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15.5k
0232T
Njx platelet plasma
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...
21210
PR GRAFT BONE NASAL/MAXILLARY/MALAR AREAS
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...
20696
PR APP MLTPLN UNI XTRNL FIX STRTCTC ADJMT 1ST&SUBSQ
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...
30400
Reconstruction 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...
21120
Reconstruction of chin
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...
20692
PR APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM
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...
38220
PR DIAGNOSTIC BONE MARROW ASPIRATIONS
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...
D7949
Reconstruct midface w/graft
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...
42225
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...
20697
PR APP MLTPLN UNI XTRNL FIX STRTCTC ADJMT EXCHANGE
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...
D6010
PR SURG PLCMT IMPL BODY: ENDOSTEAL
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...
S9055
Procuren or other growth fac
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...
D7946
Reconstruction maxilla total
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...
77385
HC IMRT SIMPLE
HCPCS
New CPT codes 77385-77387, effective 1/1/15, added to policy; deleted code 0073T and 77418 noted on policy effective 12/31/14. Coding update. New code 77387 removed from policy; this is not specific to IMRT. Coding update. HCPCS code G6015 added to the policy, new code effective 1/1/15.
77418
Radiation tx delivery imrt
HCPCS
New CPT codes 77385-77387, effective 1/1/15, added to policy; deleted code 0073T and 77418 noted on policy effective 12/31/14. Coding update. New code 77387 removed from policy; this is not specific to IMRT. Coding update. HCPCS code G6015 added to the policy, new code effective 1/1/15.
77387
HC STEREOSCOPIC X-RAY GUIDANCE
HCPCS
New CPT codes 77385-77387, effective 1/1/15, added to policy; deleted code 0073T and 77418 noted on policy effective 12/31/14. Coding update. New code 77387 removed from policy; this is not specific to IMRT. Coding update. HCPCS code G6015 added to the policy, new code effective 1/1/15.
G6015
Radiation tx delivery imrt
HCPCS
New CPT codes 77385-77387, effective 1/1/15, added to policy; deleted code 0073T and 77418 noted on policy effective 12/31/14. Coding update. New code 77387 removed from policy; this is not specific to IMRT. Coding update. HCPCS code G6015 added to the policy, new code effective 1/1/15.
0073T
Delivery comp imrt
HCPCS
New CPT codes 77385-77387, effective 1/1/15, added to policy; deleted code 0073T and 77418 noted on policy effective 12/31/14. Coding update. New code 77387 removed from policy; this is not specific to IMRT. Coding update. HCPCS code G6015 added to the policy, new code effective 1/1/15.
G6015
Radiation tx delivery imrt
HCPCS
New code 77387 removed from policy; this is not specific to IMRT. Coding update. HCPCS code G6015 added to the policy, new code effective 1/1/15. Annual Review. Policy updated with literature review through March 5, 2015.
77387
HC STEREOSCOPIC X-RAY GUIDANCE
HCPCS
New code 77387 removed from policy; this is not specific to IMRT. Coding update. HCPCS code G6015 added to the policy, new code effective 1/1/15. Annual Review. Policy updated with literature review through March 5, 2015.
G6015
Radiation tx delivery imrt
HCPCS
HCPCS code G6015 added to the policy, new code effective 1/1/15. Annual Review. Policy updated with literature review through March 5, 2015. Reference 12 added, and reference 13 updated. Title changed from “radiation therapy” to “radiotherapy” to be consistent with other medical policies.
1996
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
HCPCS
CMS is considering phasing out HCPCS. There are 3 levels within HCPCS: HCPCS Level 1 Consists of the American Medical Association's Current Procedural Terminology (CPT) and is numeric (as opposed to alphabetic like the index). HCPCS Level 2 Level 2 consists of non-physician services such as ambulatory care and durable ...
1996
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
HCPCS
There are 3 levels within HCPCS: HCPCS Level 1 Consists of the American Medical Association's Current Procedural Terminology (CPT) and is numeric (as opposed to alphabetic like the index). HCPCS Level 2 Level 2 consists of non-physician services such as ambulatory care and durable medical goods such as prosthetics. HCP...
1996
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
HCPCS
HCPCS Level 2 Level 2 consists of non-physician services such as ambulatory care and durable medical goods such as prosthetics. HCPCS Level 3 Level 3 consisted of state-level medical coding codesets. The HIPAA Act of 1996 required a nationwide standard for medical coding. As a result, level 3 was discontinued on Decemb...
