R2838CP 1

Department of Health &
CMS Manual System Human Services (DHHS)
Pub 100-04 Medicare Claims Processing Centers for Medicare &

Medicaid Services (CMS)
Transmittal 2838 Date: December 13, 2013
Change Request 8548
SUBJECT: January 2014 Integrated Outpatient Code Editor (I/OCE) Specifications Version 15.0
I. SUMMARY OF CHANGES: This notification provides the Integrated OCE instructions and
specifications for the Integrated OCE that will be utilized under the OPPS and Non-OPPS for hospital
outpatient departments, community mental health centers, all non-OPPS providers, and for limited services
when provided in a home health agency not under the Home Health Prospective Payment System or to a
hospice patient for the treatment of a non-terminal illness. The attached Recurring Updated Notification
applies to 100-04, Chapter 4, section 40.1.
EFFECTIVE DATE: January 1, 2014

IMPLEMENTATION DATE: January 6, 2014
Disclaimer for manual changes only: The revision date and transmittal number apply only to red
italicized material. Any other material was previously published and remains unchanged. However, if this
revision contains a table of contents, you will receive the new/revised information only, and not the entire
table of contents.
II. CHANGES IN MANUAL INSTRUCTIONS: (N/A if manual is not updated)

R=REVISED, N=NEW, D=DELETED-Only One Per Row.
R/N/D CHAPTER / SECTION / SUBSECTION / TITLE

N/A
III. FUNDING:
For Fiscal Intermediaries (FIs), Regional Home Health Intermediaries (RHHIs) and/or Carriers:
No additional funding will be provided by CMS; Contractors activities are to be carried out with their
operating budgets
For Medicare Administrative Contractors (MACs):

The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined
in your contract. CMS does not construe this as a change to the MAC statement of Work. The contractor is
not obliged to incur costs in excess of the amounts allotted in your contract unless and until specifically
authorized by the Contracting Officer. If the contractor considers anything provided, as described above, to
be outside the current scope of work, the contractor shall withhold performance on the part(s) in question
and immediately notify the Contracting Officer, in writing or by e-mail, and request formal directions
regarding continued performance requirements.
IV. ATTACHMENTS:
Recurring Update Notification
*Unless otherwise specified, the effective date is the date of service.

Attachment - Recurring Update Notification
Pub. 100-04 Transmittal: 2838 Date: December 13, 2013 Change Request: 8548
SUBJECT: January 2014 Integrated Outpatient Code Editor (I/OCE) Specifications Version 15.0
EFFECTIVE DATE: January 1, 2014

IMPLEMENTATION DATE: January 6, 2014
I. GENERAL INFORMATION
A. Background: This instruction informs the A/B MACs, the HHH MACs and the Fiscal Intermediary
Shared System (FISS) that the I/OCE is being updated for January 1, 2014. The I/OCE routes all
institutional outpatient claims (which includes non-OPPS hospital claims) through a single integrated OCE,
which eliminates the need to update, install, and maintain two separate OCE software packages on a
quarterly basis. The attached Recurring Update Notification applies to 100-04, Chapter 4, section 40.1.
B. Policy: This notification provides the Integrated OCE instructions and specifications for the
Integrated OCE that will be utilized under the OPPS and Non-OPPS for hospital outpatient departments,
community mental health centers, all non-OPPS providers, and for limited services when provided in a
home health agency not under the Home Health Prospective Payment System or to a hospice patient for the
treatment of a non-terminal illness. The I/OCE specifications will be posted to the CMS Website and can be
found at http://www.cms.gov/OutpatientCodeEdit/.
II. BUSINESS REQUIREMENTS TABLE
"Shall" denotes a mandatory requirement, and "should" denotes an optional requirement.
Number Requirement Responsibility

A/B D F C R Shared- Other
MAC M I A H System
E R H Maintainers
A B H R I F M V C
H M I I C M W
H A E S S S F
C R S
8548.1 The Shared System Maintainer shall install the X
Integrated OCE (I/OCE) into their systems.
8548.2 Medicare contractors shall identify the I/OCE X X X

specifications on the CMS Website at
http://www.cms.gov/OutpatientCodeEdit/
III. PROVIDER EDUCATION TABLE
Number Requirement Responsibility
A/B D F C R Other
MAC M I A H
E R H
A B H R I
H M I
H A E
C R
8548.3 MLN Article : A provider education article related X X
to this instruction will be available at
http://www.cms.gov/Outreach-and-
Education/Medicare-Learning-Network-
MLN/MLNMattersArticles/ shortly after the CR is
released. You will receive notification of the article
release via the established "MLN Matters" listserv.
Contractors shall post this article, or a direct link to
this article, on their Web sites and include
information about it in a listserv message within one
week of the availability of the provider education
article. In addition, the provider education article
shall be included in the contractor’s next regularly
scheduled bulletin. Contractors are free to
supplement MLN Matters articles with localized
information that would benefit their provider
community in billing and administering the
Medicare program correctly.
IV. SUPPORTING INFORMATION
Section A: Recommendations and supporting information associated with listed requirements: N/A
"Should" denotes a recommendation.
X-Ref Recommendations or other supporting information:

Requirement
Number
Section B: All other recommendations and supporting information: CR 5344, Transmittal 1107:
Notification of an Integrated Outpatient Code Editor (OCE) for the July 2007 Release
V. CONTACTS
Pre-Implementation Contact(s): Yvonne Young, Yvonne.Young@cms.hhs.gov , Anita Antkowiak,

Anita.Antkowiak2@cms.hhs.gov , Marina Kushnirova, Marina.Kushnirova@cms.hhs.gov
Post-Implementation Contact(s): Contact your Contracting Officer's Representative (COR) or Contractor

Manager, as applicable.
VI. FUNDING
Section A: For Fiscal Intermediaries (FIs), Regional Home Health Intermediaries (RHHIs), and/or
Carriers:
No additional funding will be provided by CMS; Contractors activities are to be carried out with their
operating budgets
Section B: For Medicare Administrative Contractors (MACs):

The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined
in your contract. CMS do not construe this as a change to the MAC Statement of Work. The contractor is not
obligated to incur costs in excess of the amounts allotted in your contract unless and until specifically
authorized by the Contracting Officer. If the contractor considers anything provided, as described above, to
be outside the current scope of work, the contractor shall withhold performance on the part(s) in question
and immediately notify the Contracting Officer, in writing or by e-mail, and request formal directions
regarding continued performance requirements.
(Attachments 2)
Appendix M
Summary of Modifications
The modifications of the IOCE for the January 2014 release (V15.0) are summarized in the table below.
Readers should also read through the entire document and note the highlighted sections, which also indicate changes
from the prior release of the software.
Some IOCE modifications in the update may also be retroactively added to prior releases. If so, the retroactive date
will appear in the 'Effective Date' column.
# Type Effective Edits Modification

Date Affected
1. Logic 1/1/2014 24 Modify the software to maintain 28 prior quarters (7 years) of programs in each release. Remove
older versions with each release.
(The earliest version date included in this January 2014 release is 4/1/2007).
2. Logic 1/1/2014 - Modify Extended Assessment and Management composite APC assignment criteria (appendix
K)
- Delete composite APCs 8002 and 8003
- Add new EAM composite 8009
3. Logic 1/1/2014 Deactivate special logic to make separate payment for certain skin substitute products when
billed with specified skin substitute application procedures (appendix N).
4. Logic 1/1/2014 87 Implement new edit to require that specific skin substitute products (high cost vs. low cost) be
submitted with specific skin substitute application procedures (appendix N).
Edit description: Skin substitute application procedure without appropriate skin
substitute product code (RTP)
Edit criteria: A list A skin substitute application procedure is submitted without a list
A skin substitute product; or a list B skin substitute application procedure is submitted
without a list B skin substitute product on the same date of service.
5. Logic 1/1/2014 Change the SI from N to A for any laboratory code (code list) submitted on 14x bill type.
6. Logic 1/1/2014 Deactivate the logic for assignment of payment adjustment flags 7 & 8 with modifiers FB & FC
for offset payment reduction.
7. Logic 1/1/2014 Deactivate Payment Adjustment Flags 7 & 8.
8. Logic 1/1/2014 75 Modify edit 75 (Incorrect billing of modifier FB or FC) to apply if modifier FB or FC is
submitted on any line/any SI on a claim.
9. Logic 1/1/2014 78 Deactivate edit 78 ((Nuclear medicine) Claim lacks required radiolabeled product)
10. Logic 1/1/2014 85 Deactivate edit 85 (Claim lacks required device code or required procedure code).
11. Logic 1/1/2014 Add code 97610 to the ‘Sometimes Therapy’ list/logic (Change SI to A if submitted with a
therapy revenue code or therapy modifier)
12. Logic 8/16/2013 67 Implement mid-quarter FDA approval coverage for code 90688.
13. Content 1/1/2014 - Make HCPCS/APC/SI changes as specified by CMS (data change files).
14. Content 1/1/2014 20, 40 Implement version 20.0 of the NCCI (as modified for applicable institutional providers).
15. Content 1/1/2014 22 Add new modifier PM (Post mortem) to the valid modifier list
16. Content 1/1/2014 8 Update procedure/sex conflict edit list
17. Content 1/1/2014 71, 77 Update procedure/device & device/procedure edit requirements
18. Content 1/1/2014 84 Update the add-on/primary procedure pair edit requirements for PHP claims (G0463 added as a
primary code when reported with psychiatric add-on codes)
19. Doc 1/1/2014 - Revise SI descriptions:
S = Procedure or service, not discounted when multiple
T = Procedure or service, multiple reduction applies
20. Doc 1/1/2014 - Update appendix F, G,K, N
21. Doc 1/1/2014 - Add new flags & code lists to data files (HcpcsMap) and user manuals (app B) for edits 87.
22. Doc 1/1/2014 - Remove code lists from user manuals (app B, C) for deactivated edit (78) & modifier FB/FC
logic
23. Other 1/1/2014 - Create 508-compliant versions of the specifications & Summary of Data Changes documents for
publication on the CMS web site.
24. Other 1/1/2014 - Deliver quarterly software update & all related documentation and files to users via electronic
means.
FINAL
Summary of Data Changes
Integrated OCE v 15.0
Effective January 1, 2014
Table of Contents
CPT codes, descriptions, and material only are Copyright 2013 American Medical Association. All Rights Reserved. No fee
schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data
contained herein. Applicable FARS/DFARS restrictions apply to government use.
DEFINITIONS ............................................................................................................................................ 8
APC CHANGES ......................................................................................................................................... 9
Added APCs................................................................................................................................................ 9
Deleted APCs .............................................................................................................................................. 9
APC Description Changes ........................................................................................................................ 11
APC Status Indicator Changes .................................................................................................................. 12
HCPCS/CPT PROCEDURE CODE CHANGES ..................................................................................... 12
Added HCPCS/CPT Procedure Codes ...................................................................................................... 12
Deleted HCPCS/CPT Procedure Codes .................................................................................................... 19
HCPCS Description Changes.................................................................................................................... 21
HCPCS Changes- APC, Status Indicator and/or Edit Assignments.......................................................... 26
Hcpcs Edit Changes .................................................................................................................................. 65
HCPCS Approval and/or Termination Date Changes ............................................................................... 65
Edit Assignments ...................................................................................................................................... 65
Radiolabeled product Changes.................................................................................................................. 66
Edit Assignments ...................................................................................................................................... 67
Procedure/ Device Pair Changes ............................................................................................................... 69
Add-on/Primary Procedure Pair Changes ................................................................................................. 70
Skin Substitute Product Changes .............................................................................................................. 70
Skin Substitute Procedure Changes .......................................................................................................... 71
Lab Services Procedure Changes .............................................................................................................. 71
Skin Substitute High Cost Product Procedure Changes ............................................................................ 89
Skin Substitute Low Cost Product Procedure Changes ............................................................................ 89
Skin Substitute High Cost Procedure Changes ......................................................................................... 90
Skin Substitute Low Cost Procedure Changes .......................................................................................... 90
MODIFIERS ............................................................................................................................................. 90
Added Modifiers ....................................................................................................................................... 90
DEFINITIONS
 A blank in a field indicates ‘no change’
 The “old” column describes the attribute prior to the change being made in the current update, which is indicated in the
“new” column. If the effective date of the change is the same as the effective date of the new update, ‘old’ describes the
attribute up to the last day of the previous quarter. If the effective date is retroactive, then ‘old’ describes the attribute for
the same date in the previous release of the software.
 “Unassigned”, “Pre-defined” or “Placeholder” in APC or HCPCS descriptions indicates that the APC or HCPCS code is
inactive. When the APC or HCPCS code is activated, it becomes valid for use in the OCE, and a new description
appears in the “new description” column, with the appropriate effective date.
 Activation Date (ActivDate) indicates the mid-quarter date of FDA approval for a drug, or the mid-quarter date of a new
or changed code resulting from a National Coverage Determination (NCD). The Activation Date is the date the code
becomes valid for use in the OCE. If the Activation Date is blank, then the effective date takes precedence.
 Termination Date (TermDate) indicates the mid-quarter date when a code or change becomes inactive. A code is not
valid for use in the OCE after its termination date.
 For codes with SI of “Q1, Q2, and Q3”, the APC assignment is the standard APC to which the code would be assigned if
it is paid separately.
APC CHANGES
Added APCs
The following APC(s) were added to the IOCE, effective 01-01-14

APC APCDesc StatusIndicator
00205 Level III Male Genital Procedures T
00219 Vascular Ligation T
00326 Level I Skin Repair T
00327 Level II Skin Repair T
00328 Level III Skin Repair T
00329 Level IV Skin Repair T
00351 Level VII Anterior Segment Eye Procedures T
00420 Level II Minor Procedures X
00431 Level IV Closed Treatment Fracture T
00435 Level III Extended EEG, Sleep, and Cardiovascular S
Studies
00631 Level 1 Examinations & Related Services V
00634 Hospital Clinic Visits V
01454 Mumps vaccine sc K
01455 Foscarnet sodium injection K
01456 Pentobarbital sodium inj K
01457 Totazoline hcl injection K
01458 Phentolaine mesylate inj K
01459 Urea injection K
01460 Interferon alfa-2a inj K
01464 Factor VIII (porcine) K
01465 Tacrolimus ex rel oral 0.1mg G
01466 Inj, vincristine sul lip 1mg G
01467 Factor IX recombinant G
01468 Inj Aripiprazole Ext Rel 1mg K
01469 Inj, Filgrastim G-CSF 1mcg K
01471 Injection, Pertuzumab, 1 mg G
01472 Inj beta interferon im 1 mcg K
01473 Interferon alfa-n3 inj K
01474 Certolizumab pegol inj 1mg K
01475 Golimumab for iv use 1mg K
08009 Extended Assessment & Management Composite V
09441 Inj, ferric carboxymaltose G
09497 Loxapine, inhalation powder G
Deleted APCs
The following APC(s) were deleted from the IOCE, effective 01-01-14
APC APCDesc
00002 Fine Needle Biopsy/Aspiration
00003 Bone Marrow Biopsy/Aspiration
00091 Level II Vascular Ligation
00092 Level I Vascular Ligation
00127 Level IV Stereotactic Radiosurgery, MRgFUS, and MEG
00133 Level I Skin Repair
00134 Level II Skin Repair
00135 Level III Skin Repair
00136 Level IV Skin Repair
APC APCDesc
00137 Level V Skin Repair
00140 Esophageal Dilation without Endoscopy
00350 Administration of flu and PPV vaccine
00397 Vascular Imaging
00409 Red Blood Cell Tests
00604 Level 1 Hospital Clinic Visits
00728 Filgrastim 300 mcg injection
00735 Ampho b cholesteryl sulfate
00828 Gemcitabine hcl injection
00884 Rho d immune globulin inj
00900 Alglucerase injection
00917 Adenosine injection
01167 Inj, epirubicin hcl
01221 Dimethyl sulfoxide 50%
01239 Rotavirus vacc 2 dose oral
01240 Apligraf skin sub
01241 Oasis wound matrix skin sub
01242 Oasis burn matrix skin sub
01243 Integra BMWD skin sub
01244 Integra DRT
01245 Dermagraft skin sub
01246 Graftjacket skin sub
01247 Integra matrix skin sub
01248 Primatrix skin sub
01249 Cymetra allograft
01250 Graftjacket express allograf
01251 Integra flowable wound matri
01252 Gammagraft skin sub
01270 Alloderm skin sub
01275 Vivaglobin, inj
01287 Alloskin skin sub
01307 Oral busulfan
01339 Oral fludarabine phosphate
01342 Matristem micromatrix
01344 Gonadorelin hydroch/ 100 mcg
01345 Theraskin
01347 Oxacillin sodium injeciton
01349 Anidulafungin injection
01351 Matristem wound matrix
01355 Itraconazole injection
01357 Inj protirelin per 250 mcg
01414 Human fibrinogen conc inj
01423 Minocycline hydrochloride
01427 Alloskin
01428 Arthroflex
01429 Flexhd/Allopatchhd/matrixhd
01432 Arbutamine hcl injection
01434 Testosterone enanthate inj
01435 Injection estrone per 1 MG
01437 Gatifloxacin injection
01438 Diazoxide injection
01441 Intraocular Fomivirsen na
01444 Oral everolimus
01446 Visualization adjunct
01447 Interferon alfacon-1 inj
01452 Memoderm/derma/tranz/integup
01453 hMatrix
APC APCDesc
01461 Mediskin
01462 EZderm
01830 Power bone marrow bx needle
01840 Telescopic intraocular lens
01886 Catheter, ablation
02210 Methyldopate hcl injection
03050 Sermorelin acetate injection
07034 Somatropin injection
07036 Urokinase 250,000 IU inj
07049 Filgrastim 480 mcg injection
07051 Leuprolide acetate implant
08002 Level I Extended Assessment & Management Composite
08003 Level II Extended Assessment & Management Composite
09022 IM inj interferon beta 1-a
09023 Rho d immune globulin
09244 Regadenoson injection
09248 Inj, clevidipine butyrate
09249 Certolizumab pegol inj
09282 Inj, ceftaroline fosamil
09283 Injection, acetaminophen
09285 Patch, lidocaine/tetracaine
09292 Injection, pertuzumab
09358 SurgiMend, fetal
09360 SurgiMend, neonatal
09363 Integra Meshed Bil Wound Mat
09365 Oasis tri-layer wound matrix
09406 Iodine I-123 ioflupane
APC Description Changes
The following APC(s) had description changes, effective 01-01-14

APC Old Description New Description
00028 Level I Breast Surgery Level I Breast and Skin Surgery
00029 Level II Breast Surgery Level II Breast and Skin Surgery
00030 Level III Breast Surgery Level III Breast and Skin Surgery
00065 Level I Stereotactic Radiosurgery, MRgFUS, and IORT, MRgFUS, and MEG
MEG
00066 Level II Stereotactic Radiosurgery, MRgFUS, and Level I Stereotactic Radiosurgery
MEG
00067 Level III Stereotactic Radiosurgery, MRgFUS, and Level II Stereotactic Radiosurgery
MEG
00093 Vascular Reconstruction/Fistula Repair without Vascular Reconstruction/Fistula Repair
Device
00106 Insertion/Replacement of Pacemaker Leads and/or Insertion/Replacement/Repair of Pacemaker
Electrodes Generator, Leads, and/or Electrodes
00340 Minor Ancillary Procedures Level I Minor Procedures
00648 Level IV Breast Surgery Level IV Breast and Skin Surgery
01356 Zoldedronic acid 1mg Zoledronic Acid 1mg
01463 Tc 99m tilmanocept Tc99 Tilmanocept diag 0.5mci
09130 Injection, IVIG Bivigam Inj, Imm Glob Bivigam, 500mg
09131 In ado-trastuzumab emtansine Inj, Ado-trastuzumab Emt 1mg
09294 Inj, taliglucerase alfa Inj, Taliglucerace Alfa 10 u
09295 Injection, carfilzomib Injection, Carfilzomib, 1 mg
09296 Injection, ziv-aflibercept Inj, ziv-aflibercept, 1mg
09297 Omacetaxine mepesuccinate Inj, Omacetaxine Mep, 0.01mg
09298 Injection, ocriplasmin Inj, Ocriplasmin, 0.125 mg
APC Status Indicator Changes
The following APC(s) had Status Indicator changes, effective 01-01-14

