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|---|---|---|---|
86825
|
X-MATCHAHG
|
HCPCS
|
Added new CPT codes 86825 and 86826. Deleted HCPCS G0265, G0266, and G0267 from the code section as these codes were deleted on 12/31/2007. Added HCPCS S2140 and S2142 to the non-covered table. 10/21/2010: Policy reviewed; no changes. 10/05/2011: Policy reviewed; no changes.
|
S2142
|
Cord blood-derived stem-cell transplantation, allogeneic
|
HCPCS
|
Added new CPT codes 86825 and 86826. Deleted HCPCS G0265, G0266, and G0267 from the code section as these codes were deleted on 12/31/2007. Added HCPCS S2140 and S2142 to the non-covered table. 10/21/2010: Policy reviewed; no changes. 10/05/2011: Policy reviewed; no changes.
|
38241
|
Transplt autol hct/donor
|
HCPCS
|
12/13/2012: Policy reviewed; no changes. 01/22/2014: Policy reviewed; no changes. 12/11/2014: Policy reviewed; description updated. Policy statements unchanged. 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.
|
G0363
|
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
|
HCPCS
|
12/13/2012: Policy reviewed; no changes. 01/22/2014: Policy reviewed; no changes. 12/11/2014: Policy reviewed; description updated. Policy statements unchanged. 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.
|
38240
|
Transplt allo hct/donor
|
HCPCS
|
12/13/2012: Policy reviewed; no changes. 01/22/2014: Policy reviewed; no changes. 12/11/2014: Policy reviewed; description updated. Policy statements unchanged. 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.
|
38242
|
Transplt allo lymphocytes
|
HCPCS
|
12/13/2012: Policy reviewed; no changes. 01/22/2014: Policy reviewed; no changes. 12/11/2014: Policy reviewed; description updated. Policy statements unchanged. 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.
|
96445
|
Chemotherapy, intracavitary
|
HCPCS
|
12/13/2012: Policy reviewed; no changes. 01/22/2014: Policy reviewed; no changes. 12/11/2014: Policy reviewed; description updated. Policy statements unchanged. 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.
|
96446
|
PR CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH
|
HCPCS
|
12/13/2012: Policy reviewed; no changes. 01/22/2014: Policy reviewed; no changes. 12/11/2014: Policy reviewed; description updated. Policy statements unchanged. 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.
|
38241
|
Transplt autol hct/donor
|
HCPCS
|
12/11/2014: Policy reviewed; description updated. Policy statements unchanged. 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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer."
|
G0363
|
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
|
HCPCS
|
12/11/2014: Policy reviewed; description updated. Policy statements unchanged. 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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer."
|
38240
|
Transplt allo hct/donor
|
HCPCS
|
12/11/2014: Policy reviewed; description updated. Policy statements unchanged. 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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer."
|
38242
|
Transplt allo lymphocytes
|
HCPCS
|
12/11/2014: Policy reviewed; description updated. Policy statements unchanged. 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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer."
|
96445
|
Chemotherapy, intracavitary
|
HCPCS
|
12/11/2014: Policy reviewed; description updated. Policy statements unchanged. 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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer."
|
96446
|
PR CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH
|
HCPCS
|
12/11/2014: Policy reviewed; description updated. Policy statements unchanged. 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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer."
|
38241
|
Transplt autol hct/donor
|
HCPCS
|
Policy statements unchanged. 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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer." Investigative definitions updated in policy guidelines.
|
G0363
|
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
|
HCPCS
|
Policy statements unchanged. 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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer." Investigative definitions updated in policy guidelines.
|
38240
|
Transplt allo hct/donor
|
HCPCS
|
Policy statements unchanged. 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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer." Investigative definitions updated in policy guidelines.
|
38242
|
Transplt allo lymphocytes
|
HCPCS
|
Policy statements unchanged. 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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer." Investigative definitions updated in policy guidelines.
|
96445
|
Chemotherapy, intracavitary
|
HCPCS
|
Policy statements unchanged. 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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer." Investigative definitions updated in policy guidelines.
|
96446
|
PR CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH
|
HCPCS
|
Policy statements unchanged. 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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer." Investigative definitions updated in policy guidelines.
|
38241
|
Transplt autol 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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer." Investigative definitions updated in policy guidelines. Blue Cross Blue Shield Association policy # 8.01.24
This may not be a comprehensive list of procedure codes applicable to this policy.
