code stringlengths 4 12 | description stringlengths 2 264 | codetype stringclasses 8
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1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | HCPCS | HCPCS was initially used voluntarily by medical entities, but after the implementation of HIPAA or also known as the name Health Insurance Portability and Accountability Act, since 1996, transaction codes were reported in HCPCS codes. On the other hand, ICD 10 had its first inception in 2015, and it is globally managed... |
90868 | PR THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG | 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... |
90867 | PR REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M | 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... |
0161T | Tcranial magn stim tx deliv | 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... |
0160T | Tcranial Magn Stim Tx Plan | 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... |
90868 | PR THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG | 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 HISTORY7/1994: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Reviewed by MPAC; investigational status maintained
2/11/2002: Investigational definition added
5/7/... |
90867 | PR REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M | 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 HISTORY7/1994: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Reviewed by MPAC; investigational status maintained
2/11/2002: Investigational definition added
5/7/... |
0161T | Tcranial magn stim tx deliv | 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 HISTORY7/1994: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Reviewed by MPAC; investigational status maintained
2/11/2002: Investigational definition added
5/7/... |
0160T | Tcranial Magn Stim Tx Plan | 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 HISTORY7/1994: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Reviewed by MPAC; investigational status maintained
2/11/2002: Investigational definition added
5/7/... |
90868 | PR THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG | HCPCS | POLICY HISTORY7/1994: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Reviewed by MPAC; investigational status maintained
2/11/2002: Investigational definition added
5/7/2002: Type of Service and Place of Service deleted
11/5/2003: Code Reference section completed
3/11/2004: Sources updated
6/23/2004: Poli... |
90867 | PR REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M | HCPCS | POLICY HISTORY7/1994: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Reviewed by MPAC; investigational status maintained
2/11/2002: Investigational definition added
5/7/2002: Type of Service and Place of Service deleted
11/5/2003: Code Reference section completed
3/11/2004: Sources updated
6/23/2004: Poli... |
0161T | Tcranial magn stim tx deliv | HCPCS | POLICY HISTORY7/1994: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Reviewed by MPAC; investigational status maintained
2/11/2002: Investigational definition added
5/7/2002: Type of Service and Place of Service deleted
11/5/2003: Code Reference section completed
3/11/2004: Sources updated
6/23/2004: Poli... |
0160T | Tcranial Magn Stim Tx Plan | HCPCS | POLICY HISTORY7/1994: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Reviewed by MPAC; investigational status maintained
2/11/2002: Investigational definition added
5/7/2002: Type of Service and Place of Service deleted
11/5/2003: Code Reference section completed
3/11/2004: Sources updated
6/23/2004: Poli... |
0161 | Med-Surg | RC | 07/23/2015: Code Reference section updated for ICD-10. Removed deleted CPT codes 0160T and 0161T. 04/26/2016: Policy Guidelines updated to revise investigative definition. 06/06/2016: Policy number added. SOURCE(S)Blue Cross Blue Shield Association policy # 2.01.24
CODE REFERENCEThis may not be a comprehensive list of ... |
0160 | ROOM & BOARD - OTHER - GENERAL CLASSIFICATION | RC | 07/23/2015: Code Reference section updated for ICD-10. Removed deleted CPT codes 0160T and 0161T. 04/26/2016: Policy Guidelines updated to revise investigative definition. 06/06/2016: Policy number added. SOURCE(S)Blue Cross Blue Shield Association policy # 2.01.24
CODE REFERENCEThis may not be a comprehensive list of ... |
0161 | Med-Surg | RC | Removed deleted CPT codes 0160T and 0161T. 04/26/2016: Policy Guidelines updated to revise investigative definition. 06/06/2016: Policy number added. SOURCE(S)Blue Cross Blue Shield Association policy # 2.01.24
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
0160 | ROOM & BOARD - OTHER - GENERAL CLASSIFICATION | RC | Removed deleted CPT codes 0160T and 0161T. 04/26/2016: Policy Guidelines updated to revise investigative definition. 06/06/2016: Policy number added. SOURCE(S)Blue Cross Blue Shield Association policy # 2.01.24
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
A4639 | Replacement pad for infrared heating pad system, each | HCPCS | For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of m... |
1999 | ANESTHESIOLOGY GROUP | CPT | For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of m... |
E0692 | Uvl sys panel 4 ft | HCPCS | For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of m... |
97028 | Ultraviolet therapy | HCPCS | For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of m... |
S9098 | Home phototherapy visit | HCPCS | For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of m... |
E0202 | Phototherapy light w/ photom | HCPCS | For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of m... |