APC Old SI New SI
00947 G K
01311 G K
01353 G K
01416 G K
01426 G K
09281 G K
09284 G K
09286 G K
09287 G K
HCPCS/CPT PROCEDURE CODE CHANGES
Added HCPCS/CPT Procedure Codes
The following new HCPCS/CPT code(s) were added to the IOCE, effective 01-01-14
HCPCS CodeDesc SI APC Edit ActivDate TermDate
0335T Extraosseous joint stblztion T 00062
0336T Lap ablat uterine fibroids T 00174
0337T Endothel fxnassmnt non-invas S 00097
0338T Trnscth renal symp denrv unl S 00279
0339T Trnscth renal symp denrv bil S 00279
0340T Ablate pulm tumors + extnsn T 00423
0341T Quant pupillometry w/ rprt N 00000
0342T Thxp apheresis w/ hdl delip S 00112
0343T Transcath mtral vlve repair C 00000
0346T Ultrasound elastography N 00000
10030 Guide cathet fluid drainage T 00006
19081 Bx breast 1st lesion strtctc T 00005
19082 Bx breast add lesion strtctc N 00000
19083 Bx breast 1st lesion us imag T 00005
19084 Bx breast add lesion us imag N 00000
19085 Bx breast 1st lesion mr imag T 00005
19086 Bx breast add lesion mr imag N 00000
19281 Perq device breast 1st imag Q2 00420
19282 Perq device breast ea imag N 00000
19283 Perq dev breast 1st strtctc Q2 00420
19284 Perq dev breast add strtctc N 00000
19285 Perq dev breast 1st us imag Q2 00420
19286 Perq dev breast add us imag N 00000
19287 Perq dev breast 1st mr guide Q2 00420
19288 Perq dev breast add mr guide N 00000
23333 Remove shoulder fb deep T 00020
23334 Shoulder prosthesis removal T 00022
23335 Shoulder prosthesis removal C 00000
33366 Trcath replace aortic valve C 00000
34841 Endovasc visc aorta 1 graft C 00000
34845 Visc & infraren abd 1 prosth C 00000
34848 Visc & infraren abd 4+ prost C 00000
37217 Stent placemt retro carotid C 00000
37236 Open/perq place stent 1st T 00229
37237 Open/perq place stent ea add T 00083
37238 Open/perq place stent same T 00229
37239 Open/perq place stent ea add T 00083
37241 Vasc embolize/occlude venous T 00082
37242 Vasc embolize/occlude artery T 00082
37243 Vasc embolize/occlude organ T 00082
37244 Vasc embolize/occlude bleed T 00082
43191 Esophagoscopy rigid trnso dx T 00141
43192 Esophagoscp rig trnso inject T 00419
43193 Esophagoscp rig trnso biopsy T 00419
43194 Esophagoscp rig trnso rem fb T 00419
43195 Esophagoscopy rigid balloon T 00419
43196 Esophagoscp guide wire dilat T 00419
43197 Esophagoscopy flex dx brush T 00141
43198 Esophagosc flex trnsn biopsy T 00141
43211 Esophagoscop mucosal resect T 00141
43212 Esophagoscop stent placement T 00384
43213 Esophagoscopy retro balloon T 00419
43214 Esophagosc dilate balloon 30 T 00419
43229 Esophagoscopy lesion ablate T 00422
43233 Egd balloon dil esoph30 mm/> T 00419
43253 Egd us transmural injxn/mark T 00419
43254 Egd endo mucosal resection T 00141
43266 Egd endoscopic stent place T 00384
43270 Egd lesion ablation T 00419
43274 Ercp duct stent placement T 00151
43275 Ercp remove forgn body duct T 00151
43276 Ercp stent exchange w/dilate T 00151
43277 Ercp ea duct/ampulla dilate T 00151
43278 Ercp lesion ablate w/dilate T 00151
49405 Image cath fluid colxn visc T 00037
49406 Image cath fluid peri/retro T 00037
49407 Image cath fluid trns/vgnl T 00685
52356 Cysto/uretero w/lithotripsy T 00429
64616 Chemodenerv musc neck dyston T 00204
64617 Chemodener muscle larynx emg T 00206
64642 Chemodenerv 1 extremity 1-4 T 00206
64643 Chemodenerv 1 extrem 1-4 ea N 00000
64644 Chemodenerv 1 extrem 5/> mus T 00206
64645 Chemodenerv 1 extrem 5/> ea N 00000
64646 Chemodenerv trunk musc 1-5 T 00206
64647 Chemodenerv trunk musc 6/> T 00206
66183 Insert ant drainage device T 00673
77293 Respirator motion mgmt simul N 00000
80155 Drug screen quant caffeine A 00000
80159 Drug screen quant clozapine A 00000
80169 Drug screen quant everolimus A 00000
80171 Drug screen quant gabapentin A 00000
80175 Drug screen quan lamotrigine A 00000
80177 Drug scrn quan levetiracetam A 00000
80180 Drug scrn quan mycophenolate A 00000
80183 Drug scrn quant oxcarbazepin A 00000
80199 Drug screen quant tiagabine A 00000
80203 Drug screen quant zonisamide A 00000
81287 Mgmt gene methylation anal A 00000
81504 Oncology tissue of origin A 00000
81507 Fetal aneuploidy trisom risk A 00000
87661 Trichomonas vaginalis amplif A 00000
88343 Immunohisto antibod add slid E 00000 28
9001F Aortic aneurysm<5cm diam ct E 00000 28
9002F Aortic aneurysm 5-5.4cm diam E 00000 28
9003F Aortic anrysm5.5-5.9cm diam M 00000 72
9004F Aortic anrysm 6/> cm diam M 00000 72
9005F Asympt carot/vrtbrbas sten E 00000 28
9006F Sympt sten-tia/strk<120days M 00000 72
9007F Other carot sten 120 days/> M 00000 72
90673 Flu vacc riv3 no preserv L 00000
92521 Evaluation of speech fluency A 00000
92522 Evaluate speech production A 00000
92523 Speech sound lang comprehen A 00000
92524 Behavral qualit analys voice A 00000
93582 Perq transcath closure pda T 00434
93583 Perq transcath septal reduxn C 00000
94669 Mechanical chest wall oscill S 00077
97610 Low frequency non-thermal us T 00013
99446 Interprof phone/online 5-10 E 00000 9
99449 Interprof phone/online 31/> E 00000 9
99481 Tot body syst hypothermia N 00000
99482 Selective head hypothermia N 00000
A4555 CA Tx E-Stim Electr/Transduc E 00000 9
A7047 Resp Suction Oral Interface N 00000
A9520 Tc99 Tilmanocept diag 0.5mci G 01463
A9575 Inj Gadoterate Meglumi 0.1mL N 00000
A9599 Radiopha dx beta amyloid pet N 00000
C5271 Low cost skin substitute app T 00327 55
C5272 Low cost skin substitute app N 00000 55
C9133 Factor IX recombinant G 01467 55
C9441 Inj, ferric carboxymaltose G 09441 55
C9497 Loxapine, inhalation powder G 09497 55
C9737 Lap esoph augmentation T 00174 55
D0393 Trtmnt simulation 3d image E 00000 9
D0394 Digital sub 2 or more images E 00000 9
D0395 Fusion 2 or more 3d images E 00000 9
D0601 Caries risk assess low risk E 00000 9
D0602 Caries risk assess mod risk E 00000 9
D0603 Caries risk assess high risk E 00000 9
D1999 Unspecified preventive proc E 00000 9
D2921 Reattach tooth fragment E 00000 9
D2941 Int therapeutic restoration E 00000 9
D2949 Restorative foundation E 00000 9
D3355 Pulpal regeneration initial E 00000 9
D3356 Pulpal regeneration interim E 00000 9
D3357 Pulpal regeneration complete E 00000 9
D3427 Periradicular surgery E 00000 9
D3428 Bone graft peri per tooth E 00000 9
D3429 Bone graft peri each addl E 00000 9
D3431 Biological materials E 00000 9
D3432 Guided tissue regeneration E 00000 9
D4921 Gingival irrigation per quad E 00000 9
D5863 Overdenture complete max E 00000 9
D5864 Overdenture partial max E 00000 9
D5865 Overdenture complete mandib E 00000 9
D5866 Overdenture partial mandib E 00000 9
D5994 Peridontal medicament E 00000 9
D6011 Second stage implant surgery E 00000 9
D6013 Surgical place mini implant E 00000 9
D6052 Semi precision attach abut E 00000 9
D8694 Repair fixed retainers E 00000 9
D9985 Sales tax E 00000 9
E0766 Elec Stim Cancer Treatment Y 00000 61
E1352 O2 flow reg pos inspir press Y 00000 61
G0461 Immunohisto/cyto chem 1st st X 00433
G0462 Immunohisto/cyto chem add N 00000
G0463 Hospital outpt clinic visit Q3 00634
G9188 Beta not given no reason M 00000 72
G9189 Beta pres or already taking M 00000 72
G9190 Medical reason for no beta M 00000 72
G9191 Pt reason for no beta M 00000 72
G9192 System reason for no beta M 00000 72
G9193 Doc not eligible for dep med M 00000 72
G9194 Mdd pt treated for 180d M 00000 72
G9195 Mdd pt not treated for 180d M 00000 72
G9196 Med reason for no ceph M 00000 72
G9197 Order for ceph M 00000 72
G9198 No order for ceph no reason M 00000 72
G9199 Doc reason for no vte M 00000 72
G9200 No reason for no vte M 00000 72
G9201 Vte given upon admission M 00000 72
G9202 Hep c aby pos M 00000 72
G9203 Hep c rna done prior to med M 00000 72
G9204 No reason for no hep c rna M 00000 72
G9205 Hep c antiviral started M 00000 72
G9206 Hep c therapy started M 00000 72
G9207 Hep c genotype prior to med M 00000 72
G9208 No reason for no hep c geno M 00000 72
G9209 Hep c rna 4to12 wk after med M 00000 72
G9210 No hepc rna after med docrsn M 00000 72
G9211 No hepc rna after med no rsn M 00000 72
G9212 Doc of dsm-iv init eval M 00000 72
G9213 No doc of dsm-iv M 00000 72
G9214 Cd4 count documented M 00000 72
G9215 No cd4 count no reason M 00000 72
G9216 No pcp proph at dx no reason M 00000 72
G9217 No pcp proph low cd4 norsn M 00000 72
G9218 No pcp prop low at cd4 norsn M 00000 72
G9219 No oder pjp for med reason M 00000 72
G9220 No order for pjp for medrsn M 00000 72
G9221 Pjp proph prescribed M 00000 72
G9222 Pjp proph ordered low cd4 M 00000 72
G9223 Pjp proph ordered cd4 low M 00000 72
G9224 Medrsn no foot exam M 00000 72
G9225 Norsn no foot exam M 00000 72
G9226 3 comp foot exam completed M 00000 72
G9227 Docrsn no care plan M 00000 72
G9228 Gc chl syp documented M 00000 72
G9229 Ptrsn no gc chl syp test M 00000 72
G9230 Norsn for gc chl syp test M 00000 72
G9231 Doc esrd dia trans preg M 00000 72
G9232 Docrsn no comm comorb M 00000 72
G9233 Tkr composite M 00000 72
G9234 Tkr intent M 00000 72
G9235 Gs mg composite M 00000 72
G9236 Op rad mg composite M 00000 72
G9237 Gs mg intent M 00000 72
G9238 Op rad mg intent M 00000 72
G9239 Docrsn for catheter M 00000 72
G9240 Doc pt w cath maint dia M 00000 72
G9241 Doc pt w out cath maint dia M 00000 72
G9242 Doc viral load >=200 M 00000 72
G9243 Doc viral load <200 M 00000 72
G9244 Antiviral not ordered M 00000 72
G9245 Antiviral ordered M 00000 72
G9246 No med visit in 24mo M 00000 72
G9247 1 med visit in 24mo M 00000 72
G9248 No med visit 6mo M 00000 72
G9249 Med visit w in 6mo M 00000 72
G9250 Doc of pain comfort 48hr M 00000 72
G9251 Doc no pain comfort 48hr M 00000 72
G9252 Neo detect scrn colo M 00000 72
G9253 No neo detect scrn colo M 00000 72
G9254 Doc pt dischg >2d M 00000 72
G9255 Doc pt dischg <=2d M 00000 72
G9256 Doc death after cas M 00000 72
G9257 Doc stroke after cas M 00000 72
G9258 Doc stroke after cea M 00000 72
G9259 Doc surv no stroke after cas M 00000 72
G9260 Doc death after cea M 00000 72
G9261 Doc surv no stroke after cea M 00000 72
G9262 Doc death in hosp aaa repair M 00000 72
G9263 Doc surv in hosp aaa repair M 00000 72
G9264 Docrsn for cath maint dia M 00000 72
G9265 Doc cath >90d for maint dia M 00000 72
G9266 Norsn pt cath >=90d M 00000 72
G9267 Doc comp or mort w in 30d M 00000 72
G9268 Doc comp or mort w in 90d M 00000 72
G9269 Doc no comp or mort w in 30d M 00000 72
G9270 Doc no comp or mort w in 90d M 00000 72
G9271 LDL under 100 M 00000 72
G9272 LDL 100 and over M 00000 72
G9273 Sys<140 and dia<90 M 00000 72
G9274 BP out of nrml limits M 00000 72
G9275 Doc of non tobacco user M 00000 72
G9276 Doc of tobacco user M 00000 72
G9277 Doc daily aspirin or contra M 00000 72
G9278 Doc no daily aspirin M 00000 72
G9279 Pne scrn done doc vac done M 00000 72
G9280 Pne not given norsn M 00000 72
G9281 Pne scrn done doc not ind M 00000 72
G9282 Doc medrsn no histo type M 00000 72
G9283 Hist type doc on report M 00000 72
G9284 No hist type doc on report M 00000 72
G9285 Site not small cell lung ca M 00000 72
G9286 Doc antibio order w in 7d M 00000 72
G9287 No doc antibio order w in 7d M 00000 72
G9288 Doc medrsn no hist type rpt M 00000 72
G9289 Doc type nsm lung ca M 00000 72
G9290 No doc type nsm lung ca M 00000 72
G9291 Not nsm lung ca M 00000 72
G9292 Medrsn no pt category M 00000 72
G9293 No pt category on report M 00000 72
G9294 Pt cat and thck on report M 00000 72
G9295 Non cutaneous loc M 00000 72
G9296 Doc share dec prior proc M 00000 72
G9297 No doc share dec prior proc M 00000 72
G9298 Eval risk vte card 30d prior M 00000 72
G9299 No eval risk vte card prior M 00000 72
G9300 Doc medrsn no compl antibio M 00000 72
G9301 Doc compl inf antibio M 00000 72
G9302 Norsn incomp inf antibio M 00000 72
G9303 Norsn no pros info op rpt M 00000 72
G9304 Pros info op rpt M 00000 72
G9305 No interv req for leak M 00000 72
G9306 Interv req for leak M 00000 72
G9307 No ret for surg w in 30d M 00000 72
G9308 Unplnd ret to surg w in 30d M 00000 72
G9309 No unplnd hosp readm in 30d M 00000 72
G9310 Unplnd hosp readm in 30d M 00000 72
G9311 No surg site infection M 00000 72
G9312 Surgical site infection M 00000 72
G9313 Docrsn not first line amox M 00000 72
G9314 Norsn not first line amox M 00000 72
G9315 Doc first line amox M 00000 72
G9316 Doc comm risk calc M 00000 72
G9317 No doc comm risk calc M 00000 72
G9318 Image std nomenclature M 00000 72
G9319 Image not std nomenclature M 00000 72
G9320 Medrsn no std nomenclature M 00000 72
G9321 Doc count of ct in 12mo M 00000 72
G9322 No doc count of ct in 12mo M 00000 72
G9323 Mdrsn no doc cnt of ct M 00000 72
G9324 Not all data norsn M 00000 72
G9325 Medrsn no ct rpt to reg M 00000 72
G9326 Norsn no ct rpt to reg M 00000 72
G9327 Ct rpt to reg M 00000 72
G9328 Medrsn no dicom format doc M 00000 72
G9329 Norsn no dicom format doc M 00000 72
G9340 Dicom format doc on rpt M 00000 72
G9341 Srch for ct w in 12 mos M 00000 72
G9342 No srch for ct in 12mo norsn M 00000 72
G9343 Medrsn no dicom srch M 00000 72
G9344 Sysrsn no dicom srch M 00000 72
G9345 Follow up pulm nod M 00000 72
G9346 No follow up pulm nod M 00000 72
G9347 No follow up pulm nod norsn M 00000 72
G9348 Docrsn no sinus ct dx M 00000 72
G9349 Doc sinus ct 28d M 00000 72
G9350 No doc sinus ct 28d or dx M 00000 72
G9351 Doc >1 sinus ct w 90d dx M 00000 72
G9352 Not >1 sinus ct w 90d dx M 00000 72
G9353 Medrsn >1 sinus ct w 90d dx M 00000 72
G9354 Norsn >1 sinus ct w 90d dx M 00000 72
G9355 No early ind/delivery M 00000 72
G9356 Early ind/delivery M 00000 72
G9357 Pp eval/edu perf M 00000 72
G9358 Pp eval/edu not perf M 00000 72
G9359 Doc of neg or man pos tb scn M 00000 72
G9360 No doc of neg or man pos tb M 00000 72
J0151 Inj Adenosine Diag 1mg N 00000
J0401 Inj Aripiprazole Ext Rel 1mg K 01468
J0717 Certolizumab pegol inj 1mg K 01474
J1442 Inj, Filgrastim G-CSF 1mcg K 01469
J1446 Inj, tbo-filgrastim, 5 mcg E 00000 9
J1556 Inj, Imm Glob Bivigam, 500mg G 09130
J1602 Golimumab for iv use 1mg K 01475
J3060 Inj, Taliglucerace Alfa 10 u G 09294
J3489 Zoledronic Acid 1mg K 01356
J7301 Skyla 13.5mg E 00000 50
J7316 Inj, Ocriplasmin, 0.125 mg G 09298
J7508 Tacrolimus ex rel oral 0.1mg G 01465
J9047 Injection, Carfilzomib, 1 mg G 09295
J9262 Inj, Omacetaxine Mep, 0.01mg G 09297
J9306 Injection, Pertuzumab, 1 mg G 01471
J9354 Inj, Ado-trastuzumab Emt 1mg G 09131
J9371 Inj, vincristine sul lip 1mg G 01466
J9400 Inj, ziv-aflibercept, 1mg G 09296
L0455 TLSO flex trnk sj-t9 pre ots A 00000
L0457 TLSO flex trnk sj-ss pre ots A 00000
L0467 TLSO r fram soft pre ots A 00000
L0469 TLSO rig fram pelvic pre ots A 00000
L0641 LO rig pos pnl L1-L5 pre ots A 00000
L0642 LO sag ri an/pos pnl pre ots A 00000
L0643 LSO sag ctr rigi pos pre ots A 00000
L0648 LSO sag r an/pos pnl pre ots A 00000
L0649 LSO sc r pos/lat pnl pre ots A 00000
L0650 LSO sc r ant/pos pnl pre ots A 00000
L0651 LSO sag-co shell pnl pre ots A 00000
L1812 Ko elastic w/joints pre ots A 00000
L1833 Ko adj jnt pos r sup pre ots A 00000
L1848 Ko dbl upright w/air pre ots A 00000
L3678 So hard plas stabili pre ots A 00000
L3809 Whfo w/o joints pre ots A 00000
L3916 Who nontorsion jnts pre ots A 00000
L3918 Metacarp fx orthosis pre ots A 00000
L3924 Hfo without joints pre ots A 00000
L3930 Hfo nontorsion jnts pre ots A 00000
L4361 Pneuma/vac walk boot pre ots A 00000
L4387 Non-pneum walk boot pre ots A 00000
L4397 Static or dynami afo pre ots A 00000
L5969 Ak/ft Power Asst Incl Motors A 00000
L8679 Imp Neurosti Pls Gn Any Type A 00000
Q0161 Chlorpromazine hcl 5mg oral N 00000
Q2028 Inj, Sculptra, 0.5mg B 00000 62
Q3027 Inj beta interferon im 1 mcg K 01472
Q3028 Inj beta interferon sq 1 mcg E 00000 9
Q4137 Amnioexcel or biodexcel, 1cm N 00000
Q4138 BioDfence DryFlex, 1cm N 00000
Q4139 Amnio or biodmatrix, inj 1cc N 00000
Q4140 Biodfence 1cm N 00000
Q4141 Alloskin ac, 1 cm N 00000
Q4142 Xcm biologic tiss matrix 1cm N 00000
Q4143 Repriza, 1cm N 00000
Q4145 Epifix, inj, 1mg N 00000
Q4146 Tensix, 1cm N 00000
Q4147 Architect ecm, 1cm N 00000
Q4148 Neox 1k, 1cm N 00000
Q4149 Excellagen, 0.1 cc N 00000
S9960 Air ambulanc nonemerg fixed E 00000 9
S9961 Air ambulan nonemerg rotary E 00000 9
T4544 Adlt disp und/pull on abv xl E 00000 9
Deleted HCPCS/CPT Procedure Codes
The following HCPCS/CPT code(s) were deleted from the IOCE, effective 01-01-14
HCPCS CodeDesc
0078T Endovasc aort repr w/device
0079T Endovasc visc extnsn repr
0080T Endovasc aort repr rad s&i
0081T Endovasc visc extnsn s&i
0124T Conjunctival drug placement
0183T Wound ultrasound
0185T Comptr probability analysis
0186T Suprachoroidal drug delivery
0192T Insert ant segment drain ext
0260T Hypthrm bdy neonate 28d/<
0261T Hypthrm head neonate 28d/<
0318T Replace aortic valve tthorac
13150 Cmplx rpr e/n/e/l 1.0 cm/<
19102 Bx breast percut w/image
19103 Bx breast percut w/device
19290 Place needle wire breast
19291 Place needle wire breast
19295 Place breast clip percut
23331 Remove shoulder foreign body
23332 Remove shoulder foreign body
32201 Drain percut lung lesion
37204 Transcatheter occlusion
37205 Transcath iv stent percut
37206 Transcath iv stent/perc addl
37207 Transcath iv stent open
37208 Transcath iv stent/open addl
37210 Embolization uterine fibroid
42802 Biopsy of throat
43219 Esophagus endoscopy
43228 Esoph endoscopy ablation
43256 Uppr gi endoscopy w/stent
43258 Operative upper GI endoscopy
43267 Endo cholangiopancreatograph
43456 Dilate esophagus
43458 Dilate esophagus
44901 Drain app abscess percut
47011 Percut drain liver lesion
48511 Drain pancreatic pseudocyst
49021 Drain abdominal abscess
49041 Drain percut abdom abscess
49061 Drain percut retroper absc
50021 Renal abscess percut drain
58823 Drain pelvic abscess percut
64613 Destroy nerve neck muscle
64614 Destroy nerve extrem musc
75960 Transcath iv stent rs&i
77031 Stereotact guide for brst bx
77032 Guidance for needle breast
92506 Speech/hearing evaluation
C1204 Tc 99m tilmanocept
C9130 Injection, IVIG Bivigam
C9131 In ado-trastuzumab emtansine
C9292 Injection, pertuzumab
HCPCS CodeDesc
C9294 Inj, taliglucerase alfa
C9295 Injection, carfilzomib
C9296 Injection, ziv-aflibercept
C9297 Omacetaxine mepesuccinate
C9298 Injection, ocriplasmin
C9736 Lap ablate uteri fibroid rf
G0275 Renal angio, cardiac cath
G8459 Doc pt rec antivir treat
G8462 Pt inelig couns no antvir tx
G8463 Pt rec antiviral treat doc
G8553 Prescrip transmit via ERx sy
G8556 Ref to doc otolog eval
G8557 Pt inelig ref otolog eval
G8558 No ref to doc otolog eval
G8588 Sys BP <140
G8589 Sys BP >= 140
G8590 Dia BP < 90
G8591 Dia BP >= 90
G8592 No BP measure
G8596 No LDL perf
G8603 Spok lang comp score
G8604 No high score spok lang
G8605 No spok lang comp score
G8606 Attention score
G8607 No high score attention
G8608 No attention score
G8609 Memory score
G8610 No high score memory
G8611 No memory score
G8612 Moto speech score
G8613 No high score moto speech
G8614 No moto speech score
G8615 Reading score
G8616 No high score reading
G8617 No reading score
G8618 Spok lang exp score
G8619 No high score spok lang exp
G8620 No spok lang exp score
G8621 Writing score
G8622 No high score writing
G8623 No writing score
G8624 Swallowing score
G8625 No high score swallowing
G8626 No swallowing score
G8642 Hrdshp rural w/o internet
G8643 Hrdshp w/o suff pharm w/eRx
G8644 EP no prescribe priv
G8741 Not tx spoken lang
G8742 Not tx attention
G8743 Not tx memory
G8744 Not tx motor speech
G8745 Not tx reading
G8746 Not tx spoken lang express
G8747 Not tx writing
G8748 Not tx swallowing
G8790 Systolic <130mmHg
G8791 Systolic 130-139mmHg
G8792 Systolic >=140mmHg
G8793 Diastolic <80mmHg
G8794 Diastolic 80-89mmHg
G8795 Diastolic >=90mmHg
HCPCS CodeDesc
G8796 BP not doc
G8799 Anticoag ordered
G8800 Doc reas anticoag not order
G8801 Anticoag not ordered
G8812 Pt not elig CTA, duplex, MRA
G8813 CTA, duplex, MRA performed
G8814 No CTA, duplex, MRA
G8827 Aneurysm <= 5.5cm for women
G8835 Asymptom no trans
G8919 Mst rcnt sys bp <140mmg
G8920 Mst rcnt sys bp >=140mmhg
G8921 Mst rcnt dia bp <90mmhg
G8922 Mst rcnt dia bp >=90mmhg
G8945 Aneurysm <=6 cm for men
G8954 Pt data rpt qual clin db reg
J0152 Adenosine injection
J0718 Certolizumab pegol inj
J1440 Filgrastim 300 mcg injection
J1441 Filgrastim 480 mcg injection
J3487 Zoledronic acid
J3488 Reclast injection
J9002 Doxil injection
L0430 Dewall posture protector
Q0090 Skyla 13.5mg
Q0165 Prochlorperazine maleate10mg
Q0168 Dronabinol 5mg oral
Q0170 Promethazine HCl 25 mg oral
Q0171 Chlorpromazine HCl 10mg oral
Q0172 Chlorpromazine HCl 25mg oral
Q0176 Perphenazine 8mg oral
Q0178 Hydroxyzine pamoate 50mg
Q2027 Sculptra injection
Q2033 Influenza Vaccine, (Flublok)
Q2051 Zoldedronic acid 1mg
Q3025 IM inj interferon beta 1-a
Q3026 Subc inj interferon beta-1a
S3625 Maternal triple screen test
S3626 Maternal serum quad screen
S3833 Comp APC sequence
S3834 Sing mutation APC
HCPCS Description Changes
The following code descriptions were changed, effective 01-01-14

