SBS Code
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| SBS Code (Hyphenated)
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| Short Description
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| Long Description
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| Chapter
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⌀ | Chapter Name
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| Block Name
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⌀ | Definition
stringlengths 11
1.18k
⌀ | Includes
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1.31k
⌀ | Excludes
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1.23k
⌀ | Guidelines
stringlengths 1
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⌀ |
|---|---|---|---|---|---|---|---|---|---|---|---|
909100000
|
90910-00-00
|
Nuclear med study of other region/organ
|
Nuclear medicine study of other region or organ
| 20
|
Imaging services
| 2,014
|
Other nuclear medicine imaging study
|
Nuclear medicine study of other region or organ.
| null | null | null |
909010010
|
90901-00-10
|
MRI of brain w/o con medium
|
Magnetic resonance imaging of brain, without contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Magnetic resonance imaging of brain, without contrast medium, excluding functional magnetic resonance imaging of brain.
| null |
Functional Magnetic Resonance Imaging of Brain (90901-09-10, 90901-09-20 [2015])
| null |
909010020
|
90901-00-20
|
MRI brain w/ con medium
|
Magnetic resonance imaging of brain, with contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Magnetic resonance imaging of brain, with contrast medium, excluding functional magnetic resonance imaging of brain.
| null |
Functional Magnetic Resonance Imaging of Brain (90901-09-10, 90901-09-20 [2015])
| null |
909010110
|
90901-01-10
|
MRI head w/o con medium
|
Magnetic resonance imaging of head, without contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
| null |
Face
orbit
Sinuses (Ethmoid) (Frontal) (Maxillary) (Sphenoid)
Skull Bone
|
That of Brain:
• Functional (90901-09-10, 90901-09-20 [2015])
• Nos (90901-09-10, 90901-09-20 [2015])
| null |
909010120
|
90901-01-20
|
MRI head w/ con medium
|
Magnetic resonance imaging of head, with contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
| null |
Face
orbit
Sinuses (Ethmoid) (Frontal) (Maxillary) (Sphenoid)
Skull Bone
|
That of Brain:
• Functional (90901-09-10, 90901-09-20 [2015])
• Nos (90901-09-10, 90901-09-20 [2015])
| null |
909010130
|
90901-01-30
|
MRI head w/ or w/o con medium
|
Magnetic resonance imaging of head, without followed by with contrast
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
| null |
Face, orbit, sinuses (ethmoid) (frontal) (maxillary) (sphenoid), skull bone
|
Do not bill with 90901-01-20 and 90901-01-30 as they are inclusive
| null |
909010210
|
90901-02-10
|
MRI neck w/o con medium
|
Magnetic resonance imaging of neck, without contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Magnetic resonance imaging of neck, without contrast medium, excluding that of cervical spine.
| null |
That of Cervical Spine (90901-03-10, 90901-03-20 [2015])
| null |
909010220
|
90901-02-20
|
MRI neck w/ con medium
|
Magnetic resonance imaging of neck, with contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Magnetic resonance imaging of neck, with contrast medium, excluding that of cervical spine.
| null |
That of Cervical Spine (90901-03-10, 90901-03-20 [2015])
| null |
909010310
|
90901-03-10
|
MRI cervical spine w/o con medium
|
Magnetic resonance imaging of cervical spine, without contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
| null |
Spinal Cord
| null | null |
909010320
|
90901-03-20
|
MRI cervical spine w/ con medium
|
Magnetic resonance imaging of cervical spine, with contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
| null |
Spinal Cord
| null | null |
909010330
|
90901-03-30
|
MRI thoracic spine w/o con medium
|
Magnetic resonance imaging of thoracic spine, without contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
| null |
Spinal Cord
| null | null |
909010340
|
90901-03-40
|
MRI thoracic spine w/ con medium
|
Magnetic resonance imaging of thoracic spine, with contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
| null |
Spinal Cord
| null | null |
909010360
|
90901-03-60
|
MRI lumbar spine w/ con medium
|
Magnetic resonance imaging of lumbar spine, with contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
| null |
Spinal Cord
| null | null |
909010370
|
90901-03-70
|
MRI lumbar spine w/o con medium
|
Magnetic resonance imaging of lumbar spine, without contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
| null |
Spinal Cord
| null | null |
909010410
|
90901-04-10
|
MRI chest w/o con medium
|
Magnetic resonance imaging of chest, without contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
| null |
Heart
| null | null |
909010420
|
90901-04-20
|
MRI chest w/ con medium
|
Magnetic resonance imaging of chest, with contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
| null |
Heart
| null | null |
909010440
|
90901-04-40
|
Stress cardiac magnetic resonance imaging, w/ con
|
Stress cardiac magnetic resonance imaging, with contrast
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Stress cardiac magnetic resonance imaging, with contrast.