|
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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer." Investigative definitions updated in policy guidelines. Blue Cross Blue Shield Association policy # 8.01.24
This may not be a comprehensive list of procedure codes applicable to this policy.
|
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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer." Investigative definitions updated in policy guidelines. Blue Cross Blue Shield Association policy # 8.01.24
This may not be a comprehensive list of procedure codes applicable to this policy.
|
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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer." Investigative definitions updated in policy guidelines. Blue Cross Blue Shield Association policy # 8.01.24
This may not be a comprehensive list of procedure codes applicable to this policy.
|
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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer." Investigative definitions updated in policy guidelines. Blue Cross Blue Shield Association policy # 8.01.24
This may not be a comprehensive list of procedure codes applicable to this policy.
|
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 make minor changes: 1) "allogeneic stem cell" changed to "allogeneic hematopoietic stem cell" and 2) "Pancreas cancer" changed to "Pancreatic cancer." Investigative definitions updated in policy guidelines. Blue Cross Blue Shield Association policy # 8.01.24
This may not be a comprehensive list of procedure codes applicable to this policy.
|
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 health care conditions. 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 status and allow for better outcomes and care. 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.
|
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 status and allow for better outcomes and care. 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 describe medical, surgical, and diagnostic services rendered to patients. CPT codes are five-digit alphanumeric codes and consist of five numbers and occasionally may have four numbers and letter, depending on the type of service.
|
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 describe medical, surgical, and diagnostic services rendered to patients. CPT codes are five-digit alphanumeric codes and consist of five numbers and occasionally may have four numbers and letter, depending on the type of service. CPT codes are used to identify services provided to patients such as, medical, surgical, diagnostic, and radiological services. These codes are submitted with ICD-9 codes on claim forms to payers and that is what is used to determine reimbursement to a provider/facility.
|
S0191
|
Misoprostol, oral, 200 mcg
|
HCPCS
|
rejections and impressive quality metrics. 26 January 2023
Four out of six: new math, new savings
David M. Glaser, Esq.March 1, 2023
AI in healthcare is here to stay
adam brenmannMarch 1, 2023
Two decades of supporting best practices for lab coding and billing
Bill JohnsonFebruary 28, 2023
Understanding why rural health is in trouble: Part II
Dr. John Zelem, FACSFebruary 27, 2023
What is the ICD-10 code for medication abortion? ›
ICD-10 code Z33. 2 for Encounter for elective termination of pregnancy is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .What is the diagnosis code for misoprostol? ›
HCPCS Code for Misoprostol, oral, 200 mcg S0191.What is the procedure code for medical abortion?
|
S0191
|
Misoprostol, oral, 200 mcg
|
HCPCS
|
26 January 2023
Four out of six: new math, new savings
David M. Glaser, Esq.March 1, 2023
AI in healthcare is here to stay
adam brenmannMarch 1, 2023
Two decades of supporting best practices for lab coding and billing
Bill JohnsonFebruary 28, 2023
Understanding why rural health is in trouble: Part II
Dr. John Zelem, FACSFebruary 27, 2023
What is the ICD-10 code for medication abortion? ›
ICD-10 code Z33. 2 for Encounter for elective termination of pregnancy is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .What is the diagnosis code for misoprostol? ›
HCPCS Code for Misoprostol, oral, 200 mcg S0191.What is the procedure code for medical abortion? ›
Methods for Medically Inducing the Termination of Pregnancy Early medical Early medical terminations are typically J3490, S0190, performed on an outpatient basis.What is the ICD-10 code for complete or unspecified spontaneous abortion without complication?
|
S0190
|
MIFEPRISTONE ORAL 200 MG
|
HCPCS
|
26 January 2023
Four out of six: new math, new savings
David M. Glaser, Esq.March 1, 2023
AI in healthcare is here to stay
adam brenmannMarch 1, 2023
Two decades of supporting best practices for lab coding and billing
Bill JohnsonFebruary 28, 2023
Understanding why rural health is in trouble: Part II
Dr. John Zelem, FACSFebruary 27, 2023
What is the ICD-10 code for medication abortion? ›
ICD-10 code Z33. 2 for Encounter for elective termination of pregnancy is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .What is the diagnosis code for misoprostol? ›
HCPCS Code for Misoprostol, oral, 200 mcg S0191.What is the procedure code for medical abortion? ›
Methods for Medically Inducing the Termination of Pregnancy Early medical Early medical terminations are typically J3490, S0190, performed on an outpatient basis.What is the ICD-10 code for complete or unspecified spontaneous abortion without complication?
