Unlisted and Not Otherwise Classified Procedure Codes (NOC)

Published 02/22/2018

IMPORTANT: Palmetto GBA will not be requesting any required documentation to process services.

  • Do not file unlisted or NOC codes for procedures (i.e., surgical) when there is an appropriate CPT code
  • Do not file unlisted or NOC codes for procedures (i.e., surgical) without indicating a description of the service being provided for payment

Electronic Claims: The description of the service MUST be submitted in Loop 2300/Elem SV101-7 or Loop 2400/ELEM SV101-7. No description entered in one of the two will result in the service being rejected. Additional information can be submitted in any of the Loop/Elements:

  • Loop 2300, NTE, 02
  • Loop 2400, NTE, 02

Paper Claims: When submitting an unlisted or NOC for paper claims, the description of the service must be indicated in the following:

  • Block 19
  • Attachment - if submitting an attachment, please indicate in Block 19 what is being attached (i.e. Operative Report attached, office notes, etc.)
  • If a description of the service is not submitted, the service will be denied

Additional Documentation Submission: When additional documentation is required for the submission of the NOC services, please refer to the Submitting Additional Documentation article located on Palmetto GBA’s website.


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