code
stringlengths
4
12
description
stringlengths
2
264
codetype
stringclasses
8 values
context
stringlengths
160
15.5k
21150
PR RCNSTJ MIDFACE LEFORT II ANTERIOR INTRUSION
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
70140
XR FACIAL BONES 2 VIEWS
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
70100
XR MANDIBLE 2 VIEWS
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
21244
Reconstruction of lower jaw
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
D7995
Synthetic graft facial bones
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
D2915
Recement cast or prefab post
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
21199
Reconstr lwr jaw w/advance
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
70110
XR MANDIBLE 4 VIEWS
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
21193
Reconst lwr jaw w/o graft
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
D2970
Temp crown (fractured tooth)
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
70250
XR Skull < 4 Views
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
21440
Treat dental ridge fracture
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
D2940
PR PROTECTIVE RESTORATION
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
70260
XR SKULL 4 VIEWS
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
70150
XR FACIAL BONES 3 VIEWS
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
21147
PR RCNSTJ MIDFACE LEFORT I 3/> PIECE W/BONE GRAFTS
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
21025
PR EXCISION BONE MANDIBLE
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
D0290
Skull/facial bone image
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
A4595
TENS suppl 2 lead per month
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
21151
PR RCNSTJ MIDFACE LEFORT II W/BONE GRAFTS
HCPCS
CPT codes 21025-21049, 21141-21147, 21150, 21151, 21193-21196, 21198, 21199, 21244-21255, 21440-21470, 70100, 70110, 70140, 70150, 70250, 70260 removed from covered table. ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered ...
D7995
Synthetic graft facial bones
HCPCS
ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/...
A4630
Repl bat t.e.n.s. own by pt
HCPCS
ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/...
D2940
PR PROTECTIVE RESTORATION
HCPCS
ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/...
D2915
Recement cast or prefab post
HCPCS
ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/...
E0731
Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient''s skin by layers of fabric)
HCPCS
ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/...
S8262
MANDIB ORTHO REPOSITION DEVICE EACH
CPT
ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/...
D5225
PR MAXILLARY PARTIAL DENTURE FLEX BASE
HCPCS
ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/...
D2971
PR ADD PROC NEW CROWN XST PART DENTURE
HCPCS
ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/...
D2934
PR PREFB ESTHET COAT STNLSS STEEL CRWN
HCPCS
ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/...
E0936
CPM device, other than knee
HCPCS
ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/...
D5226
PR MANDIBULAR PART DENTURE FLEX BASE
HCPCS
ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/...
D2970
Temp crown (fractured tooth)
HCPCS
ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/...
D0290
Skull/facial bone image
HCPCS
ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/...
A4595
TENS suppl 2 lead per month
HCPCS
ICD-9 procedure codes 76.2, 76.73-76.76, 76.91, 76.92, 80.19 removed from covered table. ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/...
D7995
Synthetic graft facial bones
HCPCS
ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy d...
A4630
Repl bat t.e.n.s. own by pt
HCPCS
ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy d...
D2940
PR PROTECTIVE RESTORATION
HCPCS
ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy d...
D2915
Recement cast or prefab post
HCPCS
ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy d...
E0731
Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient''s skin by layers of fabric)
HCPCS
ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy d...
S8262
MANDIB ORTHO REPOSITION DEVICE EACH
CPT
ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy d...
D5225
PR MAXILLARY PARTIAL DENTURE FLEX BASE
HCPCS
ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy d...
D2971
PR ADD PROC NEW CROWN XST PART DENTURE
HCPCS
ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy d...
D2934
PR PREFB ESTHET COAT STNLSS STEEL CRWN
HCPCS
ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy d...
E0936
CPM device, other than knee
HCPCS
ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy d...
D5226
PR MANDIBULAR PART DENTURE FLEX BASE
HCPCS
ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy d...
D2970
Temp crown (fractured tooth)
HCPCS
ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy d...
D0290
Skull/facial bone image
HCPCS
ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy d...
A4595
TENS suppl 2 lead per month
HCPCS
ICD-9 diagnosis codes 170.9 and 198.5 removed from covered table. HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy d...
D7995
Synthetic graft facial bones
HCPCS
HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Po...
A4630
Repl bat t.e.n.s. own by pt
HCPCS
HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Po...
D2940
PR PROTECTIVE RESTORATION
HCPCS
HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Po...
D2915
Recement cast or prefab post
HCPCS
HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Po...
E0731
Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient''s skin by layers of fabric)
HCPCS
HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Po...
S8262
MANDIB ORTHO REPOSITION DEVICE EACH
CPT
HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Po...
D5225
PR MAXILLARY PARTIAL DENTURE FLEX BASE
HCPCS
HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Po...
D2971
PR ADD PROC NEW CROWN XST PART DENTURE
HCPCS
HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Po...
D2934
PR PREFB ESTHET COAT STNLSS STEEL CRWN
HCPCS
HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Po...
