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New 2017 codes

01/06/2017

Each year billing codes are updated by the American Medical Association. Please refer to the 2017 manuals for Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) as resources.

We're in the process of updating our system for new 2017 codes. Claims submitted with new codes for covered services will be noted on the explanation of payment (EOP) statements with an explanation code of Z0 that states "New code, rate not yet established, will be adjudicated by March 31, 2017." This applies to commercial and Medicare plans.

We will automatically adjust claims with new, covered codes that are submitted between January and March 31, 2017. Providers do not need to resubmit the claims. When the adjustments are made and claims paid, an EOP will be generated to inform providers that the payment includes adjustment of the new codes that paid $0 upon initial submission.