HCPCS Old Description New Description
0052T Replace component heart syst Replace thrc unit hrt syst
0053T Replace component heart syst Replace implantable hrt syst
0054T Bone surgery using computer Bone srgry cmptr fluor image
0055T Bone surgery using computer Bone srgry cmptr ct/mri imag
0092T Artific disc addl Artific disc addl cervical
0095T Artific diskectomy addl Rmvl artific disc addl crvcl
0195T Prescrl fuse w/o instr L5/S1 Prescrl fuse w/o instr l5/s1
0196T Prescrl fuse w/o instr L4/L5 Prescrl fuse w/o instr l4/l5
0263T Im B1 mrw cel ther cmpl Im b1 mrw cel ther cmpl
0264T Im B1 mrw cel ther xcl hrvst Im b1 mrw cel ther xcl hrvst
0265T Im B1 mrw cel ther hrvst onl Im b1 mrw cel ther hrvst onl
0306T icar ischm mntr interr eval Icar ischm mntr interr eval
0575F HIV rna plan care docd Hiv rna plan care docd
1040F Dsm-iv info mdd docd Dsm-5 info mdd docd
1052F Type location activityasses Type location activityassess
1118F GERD symps assessed 12 month Gerd symps assessed 12 month
1130F Bk pain + fxn assessed Bk pain & fxn assessed
1205F EPI etiol synd rvwd and docd Epi etiol synd rvwd and docd
2021F Dilat macul+ exam done Dilat maculor exam done
21015 Resect face tum < 2 cm Resect face/scalp tum < 2 cm
21016 Resect face tum 2 cm/> Resect face/scalp tum 2 cm/>
21557 Resect neck tum < 5 cm Resect neck thorax tumor<5cm
21558 Resect neck tum 5 cm/> Resect neck tumor 5 cm/>
22586 Prescrl fuse w/ instr l5/s1 Prescrl fuse w/ instr l5-s1
22904 Resect abd tum < 5 cm Radical resect abd tumor<5cm
22905 Resect abd tum 5 cm/> Rad resect abd tumor 5 cm/>
23077 Resect shoulder tum < 5 cm Resect shoulder tumor < 5 cm
23078 Resect shoulder tum 5 cm/> Resect shoulder tumor 5 cm/>
26117 Exc hand tum ra < 3 cm Rad resect hand tumor < 3 cm
26118 Exc hand tum ra 3 cm/> Rad resect hand tumor 3 cm/>
3016F Pt scrnd unhlthy OH use Pt scrnd unhlthy oh use
3082F Kt/v >1.2 Kt/v <1.2
3115F Quant results activity +symp Quant results activity &symp
3267F path rprt w/ pt pn cat et al Path rprt w/ pt pn cat et al
3269F Bone scn b/4 txmnt/aftr Dx Bone scn b/4 txmnt/aftr dx
3270F No bone scn b/4 txmnt/aftrDx No bone scn b/4 txmnt/aftrdx
3274F Prost Cncr rsk not lw/md/hgh Prost cncr rsk not lw/md/hgh
3278F Serum lvls CA/iPTH/lpd ord Serum lvls ca/ipth/lpd ord
3280F Hgb lvl 11-12.9 g/dL Hgb lvl 11-12.9 g/dl
3285F IOP down <15% of pre-svc lvl Iop down <15% of pre-svc lvl
3290F Pt=D(Rh)- and unsensitized Pt=d(rh)- and unsensitized
3300F AJCC stage docd b/4 thxpy Ajcc stage docd b/4 thxpy
3316F ER- or PR- breast cancer Er- or pr- breast cancer
3321F AJCC cncr 0/IA melan docd Ajcc cncr 0/ia melan docd
33222 Revise pocket pacemaker Relocation pocket pacemaker
33223 Revise pocket for defib Relocate pocket for defib
3370F AJCC brst cncr stage 0 docd Ajcc brst cncr stage 0 docd
3376F AJCC brstcncr stage 2 docd Ajcc brstcncr stage 2 docd
3382F AJCC cln cncr stage 0 docd Ajcc cln cncr stage 0 docd
3455F TB scrng done-interpd 6mon Tb scrng done-interpd 6mon
3475F Disease progn RA poor docd Disease progn ra poor docd
3476F Disease progn RA good docd Disease progn ra good docd
3491F HIV unsure baby of HIV+moms Hiv unsure baby of hiv+moms
3494F CD4+cell count <200cells/mm3 Cd4+cell count <200cells/mm3
3497F CD4+ cell percentage <15% Cd4+ cell percentage <15%
3502F HIV rna vrl ld <lmts quantif Hiv rna vrl ld <lmts quantif
3503F HIV rna vrl ldnot<lmts quntf Hiv rna vrl ldnot<lmts quntf
35103 Repair artery rupture groin Repair artery rupture aorta
3513F Hep B scrng docd as done Hep b scrng docd as done
3514F Hep C scrng docd as done Hep c scrng docd as done
3515F Pt has docd immun to hep C Pt has docd immun to hep c
3751F Electrodiag polyneuro 6mon Electrodiag polyneuro 6 mn
3752F no electrodiag polyneuro6mon No electrodiag polyneuro 6mn
3753F Pt has symp+signs neuropathy Pt has symp&signs neuropathy
3755F Cog+behav imprmnt scrng done Cog&behav imprmnt scrng done
3757F Pt w/no pseudobulbaffect/als Pt w/o pseudobulbaffect/als
3758F Pt ref pulmon fx test/peak Pt ref pulm fx test/peakflow
3760F Pt w/dysphag/wt loss/nutr Pt w/ dysphag/wt loss/nutr
4010F ACE/ARB therapy rxd/taken Ace/arb therapy rxd/taken
4051F Referred for an AV fistula Referred for an av fistula
4052F Hemodialysis via AV fistula Hemodialysis via av fistula
4053F Hemodialysis via AV graft Hemodialysis via av graft
4066F ECT provided Ect provided
4148F Hep A vac injxn admin/recvd Hep a vac injxn admin/recvd
4149F Hep B vac injxn admin/recvd Hep b vac injxn admin/recvd
4155F Hep A vac series prev recvd Hep a vac series prev recvd
4157F Hep B vac series prev recvd Hep b vac series prev recvd
4169F No pt care ICU/vent in 24hrs No pt care icu/vent in 24hrs
4179F Tamoxifen/AI prescribed Tamoxifen/ai prescribed
4188F Approp ACE/ARB tstng done Approp ace/arb tstng done
4195F Pt rcvng anti-rheum thxpy RA Pt rcvng anti-rheum thxpy ra
4196F Ptnot rcvng anti-rhm thxpyRA Ptnot rcvng anti-rhm thxpyra
4269F Appropos mthd offloading Rxd Appropos mthd offloading rxd
4276F Potent antivir thxpy Rxd Potent antivir thxpy rxd
4279F PCP prophylaxis Rxd Pcp prophylaxis rxd
4280F PCP prophylax Rxd 3mon low % Pcp prophylax rxd 3mon low %
4306F Pt tlk psych & Rx opd addic Pt tlk psych & rx opd addic
43200 Esophagus endoscopy Esophagoscopy flexible brush
43202 Esophagus endoscopy biopsy Esophagoscopy flex biopsy
43215 Esophagus endoscopy Esophagoscopy flex remove fb
43216 Esophagus endoscopy/lesion Esophagoscopy lesion removal
43217 Esophagus endoscopy Esophagoscopy snare les remv
43220 Esoph endoscopy dilation Esophagoscopy balloon <30mm
43227 Esoph endoscopy repair Esophagoscopy control bleed
43231 Esoph endoscopy w/us exam Esophagoscop ultrasound exam
43232 Esoph endoscopy w/us fn bx Esophagoscopy w/us needle bx
43235 Uppr gi endoscopy diagnosis Egd diagnostic brush wash
43238 Uppr gi endoscopy w/us fn bx Egd us fine needle bx/aspir
43239 Upper gi endoscopy biopsy Egd biopsy single/multiple
43240 Esoph endoscope w/drain cyst Egd w/transmural drain cyst
43241 Upper GI endoscopy with tube Egd tube/cath insertion
43242 Uppr gi endoscopy w/us fn bx Egd us fine needle bx/aspir
43243 Upper gi endoscopy & inject Egd injection varices
43244 Upper GI endoscopy/ligation Egd varices ligation
43245 Uppr gi scope dilate strictr Egd dilate stricture
43246 Place gastrostomy tube Egd place gastrostomy tube
43247 Operative upper GI endoscopy Egd remove foreign body
43248 Uppr gi endoscopy/guide wire Egd guide wire insertion
43249 Esoph endoscopy dilation Esoph egd dilation <30 mm
43250 Upper GI endoscopy/tumor Egd cautery tumor polyp
43251 Operative upper GI endoscopy Egd remove lesion snare
43252 Uppr gi opticl endomicrscopy Egd optical endomicroscopy
43255 Operative upper GI endoscopy Egd control bleeding any
43257 Uppr gi scope w/thrml txmnt Egd w/thrml txmnt gerd
43259 Endoscopic ultrasound exam Egd us exam duodenum/jejunum
43260 Endo cholangiopancreatograph Ercp w/specimen collection
43263 Endo cholangiopancreatograph Ercp sphincter pressure meas
43264 Endo cholangiopancreatograph Ercp remove duct calculi
43265 Endo cholangiopancreatograph Ercp lithotripsy calculi
43450 Dilate esophagus Dilate esophagus 1/mult pass
43752 Nasal/orogastric w/stent Nasal/orogastric w/tube plmt
44900 Drain app abscess open Drain appendix abscess open
4550F noninvas resp support talk Noninvas resp support talk
4556F Ptw/ 3+ post-op nausea+vomm Pt w/ 3+ post-op nausea&vom
4557F Pt w/o 3+ post-opnausea+vomm Pt w/o 3+ post-opnausea&vom
4558F Pt recvd 2 rx anti-emetagnts Pt recvd 2 rx anti-emet agt
4561F Pt w/coronary artery stent Pt w/ coronary artery stent
47552 Biliary endoscopy thru skin Biliary endo perq dx w/speci
49020 Drain abdominal abscess Drainage abdom abscess open
49060 Drain open retrop abscess Drain open retroperi abscess
52601 Prostatectomy (TURP) Prostatectomy (turp)
54650 Orchiopexy (Fowler-Stephens) Orchiopexy (fowler-stephens)
56405 I & D of vulva/perineum I & d of vulva/perineum
69210 Remove impacted ear wax Remove impacted ear wax uni
74176 Ct abd & pelvis Ct abd & pelvis w/o contrast
74340 X-ray guide for GI tube X-ray guide for gi tube
76380 CAT scan follow-up study Cat scan follow-up study
76975 GI endoscopic ultrasound Gi endoscopic ultrasound
77295 Set radiation therapy field 3-d radiotherapy plan
78205 Liver imaging (3D) Liver imaging (3d)
78270 Vit B-12 absorption exam Vit b-12 absorption exam
78278 Acute GI blood loss imaging Acute gi blood loss imaging
78282 GI protein loss exam Gi protein loss exam
78299 GI nuclear procedure Gi nuclear procedure
78320 Bone imaging (3D) Bone imaging (3d)
78459 Heart muscle imaging (PET) Heart muscle imaging (pet)
78469 Heart infarct image (3D) Heart infarct image (3d)
78607 Brain imaging (3D) Brain imaging (3d)
78608 Brain imaging (PET) Brain imaging (pet)
78609 Brain imaging (PET) Brain imaging (pet)
78635 CSF ventriculography Csf ventriculography
78645 CSF shunt evaluation Csf shunt evaluation
78650 CSF leakage imaging Csf leakage imaging
78710 Kidney imaging (3D) Kidney imaging (3d)
78803 Tumor imaging (3D) Tumor imaging (3d)
80412 CRH stimulation panel Crh stimulation panel
80438 TRH stimulation panel Trh stimulation panel
81161 DMD dup/delet analysis Dmd dup/delet analysis
82163 Assay of angiotensin II Assay of angiotensin ii
82164 Angiotensin I enzyme test Angiotensin i enzyme test
82607 Vitamin B-12 Vitamin b-12
82777 Galectin 3 Galectin-3
82800 Blood pH Blood ph
82951 Glucose tolerance test (GTT) Glucose tolerance test (gtt)
82952 GTT-added samples Gtt-added samples
82960 Test for G6PD enzyme Test for g6pd enzyme
82977 Assay of GGT Assay of ggt
83615 Lactate (LD) (LDH) enzyme Lactate (ld) (ldh) enzyme
84112 Placenta alpha micro ig c/v Eval amniotic fluid protein
84202 Assay RBC protoporphyrin Assay rbc protoporphyrin
84203 Test RBC protoporphyrin Test rbc protoporphyrin
84450 Transferase (AST) (SGOT) Transferase (ast) (sgot)
84460 Alanine amino (ALT) (SGPT) Alanine amino (alt) (sgpt)
84481 Free assay (FT-3) Free assay (ft-3)
84545 Urea-N clearance test Urea-n clearance test
85547 RBC mechanical fragility Rbc mechanical fragility
85555 RBC osmotic fragility Rbc osmotic fragility
85557 RBC osmotic fragility Rbc osmotic fragility
85660 RBC sickle cell test Rbc sickle cell test
86003 Allergen specific IgE Allergen specific ige
86005 Allergen specific IgE Allergen specific ige
86021 WBC antibody identification Wbc antibody identification
86039 Antinuclear antibodies (ANA) Antinuclear antibodies (ana)
86336 Inhibin A Inhibin a
86580 TB intradermal test Tb intradermal test
86644 CMV antibody Cmv antibody
86850 RBC antibody screen Rbc antibody screen
86860 RBC antibody elution Rbc antibody elution
86870 RBC antibody identification Rbc antibody identification
88342 Immunohistochemistry Immunohisto antibody slide
90732 Pneumococcal vaccine Pneumococcal vacc 23 val im
91065 Breath hydrogen test Breath hydrogen/methane test
93040 Rhythm ECG with report Rhythm ecg with report
93268 ECG record/review Ecg record/review
93278 ECG/signal-averaged Ecg/signal-averaged
93600 Bundle of His recording Bundle of his recording
93784 Ambulatory BP monitoring Ambulatory bp monitoring
93786 Ambulatory BP recording Ambulatory bp recording
93788 Ambulatory BP analysis Ambulatory bp analysis
93790 Review/report BP recording Review/report bp recording
94200 Lung function test (MBC/MVV) Lung function test (mbc/mvv)
94400 CO2 breathing response curve Co2 breathing response curve
95830 Insert electrodes for EEG Insert electrodes for eeg
95951 EEG monitoring/videorecord Eeg monitoring/videorecord
95953 EEG monitoring/computer Eeg monitoring/computer
95954 EEG monitoring/giving drugs Eeg monitoring/giving drugs
95955 EEG during surgery Eeg during surgery
95957 EEG digital analysis Eeg digital analysis
95958 EEG monitoring/function test Eeg monitoring/function test
96910 Photochemotherapy with UV-B Photochemotherapy with uv-b
96912 Photochemotherapy with UV-A Photochemotherapy with uv-a
99170 Anogenital exam child Anogenital exam child w imag
A0428 bls Bls
A0433 als 2 Als 2
A5081 Continent stoma plug Stoma Plug or Seal, Any Type
A6198 alginate dressing > 48 sq in Alginate dressing > 48 sq in
A9272 Disposable mech wound suct Disp wound suct, drsg/access
C2618 Probe, cryoablation Probe/Needle, cryo
D3410 Apicoect/perirad surg anter Apicoectomy - anterior
D5991 Topical medicament carrier Vesiculobullous disease carr
D8693 Rebond/cement/repair retain Rebond/recement retainers
G8581 no antplt med disch No antplt med disch
G8600 tPA initi w/in 3 hrs TPA initi w/in 3 hrs
G8959 Clin tx MDD comm to tx clin Clin tx mdd comm to tx clin
G8960 Clin tx MDD not comm Clin tx mdd not comm
J7315 Opthalmic mitomycin Ophthalmic mitomycin
J7507 Tacrolimus oral per 1 MG Tacrolimus Imme Rel oral 1mg
L0120 Cerv flexible non-adjustable Cerv flex n/adj foam pre ots
L0160 Cerv semi-rig wire occ/mand Cerv sr wire occ/man pre ots
L0172 Cerv col thermplas foam 2 pi Cerv col sr foam 2pc pre ots
L0174 Cerv col foam 2 piece w thor Cerv sr 2pc thor ext pre ots
L0450 TLSO flex prefab thoracic TLSO flex trunk/thor pre ots
L0452 tlso flex custom fab thoraci Tlso flex custom fab thoraci
L0454 TLSO flex prefab sacrococ-T9 TLSO trnk sj-t9 pre cst
L0456 TLSO flex prefab TLSO flex trnk sj-ss pre cst
L0460 TLSO2Mod symphysis-stern pre Tlso 2 shl symphys-stern cst
L0466 TLSO rigid frame pre soft ap Tlso r fram soft ant pre cst
L0468 TLSO rigid frame prefab pelv Tlso rig fram pelvic pre cst
L0621 SIO flex pelvisacral prefab SIO flex pelvic/sacr pre ots
L0623 SIO panel prefab SIO rig pnl pelv/sac pre ots
L0625 LO flexibl L1-below L5 pre LO flex L1-below L5 pre ots
L0626 LO sag stays/panels pre-fab Lo sag rig pnl stays pre cst
L0627 LO sagitt rigid panel prefab LO sag ri an/pos pnl pre cst
L0628 LO flex w/o rigid stays pre LSO flex no ri stays pre ots
L0630 LSO post rigid panel pre LSO r post pnl sj-t9 pre cst
L0631 LSO sag-coro rigid frame pre LSO sag r an/pos pnl pre cst
L0633 LSO flexion control prefab LSO sc r pos/lat pnl pre cst
L0637 LSO sag-coronal panel prefab LSO sc r ant/pos pnl pre cst
L0639 LSO s/c shell/panel prefab Lso s/c shell/panel prefab
L0980 Peroneal straps pair Peroneal straps pair pre ots
L0982 Stocking supp grips set of f Stocking sup grips 4 pre ots
L0984 Protective body sock each Protect body sock ea pre ots
L1600 Abduct hip flex frejka w cvr Ho flex frejka w/cov pre cst
L1610 Abduct hip flex frejka covr Ho frejka cov only pre cst
L1620 Abduct hip flex pavlik harne Ho flex pavlik harns pre cst
L1830 Ko immobilizer canvas longit KO immob canvas long pre ots
L1832 KO adj jnt pos rigid support Ko adj jnt pos r sup pre cst
L1836 Rigid KO wo joints KO rigid w/o joints pre ots
L1843 KO single upright custom fit Ko single upright pre cst
L1845 Ko w/ adj flex/ext rotat cus Ko double upright pre cst
L1847 KO adjustable w air chambers Ko dbl upright w/air pre cst
L1850 Ko swedish type Ko swedish type pre OTS
L1902 Afo ankle gauntlet Afo ankle gauntlet pre ots
L1906 Afo multiligamentus ankle su Afo multilig ank sup pre ots
L3100 Hallus-valgus nght dynamic s Hallus-valgus nt dyn pre ots
L3170 Foot plastic heel stabilizer Foot plas heel stabi pre ots
L3650 Shlder fig 8 abduct restrain So 8 abd restraint pre ots
L3660 Abduct restrainer canvas&web So 8 ab rstr can/web pre ots
L3670 Acromio/clavicular canvas&we So acro/clav can web pre ots
L3675 Canvas vest SO So vest canvas/web pre ots
L3677 SO hard plastic stabilizer So hard plas stabili pre cst
L3710 Elbow elastic with metal joi Eo elas w/metal jnts pre ots
L3762 Rigid EO wo joints Eo rigid w/o joints pre ots
L3807 WHFO,no joint, prefabricated Whfo w/o joints pre cst
L3908 Wrist cock-up non-molded Who cock-up nonmolde pre ots
L3912 Flex glove w/elastic finger Hfo flexion glove pre ots
L3915 WHO w nontor jnt(s) prefab Who nontorsion jnts pre cst
L3917 Prefab metacarpl fx orthosis Metacarp fx orthosis pre cst
L3923 HFO w/o joints PF Hfo without joints pre cst
L3925 FO pip/dip with joint/spring Fo pip dip jnt/sprng pre ots
L3927 FO pip/dip w/o joint/spring Fo pip dip no jt spr pre ots
L3929 HFO nontorsion joint, prefab Hfo nontorsion jnts pre cst
L4350 Ankle control orthosi prefab Ankle control ortho pre ots
L4360 Pneumati walking boot prefab Pneumat walking boot pre cst
L4370 Pneumatic full leg splint Pneum full leg splnt pre ots
L4386 Non-pneum walk boot prefab Non-pneum walk boot pre cst
L4396 Static AFO Static or dynami afo pre cst
L4398 Foot drop splint recumbent Foot drop splint pre ots
L5668 Socket insert w/o lock lower BK molded distal cushion
Q0508 Misc sup/acc imp vad Mis sup/acc imp vad
Q0509 Mis sup/ac imp VAD nopay med Mis sup/ac imp vad nopay med
Q4134 hMatrix HMatrix
S0182 Procarbazine 5 mg Procarbazine, oral
S0353 Cancer treatment plan initia Cancer treatmentplan initial
T4543 Disp bariatric brief/diaper Adult disp brief/diap abv xl
HCPCS Changes- APC, Status Indicator and/or Edit Assignments
The following code(s) had an APC and/or SI and/or edit change, effective 10-01-12 **A blank in the field indicates
no change.
HCPCS CodeDesc Old APC New APC Old SI New SI Old Edit New Edit
G0409 CORF related serv 15 mins ea M B 72 62
no change.
90688 Flu vacc 4 val 3 yrs plus im E L 28 N/A
no change.
A9586 Florbetapir F18 E N 9 N/A
no change.
0071T U/s leiomyomata ablate <200 00067 00065
0072T U/s leiomyomata ablate >200 00067 00065
0172T Lumbar spine process addl 00052 00000 T N
0190T Place intraoc radiation src 00237 00000 T N
0206T Cptr dbs alys car elec dta 00340 00420
0214T Njx paravert w/us cer/thor 00204 00000 T N
0215T Njx paravert w/us cer/thor 00204 00000 T N
0217T Njx paravert w/us lumb/sac 00204 00000 T N
0218T Njx paravert w/us lumb/sac 00204 00000 T N
0222T Plmt post facet implt addl 00050 00000 T N
0227T Anoscopy hra w/biopsy 00146 00147
0229T Njx tfrml eprl w/us cer/thor 00206 00000 T N
0231T Njx tfrml eprl w/us lumb/sac 00206 00000 T N
0232T Njx platelet plasma 00340 00420
0241T Esoph motility w/stim/perf 00361 00000 X N
0269T Rev/remvl crtd sns dev total T Q2
0270T Rev/remvl crtd sns dev lead T Q2
0271T Rev/remvl crtd sns dev gen T Q2
0284T Periph field stimul revise T Q2
0285T Periph field stimul analys 00218 00216
0299T Esw wound healing init wound 00133 00326
0300T Esw wound healing addl wound 00133 00000 T N
0307T Rmvl icar ischm mntrng dvce T Q2
0308T Insj ocular telescope prosth 00234 00351
0314T Laps rmvl vgl arry & pls gen T Q2
0315T Rmvl vagus nerve pls gen T Q2
0322T Rmvl subq defib pls gen T Q2
0323T Rmvl & replc subq pls gen T Q2
0324T Rmvl subq defib electrode T Q2
0331T Heart symp image plnr 00398 00377
0332T Heart symp image plnr spect 00398 00377
0334T Perq stablj sacroiliac joint 00208 00052
0575F Hiv rna plan care docd M E 72 9
10021 Fna w/o image 00002 00015
1040F Dsm-5 info mdd docd M E 72 9
11001 Debride infected skin add-on 00013 00000 T N
11010 Debride skin at fx site 00019 00020
11012 Deb skin bone at fx site 00019 00020
11045 Deb subq tissue add-on 00016 00000 T N
11046 Deb musc/fascia add-on 00016 00000 T N
11047 Deb bone add-on 00019 00000 T N
11101 Biopsy skin add-on 00013 00000 T N
11201 Remove skin tags add-on 00013 00000 T N
11621 Exc s/n/h/f/g mal+mrg 0.6-1 00019 00020
11640 Exc f/e/e/n/l mal+mrg 0.5cm< 00019 00020
11641 Exc f/e/e/n/l mal+mrg 0.6-1 00019 00020
11642 Exc f/e/e/n/l mal+mrg 1.1-2 00019 00020
11720 Debride nail 1-5 00013 00012
11721 Debride nail 6 or more 00013 00012
11730 Removal of nail plate 00013 00015
11732 Remove nail plate add-on 00013 00000 T N
11760 Repair of nail bed 00133 00326
11762 Reconstruction of nail bed 00136 00328
11920 Correct skin color 6.0 cm/< 00134 00327
11921 Corect skin color 6.1-20.0cm 00134 00327
11922 Correct skin color ea 20.0cm 00134 00000 T N
11950 Tx contour defects 1 cc/< 00134 00327
11951 Tx contour defects 1.1-5.0cc 00134 00327
11952 Tx contour defects 5.1-10cc 00134 00327
11954 Tx contour defects >10.0 cc 00133 00326
11960 Insert tissue expander(s) 00137 00329
11971 Remove tissue expander(s) T Q2
11976 Remove contraceptive capsule T Q2
11980 Implant hormone pellet(s) 00340 00420
11981 Insert drug implant device 00340 00420
11982 Remove drug implant device 00340 00420
11983 Remove/insert drug implant 00340 00420
12001 Rpr s/n/ax/gen/trnk 2.5cm/< 00133 00013
12002 Rpr s/n/ax/gen/trnk2.6-7.5cm 00133 00013
12004 Rpr s/n/ax/gen/trk7.6-12.5cm 00133 00013
12005 Rpr s/n/a/gen/trk12.6-20.0cm 00133 00013
12006 Rpr s/n/a/gen/trk20.1-30.0cm 00133 00326
12007 Rpr s/n/ax/gen/trnk >30.0 cm 00133 00013
12011 Rpr f/e/e/n/l/m 2.5 cm/< 00133 00013
12013 Rpr f/e/e/n/l/m 2.6-5.0 cm 00133 00013
12014 Rpr f/e/e/n/l/m 5.1-7.5 cm 00133 00013
12015 Rpr f/e/e/n/l/m 7.6-12.5 cm 00133 00013
12016 Rpr fe/e/en/l/m 12.6-20.0 cm 00133 00013
12017 Rpr fe/e/en/l/m 20.1-30.0 cm 00133 00013
12018 Rpr f/e/e/n/l/m >30.0 cm 00134 00013
12020 Closure of split wound 00135 00327
12021 Closure of split wound 00134 00326
12031 Intmd rpr s/a/t/ext 2.5 cm/< 00134 00326
12032 Intmd rpr s/a/t/ext 2.6-7.5 00134 00326
12034 Intmd rpr s/tr/ext 7.6-12.5 00134 00326
12035 Intmd rpr s/a/t/ext 12.6-20 00134 00327
12036 Intmd rpr s/a/t/ext 20.1-30 00134 00327
12037 Intmd rpr s/tr/ext >30.0 cm 00134 00327
12041 Intmd rpr n-hf/genit 2.5cm/< 00133 00326
12042 Intmd rpr n-hf/genit2.6-7.5 00134 00326
12044 Intmd rpr n-hf/genit7.6-12.5 00134 00326
12045 Intmd rpr n-hf/genit12.6-20 00134 00326
12046 Intmd rpr n-hf/genit20.1-30 00134 00326
12047 Intmd rpr n-hf/genit >30.0cm 00134 00327
12051 Intmd rpr face/mm 2.5 cm/< 00134 00326
12052 Intmd rpr face/mm 2.6-5.0 cm 00134 00326
12053 Intmd rpr face/mm 5.1-7.5 cm 00134 00326
12054 Intmd rpr face/mm 7.6-12.5cm 00133 00326
12055 Intmd rpr face/mm 12.6-20 cm 00134 00326
12056 Intmd rpr face/mm 20.1-30.0 00134 00326
12057 Intmd rpr face/mm >30.0 cm 00134 00326
13100 Cmplx rpr trunk 1.1-2.5 cm 00135 00327
13101 Cmplx rpr trunk 2.6-7.5 cm 00135 00327
13102 Cmplx rpr trunk addl 5cm/< 00134 00000 T N
13120 Cmplx rpr s/a/l 1.1-2.5 cm 00134 00326
13121 Cmplx rpr s/a/l 2.6-7.5 cm 00134 00327
13122 Cmplx rpr s/a/l addl 5 cm/> 00133 00000 T N
13131 Cmplx rpr f/c/c/m/n/ax/g/h/f 00134 00326
13132 Cmplx rpr f/c/c/m/n/ax/g/h/f 00135 00327
13133 Cmplx rpr f/c/c/m/n/ax/g/h/f 00134 00000 T N
13151 Cmplx rpr e/n/e/l 1.1-2.5 cm 00135 00327
13152 Cmplx rpr e/n/e/l 2.6-7.5 cm 00135 00327
13153 Cmplx rpr e/n/e/l addl 5cm/< 00134 00000 T N
13160 Late closure of wound 00137 00328
14000 Tis trnfr trunk 10 sq cm/< 00136 00328
14001 Tis trnfr trunk 10.1-30sqcm 00136 00328
14020 Tis trnfr s/a/l 10 sq cm/< 00136 00328
14021 Tis trnfr s/a/l 10.1-30 sqcm 00136 00328
14040 Tis trnfr f/c/c/m/n/a/g/h/f 00136 00328
14041 Tis trnfr f/c/c/m/n/a/g/h/f 00136 00328
14060 Tis trnfr e/n/e/l 10 sq cm/< 00136 00328
14061 Tis trnfr e/n/e/l10.1-30sqcm 00136 00328
14301 Tis trnfr any 30.1-60 sq cm 00137 00329
14302 Tis trnfr addl 30 sq cm/< 00137 00000 T N
14350 Filleted finger/toe flap 00137 00328
15002 Wound prep trk/arm/leg 00135 00327
