code stringlengths 4 12 | description stringlengths 2 264 | codetype stringclasses 8
values | context stringlengths 160 15.5k |
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J3420 | Vitamin b12 inj per 1000 mcg | 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... |
71045 | XR CHEST 1 VIEW | 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... |
27250 | TREAT HIP DISLOCATION | 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... |
J3420 | Vitamin b12 inj per 1000 mcg | HCPCS | On the insurance claim forms, HCPCS codes have to be registered. Example of HCPCS for a drug injection: Patient receives an injection of B12 – J3420
|CDT® (Code on Dental Procedures and Nomenclature)|
The American Dental Association (ADA) owns and maintains CDT ® codes. The five-character codes start with the letter D ... |
0777-3105-02 | FLUOXETINE HCL 20 MG PO CAP | NDC | An example could be removal of the ear wax (cerumen) was performed on both ears. The code is for unilateral so the modifier 50 would be added to the procedure code to allow the insurance know it was performed on both ears. Example of modifier used on a procedure: Removal of impacted cerumen by lavage – 69209-50
|NDC (N... |
0777-3105-02 | FLUOXETINE HCL 20 MG PO CAP | NDC | The code is for unilateral so the modifier 50 would be added to the procedure code to allow the insurance know it was performed on both ears. Example of modifier used on a procedure: Removal of impacted cerumen by lavage – 69209-50
|NDC (National Drug Codes)|| To track and report all packages of drugs, the Federal Drug... |
0777-3105-02 | FLUOXETINE HCL 20 MG PO CAP | NDC | Example of modifier used on a procedure: Removal of impacted cerumen by lavage – 69209-50
|NDC (National Drug Codes)|| To track and report all packages of drugs, the Federal Drug Administration (FDA) code set is used. |
The smart codes of 10-13 alphanumeric characters allow suppliers, suppliers, and federal agencies to... |
E0485 | Oral device/appliance prefab | HCPCS | To qualify for coverage, the OAT service provided must be reasonable and medically necessary and in compliance with all Medicare coverage, coding, and billing requirements. Codes that are used to report OAT include the following. HCPCS codes and modifiers
Code E0486 may only be used for custom-fabricated mandibular adv... |
E0486 | Oral device/appliance cusfab | HCPCS | To qualify for coverage, the OAT service provided must be reasonable and medically necessary and in compliance with all Medicare coverage, coding, and billing requirements. Codes that are used to report OAT include the following. HCPCS codes and modifiers
Code E0486 may only be used for custom-fabricated mandibular adv... |
A9270 | NON-COVERED ITEM OR SERVICE | HCPCS | To qualify for coverage, the OAT service provided must be reasonable and medically necessary and in compliance with all Medicare coverage, coding, and billing requirements. Codes that are used to report OAT include the following. HCPCS codes and modifiers
Code E0486 may only be used for custom-fabricated mandibular adv... |
E0485 | Oral device/appliance prefab | HCPCS | Codes that are used to report OAT include the following. HCPCS codes and modifiers
Code E0486 may only be used for custom-fabricated mandibular advancement devices. - E0486 – Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustmen... |
E0486 | Oral device/appliance cusfab | HCPCS | Codes that are used to report OAT include the following. HCPCS codes and modifiers
Code E0486 may only be used for custom-fabricated mandibular advancement devices. - E0486 – Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustmen... |
A9270 | NON-COVERED ITEM OR SERVICE | HCPCS | Codes that are used to report OAT include the following. HCPCS codes and modifiers
Code E0486 may only be used for custom-fabricated mandibular advancement devices. - E0486 – Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustmen... |
E0485 | Oral device/appliance prefab | HCPCS | HCPCS codes and modifiers
Code E0486 may only be used for custom-fabricated mandibular advancement devices. - E0486 – Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment
In terms of Medicare reimbursement, HCPCS code E0486 is... |
E0486 | Oral device/appliance cusfab | HCPCS | HCPCS codes and modifiers
Code E0486 may only be used for custom-fabricated mandibular advancement devices. - E0486 – Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment
In terms of Medicare reimbursement, HCPCS code E0486 is... |
A9270 | NON-COVERED ITEM OR SERVICE | HCPCS | HCPCS codes and modifiers
Code E0486 may only be used for custom-fabricated mandibular advancement devices. - E0486 – Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment
In terms of Medicare reimbursement, HCPCS code E0486 is... |
E0485 | Oral device/appliance prefab | HCPCS | - E0486 – Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment
In terms of Medicare reimbursement, HCPCS code E0486 is the only reimbursable code for oral appliance therapy for OSA. Other HCPCS codes – A9270, E0485, and E1399 ... |