|
J3490
|
ZINC SULFATE 220MG 220MG CP
|
HCPCS
|
26 January 2023
Four out of six: new math, new savings
David M. Glaser, Esq.March 1, 2023
AI in healthcare is here to stay
adam brenmannMarch 1, 2023
Two decades of supporting best practices for lab coding and billing
Bill JohnsonFebruary 28, 2023
Understanding why rural health is in trouble: Part II
Dr. John Zelem, FACSFebruary 27, 2023
What is the ICD-10 code for medication abortion? ›
ICD-10 code Z33. 2 for Encounter for elective termination of pregnancy is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .What is the diagnosis code for misoprostol? ›
HCPCS Code for Misoprostol, oral, 200 mcg S0191.What is the procedure code for medical abortion? ›
Methods for Medically Inducing the Termination of Pregnancy Early medical Early medical terminations are typically J3490, S0190, performed on an outpatient basis.What is the ICD-10 code for complete or unspecified spontaneous abortion without complication?
|
S0191
|
Misoprostol, oral, 200 mcg
|
HCPCS
|
›
ICD-10 code Z33. 2 for Encounter for elective termination of pregnancy is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .What is the diagnosis code for misoprostol? ›
HCPCS Code for Misoprostol, oral, 200 mcg S0191.What is the procedure code for medical abortion? ›
Methods for Medically Inducing the Termination of Pregnancy Early medical Early medical terminations are typically J3490, S0190, performed on an outpatient basis.What is the ICD-10 code for complete or unspecified spontaneous abortion without complication? ›
9: Spontaneous abortion Complete or unspecified, without complication.What is ICD-10 code 10E0XZZ?
|
S0190
|
MIFEPRISTONE ORAL 200 MG
|
HCPCS
|
›
ICD-10 code Z33. 2 for Encounter for elective termination of pregnancy is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .What is the diagnosis code for misoprostol? ›
HCPCS Code for Misoprostol, oral, 200 mcg S0191.What is the procedure code for medical abortion? ›
Methods for Medically Inducing the Termination of Pregnancy Early medical Early medical terminations are typically J3490, S0190, performed on an outpatient basis.What is the ICD-10 code for complete or unspecified spontaneous abortion without complication? ›
9: Spontaneous abortion Complete or unspecified, without complication.What is ICD-10 code 10E0XZZ?
|
J3490
|
ZINC SULFATE 220MG 220MG CP
|
HCPCS
|
›
ICD-10 code Z33. 2 for Encounter for elective termination of pregnancy is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .What is the diagnosis code for misoprostol? ›
HCPCS Code for Misoprostol, oral, 200 mcg S0191.What is the procedure code for medical abortion? ›
Methods for Medically Inducing the Termination of Pregnancy Early medical Early medical terminations are typically J3490, S0190, performed on an outpatient basis.What is the ICD-10 code for complete or unspecified spontaneous abortion without complication? ›
9: Spontaneous abortion Complete or unspecified, without complication.What is ICD-10 code 10E0XZZ?
|
S0191
|
Misoprostol, oral, 200 mcg
|
HCPCS
|
2 for Encounter for elective termination of pregnancy is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .What is the diagnosis code for misoprostol? ›
HCPCS Code for Misoprostol, oral, 200 mcg S0191.What is the procedure code for medical abortion? ›
Methods for Medically Inducing the Termination of Pregnancy Early medical Early medical terminations are typically J3490, S0190, performed on an outpatient basis.What is the ICD-10 code for complete or unspecified spontaneous abortion without complication? ›
9: Spontaneous abortion Complete or unspecified, without complication.What is ICD-10 code 10E0XZZ? ›
A spontaneous delivery is a vaginal delivery that is manually assisted with no use of instrumentation such as forceps or vacuum extraction.