A4634 | Replacement bulb th lightbox | HCPCS | For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of m... |
E0694 | Uvl md cabinet sys 6 ft | HCPCS | For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of m... |
E0691 | Uvl pnl 2 sq ft or less | HCPCS | For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of m... |
A4633 | Uvl replacement bulb | HCPCS | For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of m... |
E0690 | UV CABINET APPROPRIATE HOME USE | CPT | For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of m... |
E0693 | Uvl sys panel 6 ft | HCPCS | For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of m... |
A4639 | Replacement pad for infrared heating pad system, each | 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... |
1999 | ANESTHESIOLOGY GROUP | CPT | 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... |
E0692 | Uvl sys panel 4 ft | 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... |
97028 | Ultraviolet therapy | 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... |
S9098 | Home phototherapy visit | 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... |
E0202 | Phototherapy light w/ photom | 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... |
A4634 | Replacement bulb th lightbox | 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... |
E0694 | Uvl md cabinet sys 6 ft | 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... |
E0691 | Uvl pnl 2 sq ft or less | 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... |
A4633 | Uvl replacement bulb | 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... |
E0690 | UV CABINET APPROPRIATE HOME USE | CPT | 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... |
E0693 | Uvl sys panel 6 ft | 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... |
A4639 | Replacement pad for infrared heating pad system, each | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service... |
1999 | ANESTHESIOLOGY GROUP | CPT | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service... |
E0692 | Uvl sys panel 4 ft | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service... |
97028 | Ultraviolet therapy | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service... |
S9098 | Home phototherapy visit | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service... |
E0202 | Phototherapy light w/ photom | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service... |
A4634 | Replacement bulb th lightbox | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service... |
E0694 | Uvl md cabinet sys 6 ft | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service... |
E0691 | Uvl pnl 2 sq ft or less | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service... |
A4633 | Uvl replacement bulb | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service... |
E0690 | UV CABINET APPROPRIATE HOME USE | CPT | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service... |
E0693 | Uvl sys panel 6 ft | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service... |
90832 | Psytx w pt 30 minutes | HCPCS | The authors concluded that these findings suggested that EMDR may be an effective treatment modality for post-operative pain. These preliminary findings need to be validated by well-designed studies. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes.... |
90899 | HC UNLISTED PSYCHIATRIC SERVICE | HCPCS | The authors concluded that these findings suggested that EMDR may be an effective treatment modality for post-operative pain. These preliminary findings need to be validated by well-designed studies. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes.... |
90832 | Psytx w pt 30 minutes | HCPCS | These preliminary findings need to be validated by well-designed studies. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|There is no specific CPT code for eye movement desensitization and ... |
90899 | HC UNLISTED PSYCHIATRIC SERVICE | HCPCS | These preliminary findings need to be validated by well-designed studies. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|There is no specific CPT code for eye movement desensitization and ... |
G0202 | Scr mammo bi incl cad | HCPCS | Digital screening mammogram with CAD was performed. Findings: Negative. CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.11
Example 2:Patient is a 52-year old female with a personal history of breast cancer, fully resolved status post right breast mastectomy in 1992. She presents for annual digital screening mammogram... |
77052 | Comp screen mammogram add-on | HCPCS | Digital screening mammogram with CAD was performed. Findings: Negative. CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.11
Example 2:Patient is a 52-year old female with a personal history of breast cancer, fully resolved status post right breast mastectomy in 1992. She presents for annual digital screening mammogram... |
G0202 | Scr mammo bi incl cad | HCPCS | CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.11
Example 2:Patient is a 52-year old female with a personal history of breast cancer, fully resolved status post right breast mastectomy in 1992. She presents for annual digital screening mammogram with CAD. CPT/HCPCS Codes: G0202-52, 77052
ICD-9-CM Codes: V76.11, V10.... |
77052 | Comp screen mammogram add-on | HCPCS | CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.11
Example 2:Patient is a 52-year old female with a personal history of breast cancer, fully resolved status post right breast mastectomy in 1992. She presents for annual digital screening mammogram with CAD. CPT/HCPCS Codes: G0202-52, 77052
ICD-9-CM Codes: V76.11, V10.... |
