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15.5k
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...