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15.5k
J9999
Not otherwise classified, antineoplastic drugs
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0359
Chemotherapy IV one hr initi
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
38230
PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0361
Prolong chemo infuse>8hrs pu
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0357
IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0356
HORMONAL ANTINEOPLASTIC
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0355
CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA...
G0358
IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0267
Bone marrow or psc harvest
CPT
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0360
Each additional hr 1-8 hrs
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0363
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
J9000
INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
S2140
Cord blood harvesting for transplantation, allogeneic
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0364
HC BONE MARROW ASPIRATE & BIOPSY
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0265
Cryopresevation Freeze+stora
CPT
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0362
Each add sequential infusion
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
J9999
Not otherwise classified, antineoplastic drugs
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0359
Chemotherapy IV one hr initi
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
38230
PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0361
Prolong chemo infuse>8hrs pu
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0357
IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0356
HORMONAL ANTINEOPLASTIC
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0266
Thawing + expansion froz cel
CPT
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
G0355
CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
S2142
Cord blood-derived stem-cell transplantation, allogeneic
HCPCS
POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC) 7/13/2004: Code Reference section completed 7/1/2004: Reviewed...
86826
Hla x-match noncytotoxc addl
HCPCS
CPT4/HCPCS revisions added to policy 5/18/2007: Policy reviewed, no changes 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions 7/14/2008: Policy updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplanta...
G0267
Bone marrow or psc harvest
CPT
CPT4/HCPCS revisions added to policy 5/18/2007: Policy reviewed, no changes 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions 7/14/2008: Policy updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplanta...
G0363
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
HCPCS
CPT4/HCPCS revisions added to policy 5/18/2007: Policy reviewed, no changes 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions 7/14/2008: Policy updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplanta...
S2140
Cord blood harvesting for transplantation, allogeneic
HCPCS
CPT4/HCPCS revisions added to policy 5/18/2007: Policy reviewed, no changes 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions 7/14/2008: Policy updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplanta...
G0265
Cryopresevation Freeze+stora
CPT
CPT4/HCPCS revisions added to policy 5/18/2007: Policy reviewed, no changes 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions 7/14/2008: Policy updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplanta...
G0266
Thawing + expansion froz cel
CPT
CPT4/HCPCS revisions added to policy 5/18/2007: Policy reviewed, no changes 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions 7/14/2008: Policy updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplanta...
86825
X-MATCHAHG
HCPCS
CPT4/HCPCS revisions added to policy 5/18/2007: Policy reviewed, no changes 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions 7/14/2008: Policy updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplanta...
S2142
Cord blood-derived stem-cell transplantation, allogeneic
HCPCS
CPT4/HCPCS revisions added to policy 5/18/2007: Policy reviewed, no changes 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions 7/14/2008: Policy updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplanta...
86826
Hla x-match noncytotoxc addl
HCPCS
High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual...
G0267
Bone marrow or psc harvest
CPT
High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual...
G0363
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
HCPCS
High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual...
S2140
Cord blood harvesting for transplantation, allogeneic
HCPCS
High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual...
G0265
Cryopresevation Freeze+stora
CPT
High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual...
G0266
Thawing + expansion froz cel
CPT
High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual...
86825
X-MATCHAHG
HCPCS
High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual...
S2142
Cord blood-derived stem-cell transplantation, allogeneic
HCPCS
High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual...
86826
Hla x-match noncytotoxc addl
HCPCS
High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied 1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted 8/07/200...
G0267
Bone marrow or psc harvest
CPT
High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied 1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted 8/07/200...
G0363
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
HCPCS
High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied 1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted 8/07/200...
S2140
Cord blood harvesting for transplantation, allogeneic
HCPCS
High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied 1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted 8/07/200...
G0265
Cryopresevation Freeze+stora
CPT
High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied 1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted 8/07/200...
G0266
Thawing + expansion froz cel
CPT
High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied 1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted 8/07/200...