15003 Wound prep addl 100 cm 00135 00000 T N
15004 Wound prep f/n/hf/g 00134 00327
15005 Wnd prep f/n/hf/g addl cm 00135 00000 T N
15040 Harvest cultured skin graft 00134 00327
15050 Skin pinch graft 00134 00327
15100 Skin splt grft trnk/arm/leg 00137 00329
15101 Skin splt grft t/a/l add-on 00137 00000 T N
15110 Epidrm autogrft trnk/arm/leg 00135 00329
15111 Epidrm autogrft t/a/l add-on 00135 00000 T N
15115 Epidrm a-grft face/nck/hf/g 00136 00328
15116 Epidrm a-grft f/n/hf/g addl 00134 00000 T N
15120 Skn splt a-grft fac/nck/hf/g 00137 00329
15121 Skn splt a-grft f/n/hf/g add 00137 00000 T N
15130 Derm autograft trnk/arm/leg 00136 00329
15131 Derm autograft t/a/l add-on 00136 00000 T N
15135 Derm autograft face/nck/hf/g 00136 00328
15136 Derm autograft f/n/hf/g add 00136 00000 T N
15150 Cult skin grft t/arm/leg 00134 00328
15151 Cult skin grft t/a/l addl 00134 00000 T N
15152 Cult skin graft t/a/l +% 00134 00000 T N
15155 Cult skin graft f/n/hf/g 00134 00329
15156 Cult skin grft f/n/hfg add 00134 00000 T N
15157 Cult epiderm grft f/n/hfg +% 00134 00000 T N
15200 Skin full graft trunk 00136 00329
15201 Skin full graft trunk add-on 00136 00000 T N
15220 Skin full graft sclp/arm/leg 00136 00328
15221 Skin full graft add-on 00135 00000 T N
15240 Skin full grft face/genit/hf 00136 00328
15260 Skin full graft een & lips 00136 00328
15271 Skin sub graft trnk/arm/leg 00134 00328
15272 Skin sub graft t/a/l add-on 00133 00000 T N
15273 Skin sub grft t/arm/lg child 00135 00329
15274 Skn sub grft t/a/l child add 00134 00000 T N
15275 Skin sub graft face/nk/hf/g 00134 00328
15276 Skin sub graft f/n/hf/g addl 00133 00000 T N
15277 Skn sub grft f/n/hf/g child 00135 00328
15278 Skn sub grft f/n/hf/g ch add 00134 00000 T N
15570 Skin pedicle flap trunk 00137 00328
15572 Skin pedicle flap arms/legs 00137 00328
15574 Pedcle fh/ch/ch/m/n/ax/g/h/f 00137 00328
15576 Pedicle e/n/e/l/ntroral 00137 00328
15600 Delay flap trunk 00137 00329
15610 Delay flap arms/legs 00137 00329
15620 Delay flap f/c/c/n/ax/g/h/f 00137 00328
15630 Delay flap eye/nos/ear/lip 00137 00328
15650 Transfer skin pedicle flap 00137 00328
15731 Forehead flap w/vasc pedicle 00137 00329
15732 Muscle-skin graft head/neck 00137 00328
15734 Muscle-skin graft trunk 00137 00329
15736 Muscle-skin graft arm 00137 00328
15738 Muscle-skin graft leg 00137 00329
15740 Island pedicle flap graft 00136 00328
15750 Neurovascular pedicle flap 00137 00328
15760 Composite skin graft 00137 00328
15770 Derma-fat-fascia graft 00137 00329
15775 Hair trnspl 1-15 punch grfts 00133 00326
15776 Hair trnspl >15 punch grafts 00133 00326
15777 Acellular derm matrix implt 00136 00000 T N
15781 Dermabrasion segmental face 00019 00020
15787 Abrasion lesions add-on 00013 00000 T N
15819 Plastic surgery neck 00134 00328
15820 Revision of lower eyelid 00137 00328
15821 Revision of lower eyelid 00137 00328
15822 Revision of upper eyelid 00137 00328
15823 Revision of upper eyelid 00137 00328
15824 Removal of forehead wrinkles 00137 00328
15825 Removal of neck wrinkles 00137 00328
15826 Removal of brow wrinkles 00137 00329
15828 Removal of face wrinkles 00137 00329
15829 Removal of skin wrinkles 00137 00329
15830 Exc skin abd 00022 00030
15840 Nerve palsy fascial graft 00137 00329
15841 Nerve palsy muscle graft 00137 00329
15842 Nerve palsy microsurg graft 00137 00329
15845 Skin and muscle repair face 00137 00329
15847 Exc skin abd add-on 00022 00000 T N
15852 Dressing change not for burn 00340 00420
15860 Test for blood flow in graft 00340 00420
15876 Suction lipectomy head&neck 00137 00329
15877 Suction lipectomy trunk 00137 00329
15878 Suction lipectomy upr extrem 00137 00329
15879 Suction lipectomy lwr extrem 00137 00329
15920 Removal of tail bone ulcer 00019 00020
15922 Removal of tail bone ulcer 00137 00328
15934 Remove sacrum pressure sore 00137 00329
15944 Remove hip pressure sore 00137 00328
15952 Remove thigh pressure sore 00136 00329
16000 Initial treatment of burn(s) 00013 00012
17003 Destruct premalg les 2-14 00012 00000 T N
17312 Mohs addl stage 00694 00000 T N
17314 Mohs addl stage t/a/l 00694 00000 T N
17315 Mohs surg addl block 00694 00000 T N
17340 Cryotherapy of skin 00013 00012
19001 Drain breast lesion add-on 00002 00000 T N
19126 Excision addl breast lesion 00028 00000 T N
19328 Removal of breast implant T Q2
19330 Removal of implant material T Q2
20101 Explore wound chest 00137 00328
20102 Explore wound abdomen 00137 00328
2028F Foot exam performed M E 72 9
20520 Removal of foreign body 00019 00020
20660 Apply rem fixation device 00138 00139 T Q2
20665 Removal of fixation device 00340 00420 X Q2
20670 Removal of support implant T Q2
20680 Removal of support implant T Q2
20694 Remove bone fixation device T Q2
20910 Remove cartilage for graft 00137 00327
20912 Remove cartilage for graft 00137 00329
20920 Removal of fascia for graft 00136 00329
20922 Removal of fascia for graft 00136 00329
20926 Removal of tissue for graft 00136 00329
21044 Removal of jaw bone lesion 00254 00256
21110 Interdental fixation T Q2
21195 Reconst lwr jaw w/o fixation 00254 00256
21230 Rib cartilage graft 00254 00256
21315 Closed tx nose fx w/o stablj 00253 00252
21445 Treat dental ridge fracture 00254 00256
22103 Remove extra spine segment 00208 00000 T N
22315 Closed tx vert fx w/manj 00139 00431
22522 Percut vertebroplasty addl 00050 00000 T N
22525 Percut kyphoplasty add-on 00052 00000 T N
22614 Spine fusion extra segment 00208 00000 T N
22851 Apply spine prosth device 00050 00000 T N
23397 Muscle transfers 00052 00051
23465 Repair shoulder capsule 00052 00051
23520 Treat clavicle dislocation 00138 00431
23540 Treat clavicle dislocation 00129 00138
23600 Treat humerus fracture 00129 00138
23650 Treat shoulder dislocation 00129 00138
23665 Treat dislocation/fracture 00138 00139
23675 Treat dislocation/fracture 00129 00138
23921 Amputation follow-up surgery 00136 00329
24160 Remove elbow joint implant T Q2
24164 Remove radius head implant T Q2
24200 Removal of arm foreign body 00019 00020
24344 Reconstruct elbow lat ligmnt 00052 00051
24346 Reconstruct elbow med ligmnt 00052 00051
24400 Revision of humerus 00052 00051
24600 Treat elbow dislocation 00129 00138
24620 Treat elbow fracture 00139 00431
24640 Treat elbow dislocation 00129 00138
24650 Treat radius fracture 00129 00138
24675 Treat ulnar fracture 00129 00138
25250 Removal of wrist prosthesis T Q2
25251 Removal of wrist prosthesis T Q2
25259 Manipulate wrist w/anesthes 00139 00431
25365 Revise radius & ulna 00052 00051
25391 Lengthen radius or ulna 00052 00051
25400 Repair radius or ulna 00052 00051
25425 Repair/graft radius or ulna 00052 00051
25440 Repair/graft wrist bone 00052 00051
25505 Treat fracture of radius 00138 00139
25535 Treat fracture of ulna 00129 00138
25600 Treat fracture radius/ulna 00129 00138
25605 Treat fracture radius/ulna 00138 00139
25622 Treat wrist bone fracture 00129 00138
25660 Treat wrist dislocation 00129 00138
25830 Fusion radioulnar jnt/ulna 00052 00051
25929 Amputation follow-up surgery 00136 00328
26125 Release palm contracture 00053 00000 T N
26320 Removal of implant from hand T Q2
26605 Treat metacarpal fracture 00129 00138
26607 Treat metacarpal fracture 00139 00431
26641 Treat thumb dislocation 00129 00138
26675 Treat hand dislocation 00129 00138
26700 Treat knuckle dislocation 00129 00138
26705 Treat knuckle dislocation 00129 00138
26706 Pin knuckle dislocation 00139 00431
26725 Treat finger fracture each 00129 00138
26775 Treat finger dislocation 00045 00426 T S
26861 Fusion of finger jnt add-on 00054 00000 T N
26863 Fuse/graft added joint 00054 00000 T N
27193 Treat pelvic ring fracture 00129 00138
27194 Treat pelvic ring fracture 00045 00139
27230 Treat thigh fracture 00129 00138
27250 Treat hip dislocation 00129 00138
27267 Cltx thigh fx 00129 00431
27358 Remove femur lesion/fixation 00050 00000 T N
27409 Repair of knee ligaments 00052 00051
27501 Treatment of thigh fracture 00129 00138
27517 Treat thigh fx growth plate 00129 00138
27520 Treat kneecap fracture 00129 00138
27530 Treat knee fracture 00129 00138
27532 Treat knee fracture 00139 00431
27538 Treat knee fracture(s) 00129 00138
27550 Treat knee dislocation 00129 00138
27562 Treat kneecap dislocation 00045 00139
27652 Repair/graft achilles tendon 00052 00051
27692 Revise additional leg tendon 00051 00000 T N
27704 Removal of ankle implant T Q2
27750 Treatment of tibia fracture 00129 00138
27752 Treatment of tibia fracture 00139 00431
27760 Cltx medial ankle fx 00129 00138
27762 Cltx med ankle fx w/mnpj 00139 00431
27780 Treatment of fibula fracture 00129 00138
27786 Treatment of ankle fracture 00129 00138
27824 Treat lower leg fracture 00129 00138
27825 Treat lower leg fracture 00139 00431
27840 Treat ankle dislocation 00129 00138
28400 Treatment of heel fracture 00129 00138
28470 Treat metatarsal fracture 00129 00138
28475 Treat metatarsal fracture 00129 00138
28495 Treat big toe fracture 00129 00138
28515 Treatment of toe fracture 00129 00138
28570 Treat foot dislocation 00129 00138
28575 Treat foot dislocation 00139 00431
28630 Treat toe dislocation 00129 00138
28635 Treat toe dislocation 00045 00431
28665 Treat toe dislocation 00045 00426 T S
29580 Application of paste boot 00058 00426
29582 Apply multlay comprs upr leg 00059 00426
29824 Shoulder arthroscopy/surgery 00041 00042
29826 Shoulder arthroscopy/surgery 00041 00000 T N
29830 Elbow arthroscopy 00041 00042
29835 Elbow arthroscopy/surgery 00041 00042
29836 Elbow arthroscopy/surgery 00041 00042
29892 Ankle arthroscopy/surgery 00052 00051
29901 Mcp joint arthroscopy surg 00041 00042
30000 Drainage of nose lesion 00251 00250
30300 Remove nasal foreign body 00340 00420
30801 Ablate inf turbinate superf 00253 00252
30915 Ligation nasal sinus artery 00092 00219
30920 Ligation upper jaw artery 00092 00219
3092F Mdd in remission M E 72 9
31200 Removal of ethmoid sinus 00254 00256
31231 Nasal endoscopy dx 00072 00071
31235 Nasal/sinus endoscopy dx 00074 00073
31237 Nasal/sinus endoscopy surg 00074 00073
31254 Revision of ethmoid sinus 00075 00074
31256 Exploration maxillary sinus 00075 00074
31267 Endoscopy maxillary sinus 00075 00074
31297 Sinus endo w/balloon dil 00075 00074
31510 Laryngoscopy with biopsy 00074 00073
31511 Remove foreign body larynx 00072 00071
31515 Laryngoscopy for aspiration 00074 00073
31525 Dx laryngoscopy excl nb 00074 00073
31526 Dx laryngoscopy w/oper scope 00074 00073
31527 Laryngoscopy for treatment 00075 00074
31528 Laryngoscopy and dilation 00075 00074
31529 Laryngoscopy and dilation 00075 00074
31530 Laryngoscopy w/fb removal 00074 00073
31531 Laryngoscopy w/fb & op scope 00074 00073
31541 Larynscop w/tumr exc + scope 00075 00074
31545 Remove vc lesion w/scope 00075 00073
31561 Larynscop remve cart + scop 00075 00074
31570 Laryngoscope w/vc inj 00074 00073
31571 Laryngoscop w/vc inj + scope 00075 00074
31575 Diagnostic laryngoscopy 00072 00071
31576 Laryngoscopy with biopsy 00074 00073
31577 Remove foreign body larynx 00073 00072
31578 Removal of larynx lesion 00074 00073
31579 Diagnostic laryngoscopy 00073 00072
31632 Bronchoscopy/lung bx addl 00076 00000 T N
31633 Bronchoscopy/needle bx addl 00076 00000 T N
31637 Bronchoscopy stent add-on 00076 00000 T N
31649 Bronchial valve remov addl T Q2
31651 Bronchial valve addl insert 00415 00000 T N
31717 Bronchial brush biopsy 00073 00072
31720 Clearance of airways 00077 00102
31730 Intro windpipe wire/tube 00073 00072
3216F Pt immunity to hep b docd M E 72 9
3218F Rna tstng hep c docd done M E 72 9
3220F Hep c quant rna tstng docd M E 72 9
32552 Remove lung catheter T Q2
3266F Hepc gn tstng docd b/4txmnt M E 72 9
33215 Reposition pacing-defib lead 00105 00103
33222 Relocation pocket pacemaker 00136 00328
33223 Relocate pocket for defib 00136 00328
33226 Reposition l ventric lead 00105 00103
33233 Removal of pm generator T Q2
33234 Removal of pacemaker system T Q2
33235 Removal pacemaker electrode T Q2
33241 Remove pulse generator T Q2
33244 Remove eltrd transven T Q2
33284 Remove pat-active ht record 00020 00021 T Q2
3490F History aids-defining cond M E 72 9
3492F History cd4+ cell count <350 M E 72 9
3493F No hist cd4+ cell count <350 M E 72 9
3500F Cd4+cell cnt/% docd as done M E 72 9
3502F Hiv rna vrl ld <lmts quantif M E 72 9
3503F Hiv rna vrl ldnot<lmts quntf M E 72 9
3511F Chlmyd/gonrh tsts docd done M E 72 9
3512F Syph scrng docd as done M E 72 9
35500 Harvest vein for bypass 00103 00000 T N
35685 Bypass graft patency/patch 00093 00000 T N
35686 Bypass graft/av fist patency 00093 00000 T N
36262 Removal of infusion pump T Q2
36415 Routine venipuncture A N
36420 Vein access cutdown < 1 yr 00035 00420
36468 Injection(s) spider veins 00013 00015
36475 Endovenous rf 1st vein 00091 00219
36476 Endovenous rf vein add-on 00092 00000 T N
36478 Endovenous laser 1st vein 00092 00219
36479 Endovenous laser vein addon 00092 00000 T N
36589 Removal tunneled cv cath T Q2
36590 Removal tunneled cv cath T Q2
36600 Withdrawal of arterial blood 00035 00420
36680 Insert needle bone cavity 00002 00340 T X
37185 Prim art m-thrombect add-on 00088 00000 T N
37186 Sec art m-thrombect add-on 00088 00000 T N
37191 Ins endovas vena cava filtr 00091 00093
37193 Rem endovas vena cava filter T Q2
37500 Endoscopy ligate perf veins 00091 00219
37501 Vascular endoscopy procedure 00092 00219
37605 Ligation of neck artery 00091 00219
37607 Ligation of a-v fistula 00092 00219
37619 Ligation of inf vena cava 00091 00219
37650 Revision of major vein 00092 00219
37700 Revise leg vein 00092 00219
37718 Ligate/strip short leg vein 00092 00219
37722 Ligate/strip long leg vein 00091 00219
37735 Removal of leg veins/lesion 00091 00219
37760 Ligate leg veins radical 00092 00219
37761 Ligate leg veins open 00092 00219
37765 Stab phleb veins xtr 10-20 00092 00219
37766 Phleb veins - extrem 20+ 00092 00219
37780 Revision of leg vein 00092 00219
37785 Ligate/divide/excise vein 00092 00219
38220 Bone marrow aspiration 00003 00020
38221 Bone marrow biopsy 00003 00020
4041F Doc order cefazolin/cefurox M E 72 9
4070F Dvt prophylx recvd day 2 M E 72 9
40804 Removal foreign body mouth 00340 00420
41108 Biopsy of floor of mouth 00019 00020
41120 Partial removal of tongue 00254 00256
4145F 2+ anti-hyprtnsv agents tkn M E 72 9
4149F Hep b vac injxn admin/recvd M E 72 9
4150F Pt recvng antivir txmnt hepc M E 72 9
41512 Tongue suspension 00254 00256
41520 Reconstruction tongue fold 00254 00256
4153F Combo pegintf/rib rx M E 72 9
4158F Pt edu re alcoh drnkng done M E 72 9
4159F Contrcp talk b/4 antiv txmnt M E 72 9
41822 Excision of gum lesion 00253 00252
41827 Excision of gum lesion 00254 00256
41872 Repair gum 00254 00256
42225 Reconstruct cleft palate 00254 00256
42235 Repair palate 00254 00256
4270F Pt rcvng anti r-viral thxpy M E 72 9
4271F Pt rcvng anti r-viral thxpy M E 72 9
4276F Potent antivir thxpy rxd M E 72 9
42809 Remove pharynx foreign body 00340 00420
4280F Pcp prophylax rxd 3mon low % M E 72 9
43030 Throat muscle surgery 00254 00256
43273 Endoscopic pancreatoscopy 00151 00000 T N
43450 Dilate esophagus 1/mult pass 00140 00141
43453 Dilate esophagus 00140 00419
43648 Lap revise/remv eltrd antrum T Q2
43752 Nasal/orogastric w/tube plmt 00272 00277
43753 Tx gastro intub w/asp 00340 00420
43754 Dx gastr intub w/asp spec 00340 00420
43755 Dx gastr intub w/asp specs 00097 00096
43886 Revise gastric port open 00137 00329
43887 Remove gastric port open 00136 00328 T Q2
43888 Change gastric port open 00137 00329
44206 Lap part colectomy w/stoma 00132 00000 T C
44207 L colectomy/coloproctostomy 00132 00000 T C
44208 L colectomy/coloproctostomy 00132 00000 T C
44213 Lap mobil splenic fl add-on 00130 00000 T C
44312 Revision of ileostomy 00137 00329
44340 Revision of colostomy 00137 00329
44377 Small bowel endoscopy/biopsy 00142 00424
44955 Appendectomy add-on 00153 00000 T N
45332 Sigmoidoscopy w/fb removal 00146 00147
46600 Diagnostic anoscopy 00340 00420
46614 Anoscopy control bleeding 00146 00147
47511 Insert bile duct drain 00152 00423
47553 Biliary endoscopy thru skin 00152 00423
49326 Lap w/omentopexy add-on 00130 00000 T N
49327 Lap ins device for rt 00130 00000 T N
49422 Remove tunneled ip cath 00105 00103 T Q2
49429 Removal of shunt 00105 00103 T Q2
49568 Hernia repair w/mesh 00154 00000 T N
50384 Remove ureter stent percut T Q2
50386 Remove stent via transureth T Q2
50389 Remove renal tube w/fluoro T Q2
50391 Instll rx agnt into rnal tub 00126 00164
51701 Insert bladder catheter 00340 00420
51702 Insert temp bladder cath 00340 00420
51703 Insert bladder cath complex 00126 00164
51720 Treatment of bladder lesion 00156 00164
51736 Urine flow measurement 00340 00420
51797 Intraabdominal pressure test 00164 00000 T N
53446 Remove uro sphincter T Q2
53600 Dilate urethra stricture 00156 00164
53855 Insert prost urethral stent 00164 00160
54110 Treatment of penis lesion 00181 00205
54111 Treat penis lesion graft 00181 00205
54112 Treat penis lesion graft 00181 00205
54300 Revision of penis 00181 00205
54304 Revision of penis 00181 00205
54308 Reconstruction of urethra 00181 00205
54324 Reconstruction of urethra 00181 00205
54328 Revise penis/urethra 00181 00205
54352 Reconstruct urethra/penis 00181 00205
54360 Penis plastic surgery 00181 00205
54406 Remove muti-comp penis pros T Q2
54408 Repair multi-comp penis pros 00181 00205
54415 Remove self-contd penis pros T Q2
54450 Preputial stretching 00156 00164
54520 Removal of testis 00183 00181
55175 Revision of scrotum 00183 00205
55500 Removal of hydrocele 00183 00181
55870 Electroejaculation 00189 00192
56405 I & d of vulva/perineum 00188 00189
56605 Biopsy of vulva/perineum 00189 00192
56606 Biopsy of vulva/perineum 00188 00000 T N
56620 Partial removal of vulva 00193 00195
56625 Complete removal of vulva 00193 00195
56740 Remove vagina gland lesion 00193 00195
56800 Repair of vagina 00193 00195
56810 Repair of perineum 00193 00195
56821 Exam/biopsy of vulva w/scope 00188 00189
57000 Exploration of vagina 00193 00195
57020 Drainage of pelvic fluid 00192 00195
57065 Destroy vag lesions complex 00193 00195
57106 Remove vagina wall partial 00193 00195
57130 Remove vagina lesion 00193 00195
57155 Insert uteri tandem/ovoids 00192 00193
57200 Repair of vagina 00193 00195
57210 Repair vagina/perineum 00193 00195
57267 Insert mesh/pelvic flr addon 00195 00000 T N
57287 Revise/remove sling repair T Q2
57295 Revise vag graft via vagina 00193 00195
57421 Exam/biopsy of vag w/scope 00189 00192
57426 Revise prosth vag graft lap 00193 00195
57452 Exam of cervix w/scope 00188 00189
57455 Biopsy of cervix w/scope 00189 00192
57511 Cryocautery of cervix 00188 00189
57520 Conization of cervix 00193 00195
57700 Revision of cervix 00193 00195
58100 Biopsy of uterus lining 00188 00189
58301 Remove intrauterine device 00188 00189 T Q2
58322 Artificial insemination 00189 00188
58323 Sperm washing 00189 00188
58615 Occlude fallopian tube(s) 00193 00195
58970 Retrieval of oocyte 00189 00192
58974 Transfer of embryo 00189 00192
59000 Amniocentesis diagnostic 00189 00192
59001 Amniocentesis therapeutic 00192 00189
59015 Chorion biopsy 00189 00192
59070 Transabdom amnioinfus w/us 00188 00192
59200 Insert cervical dilator 00188 00189
59821 Treatment of miscarriage 00193 00195
59870 Evacuate mole of uterus 00193 00195
59871 Remove cerclage suture T Q2
60512 Autotransplant parathyroid 00022 00000 T N
61050 Remove brain canal fluid 00207 00203
61215 Insert brain-fluid device 00224 00221
61880 Revise/remove neuroelectrode T Q2
61888 Revise/remove neuroreceiver T Q2
62000 Treat skull fracture 00254 00256
62194 Replace/irrigate catheter 00207 00203
62230 Replace/revise brain shunt 00224 00221
62252 Csf shunt reprogram 00691 00692
62264 Epidural lysis on single day 00203 00207
62292 Injection into disk lesion 00207 00203
62319 Inject spine w/cath lmb/scrl 00203 00207
62355 Remove spinal canal catheter T Q2
62365 Remove spine infusion device T Q2
63035 Spinal disk surgery add-on 00208 00000 T N
63048 Remove spinal lamina add-on 00208 00000 T N
63057 Decompress spine cord add-on 00208 00000 T N
63066 Decompress spine cord add-on 00208 00000 T N
63076 Neck spine disk surgery 00208 00000 T N
63661 Remove spine eltrd perq aray T Q2
63662 Remove spine eltrd plate T Q2
63688 Revise/remove neuroreceiver T Q2
63741 Install spinal shunt 00224 00221
63744 Revision of spinal shunt 00224 00221
63746 Removal of spinal shunt T Q2
64402 N block inj facial 00204 00420 T X
64448 N block inj fem cont inf 00207 00203
64480 Inj foramen epidural add-on 00206 00000 T N
64484 Inj foramen epidural add-on 00206 00000 T N
64491 Inj paravert f jnt c/t 2 lev 00204 00000 T N
64492 Inj paravert f jnt c/t 3 lev 00204 00000 T N
64494 Inj paravert f jnt l/s 2 lev 00204 00000 T N
64495 Inj paravert f jnt l/s 3 lev 00204 00000 T N
64570 Remove vagus n eltrd T Q2
64585 Revise/remove neuroelectrode T Q2
64595 Revise/rmv pn/gastr stimul T Q2
64633 Destroy cerv/thor facet jnt 00207 00203
64634 Destroy c/th facet jnt addl 00204 00000 T N
64636 Destroy l/s facet jnt addl 00207 00000 T N
64681 Injection treatment of nerve 00203 00207
64727 Internal nerve revision 00220 00000 T N
64778 Digit nerve surgery add-on 00220 00000 T N
64783 Limb nerve surgery add-on 00220 00000 T N
64787 Implant nerve end 00220 00000 T N
64832 Repair nerve add-on 00221 00000 T N
64837 Repair nerve add-on 00221 00000 T N
64859 Nerve surgery 00221 00000 T N
64872 Subsequent repair of nerve 00221 00000 T N
64874 Repair & revise nerve add-on 00221 00000 T N
64876 Repair nerve/shorten bone 00221 00000 T N
64901 Nerve graft add-on 00221 00000 T N
64902 Nerve graft add-on 00221 00000 T N
65175 Removal of ocular implant T Q2
65920 Remove implant of eye T Q2
67120 Remove eye implant material T Q2
67121 Remove eye implant material T Q2
67220 Treatment of choroid lesion 00235 00247
67225 Eye photodynamic ther add-on 00235 00000 T N
67320 Revise eye muscle(s) add-on 00243 00000 T N
67331 Eye surgery follow-up add-on 00243 00000 T N
67332 Rerevise eye muscles add-on 00243 00000 T N
67334 Revise eye muscle w/suture 00243 00000 T N
67335 Eye suture during surgery 00243 00000 T N
67340 Revise eye muscle add-on 00243 00000 T N
68200 Treat eyelid by injection 00230 00698
69424 Remove ventilating tube T Q2
69711 Remove/repair hearing aid T Q2
70120 X-ray exam of mastoids 00261 00260
70134 X-ray exam of middle ear 00261 00260
70200 X-ray exam of eye sockets 00261 00260
70220 X-ray exam of sinuses 00261 00260
72090 X-ray exam scloiosis erect 00261 00260
73092 X-ray exam of arm infant 00260 00261
73564 X-ray exam knee 4 or more 00261 00260
74190 X-ray exam of peritoneum 00263 00317
74470 X-ray exam of kidney lesion 00263 00317
75563 Card mri w/stress img & dye 00337 00377
75571 Ct hrt w/o dye w/ca test 00340 00035
75705 Artery x-rays spine 00279 00280
75726 Artery x-rays abdomen 00279 00280
75801 Lymph vessel x-ray arm/leg 00317 00263