| null | null | null |
909010510
|
90901-05-10
|
MRI abd w/o con medium
|
Magnetic resonance imaging of abdomen, without contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Magnetic resonance imaging of abdomen, without contrast medium.
| null | null | null |
909010520
|
90901-05-20
|
MRI pelv w/ con medium
|
Magnetic resonance imaging of abdomen, with contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Magnetic resonance imaging of abdomen, with contrast medium.
| null | null | null |
909010610
|
90901-06-10
|
MRI pelv w/o con medium
|
Magnetic resonance imaging of pelvis, without contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
| null |
Bladder
Prostate
Rectum
| null | null |
909010620
|
90901-06-20
|
MRI pelv w/ con mediium
|
Magnetic resonance imaging of pelvis, with contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
| null |
Bladder
Prostate
Rectum
| null | null |
909010711
|
90901-07-11
|
MRI extremity w/o con medium uni
|
Magnetic resonance imaging of extremity, without contrast medium, unilateral
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Magnetic resonance imaging of extremity, without contrast medium (one side).
| null | null | null |
909010712
|
90901-07-12
|
MRI extremity w/o con medium bil
|
Magnetic resonance imaging of extremity, without contrast medium, bilateral
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Magnetic resonance imaging of extremity, without contrast medium (both sides).
| null | null | null |
909010721
|
90901-07-21
|
MRI extremity w/ con medium uni
|
Magnetic resonance imaging of extremity, with contrast medium, unilateral
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Magnetic resonance imaging of extremity, with contrast medium (one side).
| null | null | null |
909010722
|
90901-07-22
|
MRI extremity w/ con medium bil
|
Magnetic resonance imaging of extremity, with contrast medium, bilateral
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Magnetic resonance imaging of extremity, with contrast medium (both sides).
| null | null | null |
909010810
|
90901-08-10
|
MRI othr site w/o contrast
|
Magnetic resonance imaging of other site, without contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
| null |
Bone Marrow
Blood Supply
| null | null |
909010820
|
90901-08-20
|
MRI othr site w/ contrast
|
Magnetic resonance imaging of other site, with contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
| null |
Bone Marrow
Blood Supply
| null | null |
909010910
|
90901-09-10
|
Functional MRI brain w/o contrast
|
Functional magnetic resonance imaging of brain, without contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Functional magnetic resonance imaging of brain, without contrast medium.
| null | null | null |
909010920
|
90901-09-20
|
Functional MRI brain w/ contrast
|
Functional magnetic resonance imaging of brain, with contrast medium
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Functional magnetic resonance imaging of brain, with contrast medium.
| null | null | null |
909011011
|
90901-10-11
|
MRI of breast w/o con medium uni
|
Magnetic resonance imaging of breast, without contrast medium, unilateral
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Magnetic resonance imaging of breast, without contrast medium (one side).
| null | null | null |
909011012
|
90901-10-12
|
MRI of breast w/o con medium bil
|
Magnetic resonance imaging of breast, without contrast medium, bilateral
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Magnetic resonance imaging of breast, without contrast medium (both sides).
| null | null | null |
909011021
|
90901-10-21
|
MRI of breast w/ con medium uni
|
Magnetic resonance imaging of breast, with contrast medium, unilateral
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Magnetic resonance imaging of breast, with contrast medium (one side).
| null | null | null |
909011022
|
90901-10-22
|
MRI of breast w/ con medium bil
|
Magnetic resonance imaging of breast, with contrast medium, bilateral
| 20
|
Imaging services
| 2,015
|
Magnetic resonance imaging
|
Magnetic resonance imaging of breast, with contrast medium (both sides).
| null | null | null |
909040000
|
90904-00-00
|
Thermography nec
|
Thermography, not elsewhere classified
| 20
|
Imaging services
| 2,016
|
Other imaging services
|
Thermography, not elsewhere classified.