|
S0190
|
MIFEPRISTONE ORAL 200 MG
|
HCPCS
|
2 for Encounter for elective termination of pregnancy is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .What is the diagnosis code for misoprostol? ›
HCPCS Code for Misoprostol, oral, 200 mcg S0191.What is the procedure code for medical abortion? ›
Methods for Medically Inducing the Termination of Pregnancy Early medical Early medical terminations are typically J3490, S0190, performed on an outpatient basis.What is the ICD-10 code for complete or unspecified spontaneous abortion without complication? ›
9: Spontaneous abortion Complete or unspecified, without complication.What is ICD-10 code 10E0XZZ? ›
A spontaneous delivery is a vaginal delivery that is manually assisted with no use of instrumentation such as forceps or vacuum extraction.
|
J3490
|
ZINC SULFATE 220MG 220MG CP
|
HCPCS
|
2 for Encounter for elective termination of pregnancy is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .What is the diagnosis code for misoprostol? ›
HCPCS Code for Misoprostol, oral, 200 mcg S0191.What is the procedure code for medical abortion? ›
Methods for Medically Inducing the Termination of Pregnancy Early medical Early medical terminations are typically J3490, S0190, performed on an outpatient basis.What is the ICD-10 code for complete or unspecified spontaneous abortion without complication? ›
9: Spontaneous abortion Complete or unspecified, without complication.What is ICD-10 code 10E0XZZ? ›
A spontaneous delivery is a vaginal delivery that is manually assisted with no use of instrumentation such as forceps or vacuum extraction.
|
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 with CAD. CPT/HCPCS Codes: G0202-52, 77052
ICD-9-CM Codes: V76.11, V10.3
Example 3:History: A 42-year-old female, annual exam.
|
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 with CAD. CPT/HCPCS Codes: G0202-52, 77052
ICD-9-CM Codes: V76.11, V10.3
Example 3:History: A 42-year-old female, annual exam.
|
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, V10.3
Example 3:History: A 42-year-old female, annual exam. Comparison: Mammogram one year prior. Findings: Bilateral digital implant screening mammogram, standard and displaced views were obtained.
|
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, V10.3
Example 3:History: A 42-year-old female, annual exam. Comparison: Mammogram one year prior. Findings: Bilateral digital implant screening mammogram, standard and displaced views were obtained.
|
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 please visit FindACode.com where you will find the ICD-10 code sets and the current ICD-9-CM, CPT, and HCPCS code sets plus a wealth of additional information related to medical billing and coding. This article is available for publishing on websites, blogs, and newsletters.
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77052
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Comp screen mammogram add-on
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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 please visit FindACode.com where you will find the ICD-10 code sets and the current ICD-9-CM, CPT, and HCPCS code sets plus a wealth of additional information related to medical billing and coding. This article is available for publishing on websites, blogs, and newsletters.
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G0202
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Scr mammo bi incl cad
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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-10 code sets and the current ICD-9-CM, CPT, and HCPCS code sets plus a wealth of additional information related to medical billing and coding. This article is available for publishing on websites, blogs, and newsletters. The article must be published in its entirety - all links must be active.
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77052
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Comp screen mammogram add-on
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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-10 code sets and the current ICD-9-CM, CPT, and HCPCS code sets plus a wealth of additional information related to medical billing and coding. This article is available for publishing on websites, blogs, and newsletters. The article must be published in its entirety - all links must be active.
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A9580
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Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries
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HCPCS
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04/12/2010: Description section revised to add the four oncologic applications of PET Scanning; Policy section revised to add indications considered medically necessary for Melanoma, Lymphoma, lung; colorectal; pancreatic; head & neck; esophageal; breast; ovarian and testicular cancers. Added indications considered medically necessary for differentiated thyroid and cervical cancers; added prostate cancer and cancer surveillance as investigational for all indications. Code reference section revised to add the following ICD-9 diagnosis codes to the covered codes table: 140.0 - 140.9; 141.0 - 141.9; 142.0 - 142.9; 143.0 - 143.9; 150.0 -150.9; 151.0 - 151.9, 155.1; 156.0; 156.2; 157.0 -157.9; 158.0 - 158.9; 159.0 - 159.9; 174.0 - 174.5 and 174.8 - 174.9; 175.0; 175.9; 180.0 - 180.9; 180.3 -183.9; 186.0; 186.9; 190.0 - 190.9; 191.0 - 191.9; 193; 194.0 - 194.9; 195.0; 198.3; 198.4; 198.6; 198.7; 198.81; 198.82; 209.00 - 209.03; 209.20 - 209.29; 230.0 - 230.9; 231.0 - 231.0 - 231.9; 233.0; 233.1; 234.0 - 234.9; 236.2; 235.4; 237.5; 239.0; 239.1; 239.3; 239.6; 239.9; 518.89; 784.2; and 795.81. Moved HCPCS Code A9580 from non-covered to covered table. 10/05/2010: Policy reviewed; policy statement unchanged.
