January 5, 2011

SA-11-01
HHA-11-01
MS-11-01

BC-11-01
ASC-11-01
DC-11-01
HP-11-01

To:

All Blue Cross Contracting Providers

From:

Cindy Garrison, CPC – Education/Communication Coordinator
Institutional Relations
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association

Subject:

Category III Codes

Category III codes are a set of temporary codes for emerging services, procedures, and technology.  There is not a Category I code for these services, procedures, and/or technology.  If a Category III is available, this code must be used instead of a Category I unlisted code. 

Blue Cross will review any claim submitted with Category III codes or Category I unlisted codes.  When providers use these codes, drop the claim to paper and submit with medical records describing the service, procedure, or technology being provided.  Blue Cross will determine if benefits are available and process the claim accordingly.

A full set of Category III codes are available on the AMA Web site.  Go to www.ama-assn.org/go/cpt for the most current listing.

If you have any questions, please contact your provider consultant.

cg