G0202 | Scr mammo bi incl cad | HCPCS | Bilateral subglandular breast implants are noted. Implants appear stable and mammographically intact. CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.12
Aimee Wilcox, MA, CST, CCS-P is a Certified Coding Guru (CCG) for Find-A-Code. For more information about ICD-10-CM, ICD-10-PCS, and medical coding and billing pleas... |
77052 | Comp screen mammogram add-on | HCPCS | Bilateral subglandular breast implants are noted. Implants appear stable and mammographically intact. CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.12
Aimee Wilcox, MA, CST, CCS-P is a Certified Coding Guru (CCG) for Find-A-Code. For more information about ICD-10-CM, ICD-10-PCS, and medical coding and billing pleas... |
G0202 | Scr mammo bi incl cad | HCPCS | Implants appear stable and mammographically intact. CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.12
Aimee Wilcox, MA, CST, CCS-P is a Certified Coding Guru (CCG) for Find-A-Code. For more information about ICD-10-CM, ICD-10-PCS, and medical coding and billing please visit FindACode.com where you will find the ICD-... |
77052 | Comp screen mammogram add-on | HCPCS | Implants appear stable and mammographically intact. CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.12
Aimee Wilcox, MA, CST, CCS-P is a Certified Coding Guru (CCG) for Find-A-Code. For more information about ICD-10-CM, ICD-10-PCS, and medical coding and billing please visit FindACode.com where you will find the ICD-... |
97003 | Ot evaluation | HCPCS | This cross-mapping is usually a behind-the scenes process that happens with an encoder or an electronic billing/coding system. SNOMED-CT uses an 8-digit numeric system for classifications, whereas ICD-9 uses a 3 digit primary code with a 1-2 digit extender if needed. ICD-10 and HCPCS use both alpha and numeric systems.... |
71060 | Contrast x-ray of bronchi | HCPCS | This cross-mapping is usually a behind-the scenes process that happens with an encoder or an electronic billing/coding system. SNOMED-CT uses an 8-digit numeric system for classifications, whereas ICD-9 uses a 3 digit primary code with a 1-2 digit extender if needed. ICD-10 and HCPCS use both alpha and numeric systems.... |
29710 | Removal/revision of cast | HCPCS | This cross-mapping is usually a behind-the scenes process that happens with an encoder or an electronic billing/coding system. SNOMED-CT uses an 8-digit numeric system for classifications, whereas ICD-9 uses a 3 digit primary code with a 1-2 digit extender if needed. ICD-10 and HCPCS use both alpha and numeric systems.... |
97003 | Ot evaluation | HCPCS | ICD-10 and HCPCS use both alpha and numeric systems. As the coder/biller you are the expert, so you should never rely solely on a cross-map. As you can see in the last example in the table, SNOMED-CT has the code for primary infertility cross-mapped to show both a male and a female ICD-9 code
SNOMED CT ICD-9
20897003 a... |
71060 | Contrast x-ray of bronchi | HCPCS | ICD-10 and HCPCS use both alpha and numeric systems. As the coder/biller you are the expert, so you should never rely solely on a cross-map. As you can see in the last example in the table, SNOMED-CT has the code for primary infertility cross-mapped to show both a male and a female ICD-9 code
SNOMED CT ICD-9
20897003 a... |
29710 | Removal/revision of cast | HCPCS | ICD-10 and HCPCS use both alpha and numeric systems. As the coder/biller you are the expert, so you should never rely solely on a cross-map. As you can see in the last example in the table, SNOMED-CT has the code for primary infertility cross-mapped to show both a male and a female ICD-9 code
SNOMED CT ICD-9
20897003 a... |
97003 | Ot evaluation | HCPCS | As the coder/biller you are the expert, so you should never rely solely on a cross-map. As you can see in the last example in the table, SNOMED-CT has the code for primary infertility cross-mapped to show both a male and a female ICD-9 code
SNOMED CT ICD-9
20897003 atrophy of breast 611.4 atrophy of breast
78623009 end... |
71060 | Contrast x-ray of bronchi | HCPCS | As the coder/biller you are the expert, so you should never rely solely on a cross-map. As you can see in the last example in the table, SNOMED-CT has the code for primary infertility cross-mapped to show both a male and a female ICD-9 code
SNOMED CT ICD-9
20897003 atrophy of breast 611.4 atrophy of breast
78623009 end... |
29710 | Removal/revision of cast | HCPCS | As the coder/biller you are the expert, so you should never rely solely on a cross-map. As you can see in the last example in the table, SNOMED-CT has the code for primary infertility cross-mapped to show both a male and a female ICD-9 code
SNOMED CT ICD-9
20897003 atrophy of breast 611.4 atrophy of breast
78623009 end... |
L7190 | Electronic elbow, adolescent, variety village or equal, myoelectronically controlled | HCPCS | 07/19/2012: Policy title changed back to "Myoelectric Prosthesis for the Upper Limb." Added the following policy statement: A prosthesis with individually powered digits, including but not limited to a partial hand prosthesis, is considered investigational. 09/03/2013: Policy title changed from "Myoelectric Prosthesis ... |
L7191 | Electronic elbow, child, variety village or equal, myoelectronically controlled | HCPCS | 07/19/2012: Policy title changed back to "Myoelectric Prosthesis for the Upper Limb." Added the following policy statement: A prosthesis with individually powered digits, including but not limited to a partial hand prosthesis, is considered investigational. 09/03/2013: Policy title changed from "Myoelectric Prosthesis ... |
