Administration
Chapter 1
Section 11.1
Category III Codes - Temporary Codes For
Emerging Technology, Services And Procedures
Issue Date: March
6, 2002
Copyright: CPT only © 2006
American Medical Association (or such other date of publication
of CPT).
All Rights Reserved.
Revision: C-57,
December 13, 2019
1.0 DESCRIPTION
Category III
codes are a set of temporary codes for emerging technology, services,
and procedures. These codes are used to track new and emerging technology
to determine applicability to clinical practice. When a Category
III code receives a Category I code from the American Medical Association
(AMA) it does not automatically become a benefit under TRICARE.
However, the codes that may have moved from unproven to proven must
be forwarded to the Office of Medical Benefits and Reimbursement
Section (MB&RS) for coverage determination/policy clarification.
2.0 POLICY
2.1 Category
III codes are to be used instead of unlisted codes to allow the
collection of specific data. TRICARE has not opted to track Category
III codes at this time.
2.2 Category
III codes are excluded from coverage, unless specifically
noted in policy, since clinical safety and efficacy
or applicability to clinical practice has not been established.
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