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
More examples are provided in the BCBSND Provider Manual located at https://www.bcbsnd.com/web/providers/provider-manual.