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G0363
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
HCPCS
08/27/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. 04/04/2016: Policy description updated regarding FDA regulations. Policy statement updated to ...
38240
Transplt allo hct/donor
HCPCS
08/27/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. 04/04/2016: Policy description updated regarding FDA regulations. Policy statement updated to ...
38242
Transplt allo lymphocytes
HCPCS
08/27/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. 04/04/2016: Policy description updated regarding FDA regulations. Policy statement updated to ...
96445
Chemotherapy, intracavitary
HCPCS
08/27/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. 04/04/2016: Policy description updated regarding FDA regulations. Policy statement updated to ...
96446
PR CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH
HCPCS
08/27/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. 04/04/2016: Policy description updated regarding FDA regulations. Policy statement updated to ...
E0218
Fluid circ cold pad w pump
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...
E0236
Pump for water circulating pad
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...
E0218
Fluid circ cold pad w pump
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 HISTORY2/2001: Approved by Medical Policy Advisory Committee (MPAC), Code Reference section completed, HCPCS E0218 added 5/2/2002: Type of Service and Place of Service deleted ...
E0236
Pump for water circulating pad
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 HISTORY2/2001: Approved by Medical Policy Advisory Committee (MPAC), Code Reference section completed, HCPCS E0218 added 5/2/2002: Type of Service and Place of Service deleted ...
1999
ANESTHESIOLOGY GROUP
CPT
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY1/1993: Approved by Medical Policy Advisory Committee (MPAC) 11/1998: Medical Management of Obesity approved by MPAC 8/1999: Revisions to Surgery for Morbid Obesity appr...
43644
PR LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM
HCPCS
POLICY HISTORY1/1993: Approved by Medical Policy Advisory Committee (MPAC) 11/1998: Medical Management of Obesity approved by MPAC 8/1999: Revisions to Surgery for Morbid Obesity approved by MPAC 1/2000: Medical Management of Obesity and Surgery for Morbid Obesity policies merged; interim policy revisions 2/2000: Inter...
S2083
PR ADJUSTMENT GASTRIC BAND
HCPCS
POLICY HISTORY1/1993: Approved by Medical Policy Advisory Committee (MPAC) 11/1998: Medical Management of Obesity approved by MPAC 8/1999: Revisions to Surgery for Morbid Obesity approved by MPAC 1/2000: Medical Management of Obesity and Surgery for Morbid Obesity policies merged; interim policy revisions 2/2000: Inter...
1999
ANESTHESIOLOGY GROUP
CPT
POLICY HISTORY1/1993: Approved by Medical Policy Advisory Committee (MPAC) 11/1998: Medical Management of Obesity approved by MPAC 8/1999: Revisions to Surgery for Morbid Obesity approved by MPAC 1/2000: Medical Management of Obesity and Surgery for Morbid Obesity policies merged; interim policy revisions 2/2000: Inter...
S2082
Lap adjustable gastric band
CPT
POLICY HISTORY1/1993: Approved by Medical Policy Advisory Committee (MPAC) 11/1998: Medical Management of Obesity approved by MPAC 8/1999: Revisions to Surgery for Morbid Obesity approved by MPAC 1/2000: Medical Management of Obesity and Surgery for Morbid Obesity policies merged; interim policy revisions 2/2000: Inter...
43659
HC UNLISTED LAPAROSCOPE PROC STOM
HCPCS
POLICY HISTORY1/1993: Approved by Medical Policy Advisory Committee (MPAC) 11/1998: Medical Management of Obesity approved by MPAC 8/1999: Revisions to Surgery for Morbid Obesity approved by MPAC 1/2000: Medical Management of Obesity and Surgery for Morbid Obesity policies merged; interim policy revisions 2/2000: Inter...
43633
Removal of stomach partial
HCPCS
POLICY HISTORY1/1993: Approved by Medical Policy Advisory Committee (MPAC) 11/1998: Medical Management of Obesity approved by MPAC 8/1999: Revisions to Surgery for Morbid Obesity approved by MPAC 1/2000: Medical Management of Obesity and Surgery for Morbid Obesity policies merged; interim policy revisions 2/2000: Inter...
