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More HCPCS, CPT codes will be needed for certain outpatient commercial claims, starting Aug. 1

07/05/2018

We will require HCPCS (Health Care Procedure Coding System) or CPT (Current Procedural Terminology) codes for outpatient UB04 claims billed under three additional revenue codes beginning Aug. 1.

The additional codes are:

  • 720 – labor and delivery
  • 729 – labor and delivery other
  • 769 – treatment room other

If the additional codes are not included, the claim may get rejected.

The National Uniform Billing Committee 2010 Manual allows for this requirement. This will only apply to our commercial plans.

Here’s a full listing of revenue codes which require a HCPCS or CPT code. We will add this document to our online commercial provider manual around Aug. 1.