75822 Vein x-ray arms/legs 00668 00317
75870 Vein x-ray skull 00668 00263
75898 Follow-up angiography 00397 00668
75962 Repair arterial blockage 00083 00000 Q2 N
75966 Repair arterial blockage 00083 00000 Q2 N
76001 Fluoroscope exam extensive B N 62 N/A
76098 X-ray exam breast specimen 00317 00263
76506 Echo exam of head 00265 00266
76519 Echo exam of eye 00266 00265
76529 Echo exam of eye 00265 00266
76604 Us exam chest 00265 00266
76800 Us exam spinal canal 00266 00265
76802 Ob us < 14 wks addl fetus 00265 00000 S N
76810 Ob us >/= 14 wks addl fetus 00266 00000 S N
76812 Ob us detailed addl fetus 00265 00000 S N
76813 Ob us nuchal meas 1 gest 00265 00266
76814 Ob us nuchal meas add-on 00265 00000 S N
76815 Ob us limited fetus(s) 00265 00266
76817 Transvaginal us obstetric 00265 00266
77073 X-rays bone length studies 00261 00260
77371 Srs multisource 00127 00067
77372 Srs linear based 00000 00067 B S 62 N/A
77373 Sbrt delivery 00000 00066 B S 62 N/A
77406 Radiation treatment delivery 00300 00301
77789 Apply surface radiation 00300 00301
78445 Vascular flow imaging 00397 00263 S X
78456 Acute venous thrombus image 00397 00317 S X
78457 Venous thrombosis imaging 00397 00263 S X
78458 Ven thrombosis images bilat 00397 00263 S X
78483 Heart first pass multiple 00398 00377
78605 Brain image 4+ views 00403 00402
78607 Brain imaging (3d) 00402 00408
78610 Brain flow imaging only 00403 00402
78645 Csf shunt evaluation 00403 00402
78730 Urinary bladder retention 00389 00000 S N
78801 Tumor imaging mult areas 00414 00406
80047 Metabolic panel ionized ca A N
80048 Metabolic panel total ca A N
80051 Electrolyte panel A N
80053 Comprehen metabolic panel A N
80061 Lipid panel A N
80069 Renal function panel A N
80074 Acute hepatitis panel A N
80076 Hepatic function panel A N
80102 Drug confirmation A N
80150 Assay of amikacin A N
80152 Assay of amitriptyline A N
80154 Assay of benzodiazepines A N
80156 Assay carbamazepine total A N
80157 Assay carbamazepine free A N
80158 Assay of cyclosporine A N
80160 Assay of desipramine A N
80162 Assay of digoxin A N
80164 Assay dipropylacetic acid A N
80166 Assay of doxepin A N
80168 Assay of ethosuximide A N
80170 Assay of gentamicin A N
80172 Assay of gold A N
80173 Assay of haloperidol A N
80174 Assay of imipramine A N
80176 Assay of lidocaine A N
80178 Assay of lithium A N
80182 Assay of nortriptyline A N
80184 Assay of phenobarbital A N
80185 Assay of phenytoin total A N
80186 Assay of phenytoin free A N
80188 Assay of primidone A N
80190 Assay of procainamide A N
80192 Assay of procainamide A N
80194 Assay of quinidine A N
80195 Assay of sirolimus A N
80196 Assay of salicylate A N
80197 Assay of tacrolimus A N
80198 Assay of theophylline A N
80200 Assay of tobramycin A N
80201 Assay of topiramate A N
80202 Assay of vancomycin A N
80299 Quantitative assay drug A N
80400 Acth stimulation panel A N
80408 Aldosterone suppression eval A N
80410 Calcitonin stimul panel A N
80412 Crh stimulation panel A N
80414 Testosterone response A N
80415 Estradiol response panel A N
80416 Renin stimulation panel A N
80417 Renin stimulation panel A N
80418 Pituitary evaluation panel A N
80420 Dexamethasone panel A N
80422 Glucagon tolerance panel A N
80424 Glucagon tolerance panel A N
80426 Gonadotropin hormone panel A N
80428 Growth hormone panel A N
80430 Growth hormone panel A N
80432 Insulin suppression panel A N
80434 Insulin tolerance panel A N
80435 Insulin tolerance panel A N
80436 Metyrapone panel A N
80438 Trh stimulation panel A N
80502 Lab pathology consultation 00342 00433
81000 Urinalysis nonauto w/scope A N
81001 Urinalysis auto w/scope A N
81002 Urinalysis nonauto w/o scope A N
81003 Urinalysis auto w/o scope A N
81005 Urinalysis A N
81007 Urine screen for bacteria A N
81015 Microscopic exam of urine A N
81020 Urinalysis glass test A N
81025 Urine pregnancy test A N
81050 Urinalysis volume measure A N
81099 Urinalysis test procedure A N
82000 Assay of blood acetaldehyde A N
82003 Assay of acetaminophen A N
82009 Test for acetone/ketones A N
82010 Acetone assay A N
82013 Acetylcholinesterase assay A N
82016 Acylcarnitines qual A N
82017 Acylcarnitines quant A N
82024 Assay of acth A N
82030 Assay of adp & amp A N
82040 Assay of serum albumin A N
82042 Assay of urine albumin A N
82043 Microalbumin quantitative A N
82044 Microalbumin semiquant A N
82045 Albumin ischemia modified A N
82055 Assay of ethanol A N
82075 Assay of breath ethanol A N
82085 Assay of aldolase A N
82088 Assay of aldosterone A N
82101 Assay of urine alkaloids A N
82103 Alpha-1-antitrypsin total A N
82104 Alpha-1-antitrypsin pheno A N
82105 Alpha-fetoprotein serum A N
82106 Alpha-fetoprotein amniotic A N
82107 Alpha-fetoprotein l3 A N
82108 Assay of aluminum A N
82120 Amines vaginal fluid qual A N
82127 Amino acid single qual A N
82128 Amino acids mult qual A N
82131 Amino acids single quant A N
82135 Assay aminolevulinic acid A N
82136 Amino acids quant 2-5 A N
82139 Amino acids quan 6 or more A N
82140 Assay of ammonia A N
82143 Amniotic fluid scan A N
82145 Assay of amphetamines A N
82150 Assay of amylase A N
82154 Androstanediol glucuronide A N
82157 Assay of androstenedione A N
82160 Assay of androsterone A N
82163 Assay of angiotensin ii A N
82164 Angiotensin i enzyme test A N
82172 Assay of apolipoprotein A N
82175 Assay of arsenic A N
82180 Assay of ascorbic acid A N
82190 Atomic absorption A N
82205 Assay of barbiturates A N
82232 Assay of beta-2 protein A N
82239 Bile acids total A N
82240 Bile acids cholylglycine A N
82247 Bilirubin total A N
82248 Bilirubin direct A N
82252 Fecal bilirubin test A N
82261 Assay of biotinidase A N
82270 Occult blood feces A N
82271 Occult blood other sources A N
82272 Occult bld feces 1-3 tests A N
82274 Assay test for blood fecal A N
82286 Assay of bradykinin A N
82300 Assay of cadmium A N
82306 Vitamin d 25 hydroxy A N
82308 Assay of calcitonin A N
82310 Assay of calcium A N
82330 Assay of calcium A N
82331 Calcium infusion test A N
82340 Assay of calcium in urine A N
82355 Calculus analysis qual A N
82360 Calculus assay quant A N
82365 Calculus spectroscopy A N
82370 X-ray assay calculus A N
82373 Assay c-d transfer measure A N
82374 Assay blood carbon dioxide A N
82375 Assay carboxyhb quant A N
82376 Assay carboxyhb qual A N
82378 Carcinoembryonic antigen A N
82379 Assay of carnitine A N
82380 Assay of carotene A N
82382 Assay urine catecholamines A N
82383 Assay blood catecholamines A N
82384 Assay three catecholamines A N
82387 Assay of cathepsin-d A N
82390 Assay of ceruloplasmin A N
82397 Chemiluminescent assay A N
82415 Assay of chloramphenicol A N
82435 Assay of blood chloride A N
82436 Assay of urine chloride A N
82438 Assay other fluid chlorides A N
82441 Test for chlorohydrocarbons A N
82465 Assay bld/serum cholesterol A N
82480 Assay serum cholinesterase A N
82482 Assay rbc cholinesterase A N
82485 Assay chondroitin sulfate A N
82486 Gas/liquid chromatography A N
82487 Paper chromatography A N
82488 Paper chromatography A N
82489 Thin layer chromatography A N
82491 Chromotography quant sing A N
82492 Chromotography quant mult A N
82495 Assay of chromium A N
82507 Assay of citrate A N
82520 Assay of cocaine A N
82523 Collagen crosslinks A N
82525 Assay of copper A N
82528 Assay of corticosterone A N
82530 Cortisol free A N
82533 Total cortisol A N
82540 Assay of creatine A N
82541 Column chromotography qual A N
82542 Column chromotography quant A N
82543 Column chromotograph/isotope A N
82544 Column chromotograph/isotope A N
82550 Assay of ck (cpk) A N
82552 Assay of cpk in blood A N
82553 Creatine mb fraction A N
82554 Creatine isoforms A N
82565 Assay of creatinine A N
82570 Assay of urine creatinine A N
82575 Creatinine clearance test A N
82585 Assay of cryofibrinogen A N
82595 Assay of cryoglobulin A N
82600 Assay of cyanide A N
82607 Vitamin b-12 A N
82608 B-12 binding capacity A N
82610 Cystatin c A N
82615 Test for urine cystines A N
82626 Dehydroepiandrosterone A N
82627 Dehydroepiandrosterone A N
82633 Desoxycorticosterone A N
82634 Deoxycortisol A N
82638 Assay of dibucaine number A N
82646 Assay of dihydrocodeinone A N
82649 Assay of dihydromorphinone A N
82651 Assay of dihydrotestosterone A N
82652 Vit d 1 25-dihydroxy A N
82654 Assay of dimethadione A N
82656 Pancreatic elastase fecal A N
82657 Enzyme cell activity A N
82658 Enzyme cell activity ra A N
82664 Electrophoretic test A N
82666 Assay of epiandrosterone A N
82668 Assay of erythropoietin A N
82670 Assay of estradiol A N
82671 Assay of estrogens A N
82672 Assay of estrogen A N
82677 Assay of estriol A N
82679 Assay of estrone A N
82690 Assay of ethchlorvynol A N
82693 Assay of ethylene glycol A N
82696 Assay of etiocholanolone A N
82705 Fats/lipids feces qual A N
82710 Fats/lipids feces quant A N
82715 Assay of fecal fat A N
82725 Assay of blood fatty acids A N
82726 Long chain fatty acids A N
82728 Assay of ferritin A N
82731 Assay of fetal fibronectin A N
82735 Assay of fluoride A N
82742 Assay of flurazepam A N
82746 Assay of folic acid serum A N
82747 Assay of folic acid rbc A N
82757 Assay of semen fructose A N
82759 Assay of rbc galactokinase A N
82760 Assay of galactose A N
82775 Assay galactose transferase A N
82776 Galactose transferase test A N
82777 Galectin-3 A N
82784 Assay iga/igd/igg/igm each A N
82785 Assay of ige A N
82787 Igg 1 2 3 or 4 each A N
82800 Blood ph A N
82803 Blood gases any combination A N
82805 Blood gases w/o2 saturation A N
82810 Blood gases o2 sat only A N
82820 Hemoglobin-oxygen affinity A N
82930 Gastric analy w/ph ea spec A N
82938 Gastrin test A N
82941 Assay of gastrin A N
82943 Assay of glucagon A N
82945 Glucose other fluid A N
82946 Glucagon tolerance test A N
82947 Assay glucose blood quant A N
82948 Reagent strip/blood glucose A N
82950 Glucose test A N
82951 Glucose tolerance test (gtt) A N
82952 Gtt-added samples A N
82953 Glucose-tolbutamide test A N
82955 Assay of g6pd enzyme A N
82960 Test for g6pd enzyme A N
82962 Glucose blood test A N
82963 Assay of glucosidase A N
82965 Assay of gdh enzyme A N
82975 Assay of glutamine A N
82977 Assay of ggt A N
82978 Assay of glutathione A N
82979 Assay rbc glutathione A N
82980 Assay of glutethimide A N
82985 Assay of glycated protein A N
83001 Assay of gonadotropin (fsh) A N
83002 Assay of gonadotropin (lh) A N
83003 Assay growth hormone (hgh) A N
83008 Assay of guanosine A N
83009 H pylori (c-13) blood A N
83010 Assay of haptoglobin quant A N
83012 Assay of haptoglobins A N
83013 H pylori (c-13) breath A N
83014 H pylori drug admin A N
83015 Heavy metal screen A N
83018 Quantitative screen metals A N
83020 Hemoglobin electrophoresis A N
83021 Hemoglobin chromotography A N
83026 Hemoglobin copper sulfate A N
83030 Fetal hemoglobin chemical A N
83033 Fetal hemoglobin assay qual A N
83036 Glycosylated hemoglobin test A N
83037 Glycosylated hb home device A N
83045 Blood methemoglobin test A N
83050 Blood methemoglobin assay A N
83051 Assay of plasma hemoglobin A N
83055 Blood sulfhemoglobin test A N
83060 Blood sulfhemoglobin assay A N
83065 Assay of hemoglobin heat A N
83068 Hemoglobin stability screen A N
83069 Assay of urine hemoglobin A N
83070 Assay of hemosiderin qual A N
83071 Assay of hemosiderin quant A N
83080 Assay of b hexosaminidase A N
83088 Assay of histamine A N
83090 Assay of homocystine A N
83150 Assay of homovanillic acid A N
83491 Assay of corticosteroids 17 A N
83497 Assay of 5-hiaa A N
83498 Assay of progesterone 17-d A N
83499 Assay of progesterone 20- A N
83500 Assay free hydroxyproline A N
83505 Assay total hydroxyproline A N
83516 Immunoassay nonantibody A N
83518 Immunoassay dipstick A N
83519 Ria nonantibody A N
83520 Immunoassay quant nos nonab A N
83525 Assay of insulin A N
83527 Assay of insulin A N
83528 Assay of intrinsic factor A N
83540 Assay of iron A N
83550 Iron binding test A N
83570 Assay of idh enzyme A N
83582 Assay of ketogenic steroids A N
83586 Assay 17- ketosteroids A N
83593 Fractionation ketosteroids A N
83605 Assay of lactic acid A N
83615 Lactate (ld) (ldh) enzyme A N
83625 Assay of ldh enzymes A N
83630 Lactoferrin fecal (qual) A N
83631 Lactoferrin fecal (quant) A N
83632 Placental lactogen A N
83633 Test urine for lactose A N
83634 Assay of urine for lactose A N
83655 Assay of lead A N
83661 L/s ratio fetal lung A N
83662 Foam stability fetal lung A N
83663 Fluoro polarize fetal lung A N
83664 Lamellar bdy fetal lung A N
83670 Assay of lap enzyme A N
83690 Assay of lipase A N
83695 Assay of lipoprotein(a) A N
83698 Assay lipoprotein pla2 A N
83700 Lipopro bld electrophoretic A N
83701 Lipoprotein bld hr fraction A N
83704 Lipoprotein bld by nmr A N
83718 Assay of lipoprotein A N
83719 Assay of blood lipoprotein A N
83721 Assay of blood lipoprotein A N
83727 Assay of lrh hormone A N
83735 Assay of magnesium A N
83775 Assay malate dehydrogenase A N
83785 Assay of manganese A N
83788 Mass spectrometry qual A N
83789 Mass spectrometry quant A N
83805 Assay of meprobamate A N
83825 Assay of mercury A N
83835 Assay of metanephrines A N
83840 Assay of methadone A N
83857 Assay of methemalbumin A N
83858 Assay of methsuximide A N
83861 Microfluid analy tears A N
83864 Mucopolysaccharides A N
83866 Mucopolysaccharides screen A N
83872 Assay synovial fluid mucin A N
83873 Assay of csf protein A N
83874 Assay of myoglobin A N
83876 Assay myeloperoxidase A N
83880 Assay of natriuretic peptide A N
83883 Assay nephelometry not spec A N
83885 Assay of nickel A N
83887 Assay of nicotine A N
83915 Assay of nucleotidase A N
83916 Oligoclonal bands A N
83918 Organic acids total quant A N
83919 Organic acids qual each A N
83921 Organic acid single quant A N
83925 Assay of opiates A N
83930 Assay of blood osmolality A N
83935 Assay of urine osmolality A N
83937 Assay of osteocalcin A N
83945 Assay of oxalate A N
83950 Oncoprotein her-2/neu A N
83951 Oncoprotein dcp A N
83970 Assay of parathormone A N
83986 Assay ph body fluid nos A N
83987 Exhaled breath condensate A N
83992 Assay for phencyclidine A N
83993 Assay for calprotectin fecal A N
84022 Assay of phenothiazine A N
84030 Assay of blood pku A N
84035 Assay of phenylketones A N
84060 Assay acid phosphatase A N
84061 Phosphatase forensic exam A N
84066 Assay prostate phosphatase A N
84075 Assay alkaline phosphatase A N
84078 Assay alkaline phosphatase A N
84080 Assay alkaline phosphatases A N
84081 Assay phosphatidylglycerol A N
84085 Assay of rbc pg6d enzyme A N
84087 Assay phosphohexose enzymes A N
84100 Assay of phosphorus A N
84105 Assay of urine phosphorus A N
84106 Test for porphobilinogen A N
84110 Assay of porphobilinogen A N
84112 Eval amniotic fluid protein A N
84119 Test urine for porphyrins A N
84120 Assay of urine porphyrins A N
84126 Assay of feces porphyrins A N
84127 Assay of feces porphyrins A N
84132 Assay of serum potassium A N
84133 Assay of urine potassium A N
84134 Assay of prealbumin A N
84135 Assay of pregnanediol A N
84138 Assay of pregnanetriol A N
84140 Assay of pregnenolone A N
84143 Assay of 17-hydroxypregneno A N
84144 Assay of progesterone A N
84145 Procalcitonin (pct) A N
84146 Assay of prolactin A N
84150 Assay of prostaglandin A N
84152 Assay of psa complexed A N
84153 Assay of psa total A N
84154 Assay of psa free A N
84155 Assay of protein serum A N
84156 Assay of protein urine A N
84157 Assay of protein other A N
84160 Assay of protein any source A N
84163 Pappa serum A N
84165 Protein e-phoresis serum A N
84166 Protein e-phoresis/urine/csf A N
84181 Western blot test A N
84182 Protein western blot test A N
84202 Assay rbc protoporphyrin A N
84203 Test rbc protoporphyrin A N
84206 Assay of proinsulin A N
84207 Assay of vitamin b-6 A N
84210 Assay of pyruvate A N
84220 Assay of pyruvate kinase A N
84228 Assay of quinine A N
84233 Assay of estrogen A N
84234 Assay of progesterone A N
84235 Assay of endocrine hormone A N
84238 Assay nonendocrine receptor A N
84244 Assay of renin A N
84255 Assay of selenium A N
84260 Assay of serotonin A N
84270 Assay of sex hormone globul A N
84275 Assay of sialic acid A N
84285 Assay of silica A N
84295 Assay of serum sodium A N
84300 Assay of urine sodium A N
84302 Assay of sweat sodium A N
84305 Assay of somatomedin A N
84307 Assay of somatostatin A N
84311 Spectrophotometry A N
84315 Body fluid specific gravity A N
84375 Chromatogram assay sugars A N
84376 Sugars single qual A N
84377 Sugars multiple qual A N
84378 Sugars single quant A N
84379 Sugars multiple quant A N
84392 Assay of urine sulfate A N
84402 Assay of free testosterone A N
84403 Assay of total testosterone A N
84430 Assay of thiocyanate A N
84431 Thromboxane urine A N
84432 Assay of thyroglobulin A N
84436 Assay of total thyroxine A N
84437 Assay of neonatal thyroxine A N
84439 Assay of free thyroxine A N
84442 Assay of thyroid activity A N
84443 Assay thyroid stim hormone A N
84445 Assay of tsi globulin A N
84446 Assay of vitamin e A N
84449 Assay of transcortin A N
84450 Transferase (ast) (sgot) A N
84460 Alanine amino (alt) (sgpt) A N
84466 Assay of transferrin A N
84478 Assay of triglycerides A N
84479 Assay of thyroid (t3 or t4) A N
84480 Assay triiodothyronine (t3) A N
84481 Free assay (ft-3) A N
84482 T3 reverse A N
84484 Assay of troponin quant A N
84485 Assay duodenal fluid trypsin A N
84488 Test feces for trypsin A N
84490 Assay of feces for trypsin A N
84510 Assay of tyrosine A N
84512 Assay of troponin qual A N
84520 Assay of urea nitrogen A N
84525 Urea nitrogen semi-quant A N
84540 Assay of urine/urea-n A N
84545 Urea-n clearance test A N
84550 Assay of blood/uric acid A N
84560 Assay of urine/uric acid A N
84577 Assay of feces/urobilinogen A N
84578 Test urine urobilinogen A N
84580 Assay of urine urobilinogen A N
84583 Assay of urine urobilinogen A N
84585 Assay of urine vma A N
84586 Assay of vip A N
84588 Assay of vasopressin A N
84590 Assay of vitamin a A N
84591 Assay of nos vitamin A N
84597 Assay of vitamin k A N
84600 Assay of volatiles A N
84620 Xylose tolerance test A N
84630 Assay of zinc A N
84681 Assay of c-peptide A N
84702 Chorionic gonadotropin test A N
84703 Chorionic gonadotropin assay A N
84704 Hcg free betachain test A N
84830 Ovulation tests A N
84999 Clinical chemistry test A N
85002 Bleeding time test A N
85004 Automated diff wbc count A N
85007 Bl smear w/diff wbc count A N
85008 Bl smear w/o diff wbc count A N
85009 Manual diff wbc count b-coat A N
85013 Spun microhematocrit A N
85014 Hematocrit A N
85018 Hemoglobin A N
85025 Complete cbc w/auto diff wbc A N
85027 Complete cbc automated A N
85032 Manual cell count each A N
85041 Automated rbc count A N
85044 Manual reticulocyte count A N
85045 Automated reticulocyte count A N
85046 Reticyte/hgb concentrate A N
85048 Automated leukocyte count A N
85049 Automated platelet count A N
85055 Reticulated platelet assay A N
85097 Bone marrow interpretation 00343 00433
85130 Chromogenic substrate assay A N
85170 Blood clot retraction A N
85175 Blood clot lysis time A N
85210 Clot factor ii prothrom spec A N
85220 Blooc clot factor v test A N
85230 Clot factor vii proconvertin A N
85240 Clot factor viii ahg 1 stage A N
85244 Clot factor viii reltd antgn A N
85245 Clot factor viii vw ristoctn A N
85246 Clot factor viii vw antigen A N
85247 Clot factor viii multimetric A N
85250 Clot factor ix ptc/chrstmas A N
85260 Clot factor x stuart-power A N
85270 Clot factor xi pta A N
85280 Clot factor xii hageman A N
85290 Clot factor xiii fibrin stab A N
85291 Clot factor xiii fibrin scrn A N
85292 Clot factor fletcher fact A N
85293 Clot factor wght kininogen A N
85300 Antithrombin iii activity A N
85301 Antithrombin iii antigen A N
85302 Clot inhibit prot c antigen A N
85303 Clot inhibit prot c activity A N
85305 Clot inhibit prot s total A N
85306 Clot inhibit prot s free A N
85307 Assay activated protein c A N
85335 Factor inhibitor test A N
85337 Thrombomodulin A N
85345 Coagulation time lee & white A N
85347 Coagulation time activated A N
85348 Coagulation time otr method A N
85360 Euglobulin lysis A N
85362 Fibrin degradation products A N
85366 Fibrinogen test A N
85370 Fibrinogen test A N
85378 Fibrin degrade semiquant A N
85379 Fibrin degradation quant A N
85380 Fibrin degradj d-dimer A N
85384 Fibrinogen activity A N
85385 Fibrinogen antigen A N
85390 Fibrinolysins screen i&r A N
85397 Clotting funct activity A N
85400 Fibrinolytic plasmin A N
85410 Fibrinolytic antiplasmin A N
85415 Fibrinolytic plasminogen A N
85441 Heinz bodies direct A N
85445 Heinz bodies induced A N
85460 Hemoglobin fetal A N
85461 Hemoglobin fetal A N
85475 Hemolysin acid A N
85520 Heparin assay A N
85525 Heparin neutralization A N
85530 Heparin-protamine tolerance A N
85536 Iron stain peripheral blood A N
85540 Wbc alkaline phosphatase A N
85547 Rbc mechanical fragility A N
85549 Muramidase A N
85555 Rbc osmotic fragility A N
85557 Rbc osmotic fragility A N
85576 Blood platelet aggregation A N
85597 Phospholipid pltlt neutraliz A N
85598 Hexagnal phosph pltlt neutrl A N
85610 Prothrombin time A N
85611 Prothrombin test A N
85612 Viper venom prothrombin time A N
85613 Russell viper venom diluted A N
85635 Reptilase test A N
85651 Rbc sed rate nonautomated A N
85652 Rbc sed rate automated A N
85660 Rbc sickle cell test A N
85670 Thrombin time plasma A N
85675 Thrombin time titer A N
85705 Thromboplastin inhibition A N
85730 Thromboplastin time partial A N
85732 Thromboplastin time partial A N
85810 Blood viscosity examination A N
85999 Hematology procedure A N
86000 Agglutinins febrile antigen A N
86001 Allergen specific igg A N
86003 Allergen specific ige A N
86005 Allergen specific ige A N
86021 Wbc antibody identification A N
86022 Platelet antibodies A N
86023 Immunoglobulin assay A N
86038 Antinuclear antibodies A N
86039 Antinuclear antibodies (ana) A N
86060 Antistreptolysin o titer A N
86063 Antistreptolysin o screen A N
86078 Phys blood bank serv reactj 00433 00343
86079 Phys blood bank serv authrj 00433 00342
86140 C-reactive protein A N
86141 C-reactive protein hs A N
86146 Beta-2 glycoprotein antibody A N
86147 Cardiolipin antibody ea ig A N
86148 Anti-phospholipid antibody A N
86152 Cell enumeration & id 00342 00000 X N
86153 Cell enumeration phys interp 00342 00000 X B N/A 62
86155 Chemotaxis assay A N
86156 Cold agglutinin screen A N
86157 Cold agglutinin titer A N
86160 Complement antigen A N
86161 Complement/function activity A N
86162 Complement total (ch50) A N
86171 Complement fixation each A N
86185 Counterimmunoelectrophoresis A N
86200 Ccp antibody A N
86215 Deoxyribonuclease antibody A N
86225 Dna antibody native A N
86226 Dna antibody single strand A N
86235 Nuclear antigen antibody A N
86243 Fc receptor A N
86255 Fluorescent antibody screen A N
86256 Fluorescent antibody titer A N
86277 Growth hormone antibody A N
86280 Hemagglutination inhibition A N
86294 Immunoassay tumor qual A N
