code stringlengths 4 12 | description stringlengths 2 264 | codetype stringclasses 8
values | context stringlengths 160 15.5k |
|---|---|---|---|
L8617 | Transmitting coil for use with cochlear implant device, replacement | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
92601 | PR ANALYSIS COCHLEAR IMPLT PT <7 YR PRGRMG | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
V5299 | Hearing service | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
V5362 | Speech screening | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
92604 | Reprogram cochlear implt 7/> | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
L8618 | Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
1999 | ANESTHESIOLOGY GROUP | CPT | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
92603 | PR ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
L8619 | PROCESSOR SOUND SONNET/RONDO 3 KT | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
92602 | Reprogram cochlear implt <7 | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
69949 | Unlisted px inner ear | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
L8616 | Microphone for use with cochlear implant device, replacement | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
V5363 | Language screening | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
V5336 | Repair communication device | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
92507 | Treatment of speech, language, voice, communication, and/or hearing processing disorder | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
V5273 | Ald for cochlear implant | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
92508 | Speech/hearing therapy | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
V5269 | Alerting device, any type | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
92510 | Rehab for ear implant | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
L8615 | Headset/headpiece for use with cochlear implant device, replacement | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
L8617 | Transmitting coil for use with cochlear implant device, replacement | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
92601 | PR ANALYSIS COCHLEAR IMPLT PT <7 YR PRGRMG | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
V5299 | Hearing service | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
V5362 | Speech screening | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
92604 | Reprogram cochlear implt 7/> | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
L8618 | Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
1999 | ANESTHESIOLOGY GROUP | CPT | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
92603 | PR ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
L8619 | PROCESSOR SOUND SONNET/RONDO 3 KT | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
92602 | Reprogram cochlear implt <7 | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
69949 | Unlisted px inner ear | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
L8616 | Microphone for use with cochlear implant device, replacement | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield ... |
V5363 | Language screening | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
V5336 | Repair communication device | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
92507 | Treatment of speech, language, voice, communication, and/or hearing processing disorder | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
V5273 | Ald for cochlear implant | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
92508 | Speech/hearing therapy | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
V5269 | Alerting device, any type | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
92510 | Rehab for ear implant | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
L8615 | Headset/headpiece for use with cochlear implant device, replacement | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
L8617 | Transmitting coil for use with cochlear implant device, replacement | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
92601 | PR ANALYSIS COCHLEAR IMPLT PT <7 YR PRGRMG | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
V5299 | Hearing service | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
V5362 | Speech screening | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
92604 | Reprogram cochlear implt 7/> | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
L8618 | Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
1999 | ANESTHESIOLOGY GROUP | CPT | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
92603 | PR ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
L8619 | PROCESSOR SOUND SONNET/RONDO 3 KT | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
92602 | Reprogram cochlear implt <7 | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
69949 | Unlisted px inner ear | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
L8616 | Microphone for use with cochlear implant device, replacement | HCPCS | POLICY HISTORY7/1992: Approved by Medical Policy Advisory Committee (MPAC)
12/30/1999: Policy Guidelines updated
9/21/2001:Policy rewritten to be reflective of Blue Cross Blue Shield Association policy # 7.01.05, Code Reference section updated, CPT code 92507, 92510 added
11/2001: Reviewed by MPAC; revisions approved
4... |
L8627 | Cochlear implant, external speech processor, component, replacement | HCPCS | ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from in... |
L8628 | Cochlear implant, external controller component, replacement | HCPCS | ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from in... |
L8629 | Transmitting coil and cable, integrated, for use with cochlear implant device, replacement | HCPCS | ICD9 2006 revisions added to policy
12/27/2006: Code Reference section updated per the 2007 HCPCS revisions
3/27/2007: Policy reviewed, no changes to policy statement. Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from in... |
L8627 | Cochlear implant, external speech processor, component, replacement | HCPCS | Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated. ICD-9 2007 revisions added to... |
L8628 | Cochlear implant, external controller component, replacement | HCPCS | Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated. ICD-9 2007 revisions added to... |
L8629 | Transmitting coil and cable, integrated, for use with cochlear implant device, replacement | HCPCS | Bilateral cochlear implantation added to Policy Guidelines section
06/26/2007: Policy statement updated; bilateral cochlear implantation changed from investigational to may be considered medically necessary
7/19/2007: Reviewed and approved by MPAC
9/18/2007: Code reference section updated. ICD-9 2007 revisions added to... |