E0486 | Oral device/appliance cusfab | HCPCS | - E0486 – Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment
In terms of Medicare reimbursement, HCPCS code E0486 is the only reimbursable code for oral appliance therapy for OSA. Other HCPCS codes – A9270, E0485, and E1399 ... |
A9270 | NON-COVERED ITEM OR SERVICE | HCPCS | - E0486 – Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment
In terms of Medicare reimbursement, HCPCS code E0486 is the only reimbursable code for oral appliance therapy for OSA. Other HCPCS codes – A9270, E0485, and E1399 ... |
E0485 | Oral device/appliance prefab | HCPCS | Other HCPCS codes – A9270, E0485, and E1399 are not payable codes, but rather only billable codes. HCPCS modifiers for oral appliance therapy may include:
- KX: Requirements specified in the medical policy have been met
- EY: No physician order, or other licensed health care provider order, for this item or service
- G... |
A9270 | NON-COVERED ITEM OR SERVICE | HCPCS | Other HCPCS codes – A9270, E0485, and E1399 are not payable codes, but rather only billable codes. HCPCS modifiers for oral appliance therapy may include:
- KX: Requirements specified in the medical policy have been met
- EY: No physician order, or other licensed health care provider order, for this item or service
- G... |
76536 | US THYROID | HCPCS | It signifies the professional component and can be billed only by a physician, a nurse practitioner or physician assistant. Face-to-face visits with the patient can be reported using the appropriate evaluation and management code. The device component for CGM is reported using HCPCS codes. Specifically assigned HCPCS c... |
76942 | US GUID NEEDLE PLCMNTPORTABLE | HCPCS | Face-to-face visits with the patient can be reported using the appropriate evaluation and management code. The device component for CGM is reported using HCPCS codes. Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound E... |
76536 | US THYROID | HCPCS | Face-to-face visits with the patient can be reported using the appropriate evaluation and management code. The device component for CGM is reported using HCPCS codes. Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound E... |
60100 | PR BIOPSY THYROID PERCUTANEOUS CORE NEEDLE | HCPCS | The device component for CGM is reported using HCPCS codes. Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound Evaluation
Diagnostic ultrasound and associated ultrasound guided procedures performed by endocrinologists a... |
76942 | US GUID NEEDLE PLCMNTPORTABLE | HCPCS | The device component for CGM is reported using HCPCS codes. Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound Evaluation
Diagnostic ultrasound and associated ultrasound guided procedures performed by endocrinologists a... |
10022 | Fna w/image | HCPCS | The device component for CGM is reported using HCPCS codes. Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound Evaluation
Diagnostic ultrasound and associated ultrasound guided procedures performed by endocrinologists a... |
76536 | US THYROID | HCPCS | The device component for CGM is reported using HCPCS codes. Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound Evaluation
Diagnostic ultrasound and associated ultrasound guided procedures performed by endocrinologists a... |
60100 | PR BIOPSY THYROID PERCUTANEOUS CORE NEEDLE | HCPCS | Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound Evaluation
Diagnostic ultrasound and associated ultrasound guided procedures performed by endocrinologists are coded in the following manner:
- CPT 76536 – ultrasound, ... |
76942 | US GUID NEEDLE PLCMNTPORTABLE | HCPCS | Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound Evaluation
Diagnostic ultrasound and associated ultrasound guided procedures performed by endocrinologists are coded in the following manner:
- CPT 76536 – ultrasound, ... |
10022 | Fna w/image | HCPCS | Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound Evaluation
Diagnostic ultrasound and associated ultrasound guided procedures performed by endocrinologists are coded in the following manner:
- CPT 76536 – ultrasound, ... |
76536 | US THYROID | HCPCS | Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials. Coding for Ultrasound Evaluation
Diagnostic ultrasound and associated ultrasound guided procedures performed by endocrinologists are coded in the following manner:
- CPT 76536 – ultrasound, ... |
1749 | Other and unspecified robotic assisted procedure | ICD | - Lamellar ichthyosis
Ichthyosis lamellaris Classification and external resources ICD-10 Q80.2 OMIM 242300 DiseasesDB 30052 eMedicine derm/190 MeSH D017490
Lamellar ichthyosis, also known as ichthyosis lammellaris and nonbullous congenital ichthyosis, is a rare inherited skin disorder, affecting around 1 in 600,000 peo... |
1749 | Other and unspecified robotic assisted procedure | ICD | - Lamellar ichthyosis
Ichthyosis lamellaris Classification and external resources ICD-10 Q80.2 OMIM 242300 DiseasesDB 30052 eMedicine derm/190 MeSH D017490
Lamellar ichthyosis, also known as ichthyosis lammellaris and nonbullous congenital ichthyosis, is a rare inherited skin disorder, affecting around 1 in 600,000 peo... |