| null |
thermography of Breast with Radiography (59300-01-00, 59303-01-00 [1973])
| null |
909040010
|
90904-00-10
|
Fusion 2 or more 3d imge volumesone or more modalities
|
Fusion of two or more 3-dimensional image volumes of one or more modalities
| 20
|
Imaging services
| 2,016
|
Other imaging services
|
Fusion of two or more 3-dimensional image volumes of one or more modalities.
| null | null | null |
112190011
|
11219-00-11
|
Optical coherence tomography uni
|
Optical coherence tomography, unilateral
| 20
|
Imaging services
| 2,016
|
Other imaging services
|
Optical coherence tomography (one side).
| null | null | null |
112190012
|
11219-00-12
|
Optical coherence tomography bil
|
Optical coherence tomography, bilateral
| 20
|
Imaging services
| 2,016
|
Other imaging services
|
Optical coherence tomography (both sides).
| null | null | null |
999999992
|
99999-99-92
|
Unlist img code
|
Unlisted imaging code
| 20
|
Imaging services
| 2,016
|
Imaging services
|
Specified imaging code.
| null | null | null |
850000000
|
85000-00-00
|
BLS ambul response & treatment w/o transport
|
Basic life support ambulance response and the team has physically attended and treated the patient without transport.
| 24
|
EMS
| 2,050
|
EMS
|
Basic life support ambulance response and the team has physically attended and treated the patient without transport.
| null | null |
on-site medical service without transportation - Basic Life Support
|
850000100
|
85000-01-00
|
BLS transport up to 50 km
|
Patient transport that was carried out by a bls team up to 50 km distance excluding medications.
| 24
|
EMS
| 2,050
|
EMS
|
Patient transport that was carried out by a basic life support team up to 50 km distance excluding medications.
| null | null |
Code includes ambulance transport for 50 km , team fees, routine service and disposable supplies but excludes any medications given, BLS used for low priority cases.
|
851000000
|
85100-00-00
|
BLS ambl chrge per ea 10 km exceed 1st 50 km (add-on)
|
Basic life support ambulance extra distance charge per 10 km exceeding first 50 km. (add-on code)
| 24
|
EMS
| 2,050
|
EMS
|
Basic life support ambulance extra distance charge per 10 km exceeding first 50 km.
| null | null |
This is an add-on code for 85000-01-00 for each additional 10 km distance more than the first 50 km
|
851100000
|
85110-00-00
|
BLS team deploy to dynamic post, standby; calcultd by hour
|
Basic life support team deployed to a dynamic post, on standby; calculated by hour
| 24
|
EMS
| 2,050
|
EMS
|
Basic life support team deployed to a dynamic post, on standby; per hour.
| null | null |
attendance of the BLS ambulance for any event, in a state of readiness; calculation for code per each hour
Direct contracting with non insurance
|
851200000
|
85120-00-00
|
BLS transport declination
|
A patient transport request that was declined by the patient after srca dispatch has deployed a bls team and the team has physically attended to the patient
| 24
|
EMS
| 2,050
|
EMS
|
A patient transport request that was declined by the patient after srca dispatch has deployed a basic life support team and the team has physically attended to the patient.
| null | null |
Not for insurance reimbursement
|
851300000
|
85130-00-00
|
BLS cancelation
|
A patient transport request that was canceled after srca dispatch has deployed a bls team and before the team has physically attended to the patient
| 24
|
EMS
| 2,050
|
EMS
|
A patient transport request that was canceled after srca dispatch has deployed a basic life support team and before the team has physically attended to the patient.
| null | null |
Not for insurance reimbursement
|
852000000
|
85200-00-00
|
ALS ambul response & treatment w/o transport
|
Advanced life support ambulance response and the team has physically attended and treated the patient without transport.
| 24
|
EMS
| 2,050
|
EMS
|
Advanced life support ambulance response and the team has physically attended and treated the patient without transport.
| null | null |
on-site medical service without transportation - Advanced Life Support
|
852000100
|
85200-01-00
|
ALS support transport up to 50 km
|
Patient transport that was carried out by a als team, up to 50 km distance, in cases of mid to high priority and possibly life threatening situations, excluding medications.
| 24
|
EMS
| 2,050
|
EMS
|
Patient transport that was carried out by ALS team, up to 50 km distance, in cases of mid to high priority and possibly life threatening situations, excluding medications.