E0936
CPM device, other than knee
HCPCS
HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Po...
D5226
PR MANDIBULAR PART DENTURE FLEX BASE
HCPCS
HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Po...
D2970
Temp crown (fractured tooth)
HCPCS
HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Po...
D0290
Skull/facial bone image
HCPCS
HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Po...
A4595
TENS suppl 2 lead per month
HCPCS
HCPCS D0290, D7995, and S8262 removed from covered. HCPCS A4595, A4630, D2915, D2934, D2970, D2971, D5225, D5226, D2940, E0731, E0936 added to non-covered table. 12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Po...
64570
Remove vagus n eltrd
HCPCS
12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Policy statement revised to acupuncture as an investigational non-surgical treatment. 10/19/2010: Annual ICD-9 code update: added new code 784.92 to the Covered Cod...
64568
PR OPEN IMPLANTATION CRANIAL NERVE NEA & PULSE GEN
HCPCS
12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Policy statement revised to acupuncture as an investigational non-surgical treatment. 10/19/2010: Annual ICD-9 code update: added new code 784.92 to the Covered Cod...
64569
Revise/repl vagus n eltrd
HCPCS
12/31/2008: Code reference section updated per 2009 CPT/HCPCS revisions 07/08/2010: Policy description updated regarding etiology and treatment approaches. Policy statement revised to acupuncture as an investigational non-surgical treatment. 10/19/2010: Annual ICD-9 code update: added new code 784.92 to the Covered Cod...
S8262
MANDIB ORTHO REPOSITION DEVICE EACH
CPT
Medical Necessity documentation and a treatment plan, including charges for each service, must be submitted to and approved prior to the commencement of treatment. No benefits will be provided for temporomandibular joint disorder when a Member receives services from a Non-Network Provider. Added CPT codes D0368, D0384,...
S8262
MANDIB ORTHO REPOSITION DEVICE EACH
CPT
No benefits will be provided for temporomandibular joint disorder when a Member receives services from a Non-Network Provider. Added CPT codes D0368, D0384, and S8262 to the Covered Codes table. Removed deleted CPT code D0360 from the Code Reference section. 09/19/2014: Policy reviewed; description updated. Policy stat...
E0485
Oral device/appliance prefab
HCPCS
Added the following new 2015 CPT code(s) to the Code Reference section: 20606. 09/01/2015: Code Reference section updated for ICD-10. Extended ICD-9 diagnosis code 524.8 to the fifth digit as 524.81, 524.82, and 524.89. Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes t...
E0486
Oral device/appliance cusfab
HCPCS
Added the following new 2015 CPT code(s) to the Code Reference section: 20606. 09/01/2015: Code Reference section updated for ICD-10. Extended ICD-9 diagnosis code 524.8 to the fifth digit as 524.81, 524.82, and 524.89. Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes t...
20606
PROFEE ARTHROCENTESIS OR INJ JNT OR BURS
HCPCS
Added the following new 2015 CPT code(s) to the Code Reference section: 20606. 09/01/2015: Code Reference section updated for ICD-10. Extended ICD-9 diagnosis code 524.8 to the fifth digit as 524.81, 524.82, and 524.89. Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes t...
E0485
Oral device/appliance prefab
HCPCS
09/01/2015: Code Reference section updated for ICD-10. Extended ICD-9 diagnosis code 524.8 to the fifth digit as 524.81, 524.82, and 524.89. Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes table: 87.17, 93.04, 93.05, 93.34, and 93.35. 09/14/2015: Added HCPCS codes E048...
E0486
Oral device/appliance cusfab
HCPCS
09/01/2015: Code Reference section updated for ICD-10. Extended ICD-9 diagnosis code 524.8 to the fifth digit as 524.81, 524.82, and 524.89. Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes table: 87.17, 93.04, 93.05, 93.34, and 93.35. 09/14/2015: Added HCPCS codes E048...
E0485
Oral device/appliance prefab
HCPCS
Extended ICD-9 diagnosis code 524.8 to the fifth digit as 524.81, 524.82, and 524.89. Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes table: 87.17, 93.04, 93.05, 93.34, and 93.35. 09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Pol...
D5660
PR ADD CLASP XST PRT DENTURE-PER TOOTH
HCPCS
Extended ICD-9 diagnosis code 524.8 to the fifth digit as 524.81, 524.82, and 524.89. Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes table: 87.17, 93.04, 93.05, 93.34, and 93.35. 09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Pol...
E0486
Oral device/appliance cusfab
HCPCS
Extended ICD-9 diagnosis code 524.8 to the fifth digit as 524.81, 524.82, and 524.89. Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes table: 87.17, 93.04, 93.05, 93.34, and 93.35. 09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Pol...
D5875
Prosthesis modification
HCPCS
Extended ICD-9 diagnosis code 524.8 to the fifth digit as 524.81, 524.82, and 524.89. Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes table: 87.17, 93.04, 93.05, 93.34, and 93.35. 09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Pol...