1996
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
HCPCS
HCPCS Level 3 Level 3 consisted of state-level medical coding codesets. The HIPAA Act of 1996 required a nationwide standard for medical coding. As a result, level 3 was discontinued on December 31, 2003. Current Procedural Terminology (CPT) is an outpatient medical coding codeset that is copy-written by the American M...
L8692
Non-osseointegrated snd proc
HCPCS
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and ...
L8692
Non-osseointegrated snd proc
HCPCS
The coverage guidelines outlined in the Medical Policy should not be used in lieu of the Member's specific benefit plan language. 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 chang...
L8692
Non-osseointegrated snd proc
HCPCS
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 ...
L8692
Non-osseointegrated snd proc
HCPCS
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...
L8692
Non-osseointegrated snd proc
HCPCS
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 po...
L8693
IMPL COCLR 4MM BAHA TI ABTMNT B1300
HCPCS
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 partiall...
L8693
IMPL COCLR 4MM BAHA TI ABTMNT B1300
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 u...
L8693
IMPL COCLR 4MM BAHA TI ABTMNT B1300
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 ...
95904
Sense nerve conduction test
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...
95903
Motor nerve conduction test
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...
95900
Motor nerve conduction test
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...
95904
Sense nerve conduction test
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/2/2007: Policy added 3/22/2007: Reviewed and approved by Medical Policy Advisory Committee (MPAC) 6/14/2007: Code Reference section updated per quarterly HCPCS and Cat...
95903
Motor nerve conduction test
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/2/2007: Policy added 3/22/2007: Reviewed and approved by Medical Policy Advisory Committee (MPAC) 6/14/2007: Code Reference section updated per quarterly HCPCS and Cat...
95900
Motor nerve conduction test
HCPCS
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/2/2007: Policy added 3/22/2007: Reviewed and approved by Medical Policy Advisory Committee (MPAC) 6/14/2007: Code Reference section updated per quarterly HCPCS and Cat...
00100
ANESTH SALIVARY GLAND
CPT
The American Medical Association was first to introduce Current Procedural Terminology codes. It was in the 1960s and its aim was to enable medical staff to use standardized terms to document procedures and services in medical records. Nowadays, more than 10,000 different 6-digit CPT codes ranging between 00100 and 994...
1000
HC ASAM LEVEL 3.7 MEDICALLY MONITORED INPATIENT
RC
The ICD-10 codes are applicable for hospital inpatient procedures. ICD-10-PCS (Procedure Coding System), designed by 3M Health Information Management for Centers of Medicare and Medicaid, is the code set to replace the Volume 3 of ICD-9-CM for inpatient procedure reporting. This ICD-10-PCS has approx. 71000 alpha-numer...
1000
HC ASAM LEVEL 3.7 MEDICALLY MONITORED INPATIENT
RC
ICD-10-PCS (Procedure Coding System), designed by 3M Health Information Management for Centers of Medicare and Medicaid, is the code set to replace the Volume 3 of ICD-9-CM for inpatient procedure reporting. This ICD-10-PCS has approx. 71000 alpha-numeric codes which has seven digits. Structure of ICD-10-PCS Codes: In ...
1000
HC ASAM LEVEL 3.7 MEDICALLY MONITORED INPATIENT
RC
This ICD-10-PCS has approx. 71000 alpha-numeric codes which has seven digits. Structure of ICD-10-PCS Codes: In the structure, For the example shown above, ICD-10 code for knee joint replacement (0SRC0JZ – Replacement of Right Knee Joint with Synthetic Substitute, Open Approach) means the following: For more informatio...
1743
Percutaneous robotic assisted procedure
ICD
2010, 7, 1720–1743. [Google Scholar] [CrossRef] - Good Health Adds Life to Years. Global Brief for World Health Day 2012; WHO: Geneva, Switzerland, 2012. - Giannangelo, K.; Millar, J. Mapping SNOMED CT to ICD-10. Stud.
28309
PR OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT
HCPCS
A cast is placed on the foot during the tenotomy procedure, but this is not billable because it’s not a separately identifiable procedure. More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, part...