43847
PR GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ
HCPCS
POLICY HISTORY1/1993: Approved by Medical Policy Advisory Committee (MPAC) 11/1998: Medical Management of Obesity approved by MPAC 8/1999: Revisions to Surgery for Morbid Obesity approved by MPAC 1/2000: Medical Management of Obesity and Surgery for Morbid Obesity policies merged; interim policy revisions 2/2000: Inter...
43845
PR GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM
HCPCS
POLICY HISTORY1/1993: Approved by Medical Policy Advisory Committee (MPAC) 11/1998: Medical Management of Obesity approved by MPAC 8/1999: Revisions to Surgery for Morbid Obesity approved by MPAC 1/2000: Medical Management of Obesity and Surgery for Morbid Obesity policies merged; interim policy revisions 2/2000: Inter...
43846
PR GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<
HCPCS
POLICY HISTORY1/1993: Approved by Medical Policy Advisory Committee (MPAC) 11/1998: Medical Management of Obesity approved by MPAC 8/1999: Revisions to Surgery for Morbid Obesity approved by MPAC 1/2000: Medical Management of Obesity and Surgery for Morbid Obesity policies merged; interim policy revisions 2/2000: Inter...
43645
PR LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ
HCPCS
POLICY HISTORY1/1993: Approved by Medical Policy Advisory Committee (MPAC) 11/1998: Medical Management of Obesity approved by MPAC 8/1999: Revisions to Surgery for Morbid Obesity approved by MPAC 1/2000: Medical Management of Obesity and Surgery for Morbid Obesity policies merged; interim policy revisions 2/2000: Inter...
S2085
Laparoscop gastric bypass
CPT
POLICY HISTORY1/1993: Approved by Medical Policy Advisory Committee (MPAC) 11/1998: Medical Management of Obesity approved by MPAC 8/1999: Revisions to Surgery for Morbid Obesity approved by MPAC 1/2000: Medical Management of Obesity and Surgery for Morbid Obesity policies merged; interim policy revisions 2/2000: Inter...
43848
Revision gastroplasty
HCPCS
POLICY HISTORY1/1993: Approved by Medical Policy Advisory Committee (MPAC) 11/1998: Medical Management of Obesity approved by MPAC 8/1999: Revisions to Surgery for Morbid Obesity approved by MPAC 1/2000: Medical Management of Obesity and Surgery for Morbid Obesity policies merged; interim policy revisions 2/2000: Inter...
43644
PR LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM
HCPCS
See Surgical Management 1/9/2001: See POLICY EXCEPTIONS for BancorpSouth 2/2/2001: See POLICY EXCEPTIONS for Mississippi Power 11/29/2001: See POLICY EXCEPTIONS for Ryder System, Incorporation 1/7/2002: Singing River (self insured group) will cover all 5 surgical procedures for morbid obesity added to POLICY EXCEPTIONS...
S2083
PR ADJUSTMENT GASTRIC BAND
HCPCS
See Surgical Management 1/9/2001: See POLICY EXCEPTIONS for BancorpSouth 2/2/2001: See POLICY EXCEPTIONS for Mississippi Power 11/29/2001: See POLICY EXCEPTIONS for Ryder System, Incorporation 1/7/2002: Singing River (self insured group) will cover all 5 surgical procedures for morbid obesity added to POLICY EXCEPTIONS...
S2082
Lap adjustable gastric band
CPT
See Surgical Management 1/9/2001: See POLICY EXCEPTIONS for BancorpSouth 2/2/2001: See POLICY EXCEPTIONS for Mississippi Power 11/29/2001: See POLICY EXCEPTIONS for Ryder System, Incorporation 1/7/2002: Singing River (self insured group) will cover all 5 surgical procedures for morbid obesity added to POLICY EXCEPTIONS...