S8035 | MAGNETIC SOURCE IMAGING | HCPCS | HCPCS code S8035 was previously added to codes table. FEP verbiage added to the Policy Exceptions section. Deleted outdated references from the Sources section. 04/20/2011: Policy reviewed; no changes. 11/30/2012: Policy statement revised to state that magnetoencephalography/magnetic source imaging as part of the preop... |
G0358 | IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
G0360 | Each additional hr 1-8 hrs | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
J9000 | INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
G0364 | HC BONE MARROW ASPIRATE & BIOPSY | 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... |
G0362 | Each add sequential infusion | 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... |
J9999 | Not otherwise classified, antineoplastic drugs | 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... |
G0359 | Chemotherapy IV one hr initi | 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... |
38230 | PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC | 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... |
G0361 | Prolong chemo infuse>8hrs pu | 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... |
G0357 | IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
G0356 | HORMONAL ANTINEOPLASTIC | 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... |
G0355 | CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC | 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... |
G0358 | IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01... |
G0360 | Each additional hr 1-8 hrs | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01... |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01... |
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. 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01... |
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. 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01... |
G0362 | Each add sequential infusion | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01... |
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. 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01... |
G0359 | Chemotherapy IV one hr initi | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01... |
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. 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01... |
G0361 | Prolong chemo infuse>8hrs pu | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01... |
G0357 | IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01... |
G0356 | HORMONAL ANTINEOPLASTIC | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01... |
G0355 | CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01... |
G0358 | IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG | HCPCS | 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.20 per approval by Medical Policy Advisory Committee (MPAC)
7/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC, “H... |
G0360 | Each additional hr 1-8 hrs | HCPCS | 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.20 per approval by Medical Policy Advisory Committee (MPAC)
7/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC, “H... |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.20 per approval by Medical Policy Advisory Committee (MPAC)
7/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC, “H... |
J9000 | INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG | HCPCS | 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.20 per approval by Medical Policy Advisory Committee (MPAC)
7/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC, “H... |
G0364 | HC BONE MARROW ASPIRATE & BIOPSY | HCPCS | 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.20 per approval by Medical Policy Advisory Committee (MPAC)
7/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC, “H... |
G0362 | Each add sequential infusion | HCPCS | 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.20 per approval by Medical Policy Advisory Committee (MPAC)
7/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC, “H... |
J9999 | Not otherwise classified, antineoplastic drugs | HCPCS | 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.20 per approval by Medical Policy Advisory Committee (MPAC)
7/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC, “H... |
G0359 | Chemotherapy IV one hr initi | HCPCS | 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.20 per approval by Medical Policy Advisory Committee (MPAC)
7/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC, “H... |
38230 | PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC | HCPCS | 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.20 per approval by Medical Policy Advisory Committee (MPAC)
7/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC, “H... |
G0361 | Prolong chemo infuse>8hrs pu | HCPCS | 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.20 per approval by Medical Policy Advisory Committee (MPAC)
7/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC, “H... |
