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38242
Transplt allo lymphocytes
HCPCS
08/25/2015: Code Reference section updated to add ICD-10 codes. Revised the descriptions for CPT codes 38240, 38241, and 38242; removed deleted HCPCS code G0363, G0265, G0266, and G0267; removed deleted code CPT 96445 and replaced with CPT code 96446. 05/26/2016: Policy number L.8.01.405 added. Investigative definition...
G0266
Thawing + expansion froz cel
CPT
08/25/2015: Code Reference section updated to add ICD-10 codes. Revised the descriptions for CPT codes 38240, 38241, and 38242; removed deleted HCPCS code G0363, G0265, G0266, and G0267; removed deleted code CPT 96445 and replaced with CPT code 96446. 05/26/2016: Policy number L.8.01.405 added. Investigative definition...
96445
Chemotherapy, intracavitary
HCPCS
08/25/2015: Code Reference section updated to add ICD-10 codes. Revised the descriptions for CPT codes 38240, 38241, and 38242; removed deleted HCPCS code G0363, G0265, G0266, and G0267; removed deleted code CPT 96445 and replaced with CPT code 96446. 05/26/2016: Policy number L.8.01.405 added. Investigative definition...
96446
PR CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH
HCPCS
08/25/2015: Code Reference section updated to add ICD-10 codes. Revised the descriptions for CPT codes 38240, 38241, and 38242; removed deleted HCPCS code G0363, G0265, G0266, and G0267; removed deleted code CPT 96445 and replaced with CPT code 96446. 05/26/2016: Policy number L.8.01.405 added. Investigative definition...
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...
1999
ANESTHESIOLOGY GROUP
CPT
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 m...
G0007
PT DEMAND RECORD/30 DA; MD REVIEW &
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 m...
93270
PR XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS
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 m...
33999
Unlisted px cardiac surgery
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 m...
93014
Report on transmitted ecg
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 m...
G0004
PT DEMAND RECORD/30 DA; INCL TRANSM
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 m...
93012
Transmission of ecg
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 m...
93271
PR XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS
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 m...
93272
PR XTRNL PT ACTIVTD ECG DWNLD W/R&I </30 DAYS
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 m...
G0015
Post Symptom Ecg Tracing
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 m...
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...
G0007
PT DEMAND RECORD/30 DA; MD REVIEW &
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...
93270
PR XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS
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...
33999
Unlisted px cardiac surgery
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...
93014
Report on transmitted ecg
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...
G0004
PT DEMAND RECORD/30 DA; INCL TRANSM
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...
93012
Transmission of ecg
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...
93271
PR XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS
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...
93272
PR XTRNL PT ACTIVTD ECG DWNLD W/R&I </30 DAYS
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...
G0015
Post Symptom Ecg Tracing
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
2/1999: Implantable Continuous "Memory Loop" Devices policy approved by Medical Policy Advisory Committee (MPAC), CPT 33999 added 5/1999: MPAC expanded and renamed policy to include all Ambulatory Event Monitors 1/23/2002: Prior authorization deleted 2/15/2002: Investigational definition added 4/18/2002: Type of Servic...
G0007
PT DEMAND RECORD/30 DA; MD REVIEW &
HCPCS
2/1999: Implantable Continuous "Memory Loop" Devices policy approved by Medical Policy Advisory Committee (MPAC), CPT 33999 added 5/1999: MPAC expanded and renamed policy to include all Ambulatory Event Monitors 1/23/2002: Prior authorization deleted 2/15/2002: Investigational definition added 4/18/2002: Type of Servic...
93228
TELEMETRY MONITOR UP TO 30 DAYS
HCPCS
2/1999: Implantable Continuous "Memory Loop" Devices policy approved by Medical Policy Advisory Committee (MPAC), CPT 33999 added 5/1999: MPAC expanded and renamed policy to include all Ambulatory Event Monitors 1/23/2002: Prior authorization deleted 2/15/2002: Investigational definition added 4/18/2002: Type of Servic...