| null | null |
Code includes ambulance transport up to 50 km, team fees, routine services and disposable supplies but excludes any medications given, ALS used for high-priority cases
|
853000000
|
85300-00-00
|
ALS ambl charge per ea 10km exceed 50 km up to 300 km (add-on)
|
Advance life support ambulance extra distance charge per 10 km exceeding first 50 km up to 300 km (add-on code)
| 24
|
EMS
| 2,050
|
EMS
|
Advanced life support ambulance extra distance charge per 10 km exceeding first 50 km up to 300 km.
| null | null |
This code is an add-on code for 85200-01-00 for each additional 10 km distance more than the first 50 km
|
853100000
|
85310-00-00
|
ALS - standby per hour
|
Als team deployed to a dynamic post, on standby; calculated by hour.
| 24
|
EMS
| 2,050
|
EMS
|
Advanced life support team deployed to a dynamic post, on standby; per hour.
| null | null |
attendance of the ALS ambulance for any event, in a state of readiness, calculation for code per each hour
Direct contracting with non insurance
|
853200000
|
85320-00-00
|
ALS transport declination
|
A patient transport request that was declined by the patient afteremsdispatch has deployed an als team and the team has physically attended to the patient
| 24
|
EMS
| 2,050
|
EMS
|
A patient transport request that was declined by the patient after emergency medical services dispatch has deployed an als team and the team has physically attended to the patient.
| null | null |
Not for insurance reimbursement
|
853300000
|
85330-00-00
|
ALS cancelation
|
ALS team transport request that was canceled after EMS dispatch has deployed the team and before the team has physically attended to the patient
| 24
|
EMS
| 2,050
|
EMS
|
Advanced life support team transport request that was canceled after emergency medical services dispatch has deployed the team and before the team has physically attended to the patient.
| null | null |
Not for insurance reimbursement
|
854000000
|
85400-00-00
|
ALS service by specialized team (add-on code)
|
The deployment of a specialized team for highly specialized patient care service that may or may not include transport (add-on code)
| 24
|
EMS
| 2,050
|
EMS
|
The deployment of a specialized team for highly specialized patient care service that may or may not include transport.
| null | null |
This code is used to report the attendance of a specialized team in addition to the ALS ambulance. Must be reported with ALS codes.(** list codes here**) Examples of this service include hazardous material response, tactical event response, urban search and rescue response, wilderness response and others.
|
855000000
|
85500-00-00
|
Aeromedical transport (medivac)
|
Patient transport that was carried out by an aeromedical services team
| 24
|
EMS
| 2,050
|
EMS
|
Transports patient by an aeromedical services team.
| null | null |
for All Medivac transport - Extra insurance benefit
|
730000000
|
73000-00-00
|
BMP (Ca ionized)
|
Basic metabolic panel [ionized calcium, carbon dioxide (bicarbonate), chloride, creatinine, glucose, potassium, sodium, blood urea nitrogen (BUN)]
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
Basic metabolic panel (BMP) measures the blood level of ionized calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood urea nitrogen (BUN), and creatinine.
| null | null |
If two or more test panels of same substances are reported, assign only one code for the panel with the greater number of substances measured (e.g. do not code 73000-00-00 with 73000-00-40)
|
730000010
|
73000-00-10
|
BMP (Ca total)
|
Basic metabolic panel [total calcium, carbon dioxide (bicarbonate), chloride, creatinine, glucose, potassium, sodium, blood urea nitrogen (BUN)]
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
Basic metabolic panel (BMP) measures the blood level of total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood urea nitrogen (BUN), and creatinine.
| null | null | null |
730000020
|
73000-00-20
|
General health panel
|
General health panel [comprehensive metabolic panel (CMP) and (automated complete blood count (CBC) and automated differential white blood cells (WBC) or automated complete blood count (CBC) and manual differential white blood cells (WBC)) or thyroid stimulating hormone (TSH)]
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
Three components are required; comprehensive metabolic panel, thyroid stimulating hormone (TSH), and a blood count with manual or automated differential (e.g. patient’s metabolic processes as blood/thyroid state
| null | null | null |
730000030
|
73000-00-30
|
Serum electrolyte panel
|
Serum electrolyte panel [Carbon dioxide (bicarbonate)(CO2), Chloride (Cl), Potassium (K), Sodium (Na)]
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
Electrolyte panel measures carbon dioxide, chloride, potassium, and sodium in a specimen.