L6880 | Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s) | HCPCS | 07/19/2012: Policy title changed back to "Myoelectric Prosthesis for the Upper Limb." Added the following policy statement: A prosthesis with individually powered digits, including but not limited to a partial hand prosthesis, is considered investigational. 09/03/2013: Policy title changed from "Myoelectric Prosthesis ... |
L7190 | Electronic elbow, adolescent, variety village or equal, myoelectronically controlled | HCPCS | 09/03/2013: Policy title changed from "Myoelectric Prosthesis for the Upper Limb" to "Myoelectric Prosthetic Components for the Upper Limb." Policy statement unchanged. Added HCPCS codes L6880, L7190, and L7191 to the Code Reference section. 08/14/2014: Policy reviewed; description updated regarding devices. Policy sta... |
L7191 | Electronic elbow, child, variety village or equal, myoelectronically controlled | HCPCS | 09/03/2013: Policy title changed from "Myoelectric Prosthesis for the Upper Limb" to "Myoelectric Prosthetic Components for the Upper Limb." Policy statement unchanged. Added HCPCS codes L6880, L7190, and L7191 to the Code Reference section. 08/14/2014: Policy reviewed; description updated regarding devices. Policy sta... |
L6880 | Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s) | HCPCS | 09/03/2013: Policy title changed from "Myoelectric Prosthesis for the Upper Limb" to "Myoelectric Prosthetic Components for the Upper Limb." Policy statement unchanged. Added HCPCS codes L6880, L7190, and L7191 to the Code Reference section. 08/14/2014: Policy reviewed; description updated regarding devices. Policy sta... |
L6026 | Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectr | HCPCS | Policy statement unchanged. Added HCPCS codes L6880, L7190, and L7191 to the Code Reference section. 08/14/2014: Policy reviewed; description updated regarding devices. Policy statement unchanged. 12/31/2014: Added the following new 2015 HCPCS code to the Code Reference section: L6026. |
L7190 | Electronic elbow, adolescent, variety village or equal, myoelectronically controlled | HCPCS | Policy statement unchanged. Added HCPCS codes L6880, L7190, and L7191 to the Code Reference section. 08/14/2014: Policy reviewed; description updated regarding devices. Policy statement unchanged. 12/31/2014: Added the following new 2015 HCPCS code to the Code Reference section: L6026. |
L7191 | Electronic elbow, child, variety village or equal, myoelectronically controlled | HCPCS | Policy statement unchanged. Added HCPCS codes L6880, L7190, and L7191 to the Code Reference section. 08/14/2014: Policy reviewed; description updated regarding devices. Policy statement unchanged. 12/31/2014: Added the following new 2015 HCPCS code to the Code Reference section: L6026. |
L6880 | Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s) | HCPCS | Policy statement unchanged. Added HCPCS codes L6880, L7190, and L7191 to the Code Reference section. 08/14/2014: Policy reviewed; description updated regarding devices. Policy statement unchanged. 12/31/2014: Added the following new 2015 HCPCS code to the Code Reference section: L6026. |
L6026 | Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectr | HCPCS | 08/14/2014: Policy reviewed; description updated regarding devices. Policy statement unchanged. 12/31/2014: Added the following new 2015 HCPCS code to the Code Reference section: L6026. 08/26/2015: Medical policy revised to add ICD-10 codes. SOURCESBlue Cross Blue Shield Association policy # 1.04.04
CODE REFERENCEThis ... |
L6026 | Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectr | HCPCS | Policy statement unchanged. 12/31/2014: Added the following new 2015 HCPCS code to the Code Reference section: L6026. 08/26/2015: Medical policy revised to add ICD-10 codes. SOURCESBlue Cross Blue Shield Association policy # 1.04.04
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to thi... |
L6026 | Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectr | HCPCS | 12/31/2014: Added the following new 2015 HCPCS code to the Code Reference section: L6026. 08/26/2015: Medical policy revised to add ICD-10 codes. SOURCESBlue Cross Blue Shield Association policy # 1.04.04
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed... |
J9000 | INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a... |
G0364 | HC BONE MARROW ASPIRATE & BIOPSY | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a... |
J9999 | Not otherwise classified, antineoplastic drugs | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a... |
38230 | PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a... |
86812 | Immunologic analysis for autoimmune disease, A, B, or C, single antigen | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a... |
86822 | Lymphocyte culture primed | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a... |
38204 | PR MGMT RCP HEMATOP PROGENITOR CELL DONOR &ACQUISJ | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a... |
G0355 | CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a... |
J9000 | INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG | 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... |
G0364 | HC BONE MARROW ASPIRATE & BIOPSY | 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... |
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... |
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... |
86812 | Immunologic analysis for autoimmune disease, A, B, or C, single antigen | 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... |
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