CPT and HCPCS Coding

Baruch College/Mount Sinai School of Medicine

Program in Health Care Administration and Policy

Current Procedural

Terminology (CPT) and Health Care Procedure

Coding System (HCPCS)

Lecture 10CPT

January 17, 2011

Raymond R. Arons, Dr. P.H., M.P.H

Lecture 10 CPT and HCPCS Coding System 2

Lecture 10CPT January 11, 2011Current Procedural Terminology (CPT) and Health Care Procedure Coding System (HCPCS)

Baruch College/Mount Sinai School of MedicineProgram In Health Care Administration and PolicyBUS 9100: The Social and Governmental Environment of the Business of Health Care

Raymond R. Arons, Dr. P.H, M.P.H

2

Coding Methods Currently in UseInternational Classification of Diseases - ICD-9-CM – Coding of Inpatient Discharges

International Classification of Diseases - ICD-10-CM– Not yet adopted

Diagnosis-related Groupings (DRGs) Medicare– Hospital reimbursement

Physician Current Procedure Terminology (CPT)– Physicians for procedures performed

Common Procedure Coding System (HCPCS)– Used by vendors of equipment and services

Copyright © 2011 Raymond R. Arons, Teaneck, NJ, USA


3

Current Procedural Terminology (CPT)

History OperationsDefinitionsClassification of Procedure GroupingsExample codes

4

Current Procedural Terminology (CPT) History CPT was first developed and published by the AMA in 1966. We are now using the fourth edition, the CPT-4 version of this coding system.

The purpose of the system when first developed had nothing to do with reimbursement; it was to help standardize terminology among physicians and to serve as a type of shorthand that would simplify medical records for physicians and record clerks.

continued... http://findarticles.com/p/articles/mi_m3230/is_10_32/ai_66498630/ (Visited January 10, 2011)


http://findarticles.com/p/articles/mi_m3230/is_10_32/ai_66498630/


5

Current Procedural Terminology (CPT) History With the introduction of the second edition in 1970, the codes changed from 4 digits to 5 and became far more inclusive.

Sometime during this period, laboratory procedures were incorporated into the CPT system.

In 1983, HCFA merged CPT with its own Common Procedure Coding System (HCPCS) and mandated that CPT be used for all Medicare billing.

.


6

Current Procedural Terminology (CPT) History A similar mandate extended this system to Medicaid billing in 1986. The AMA owns the copyright for CPT and collects fees from the users to help defray maintenance expenses.

CPT tends to be organized around procedures, while ICD is more focused on diagnosis. Almost all third party payers use CPT as the codified means of processing claims for physician billing




7

(CPT) Updates and MethodsThe CPT system, as developed and maintained by the AMA, is governed by the CPT editorial panel, a group of 16 individuals (virtually all physicians) who are empowered to make final decisions with regard to the content of CPT. This panel is supported at the AMA by a staff of about 12 and by about 75 CPT advisors representing nearly all of the medical specialty societies seated in the AMA House of Delegates).


8

(CPT) Updates and Methods The CPT panel also has members from CMS, the Blue Cross/Blue Shield Association, the American Hospital Association, and the private insurance industry. This panel meets about quarterly to consider alterations to the code and any other matters related to the publishing and use of CPT. The AMA Publications Office is responsible for publishing the standard yearly edition of CPT-4, as well as various editions directed at specific specialties.

continued... Copyright © 2011 Raymond R. Arons, Teaneck, NJ, USA


http://findarticles.com/p/articles/mi_m3230/is_10_32/ai_66498630/ (Visited January 10, 2011)

9

(CPT) Updates and MethodThe process of generating a new code or revising an existing one usually begins with a query to the AMA CPT coding office. Requests for changes may come from physicians, medical societies, manufacturers, billing services, hospital coders, or any other interested party. To request a new code or to suggest revising or deleting an existing one, the requesting party must provide information about the frequency of use of the procedure/test in question, how the test/procedure is presently being coded, and documentation of the need for the request

continued...

10

CPT Code OrganizationMedical ManagementAnesthesiaSurgeryRadiologyPathology and LaboratoryMedicine



American Medical Association, Current Procedure Terminology CPT 2007,Standard Edition, 2006, Chicago, Illinois

S9100

11

Medical Evaluation and ManagementExamples

Office or Other Outpatient ServicesHospital Observation ServicesHospital Inpatient ServicesConsultationsED ServicesPediatric Critical Care TransportCritical Care ServicesNeonatal ServicesPediatric Critical CareInpatient Neonatal Care


anuary 17, 2011



12

Anesthesia ExamplesHeadNeckThoraxIntrathoracicSpine and Spinal CordUpper AbdomenLower AbdomenPerineumPelvis


ecture 10CPT

13

Surgery ExamplesGeneralIntegumentary Musculoskeletal RespiratoryCardiovascularHemic and Lymphatic Mediastinum DigestiveUrinaryMale Genital




14

Radiology ExamplesDiagnostic ImagingDiagnostic UltrasoundRadiologic GuidanceBreast MammographyBone/Joint StudiesRadiology OncologyNuclear Medicine




15

Pathology and Laboratory ExamplesOrgan or Disease-Oriented PanelsDrug TestingTherapeutic Drug AssaysEvocation/Suppression TestingConsultation (Clinical Pathology)UrinalysisHematology and CoagulationsImmunologyTransfusion MedicineMicrobiology


16

Medicine ExamplesImmune GlobulinsImmunizations for VaccinesVaccines ToxidsHydration TherapeuticsPsychiatryBiofeedbackDialysisGastroenterologyOphthalmologyCardiovascular




17

CODE DESCRIPTION

NON-FACILITY GLOBAL

FEE

FACILITY GLOBAL

FEE81000 URINALYSIS, BY DIP STICK OR TABLET REAGE 4.00 4.0081001 URINALYSIS, BY DIP STICK OR TABLET REAGE 4.00 4.0081002 URINALYSIS, BY DIP STICK OR TABLET REAGE 2.00 2.0081003 URINALYSIS, BY DIP STICK OR TABLET REAGE 2.00 2.0081015 URINALYSIS; MICROSCOPIC ONLY 2.00 2.0081025 URINE PREGNANCY TEST, BY VISUAL COLOR CO 2.00 2.0083655 LEAD 15.00 15.0085007 BLOOD COUNT; BLOOD SMEAR, MICROSCOPIC EX 1.43 1.4385013 BLOOD COUNT; SPUN MICROHEMATOCRIT 2.00 2.0085018 BLOOD COUNT; HEMOGLOBIN (HGB) 2.00 2.0085025 BLOOD COUNT; COMPLETE (CBC), AUTOMATED ( 3.17 3.1785041 BLOOD COUNT; RED BLOOD CELL (RBC), AUTOM 3.17 3.1785048 BLOOD COUNT; LEUKOCYTE (WBC), AUTOMATED 3.17 3.1785651 SEDIMENTATION RATE, ERYTHROCYTE; NON-AUT 2.00 2.00