| null | null | null |
730000040
|
73000-00-40
|
CMP
|
Comprehensive metabolic panel [albumin, total bilirubin, total calcium, carbon dioxide (bicarbonate), chloride, creatinine, glucose, phosphatase, alkaline, potassium, total protein, sodium, alanine amino-transferase (ALT), serum glutamic-pyruvic transaminase (SGPT), aspartate amino-transferase (AST), serum glutamic-oxaloacetic transaminase (SGOT), blood urea nitrogen (BUN)]
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
Comprehensive metabolic panel measures the blood level of 14 chemicals
| null | null |
If two or more test panels of same substances are reported, assign only one code for the panel with the greater number of substances measured (e.g. do not code 73000-00-00 with 73000-00-40)
|
730000050
|
73000-00-50
|
Obstetric panel
|
Obstetric panel [automated complete blood count (CBC) and automated differential white blood cell (WBC) count or automated complete blood count (CBC), and manual differential white blood cell (WBC) count, Hepatitis B surface antigen (HBsAg), rubella antibody , syphilis test (non-treponemal antibody) qualitative (e.g. VDRL, RPR, ART), RBC antibody (each serum technique), blood typing, ABO and Rh (D)]
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
Obstetric panel includes tests for a complete blood count with differential, a hepatitis B surface antigen, a rubella antibody, a qualitative non treponemal syphilis test, a red blood cell antibody screen, ABO blood typing, and Rh typing.
| null | null | null |
730000060
|
73000-00-60
|
Lipid profile
|
Lipid profile [total serum Cholesterol, Triglycerides, High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL)]
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
Lipid panel measures the blood level of cholesterol and triglycerides in the blood
| null | null | null |
730000070
|
73000-00-70
|
Renal function profile
|
Renal function profile [albumin, calcium (Ca), carbon dioxide (bicarbonate)(Co2), chloride (Cl), creatinine (Cr), glucose (Glu), phosphorus inorganic (phosphate), potassium (K), sodium (Na), blood urea nitrogen (BUN)]
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
Renal function panel measures the blood level of chemicals for kidney function evaluation.
| null | null | null |
730000080
|
73000-00-80
|
Acute hepatitis panel
|
Acute hepatitis panel [Hepatitis A antibody (HAAb), Immunoglobulin M (IgM) antibody, Hepatitis B core antibody (HBcAb), IgM antibody, Hepatitis B surface antigen (HBsAg), Hepatitis C antibody]
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
Acute hepatitis panel includes tests for hepatitis A IgM antibody, hepatitis B core IgM antibody, hepatitis B surface antigen, and hepatitis C antibody.
| null | null | null |
730000090
|
73000-00-90
|
Liver function panel
|
Liver function panel [Albumin, Bilirubin, Alanine Amino-Transferase (ALT), Serum Glutamic-Pyruvic Transaminase (SGPT), Aspartate Amino-Transferase (AST), Serum Glutamic-Oxaloacetic Transaminase (SGOT), Phosphatase)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
Liver function panel measures the levels of total protein, albumin, alkaline phosphatase, bilirubin, both total and direct, and liver enzymes.
| null | null | null |
730000100
|
73000-01-00
|
Obstetric panel w/ HIV testing
|
Obstetric panel [complete blood count (CBC) and automated differential white blood cell (WBC) count or automated complete blood count (CBC) and manual differential WBC count, hepatitis B surface antigen (HBsAg), HIV-1 antigen(s) with HIV-1 and HIV-2 antibodies (single result), rubella antibody, syphilis test (non-treponemal antibody) qualitative (e.g., VDRL, RPR, ART), RBC antibody screen (each serum technique), blood typing, ABO and Rh (D)]
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
Obstetric panel includes tests for a complete blood and differential count, a hepatitis B surface antigen test, a single–result test for HIV–1 antigens and antibodies for HIV–1 and HIV–2, a rubella antibody test, a qualitative nontreponemal syphilis test, a red blood cell antibody screen, ABO blood typing, and Rh typing.
