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TRICARE Policy Manual 6010.60-M, April 1, 2015
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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