NYS Medicaid Physician Medicine Services Fee Fee

http://www.emedny.org/ProviderManuals/Physician/index.html (visited January 11, 2011)


http://www.emedny.org/ProviderManuals/Physician/index.html


18

NYS Medicaid Physician Medicine ServicesFee Schedule

93603 RIGHT VENTRICULAR RECORDING 143.48 143.4893609 INTRAVENTRICULAR AND/OR INTRA-ATRIAL MAP 297.03 297.0393610 INTRA-ATRIAL PACING 169.83 169.8393612 INTRAVENTRICULAR PACING 178.16 178.1693613 INTRACARDIAC ELECTROPHYSIOLOGIC 3-DIMENS 243.20 202.6793615 ESOPHAGEAL RECORDING OF ATRIAL ELECTROGR 47.39 47.3993616 ESOPHAGEAL RECORDING OF ATRIAL ELECTROGR 61.65 61.6593618 INDUCTION OF ARRHYTHMIA BY ELECTRICAL PA 306.84 306.8493619 COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUAT 563.12 563.1293620 COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUAT 781.92 781.9293621 COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUAT 1,670.54 1,670.5493622 COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUAT 1,742.22 1,742.22

continued... http://www.emedny.org/ProviderManuals/Physician/index.html (visited January 11, 2011)

19

NYS Medicaid Physician Medicine Services Fee Schedule

93455 CATHETER PLACEMENT IN CORONARY ARTERY(S) 487.72 487.72 173.7493456 CATHETER PLACEMENT IN CORONARY ARTERY(S) 523.05 523.05 193.0493457 CATHETER PLACEMENT IN CORONARY ARTERY(S) 592.62 592.62 216.0693458 CATHETER PLACEMENT IN CORONARY ARTERY(S) 504.21 504.21 186.6693459 CATHETER PLACEMENT IN CORONARY ARTERY(S) 556.83 556.83 206.8893460 CATHETER PLACEMENT IN CORONARY ARTERY(S) 595.45 595.45 230.4993461 CATHETER PLACEMENT IN CORONARY ARTERY(S) 682.69 682.69 254.2593462 LEFT HEART CATHETERIZATION BY TRANSSEPTA 97.78 78.1593463 PHARMACOLOGIC AGENT ADMINISTRATION (EG, 49.67 41.3993464 PHYSIOLOGIC EXERCISE STUDY (EG, BICYCLE 119.97 119.97 54.6093503 INSERTION AND PLACEMENT OF FLOW DIRECTED 140.00 140.0093505 ENDOMYOCARDIAL BIOPSY 502.53 502.53 180.8693530 RIGHT HEART CATHETERIZATION, FOR CONGENI 733.61 733.61 174.0493531 COMBINED RIGHT HEART CATHETERIZATION AND 1,934.96 1,934.96 339.0393532 COMBINED RIGHT HEART CATHETERIZATION AND 1,924.01 1,924.01 395.7993533 COMBINED RIGHT HEART CATHETERIZATION AND 1,803.39 1,803.39 275.48



20

NYS Medicaid Physician AnesthesiaServices Fee Schedule Examples

CODE DESCRIPTIONANEST BASE

00100 ANESTHESIA FOR PROCEDURES ON SALIVARY 500102 ANESTHESIA FOR PROCEDURES INVOLVING PLA 600103 ANESTHESIA FOR RECONSTRUCTIVE PROCEDU 500104 ANESTHESIA FOR ELECTROCONVULSIVE THERA 400120 ANESTHESIA FOR PROCEDURES ON EXTERNAL, 500124 ANESTHESIA FOR PROCEDURES ON EXTERNAL, 400126 ANESTHESIA FOR PROCEDURES ON EXTERNAL, 400140 ANESTHESIA FOR PROCEDURES ON EYE; NOT 500142 ANESTHESIA FOR PROCEDURES ON EYE; LENS 400144 ANESTHESIA FOR PROCEDURES ON EYE; COR 600145 ANESTHESIA FOR PROCEDURES ON EYE; VITR 600147 ANESTHESIA FOR PROCEDURES ON EYE; IRIDE 4


21

NYS Medicaid Physician AnesthesiaServices Fee Schedule Examples

01634 ANESTHESIA FOR OPEN OR SURGICAL ARTHRO 901636 ANESTHESIA FOR OPEN OR SURGICAL ARTHRO 1501638 ANESTHESIA FOR OPEN OR SURGICAL ARTHRO 1001650 ANESTHESIA FOR PROCEDURES ON ARTERIES 601652 ANESTHESIA FOR PROCEDURES ON ARTERIES 1001654 ANESTHESIA FOR PROCEDURES ON ARTERIES 801656 ANESTHESIA FOR PROCEDURES ON ARTERIES 1001670 ANESTHESIA FOR ALL PROCEDURES ON VEINS 401680 ANESTHESIA FOR SHOULDER CAST APPLICATIO 301682 ANESTHESIA FOR SHOULDER CAST APPLICATIO 401710 ANESTHESIA FOR PROCEDURES ON NERVES, 301712 ANESTHESIA FOR PROCEDURES ON NERVES, 501714 ANESTHESIA FOR PROCEDURES ON NERVES, 501716 ANESTHESIA FOR PROCEDURES ON NERVES, 5




