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Procedure Codes

Blue Cross and Blue Shield of Alabama utilizes the Healthcare Common Procedure Coding System (HCPCS) that contains three levels of codes:

Level I: Physicians’ Current Procedural Terminology (CPT) codes
Level II: Alpha numeric five position codes
Level III: Alpha numeric temporary codes

The Level II and Level III codes primarily represent items and non-physician services that are not represented in the Level I codes. Included are codes and descriptors copyrighted by the American Dental Association’s Current Dental Terminology. All other Level II codes and descriptors are approved and maintained jointly by the Alpha-Numeric Editorial Panel (consisting of the Centers for Medicare and Medicaid Services, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association).

CPT is a listing of descriptive terms and identifying codes for reporting medical services and procedures performed by physicians. The CPT is published by the American Medical Association and is updated yearly. Providers will assign these codes at the time of service.

It may be necessary at times to report an “unlisted” or “not otherwise classified” (NOC) code.  These claims should be submitted on a paper claim form, along with the procedure or operative note to Blue Cross and Blue Shield of Alabama to ensure appropriate coding.  In addition, a description of the unlisted service should be reported in item 19 on the claim form.  If the unlisted service is a drug, report the National Drug Code (NDC) and dosage rather than description.    

Last Updated January 2010