2012
Provider Type(s)
All Providers  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.

Policy

Category II CPT Codes

Category II CPT Codes are descriptive administrative data codes. When submitted on a claim, there should be no corresponding charges on that line item. These codes are used by Blue Cross of Idaho to monitor the quality and processes of care and to determine process and clinical outcomes. National initiatives through The Centers for Medicare and Medicaid Services (CMS) and The American Medical Association (AMA) now require this data.

When submitting a claim containing a Category II CPT Code, please enter the charge amount as $0.00. If you experience system limitations with the $0.00 amount, you may enter $0.01 as the charge amount and Blue Cross of Idaho will convert it to $0.00.

Please note that FEP will delete the Category II CPT line altogether. Their processing system will not allow $0.00 lines.


Policy History

Date Action Reason
September 2012 Revised Language Revision

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