22

NYS Medicaid Physician RadiologyServices Fee Schedule Examples

CODE DESCRIPTION

NON-FACILITY GLOBAL

FEE

FACILITY GLOBAL

FEE70010 MYELOGRAPHY, POSTERIOR FOSSA, RADIOLOGIC 153.98 153.9870015 CISTERNOGRAPHY, POSITIVE CONTRAST, RADIO 106.59 106.5970030 RADIOLOGIC EXAMINATION, EYE, FOR DETECTI 21.80 21.8070100 RADIOLOGIC EXAMINATION, MANDIBLE; PARTIA 24.24 24.2470110 RADIOLOGIC EXAMINATION, MANDIBLE; COMPLE 30.85 30.8570120 RADIOLOGIC EXAMINATION, MASTOIDS; LESS T 27.26 27.2670130 RADIOLOGIC EXAMINATION, MASTOIDS; COMPLE 42.04 42.0470134 RADIOLOGIC EXAMINATION, INTERNAL AUDITOR 37.42 37.4270140 RADIOLOGIC EXAMINATION, FACIAL BONES; LE 25.40 25.4070150 RADIOLOGIC EXAMINATION, FACIAL BONES; CO 34.50 34.5070160 RADIOLOGIC EXAMINATION, NASAL BONES, COM 24.88 24.88


23

NYS Medicaid Physician RadiologyServices Fee Schedule Examples

70488 COMPUTED TOMOGRAPHY, MAXILLOFACIAL AREA; 314.73 314.73 52.6670490 COMPUTED TOMOGRAPHY, SOFT TISSUE NECK; W 202.11 202.11 47.9670491 COMPUTED TOMOGRAPHY, SOFT TISSUE NECK; W 263.26 263.26 51.4870492 COMPUTED TOMOGRAPHY, SOFT TISSUE NECK; W 315.91 315.91 53.8470496 COMPUTED TOMOGRAPHIC ANGIOGRAPHY, HEAD, 329.87 329.87 65.3170498 COMPUTED TOMOGRAPHIC ANGIOGRAPHY, NECK, 330.18 330.18 65.6270540 MAGNETIC RESONANCE (EG, PROTON) IMAGING, 326.77 326.77 50.0070542 MAGNETIC RESONANCE (EG, PROTON) IMAGING, 380.27 380.27 60.3170543 MAGNETIC RESONANCE (EG, PROTON) IMAGING, 502.55 502.55 79.7070544 MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WI 321.20 321.20 44.7270545 MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WI 364.11 364.11 44.72




24

NYS Medicaid Physician Surgery Services Fee Schedule

CODE DESCRIPTION

NON-FACILITY GLOBAL

FEE

FACILITY GLOBAL

FEE10021 FINE NEEDLE ASPIRATION; WITHOUT IMAGING 81.61 60.0010022 FINE NEEDLE ASPIRATION; WITH IMAGING GUI 85.59 72.0010040 ACNE SURGERY (EG, MARSUPIALIZATION, OPEN 54.25 39.2610060 INCISION AND DRAINAGE OF ABSCESS (EG, CA 60.50 43.2410061 INCISION AND DRAINAGE OF ABSCESS (EG, CA 103.19 76.7610080 INCISION AND DRAINAGE OF PILONIDAL CYST; 97.93 45.1010081 INCISION AND DRAINAGE OF PILONIDAL CYST; 148.94 76.7410120 INCISION AND REMOVAL OF FOREIGN BODY, SU 78.42 42.7910121 INCISION AND REMOVAL OF FOREIGN BODY, SU 149.18 87.6110140 INCISION AND DRAINAGE OF HEMATOMA, SEROM 85.50 56.2810160 PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA 70.27 45.4410180 INCISION AND DRAINAGE, COMPLEX, POSTOPER 131.00 83.9411000 DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR I 29.85 15.44


25

NYS Medicaid Physician Surgery Services Fee Schedule32665 THORACOSCOPY, SURGICAL; WITH ESOPHAGOMYO 691.75 576.4632800 REPAIR LUNG HERNIA THROUGH CHEST WALL 539.32 449.4432810 CLOSURE OF CHEST WALL FOLLOWING OPEN FLA 524.65 437.2132815 OPEN CLOSURE OF MAJOR BRONCHIAL FISTULA 1,453.79 1,211.4932820 MAJOR RECONSTRUCTION, CHEST WALL (POSTTR32851 LUNG TRANSPLANT, SINGLE; WITHOUT CARDIOP 1,549.91 1,291.5932852 LUNG TRANSPLANT, SINGLE; WITH CARDIOPULM 1,732.54 1,443.7832853 LUNG TRANSPLANT, DOUBLE (BILATERAL SEQUE 1,853.06 1,544.2232854 LUNG TRANSPLANT, DOUBLE (BILATERAL SEQUE 2,006.71 1,672.2632900 RESECTION OF RIBS, EXTRAPLEURAL, ALL STA 788.89 657.4132905 THORACOPLASTY, SCHEDE TYPE OR EXTRAPLEUR 785.88 654.9032906 THORACOPLASTY, SCHEDE TYPE OR EXTRAPLEUR 969.20 807.6732940 PNEUMONOLYSIS, EXTRAPERIOSTEAL, INCLUDIN 719.27 599.3932960 PNEUMOTHORAX, THERAPEUTIC, INTRAPLEURAL 82.48 47.00




26

NYS Medicaid Physician Drug and Drug Administration Services Fee Schedule

CODE DESCRIPTION

NON-FACILITY GLOBAL

FEE

FACILITY GLOBAL

FEE90281 IMMUNE GLOBULIN (IG), HUMAN, FOR INTRAMU cost cost90283 IMMUNE GLOBULIN (IGIV), HUMAN, FOR INTRA cost cost90284 IMMUNE GLOBULIN (SCIG), HUMAN, FOR USE I cost cost90291 CYTOMEGALOVIRUS IMMUNE GLOBULIN (CMV-IGI cost cost90371 HEPATITIS B IMMUNE GLOBULIN (HBIG), HUMA cost cost90375 RABIES IMMUNE GLOBULIN (RIG), HUMAN, FOR cost cost90376 RABIES IMMUNE GLOBULIN, HEAT-TREATED (RI cost cost90378 RESPIRATORY SYNCYTIAL VIRUS, MONOCLONAL cost cost90384 RHO(D) IMMUNE GLOBULIN (RHIG), HUMAN, FU cost cost90385 RHO(D) IMMUNE GLOBULIN (RHIG), HUMAN, MI cost cost90386 RHO(D) IMMUNE GLOBULIN (RHIGIV), HUMAN, cost cost90389 TETANUS IMMUNE GLOBULIN (TIG), HUMAN, FO cost cost


