What must be provided when using an unlisted procedure code?

When utilizing an unlisted procedure code, it is essential to provide an operative report along with a suggested fee. This is critical because unlisted codes are used when a procedure does not have a specific code assigned or when a unique procedure is performed that does not fall within existing categories. The operative report serves to explain the specifics of the procedure, detailing what was done, why it was necessary, and how it differs from standard procedures. This documentation justifies the need for using an unlisted code and assists insurance companies in understanding the service that was provided. Additionally, including a suggested fee gives insurers guidance on the expected reimbursement amount for the procedure, facilitating the claims process.