I’m a provider who is using a valid CPT code for something other than for what it is defined. There is no available code that accurately identifies the program and reimbursement arrangement Blue Cross has with providers. If I continue to use this code in that way, would this be in violation of HIPAA compliance?

In situations where there is no clear national code set equivalent, the closest valid national code set will be selected and used to process applicable claims.

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In situations where there is no clear national code set equivalent, the closest valid national code set will be selected and used to process applicable claims.