86300 Immunoassay tumor ca 15-3 A N
86301 Immunoassay tumor ca 19-9 A N
86304 Immunoassay tumor ca 125 A N
86305 Human epididymis protein 4 A N
86308 Heterophile antibody screen A N
86309 Heterophile antibody titer A N
86310 Heterophile antibody absrbj A N
86316 Immunoassay tumor other A N
86317 Immunoassay infectious agent A N
86318 Immunoassay infectious agent A N
86320 Serum immunoelectrophoresis A N
86325 Other immunoelectrophoresis A N
86327 Immunoelectrophoresis assay A N
86329 Immunodiffusion nes A N
86331 Immunodiffusion ouchterlony A N
86332 Immune complex assay A N
86334 Immunofix e-phoresis serum A N
86335 Immunfix e-phorsis/urine/csf A N
86336 Inhibin a A N
86337 Insulin antibodies A N
86340 Intrinsic factor antibody A N
86341 Islet cell antibody A N
86343 Leukocyte histamine release A N
86344 Leukocyte phagocytosis A N
86352 Cell function assay w/stim A N
86353 Lymphocyte transformation A N
86355 B cells total count A N
86356 Mononuclear cell antigen A N
86357 Nk cells total count A N
86359 T cells total count A N
86360 T cell absolute count/ratio A N
86361 T cell absolute count A N
86367 Stem cells total count A N
86376 Microsomal antibody each A N
86378 Migration inhibitory factor A N
86382 Neutralization test viral A N
86384 Nitroblue tetrazolium dye A N
86386 Nuclear matrix protein 22 A N
86403 Particle agglut antbdy scrn A N
86406 Particle agglut antbdy titr A N
86430 Rheumatoid factor test qual A N
86431 Rheumatoid factor quant A N
86480 Tb test cell immun measure A N
86481 Tb ag response t-cell susp A N
86590 Streptokinase antibody A N
86592 Syphilis test non-trep qual A N
86593 Syphilis test non-trep quant A N
86602 Antinomyces antibody A N
86603 Adenovirus antibody A N
86606 Aspergillus antibody A N
86609 Bacterium antibody A N
86611 Bartonella antibody A N
86612 Blastomyces antibody A N
86615 Bordetella antibody A N
86617 Lyme disease antibody A N
86618 Lyme disease antibody A N
86619 Borrelia antibody A N
86622 Brucella antibody A N
86625 Campylobacter antibody A N
86628 Candida antibody A N
86631 Chlamydia antibody A N
86632 Chlamydia igm antibody A N
86635 Coccidioides antibody A N
86638 Q fever antibody A N
86641 Cryptococcus antibody A N
86644 Cmv antibody A N
86645 Cmv antibody igm A N
86648 Diphtheria antibody A N
86651 Encephalitis californ antbdy A N
86652 Encephaltis east eqne anbdy A N
86653 Encephaltis st louis antbody A N
86654 Encephaltis west eqne antbdy A N
86658 Enterovirus antibody A N
86663 Epstein-barr antibody A N
86664 Epstein-barr nuclear antigen A N
86665 Epstein-barr capsid vca A N
86666 Ehrlichia antibody A N
86668 Francisella tularensis A N
86671 Fungus nes antibody A N
86674 Giardia lamblia antibody A N
86677 Helicobacter pylori antibody A N
86682 Helminth antibody A N
86684 Hemophilus influenza antibdy A N
86687 Htlv-i antibody A N
86688 Htlv-ii antibody A N
86689 Htlv/hiv confirmj antibody A N
86692 Hepatitis delta agent antbdy A N
86694 Herpes simplex nes antbdy A N
86695 Herpes simplex type 1 test A N
86696 Herpes simplex type 2 test A N
86698 Histoplasma antibody A N
86701 Hiv-1antibody A N
86702 Hiv-2 antibody A N
86703 Hiv-1/hiv-2 1 result antbdy A N
86704 Hep b core antibody total A N
86705 Hep b core antibody igm A N
86706 Hep b surface antibody A N
86707 Hepatitis be antibody A N
86708 Hepatitis a total antibody A N
86709 Hepatitis a igm antibody A N
86710 Influenza virus antibody A N
86711 John cunningham antibody A N
86713 Legionella antibody A N
86717 Leishmania antibody A N
86720 Leptospira antibody A N
86723 Listeria monocytogenes A N
86727 Lymph choriomeningitis ab A N
86729 Lympho venereum antibody A N
86732 Mucormycosis antibody A N
86735 Mumps antibody A N
86738 Mycoplasma antibody A N
86741 Neisseria meningitidis A N
86744 Nocardia antibody A N
86747 Parvovirus antibody A N
86750 Malaria antibody A N
86753 Protozoa antibody nos A N
86756 Respiratory virus antibody A N
86757 Rickettsia antibody A N
86759 Rotavirus antibody A N
86762 Rubella antibody A N
86765 Rubeola antibody A N
86768 Salmonella antibody A N
86771 Shigella antibody A N
86774 Tetanus antibody A N
86777 Toxoplasma antibody A N
86778 Toxoplasma antibody igm A N
86780 Treponema pallidum A N
86784 Trichinella antibody A N
86787 Varicella-zoster antibody A N
86788 West nile virus ab igm A N
86789 West nile virus antibody A N
86790 Virus antibody nos A N
86793 Yersinia antibody A N
86800 Thyroglobulin antibody A N
86803 Hepatitis c ab test A N
86804 Hep c ab test confirm A N
86805 Lymphocytotoxicity assay A N
86806 Lymphocytotoxicity assay A N
86807 Cytotoxic antibody screening A N
86808 Cytotoxic antibody screening A N
86812 Hla typing a b or c A N
86813 Hla typing a b or c A N
86816 Hla typing dr/dq A N
86817 Hla typing dr/dq A N
86821 Lymphocyte culture mixed A N
86822 Lymphocyte culture primed A N
86825 Hla x-math non-cytotoxic A N
86826 Hla x-match noncytotoxc addl A N
86828 Hla class i&ii antibody qual A N
86829 Hla class i/ii antibody qual A N
86830 Hla class i phenotype qual A N
86831 Hla class ii phenotype qual A N
86832 Hla class i high defin qual A N
86833 Hla class ii high defin qual A N
86834 Hla class i semiquant panel A N
86835 Hla class ii semiquant panel A N
86849 Immunology procedure A N
86860 Rbc antibody elution 00346 00347
86870 Rbc antibody identification 00347 00346
86880 Coombs test direct 00409 00345
86885 Coombs test indirect qual 00409 00345
86886 Coombs test indirect titer 00409 00346
86891 Autologous blood op salvage 00345 00347
86900 Blood typing abo 00409 00345
86901 Blood typing rh (d) 00409 00345
86902 Blood type antigen donor ea 00345 00346
86920 Compatibility test spin 00345 00346
86923 Compatibility test electric 00345 00346
86927 Plasma fresh frozen 00345 00438 X S
86932 Frozen blood freeze/thaw 00347 00345
86940 Hemolysins/agglutinins auto A N
86941 Hemolysins/agglutinins A N
86960 Vol reduction of blood/prod 00345 00346
86965 Pooling blood platelets 00346 00347
86970 Rbc pretx incubatj w/chemicl 00345 00346
86971 Rbc pretx incubatj w/enzymes 00345 00346
86972 Rbc pretx incubatj w/density 00345 00346
86975 Rbc serum pretx incubj drugs 00347 00346
86976 Rbc serum pretx id dilution 00345 00347
86985 Split blood or products 00345 00347
87001 Small animal inoculation A N
87003 Small animal inoculation A N
87015 Specimen infect agnt concntj A N
87040 Blood culture for bacteria A N
87045 Feces culture aerobic bact A N
87046 Stool cultr aerobic bact ea A N
87070 Culture othr specimn aerobic A N
87071 Culture aerobic quant other A N
87073 Culture bacteria anaerobic A N
87075 Cultr bacteria except blood A N
87076 Culture anaerobe ident each A N
87077 Culture aerobic identify A N
87081 Culture screen only A N
87084 Culture of specimen by kit A N
87086 Urine culture/colony count A N
87088 Urine bacteria culture A N
87101 Skin fungi culture A N
87102 Fungus isolation culture A N
87103 Blood fungus culture A N
87106 Fungi identification yeast A N
87107 Fungi identification mold A N
87109 Mycoplasma A N
87110 Chlamydia culture A N
87116 Mycobacteria culture A N
87118 Mycobacteric identification A N
87140 Culture type immunofluoresc A N
87143 Culture typing glc/hplc A N
87147 Culture type immunologic A N
87149 Dna/rna direct probe A N
87150 Dna/rna amplified probe A N
87152 Culture type pulse field gel A N
87153 Dna/rna sequencing A N
87158 Culture typing added method A N
87164 Dark field examination A N
87166 Dark field examination A N
87168 Macroscopic exam arthropod A N
87169 Macroscopic exam parasite A N
87172 Pinworm exam A N
87176 Tissue homogenization cultr A N
87177 Ova and parasites smears A N
87181 Microbe susceptible diffuse A N
87184 Microbe susceptible disk A N
87185 Microbe susceptible enzyme A N
87186 Microbe susceptible mic A N
87187 Microbe susceptible mlc A N
87188 Microbe suscept macrobroth A N
87190 Microbe suscept mycobacteri A N
87197 Bactericidal level serum A N
87205 Smear gram stain A N
87206 Smear fluorescent/acid stai A N
87207 Smear special stain A N
87209 Smear complex stain A N
87210 Smear wet mount saline/ink A N
87220 Tissue exam for fungi A N
87230 Assay toxin or antitoxin A N
87250 Virus inoculate eggs/animal A N
87252 Virus inoculation tissue A N
87253 Virus inoculate tissue addl A N
87254 Virus inoculation shell via A N
87255 Genet virus isolate hsv A N
87260 Adenovirus ag if A N
87265 Pertussis ag if A N
87267 Enterovirus antibody dfa A N
87269 Giardia ag if A N
87270 Chlamydia trachomatis ag if A N
87271 Cytomegalovirus dfa A N
87272 Cryptosporidium ag if A N
87273 Herpes simplex 2 ag if A N
87274 Herpes simplex 1 ag if A N
87275 Influenza b ag if A N
87276 Influenza a ag if A N
87277 Legionella micdadei ag if A N
87278 Legion pneumophilia ag if A N
87279 Parainfluenza ag if A N
87280 Respiratory syncytial ag if A N
87281 Pneumocystis carinii ag if A N
87283 Rubeola ag if A N
87285 Treponema pallidum ag if A N
87290 Varicella zoster ag if A N
87299 Antibody detection nos if A N
87300 Ag detection polyval if A N
87301 Adenovirus ag eia A N
87305 Aspergillus ag eia A N
87320 Chylmd trach ag eia A N
87324 Clostridium ag eia A N
87327 Cryptococcus neoform ag eia A N
87328 Cryptosporidium ag eia A N
87329 Giardia ag eia A N
87332 Cytomegalovirus ag eia A N
87335 E coli 0157 ag eia A N
87336 Entamoeb hist dispr ag eia A N
87337 Entamoeb hist group ag eia A N
87338 Hpylori stool eia A N
87339 H pylori ag eia A N
87340 Hepatitis b surface ag eia A N
87341 Hepatitis b surface ag eia A N
87350 Hepatitis be ag eia A N
87380 Hepatitis delta ag eia A N
87385 Histoplasma capsul ag eia A N
87389 Hiv-1 ag w/hiv-1 & hiv-2 ab A N
87390 Hiv-1 ag eia A N
87391 Hiv-2 ag eia A N
87400 Influenza a/b ag eia A N
87420 Resp syncytial ag eia A N
87425 Rotavirus ag eia A N
87427 Shiga-like toxin ag eia A N
87430 Strep a ag eia A N
87449 Ag detect nos eia mult A N
87450 Ag detect nos eia single A N
87451 Ag detect polyval eia mult A N
87470 Bartonella dna dir probe A N
87471 Bartonella dna amp probe A N
87472 Bartonella dna quant A N
87475 Lyme dis dna dir probe A N
87476 Lyme dis dna amp probe A N
87477 Lyme dis dna quant A N
87480 Candida dna dir probe A N
87481 Candida dna amp probe A N
87482 Candida dna quant A N
87485 Chylmd pneum dna dir probe A N
87486 Chylmd pneum dna amp probe A N
87487 Chylmd pneum dna quant A N
87490 Chylmd trach dna dir probe A N
87491 Chylmd trach dna amp probe A N
87492 Chylmd trach dna quant A N
87493 C diff amplified probe A N
87495 Cytomeg dna dir probe A N
87496 Cytomeg dna amp probe A N
87497 Cytomeg dna quant A N
87498 Enterovirus probe&revrs trns A N
87500 Vanomycin dna amp probe A N
87501 Influenza dna amp prob 1+ A N
87502 Influenza dna amp probe A N
87503 Influenza dna amp prob addl A N
87510 Gardner vag dna dir probe A N
87511 Gardner vag dna amp probe A N
87512 Gardner vag dna quant A N
87515 Hepatitis b dna dir probe A N
87516 Hepatitis b dna amp probe A N
87517 Hepatitis b dna quant A N
87520 Hepatitis c rna dir probe A N
87521 Hepatitis c probe&rvrs trnsc A N
87522 Hepatitis c revrs trnscrpj A N
87525 Hepatitis g dna dir probe A N
87526 Hepatitis g dna amp probe A N
87527 Hepatitis g dna quant A N
87528 Hsv dna dir probe A N
87529 Hsv dna amp probe A N
87530 Hsv dna quant A N
87531 Hhv-6 dna dir probe A N
87532 Hhv-6 dna amp probe A N
87533 Hhv-6 dna quant A N
87534 Hiv-1 dna dir probe A N
87535 Hiv-1 probe&reverse trnscrpj A N
87536 Hiv-1 quant&revrse trnscrpj A N
87537 Hiv-2 dna dir probe A N
87538 Hiv-2 probe&revrse trnscripj A N
87539 Hiv-2 quant&revrse trnscripj A N
87540 Legion pneumo dna dir prob A N
87541 Legion pneumo dna amp prob A N
87542 Legion pneumo dna quant A N
87550 Mycobacteria dna dir probe A N
87551 Mycobacteria dna amp probe A N
87552 Mycobacteria dna quant A N
87555 M.tuberculo dna dir probe A N
87556 M.tuberculo dna amp probe A N
87557 M.tuberculo dna quant A N
87560 M.avium-intra dna dir prob A N
87561 M.avium-intra dna amp prob A N
87562 M.avium-intra dna quant A N
87580 M.pneumon dna dir probe A N
87581 M.pneumon dna amp probe A N
87582 M.pneumon dna quant A N
87590 N.gonorrhoeae dna dir prob A N
87591 N.gonorrhoeae dna amp prob A N
87592 N.gonorrhoeae dna quant A N
87620 Hpv dna dir probe A N
87621 Hpv dna amp probe A N
87622 Hpv dna quant A N
87631 Resp virus 3-5 targets A N
87640 Staph a dna amp probe A N
87641 Mr-staph dna amp probe A N
87650 Strep a dna dir probe A N
87651 Strep a dna amp probe A N
87652 Strep a dna quant A N
87653 Strep b dna amp probe A N
87660 Trichomonas vagin dir probe A N
87797 Detect agent nos dna dir A N
87798 Detect agent nos dna amp A N
87799 Detect agent nos dna quant A N
87800 Detect agnt mult dna direc A N
87801 Detect agnt mult dna ampli A N
87802 Strep b assay w/optic A N
87803 Clostridium toxin a w/optic A N
87804 Influenza assay w/optic A N
87807 Rsv assay w/optic A N
87808 Trichomonas assay w/optic A N
87809 Adenovirus assay w/optic A N
87810 Chylmd trach assay w/optic A N
87850 N. gonorrhoeae assay w/optic A N
87880 Strep a assay w/optic A N
87899 Agent nos assay w/optic A N
87900 Phenotype infect agent drug A N
87901 Genotype dna hiv reverse t A N
87902 Genotype dna/rna hep c A N
87903 Phenotype dna hiv w/culture A N
87904 Phenotype dna hiv w/clt add A N
87905 Sialidase enzyme assay A N
87906 Genotype dna/rna hiv A N
87910 Genotype cytomegalovirus A N
87912 Genotype dna hepatitis b A N
87999 Microbiology procedure A N
88104 Cytopath fl nongyn smears 00433 00342
88106 Cytopath fl nongyn filter 00433 00342
88108 Cytopath concentrate tech 00433 00342
88120 Cytp urne 3-5 probes ea spec 00661 00343
88121 Cytp urine 3-5 probes cmptr 00661 00344
88130 Sex chromatin identification A N
88140 Sex chromatin identification A N
88142 Cytopath c/v thin layer A N
88143 Cytopath c/v thin layer redo A N
88147 Cytopath c/v automated A N
88148 Cytopath c/v auto rescreen A N
88150 Cytopath c/v manual A N
88152 Cytopath c/v auto redo A N
88153 Cytopath c/v redo A N
88154 Cytopath c/v select A N
88155 Cytopath c/v index add-on A N
88162 Cytopath smear other source 00433 00342
88164 Cytopath tbs c/v manual A N
88165 Cytopath tbs c/v redo A N
88166 Cytopath tbs c/v auto redo A N
88167 Cytopath tbs c/v select A N
88172 Cytp dx eval fna 1st ea site 00433 00342
88173 Cytopath eval fna report 00343 00433
88174 Cytopath c/v auto in fluid A N
88175 Cytopath c/v auto fluid redo A N
88177 Cytp fna eval ea addl 00342 00000 X N
88182 Cell marker study 00343 00433
88185 Flowcytometry/tc add-on 00342 00000 X N
88187 Flowcytometry/read 2-8 00433 00344
88188 Flowcytometry/read 9-15 00433 00661
88230 Tissue culture lymphocyte A N
88233 Tissue culture skin/biopsy A N
88235 Tissue culture placenta A N
88237 Tissue culture bone marrow A N
88239 Tissue culture tumor A N
88240 Cell cryopreserve/storage A N
88241 Frozen cell preparation A N
88245 Chromosome analysis 20-25 A N
88249 Chromosome analysis 100 A N
88267 Chromosome analys placenta A N
88269 Chromosome analys amniotic A N
88271 Cytogenetics dna probe A N
88272 Cytogenetics 3-5 A N
88280 Chromosome karyotype study A N
88283 Chromosome banding study A N
88285 Chromosome count additional A N
88289 Chromosome study additional A N
88302 Tissue exam by pathologist 00433 00342
88311 Decalcify tissue 00342 00000 X N
88312 Special stains group 1 00433 00342
88313 Special stains group 2 00433 00342
88314 Histochemical stains add-on 00433 00000 X N
88319 Enzyme histochemistry 00433 00344
88323 Microslide consultation 00343 00433
88325 Comprehensive review of data 00344 00343
88332 Path consult intraop addl 00342 00000 X N
88334 Intraop cyto path consult 2 00342 00000 X N
88342 Immunohisto antibody slide 00343 00000 X E N/A 28
88346 Immunofluorescent study 00343 00433
88348 Electron microscopy 00661 00344
88349 Scanning electron microscopy 00661 00343
88355 Analysis skeletal muscle 00343 00344
88360 Tumor 00343 00433
immunohistochem/manual
88361 Tumor 00343 00433
immunohistochem/comput
88365 Insitu hybridization (fish) 00343 00433
88367 Insitu hybridization auto 00343 00433
88368 Insitu hybridization manual 00344 00433
88371 Protein western blot tissue A N
88372 Protein analysis w/probe A N
88720 Bilirubin total transcut A N
88738 Hgb quant transcutaneous A N
88740 Transcutaneous carboxyhb A N
88741 Transcutaneous methb A N
88749 In vivo lab service A N
89049 Chct for mal hyperthermia 00342 00433
89050 Body fluid cell count A N
89051 Body fluid cell count A N
89055 Leukocyte assessment fecal A N
89060 Exam synovial fluid crystals A N
89125 Specimen fat stain A N
89160 Exam feces for meat fibers A N
89190 Nasal smear for eosinophils A N
89230 Collect sweat for test 00343 00433
89253 Embryo hatching 00344 00433
89255 Prepare embryo for transfer 00344 00433
89258 Cryopreservation embryo(s) 00344 00661
89259 Cryopreservation sperm 00433 00343
89260 Sperm isolation simple 00343 00433
89280 Assist oocyte fertilization 00343 00661
89300 Semen analysis w/huhner A N
89310 Semen analysis w/count A N
89320 Semen anal vol/count/mot A N
89321 Semen anal sperm detection A N
89322 Semen anal strict criteria A N
89325 Sperm antibody test A N
89329 Sperm evaluation test A N
89330 Evaluation cervical mucus A N
89331 Retrograde ejaculation anal A N
89335 Cryopreserve testicular tiss 00344 00342
89342 Storage/year embryo(s) 00344 00343
89343 Storage/year sperm/semen 00344 00433
89344 Storage/year reprod tissue 00344 00343
89353 Thawing cryopresrved sperm 00344 00433
90296 Diphtheria antitoxin E N 9 N/A
90472 Immunization admin each add 00436 00000 S N
90473 Immune admin oral/nasal 00436 00437
90474 Immune admin oral/nasal addl 00436 00000 S N
90644 Meningoccl hib vac 4 dose im N E N/A 9
90681 Rotavirus vacc 2 dose oral 01239 00000 K E N/A 9
90704 Mumps vaccine sc 00000 01454 N K
90706 Rubella vaccine sc E N 28 N/A
90725 Cholera vaccine injectable E N 9 N/A
90869 Tcran magn stim redetemine 00216 00218
90945 Dialysis one evaluation 00608 00633
91013 Esophgl motil w/stim/perfus 00361 00000 X N
91122 Anal pressure record 00156 00164
92002 Eye exam new patient 00606 00632
92004 Eye exam new patient 00606 00632
92012 Eye exam establish patient 00605 00632
92014 Eye exam&tx estab pt 1/>vst 00605 00632
92140 Glaucoma provocative tests 00230 00698
92227 Remote dx retinal imaging 00035 00340
92250 Eye exam with photos 00230 00698
92270 Electro-oculography 00230 00698
92283 Color vision examination 00230 00698
92284 Dark adaptation eye exam 00230 00698
92317 Rx corneoscleral cntact lens 00230 00698
92326 Replacement of contact lens 00230 00698
92358 Aphakia prosth service temp 00230 00698
92520 Laryngeal function studies 00660 00340
92542 Positional nystagmus test 00363 00340
92548 Posturography 00660 00363
92550 Tympanometry & reflex thresh 00364 00365
92562 Loudness balance test 00364 00365
92584 Electrocochleography 00216 00218
92973 Prq coronary mech thrombect 00088 00000 T N
92974 Cath place cardio brachytx 00103 00000 T N
93017 Cardiovascular stress test X Q1
93041 Rhythm ecg tracing 00035 00340
93229 Remote 30 day ecg tech supp 00213 00209
93270 Remote 30 day ecg rev/report 00097 00690
93278 Ecg/signal-averaged 00035 00340
93290 Icm device eval 00035 00690 X S
93462 L hrt cath trnsptl puncture 00080 00000 T N
93724 Analyze pacemaker system 00690 00691
93745 Set-up cardiovert-defibrill 00690 00691
93888 Intracranial limited study 00265 00266
94012 Spirmtry w/brnchdil inf-2 yr 00367 00368
94375 Respiratory flow volume loop 00367 00368
94400 Co2 breathing response curve 00367 00368
94610 Surfactant admin thru tube 00077 00102
94640 Airway inhalation treatment 00077 00102
94644 Cbt 1st hour 00340 00420
94645 Cbt each addl hour 00340 00000 X N
94660 Pos airway pressure cpap 00078 00102
94664 Evaluate pt use of inhaler 00077 00102
94667 Chest wall manipulation 00077 00102
94680 Exhaled air analysis o2 00369 00368
94690 Exhaled air analysis 00367 00035
94726 Pulm funct tst plethysmograp 00367 00368
94727 Pulm function test by gas 00367 00368
94728 Pulm funct test oscillometry 00367 00368
94729 Co/membane diffuse capacity 00368 00000 X N
94762 Measure blood oxygen level 00097 00096
94781 Car seat/bed test + 30 min 00340 00000 X N
95004 Percut allergy skin tests 00381 00370
95044 Allergy patch tests 00381 00370
95079 Ingest challenge addl 60 min 00360 00000 X N
95250 Glucose monitoring cont 00606 00632
95803 Actigraphy testing 00218 00340 S X
95805 Multiple sleep latency test 00209 00435
95808 Polysom any age 1-3> param 00209 00435
95810 Polysom 6/> yrs 4/> param 00209 00435
95811 Polysom 6/>yrs cpap 4/> parm 00209 00435
95827 Eeg all night recording 00213 00209
95860 Muscle test one limb 00218 00215
95865 Muscle test larynx 00218 00215
95866 Muscle test hemidiaphragm 00218 00215
95870 Muscle test nonparaspinal 00215 00340 S X
95885 Musc tst done w/nerv tst lim 00218 00000 S N
95886 Musc test done w/n test comp 00218 00000 S N
95887 Musc tst done w/n tst nonext 00215 00000 S N
95907 Nvr cndj tst 1-2 studies 00215 00218
95908 Nrv cndj tst 3-4 studies 00215 00216
95909 Nrv cndj tst 5-6 studies 00215 00216
95910 Nrv cndj test 7-8 studies 00215 00216
95913 Nrv cndj test 13/> studies 00218 00216
95921 Autonomic nrv parasym inervj 00218 00215
95922 Autonomic nrv adrenrg inervj 00218 00215
95923 Autonomic nrv syst funj test 00218 00215
95926 Somatosensory testing 00216 00218
95928 C motor evoked uppr limbs 00218 00216
95929 C motor evoked lwr limbs 00218 00215
95930 Visual evoked potential test 00216 00218
95937 Neuromuscular junction test 00218 00215
95939 C motor evoked upr&lwr limbs 00218 00216
95943 Parasymp&symp hrt rate test 00215 00218
95951 Eeg monitoring/videorecord 00209 00435
95958 Eeg monitoring/function test 00213 00435
95962 Electrode stim brain add-on 00216 00000 S N
95965 Meg spontaneous 00066 00065
95967 Meg evoked each addl 00065 00000 S N
95970 Analyze neurostim no prog 00218 00215
95973 Analyze neurostim complex 00218 00000 S N
95975 Cranial neurostim complex 00218 00000 S N
95979 Analyz neurostim brain addon 00692 00000 S N
95981 Io anal gast n-stim subsq 00218 00215
95982 Io ga n-stim subsq w/reprog 00692 00690
96003 Dynamic fine wire emg 00218 00215
96371 Sc ther infusion reset pump 00437 00000 S N
96373 Ther/proph/diag inj ia 00437 00438
96374 Ther/proph/diag inj iv push 00437 00438
96401 Chemo anti-neopl sq/im 00437 00438
96411 Chemo iv push addl drug 00438 00437
96417 Chemo iv infus each addl seq 00438 00437
96570 Photodynmc tx 30 min add-on 00015 00000 T N
96571 Photodynamic tx addl 15 min 00015 00000 T N
97598 Rmvl devital tis addl 20cm/< 00015 00000 T N
99201 Office/outpatient visit new 00604 00000 V B N/A 62
99205 Office/outpatient visit new 00608 00000 Q3 B N/A 62
99211 Office/outpatient visit est 00604 00000 V B N/A 62
99215 Office/outpatient visit est 00607 00000 Q3 B N/A 62
99460 Init nb em per day hosp 00605 00632
99463 Same day nb discharge 00605 00632
99495 Trans care mgmt 14 day disch 00605 00632