L1960
HC SUPPLY ANKLE FOOT ORTHOSIS POSTERIOR SOLID ANKLE CUSTOM - L1960
HCPCS
A cast is placed on the foot during the tenotomy procedure, but this is not billable because it’s not a separately identifiable procedure. More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, part...
28285
Repair of hammertoe
HCPCS
A cast is placed on the foot during the tenotomy procedure, but this is not billable because it’s not a separately identifiable procedure. More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, part...
L2300
Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable
HCPCS
A cast is placed on the foot during the tenotomy procedure, but this is not billable because it’s not a separately identifiable procedure. More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, part...
L2280
Molded inner boot
HCPCS
A cast is placed on the foot during the tenotomy procedure, but this is not billable because it’s not a separately identifiable procedure. More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, part...
L2768
Orthotic side bar disconnect device, per bar
HCPCS
A cast is placed on the foot during the tenotomy procedure, but this is not billable because it’s not a separately identifiable procedure. More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, part...
28300
PR OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION
HCPCS
A cast is placed on the foot during the tenotomy procedure, but this is not billable because it’s not a separately identifiable procedure. More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, part...
28309
PR OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT
HCPCS
More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)) and osteotomies (code range 28300-28309, depending on the affected bones in the foot). DME Supply Coding For t...
L1960
HC SUPPLY ANKLE FOOT ORTHOSIS POSTERIOR SOLID ANKLE CUSTOM - L1960
HCPCS
More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)) and osteotomies (code range 28300-28309, depending on the affected bones in the foot). DME Supply Coding For t...
28285
Repair of hammertoe
HCPCS
More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)) and osteotomies (code range 28300-28309, depending on the affected bones in the foot). DME Supply Coding For t...
L2300
Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable
HCPCS
More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)) and osteotomies (code range 28300-28309, depending on the affected bones in the foot). DME Supply Coding For t...
L2280
Molded inner boot
HCPCS
More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)) and osteotomies (code range 28300-28309, depending on the affected bones in the foot). DME Supply Coding For t...
L2768
Orthotic side bar disconnect device, per bar
HCPCS
More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)) and osteotomies (code range 28300-28309, depending on the affected bones in the foot). DME Supply Coding For t...
28300
PR OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION
HCPCS
More extensive procedures may be necessary if the deformity is severe. Some examples of these are hammertoe correction (28285 Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)) and osteotomies (code range 28300-28309, depending on the affected bones in the foot). DME Supply Coding For t...
L1960
HC SUPPLY ANKLE FOOT ORTHOSIS POSTERIOR SOLID ANKLE CUSTOM - L1960
HCPCS
DME Supply Coding For the bracing, the following HCPCS Level II supply codes may be used, as prescribed by the physician: L1960 Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated L2280 Addition to lower extremity, molded inner boot L2300 Addition to lower extremity, abduction bar (bilateral hip invo...
L2300
Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable
HCPCS
DME Supply Coding For the bracing, the following HCPCS Level II supply codes may be used, as prescribed by the physician: L1960 Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated L2280 Addition to lower extremity, molded inner boot L2300 Addition to lower extremity, abduction bar (bilateral hip invo...
L2280
Molded inner boot
HCPCS
DME Supply Coding For the bracing, the following HCPCS Level II supply codes may be used, as prescribed by the physician: L1960 Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated L2280 Addition to lower extremity, molded inner boot L2300 Addition to lower extremity, abduction bar (bilateral hip invo...
L2768
Orthotic side bar disconnect device, per bar
HCPCS
DME Supply Coding For the bracing, the following HCPCS Level II supply codes may be used, as prescribed by the physician: L1960 Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated L2280 Addition to lower extremity, molded inner boot L2300 Addition to lower extremity, abduction bar (bilateral hip invo...
1999
ANESTHESIOLOGY GROUP
CPT
- Ophthalmic Technology Assessment Committee Cornea Panel American Academy of Ophthalmology. Corneal topography. Ophthalmology 1999; 106(8-Jan):1628-38. |CPT||92025||Computerized corneal topography, unilateral or bilateral, with interpretation and report| |92002–92014||General ophthalmological services| |ICD-9 Procedur...
1999
ANESTHESIOLOGY GROUP
CPT
Corneal topography. Ophthalmology 1999; 106(8-Jan):1628-38. |CPT||92025||Computerized corneal topography, unilateral or bilateral, with interpretation and report| |92002–92014||General ophthalmological services| |ICD-9 Procedure||95.02||Comprehensive eye examination| |95.09||Eye examination, not otherwise specified| |I...