27

NYS Medicaid Physician Drug and Drug Administration Services Fee Schedule

96361 INTRAVENOUS INFUSION, HYDRATION; EACH AD 10.38 8.6596365 INTRAVENOUS INFUSION, FOR THERAPY, PROPH 43.84 36.5496366 INTRAVENOUS INFUSION, FOR THERAPY, PROPH 13.75 11.4696367 INTRAVENOUS INFUSION, FOR THERAPY, PROPH 21.89 18.2596368 INTRAVENOUS INFUSION, FOR THERAPY, PROPH 12.83 10.7096369 SUBCUTANEOUS INFUSION FOR THERAPY OR PRO 96.10 80.0996370 SUBCUTANEOUS INFUSION FOR THERAPY OR PRO 9.79 8.1696371 SUBCUTANEOUS INFUSION FOR THERAPY OR PRO 46.79 38.9996372 THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC 13.23 11.0396405 CHEMOTHERAPY ADMINISTRATION; INTRALESION 86.65 14.3796406 CHEMOTHERAPY ADMINISTRATION; INTRALESION 98.36 20.4496409 CHEMOTHERAPY ADMINISTRATION; INTRAVENOUS 76.60 63.8496413 CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS 103.82 86.5296415 CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS 22.99 19.16




Part 2

Health Care Procedure Coding System -HCPCS

31

Health Care Procedure Coding System -HCPCS

History OperationsDefinitionsClassification of Procedure GroupingsExample codes

Practice Management Information Corporation, HCPCS, Health Care Procedure Coding System, National Level II Medicare Codes, 2006, Los Angeles, Cal. 2005.



32

HCPCS HistoryEach year, in the United States, health care insurers process over 5 billion claims for payment. The HCPCS Level II Code Set is one of the standard code sets used for this purpose. The HCPCS is divided into two principal subsystems, referred to as level I and level II of the HCPCS.). Level I of the HCPCS, the CPT codes, does not include codes needed to separately report medical items or services that are regularly billed by suppliers other than physicians.

https://www.cms.gov/HCPCSReleaseCodeSets/01_Overview.asp#TopOfPage (Visited Jan 17, 2011)

33

HCPCS HistoryLevel II standardized coding system that is used primarily to identify products, supplies, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician's office. Because Medicare and other insurers cover a variety of services, supplies, and equipment the level II HCPCS codes were established for submitting claims for these items. The development and use of level II of the HCPCS began in the 1980's. Level II codes are also referred to as alpha-numeric codes because they consist of a single alphabetical letter followed by 4 numeric digits, while CPT codes are identified using 5 numeric digits.

https://www.cms.gov/HCPCSReleaseCodeSets/01_Overview.asp#TopOfPage (Visited Jan 17, 2011)


https://www.cms.gov/HCPCSReleaseCodeSets/01_Overview.asp#TopOfPage


34

HCPCS CategoriesTransportation ServicesMedical and Surgical SuppliesAdministrative, Miscellaneous and InvestigationalEnteral and Parenteral TherapyHospital Outpatient PPS CodesDental ProceduresProcedures and Professional ServicesRehabilitative ServicesDrugs Administered Other Than Oral MethodChemotherapy Drugs

continued... Practice Management Information Corporation, HCPCS, Health Care Procedure Coding System, National Level II Medicare Codes, 2006, Los Angeles, Cal. 2005.

35

HCPCS CategoriesK Codes for DMERCS’ USE OnlyOrthotic ProceduresProstheticsMedical ServicesPathology and LaboratoryDiagnostic Radiology ServicersPrivate Payer CodesState Medicaid Agency Codes Vision ServicesHearing Services

continued... Practice Management Information Corporation, HCPCS, Health Care Procedure Coding System, National Level II Medicare Codes, 2006, Los Angeles, Cal. 2005.



36

HCPCS For Medical and Surgical Supplies

HCPC Seq Num RIC Long Description A1 00100 7 DRESSING FOR ONE WOUND A2 00100 7 DRESSING FOR TWO WOUNDS A3 00100 7 DRESSING FOR THREE WOUNDS A4 00100 7 DRESSING FOR FOUR WOUNDS A5 00100 7 DRESSING FOR FIVE WOUNDS A6 00100 7 DRESSING FOR SIX WOUNDS A7 00100 7 DRESSING FOR SEVEN WOUNDS A8 00100 7 DRESSING FOR EIGHT WOUNDS A9 00100 7 DRESSING FOR NINE OR MORE WOUNDS AA 00100 7 ANESTHESIA SERVICES PERFORMED PERSONALLY BY ANESTHESIOLOGIST AD 00100 7 MEDICAL SUPERVISION BY A PHYSICIAN: MORE THAN FOUR CONCURRENT ANESTHESIA


37

HCPCS For Transportation

A0100 00100 3 NON-EMERGENCY TRANSPORTATION; TAXIA0110 00100 3 NON-EMERGENCY TRANSPORTATION AND BUS, INTRA OR INTER STATE CARRIERA0120 00100 3 NON-EMERGENCY TRANSPORTATION: MINI-BUS, MOUNTAIN AREA TRANSPORTS, OR OTHERA0120 00200 4 TRANSPORTATION SYSTEMSA0130 00100 3 NON-EMERGENCY TRANSPORTATION: WHEEL-CHAIR VANA0140 00100 3 NON-EMERGENCY TRANSPORTATION AND AIR TRAVEL (PRIVATE OR COMMERCIAL) INTRA ORA0140 00200 4 INTER STATEA0160 00100 3 NON-EMERGENCY TRANSPORTATION: PER MILE - CASE WORKER OR SOCIAL WORKERA0170 00100 3 TRANSPORTATION ANCILLARY: PARKING FEES, TOLLS, OTHERA0180 00100 3 NON-EMERGENCY TRANSPORTATION: ANCILLARY: LODGING-RECIPIENTA0190 00100 3 NON-EMERGENCY TRANSPORTATION: ANCILLARY: MEALS-RECIPIENTA0200 00100 3 NON-EMERGENCY TRANSPORTATION: ANCILLARY: LODGING ESCORTA0210 00100 3 NON-EMERGENCY TRANSPORTATION: ANCILLARY: MEALS-ESCORTA0225 00100 3 AMBULANCE SERVICE, NEONATAL TRANSPORT, BASE RATE, EMERGENCY TRANSPORT, ONE WAY