99496 Trans care mgmt 7 day disch 00606 00632
A0382 Basic support routine suppls A E N/A 9
A0384 Bls defibrillation supplies A E N/A 9
A0392 Als defibrillation supplies A E N/A 9
A0394 Als IV drug therapy supplies A E N/A 9
A0396 Als esophageal intub suppls A E N/A 9
A0398 Als routine disposble suppls A E N/A 9
A0420 Ambulance waiting 1/2 hr A E N/A 9
A0422 Ambulance 02 life sustaining A E N/A 9
A0424 Extra ambulance attendant A E N/A 9
A4216 Sterile water/saline, 10 ml A N
A4217 Sterile water/saline, 500 ml A N
A4280 Brst prsths adhsv attchmnt A N
A4450 Non-waterproof tape A N
A4452 Waterproof tape A N
A4455 Adhesive remover per ounce A N
A4456 Adhesive remover, wipes A N
A4461 Surgicl dress hold non-reuse A N
A4463 Surgical dress holder reuse A N
A4481 Tracheostoma filter A N
A4483 Moisture exchanger A N
A4606 Oxygen probe used w oximeter A N
A4608 Transtracheal oxygen cath Y N 61 N/A
A4611 Heavy duty battery Y E 61 9
A4612 Battery cables Y E 61 9
A4613 Battery charger Y E 61 9
A4623 Tracheostomy inner cannula A N
A4625 Trach care kit for new trach A N
A4626 Tracheostomy cleaning brush A N
A4629 Tracheostomy care kit A N
A4634 Replacement bulb th lightbox A N
A4651 Calibrated microcap tube A N
A4652 Microcapillary tube sealant A N
A4653 PD catheter anchor belt A N
A6010 Collagen based wound filler A N
A6011 Collagen gel/paste wound fil A N
A6021 Collagen dressing <=16 sq in A N
A6022 Collagen drsg>16<=48 sq in A N
A6023 Collagen dressing >48 sq in A N
A6024 Collagen dsg wound filler A N
A6154 Wound pouch each A N
A6196 Alginate dressing <=16 sq in A N
A6197 Alginate drsg >16 <=48 sq in A N
A6198 Alginate dressing > 48 sq in A N
A6199 Alginate drsg wound filler A N
A6203 Composite drsg <= 16 sq in A N
A6204 Composite drsg >16<=48 sq in A N
A6205 Composite drsg > 48 sq in A N
A6206 Contact layer <= 16 sq in A N
A6207 Contact layer >16<= 48 sq in A N
A6208 Contact layer > 48 sq in A N
A6209 Foam drsg <=16 sq in w/o bdr A N
A6210 Foam drg >16<=48 sq in w/o b A N
A6211 Foam drg > 48 sq in w/o brdr A N
A6212 Foam drg <=16 sq in w/border A N
A6213 Foam drg >16<=48 sq in w/bdr A N
A6214 Foam drg > 48 sq in w/border A N
A6215 Foam dressing wound filler A N
A6216 Non-sterile gauze<=16 sq in A N
A6217 Non-sterile gauze>16<=48 sq A N
A6218 Non-sterile gauze > 48 sq in A N
A6219 Gauze <= 16 sq in w/border A N
A6220 Gauze >16 <=48 sq in w/bordr A N
A6221 Gauze > 48 sq in w/border A N
A6222 Gauze <=16 in no w/sal w/o b A N
A6223 Gauze >16<=48 no w/sal w/o b A N
A6224 Gauze > 48 in no w/sal w/o b A N
A6228 Gauze <= 16 sq in water/sal A N
A6229 Gauze >16<=48 sq in watr/sal A N
A6230 Gauze > 48 sq in water/salne A N
A6231 Hydrogel dsg<=16 sq in A N
A6232 Hydrogel dsg>16<=48 sq in A N
A6233 Hydrogel dressing >48 sq in A N
A6234 Hydrocolld drg <=16 w/o bdr A N
A6235 Hydrocolld drg >16<=48 w/o b A N
A6236 Hydrocolld drg > 48 in w/o b A N
A6237 Hydrocolld drg <=16 in w/bdr A N
A6238 Hydrocolld drg >16<=48 w/bdr A N
A6239 Hydrocolld drg > 48 in w/bdr A N
A6240 Hydrocolld drg filler paste A N
A6241 Hydrocolloid drg filler dry A N
A6242 Hydrogel drg <=16 in w/o bdr A N
A6243 Hydrogel drg >16<=48 w/o bdr A N
A6244 Hydrogel drg >48 in w/o bdr A N
A6245 Hydrogel drg <= 16 in w/bdr A N
A6246 Hydrogel drg >16<=48 in w/b A N
A6247 Hydrogel drg > 48 sq in w/b A N
A6248 Hydrogel drsg gel filler A N
A6250 Skin seal protect moisturizr A N
A6251 Absorpt drg <=16 sq in w/o b A N
A6252 Absorpt drg >16 <=48 w/o bdr A N
A6253 Absorpt drg > 48 sq in w/o b A N
A6254 Absorpt drg <=16 sq in w/bdr A N
A6255 Absorpt drg >16<=48 in w/bdr A N
A6256 Absorpt drg > 48 sq in w/bdr A N
A6257 Transparent film <= 16 sq in A N
A6258 Transparent film >16<=48 in A N
A6259 Transparent film > 48 sq in A N
A6260 Wound cleanser any type/size A N
A6261 Wound filler gel/paste /oz A N
A6262 Wound filler dry form / gram A N
A6266 Impreg gauze no h20/sal/yard A N
A6402 Sterile gauze <= 16 sq in A N
A6403 Sterile gauze>16 <= 48 sq in A N
A6404 Sterile gauze > 48 sq in A N
A6407 Packing strips, non-impreg A N
A6410 Sterile eye pad A N
A6411 Non-sterile eye pad A N
A6412 Occlusive eye patch A N
A6441 Pad band w>=3" <5"/yd A N
A6442 Conform band n/s w<3"/yd A N
A6443 Conform band n/s w>=3"<5"/yd A N
A6444 Conform band n/s w>=5"/yd A N
A6445 Conform band s w <3"/yd A N
A6446 Conform band s w>=3" <5"/yd A N
A6447 Conform band s w >=5"/yd A N
A6448 Lt compres band <3"/yd A N
A6449 Lt compres band >=3" <5"/yd A N
A6450 Lt compres band >=5"/yd A N
A6451 Mod compres band A N
w>=3"<5"/yd
A6452 High compres band A N
w>=3"<5"yd
A6453 Self-adher band w <3"/yd A N
A6454 Self-adher band w>=3" <5"/yd A N
A6455 Self-adher band >=5"/yd A N
A6456 Zinc paste band w >=3"<5"/yd A N
A6457 Tubular dressing A N
A6501 Compres burngarment bodysuit A N
A6502 Compres burngarment chinstrp A N
A6503 Compres burngarment facehood A N
A6504 Cmprsburngarment glove-wrist A N
A6505 Cmprsburngarment glove- A N
elbow
A6506 Cmprsburngrmnt glove-axilla A N
A6507 Cmprs burngarment foot-knee A N
A6508 Cmprs burngarment foot-thigh A N
A6509 Compres burn garment jacket A N
A6510 Compres burn garment leotard A N
A6511 Compres burn garment panty A N
A6512 Compres burn garment, noc A N
A6531 Compression stocking BK30-40 A N
A6532 Compression stocking BK40-50 A N
A6545 Grad comp non-elastic BK A N
A7040 One way chest drain valve A N
A7041 Water seal drain container A N
A7043 Vacuum drainagebottle/tubing A N
A7501 Tracheostoma valve w diaphra A N
A7502 Replacement diaphragm/fplate A N
A7503 HMES filter holder or cap A N
A7504 Tracheostoma HMES filter A N
A7505 HMES or trach valve housing A N
A7506 HMES/trachvalve adhesivedisk A N
A7507 Integrated filter & holder A N
A7508 Housing & Integrated Adhesiv A N
A7509 Heat & moisture exchange sys A N
A7520 Trach/laryn tube non-cuffed A N
A7521 Trach/laryn tube cuffed A N
A7522 Trach/laryn tube stainless A N
A7523 Tracheostomy shower protect A N
A7524 Tracheostoma stent/stud/bttn A N
A7525 Tracheostomy mask A N
A7526 Tracheostomy tube collar A N
A7527 Trach/laryn tube plug/stop A N
A9584 Iodine I-123 ioflupane 09406 00000 G N
C1830 Power bone marrow bx needle 01830 00000 H N
C1840 Telescopic intraocular lens 01840 00000 H N
C1886 Catheter, ablation 01886 00000 H N
C9248 Inj, clevidipine butyrate 09248 00000 K N
C9285 Patch, lidocaine/tetracaine 09285 00000 G N
C9358 SurgiMend, fetal 09358 00000 K N
C9360 SurgiMend, neonatal 09360 00000 K N
C9363 Integra Meshed Bil Wound Mat 09363 00000 K N
C9726 Rxt breast appl place/remov 00028 00000 T N
C9733 Non-ophthalmic FVA 00397 00263
C9734 U/S trtmt, not leiomyomata 00067 00065
C9800 Dermal filler inj px/suppl 00135 00328
E0457 Chest shell Y E 61 9
E0459 Chest wrap Y E 61 9
G0008 Admin influenza virus vac 00350 00436
G0009 Admin pneumococcal vaccine 00350 00437
G0010 Admin hepatitis b vaccine 00436 00437
G0101 CA screen;pelvic/breast exam 00604 00631
G0130 Single energy x-ray study 00261 00260
G0173 Linear acc stereo radsur com 00067 00000 S B N/A 62
G0175 OPPS Service,sched team conf 00608 00633
G0245 Initial foot exam pt lops 00604 00631
G0246 Followup eval of foot pt lop 00604 00631
G0247 Routine footcare pt w lops 00013 00012
G0248 Demonstrate use home inr mon 00607 00632
G0249 Provide INR test mater/equip 00607 00632
G0251 Linear acc based stero radio 00065 00000 S B N/A 62
G0339 Robot lin-radsurg com, first 00067 00000 S B N/A 62
G0340 Robt lin-radsurg fractx 2-5 00066 00000 S B N/A 62
G0364 Bone marrow aspirate &biopsy 00340 00019 X T
G0379 Direct refer hospital observ 00608 00633
G0389 Ultrasound exam AAA screen 00266 00265
G0402 Initial preventive exam 00606 00632
G0404 EKG tracing for initial prev 00099 00035 S X
G0416 Sat biopsy 10-20 00661 00344
G0424 Pulmonary rehab w exer 00102 00077
G0444 Depression screen annual 00432 00031
G0445 High inten beh couns STD 30m 00432 00031
G0446 Intens behave ther cardio dx 00432 00031
G0460 Autologous PRP for ulcers 00013 00327
J0131 Acetaminophen injection 09283 00000 G N
J0205 Alglucerase injection 00900 00000 K E N/A 9
J0210 Methyldopate hcl injection 02210 00000 K N
J0288 Ampho b cholesteryl sulfate 00735 00000 K N
J0348 Anidulafungin injection 01349 00000 K N
J0350 Injection anistreplase 30 u N E N/A 9
J0395 Arbutamine hcl injection 01432 00000 K E N/A 9
J0485 Belatacept injection G K
J0490 Belimumab injection G K
J0638 Canakinumab injection G K
J0712 Ceftaroline fosamil inj 09282 00000 G N
J0900 Testosterone enanthate inj 01434 00000 K N
J1180 Dyphylline injection N E N/A 9
J1212 Dimethyl sulfoxide 50% 50 ML 01221 00000 K N
J1435 Injection estrone per 1 MG 01435 00000 K E N/A 9
J1452 Intraocular Fomivirsen na 01441 00000 K N
J1455 Foscarnet sodium injection 00000 01455 N K
J1562 Vivaglobin, inj 01275 00000 K E N/A 9
J1572 Flebogamma injection G K
J1590 Gatifloxacin injection 01437 00000 K N
J1620 Gonadorelin hydroch/ 100 mcg 01344 00000 K E N/A 9
J1730 Diazoxide injection 01438 00000 K E N/A 9
J1835 Itraconazole injection 01355 00000 K E N/A 9
J2265 Minocycline hydrochloride 01423 00000 K N
J2460 Oxytetracycline injection N E N/A 9
J2507 Pegloticase injection G K
J2515 Pentobarbital sodium inj 00000 01456 N K
J2670 Totazoline hcl injection 00000 01457 E K 28 N/A
J2700 Oxacillin sodium injeciton 01347 00000 K N
J2725 Inj protirelin per 250 mcg 01357 00000 K E N/A 9
J2760 Phentolaine mesylate inj 00000 01458 N K
J2785 Regadenoson injection 09244 00000 K N
J2788 Rho d immune globulin 50 mcg 09023 00000 K N
J2790 Rho d immune globulin inj 00884 00000 K N
J2941 Somatropin injection 07034 00000 K N
J3305 Inj trimetrexate glucoronate E N 9 N/A
J3320 Spectinomycn di-hcl inj E N 9 N/A
J3350 Urea injection 00000 01459 N K
J3365 Urokinase 250,000 IU inj 07036 00000 K E N/A 9
J7178 Human fibrinogen conc inj 01414 00000 K N
J7180 Factor XIII anti-hem factor G K
J7191 Factor VIII (porcine) 00000 01464 N K
J7527 Oral everolimus 01444 00000 K N
J8510 Oral busulfan 01307 00000 K N
J8562 Oral fludarabine phosphate 01339 00000 K N
J9042 Brentuximab vedotin inj G K
J9178 Inj, epirubicin hcl, 2 mg 01167 00000 K N
J9179 Eribulin mesylate injection G K
J9201 Gemcitabine hcl injection 00828 00000 K N
J9212 Interferon alfacon-1 inj 01447 00000 K N
J9213 Interferon alfa-2a inj 00000 01460 N K
J9215 Interferon alfa-n3 inj 00000 01473 N K
J9219 Leuprolide acetate implant 07051 00000 K E N/A 9
J9228 Ipilimumab injection G K
M0064 Visit for drug monitoring 00606 00632
Q0507 Misc sup/acc ext vad A N
Q0508 Mis sup/acc imp vad A N
Q0509 Mis sup/ac imp vad nopay med A N
Q0515 Sermorelin acetate injection 03050 00000 K E N/A 9
Q4101 Apligraf 01240 00000 K N
Q4102 Oasis wound matrix 01241 00000 K N
Q4103 Oasis burn matrix 01242 00000 K N
Q4104 Integra BMWD 01243 00000 K N
Q4105 Integra DRT 01244 00000 K N
Q4106 Dermagraft 01245 00000 K N
Q4107 Graftjacket 01246 00000 K N
Q4108 Integra matrix 01247 00000 K N
Q4110 Primatrix 01248 00000 K N
Q4111 Gammagraft 01252 00000 K N
Q4112 Cymetra injectable 01249 00000 K N
Q4113 Graftjacket xpress 01250 00000 K N
Q4114 Integra flowable wound matri 01251 00000 K N
Q4115 Alloskin 01287 00000 K N
Q4116 Alloderm 01270 00000 K N
Q4117 Hyalomatrix E N 28 N/A
Q4118 Matristem micromatrix 01342 00000 K N
Q4119 Matristem wound matrix 01351 00000 K N
Q4120 Matristem burn matrix E N 28 N/A
Q4121 Theraskin 01345 00000 K N
Q4123 Alloskin 01427 00000 K N
Q4124 Oasis tri-layer wound matrix 09365 00000 G N
Q4125 Arthroflex 01428 00000 K N
Q4126 Memoderm/derma/tranz/integup 01452 00000 K N
Q4128 Flexhd/Allopatchhd/matrixhd 01429 00000 K N
Q4129 Unite biomatrix E N 9 N/A
Q4134 HMatrix 01453 00000 K N
Q4135 Mediskin 01461 00000 K N
Q4136 EZderm 01462 00000 K N
Q9968 Visualization adjunct 01446 00000 K N
Hcpcs Edit Changes
The following code(s) were added to the list of female procedures, effective 01-01-14
Hcpcs
0336T
81507
J7301
HCPCS Approval and/or Termination Date Changes
The following code(s) had approval and /or termination date changes
HCPCS Old ApprovalDt New ApprovalDt Old TerminationDt New TerminationDt
90688 0 20130816
Edit Assignments
The following code(s) were added to edit 67, 68, 69 or 83 effective 07-01-13
HCPCS Edit# ActivDate TermDate
90688 67 20130816
The following code(s) were added to the conditional bilateral list, effective 01-01-14
HCPCS
19081
19083
19085
19281
19283
19285
19287
23333
23334
23335
37217
37236
37237
37238
37239
52356
64616
64617
66183
Radiolabeled product Changes
The following code(s) were removed from the radiolabeled product list, effective 01-01-14
HCPCS
A4641
A4642
A9500
A9501
A9502
A9503
A9504
A9505
A9507
A9508
A9509
A9510
A9512
A9516
A9517
A9521
A9524
A9526
A9527
A9528
A9529
A9530
A9531
A9532
A9536
A9537
A9538
A9539
A9540
A9541
A9542
A9543
A9544
A9545
A9546
A9547
A9548
A9550
A9551
A9552
A9553
A9554
A9555
A9556
A9557
A9558
A9559
A9560
A9561
A9562
A9563
A9564
A9566
A9567
A9568
A9569
A9570
HCPCS
A9571
A9572
A9580
A9582
A9584
A9600
A9604
A9699
C1716
C1717
C1719
C2616
C2634
C2635
C2636
C2638
C2639
C2640
C2641
C2642
C2643
C2698
C2699
C9898
Edit Assignments
The following code(s) were removed from the nuclear medicine list, effective 01-01-14
HCPCS
78012
78013
78014
78015
78016
78018
78020
78070
78071
78072
78075
78099
78102
78103
78104
78110
78111
78120
78121
78122
78130
78135
78140
78185
78190
78191
78195
78199
78201
78202
HCPCS
78205
78206
78215
78216
78226
78227
78230
78231
78232
78258
78261
78262
78264
78270
78271
78272
78278
78282
78290
78291
78299
78300
78305
78306
78315
78320
78399
78414
78428
78445
78451
78452
78453
78454
78456
78457
78458
78459
78466
78468
78469
78472
78473
78481
78483
78491
78492
78494
78496
78499
78579
78580
78582
78597
78598
78599
78600
78601
78605
78606
78607
HCPCS
78608
78610
78630
78635
78645
78647
78650
78660
78699
78700
78701
78707
78708
78709
78710
78725
78730
78740
78761
78799
78800
78801
78802
78803
78804
78805
78806
78807
78811
78812
78813
78814
78815
78816
78999
Procedure/ Device Pair Changes
The following procedure/device code pair requirements were removed, effective 01-01-14
Proc Device1
37205 C1874
37205 C1875
37205 C1876
37205 C1877
37205 C2617
37205 C2625
37206 C1874
37206 C1875
37206 C1876
37206 C1877
37206 C2617
37206 C2625
37207 C1874
37207 C1875
37207 C1876
37207 C1877
37207 C2617
37207 C2625
37208 C1874
Proc Device1
37208 C1875
37208 C1876
37208 C1877
37208 C2617
37208 C2625
43256 C1874
43256 C1875
43256 C1876
43256 C1877
43256 C2617
43256 C2625
64569 C1778
Add-on/Primary Procedure Pair Changes
The following add-on/primary procedure pair requirements were added, effective 01-01-14
Addon Primary
90785 G0463
90833 G0463
90836 G0463
90838 G0463
Skin Substitute Product Changes
The following code(s) were removed from the skin substitute product list, effective 01-01-14
HCPCS
C9358
C9360
C9363
Q4101
Q4102
Q4103
Q4104
Q4105
Q4106
Q4107
Q4108
Q4110
Q4111
Q4112
Q4113
Q4114
Q4115
Q4116
Q4118
Q4119
Q4121
Q4122
Q4123
Q4124
Q4125
Q4126
Q4127
Q4128
Q4131
Q4132
HCPCS
Q4133
Q4134
Q4135
Q4136
Skin Substitute Procedure Changes
The following code(s) were removed from the skin substitute procedure list, effective 01-01-14
HCPCS
15271
15272
15273
15274
15275
15276
15277
15278
Lab Services Procedure Changes
The following code(s) were added to the lab services procedure list, effective 01-01-14
HCPCS
36415
80047
80048
80051
80053
80061
80069
80074
80076
80102
80150
80152
80154
80156
80157
80158
80160
80162
80164
80166
80168
80170
80172
80173
80174
80176
80178
80182
80184
80185
80186
80188
80190
80192
HCPCS
80194
80195
80196
80197
80198
80200
80201
80202
80299
80400
80402
80406
80408
80410
80412
80414
80415
80416
80417
80418
80420
80422
80424
80426
80428
80430
80432
80434
80435
80436
80438
80439
80440
81000
81001
81002
81003
81005
81007
81015
81020
81025
81050
81099
82000
82003
82009
82010
82013
82016
82017
82024
82030
82040
82042
82043
82044
82045
82055
82075
82085
HCPCS
82088
82101
82103
82104
82105
82106
82107
82108
82120
82127
82128
82131
82135
82136
82139
82140
82143
82145
82150
82154
82157
82160
82163
82164
82172
82175
82180
82190
82205
82232
82239
82240
82247
82248
82252
82261
82270
82271
82272
82274
82286
82300
82306
82308
82310
82330
82331
82340
82355
82360
82365
82370
82373
82374
82375
82376
82378
82379
82380
82382
82383
HCPCS
82384
82387
82390
82397
82415
82435
82436
82438
82441
82465
82480
82482
82485
82486
82487
82488
82489
82491
82492
82495
82507
82520
82523
82525
82528
82530
82533
82540
82541
82542
82543
82544
82550
82552
82553
82554
82565
82570
82575
82585
82595
82600
82607
82608
82610
82615
82626
82627
82633
82634
82638
82646
82649
82651
82652
82654
82656
82657
82658
82664
82666
HCPCS
82668
82670
82671
82672
82677
82679
82690
82693
82696
82705
82710
82715
82725
82726
82728
82731
82735
82742
82746
82747
82757
82759
82760
82775
82776
82777
82784
82785
82787
82800
82803
82805
82810
82820
82930
82938
82941
82943
82945
82946
82947
82948
82950
82951
82952
82953
82955
82960
82962
82963
82965
82975
82977
82978
82979
82980
82985
83001
83002
83003
83008
HCPCS
83009
83010
83012
83013
83014
83015
83018
83020
83021
83026
83030
83033
83036
83037
83045
83050
83051
83055
83060
83065
83068
83069
83070
83071
83080
83088
83090
83150
83491
83497
83498
83499
83500
83505
83516
83518
83519
83520
83525
83527
83528
83540
83550
83570
83582
83586
83593
83605
83615
83625
83630
83631
83632
83633
83634
83655
83661
83662
83663
83664
83670
HCPCS
83690
83695
83698
83700
83701
83704
83718
83719
83721
83727
83735
83775
83785
83788
83789
83805
83825
83835
83840
83857
83858
83861
83864
83866
83872
83873
83874
83876
83880
83883
83885
83887
83915
83916
83918
83919
83921
83925
83930
83935
83937
83945
83950
83951
83970
83986
83987
83992
83993
84022
84030
84035
84060
84061
84066
84075
84078
84080
84081
84085
84087
HCPCS
84100
84105
84106
84110
84112
84119
84120
84126
84127
84132
84133
84134
84135
84138
84140
84143
84144
84145
84146
84150
84152
84153
84154
84155
84156
84157
84160
84163
84165
84166
84181
84182
84202
84203
84206
84207
84210
84220
84228
84233
84234
84235
84238
84244
84252
84255
84260
84270
84275
84285
84295
84300
84302
84305
84307
84311
84315
84375
84376
84377
84378
HCPCS
84379
84392
84402
84403
84425
84430
84431
84432
84436
84437
84439
84442
84443
84445
84446
84449
84450
84460
84466
84478
84479
84480
84481
84482
84484
84485
84488
84490
84510
84512
84520
84525
84540
84545
84550
84560
84577
84578
84580
84583
84585
84586
84588
84590
84591
84597
84600
84620
84630
84681
84702
84703
84704
84830
84999
85002
85004
85007
85008
85009
85013
HCPCS
85014
85018
85025
85027
85032
85041
85044
85045
85046
85048
85049
85055
85130
85170
85175
85210
85220
85230
85240
85244
85245
85246
85247
85250
85260
85270
85280
85290
85291
85292
85293
85300
85301
85302
85303
85305
85306
85307
85335
85337
85345
85347
85348
85360
85362
85366
85370
85378
85379
85380
85384
85385
85390
85397
85400
85410
85415
85420
85421
85441
85445
HCPCS
85460
85461
85475
85520
85525
85530
85536
85540
85547
85549
85555
85557
85576
85597
85598
85610
85611
85612
85613
85635
85651
85652
85660
85670
85675
85705
85730
85732
85810
85999
86000
86001
86003
86005
86021
86022
86023
86038
86039
86060
86063
86140
86141
86146
86147
86148
86152
86155
86156
86157
86160
86161
86162
86171
86185
86200
86215
86225
86226
86235
86243
HCPCS
86255
86256
86277
86280
86294
86300
86301
86304
86305
86308
86309
86310
86316
86317
86318
86320
86325
86327
86329
86331
86332
86334
86335
86336
86337
86340
86341
86343
86344
86352
86353
86355
86356
86357
86359
86360
86361
86367
86376
86378
86382
86384
86386
86403
86406
86430
86431
86480
86481
86590
86592
86593
86602
86603
86606
86609
86611
86612
86615
86617
86618
HCPCS
86619
86622
86625
86628
86631
86632
86635
86638
86641
86644
86645
86648
86651
86652
86653
86654
86658
86663
86664
86665
86666
86668
86671
86674
86677
86682
86684
86687
86688
86689
86692
86694
86695
86696
86698
86701
86702
86703
86704
86705
86706
86707
86708
86709
86710
86711
86713
86717
86720
86723
86727
86729
86732
86735
86738
86741
86744
86747
86750
86753
86756
HCPCS
86757
86759
86762
86765
86768
86771
86774
86777
86778
86780
86784
86787
86788
86789
86790
86793
86800
86803
86804
86805
86806
86807
86808
86812
86813
86816
86817
86821
86822
86825
86826
86828
86829
86830
86831
86832
86833
86834
86835
86849
86940
86941
87001
87003
87015
87040
87045
87046
87070
87071
87073
87075
87076
87077
87081
87084
87086
87088
87101
87102
87103
HCPCS
87106
87107
87109
87110
87116
87118
87140
87143
87147
87149
87150
87152
87153
87158
87164
87166
87168
87169
87172
87176
87177
87181
87184
87185
87186
87187
87188
87190
87197
87205
87206
87207
87209
87210
87220
87230
87250
87252
87253
87254
87255
87260
87265
87267
87269
87270
87271
87272
87273
87274
87275
87276
87277
87278
87279
87280
87281
87283
87285
87290
87299
HCPCS
87300
87301
87305
87320
87324
87327
87328
87329
87332
87335
87336
87337
87338
87339
87340
87341
87350
87380
87385
87389
87390
87391
87400
87420
87425
87427
87430
87449
87450
87451
87470
87471
87472
87475
87476
87477
87480
87481
87482
87485
87486
87487
87490
87491
87492
87493
87495
87496
87497
87498
87500
87501
87502
87503
87510
87511
87512
87515
87516
87517
87520
HCPCS
87521
87522
87525
87526
87527
87528
87529
87530
87531
87532
87533
87534
87535
87536
87537
87538
87539
87540
87541
87542
87550
87551
87552
87555
87556
87557
87560
87561
87562
87580
87581
87582
87590
87591
87592
87620
87621
87622
87631
87632
87633
87640
87641
87650
87651
87652
87653
87660
87797
87798
87799
87800
87801
87802
87803
87804
87807
87808
87809
87810
87850
HCPCS
87880
87899
87900
87901
87902
87903
87904
87905
87906
87910
87912
87999
88130
88140
88142
88143
88147
88148
88150
88152
88153
88154
88155
88164
88165
88166
88167
88174
88175
88230
88233
88235
88237
88239
88240
88241
88245
88248
88249
88261
88262
88263
88264
88267
88269
88271
88272
88273
88274
88275
88280
88283
88285
88289
88371
88372
88720
88738
88740
88741
88749
HCPCS
89050
89051
89055
89060
89125
89160
89190
89300
89310
89320
89321
89322
89325
89329
89330
89331
Skin Substitute High Cost Product Procedure Changes
The following code(s) were added to the skin substitute high cost product list, effective 01-01-14
HCPCS
Q4101
Q4106
Q4107
Q4110
Q4116
Q4122
Q4125
Q4126
Q4127
Q4131
Q4132
Q4133
Q4134
Skin Substitute Low Cost Product Procedure Changes
The following code(s) were added to the skin substitute low cost product list, effective 01-01-14
HCPCS
C9358
C9360
C9363
Q4100
Q4102
Q4103
Q4104
Q4105
Q4108
Q4111
Q4115
Q4117
Q4119
Q4120
Q4121
Q4123
Q4124
HCPCS
Q4128
Q4129
Q4135
Q4136
Q4137
Q4138
Q4140
Q4141
Q4142
Q4143
Q4146
Q4147
Q4148
Skin Substitute High Cost Procedure Changes
The following code(s) were added to the skin substitute high cost procedure list, effective 01-01-14
HCPCS
15271
15273
15275
15277
Skin Substitute Low Cost Procedure Changes
The following code(s) were added to the skin substitute low cost procedure list, effective 01-01-14
HCPCS
C5271
C5273
C5275
C5277
MODIFIERS
Added Modifiers
The following modifier(s) were added to the list of valid modifiers, effective 01-01-14
modif ACTIVATIONDATE
PM 0