93270
PR XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS
HCPCS
2/1999: Implantable Continuous "Memory Loop" Devices policy approved by Medical Policy Advisory Committee (MPAC), CPT 33999 added 5/1999: MPAC expanded and renamed policy to include all Ambulatory Event Monitors 1/23/2002: Prior authorization deleted 2/15/2002: Investigational definition added 4/18/2002: Type of Servic...
33999
Unlisted px cardiac surgery
HCPCS
2/1999: Implantable Continuous "Memory Loop" Devices policy approved by Medical Policy Advisory Committee (MPAC), CPT 33999 added 5/1999: MPAC expanded and renamed policy to include all Ambulatory Event Monitors 1/23/2002: Prior authorization deleted 2/15/2002: Investigational definition added 4/18/2002: Type of Servic...
93014
Report on transmitted ecg
HCPCS
2/1999: Implantable Continuous "Memory Loop" Devices policy approved by Medical Policy Advisory Committee (MPAC), CPT 33999 added 5/1999: MPAC expanded and renamed policy to include all Ambulatory Event Monitors 1/23/2002: Prior authorization deleted 2/15/2002: Investigational definition added 4/18/2002: Type of Servic...
G0004
PT DEMAND RECORD/30 DA; INCL TRANSM
HCPCS
2/1999: Implantable Continuous "Memory Loop" Devices policy approved by Medical Policy Advisory Committee (MPAC), CPT 33999 added 5/1999: MPAC expanded and renamed policy to include all Ambulatory Event Monitors 1/23/2002: Prior authorization deleted 2/15/2002: Investigational definition added 4/18/2002: Type of Servic...
93012
Transmission of ecg
HCPCS
2/1999: Implantable Continuous "Memory Loop" Devices policy approved by Medical Policy Advisory Committee (MPAC), CPT 33999 added 5/1999: MPAC expanded and renamed policy to include all Ambulatory Event Monitors 1/23/2002: Prior authorization deleted 2/15/2002: Investigational definition added 4/18/2002: Type of Servic...
93271
PR XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS
HCPCS
2/1999: Implantable Continuous "Memory Loop" Devices policy approved by Medical Policy Advisory Committee (MPAC), CPT 33999 added 5/1999: MPAC expanded and renamed policy to include all Ambulatory Event Monitors 1/23/2002: Prior authorization deleted 2/15/2002: Investigational definition added 4/18/2002: Type of Servic...
93272
PR XTRNL PT ACTIVTD ECG DWNLD W/R&I </30 DAYS
HCPCS
2/1999: Implantable Continuous "Memory Loop" Devices policy approved by Medical Policy Advisory Committee (MPAC), CPT 33999 added 5/1999: MPAC expanded and renamed policy to include all Ambulatory Event Monitors 1/23/2002: Prior authorization deleted 2/15/2002: Investigational definition added 4/18/2002: Type of Servic...
G0015
Post Symptom Ecg Tracing
HCPCS
2/1999: Implantable Continuous "Memory Loop" Devices policy approved by Medical Policy Advisory Committee (MPAC), CPT 33999 added 5/1999: MPAC expanded and renamed policy to include all Ambulatory Event Monitors 1/23/2002: Prior authorization deleted 2/15/2002: Investigational definition added 4/18/2002: Type of Servic...
93229
Remote 30 day ecg tech supp
HCPCS
2/1999: Implantable Continuous "Memory Loop" Devices policy approved by Medical Policy Advisory Committee (MPAC), CPT 33999 added 5/1999: MPAC expanded and renamed policy to include all Ambulatory Event Monitors 1/23/2002: Prior authorization deleted 2/15/2002: Investigational definition added 4/18/2002: Type of Servic...
93229
Remote 30 day ecg tech supp
HCPCS
HCPCS 2006 revisions added to policy 09/12/2006: Coding updated. ICD9 2006 revisions added to policy 1/3/2007: Policy reviewed, policy section clarified 5/11/2007: Policy reviewed. Policy section updated; no change to policy statements 12/24/2008: Coding reference section updated per the 2009 CPT/HCPCS revisions 5/14/2...
93228
TELEMETRY MONITOR UP TO 30 DAYS
HCPCS
HCPCS 2006 revisions added to policy 09/12/2006: Coding updated. ICD9 2006 revisions added to policy 1/3/2007: Policy reviewed, policy section clarified 5/11/2007: Policy reviewed. Policy section updated; no change to policy statements 12/24/2008: Coding reference section updated per the 2009 CPT/HCPCS revisions 5/14/2...