D0340
PR 2D CEPHALOMET X-RAY-ACQN MSR&ANALY
HCPCS
Extended ICD-9 diagnosis code 524.8 to the fifth digit as 524.81, 524.82, and 524.89. Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes table: 87.17, 93.04, 93.05, 93.34, and 93.35. 09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Pol...
D5630
Rep partial denture clasp
HCPCS
Extended ICD-9 diagnosis code 524.8 to the fifth digit as 524.81, 524.82, and 524.89. Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes table: 87.17, 93.04, 93.05, 93.34, and 93.35. 09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Pol...
E0485
Oral device/appliance prefab
HCPCS
Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes table: 87.17, 93.04, 93.05, 93.34, and 93.35. 09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code ...
D5660
PR ADD CLASP XST PRT DENTURE-PER TOOTH
HCPCS
Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes table: 87.17, 93.04, 93.05, 93.34, and 93.35. 09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code ...
E0486
Oral device/appliance cusfab
HCPCS
Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes table: 87.17, 93.04, 93.05, 93.34, and 93.35. 09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code ...
D5875
Prosthesis modification
HCPCS
Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes table: 87.17, 93.04, 93.05, 93.34, and 93.35. 09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code ...
D0340
PR 2D CEPHALOMET X-RAY-ACQN MSR&ANALY
HCPCS
Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes table: 87.17, 93.04, 93.05, 93.34, and 93.35. 09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code ...
D5630
Rep partial denture clasp
HCPCS
Removed the following ICD-9 procedure codes from the Not Medically Necessary/Investigational Codes table: 87.17, 93.04, 93.05, 93.34, and 93.35. 09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code ...
E0485
Oral device/appliance prefab
HCPCS
09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code Reference section updated to revise the descriptions for the following HCPCS codes: D0340, D5630, D5660, and D5875. 02/19/2016: Policy descriptio...
D5660
PR ADD CLASP XST PRT DENTURE-PER TOOTH
HCPCS
09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code Reference section updated to revise the descriptions for the following HCPCS codes: D0340, D5630, D5660, and D5875. 02/19/2016: Policy descriptio...
E0486
Oral device/appliance cusfab
HCPCS
09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code Reference section updated to revise the descriptions for the following HCPCS codes: D0340, D5630, D5660, and D5875. 02/19/2016: Policy descriptio...
D5875
Prosthesis modification
HCPCS
09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code Reference section updated to revise the descriptions for the following HCPCS codes: D0340, D5630, D5660, and D5875. 02/19/2016: Policy descriptio...
D0340
PR 2D CEPHALOMET X-RAY-ACQN MSR&ANALY
HCPCS
09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code Reference section updated to revise the descriptions for the following HCPCS codes: D0340, D5630, D5660, and D5875. 02/19/2016: Policy descriptio...
D5630
Rep partial denture clasp
HCPCS
09/14/2015: Added HCPCS codes E0485 and E0486 to the Covered Codes table. 12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code Reference section updated to revise the descriptions for the following HCPCS codes: D0340, D5630, D5660, and D5875. 02/19/2016: Policy descriptio...
D5875
Prosthesis modification
HCPCS
12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code Reference section updated to revise the descriptions for the following HCPCS codes: D0340, D5630, D5660, and D5875. 02/19/2016: Policy description updated regarding devices. Policy statement unchanged. 06/01/2016: Polic...
D0340
PR 2D CEPHALOMET X-RAY-ACQN MSR&ANALY
HCPCS
12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code Reference section updated to revise the descriptions for the following HCPCS codes: D0340, D5630, D5660, and D5875. 02/19/2016: Policy description updated regarding devices. Policy statement unchanged. 06/01/2016: Polic...
D5630
Rep partial denture clasp
HCPCS
12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code Reference section updated to revise the descriptions for the following HCPCS codes: D0340, D5630, D5660, and D5875. 02/19/2016: Policy description updated regarding devices. Policy statement unchanged. 06/01/2016: Polic...
D5660
PR ADD CLASP XST PRT DENTURE-PER TOOTH
HCPCS
12/31/2015: Policy guidelines updated to add medically necessary and investigative definitions. Code Reference section updated to revise the descriptions for the following HCPCS codes: D0340, D5630, D5660, and D5875. 02/19/2016: Policy description updated regarding devices. Policy statement unchanged. 06/01/2016: Polic...
0230
Incremental Nursing Charge - General Classification
RC
SOURCE(S)Blue Cross Blue Shield Association policy # 2.01.21 CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document. Arthroscopy, temporomandib...
0210
Other Inpatient
RC
SOURCE(S)Blue Cross Blue Shield Association policy # 2.01.21 CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document. Arthroscopy, temporomandib...
G0358
IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG
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...
G0360
Each additional hr 1-8 hrs
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...
G0363
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
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...
J9000
INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG
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...