G0357 | IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG | HCPCS | 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.20 per approval by Medical Policy Advisory Committee (MPAC)
7/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC, “H... |
G0356 | HORMONAL ANTINEOPLASTIC | HCPCS | 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.20 per approval by Medical Policy Advisory Committee (MPAC)
7/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC, “H... |
G0355 | CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC | HCPCS | 3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.20 per approval by Medical Policy Advisory Committee (MPAC)
7/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC, “H... |
86826 | Hla x-match noncytotoxc addl | HCPCS | Policy statement updated to include medically necessary indications for allogeneic SCT and/or autologous SCT and medically necessary indications for reduced intensity conditioning allogeneic SCT. FEP and State and School Employee verbiage added to Policy Exceptions section. Added new CPT Codes 86825 and 86826 to Covere... |
G0267 | Bone marrow or psc harvest | CPT | Policy statement updated to include medically necessary indications for allogeneic SCT and/or autologous SCT and medically necessary indications for reduced intensity conditioning allogeneic SCT. FEP and State and School Employee verbiage added to Policy Exceptions section. Added new CPT Codes 86825 and 86826 to Covere... |
G0265 | Cryopresevation Freeze+stora | CPT | Policy statement updated to include medically necessary indications for allogeneic SCT and/or autologous SCT and medically necessary indications for reduced intensity conditioning allogeneic SCT. FEP and State and School Employee verbiage added to Policy Exceptions section. Added new CPT Codes 86825 and 86826 to Covere... |
G0266 | Thawing + expansion froz cel | CPT | Policy statement updated to include medically necessary indications for allogeneic SCT and/or autologous SCT and medically necessary indications for reduced intensity conditioning allogeneic SCT. FEP and State and School Employee verbiage added to Policy Exceptions section. Added new CPT Codes 86825 and 86826 to Covere... |
86825 | X-MATCHAHG | HCPCS | Policy statement updated to include medically necessary indications for allogeneic SCT and/or autologous SCT and medically necessary indications for reduced intensity conditioning allogeneic SCT. FEP and State and School Employee verbiage added to Policy Exceptions section. Added new CPT Codes 86825 and 86826 to Covere... |
86826 | Hla x-match noncytotoxc addl | HCPCS | FEP and State and School Employee verbiage added to Policy Exceptions section. Added new CPT Codes 86825 and 86826 to Covered Codes Table. HCPCS Codes G0265, G0266 and G0267 were removed from covered table due to these codes were deleted as of 12-31-2007. 04/20/2011: Policy description updated regarding disease classif... |
G0267 | Bone marrow or psc harvest | CPT | FEP and State and School Employee verbiage added to Policy Exceptions section. Added new CPT Codes 86825 and 86826 to Covered Codes Table. HCPCS Codes G0265, G0266 and G0267 were removed from covered table due to these codes were deleted as of 12-31-2007. 04/20/2011: Policy description updated regarding disease classif... |
G0265 | Cryopresevation Freeze+stora | CPT | FEP and State and School Employee verbiage added to Policy Exceptions section. Added new CPT Codes 86825 and 86826 to Covered Codes Table. HCPCS Codes G0265, G0266 and G0267 were removed from covered table due to these codes were deleted as of 12-31-2007. 04/20/2011: Policy description updated regarding disease classif... |
G0266 | Thawing + expansion froz cel | CPT | FEP and State and School Employee verbiage added to Policy Exceptions section. Added new CPT Codes 86825 and 86826 to Covered Codes Table. HCPCS Codes G0265, G0266 and G0267 were removed from covered table due to these codes were deleted as of 12-31-2007. 04/20/2011: Policy description updated regarding disease classif... |
86825 | X-MATCHAHG | HCPCS | FEP and State and School Employee verbiage added to Policy Exceptions section. Added new CPT Codes 86825 and 86826 to Covered Codes Table. HCPCS Codes G0265, G0266 and G0267 were removed from covered table due to these codes were deleted as of 12-31-2007. 04/20/2011: Policy description updated regarding disease classif... |
86826 | Hla x-match noncytotoxc addl | HCPCS | Added new CPT Codes 86825 and 86826 to Covered Codes Table. HCPCS Codes G0265, G0266 and G0267 were removed from covered table due to these codes were deleted as of 12-31-2007. 04/20/2011: Policy description updated regarding disease classification, prevalence, and treatment approaches. Policy statement revised to brea... |
G0267 | Bone marrow or psc harvest | CPT | Added new CPT Codes 86825 and 86826 to Covered Codes Table. HCPCS Codes G0265, G0266 and G0267 were removed from covered table due to these codes were deleted as of 12-31-2007. 04/20/2011: Policy description updated regarding disease classification, prevalence, and treatment approaches. Policy statement revised to brea... |