43659
HC UNLISTED LAPAROSCOPE PROC STOM
HCPCS
See Surgical Management 1/9/2001: See POLICY EXCEPTIONS for BancorpSouth 2/2/2001: See POLICY EXCEPTIONS for Mississippi Power 11/29/2001: See POLICY EXCEPTIONS for Ryder System, Incorporation 1/7/2002: Singing River (self insured group) will cover all 5 surgical procedures for morbid obesity added to POLICY EXCEPTIONS...
43633
Removal of stomach partial
HCPCS
See Surgical Management 1/9/2001: See POLICY EXCEPTIONS for BancorpSouth 2/2/2001: See POLICY EXCEPTIONS for Mississippi Power 11/29/2001: See POLICY EXCEPTIONS for Ryder System, Incorporation 1/7/2002: Singing River (self insured group) will cover all 5 surgical procedures for morbid obesity added to POLICY EXCEPTIONS...
43847
PR GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ
HCPCS
See Surgical Management 1/9/2001: See POLICY EXCEPTIONS for BancorpSouth 2/2/2001: See POLICY EXCEPTIONS for Mississippi Power 11/29/2001: See POLICY EXCEPTIONS for Ryder System, Incorporation 1/7/2002: Singing River (self insured group) will cover all 5 surgical procedures for morbid obesity added to POLICY EXCEPTIONS...
43845
PR GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM
HCPCS
See Surgical Management 1/9/2001: See POLICY EXCEPTIONS for BancorpSouth 2/2/2001: See POLICY EXCEPTIONS for Mississippi Power 11/29/2001: See POLICY EXCEPTIONS for Ryder System, Incorporation 1/7/2002: Singing River (self insured group) will cover all 5 surgical procedures for morbid obesity added to POLICY EXCEPTIONS...
43846
PR GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<
HCPCS
See Surgical Management 1/9/2001: See POLICY EXCEPTIONS for BancorpSouth 2/2/2001: See POLICY EXCEPTIONS for Mississippi Power 11/29/2001: See POLICY EXCEPTIONS for Ryder System, Incorporation 1/7/2002: Singing River (self insured group) will cover all 5 surgical procedures for morbid obesity added to POLICY EXCEPTIONS...
43645
PR LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ
HCPCS
See Surgical Management 1/9/2001: See POLICY EXCEPTIONS for BancorpSouth 2/2/2001: See POLICY EXCEPTIONS for Mississippi Power 11/29/2001: See POLICY EXCEPTIONS for Ryder System, Incorporation 1/7/2002: Singing River (self insured group) will cover all 5 surgical procedures for morbid obesity added to POLICY EXCEPTIONS...
S2085
Laparoscop gastric bypass
CPT
See Surgical Management 1/9/2001: See POLICY EXCEPTIONS for BancorpSouth 2/2/2001: See POLICY EXCEPTIONS for Mississippi Power 11/29/2001: See POLICY EXCEPTIONS for Ryder System, Incorporation 1/7/2002: Singing River (self insured group) will cover all 5 surgical procedures for morbid obesity added to POLICY EXCEPTIONS...
43848
Revision gastroplasty
HCPCS
See Surgical Management 1/9/2001: See POLICY EXCEPTIONS for BancorpSouth 2/2/2001: See POLICY EXCEPTIONS for Mississippi Power 11/29/2001: See POLICY EXCEPTIONS for Ryder System, Incorporation 1/7/2002: Singing River (self insured group) will cover all 5 surgical procedures for morbid obesity added to POLICY EXCEPTIONS...
43644
PR LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM
HCPCS
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
S2083
PR ADJUSTMENT GASTRIC BAND
HCPCS
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
S2082
Lap adjustable gastric band
CPT
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
43659
HC UNLISTED LAPAROSCOPE PROC STOM
HCPCS
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
43633
Removal of stomach partial
HCPCS
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
43847
PR GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ
HCPCS
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
43845
PR GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM
HCPCS
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
43846
PR GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<
HCPCS
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
43645
PR LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ
HCPCS
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
S2085
Laparoscop gastric bypass
CPT
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
43848
Revision gastroplasty
HCPCS
2/1/2002: Mid-Delta Home Health added to POLICY EXCEPTIONS 2/13/2002: Investigational definition added 3/8/2002: Prior authorization deleted. Policy Exceptions are Group Specific, Renal Care Group added to POLICY EXCEPTIONS 5/1/2002: Type of Service and Place of Service deleted 6/3/2002: CPT code 43848 moved to covered...