| null | null | null |
730000105
|
73000-01-05
|
New born profile
|
New born profile (17 tests)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
New born profile
| null | null |
Code when performed to a newborn and only when all 17 tests are done
|
730000110
|
73000-01-10
|
ACTH stimulation panel
|
Adrenocorticotropic hormone (ACTH) stimulation panel; (Cortisol x2)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
(ACTH) Stimulation panel measures cortisol and 11 deoxycortisol levels, before and after the administration of the drug metyrapone.
| null | null | null |
730000120
|
73000-01-20
|
ACTH (21 Hydroxylase) panel
|
Adrenocorticotropic hormone (ACTH) stimulation panel for 21 hydroxylase deficiency; (Cortisol x2, 17 Hydroxyprogesterone x2)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
This test measures levels of cortisol and 17 hydroxyprogesterone in response to the inection of synthetic adrenocorticotropic hormone (ACTH).
| null | null |
Assign this code only if all panel tests are performed, otherwise assign the individual test code
|
730000130
|
73000-01-30
|
ACTH (3 Beta-Hydroxydehydrogenase) panel
|
Adrenocorticotropic hormone (ACTH) stimulation panel for 3-Beta-Hydroxydehydrogenase deficiency; (Cortisol x2, 17 Hydroxypregnenolone x2)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
This test measures levels of cortisol and 17 hydroxypregnenolone in response to the inection of synthetic adrenocorticotropic hormone (ACTH).
| null | null |
Assign this code only if all panel tests are performed, otherwise assign the individual test code
|
730000140
|
73000-01-40
|
Aldosterone suppression panel
|
Aldosterone suppression evaluation panel; (Aldosterone x2, Renin x2)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
This panel includes four separate tests: two aldosterone assays and two renin assays.
| null | null |
Assign this code only if all panel tests are performed, otherwise assign the individual test codes.
If this panel test performed in addition to different individual tests, assign codes for each (test panel code and individual test codes)
|
730000150
|
73000-01-50
|
Calcitonin profile
|
Calcitonins stimulation profile; (Calcitonin x3)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
This panel includes three separate tests for calcitonin.
| null | null |
Assign this code only if all panel tests are performed, otherwise assign the individual test codes.
If this panel test performed in addition to different individual tests, assign codes for each (test panel code and individual test codes)
|
730000160
|
73000-01-60
|
CRH stimulation profile
|
Corticotropic releasing hormone (CRH) stimulation profile; (Cortisol x6, Adrenocorticotropic Hormone x6)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
This panel includes six cortisol assays and six ACTH assays.
| null | null |
Assign this code only if all panel tests are performed, otherwise assign the individual test codes.
If this panel test performed in addition to different individual tests, assign codes for each (test panel code and individual test codes)
|
730000170
|
73000-01-70
|
HCG testosterone profile
|
Human chorionic gonadotropin (HCG) stimulation profile; (Testosterone x2) on 3 pooled blood samples
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
This panel includes two testosterone assays on three pooled blood samples to measure testosterone response.
| null | null |
Assign this code only if all panel tests are performed, otherwise assign the individual test codes.
If this panel test performed in addition to different individual tests, assign codes for each (test panel code and individual test codes)
|
730000180
|
73000-01-80
|
HCG estradiol profile
|
Human chorionic gonadotropin (HCG) stimulation profile; (Estradiol x2) on 3 pooled blood samples
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
This panel includes two testosterone assays on three pooled blood samples to measure estradiol response.
| null | null |
Assign this code only if all panel tests are performed, otherwise assign the individual test codes.
