- Outpatient Institutional Providers Reimbursed Under MPFS: When to Split Claims for Updated Rates
- Outpatient Services for Registered Inpatients
- Allergen Immunotherapy Preparation (95144-95165)
- Ambulatory Surgical Center Approved HCPCS Codes and Payment Rates
- Billing for FQHC MAO Plan Supplemental Payment (PPS Providers)
- Billing for Services Not Included in the FQHC Benefit
- Attention all OPPS Providers: Provider-Based Department Edits Being Implemented on/after 8/1/2023
- Billing for Drug Wastage: JW and JZ Modifier
- Billing Medicare for a Denial - Condition Code 21
- URGENT: Billing Reminders for OPPS Providers with Multiple Service Locations
- Billing Medicare Part A When Veteran’s Administration Eligible Medicare Beneficiaries Receive Services in Non-VA Facilities
- Condition Code G0 Reminder
- CPT Code 15830: Excision, Excess Skin and Subcutaneous Tissue; Abdomen, Infraumbilical Panniculectomy
- Medicare Part B Electronic Claims that Exceed the Threshold for Charges and Units of Service
- ESRD Facilities: Clarification for Providing Dialysis Services to Patients Acute Kidney Injury
- Federally Qualified Health Centers Behavioral Health Claims Job Aid
- Federally Qualified Health Centers Contracting with Medicare Advantage Plans
- Fee-For-Time Compensation Arrangement and Reciprocal Billing Job Aid
- Answers to Common Fee-for-Time Compensation Arrangements Questions
- FQHC and Group Therapy Services Job Aid
- Long-Term Care Hospitals: How to Request Adjustments of Claims Paid at the Site Neutral Rate
- Inhalation Treatment CPT 94640 – Billing Errors
- Immunization Roster Billing
- Nonphysician Practitioners Billing for Surgical Procedures
- Professional Services During a Patient Hospice Election
- Professional Services During a Patient Hospice Election
- Proper Billing for Finger and Toe Procedures
- Proper Submission of Fee-For-Time Compensation Arrangements and Reciprocal Billing Arrangements
- Proper Use of Taxonomy Codes
- A/B Rebilling Facts
- Common Reciprocal Billing Questions and Answers
- Reminder for Avoiding Claim Denials for Positron Emission Tomography Scans
- Reminder on Deleting Revenue Code Line(s) in the Fiscal Intermediary Standard System Direct Data Entry System
- Repetitive Outpatient Services for Providers Submitting Institutional Outpatient Claims
- Reporting Multiple Qualifying Visits on the Same Date of Service for FQHC Reimbursement
- Unlisted and Not Otherwise Classified Procedure Codes
- What All Facilities Need to Know About the Long-Term Care Hospital Three-Day or Less Interrupted Stay Policy
- Fiscal Year/Calendar Year Claim Split
Unlisted and Not Otherwise Classified Procedure Codes
Table of Contents
- Unlisted and Not Otherwise Classified Procedure Codes
- Proper Billing for NOC Procedures
Unlisted and Not Otherwise Classified Procedure Codes
It is important, when billing any service, that providers always use the most appropriate CPT code that accurately describes the procedure performed.
The purpose of a NOC code is to report services having absolutely no existing code(s) that appropriately describe the service(s). Billers should use the reference aids available in the coding manuals before billing any service with a NOC code.
Upon medical review, services reported with NOC codes when specific codes are available will be denied; regardless of any supporting documentation accompanying the claim.
Medicare may view the deliberate use of inappropriate NOC codes for maximizing payments or "unbundling" procedures as a fraudulent billing practice. Misrepresentation of noncovered or non-chargeable services with NOC codes as approved, covered services is also inappropriate.
Proper Billing for NOC Procedures
Electronic Claims
- Loop 2400, SV101-7 - A detailed description of the service
- Loop 2400, SV104 - Bill only one unit of service
Note: An unprocessable rejection occurs when any of the information above is missing/invalid.
Paper Claims
- Item 19 – A detailed description of the service
- If submitting an attachment, please also indicate in Block 19 what is being attached (i.e. operative report attached, office notes, etc.)
- Item 24G - Bill only one unit of service
Note: An unprocessable rejection occurs when any of the information above is missing/invalid.
The following tips will help you bill NOC procedure codes
- Do not file unlisted or NOC codes for procedures (i.e., surgical) when there is an appropriate CPT code
- Do not file unlisted or NOC codes for procedures (i.e., surgical) without indicating a detailed description of the service being provided for payment
- If you provide a comparable code for the service performed, include the actual name of the surgical or medical procedure
Examples of adequate descriptions of NOC codes
- Stab Phlebectomy of Varicose Veins 1 Extremity 6 Stab Incisions
- Pharyngeal scar band lysed with monopolar cautery
- Arthroscopic decompression of the suprascapular nerve
Examples of inadequate descriptions of NOC codes
- Breast Surgery Procedure Unlisted
- Not Otherwise Classified
- Biologic Injection
Reviewed 8/28/2024