When the provider determines what HCPCS Level II code will replace the local code on an existing TAR/SAR, will the field office accept the HCPCS Level II code listed on the new TAR/SAR without further documentation?
Yes. If the authorization period does not suprass the approved authorization period on the original TAR or SAR, the field office will accept the HCPCS Level II codes. However, if the service authorization period is longer than the approved authorization period, medical justification documentation must accompany the TAR or SAR.
Related Questions
- How should providers bill for different non-contracted items that have the same HCPCS Level II code (such as administration sets/extension sets) without the claim being denied or rejected for duplicate charges?
- If a provider enters the HCPCS Level I, II or III code, units and/or NDC correctly, but does not enter the unit of measurement correctly, will that line item be denied?
- Many of the Level II HCPCS codes (L codes) do not describe the splints that I am fabricating. How do I choose the proper code?