R2838CP 1

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R2838CP 1

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Department of Health &

CMS Manual System Human Services (DHHS)

Pub 100-04 Medicare Claims Processing Centers for Medicare &

EFFECTIVE DATE: January 1, 2014

II. CHANGES IN MANUAL INSTRUCTIONS: (N/A if manual is not updated)

R/N/D CHAPTER / SECTION / SUBSECTION / TITLE

For Medicare Administrative Contractors (MACs):

*Unless otherwise specified, the effective date is the date of service.

EFFECTIVE DATE: January 1, 2014

II. BUSINESS REQUIREMENTS TABLE

"Shall" denotes a mandatory requirement, and "should" denotes an optional requirement.

Number Requirement Responsibility

8548.2 Medicare contractors shall identify the I/OCE X X X

III. PROVIDER EDUCATION TABLE

Number Requirement Responsibility

IV. SUPPORTING INFORMATION

"Should" denotes a recommendation.

X-Ref Recommendations or other supporting information:

Pre-Implementation Contact(s): Yvonne Young, Yvonne.Young@cms.hhs.gov , Anita Antkowiak,

Post-Implementation Contact(s): Contact your Contracting Officer's Representative (COR) or Contractor

Section B: For Medicare Administrative Contractors (MACs):

# Type Effective Edits Modification

The following APC(s) were added to the IOCE, effective 01-01-14

APC Description Changes

The following APC(s) had description changes, effective 01-01-14

The following APC(s) had Status Indicator changes, effective 01-01-14

HCPCS/CPT PROCEDURE CODE CHANGES

Added HCPCS/CPT Procedure Codes

HCPCS Description Changes

The following code descriptions were changed, effective 01-01-14

HCPCS Changes- APC, Status Indicator and/or Edit Assignments

Hcpcs Edit Changes

HCPCS Approval and/or Termination Date Changes

Procedure/ Device Pair Changes

Add-on/Primary Procedure Pair Changes

Skin Substitute Product Changes

Skin Substitute Procedure Changes

Lab Services Procedure Changes

Skin Substitute High Cost Product Procedure Changes

Skin Substitute Low Cost Product Procedure Changes

Skin Substitute High Cost Procedure Changes

Skin Substitute Low Cost Procedure Changes

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