AMA – Practice Management Alerts

Clarification: Payers not accepting 2013 CPT codes? Report them.

In response to questions regarding the “Payers not accepting 2013 CPT codes? Report them” PMAlert that went out on January 7, 2013, we want to clarify that rejection of a valid Current Procedural Terminology (CPT®) code refers to the code itself not being recognized by the health insurer. This may happen when an insurer has not updated its database with the new codes introduced. The message was not intended to imply any information requiring health insurance coverage or reimbursement policy as stated in the instructions provided in the introduction of the 2013 valid Current Procedural Terminology (CPT®) Professional edition. In addition, while the CPT book instructions governing code recognition on January 1 appear in the introduction, instruction on the use of CPT codes appear throughout the CPT code set.

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