US · guidance
CMS Pub. 100-08, ch. 3, § 3.4.1.2
Not Otherwise Classified (NOC) Codes
This section applies to MACs.
The MAC MR staff should assist claims processing staff in making coverage and pricing
determinations on NOC HCPCS/CPT codes. The claims processing staff will need
information from the MR staff so that they can price the service in accordance with CMS
pricing methodologies described in the Claims Processing Manual (IOM Pub. 100-04).
MACs shall keep track of pricing determinations for frequently billed services so that the
claims processing staff can price future claims using established MR pricing guidelines
for that service.
History
(Rev. 377, Issued: 05-27-11, Effective: 06-28-11, Implementation: 06-28-11)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
b85a3dde2ce88f4a422431c4274a39e95d32fdfb1aeed5a0a31e0eabcf0d7d64
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