Forum - Questions & Answers
NOC - Not-Otherwise-Classified
Hello,
Does anyone know where I can find billing and coding guidelines for NOC on the CMS Part B or CGS website?
Thanks
re: NOC - Not-Otherwise-Classified
http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Part-B-Drugs/McrPartBDrugAvgSalesPrice/2012ASPFiles.html
re: NOC - Not-Otherwise-Classified
Sorry, the previous link was to pricing. Perhaps these can help:
http://www.cms.gov/Regulations-and-Guidance/HIPAA-Administrative-Simplification/Versions5010andD0/downloads/Important_5010_Update_PDF_for_March_2012.pdf
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE1138.pdf
re: NOC - Not-Otherwise-Classified
This is an ICD-9-CM term, not a CMS term. NOC is not otherwise specified. This is equivalent to unspecified. Ex: Influenza NOC. You will see this with an ill defined diagnostic statement, meaning if you had more information you could get a better code. Can consult doctor for better code.
http://health-information.advanceweb.com/web-extras/ccs-prep/official-icd-9-cm-coding-conventions.aspx
re: NOC - Not-Otherwise-Classified Drugs
Sorry, but I meant for new Drugs & Biologicals (J3490, J9999...) Thanks
re: NOC - Not-Otherwise-Classified
Thank you
re: NOC - Not-Otherwise-Classified
Also found this on our states new MAC: "Issued: December 29, 2011
As part of the transition from 4010.A1 to 5010, Medicare Fee-for-Service (FFS) is utilizing codes sets for editing of the inbound American Standards Committee (ASC) X12 version 5010 transactions. These codes sets are listed in the ASC X12 Technical Report Type 3 (TR3), also known as an Implementation Guide. To meet the requirements of the TR3 for proper editing of the Not Otherwise Classified (NOC) procedure codes, the Centers for Medicare and Medicaid Services (CMS) created an NOC code set* for editing Medicare transactions only.
Any procedure code that is considered an NOC code will require a description of the service rendered in the 2400 SV202-7 for Part A Institutional claims and in 2400 SV101-7 for Part B Professional claims. Failure to supply the description accurately will result in claim rejections. Please utilize this NOC code set* to determine if the procedure codes in your version 5010 Medicare claims require an NOC description"
Your software support should be able to tell you how to link the description to the charge to transmit electronically.