38

HCPCS For Parenteral Nutrition

B4185 00100 3 PARENTERAL NUTRITION SOLUTION, PER 10 GRAMS LIPIDSB4189 00100 3 PARENTERAL NUTRITION SOLUTION; COMPOUNDED AMINO ACID AND CARBOHYDRATES WITHB4189 00200 4 ELECTROLYTES, TRACE ELEMENTS, AND VITAMINS, INCLUDING PREPARATION, ANYB4189 00300 4 STRENGTH, 10 TO 51 GRAMS OF PROTEIN - PREMIXB4193 00100 3 PARENTERAL NUTRITION SOLUTION; COMPOUNDED AMINO ACID AND CARBOHYDRATES WITHB4193 00200 4 ELECTROLYTES, TRACE ELEMENTS, AND VITAMINS, INCLUDING PREPARATION, ANYB4193 00300 4 STRENGTH, 52 TO 73 GRAMS OF PROTEIN - PREMIXB4197 00100 3 PARENTERAL NUTRITION SOLUTION; COMPOUNDED AMINO ACID AND CARBOHYDRATES WITHB4197 00200 4 ELECTROLYTES, TRACE ELEMENTS AND VITAMINS, INCLUDING PREPARATION, ANY STRENGTH,B4197 00300 4 74 TO 100 GRAMS OF PROTEIN - PREMIXB4199 00100 3 PARENTERAL NUTRITION SOLUTION; COMPOUNDED AMINO ACID AND CARBOHYDRATES WITHB4199 00200 4 ELECTROLYTES, TRACE ELEMENTS AND VITAMINS, INCLUDING PREPARATION, ANY STRENGTH,B4199 00300 4 OVER 100 GRAMS OF PROTEIN - PREMIXB4216 00100 3 PARENTERAL NUTRITION; ADDITIVES (VITAMINS, TRACE ELEMENTS, HEPARIN,B4216 00200 4 ELECTROLYTES) HOMEMIX PER DAYB4220 00100 3 PARENTERAL NUTRITION SUPPLY KIT; PREMIX, PER DAYB4222 00100 3 PARENTERAL NUTRITION SUPPLY KIT; HOME MIX, PER DAY


39

HCPCS For Cardiac Catheters C1722 00100 3 CARDIOVERTER-DEFIBRILLATOR, SINGLE CHAMBER (IMPLANTABLE)C1724 00100 3 CATHETER, TRANSLUMINAL ATHERECTOMY, ROTATIONALC1725 00100 3 CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE,C1725 00200 4 INFUSION/PERFUSION CAPABILITY)C1726 00100 3 CATHETER, BALLOON DILATATION, NON-VASCULARC1727 00100 3 CATHETER, BALLOON TISSUE DISSECTOR, NON-VASCULAR (INSERTABLE)C1728 00100 3 CATHETER, BRACHYTHERAPY SEED ADMINISTRATIONC1729 00100 3 CATHETER, DRAINAGEC1730 00100 3 CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (19 OR FEWERC1730 00200 4 ELECTRODES)C1731 00100 3 CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (20 OR MOREC1731 00200 4 ELECTRODES)C1732 00100 3 CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, 3D OR VECTOR MAPPINGC1733 00100 3 CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, OTHER THAN 3D OR VECTORC1733 00200 4 MAPPING, OTHER THAN COOL-TIPC1749 00100 3 ENDOSCOPE, RETROGRADE IMAGING/ILLUMINATION COLONOSCOPE DEVICE (IMPLANTABLE)C1750 00100 3 CATHETER, HEMODIALYSIS/PERITONEAL, LONG-TERMC1751 00100 3 CATHETER, INFUSION, INSERTED PERIPHERALLY, CENTRALLY OR MIDLINE (OTHER THANC1751 00200 4 HEMODIALYSIS)C1752 00100 3 CATHETER, HEMODIALYSIS/PERITONEAL, SHORT-TERMC1753 00100 3 CATHETER, INTRAVASCULAR ULTRASOUNDC1754 00100 3 CATHETER, INTRADISCAL






40

HCPCS For Durable Medical Equipment (DME)

E0100 00100 3 CANE, INCLUDES CANES OF ALL MATERIALS, ADJUSTABLE OR FIXED, WITH TIPE0105 00100 3 CANE, QUAD OR THREE PRONG, INCLUDES CANES OF ALL MATERIALS, ADJUSTABLE ORE0105 00200 4 FIXED, WITH TIPSE0110 00100 3 CRUTCHES, FOREARM, INCLUDES CRUTCHES OF VARIOUS MATERIALS, ADJUSTABLE OR FIXED,E0110 00200 4 PAIR, COMPLETE WITH TIPS AND HANDGRIPSE0111 00100 3 CRUTCH FOREARM, INCLUDES CRUTCHES OF VARIOUS MATERIALS, ADJUSTABLE OR FIXED,E0111 00200 4 EACH, WITH TIP AND HANDGRIPSE0112 00100 3 CRUTCHES UNDERARM, WOOD, ADJUSTABLE OR FIXED, PAIR, WITH PADS, TIPS ANDE0112 00200 4 HANDGRIPSE0113 00100 3 CRUTCH UNDERARM, WOOD, ADJUSTABLE OR FIXED, EACH, WITH PAD, TIP AND HANDGRIPE0114 00100 3 CRUTCHES UNDERARM, OTHER THAN WOOD, ADJUSTABLE OR FIXED, PAIR, WITH PADS, TIPSE0114 00200 4 AND HANDGRIPSE0116 00100 3 CRUTCH, UNDERARM, OTHER THAN WOOD, ADJUSTABLE OR FIXED, WITH PAD, TIP,E0116 00200 4 HANDGRIP, WITH OR WITHOUT SHOCK ABSORBER, EACHE0117 00100 3 CRUTCH, UNDERARM, ARTICULATING, SPRING ASSISTED, EACHE0118 00100 3 CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, WITH OR WITHOUT WHEELS, EACHE0130 00100 3 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHTE0135 00100 3 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT


41

HCPCS For Outpatient Procedures

G0106 00200 4 BARIUM ENEMAG0108 00100 3 DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30G0108 00200 4 MINUTESG0109 00100 3 DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION (2 ORG0109 00200 4 MORE), PER 30 MINUTESG0117 00100 3 GLAUCOMA SCREENING FOR HIGH RISK PATIENTS FURNISHED BY AN OPTOMETRIST ORG0117 00200 4 OPHTHALMOLOGISTG0118 00100 3 GLAUCOMA SCREENING FOR HIGH RISK PATIENT FURNISHED UNDER THE DIRECT SUPERVISIONG0118 00200 4 OF AN OPTOMETRIST OR OPHTHALOMOLOGISTG0120 00100 3 COLORECTAL CANCER SCREENING; ALTERNATIVE TO G0105, SCREENING COLONOSCOPY,G0120 00200 4 BARIUM ENEMA.G0121 00100 3 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FORG0121 00200 4 HIGH RISKG0122 00100 3 COLORECTAL CANCER SCREENING; BARIUM ENEMAG0123 00100 3 SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTEDG0123 00200 4 IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, SCREENING BYG0123 00300 4 CYTOTECHNOLOGIST UNDER PHYSICIAN SUPERVISION






42

HCPCS For Rehabilitation

H0001 00100 3 ALCOHOL AND/OR DRUG ASSESSMENTH0002 00100 3 BEHAVIORAL HEALTH SCREENING TO DETERMINE ELIGIBILITY FOR ADMISSION TO TREATMENTH0002 00200 4 PROGRAMH0003 00100 3 ALCOHOL AND/OR DRUG SCREENING; LABORATORY ANALYSIS OF SPECIMENS FOR PRESENCE OFH0003 00200 4 ALCOHOL AND/OR DRUGSH0004 00100 3 BEHAVIORAL HEALTH COUNSELING AND THERAPY, PER 15 MINUTESH0005 00100 3 ALCOHOL AND/OR DRUG SERVICES; GROUP COUNSELING BY A CLINICIANH0006 00100 3 ALCOHOL AND/OR DRUG SERVICES; CASE MANAGEMENTH0007 00100 3 ALCOHOL AND/OR DRUG SERVICES; CRISIS INTERVENTION (OUTPATIENT)H0008 00100 3 ALCOHOL AND/OR DRUG SERVICES; SUB-ACUTE DETOXIFICATION (HOSPITAL INPATIENT)H0009 00100 3 ALCOHOL AND/OR DRUG SERVICES; ACUTE DETOXIFICATION (HOSPITAL INPATIENT)H0010 00100 3 ALCOHOL AND/OR DRUG SERVICES; SUB-ACUTE DETOXIFICATION (RESIDENTIAL ADDICTIONH0010 00200 4 PROGRAM INPATIENT)H0011 00100 3 ALCOHOL AND/OR DRUG SERVICES; ACUTE DETOXIFICATION (RESIDENTIAL ADDICTIONH0011 00200 4 PROGRAM INPATIENT)H0012 00100 3 ALCOHOL AND/OR DRUG SERVICES; SUB-ACUTE DETOXIFICATION (RESIDENTIAL ADDICTION


43

HCPCS For Injections

J1670 00100 3 INJECTION, TETANUS IMMUNE GLOBULIN, HUMAN, UP TO 250 UNITSJ1675 00100 3 INJECTION, HISTRELIN ACETATE, 10 MICROGRAMSJ1680 00100 3 INJECTION, HUMAN FIBRINOGEN CONCENTRATE, 100 MGJ1700 00100 3 INJECTION, HYDROCORTISONE ACETATE, UP TO 25 MGJ1710 00100 3 INJECTION, HYDROCORTISONE SODIUM PHOSPHATE, UP TO 50 MGJ1720 00100 3 INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MGJ1730 00100 3 INJECTION, DIAZOXIDE, UP TO 300 MGJ1740 00100 3 INJECTION, IBANDRONATE SODIUM, 1 MGJ1742 00100 3 INJECTION, IBUTILIDE FUMARATE, 1 MGJ1743 00100 3 INJECTION, IDURSULFASE, 1 MGJ1745 00100 3 INJECTION INFLIXIMAB, 10 MGJ1750 00100 3 INJECTION, IRON DEXTRAN, 50 MGJ1751 00100 3 INJECTION, IRON DEXTRAN 165, 50 MGJ1752 00100 3 INJECTION, IRON DEXTRAN 267, 50 MGJ1756 00100 3 INJECTION, IRON SUCROSE, 1 MGJ1785 00100 3 INJECTION, IMIGLUCERASE, PER UNITJ1786 00100 3 INJECTION, IMIGLUCERASE, 10 UNITSJ1790 00100 3 INJECTION, DROPERIDOL, UP TO 5 MGJ1800 00100 3 INJECTION, PROPRANOLOL HCL, UP TO 1 MG






44

HCPCS For Power Chairs (DME)

K0849 00100 3 POWER WHEELCHAIR, GROUP 3 STANDARD, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UPK0849 00200 4 TO AND INCLUDING 300 POUNDSK0850 00100 3 POWER WHEELCHAIR, GROUP 3 HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHTK0850 00200 4 CAPACITY 301 TO 450 POUNDSK0851 00100 3 POWER WHEELCHAIR, GROUP 3 HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITYK0851 00200 4 301 TO 450 POUNDSK0852 00100 3 POWER WHEELCHAIR, GROUP 3 VERY HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENTK0852 00200 4 WEIGHT CAPACITY 451 TO 600 POUNDSK0853 00100 3 POWER WHEELCHAIR, GROUP 3 VERY HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHTK0853 00200 4 CAPACITY 451 TO 600 POUNDSK0854 00100 3 POWER WHEELCHAIR, GROUP 3 EXTRA HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENTK0854 00200 4 WEIGHT CAPACITY 601 POUNDS OR MOREK0855 00100 3 POWER WHEELCHAIR, GROUP 3 EXTRA HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHTK0855 00200 4 CAPACITY 601 POUNDS OR MOREK0856 00100 3 POWER WHEELCHAIR, GROUP 3 STANDARD, SINGLE POWER OPTION, SLING/SOLID SEAT/BACK,K0856 00200 4 PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDSK0857 00100 3 POWER WHEELCHAIR, GROUP 3 STANDARD, SINGLE POWER OPTION, CAPTAINS CHAIR,K0857 00200 4 PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDSK0858 00100 3 POWER WHEELCHAIR, GROUP 3 HEAVY DUTY, SINGLE POWER OPTION, SLING/SOLIDK0858 00200 4 SEAT/BACK, PATIENT WEIGHT 301 TO 450 POUNDS


