Blue Cross and Blue Shield of North Carolina (Blue Cross NC) continues to monitor claims to ensure that claims are being coded properly. Treatment room (revenue code 0761) is not appropriate to report office or clinic-based Evaluation and Management services (99202-99215, 99241-99245, G0463). Per the National Uniform Billing Committee: Data Specifications Manual (UB-04 Manual), revenue code 0761 should only be used when a specific procedure has been performed or treatment has been rendered.
Providers should ensure that they do not improperly report revenue code 0761 to represent Evaluation and Management services.
These changes apply to the following lines of business: Administrative Services Only (ASO), fully insured membership, Blue Card IPP Host and the State Health Plan (SHP).
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
Information in other languages: Español 中文 Tiếng Việt 한국어 Français العَرَبِيَّة Hmoob ру́сский Tagalog ગુજરાતી ភាសាខ្មែរ Deutsch हिन्दी ລາວ 日本語
© 2025 Blue Cross and Blue Shield of North Carolina. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. All other marks and names are property of their respective owners. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association.