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A9580
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Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries
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HCPCS
|
Added indications considered medically necessary for differentiated thyroid and cervical cancers; added prostate cancer and cancer surveillance as investigational for all indications. Code reference section revised to add the following ICD-9 diagnosis codes to the covered codes table: 140.0 - 140.9; 141.0 - 141.9; 142.0 - 142.9; 143.0 - 143.9; 150.0 -150.9; 151.0 - 151.9, 155.1; 156.0; 156.2; 157.0 -157.9; 158.0 - 158.9; 159.0 - 159.9; 174.0 - 174.5 and 174.8 - 174.9; 175.0; 175.9; 180.0 - 180.9; 180.3 -183.9; 186.0; 186.9; 190.0 - 190.9; 191.0 - 191.9; 193; 194.0 - 194.9; 195.0; 198.3; 198.4; 198.6; 198.7; 198.81; 198.82; 209.00 - 209.03; 209.20 - 209.29; 230.0 - 230.9; 231.0 - 231.0 - 231.9; 233.0; 233.1; 234.0 - 234.9; 236.2; 235.4; 237.5; 239.0; 239.1; 239.3; 239.6; 239.9; 518.89; 784.2; and 795.81. Moved HCPCS Code A9580 from non-covered to covered table. 10/05/2010: Policy reviewed; policy statement unchanged. Removed the following ICD-9 codes from the Covered Codes table to be consistent with the policy statement: 151.0-151.9, 152.0-152.9, 155.0-155.2, 156.0-156.9, 158.0-158.9, 159.0, 159.1, 159.8, 159.9, 194.0-194.9, 197.4, 197.5, 197.8, 198.3, 198.4, 198.6, 198.7, 198.81, 198.82, 209.00, 209.01, 209.02, 209.03, 209.11, 209.20-209.29, 230.2, 231.9, 234.8, 234.9, 235.2, 235.3, 235.4, 784.2, and 795.81.
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A9580
|
Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries
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HCPCS
|
Code reference section revised to add the following ICD-9 diagnosis codes to the covered codes table: 140.0 - 140.9; 141.0 - 141.9; 142.0 - 142.9; 143.0 - 143.9; 150.0 -150.9; 151.0 - 151.9, 155.1; 156.0; 156.2; 157.0 -157.9; 158.0 - 158.9; 159.0 - 159.9; 174.0 - 174.5 and 174.8 - 174.9; 175.0; 175.9; 180.0 - 180.9; 180.3 -183.9; 186.0; 186.9; 190.0 - 190.9; 191.0 - 191.9; 193; 194.0 - 194.9; 195.0; 198.3; 198.4; 198.6; 198.7; 198.81; 198.82; 209.00 - 209.03; 209.20 - 209.29; 230.0 - 230.9; 231.0 - 231.0 - 231.9; 233.0; 233.1; 234.0 - 234.9; 236.2; 235.4; 237.5; 239.0; 239.1; 239.3; 239.6; 239.9; 518.89; 784.2; and 795.81. Moved HCPCS Code A9580 from non-covered to covered table. 10/05/2010: Policy reviewed; policy statement unchanged. Removed the following ICD-9 codes from the Covered Codes table to be consistent with the policy statement: 151.0-151.9, 152.0-152.9, 155.0-155.2, 156.0-156.9, 158.0-158.9, 159.0, 159.1, 159.8, 159.9, 194.0-194.9, 197.4, 197.5, 197.8, 198.3, 198.4, 198.6, 198.7, 198.81, 198.82, 209.00, 209.01, 209.02, 209.03, 209.11, 209.20-209.29, 230.2, 231.9, 234.8, 234.9, 235.2, 235.3, 235.4, 784.2, and 795.81. Corrected typo to change 235.4 to 236.4.