45

HCPCS For Prosthetics

L0635 00500 4 PRESSURE TO REDUCE LOAD ON INTERVERTEBRAL DISCS, INCLUDES STRAPS, CLOSURES, MAYL0635 00600 4 INCLUDE PADDING, ANTERIOR PANEL, PENDULOUS ABDOMEN DESIGN, PREFABRICATED,L0635 00700 4 INCLUDES FITTING AND ADJUSTMENTL0636 00100 3 LUMBAR SACRAL ORTHOSIS, SAGITTAL-CORONAL CONTROL, LUMBAR FLEXION, RIGIDL0636 00200 4 POSTERIOR FRAME/PANELS, LATERAL ARTICULATING DESIGN TO FLEX THE LUMBAR SPINE,L0636 00300 4 POSTERIOR EXTENDS FROM SACROCOCCYGEAL JUNCTION TO T-9 VERTEBRA, LATERALL0636 00400 4 STRENGTH PROVIDED BY RIGID LATERAL FRAME/PANELS, PRODUCES INTRACAVITARYL0636 00500 4 PRESSURE TO REDUCE LOAD ON INTERVERTEBRAL DISCS, INCLUDES STRAPS, CLOSURES, MAYL0636 00600 4 INCLUDE PADDING, ANTERIOR PANEL, PENDULOUS ABDOMEN DESIGN, CUSTOM FABRICATEDL0637 00100 3 LUMBAR-SACRAL ORTHOSIS, SAGITTAL-CORONAL CONTROL, WITH RIGID ANTERIOR ANDL0637 00200 4 POSTERIOR FRAME/PANELS, POSTERIOR EXTENDS FROM SACROCOCCYGEAL JUNCTION TO T-9L0637 00300 4 VERTEBRA, LATERAL STRENGTH PROVIDED BY RIGID LATERAL FRAME/PANELS, PRODUCESL0637 00400 4 INTRACAVITARY PRESSURE TO REDUCE LOAD ON INTERVERTEBRAL DISCS, INCLUDES STRAPS,L0637 00500 4 CLOSURES, MAY INCLUDE PADDING, SHOULDER STRAPS, PENDULOUS ABDOMEN DESIGN,L0637 00600 4 PREFABRICATED, INCLUDES FITTING AND ADJUSTMENTL0638 00100 3 LUMBAR-SACRAL ORTHOSIS, SAGITTAL-CORONAL CONTROL, WITH RIGID ANTERIOR ANDL0638 00200 4 POSTERIOR FRAME/PANELS, POSTERIOR EXTENDS FROM SACROCOCCYGEAL JUNCTION TO T-9






46

HCPCS For Laboratory Assays

M0064 00100 3 BRIEF OFFICE VISIT FOR THE SOLE PURPOSE OF MONITORING OR CHANGING DRUGM0064 00200 4 PRESCRIPTIONS USED IN THE TREATMENT OF MENTAL PSYCHONEUROTIC AND PERSONALITYM0064 00300 4 DISORDERSM0075 00100 3 CELLULAR THERAPYM0076 00100 3 PROLOTHERAPYM0100 00100 3 INTRAGASTRIC HYPOTHERMIA USING GASTRIC FREEZINGM0300 00100 3 IV CHELATION THERAPY (CHEMICAL ENDARTERECTOMY)M0301 00100 3 FABRIC WRAPPING OF ABDOMINAL ANEURYSMP2028 00100 3 CEPHALIN FLOCULATION, BLOODP2029 00100 3 CONGO RED, BLOODP2031 00100 3 HAIR ANALYSIS (EXCLUDING ARSENIC)P2033 00100 3 THYMOL TURBIDITY, BLOODP2038 00100 3 MUCOPROTEIN, BLOOD (SEROMUCOID) (MEDICAL NECESSITY PROCEDURE)P3000 00100 3 SCREENING PAPANICOLAOU SMEAR, CERVICAL OR VAGINAL, UP TO THREE SMEARS, BYP3000 00200 4 TECHNICIAN UNDER PHYSICIAN SUPERVISIONP3001 00100 3 SCREENING PAPANICOLAOU SMEAR, CERVICAL OR VAGINAL, UP TO THREE SMEARS,P3001 00200 4 REQUIRING INTERPRETATION BY PHYSICIANP7001 00100 3 CULTURE, BACTERIAL, URINE; QUANTITATIVE, SENSITIVITY STUDY


47

HCPCS For Internal Cardiac LVADS

Q0495 00100 3 BATTERY/POWER PACK CHARGER FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATICQ0495 00200 4 VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLYQ0496 00100 3 BATTERY, OTHER THAN LITHIUM-ION, FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATICQ0496 00200 4 VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLYQ0497 00100 3 BATTERY CLIPS FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSISTQ0497 00200 4 DEVICE, REPLACEMENT ONLYQ0498 00100 3 HOLSTER FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE,Q0498 00200 4 REPLACEMENT ONLYQ0499 00100 3 BELT/VEST/BAG FOR USE TO CARRY EXTERNAL PERIPHERAL COMPONENTS OF ANY TYPEQ0499 00200 4 VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLYQ0500 00100 3 FILTERS FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE,Q0500 00200 4 REPLACEMENT ONLYQ0501 00100 3 SHOWER COVER FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSISTQ0501 00200 4 DEVICE, REPLACEMENT ONLYQ0502 00100 3 MOBILITY CART FOR PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLYQ0503 00100 3 BATTERY FOR PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY, EACHQ0504 00100 3 POWER ADAPTER FOR PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY,Q0504 00200 4 VEHICLE TYPEQ0505 00100 3 MISCELLANEOUS SUPPLY OR ACCESSORY FOR USE WITH VENTRICULAR ASSIST DEVICEQ0506 00100 3 BATTERY, LITHIUM-ION, FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULARQ0506 00200 4 ASSIST DEVICE, REPLACEMENT ONLY






