QUEST Integration – Miscellaneous Procedure Codes

Original Effective Date:

02/01/2004

Current Effective Date:

01/01/2022

Important Note:

Effective January 1, 2022, HMSA has partnered with EyeMed for routine vision services for the following lines of business: Commercial, Akamai Advantage®, QUEST Integration, Fed 87, and HMSA Plan for Postal Service Employees.

Non-routine vision services remain under our medical benefit and will be processed as such.

For more information, please visit EyeMed at www.eyemedinfocus.com.

Claims for services billed with miscellaneous CPT or HCPCS procedure codes must include a description of the service in order to determine the benefit status and payment level for the service. Without a description, the service cannot be processed for payment.

The following is an abridged list of some alphanumeric HCPCS procedure codes that must be submitted with a description of the billed service. This list is provided as a guide to determine billing requirements only and is not confirmation of benefit coverage. This is not a comprehensive list of miscellaneous codes. As a general rule, any CPT or HCPCS procedure code described by words such as “other,” “unlisted,” “miscellaneous,” “unspecified,” “by report” or other similar wording should be submitted with a description of the service rendered even if it is not on this list. Surgical procedures or other comprehensive services will require a report to document the services that were rendered. See QUEST Integration – Claims Requiring Attachments or Documentation.

Revision History