• December 2018

Not Otherwise Specified (NOS) and Not Otherwise Classified (NOC)

As referenced in the Blue Cross Blue Shield of North Dakota (BCBSND) Provider Manual, all CPT and HCPCS codes that do not have a specific code description (i.e. Unlisted, Not Otherwise Specified (NOS), Not otherwise Classified (NOC), Unclassified, etc. codes) will be rejected. Previously, BCBSND would return these claims with a letter. With the new HMHS claims processing system, these claims will be rejected. This requirement is excluded for anesthesia services, codes 00100-01996.

The required information related to these codes can be submitted in the following manner:

  • For electronic claim submission, the information is placed in the SV101-7 of the 2400 service line loop.
  • For paper claim submission, the information is placed in Box 19 of the CMS-1500 claim form.

Examples of NOS/Unlisted or Unspecified Codes:

  • 83520 (Immunoassay, quantitative, not otherwise specified) – a description of the method or technique would be needed
  • 21499 (Unlisted musculoskeletal procedure, head) – requires a description of the procedure performed

More examples are provided in the BCBSND Provider Manual located at https://www.bcbsnd.com/content/dam/bcbsnd/documents/manuals/provider-manual-full.pdf