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A9580
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Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries
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HCPCS
|
Moved HCPCS Code A9580 from non-covered to covered table. 10/05/2010: Policy reviewed; policy statement unchanged. Removed the following ICD-9 codes from the Covered Codes table to be consistent with the policy statement: 151.0-151.9, 152.0-152.9, 155.0-155.2, 156.0-156.9, 158.0-158.9, 159.0, 159.1, 159.8, 159.9, 194.0-194.9, 197.4, 197.5, 197.8, 198.3, 198.4, 198.6, 198.7, 198.81, 198.82, 209.00, 209.01, 209.02, 209.03, 209.11, 209.20-209.29, 230.2, 231.9, 234.8, 234.9, 235.2, 235.3, 235.4, 784.2, and 795.81. Corrected typo to change 235.4 to 236.4. Added 199.1, 209.20, 209.72, and 233.6 to the Covered Codes table.
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L8692
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Non-osseointegrated snd proc
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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 medical practitioners practicing in relevant clinical areas and any other relevant factors. 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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY8/24/2007: Policy added
9/19/2007: Code reference section updated. ICD-9 2007 revisions added to policy
11/15/2007: Policy approved by MPAC
10/7/2008: Policy reviewed, no changes
3/15/2010: Code Reference section updated. New HCPCS code L8692 added to covered table.
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L8692
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Non-osseointegrated snd proc
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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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY8/24/2007: Policy added
9/19/2007: Code reference section updated. ICD-9 2007 revisions added to policy
11/15/2007: Policy approved by MPAC
10/7/2008: Policy reviewed, no changes
3/15/2010: Code Reference section updated. New HCPCS code L8692 added to covered table. 04/21/2010: Policy description updated regarding FDA approval of devices.
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L8692
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Non-osseointegrated snd proc
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HCPCS
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POLICY HISTORY8/24/2007: Policy added
9/19/2007: Code reference section updated. ICD-9 2007 revisions added to policy
11/15/2007: Policy approved by MPAC
10/7/2008: Policy reviewed, no changes
3/15/2010: Code Reference section updated. New HCPCS code L8692 added to covered table. 04/21/2010: Policy description updated regarding FDA approval of devices. The medically necessary policy statements were revised to add “5 years of age and older” to be consistent with FDA-approved labeling.
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L8692
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Non-osseointegrated snd proc
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HCPCS
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ICD-9 2007 revisions added to policy
11/15/2007: Policy approved by MPAC
10/7/2008: Policy reviewed, no changes
3/15/2010: Code Reference section updated. New HCPCS code L8692 added to covered table. 04/21/2010: Policy description updated regarding FDA approval of devices. The medically necessary policy statements were revised to add “5 years of age and older” to be consistent with FDA-approved labeling. “Sensorineural” added to the second statement.
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L8692
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Non-osseointegrated snd proc
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HCPCS
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New HCPCS code L8692 added to covered table. 04/21/2010: Policy description updated regarding FDA approval of devices. The medically necessary policy statements were revised to add “5 years of age and older” to be consistent with FDA-approved labeling. “Sensorineural” added to the second statement. The intent of the policy statements unchanged.
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L8693
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IMPL COCLR 4MM BAHA TI ABTMNT B1300
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HCPCS
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The intent of the policy statements unchanged. FEP verbiage added to the Policy Exceptions section. 03/09/2011: Added new HCPCS code L8693 to the Code Reference section. 04/25/2011: Audiologic criteria moved from the policy guidelines to the policy statement. 03/02/2012: Added policy statement to indicate that partially implantable bone conduction hearing systems using magnetic coupling for acoustic transmission are considered investigational.
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L8693
|
IMPL COCLR 4MM BAHA TI ABTMNT B1300
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HCPCS
|
FEP verbiage added to the Policy Exceptions section. 03/09/2011: Added new HCPCS code L8693 to the Code Reference section. 04/25/2011: Audiologic criteria moved from the policy guidelines to the policy statement. 03/02/2012: Added policy statement to indicate that partially implantable bone conduction hearing systems using magnetic coupling for acoustic transmission are considered investigational. Other policy statements unchanged.
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L8693
|
IMPL COCLR 4MM BAHA TI ABTMNT B1300
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HCPCS
|
03/09/2011: Added new HCPCS code L8693 to the Code Reference section. 04/25/2011: Audiologic criteria moved from the policy guidelines to the policy statement. 03/02/2012: Added policy statement to indicate that partially implantable bone conduction hearing systems using magnetic coupling for acoustic transmission are considered investigational. Other policy statements unchanged. 04/04/2013: Policy reviewed; no changes.