86825
X-MATCHAHG
HCPCS
High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied 1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted 8/07/200...
S2142
Cord blood-derived stem-cell transplantation, allogeneic
HCPCS
High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support 9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied 1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted 8/07/200...
00872
ANESTH KIDNEY STONE DESTRUCT
CPT
POLICY HISTORY3/1993: ESWT for Gallstones approved by Medical Policy Advisory Committee (MPAC) 9/1994: ESWT for Kidney Stone approved by Medical Policy Advisory Committee (MPAC) 4/6/2001: Policy reviewed; Title changed to "ESWT", ESWT for kidney stones policy combined with ESWT for gallstones policy, ESWT for salivary ...
0020T
XTRACORP SHOCK WAVE THERAPY-INVLV PLANTAR FASC
CPT
POLICY HISTORY3/1993: ESWT for Gallstones approved by Medical Policy Advisory Committee (MPAC) 9/1994: ESWT for Kidney Stone approved by Medical Policy Advisory Committee (MPAC) 4/6/2001: Policy reviewed; Title changed to "ESWT", ESWT for kidney stones policy combined with ESWT for gallstones policy, ESWT for salivary ...
00873
ANESTH KIDNEY STONE DESTRUCT
CPT
POLICY HISTORY3/1993: ESWT for Gallstones approved by Medical Policy Advisory Committee (MPAC) 9/1994: ESWT for Kidney Stone approved by Medical Policy Advisory Committee (MPAC) 4/6/2001: Policy reviewed; Title changed to "ESWT", ESWT for kidney stones policy combined with ESWT for gallstones policy, ESWT for salivary ...
0020T
XTRACORP SHOCK WAVE THERAPY-INVLV PLANTAR FASC
CPT
Policy exception - FEP subscribers only - for ESWT treatment of gallstones added. 10/2/2001: New 2002 codes added 2/8/2002: Investigational definition added 4/22/2002: Type of Service and Place of Service deleted 5/7/2002: Code Reference section updated, ICD-9 diagnosis code 726.71, 726.72, 726.79, 726.90, 727.00, 727....
00873
ANESTH KIDNEY STONE DESTRUCT
CPT
Policy exception - FEP subscribers only - for ESWT treatment of gallstones added. 10/2/2001: New 2002 codes added 2/8/2002: Investigational definition added 4/22/2002: Type of Service and Place of Service deleted 5/7/2002: Code Reference section updated, ICD-9 diagnosis code 726.71, 726.72, 726.79, 726.90, 727.00, 727....
00872
ANESTH KIDNEY STONE DESTRUCT
CPT
Policy exception - FEP subscribers only - for ESWT treatment of gallstones added. 10/2/2001: New 2002 codes added 2/8/2002: Investigational definition added 4/22/2002: Type of Service and Place of Service deleted 5/7/2002: Code Reference section updated, ICD-9 diagnosis code 726.71, 726.72, 726.79, 726.90, 727.00, 727....
28899
HC UNLISTED PROCEDURE, FOOT OR TOES
HCPCS
Policy exception - FEP subscribers only - for ESWT treatment of gallstones added. 10/2/2001: New 2002 codes added 2/8/2002: Investigational definition added 4/22/2002: Type of Service and Place of Service deleted 5/7/2002: Code Reference section updated, ICD-9 diagnosis code 726.71, 726.72, 726.79, 726.90, 727.00, 727....
48999
HC UNLISTED PROCEDURE PANCREAS
HCPCS
Policy exception - FEP subscribers only - for ESWT treatment of gallstones added. 10/2/2001: New 2002 codes added 2/8/2002: Investigational definition added 4/22/2002: Type of Service and Place of Service deleted 5/7/2002: Code Reference section updated, ICD-9 diagnosis code 726.71, 726.72, 726.79, 726.90, 727.00, 727....
