Process for CPT category III T codes
Important billing information
Effective February 26, 2024, when records are not submitted to support the code billed (of T codes linked below), the service will be rejected. The claim must then be resubmitted with the appropriate information.
First Coast requests the following documentation be submitted with the initial claim submission for the T codes linked below.
- History and physical examination
- Lab or Diagnostic test results, if applicable
- Progress or office notes for the service performed
- Operative or procedure report, if applicable
- Full text peer reviewed articles
- Society guidelines
- Any additional documentation that supports the need for the service
CPT category III T codes
Avoid negative impacts to your claims by providing the medical records with your claim submission for the T codes linked above. Please consult this list frequently as First Coast anticipates the list may be updated quarterly.