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A5120
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Skin barrier, wipes or swabs, each
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HCPCS
|
HCPCS codes are five digits in length with no decimal holders and are alphanumeric in nature. Each codes begins with a letter and is followed by four numbers. The HCPCS book structured very similar to the CPT book. HCPCS Code ExamplesK0011 - Standard-weight frame motorized power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking
A5120 - Skin barrier, wipes or swabs, each
Q4011 - Cast supplies, short arm cast, pediatric (0-10 years), plaster. ~ The Table of Drugs with drugs listed alphabeticaly is next.
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K0011
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Stnd wt pwr whlchr w control
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HCPCS
|
HCPCS codes are five digits in length with no decimal holders and are alphanumeric in nature. Each codes begins with a letter and is followed by four numbers. The HCPCS book structured very similar to the CPT book. HCPCS Code ExamplesK0011 - Standard-weight frame motorized power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking
A5120 - Skin barrier, wipes or swabs, each
Q4011 - Cast supplies, short arm cast, pediatric (0-10 years), plaster. ~ The Table of Drugs with drugs listed alphabeticaly is next.
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Q4011
|
Cast sup sht arm ped plaster
|
HCPCS
|
HCPCS codes are five digits in length with no decimal holders and are alphanumeric in nature. Each codes begins with a letter and is followed by four numbers. The HCPCS book structured very similar to the CPT book. HCPCS Code ExamplesK0011 - Standard-weight frame motorized power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking
A5120 - Skin barrier, wipes or swabs, each
Q4011 - Cast supplies, short arm cast, pediatric (0-10 years), plaster. ~ The Table of Drugs with drugs listed alphabeticaly is next.
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A5120
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Skin barrier, wipes or swabs, each
|
HCPCS
|
Each codes begins with a letter and is followed by four numbers. The HCPCS book structured very similar to the CPT book. HCPCS Code ExamplesK0011 - Standard-weight frame motorized power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking
A5120 - Skin barrier, wipes or swabs, each
Q4011 - Cast supplies, short arm cast, pediatric (0-10 years), plaster. ~ The Table of Drugs with drugs listed alphabeticaly is next. ~ HCPCS modifiers listed with their full description is located between the Table of Drugs and the Tabula index.
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K0011
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Stnd wt pwr whlchr w control
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HCPCS
|
Each codes begins with a letter and is followed by four numbers. The HCPCS book structured very similar to the CPT book. HCPCS Code ExamplesK0011 - Standard-weight frame motorized power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking
A5120 - Skin barrier, wipes or swabs, each
Q4011 - Cast supplies, short arm cast, pediatric (0-10 years), plaster. ~ The Table of Drugs with drugs listed alphabeticaly is next. ~ HCPCS modifiers listed with their full description is located between the Table of Drugs and the Tabula index.
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Q4011
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Cast sup sht arm ped plaster
|
HCPCS
|
Each codes begins with a letter and is followed by four numbers. The HCPCS book structured very similar to the CPT book. HCPCS Code ExamplesK0011 - Standard-weight frame motorized power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking
A5120 - Skin barrier, wipes or swabs, each
Q4011 - Cast supplies, short arm cast, pediatric (0-10 years), plaster. ~ The Table of Drugs with drugs listed alphabeticaly is next. ~ HCPCS modifiers listed with their full description is located between the Table of Drugs and the Tabula index.
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A5120
|
Skin barrier, wipes or swabs, each
|
HCPCS
|
HCPCS Code ExamplesK0011 - Standard-weight frame motorized power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking
A5120 - Skin barrier, wipes or swabs, each
Q4011 - Cast supplies, short arm cast, pediatric (0-10 years), plaster. ~ The Table of Drugs with drugs listed alphabeticaly is next. ~ HCPCS modifiers listed with their full description is located between the Table of Drugs and the Tabula index. ~ The Tabular index lists all codes with their full description, conventions, and notations and is located in the center of the book. ~ Appendix A which is for Internet Only Manuals makes up the remainder of the book.
|
K0011
|
Stnd wt pwr whlchr w control
|
HCPCS
|
HCPCS Code ExamplesK0011 - Standard-weight frame motorized power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking
A5120 - Skin barrier, wipes or swabs, each
Q4011 - Cast supplies, short arm cast, pediatric (0-10 years), plaster. ~ The Table of Drugs with drugs listed alphabeticaly is next. ~ HCPCS modifiers listed with their full description is located between the Table of Drugs and the Tabula index. ~ The Tabular index lists all codes with their full description, conventions, and notations and is located in the center of the book. ~ Appendix A which is for Internet Only Manuals makes up the remainder of the book.
