Each year billing codes are updated by the American Medical Association. Please refer to the 2018 manuals for Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) as resources.
We’re updating our system for new 2018 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, 2018.” This applies to commercial and Medicare plans.
We will automatically adjust claims with new, covered codes that are submitted between January and March 31, 2018. Providers do not need to resubmit claims. When the adjustments are made and claims paid, EOPs will inform providers that the payment includes adjustment of the new codes that paid $0 upon initial submission.