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Notice: Effective October 1, 2009, Blue Cross and Blue Shield of North Carolina (BCBSNC) to require all appropriate CPT and HCPCS at the line level of the UB-04

In a move consistent with industry claim submission standards Blue Cross and Blue Shield of North Carolina (BCBSNC) will begin requiring all appropriate CPT and HCPCS codes be included at the line level of the UB-04 when used to report outpatient and ambulatory surgery center services. UB-04 outpatient claims must be billed with both revenue codes and appropriate CPT or HCPCS codes when applicable codes exist.

Appropriate revenue codes must be placed in Form Locator 42 for each line item. CPT and HCPCS codes are assigned in Form Locator 44. Outpatient hospital and ambulatory surgery centers must include CPT/HCPCS codes in Form Locator 44 to describe specific procedures, when and if, appropriate codes are available. If multiple CPT or HCPCS codes are necessary to reflect multiple, distinct, or independent services matching a single revenue code, claims should be coded to repeat that revenue code as necessary.

UB-04 filers should note that absence of an appropriate HCPCS, CPT or revenue code on an outpatient claim could likely result in a rejected claim or affect processing time. This change will become effective October 1, 2009.