1999
ANESTHESIOLOGY GROUP
CPT
Ophthalmology 1999; 106(8-Jan):1628-38. |CPT||92025||Computerized corneal topography, unilateral or bilateral, with interpretation and report| |92002–92014||General ophthalmological services| |ICD-9 Procedure||95.02||Comprehensive eye examination| |95.09||Eye examination, not otherwise specified| |ICD-9 Diagnosis||Not ...
1745
Thoracoscopic robotic assisted procedure
ICD
PMID 17141745. - World Health Organisation. (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organisation.
9067
Lutetium lu 177 dotatat t
APC
According to the CDC, flu vaccines protect against the three or four viruses (depending on the vaccine) that research suggests will be most common. For 2019-2020, trivalent (three-component) influenza vaccines contain: - A/Brisbane/02/2018 (H1N1)pdm09-like virus (updated) - A/Kansas/14/2017 (H3N2)-like virus (updated) ...
9075
Inj, kovaltry, 1 i.u.
APC
According to the CDC, flu vaccines protect against the three or four viruses (depending on the vaccine) that research suggests will be most common. For 2019-2020, trivalent (three-component) influenza vaccines contain: - A/Brisbane/02/2018 (H1N1)pdm09-like virus (updated) - A/Kansas/14/2017 (H3N2)-like virus (updated) ...
9065
Argatroban esrd dialysis
APC
According to the CDC, flu vaccines protect against the three or four viruses (depending on the vaccine) that research suggests will be most common. For 2019-2020, trivalent (three-component) influenza vaccines contain: - A/Brisbane/02/2018 (H1N1)pdm09-like virus (updated) - A/Kansas/14/2017 (H3N2)-like virus (updated) ...
9068
Smallpox&monkeypox vac 0.
APC
According to the CDC, flu vaccines protect against the three or four viruses (depending on the vaccine) that research suggests will be most common. For 2019-2020, trivalent (three-component) influenza vaccines contain: - A/Brisbane/02/2018 (H1N1)pdm09-like virus (updated) - A/Kansas/14/2017 (H3N2)-like virus (updated) ...
9067
Lutetium lu 177 dotatat t
APC
Compared with the 2018-19 season, the composition for 2019-20 represents updates in the influenza A(H1N1)pdm09 and influenza A(H3N2) components of the vaccine. Healthcare providers should prepare for the flux of injections by updating their billing systems with the 2019 Average Sales Price (ASP) Drug Pricing files and ...
9075
Inj, kovaltry, 1 i.u.
APC
Compared with the 2018-19 season, the composition for 2019-20 represents updates in the influenza A(H1N1)pdm09 and influenza A(H3N2) components of the vaccine. Healthcare providers should prepare for the flux of injections by updating their billing systems with the 2019 Average Sales Price (ASP) Drug Pricing files and ...
9065
Argatroban esrd dialysis
APC
Compared with the 2018-19 season, the composition for 2019-20 represents updates in the influenza A(H1N1)pdm09 and influenza A(H3N2) components of the vaccine. Healthcare providers should prepare for the flux of injections by updating their billing systems with the 2019 Average Sales Price (ASP) Drug Pricing files and ...
9068
Smallpox&monkeypox vac 0.
APC
Compared with the 2018-19 season, the composition for 2019-20 represents updates in the influenza A(H1N1)pdm09 and influenza A(H3N2) components of the vaccine. Healthcare providers should prepare for the flux of injections by updating their billing systems with the 2019 Average Sales Price (ASP) Drug Pricing files and ...
9067
Lutetium lu 177 dotatat t
APC
Healthcare providers should prepare for the flux of injections by updating their billing systems with the 2019 Average Sales Price (ASP) Drug Pricing files and reading the latest vaccine recommendations. CPT Vaccine Codes 2019-2020 CPT vaccine codes for the 2019-2020 flu season are as follows: - 90653: Influenza vaccin...
9075
Inj, kovaltry, 1 i.u.
APC
Healthcare providers should prepare for the flux of injections by updating their billing systems with the 2019 Average Sales Price (ASP) Drug Pricing files and reading the latest vaccine recommendations. CPT Vaccine Codes 2019-2020 CPT vaccine codes for the 2019-2020 flu season are as follows: - 90653: Influenza vaccin...
