A special report is included electronically with an insurance claim as an attachment that explains why an unlisted procedure or service was performed on a patient rather than a regularly listed CPT Category I code in the Tabular section. As a medical coder, this is a very important step!

Apply your understanding of the proper use of special reports.

Include the following aspects in the discussion:

• Describe at least two reasons why an unlisted procedure or service would be coded
• Provide two examples of additional information would be included in a special report
• Select one unlisted procedure code from the Pathology and Laboratory section and include the description of the code
• Discuss what types of ramifications could result if a special report is not included with the insurance claim