43644
PR LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM
HCPCS
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
S2083
PR ADJUSTMENT GASTRIC BAND
HCPCS
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
S2082
Lap adjustable gastric band
CPT
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
43659
HC UNLISTED LAPAROSCOPE PROC STOM
HCPCS
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
43846
PR GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<
HCPCS
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
43847
PR GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ
HCPCS
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
43645
PR LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ
HCPCS
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
43845
PR GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM
HCPCS
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
S2085
Laparoscop gastric bypass
CPT
All surgical procedures must be prior authorized and all BCBSMS policy requirements under 'Surgical Management' section in effect at the time of the surgical procedure must be satisfied for coverage.” added 10/21/2004: Metropolitan Life Height and Weight Tables added 11/18/2004: Reviewed by MPAC, no changes, Sources up...
S2083
PR ADJUSTMENT GASTRIC BAND
HCPCS
CPT codes 43770-43774, 43886-43888, HCPCS code S2083, ICD-9 procedure codes 44.95, 44.97, 44.98 moved to covered 7/30/2010: Policy description updated to include detailed descriptions of gastric restrictive procedures and malabsorptive procedures. Policy statement section updated to include open or laparoscopic biliopa...
43774
PR LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT
HCPCS
CPT codes 43770-43774, 43886-43888, HCPCS code S2083, ICD-9 procedure codes 44.95, 44.97, 44.98 moved to covered 7/30/2010: Policy description updated to include detailed descriptions of gastric restrictive procedures and malabsorptive procedures. Policy statement section updated to include open or laparoscopic biliopa...
43888
PR GSTR RSTCV OPN RMVL & RPLCMT SUBQ PORT
HCPCS
CPT codes 43770-43774, 43886-43888, HCPCS code S2083, ICD-9 procedure codes 44.95, 44.97, 44.98 moved to covered 7/30/2010: Policy description updated to include detailed descriptions of gastric restrictive procedures and malabsorptive procedures. Policy statement section updated to include open or laparoscopic biliopa...
43770
PR LAPS GASTRIC RESTRICTIVE PROCEDURE PLACE DEVICE
HCPCS
CPT codes 43770-43774, 43886-43888, HCPCS code S2083, ICD-9 procedure codes 44.95, 44.97, 44.98 moved to covered 7/30/2010: Policy description updated to include detailed descriptions of gastric restrictive procedures and malabsorptive procedures. Policy statement section updated to include open or laparoscopic biliopa...
43886
Revise gastric port open
HCPCS
CPT codes 43770-43774, 43886-43888, HCPCS code S2083, ICD-9 procedure codes 44.95, 44.97, 44.98 moved to covered 7/30/2010: Policy description updated to include detailed descriptions of gastric restrictive procedures and malabsorptive procedures. Policy statement section updated to include open or laparoscopic biliopa...
43845
PR GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM
HCPCS
FEP prior authorization requirement and FDA language added to policy exception section. Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to c...
S9452
Nutrition class
HCPCS
FEP prior authorization requirement and FDA language added to policy exception section. Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to c...
43659
HC UNLISTED LAPAROSCOPE PROC STOM
HCPCS
FEP prior authorization requirement and FDA language added to policy exception section. Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to c...
43846
PR GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<
HCPCS
FEP prior authorization requirement and FDA language added to policy exception section. Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to c...
43845
PR GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM
HCPCS
Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added ...
S9452
Nutrition class
HCPCS
Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added ...
43659
HC UNLISTED LAPAROSCOPE PROC STOM
HCPCS
Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added ...