9065
Argatroban esrd dialysis
APC
Healthcare providers should prepare for the flux of injections by updating their billing systems with the 2019 Average Sales Price (ASP) Drug Pricing files and reading the latest vaccine recommendations. CPT Vaccine Codes 2019-2020 CPT vaccine codes for the 2019-2020 flu season are as follows: - 90653: Influenza vaccin...
9068
Smallpox&monkeypox vac 0.
APC
Healthcare providers should prepare for the flux of injections by updating their billing systems with the 2019 Average Sales Price (ASP) Drug Pricing files and reading the latest vaccine recommendations. CPT Vaccine Codes 2019-2020 CPT vaccine codes for the 2019-2020 flu season are as follows: - 90653: Influenza vaccin...
9067
Lutetium lu 177 dotatat t
APC
CPT Vaccine Codes 2019-2020 CPT vaccine codes for the 2019-2020 flu season are as follows: - 90653: Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for intramuscular use - 90662: Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramus...
9075
Inj, kovaltry, 1 i.u.
APC
CPT Vaccine Codes 2019-2020 CPT vaccine codes for the 2019-2020 flu season are as follows: - 90653: Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for intramuscular use - 90662: Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramus...
9065
Argatroban esrd dialysis
APC
CPT Vaccine Codes 2019-2020 CPT vaccine codes for the 2019-2020 flu season are as follows: - 90653: Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for intramuscular use - 90662: Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramus...
9068
Smallpox&monkeypox vac 0.
APC
CPT Vaccine Codes 2019-2020 CPT vaccine codes for the 2019-2020 flu season are as follows: - 90653: Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for intramuscular use - 90662: Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramus...
S9345
HIT anti-hemophil diem
HCPCS
BCBSMS makes no payment for services, treatments, procedures, equipment, drugs, devices, items or supplies which are not documented to be Medically Necessary. The fact that a Physician or other Provider has prescribed, ordered, recommended, or approved a service or supply does not in itself, make it Medically Necessary...
36440
PR PUSH TRANSFUSION BLOOD 2 YR OR YOUNGER
HCPCS
BCBSMS makes no payment for services, treatments, procedures, equipment, drugs, devices, items or supplies which are not documented to be Medically Necessary. The fact that a Physician or other Provider has prescribed, ordered, recommended, or approved a service or supply does not in itself, make it Medically Necessary...
85244
HC CLOTTING; FACTOR VIII (AHG) RELATED ANTIGEN
HCPCS
BCBSMS makes no payment for services, treatments, procedures, equipment, drugs, devices, items or supplies which are not documented to be Medically Necessary. The fact that a Physician or other Provider has prescribed, ordered, recommended, or approved a service or supply does not in itself, make it Medically Necessary...
1999
ANESTHESIOLOGY GROUP
CPT
BCBSMS makes no payment for services, treatments, procedures, equipment, drugs, devices, items or supplies which are not documented to be Medically Necessary. The fact that a Physician or other Provider has prescribed, ordered, recommended, or approved a service or supply does not in itself, make it Medically Necessary...
S9345
HIT anti-hemophil diem
HCPCS
The fact that a Physician or other Provider has prescribed, ordered, recommended, or approved a service or supply does not in itself, make it Medically Necessary. 4/1999: Approved by Pharmacy & Therapeutics (P & T) Oncology Committee 1/30/2002: Factor VIII (Human), Factor VIII (Recombinant) and Factor VIII (Porcine) po...
36440
PR PUSH TRANSFUSION BLOOD 2 YR OR YOUNGER
HCPCS
The fact that a Physician or other Provider has prescribed, ordered, recommended, or approved a service or supply does not in itself, make it Medically Necessary. 4/1999: Approved by Pharmacy & Therapeutics (P & T) Oncology Committee 1/30/2002: Factor VIII (Human), Factor VIII (Recombinant) and Factor VIII (Porcine) po...
85244
HC CLOTTING; FACTOR VIII (AHG) RELATED ANTIGEN
HCPCS
The fact that a Physician or other Provider has prescribed, ordered, recommended, or approved a service or supply does not in itself, make it Medically Necessary. 4/1999: Approved by Pharmacy & Therapeutics (P & T) Oncology Committee 1/30/2002: Factor VIII (Human), Factor VIII (Recombinant) and Factor VIII (Porcine) po...