52353
PR CYSTO W/URETEROSCOPY W/LITHOTRIPSY
HCPCS
Policy exception - FEP subscribers only - for ESWT treatment of gallstones added. 10/2/2001: New 2002 codes added 2/8/2002: Investigational definition added 4/22/2002: Type of Service and Place of Service deleted 5/7/2002: Code Reference section updated, ICD-9 diagnosis code 726.71, 726.72, 726.79, 726.90, 727.00, 727....
0020T
XTRACORP SHOCK WAVE THERAPY-INVLV PLANTAR FASC
CPT
10/2/2001: New 2002 codes added 2/8/2002: Investigational definition added 4/22/2002: Type of Service and Place of Service deleted 5/7/2002: Code Reference section updated, ICD-9 diagnosis code 726.71, 726.72, 726.79, 726.90, 727.00, 727.01, 727.02. 727.03, 727.04, 727.05, 726.06, 727.09, 727.82, 728.71, 728.79, 728.86...
00873
ANESTH KIDNEY STONE DESTRUCT
CPT
10/2/2001: New 2002 codes added 2/8/2002: Investigational definition added 4/22/2002: Type of Service and Place of Service deleted 5/7/2002: Code Reference section updated, ICD-9 diagnosis code 726.71, 726.72, 726.79, 726.90, 727.00, 727.01, 727.02. 727.03, 727.04, 727.05, 726.06, 727.09, 727.82, 728.71, 728.79, 728.86...
00872
ANESTH KIDNEY STONE DESTRUCT
CPT
10/2/2001: New 2002 codes added 2/8/2002: Investigational definition added 4/22/2002: Type of Service and Place of Service deleted 5/7/2002: Code Reference section updated, ICD-9 diagnosis code 726.71, 726.72, 726.79, 726.90, 727.00, 727.01, 727.02. 727.03, 727.04, 727.05, 726.06, 727.09, 727.82, 728.71, 728.79, 728.86...
28899
HC UNLISTED PROCEDURE, FOOT OR TOES
HCPCS
10/2/2001: New 2002 codes added 2/8/2002: Investigational definition added 4/22/2002: Type of Service and Place of Service deleted 5/7/2002: Code Reference section updated, ICD-9 diagnosis code 726.71, 726.72, 726.79, 726.90, 727.00, 727.01, 727.02. 727.03, 727.04, 727.05, 726.06, 727.09, 727.82, 728.71, 728.79, 728.86...
48999
HC UNLISTED PROCEDURE PANCREAS
HCPCS
10/2/2001: New 2002 codes added 2/8/2002: Investigational definition added 4/22/2002: Type of Service and Place of Service deleted 5/7/2002: Code Reference section updated, ICD-9 diagnosis code 726.71, 726.72, 726.79, 726.90, 727.00, 727.01, 727.02. 727.03, 727.04, 727.05, 726.06, 727.09, 727.82, 728.71, 728.79, 728.86...
52353
PR CYSTO W/URETEROSCOPY W/LITHOTRIPSY
HCPCS
10/2/2001: New 2002 codes added 2/8/2002: Investigational definition added 4/22/2002: Type of Service and Place of Service deleted 5/7/2002: Code Reference section updated, ICD-9 diagnosis code 726.71, 726.72, 726.79, 726.90, 727.00, 727.01, 727.02. 727.03, 727.04, 727.05, 726.06, 727.09, 727.82, 728.71, 728.79, 728.86...
0020T
XTRACORP SHOCK WAVE THERAPY-INVLV PLANTAR FASC
CPT
727.03, 727.04, 727.05, 726.06, 727.09, 727.82, 728.71, 728.79, 728.86, 728.89, 729.4 added to non-covered codes 5/2002: Reviewed by MPAC, ESWT criteria for kidney stones deleted, ESWT for chronic plantar fasciitis considered medically necessary as an alternative to surgery with certain criteria, Sources updated, CPT c...
00873
ANESTH KIDNEY STONE DESTRUCT
CPT
727.03, 727.04, 727.05, 726.06, 727.09, 727.82, 728.71, 728.79, 728.86, 728.89, 729.4 added to non-covered codes 5/2002: Reviewed by MPAC, ESWT criteria for kidney stones deleted, ESWT for chronic plantar fasciitis considered medically necessary as an alternative to surgery with certain criteria, Sources updated, CPT c...