48

HCPCS For More Injections

S0017 00100 3 INJECTION, AMINOCAPROIC ACID, 5 GRAMSS0020 00100 3 INJECTION, BUPIVICAINE HYDROCHLORIDE, 30 MLS0021 00100 3 INJECTION, CEFOPERAZONE SODIUM, 1 GRAMS0023 00100 3 INJECTION, CIMETIDINE HYDROCHLORIDE, 300 MGS0028 00100 3 INJECTION, FAMOTIDINE, 20 MGS0030 00100 3 INJECTION, METRONIDAZOLE, 500 MGS0032 00100 3 INJECTION, NAFCILLIN SODIUM, 2 GRAMSS0034 00100 3 INJECTION, OFLOXACIN, 400 MGS0039 00100 3 INJECTION, SULFAMETHOXAZOLE AND TRIMETHOPRIM, 10 MLS0040 00100 3 INJECTION, TICARCILLIN DISODIUM AND CLAVULANATE POTASSIUM, 3.1 GRAMSS0073 00100 3 INJECTION, AZTREONAM, 500 MGS0074 00100 3 INJECTION, CEFOTETAN DISODIUM, 500 MGS0077 00100 3 INJECTION, CLINDAMYCIN PHOSPHATE, 300 MGS0078 00100 3 INJECTION, FOSPHENYTOIN SODIUM, 750 MGS0080 00100 3 INJECTION, PENTAMIDINE ISETHIONATE, 300 MGS0081 00100 3 INJECTION, PIPERACILLIN SODIUM, 500 MGS0088 00100 3 IMATINIB, 100 MG


49

HCPCS For Encounters with Health WorkersT1015 00100 3 CLINIC VISIT/ENCOUNTER, ALL-INCLUSIVET1016 00100 3 CASE MANAGEMENT, EACH 15 MINUTEST1017 00100 3 TARGETED CASE MANAGEMENT, EACH 15 MINUTEST1018 00100 3 SCHOOL-BASED INDIVIDUALIZED EDUCATION PROGRAM (IEP) SERVICES, BUNDLEDT1019 00100 3 PERSONAL CARE SERVICES, PER 15 MINUTES, NOT FOR AN INPATIENT OR RESIDENT OF AT1019 00200 4 HOSPITAL, NURSING FACILITY, ICF/MR OR IMD, PART OF THE INDIVIDUALIZED PLAN OFT1019 00300 4 TREATMENT (CODE MAY NOT BE USED TO IDENTIFY SERVICES PROVIDED BY HOME HEALTHT1019 00400 4 AIDE OR CERTIFIED NURSE ASSISTANT)T1020 00100 3 PERSONAL CARE SERVICES, PER DIEM, NOT FOR AN INPATIENT OR RESIDENT OF AT1020 00200 4 HOSPITAL, NURSING FACILITY, ICF/MR OR IMD, PART OF THE INDIVIDUALIZED PLAN OFT1020 00300 4 TREATMENT (CODE MAY NOT BE USED TO IDENTIFY SERVICES PROVIDED BY HOME HEALTHT1020 00400 4 AIDE OR CERTIFIED NURSE ASSISTANT)T1021 00100 3 HOME HEALTH AIDE OR CERTIFIED NURSE ASSISTANT, PER VISITT1022 00100 3 CONTRACTED HOME HEALTH AGENCY SERVICES, ALL SERVICES PROVIDED UNDER CONTRACT,T1022 00200 4 PER DAYT1023 00100 3 SCREENING TO DETERMINE THE APPROPRIATENESS OF CONSIDERATION OF AN INDIVIDUALT1023 00200 4 FOR PARTICIPATION IN A SPECIFIED PROGRAM, PROJECT OR TREATMENT PROTOCOL, PERT1023 00300 4 ENCOUNTERT1024 00100 3 EVALUATION AND TREATMENT BY AN INTEGRATED, SPECIALTY TEAM CONTRACTED TO PROVIDET1024 00200 4 COORDINATED CARE TO MULTIPLE OR SEVERELY HANDICAPPED CHILDREN, PER ENCOUNTERT1025 00100 3 INTENSIVE, EXTENDED MULTIDISCIPLINARY SERVICES PROVIDED IN A CLINIC SETTING TOT1025 00200 4 CHILDREN WITH COMPLEX MEDICAL, PHYSICAL, MENTAL AND PSYCHOSOCIAL IMPAIRMENTS,






50

HCPCS For Ophthalmology Items

V2020 00100 3 FRAMES, PURCHASESV2025 00100 3 DELUXE FRAMEV2100 00100 3 SPHERE, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00, PER LENSV2101 00100 3 SPHERE, SINGLE VISION, PLUS OR MINUS 4.12 TO PLUS OR MINUS 7.00D, PER LENSV2102 00100 3 SPHERE, SINGLE VISION, PLUS OR MINUS 7.12 TO PLUS OR MINUS 20.00D, PER LENSV2103 00100 3 SPHEROCYLINDER, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00D SPHERE, .12 TOV2103 00200 4 2.00D CYLINDER, PER LENSV2104 00100 3 SPHEROCYLINDER, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00D SPHERE, 2.12 TOV2104 00200 4 4.00D CYLINDER, PER LENSV2105 00100 3 SPHEROCYLINDER, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00D SPHERE, 4.25 TOV2105 00200 4 6.00D CYLINDER, PER LENSV2106 00100 3 SPHEROCYLINDER, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00D SPHERE, OVER 6.00DV2106 00200 4 CYLINDER, PER LENSV2107 00100 3 SPHEROCYLINDER, SINGLE VISION, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00 SPHERE,V2107 00200 4 .12 TO 2.00D CYLINDER, PER LENSV2108 00100 3 SPHEROCYLINDER, SINGLE VISION, PLUS OR MINUS 4.25D TO PLUS OR MINUS 7.00DV2108 00200 4 SPHERE, 2.12 TO 4.00D CYLINDER, PER LENSV2109 00100 3 SPHEROCYLINDER, SINGLE VISION, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00DV2109 00200 4 SPHERE, 4.25 TO 6.00D CYLINDER, PER LENSV2110 00100 3 SPHEROCYLINDER, SINGLE VISION, PLUS OR MINUS 4.25 TO 7.00D SPHERE, OVER 6.00DV2110 00200 4 CYLINDER, PER LENS


51

9,148 HCPCS Codes



Documents

CPT and HCPCS Coding