43846
PR GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<
HCPCS
Policy guidelines section updated to include detailed information regarding patient selection criteria and BMI calculation. Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added ...
43845
PR GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM
HCPCS
Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added to covered table. 10/19/2010: Annual ICD-9 code update: V85.4 deleted/expanded to the fifth digit. Added V85.41-V85.45 to th...
S9452
Nutrition class
HCPCS
Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added to covered table. 10/19/2010: Annual ICD-9 code update: V85.4 deleted/expanded to the fifth digit. Added V85.41-V85.45 to th...
43659
HC UNLISTED LAPAROSCOPE PROC STOM
HCPCS
Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added to covered table. 10/19/2010: Annual ICD-9 code update: V85.4 deleted/expanded to the fifth digit. Added V85.41-V85.45 to th...
43846
PR GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<
HCPCS
Code reference section updated: Description revised for CPT codes 43659 and 43846. CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added to covered table. 10/19/2010: Annual ICD-9 code update: V85.4 deleted/expanded to the fifth digit. Added V85.41-V85.45 to th...
43845
PR GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM
HCPCS
CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added to covered table. 10/19/2010: Annual ICD-9 code update: V85.4 deleted/expanded to the fifth digit. Added V85.41-V85.45 to the Covered Codes table. 08/19/2011: Policy statement revised to state that the patie...
S9452
Nutrition class
HCPCS
CPT code 43845 added to covered table, ICD-9 diagnosis code 997.4 added to covered table, HCPCS code S9452 added to covered table. 10/19/2010: Annual ICD-9 code update: V85.4 deleted/expanded to the fifth digit. Added V85.41-V85.45 to the Covered Codes table. 08/19/2011: Policy statement revised to state that the patie...
00100
ANESTH SALIVARY GLAND
CPT
Note: Medical necessity is the overarching criteria for a service and the diagnosis code is used to indicate medical necessity in conjunction with a CPT code. On Oct. 1, 2014, ICD-10 will be implemented and will be the standard coding system for the U.S. ICD-10 is currently used by the rest of the world to report healt...
00100
ANESTH SALIVARY GLAND
CPT
The most current list of codes in use is ICD-10 which is beginning to be implemented in the U.S. It will give billing and coding professionals and providers the ability to report conditions, diseases, and injuries with more accurate specificity, which will provide clearer information overall about a person’s health sta...
00100
ANESTH SALIVARY GLAND
CPT
CPT (Current Procedural Terminology) codes are published by the American Medical Association, and there are approximately 7,800 CPT codes ranging from 00100 through 99499, currently at use. The U.S. and other countries use the fourth edition and they were designed to provide a uniform data set that could be used to des...
90653
HC FLU VACCINE ADJUVANT IM
HCPCS
It is also used by physicians to report care they administer in inpatient facilities. Here’s a little behind the scenes about CPT ® codes being made. Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. E...
49540
Repair lumbar hernia
HCPCS
It is also used by physicians to report care they administer in inpatient facilities. Here’s a little behind the scenes about CPT ® codes being made. Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. E...
99213
Telehealth visit INT
HCPCS
It is also used by physicians to report care they administer in inpatient facilities. Here’s a little behind the scenes about CPT ® codes being made. Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. E...
71045
XR CHEST 1 VIEW
HCPCS
It is also used by physicians to report care they administer in inpatient facilities. Here’s a little behind the scenes about CPT ® codes being made. Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. E...
27250
TREAT HIP DISLOCATION
HCPCS
It is also used by physicians to report care they administer in inpatient facilities. Here’s a little behind the scenes about CPT ® codes being made. Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. E...
90653
HC FLU VACCINE ADJUVANT IM
HCPCS
Here’s a little behind the scenes about CPT ® codes being made. Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for tr...
49540
Repair lumbar hernia
HCPCS
Here’s a little behind the scenes about CPT ® codes being made. Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for tr...
99213
Telehealth visit INT
HCPCS
Here’s a little behind the scenes about CPT ® codes being made. Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for tr...
