To add a Non-Standard CPT and a NOC to the description for claim processing.
NOTE: You must be an "Account Manager" user in ProviderSuite to perform this task. If you do not have access to the Settings tab in the ProviderSuite, please forward these instructions to another user with Account Manager permissions.
1. Go to the Settings tab
2. Select CPT Codes from the menu line
3. Scroll down to the Non-Standard Practice CPTs section
4. Enter a six or seven digit, alpha-numeric code, be sure "Active" is checked, be sure "NOC" is checked and select Update to save the new entry.
5. Repeat for additional non-standard CPT codes.
Please note that you will need to enter the charge amount manually or update your fee schedule to include an amount for the new non-standard CPT code.
*** If a payer is requiring “NOC” for a Non Standard code that is sending NDC information please see below.
The description you add in the "Non-Standard Practice CPTs" is what will go out in the EDI File. The characters "NOC" should precede the description. "NOC" is required by the clearinghouse in order to include the description and place it in the correct loop and segment (Loop 2400 SV101-7) required by the payer.
For example for a Non Standard code J3490VP, the original description under "Non-Standard Practice CPTs" was “VERAPAMIL 2.5MG 1ML NDC#00409114402”. The description will now appear in the claim file once the claims have been submitted electronically. The "NOC" will be included in the description and appear as “NOC VERAPAMIL 2.5MG”.
Here is what pulls into the EDI File:
NTE*ADD*NOC VERAPAMIL 2.5MG~ ***DESCRIPTION***
Please let us know if you have additional questions or concerns regarding Non Standard CPT codes and NDC/ NOC descriptions.