If this panel test performed in addition to different individual tests, assign codes for each (test panel code and individual test codes)
|
730000190
|
73000-01-90
|
Renal vein stimulation panel
|
Renal vein stimulation panel; (Renin x6)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
The test measures renal vein renin samples before and after the injection of a stimulant
| null | null | null |
730000200
|
73000-02-00
|
Peripheral vein stimulation panel
|
Peripheral vein stimulation panel; (Renin x2)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
The test measures peripheral vein renin samples before and after the injection of a stimulant
| null | null | null |
730000210
|
73000-02-10
|
Pituitary evaluation panel
|
Combined-rapid anterior pituitary evaluation panel; [Adrenocorticotropic hormone (ACTH) x4, Luteinizing hormone (LH) x4, Follicle stimulating hormone (FSH) x4, Prolactin x4, Human growth hormone x4, Cortisol x4, and Thyroid stimulating hormone (TSH) x4]
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
Seven hormones are measured with four units for each (e.g. suspected pituitary tumor)
| null | null | null |
730000220
|
73000-02-20
|
Dexamethasone suppression panel
|
Dexamethasone suppression panel [free cortisol x2 (urine), cortisol x2, volume measurement for timed collection x2]
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
The test measures serum cortisol and 24 hour urine free cortisol then measures a second sampling for the serum cortisol and 24 hour urine free cortisol after administration of a suppressant
| null | null | null |
730000230
|
73000-02-30
|
Glucagon tolerance insulinoma panel
|
Glucagon tolerance panel for insulinoma; (Glucose x3, Insulin x3)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
The test measures three samples of glucose and insulin before and after receiving a stimulant at three different times, to diagnose insulinoma condition
| null | null | null |
730000240
|
73000-02-40
|
Glucagon tolerance pheochromocytoma panel
|
Glucagon tolerance panel for pheochromocytoma; (Catecholamines fractionated x2)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
The test measures fractionated catecholamines before and after receiving a stimulant
|
HorMonE INFERTILITY LAB-PKG (M)
| null | null |
730000250
|
73000-02-50
|
Reproductive hormone profile
|
Reproductive hormone profile [follicle stimulating hormone (FSH), luteinizing hormone (LH)]
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
The test measures four serum samples of follicle stimulating hormone and luteinizing hormone at four different times
| null | null | null |
730000260
|
73000-02-60
|
GH stimulation panel
|
Growth hormone stimulation panel; (Human Growth Hormone x4)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
The test measures one sample of growth hormone before and three samples after receiving a stimulant
| null | null | null |
730000270
|
73000-02-70
|
GH suppression panel
|
Growth hormone suppression panel; (Glucose x3, Human Growth Hormone x4)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
The test measures one sample of glucose before and two samples after receiving a glucose, it also measures one sample of growth hormone before and three samples after receiving a glucose
| null | null | null |
730000280
|
73000-02-80
|
Insulin C peptide Suppression panel
|
Insulin Induced C-Peptide Suppression Panel; (Insulin C-peptide x5, Glucose x5)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
The test measures one sample of glucose and the C peptide before and four samples after receiving insulin, it also measures one sample of insulin
| null | null | null |
730000290
|
73000-02-90
|
Insulin tolerance panel; ACTH insufficiency
|
Adrenocorticotropic hormone (ACTH) insufficiency insulin tolerance panel; (Cortisol x5, Glucose x5)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
The test measures one sample of glucose and cortisol before and four samples after receiving insulin
| null | null | null |
730000300
|
73000-03-00
|
Insulin tolerance panel; GH deficiency
|
Growth hormone deficiency insulin tolerance panel; (Glucose x5, Human Growth Hormone x5)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
The test measures one sample of glucose and human growth hormone before and four samples after receiving insulin
| null | null | null |
730000310
|
73000-03-10
|
Metyrapone panel
|
Metyrapone panel; (Cortisol x2, 11 Deoxycortisol x2)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
The test measures one sample cortisol and 11 deoxycortisol before and one sample after metyrapone injection
| null | null | null |
730000320
|
73000-03-20
|
TRH stimulation panel; 1 hour
|
Thyrotropin releasing hormone (TRH) stimulation panel; [Thyroid stimulating hormone (TSH x3)] 1 hour test
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
The test measures one sample of thyroid stimulating hormone before and two samples after thyrotropin releasing hormone drug injection
| null | null | null |
730000330
|
73000-03-30
|
TRH stimulation panel; 2 hour
|
Thyrotropin releasing hormone (TRH) stimulation panel; [Thyroid stimulating hormone (TSH x4)] 2 hour test
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
The test measures one sample of thyroid stimulating hormone before and three samples after thyrotropin releasing hormone drug injection
| null | null | null |
730000071
|
73000-00-71
|
Pre-op investigation for kidney; group tests
|
Pre-operative investigation for kidney group tests
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
Group of tests for investigation of kidney function
| null | null | null |
730000340
|
73000-03-40
|
Thyroid hormones PKG (TSH FT3 FT4)
|
Thyroid hormones package (TSH, FT3, FT4)
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
The test measures a group of thyroid hormones
| null | null | null |
730000350
|
73000-03-50
|
Pleural Fluid Panel
|
Pleural fluid panel for diagnostic analysis of pleural effusion
| 21
|
Laboratory and Pathology
| 3,000
|
Essential Test Panels
|
A panel of tests which may include any of the following: (pH level, Gram stain culture, Blood cell count and differential, Glucose level, protein levels, and lactic acid dehydrogenase (LDH) level,Creatinine level, or Cytology).
