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Last Modified: 12/7/2009 Location: FL, PR, USVI Business: Part B

CO 181

Procedure code was invalid on the date of service.

(THIS CODE IS NO LONGER VALID. RESUBMIT WITH THE CORRECT CODE)
Resources/tips for avoiding this unprocessable claim
This occurs when outdated procedure codes are billed.
• Before submitting your claim, ensure you use the most current year's Current Procedural Terminology (CPT) codes.
• Providers can utilize the First Coast Service Options Inc. (FCSO) PC-ACE Pro32® software to avoid this returned claim. PC-ACE Pro32® software is updated with the most current CPT codes, to help you avoid submitting claims without a valid CPT code. The software does not implement or check against billing guidelines, but will help avoid a claim completion error. Click here for additional information on PC-ACE Pro32®.
• Verify the procedure codes being billed are payable and allowed under the Medicare program for the date of service being billed.
• Submit separate claims for services in different years of service. A procedure code valid in one year may not be valid in the other and will cause the entire claim to reject or deny.
• CMS provides quarterly updates to some procedure codes. Although the codes may be valid, they may not be valid for the dates of service you are billing.
• These quarterly updates occur in January, April, July, and October. Be sure to check the FCSO Medicare provider Web site and search for "quarterly update."
• The FCSO PC-ACE Pro32® software is updated with the most current CPT codes, to help you avoid submitting claims without a valid CPT code. The software does not implement or check against billing guidelines, but will help avoid a claim completion error. Click here for additional information on PC-ACE Pro32®.
• The FCSO Medicare provider Web site has links addressing local medical coverage. Specific codes and data may be found within the local medical coverage Active/Future/Retired LCDs for indications and limitations of coverage or medical necessity.
Tip to correct the unprocessable claim
Resubmit the claim with a correct and current CPT code for the date(s) of service.
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Source: FCSO Education Action Team