What must be included with claims submitted for unusual, new, or seldom-used codes?

When submitting claims for unusual, new, or seldom-used codes, a special report is essential. This requirement arises because these types of codes often represent procedures or services that are not frequently performed or that deviate from standard practice. The special report serves to provide the insurer with the necessary context and detailed justification around the use of these codes, ensuring that the services rendered are clearly understood and deemed appropriate for coverage.

The special report typically includes information such as the medical necessity of the procedure, details on its uniqueness, and documentation supporting why a standard code was not applicable. This added documentation is crucial for facilitating the claims review process and aiding in the approval of payment for services that may require additional scrutiny by the insurance company.

Other options, while potentially useful in different contexts, do not fulfill the same requirement for detailed justification and context that the special report provides.