00872
ANESTH KIDNEY STONE DESTRUCT
CPT
727.03, 727.04, 727.05, 726.06, 727.09, 727.82, 728.71, 728.79, 728.86, 728.89, 729.4 added to non-covered codes 5/2002: Reviewed by MPAC, ESWT criteria for kidney stones deleted, ESWT for chronic plantar fasciitis considered medically necessary as an alternative to surgery with certain criteria, Sources updated, CPT c...
28899
HC UNLISTED PROCEDURE, FOOT OR TOES
HCPCS
727.03, 727.04, 727.05, 726.06, 727.09, 727.82, 728.71, 728.79, 728.86, 728.89, 729.4 added to non-covered codes 5/2002: Reviewed by MPAC, ESWT criteria for kidney stones deleted, ESWT for chronic plantar fasciitis considered medically necessary as an alternative to surgery with certain criteria, Sources updated, CPT c...
48999
HC UNLISTED PROCEDURE PANCREAS
HCPCS
727.03, 727.04, 727.05, 726.06, 727.09, 727.82, 728.71, 728.79, 728.86, 728.89, 729.4 added to non-covered codes 5/2002: Reviewed by MPAC, ESWT criteria for kidney stones deleted, ESWT for chronic plantar fasciitis considered medically necessary as an alternative to surgery with certain criteria, Sources updated, CPT c...
52353
PR CYSTO W/URETEROSCOPY W/LITHOTRIPSY
HCPCS
727.03, 727.04, 727.05, 726.06, 727.09, 727.82, 728.71, 728.79, 728.86, 728.89, 729.4 added to non-covered codes 5/2002: Reviewed by MPAC, ESWT criteria for kidney stones deleted, ESWT for chronic plantar fasciitis considered medically necessary as an alternative to surgery with certain criteria, Sources updated, CPT c...
A9505
TL201 THALLOUS CL DX MCI Injectable Drugs Not on Fee Schedule
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
A4642
RRX INDIUM 111 SATUMOMAB DX 0 6MCI
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
S8080
SCINTIMAMMO UNI W/SPL RADIOPHARM
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
A4641
RADIOPHARM DX NOC Injectable Drugs Not on Fee Schedule
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
A9500
TECHNETIUM TC 99M SESTAMIBI IV KIT
HCPCS
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus...
A9505
TL201 THALLOUS CL DX MCI Injectable Drugs Not on Fee Schedule
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 1/29/2001: HCPCS A4642 added 2/11/2002: Investigational definition added 5/2/2002: Type of Service and Place...
A4642
RRX INDIUM 111 SATUMOMAB DX 0 6MCI
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 1/29/2001: HCPCS A4642 added 2/11/2002: Investigational definition added 5/2/2002: Type of Service and Place...
A9549
Tc99m arcitumomab
CPT
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 1/29/2001: HCPCS A4642 added 2/11/2002: Investigational definition added 5/2/2002: Type of Service and Place...
A9565
In111 pentetreotide
CPT
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 1/29/2001: HCPCS A4642 added 2/11/2002: Investigational definition added 5/2/2002: Type of Service and Place...
S8080
SCINTIMAMMO UNI W/SPL RADIOPHARM
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 1/29/2001: HCPCS A4642 added 2/11/2002: Investigational definition added 5/2/2002: Type of Service and Place...
A4641
RADIOPHARM DX NOC Injectable Drugs Not on Fee Schedule
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 1/29/2001: HCPCS A4642 added 2/11/2002: Investigational definition added 5/2/2002: Type of Service and Place...
A9500
TECHNETIUM TC 99M SESTAMIBI IV KIT
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 1/29/2001: HCPCS A4642 added 2/11/2002: Investigational definition added 5/2/2002: Type of Service and Place...
