Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Coding)
General Guides Submit the code that most accurately identifies the service(s)
performed. Documentation in the patient’s medical record must
support the codes submitted.
11-22
Do not use multiple codes when services can be represented by
a single code, unless otherwise instructed. Fragmented services
(reporting several codes when one adequately defines the
service) will be subject to our coding software edits and may
be denied.
Unlisted codes should only be used if no code exists to
describe the service or supply. HCPCS codes for unlisted
services require a complete narrative description.
Submit all services for the same date of service on the same
claim.
“C” HCPCS codes.
Codes C1000-C9999 are for items classified in newtechnology
ambulatory payment classifications (APCs)
under the outpatient prospective payment systems. These
codes are exclusively for use in billing for institutional
transitional pass-through payments. Blue Cross does not
use an APC methodology for adjudication or payment of
claims, thus C codes will not be used in adjudication.
Processing and payment will be determined by other
factors on the claim, such as a revenue code.
It is the intention of CMS to allow the use of the codes by
all payers regardless of payment methodology, so C
HCPCS codes will be accepted on institutional (UB-04 or
837I) claims only. However, C codes submitted on a
professional claim (CMS HICF/837P), other than
freestanding ambulatory surgical centers (ASC), will deny
as provider liability.
Free-standing ASC services are submitted on a professional
claim format. C-codes may be submitted, as appropriate, on
freestanding ASC claims.
Zero-billing Blue Cross will allow zero-billing or no-charge claim lines.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (07/12/12)