L8627 | Cochlear implant, external speech processor, component, replacement | HCPCS | ICD-9 2007 revisions added to policy
1/7/2009: Policy reviewed, policy section partially rewritten and clarified. 3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table. 04/26/2010: Policy description updated regarding devices. Policy statements modified for clarity; in... |
L8628 | Cochlear implant, external controller component, replacement | HCPCS | ICD-9 2007 revisions added to policy
1/7/2009: Policy reviewed, policy section partially rewritten and clarified. 3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table. 04/26/2010: Policy description updated regarding devices. Policy statements modified for clarity; in... |
L8629 | Transmitting coil and cable, integrated, for use with cochlear implant device, replacement | HCPCS | ICD-9 2007 revisions added to policy
1/7/2009: Policy reviewed, policy section partially rewritten and clarified. 3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table. 04/26/2010: Policy description updated regarding devices. Policy statements modified for clarity; in... |
L8627 | Cochlear implant, external speech processor, component, replacement | HCPCS | 3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table. 04/26/2010: Policy description updated regarding devices. Policy statements modified for clarity; intent unchanged. Contraindications to cochlear implantation added to the policy guidelines. |
L8628 | Cochlear implant, external controller component, replacement | HCPCS | 3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table. 04/26/2010: Policy description updated regarding devices. Policy statements modified for clarity; intent unchanged. Contraindications to cochlear implantation added to the policy guidelines. |
L8629 | Transmitting coil and cable, integrated, for use with cochlear implant device, replacement | HCPCS | 3/12/2010: Code Reference section updated. New HCPCS codes L8627, L8628 and L8629 added to covered table. 04/26/2010: Policy description updated regarding devices. Policy statements modified for clarity; intent unchanged. Contraindications to cochlear implantation added to the policy guidelines. |
1000 | HC ASAM LEVEL 3.7 MEDICALLY MONITORED INPATIENT | RC | Medically necessary policy statement updated to make correction: "100 HZ" updated to "1000 HZ." Policy Guidelines section updated regarding cochlear ossification and to add medically necessary and investigative definitions. 05/31/2016: Policy number added. SOURCE(S)Blue Cross Blue Shield Association policy # 7.01.05
CO... |
20694 | Rmvl ext fixj sys under anes | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
21206 | Reconstruct upper jaw bone | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
42200 | Reconstruct cleft palate | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
D6199 | PR UNSPEC IMPLANT PROCEDURE BY REPORT | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
21196 | Reconst lwr jaw w/fixation | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
21247 | Reconstruct lower jaw bone | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
D8999 | PR UNS ORTHODONTIC PROCEDURE BY REPORT | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
20693 | PR ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
D8010 | PR LTD ORTHODONT TX PRIMARY DENTITION | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
30462 | Revision of nose | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
21110 | PR APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
0232T | Njx platelet plasma | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
21210 | PR GRAFT BONE NASAL/MAXILLARY/MALAR AREAS | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
20696 | PR APP MLTPLN UNI XTRNL FIX STRTCTC ADJMT 1ST&SUBSQ | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
30400 | Reconstruction of nose | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
21120 | Reconstruction of chin | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
20692 | PR APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
38220 | PR DIAGNOSTIC BONE MARROW ASPIRATIONS | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
D7949 | Reconstruct midface w/graft | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
42225 | Reconstruct cleft palate | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
20697 | PR APP MLTPLN UNI XTRNL FIX STRTCTC ADJMT EXCHANGE | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
D6010 | PR SURG PLCMT IMPL BODY: ENDOSTEAL | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
S9055 | Procuren or other growth fac | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
D7946 | Reconstruction maxilla total | HCPCS | The mean follow-up time was 28.7 months. The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriat... |
20694 | Rmvl ext fixj sys under anes | HCPCS | The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriately selected patients. |CPT Codes / HCPCS... |
21206 | Reconstruct upper jaw bone | HCPCS | The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriately selected patients. |CPT Codes / HCPCS... |
42200 | Reconstruct cleft palate | HCPCS | The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriately selected patients. |CPT Codes / HCPCS... |
D6199 | PR UNSPEC IMPLANT PROCEDURE BY REPORT | HCPCS | The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriately selected patients. |CPT Codes / HCPCS... |
21196 | Reconst lwr jaw w/fixation | HCPCS | The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriately selected patients. |CPT Codes / HCPCS... |
21247 | Reconstruct lower jaw bone | HCPCS | The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriately selected patients. |CPT Codes / HCPCS... |
D8999 | PR UNS ORTHODONTIC PROCEDURE BY REPORT | HCPCS | The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriately selected patients. |CPT Codes / HCPCS... |
20693 | PR ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES | HCPCS | The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriately selected patients. |CPT Codes / HCPCS... |
D8010 | PR LTD ORTHODONT TX PRIMARY DENTITION | HCPCS | The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriately selected patients. |CPT Codes / HCPCS... |
30462 | Revision of nose | HCPCS | The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriately selected patients. |CPT Codes / HCPCS... |
21110 | PR APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC | HCPCS | The authors concluded that in addition to its positive effect on facial appearance, mandibular distraction osteogenesis is an effective procedure for the treatment of airway obstruction associated with congenital craniofacial defects involving mandibular hypoplasia in appropriately selected patients. |CPT Codes / HCPCS... |
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