00100
ANESTH SALIVARY GLAND
CPT
The more than 7,000 five-character CPT Codes are an important part of the billing process. They are used by insurers to aid in determining the amount of reimbursement the physician or healthcare provider will receive for services rendered. - CPT Codes are copyrighted and maintained by the American Medical Association (...
00100
ANESTH SALIVARY GLAND
CPT
- CPT Codes are copyrighted and maintained by the American Medical Association (AMA). Updated annually, these codes fall into three major categories. - Category I- The code range is 00100 to 99499. Each five-digit code has a corresponding description of the procedure or service. - Category II – These are more of alphan...
1999
ANESTHESIOLOGY GROUP
CPT
CPT codes help government agencies keep tabs on the value and prevalence of particular procedures whereas hospitals may evaluate the efficiency of divisions and individuals in their facility using Current Procedural Terminology Codes. CPT Code Categories Category I is concerning procedures and contemporary medical prac...
00100
ANESTH SALIVARY GLAND
CPT
CPT codes help government agencies keep tabs on the value and prevalence of particular procedures whereas hospitals may evaluate the efficiency of divisions and individuals in their facility using Current Procedural Terminology Codes. CPT Code Categories Category I is concerning procedures and contemporary medical prac...
01999
Unlisted anesth procedure
CPT
CPT codes help government agencies keep tabs on the value and prevalence of particular procedures whereas hospitals may evaluate the efficiency of divisions and individuals in their facility using Current Procedural Terminology Codes. CPT Code Categories Category I is concerning procedures and contemporary medical prac...
1999
ANESTHESIOLOGY GROUP
CPT
CPT Code Categories Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This cat...
00100
ANESTH SALIVARY GLAND
CPT
CPT Code Categories Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This cat...
10000
Incision & drainage of sebaceous cyst-one
CPT
CPT Code Categories Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This cat...
01999
Unlisted anesth procedure
CPT
CPT Code Categories Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This cat...
1999
ANESTHESIOLOGY GROUP
CPT
This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This category is broken down into six sections and they are: Evaluation and Management (99201-99499) – which includes hospital observat...
00100
ANESTH SALIVARY GLAND
CPT
This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This category is broken down into six sections and they are: Evaluation and Management (99201-99499) – which includes hospital observat...
10000
Incision & drainage of sebaceous cyst-one
CPT
This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This category is broken down into six sections and they are: Evaluation and Management (99201-99499) – which includes hospital observat...
01999
Unlisted anesth procedure
CPT
This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA and performed by a physician or healthcare professional. This category is broken down into six sections and they are: Evaluation and Management (99201-99499) – which includes hospital observat...
99199
Unlisted special svc px/rprt
CPT
Radiology (70000-79999) –including ultrasound, mammography, bone/joint, oncology, and nuclear medicine. Pathology and Laboratory (80000–89398) – including organ or disease-oriented panels, drug testing, therapeutic drug assays, evocative/suppression testing, consultations (clinical pathology), urinalysis, transfusion m...
99199
Unlisted special svc px/rprt
CPT
Medicine (90281–99099; 99151–99199; 99500–99607) – including vaccines, toxoids, psychiatry, biofeedback, dialysis, gastroenterology, ophthalmology, special otorhinolaryngologic services, cardiovascular, noninvasive vascular diagnostic studies, pulmonary, allergy and clinical immunology, endocrinology and more. Category...
11710
Debridement of nails-electric grinder-five or less
CPT
For example, a doctor may provide documentation of a mole removed from the torso of a patient via cryoablation (essentially, freezing the mole). The medical biller and coder would look at the procedure documentation and decide which codes correspond to the diagnosis and procedure listed. In the case of this example, a ...
28309
PR OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT
HCPCS
A cast is placed on the foot during the tenotomy procedure, but this is not billable because it’s not a separately identifiable procedure. More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, part...
L1960
HC SUPPLY ANKLE FOOT ORTHOSIS POSTERIOR SOLID ANKLE CUSTOM - L1960
HCPCS
A cast is placed on the foot during the tenotomy procedure, but this is not billable because it’s not a separately identifiable procedure. More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, part...