CPT Codes that will NO LONGER Automatically Pend a Claim for an Attachment

Health Plans and Providers are reducing the number of attachments that are required to process claims. Participating health plans have agreed that the attached list of CPT codes will NO LONGER trigger an automatic pend for an attachment. (NOTE: Not all of the participating health plans were automatically pending claims billed with these codes to await an attachment, but one or more were previoously doing so. Now, none of the participating health plans will automatically pend claims with CPT codes on the attached list.)

Providers who have put automated edits into place to submit attachments when billing with these CPT codes should review their edits and adjust accordingly. Provider should also encourage non-participating health plans to similarly relax their requirements for these CPT codes.