1999
ANESTHESIOLOGY GROUP
CPT
The fact that a Physician or other Provider has prescribed, ordered, recommended, or approved a service or supply does not in itself, make it Medically Necessary. 4/1999: Approved by Pharmacy & Therapeutics (P & T) Oncology Committee 1/30/2002: Factor VIII (Human), Factor VIII (Recombinant) and Factor VIII (Porcine) po...
Q2023
Xyntha - inj
CPT
01/01/2009: Accredo preferred provider information removed. BCBSMS information added. 6/30/2009: New HCPC code Q2023 added to covered table. 8/26/2009: Policy statement updated to include medically necessary indications for VIII for routine prophylaxis to reduce the frequency of bleeding episodes and the risk of joint ...
Q2023
Xyntha - inj
CPT
BCBSMS information added. 6/30/2009: New HCPC code Q2023 added to covered table. 8/26/2009: Policy statement updated to include medically necessary indications for VIII for routine prophylaxis to reduce the frequency of bleeding episodes and the risk of joint damage in children (0-16) with hemophilia A with no pre-exis...
Q2023
Xyntha - inj
CPT
6/30/2009: New HCPC code Q2023 added to covered table. 8/26/2009: Policy statement updated to include medically necessary indications for VIII for routine prophylaxis to reduce the frequency of bleeding episodes and the risk of joint damage in children (0-16) with hemophilia A with no pre-existing joint damage. 12/15/2...
J7185
Xyntha inj
HCPCS
Policy Section updated with coverage for Von Willebrand disease for Factor VIII. Policy Exceptions Section updated to remove Risk Pool language. HCPCS code J7185 & J7187 were added to Covered Codes for Factor VIII. 02/28/2011: Added new HCPCS code J7184 for Wilate® to the Code Reference section. 04/01/2014: Policy titl...
J7187
Injection, von willebrand factor complex (humate-p), per iu vwf:rco
HCPCS
Policy Section updated with coverage for Von Willebrand disease for Factor VIII. Policy Exceptions Section updated to remove Risk Pool language. HCPCS code J7185 & J7187 were added to Covered Codes for Factor VIII. 02/28/2011: Added new HCPCS code J7184 for Wilate® to the Code Reference section. 04/01/2014: Policy titl...
J7184
Wilate injection
HCPCS
Policy Section updated with coverage for Von Willebrand disease for Factor VIII. Policy Exceptions Section updated to remove Risk Pool language. HCPCS code J7185 & J7187 were added to Covered Codes for Factor VIII. 02/28/2011: Added new HCPCS code J7184 for Wilate® to the Code Reference section. 04/01/2014: Policy titl...
J7185
Xyntha inj
HCPCS
Policy Exceptions Section updated to remove Risk Pool language. HCPCS code J7185 & J7187 were added to Covered Codes for Factor VIII. 02/28/2011: Added new HCPCS code J7184 for Wilate® to the Code Reference section. 04/01/2014: Policy title changed from "Hemophilia Factor VIII (Human, Recombinant, Porcine) and Factor I...
J7187
Injection, von willebrand factor complex (humate-p), per iu vwf:rco
HCPCS
Policy Exceptions Section updated to remove Risk Pool language. HCPCS code J7185 & J7187 were added to Covered Codes for Factor VIII. 02/28/2011: Added new HCPCS code J7184 for Wilate® to the Code Reference section. 04/01/2014: Policy title changed from "Hemophilia Factor VIII (Human, Recombinant, Porcine) and Factor I...
J7184
Wilate injection
HCPCS
Policy Exceptions Section updated to remove Risk Pool language. HCPCS code J7185 & J7187 were added to Covered Codes for Factor VIII. 02/28/2011: Added new HCPCS code J7184 for Wilate® to the Code Reference section. 04/01/2014: Policy title changed from "Hemophilia Factor VIII (Human, Recombinant, Porcine) and Factor I...
J7185
Xyntha inj
HCPCS
HCPCS code J7185 & J7187 were added to Covered Codes for Factor VIII. 02/28/2011: Added new HCPCS code J7184 for Wilate® to the Code Reference section. 04/01/2014: Policy title changed from "Hemophilia Factor VIII (Human, Recombinant, Porcine) and Factor IX (Human, Complex, Recombinant)" to "Hemophilia Factor VIII Fact...