| null | null | null |
730504361
|
73050-43-61
|
Antimicrobial Susceptibility; Agar Dilution
|
Antimicrobes susceptibility studyies by agar dilution method
| 21
|
Laboratory and Pathology
| 3,050
|
Chemistry & Microbiology
|
Antimicrobes susceptibility studyies by agar dilution method
| null | null | null |
730504441
|
73050-44-41
|
Fluorescent Noninfectious Agent Mitochondrial Ab; Titer
|
Fluorescent Noninfectious Agent Mitochondrial Antibody in Titer
| 21
|
Laboratory and Pathology
| 3,050
|
Chemistry & Microbiology
|
Identification of mitrochondrial antibodies by fluorescence
| null | null | null |
730504551
|
73050-45-51
|
RotaVirus & Adenovirus Screening (Stool)
|
Combined Rotavirus and Adenovirus Screening in Stool
| 21
|
Laboratory and Pathology
| 3,050
|
Chemistry & Microbiology
|
Stool screen for rotavirus and adenovirus
| null | null | null |
730504581
|
73050-45-81
|
Cryptosporidium Parvum Giardia Lamblia Entamoeba Histolytica; Ag Panel
|
Panel for detection of Cryptosporidium Parvum, Giardia Lamblia, and Entamoeba Histolytica Antigens In Stool
| 21
|
Laboratory and Pathology
| 3,050
|
Chemistry & Microbiology
|
Detection panel for Cryptosporidium Parvum, Giardia Lamblia And Entamoeba Histolytica Antigens In Human Stool
| null | null | null |
730504975
|
73050-49-75
|
Coronavirus Ag; IFA; Qual/SemiQuant
|
Qualitative/semiquantitative immunofluorescent technique (IFA) detection of severe acute respiratory syndrome coronavirus Antigen (Ag)
| 21
|
Laboratory and Pathology
| 3,050
|
Chemistry & Microbiology
|
Immunofluorescent technique detection of severe acute respiratory syndrome coronavirus Ag qualitatively or semiquantitatively
| null | null | null |
730504976
|
73050-49-76
|
Coronavirus & Influenza A/B Ag; IFA; Qual/SemiQuant
|
Qualitative/semiquantitative immunofluorescent technique (IFA) detection of severe acute respiratory syndrome coronavirus and Influenza Virus types A and B Antigen (Ag)
| 21
|
Laboratory and Pathology
| 3,050
|
Chemistry & Microbiology
|
Immunofluorescent technique detection of severe acute respiratory syndrome coronavirus and influenza virus types A and B Ag qualitatively or semiquantitatively
| null | null | null |
730505675
|
73050-56-75
|
Mycobacteria Genitalium; Direct probe
|
Detection of Mycobacteria Genitalium by nucleic acid (DNA or RNA) amplified probe technique
| 21
|
Laboratory and Pathology
| 3,050
|
Chemistry & Microbiology
|
Detection of mycobacteria genitalium by nucleic acid (DNA or RNA) amplified probe technique
| null | null | null |
730505711
|
73050-57-11
|
Culture & Sensitivity; Gonorrhea
|
Culture and sensitivity Gonorrhea
| 21
|
Laboratory and Pathology
| 3,050
|
Chemistry & Microbiology
|
Culture and sensitivity test for Gonorrhea
| null | null | null |
730505765
|
73050-57-65
|
Orthopoxvirus; Amplified probe
|
Detection of Orthopoxvirus by nucleic acid (DNA or RNA) amplified probe technique
| 21
|
Laboratory and Pathology
| 3,050
|
Chemistry & Microbiology
|
Detection of orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus) by nucleic acid (DNA or RNA) amplified probe technique
| null | null | null |
730505811
|
73050-58-11
|
CoronaVirus; Multiplex Amplified probe
|
Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) by nucleic acid (DNA or RNA), influenza virus types A and B multiplex amplified probe technique
| 21
|
Laboratory and Pathology
| 3,050
|
Chemistry & Microbiology
|
Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) by nucleic acid (DNA or RNA), influenza virus types A and B multiplex amplified probe technique
| null | null | null |
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