G0265 | Cryopresevation Freeze+stora | CPT | Added new CPT Codes 86825 and 86826 to Covered Codes Table. HCPCS Codes G0265, G0266 and G0267 were removed from covered table due to these codes were deleted as of 12-31-2007. 04/20/2011: Policy description updated regarding disease classification, prevalence, and treatment approaches. Policy statement revised to brea... |
G0266 | Thawing + expansion froz cel | CPT | Added new CPT Codes 86825 and 86826 to Covered Codes Table. HCPCS Codes G0265, G0266 and G0267 were removed from covered table due to these codes were deleted as of 12-31-2007. 04/20/2011: Policy description updated regarding disease classification, prevalence, and treatment approaches. Policy statement revised to brea... |
86825 | X-MATCHAHG | HCPCS | Added new CPT Codes 86825 and 86826 to Covered Codes Table. HCPCS Codes G0265, G0266 and G0267 were removed from covered table due to these codes were deleted as of 12-31-2007. 04/20/2011: Policy description updated regarding disease classification, prevalence, and treatment approaches. Policy statement revised to brea... |
38241 | Transplt autol hct/donor | HCPCS | In first medically necessary statement for patients with mature T-cell or NK-cell (peripheral T-cell) neoplasms, "high-risk peripheral T-cell lymphoma" changed to "high-risk subtypes." Policy guidelines updated to add information regarding salvage therapy and high-risk (aggressive) T-cell and natural killer cell neopla... |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | In first medically necessary statement for patients with mature T-cell or NK-cell (peripheral T-cell) neoplasms, "high-risk peripheral T-cell lymphoma" changed to "high-risk subtypes." Policy guidelines updated to add information regarding salvage therapy and high-risk (aggressive) T-cell and natural killer cell neopla... |
38240 | Transplt allo hct/donor | HCPCS | In first medically necessary statement for patients with mature T-cell or NK-cell (peripheral T-cell) neoplasms, "high-risk peripheral T-cell lymphoma" changed to "high-risk subtypes." Policy guidelines updated to add information regarding salvage therapy and high-risk (aggressive) T-cell and natural killer cell neopla... |
96445 | Chemotherapy, intracavitary | HCPCS | In first medically necessary statement for patients with mature T-cell or NK-cell (peripheral T-cell) neoplasms, "high-risk peripheral T-cell lymphoma" changed to "high-risk subtypes." Policy guidelines updated to add information regarding salvage therapy and high-risk (aggressive) T-cell and natural killer cell neopla... |
96446 | PR CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH | HCPCS | In first medically necessary statement for patients with mature T-cell or NK-cell (peripheral T-cell) neoplasms, "high-risk peripheral T-cell lymphoma" changed to "high-risk subtypes." Policy guidelines updated to add information regarding salvage therapy and high-risk (aggressive) T-cell and natural killer cell neopla... |
38241 | Transplt autol hct/donor | HCPCS | Policy guidelines updated to add information regarding salvage therapy and high-risk (aggressive) T-cell and natural killer cell neoplasms. 08/27/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240 and 38241; removed deleted HCPCS code G0363, and removed deleted code CPT 96... |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | Policy guidelines updated to add information regarding salvage therapy and high-risk (aggressive) T-cell and natural killer cell neoplasms. 08/27/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240 and 38241; removed deleted HCPCS code G0363, and removed deleted code CPT 96... |
38240 | Transplt allo hct/donor | HCPCS | Policy guidelines updated to add information regarding salvage therapy and high-risk (aggressive) T-cell and natural killer cell neoplasms. 08/27/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240 and 38241; removed deleted HCPCS code G0363, and removed deleted code CPT 96... |
96445 | Chemotherapy, intracavitary | HCPCS | Policy guidelines updated to add information regarding salvage therapy and high-risk (aggressive) T-cell and natural killer cell neoplasms. 08/27/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240 and 38241; removed deleted HCPCS code G0363, and removed deleted code CPT 96... |
96446 | PR CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH | HCPCS | Policy guidelines updated to add information regarding salvage therapy and high-risk (aggressive) T-cell and natural killer cell neoplasms. 08/27/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240 and 38241; removed deleted HCPCS code G0363, and removed deleted code CPT 96... |
15878 | Suction lipectomy upr extrem | HCPCS | changed from investigational to medically necessary as follows: "Treatment of severe primary axillary hyperhidrosis with botulinum toxin is considered medically necessary after failed treatment using topical agents. "; "The treatment of axillary hyperhidrosis is considered cosmetic and therefore not eligible for covera... |
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