71045
XR CHEST 1 VIEW
HCPCS
Here’s a little behind the scenes about CPT ® codes being made. Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for tr...
27250
TREAT HIP DISLOCATION
HCPCS
Here’s a little behind the scenes about CPT ® codes being made. Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for tr...
90653
HC FLU VACCINE ADJUVANT IM
HCPCS
Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for treatment of hip dislocation 49540 billed for repair of a lumbar h...
49540
Repair lumbar hernia
HCPCS
Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for treatment of hip dislocation 49540 billed for repair of a lumbar h...
99213
Telehealth visit INT
HCPCS
Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for treatment of hip dislocation 49540 billed for repair of a lumbar h...
J3420
Vitamin b12 inj per 1000 mcg
HCPCS
Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for treatment of hip dislocation 49540 billed for repair of a lumbar h...
71045
XR CHEST 1 VIEW
HCPCS
Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for treatment of hip dislocation 49540 billed for repair of a lumbar h...
27250
TREAT HIP DISLOCATION
HCPCS
Over 10,000 CPT codes are available and are updated at the start of each year and no memorization is needed. On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for treatment of hip dislocation 49540 billed for repair of a lumbar h...
90653
HC FLU VACCINE ADJUVANT IM
HCPCS
On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for treatment of hip dislocation 49540 billed for repair of a lumbar hernia 71045 billed for chest x-ray 90653 billed for flu injection |HCPCS Level II (Health Care Procedural Cod...
49540
Repair lumbar hernia
HCPCS
On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for treatment of hip dislocation 49540 billed for repair of a lumbar hernia 71045 billed for chest x-ray 90653 billed for flu injection |HCPCS Level II (Health Care Procedural Cod...
99213
Telehealth visit INT
HCPCS
On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for treatment of hip dislocation 49540 billed for repair of a lumbar hernia 71045 billed for chest x-ray 90653 billed for flu injection |HCPCS Level II (Health Care Procedural Cod...
J3420
Vitamin b12 inj per 1000 mcg
HCPCS
On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for treatment of hip dislocation 49540 billed for repair of a lumbar hernia 71045 billed for chest x-ray 90653 billed for flu injection |HCPCS Level II (Health Care Procedural Cod...
71045
XR CHEST 1 VIEW
HCPCS
On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for treatment of hip dislocation 49540 billed for repair of a lumbar hernia 71045 billed for chest x-ray 90653 billed for flu injection |HCPCS Level II (Health Care Procedural Cod...
27250
TREAT HIP DISLOCATION
HCPCS
On the insurance claim forms, CPT codes must be registered. Examples of CPT codes: 99213 billed for an established office visit 27250 billed for treatment of hip dislocation 49540 billed for repair of a lumbar hernia 71045 billed for chest x-ray 90653 billed for flu injection |HCPCS Level II (Health Care Procedural Cod...
90653
HC FLU VACCINE ADJUVANT IM
HCPCS
Examples of CPT codes: 99213 billed for an established office visit 27250 billed for treatment of hip dislocation 49540 billed for repair of a lumbar hernia 71045 billed for chest x-ray 90653 billed for flu injection |HCPCS Level II (Health Care Procedural Coding System, Level II)||HCPCS Level II’s 7,000-plus alphanume...
49540
Repair lumbar hernia
HCPCS
Examples of CPT codes: 99213 billed for an established office visit 27250 billed for treatment of hip dislocation 49540 billed for repair of a lumbar hernia 71045 billed for chest x-ray 90653 billed for flu injection |HCPCS Level II (Health Care Procedural Coding System, Level II)||HCPCS Level II’s 7,000-plus alphanume...
99213
Telehealth visit INT
HCPCS
Examples of CPT codes: 99213 billed for an established office visit 27250 billed for treatment of hip dislocation 49540 billed for repair of a lumbar hernia 71045 billed for chest x-ray 90653 billed for flu injection |HCPCS Level II (Health Care Procedural Coding System, Level II)||HCPCS Level II’s 7,000-plus alphanume...