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Q4011
|
Cast sup sht arm ped plaster
|
HCPCS
|
HCPCS Code ExamplesK0011 - Standard-weight frame motorized power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking
A5120 - Skin barrier, wipes or swabs, each
Q4011 - Cast supplies, short arm cast, pediatric (0-10 years), plaster. ~ The Table of Drugs with drugs listed alphabeticaly is next. ~ HCPCS modifiers listed with their full description is located between the Table of Drugs and the Tabula index. ~ The Tabular index lists all codes with their full description, conventions, and notations and is located in the center of the book. ~ Appendix A which is for Internet Only Manuals makes up the remainder of the book.
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1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
CPT identifies the services provided and helps determine how much physicians will be paid for their services by insurance companies. HCPCS – Healthcare Common Procedure Coding System (HCPCS) is a set of health care procedure codes based on the AMA’s CPT system. HCPCS is a medical billing process used by the Centers for Medicare and Medicaid Services (CMS). The HCPCS coding procedure was created to standardize the coding of specific items and services provided by health care professionals and billed to Medicare and Medicaid. The HIPPA Act of 1996 made the use of HCPCS coding mandatory for processing insurance claims through Medicare and Medicaid.
|
1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
HCPCS – Healthcare Common Procedure Coding System (HCPCS) is a set of health care procedure codes based on the AMA’s CPT system. HCPCS is a medical billing process used by the Centers for Medicare and Medicaid Services (CMS). The HCPCS coding procedure was created to standardize the coding of specific items and services provided by health care professionals and billed to Medicare and Medicaid. The HIPPA Act of 1996 made the use of HCPCS coding mandatory for processing insurance claims through Medicare and Medicaid. The Six C’s of Medical Records
Medical office administrative assistants should memorize these six C’s to maintain accurate patient medical records.
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1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
HCPCS is a medical billing process used by the Centers for Medicare and Medicaid Services (CMS). The HCPCS coding procedure was created to standardize the coding of specific items and services provided by health care professionals and billed to Medicare and Medicaid. The HIPPA Act of 1996 made the use of HCPCS coding mandatory for processing insurance claims through Medicare and Medicaid. The Six C’s of Medical Records
Medical office administrative assistants should memorize these six C’s to maintain accurate patient medical records. They are client’s words, clarity, completeness, conciseness, chronological order, and confidentiality.
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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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
86816
|
HC HLA TYPING DR/DQ SINGLE AG
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
38204
|
PR MGMT RCP HEMATOP PROGENITOR CELL DONOR &ACQUISJ
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
86821
|
Lymphocyte culture mixed
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
86812
|
Immunologic analysis for autoimmune disease, A, B, or C, single antigen
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
86822
|
Lymphocyte culture primed
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
86817
|
HC HLA TYPING; DR/DQ, MULTIPLE ANTIGENS
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
86813
|
HC HLA TYPING; A, B, OR C, MULTIPLE ANTIGENS
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
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 must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed.
|
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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed. No changes.
|
86816
|
HC HLA TYPING DR/DQ SINGLE AG
|
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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed. No changes.
|
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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed. No changes.
|
38204
|
PR MGMT RCP HEMATOP PROGENITOR CELL DONOR &ACQUISJ
|
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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed. No changes.
|
86821
|
Lymphocyte culture mixed
|
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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed. No changes.
|
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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed. No changes.
|
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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed. No changes.
|
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. 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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed. No changes.
|
86822
|
Lymphocyte culture primed
|
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 # 8.01.27 per approval by Medical Policy Advisory Committee (MPAC)
6/25/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; Covered table - CPT-4 code 38230 added; ICD-9 Procedure 41.01, 41.09 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table - CPT-4 code 38204, 86812, 86813, 86816, 86817, 86821, 86822 added, ICD-9 Procedure 41.02, 41.03 added
3/22/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy
1/3/2007: Policy reviewed, all medically necessary language removed as newer studies have shown no increase survival of patients with stem cell transplants after high-dose chemotherapy
1/4/2007: Code reference section updated; All CPT, HCPCS, and ICD-9 procedure codes moved to non-covered. Covered codes removed
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
1/06/2009: Policy reviewed. No changes.
|
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