93229
Remote 30 day ecg tech supp
HCPCS
ICD9 2006 revisions added to policy 1/3/2007: Policy reviewed, policy section clarified 5/11/2007: Policy reviewed. Policy section updated; no change to policy statements 12/24/2008: Coding reference section updated per the 2009 CPT/HCPCS revisions 5/14/2009: Outpatient cardiac telemetry (MCOT) changed from "investigat...
93228
TELEMETRY MONITOR UP TO 30 DAYS
HCPCS
ICD9 2006 revisions added to policy 1/3/2007: Policy reviewed, policy section clarified 5/11/2007: Policy reviewed. Policy section updated; no change to policy statements 12/24/2008: Coding reference section updated per the 2009 CPT/HCPCS revisions 5/14/2009: Outpatient cardiac telemetry (MCOT) changed from "investigat...
93229
Remote 30 day ecg tech supp
HCPCS
Policy section updated; no change to policy statements 12/24/2008: Coding reference section updated per the 2009 CPT/HCPCS revisions 5/14/2009: Outpatient cardiac telemetry (MCOT) changed from "investigational" to "not medically necessary" 04/12/2010: Description section revised with other outpatient cardiac telemetry ...
93228
TELEMETRY MONITOR UP TO 30 DAYS
HCPCS
Policy section updated; no change to policy statements 12/24/2008: Coding reference section updated per the 2009 CPT/HCPCS revisions 5/14/2009: Outpatient cardiac telemetry (MCOT) changed from "investigational" to "not medically necessary" 04/12/2010: Description section revised with other outpatient cardiac telemetry ...
93229
Remote 30 day ecg tech supp
HCPCS
Coding Section revised to add CPT Codes 93228 and 93229 and ICD-9 Diagnosis codes 427.0, 427.1, 427.2, 427.31, 427.32, 427.41, 427.42, 427.61, 427.69 and 427.81 to the Covered Codes Table. Also identified HCPCS Codes S0345, S0346 & S0347 were deleted as of 12/31/2009. 10/21/2010: Policy reviewed; no changes. 03/10/2011...
93228
TELEMETRY MONITOR UP TO 30 DAYS
HCPCS
Coding Section revised to add CPT Codes 93228 and 93229 and ICD-9 Diagnosis codes 427.0, 427.1, 427.2, 427.31, 427.32, 427.41, 427.42, 427.61, 427.69 and 427.81 to the Covered Codes Table. Also identified HCPCS Codes S0345, S0346 & S0347 were deleted as of 12/31/2009. 10/21/2010: Policy reviewed; no changes. 03/10/2011...
88145
Cytopath, c/v, thin lyr sel
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 m...
G0148
Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening
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 m...
87620
Hpv dna dir probe
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 m...
88174
Cytopath c/v auto in fluid
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 m...
88148
Cytopath c/v auto rescreen
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 m...
G0143
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under
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 m...
88153
Cytopath c/v redo
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 m...
87621
Hpv dna amp probe
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 m...
87622
Hpv dna quant
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 m...
G0141
Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician
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 m...
88147
Cytopath c/v automated
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 m...
G0124
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician
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 m...
88165
Cytopath tbs c/v redo
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 m...
P3000
Screen pap by tech w md supv
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 m...
G0123
SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, SCREENING BY CYTOTECHNOLOGIST UNDER PHYSICIAN SUPERVISION
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 m...
G0145
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under
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 m...
G0147
Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision
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 m...
P3001
Screening pap smear by phys
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 m...
88164
HC CYTOPATHOLOGY, SLIDES, CERVICAL OR VAGINAL; MANUAL SCREENING
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 m...
88144
Cytopath, c/v, thin lyr redo
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 m...
88175
PAP
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 m...
88145
Cytopath, c/v, thin lyr sel
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
G0148
Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
87620
Hpv dna dir probe
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
88174
Cytopath c/v auto in fluid
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
88148
Cytopath c/v auto rescreen
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
G0143
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
88153
Cytopath c/v redo
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
87621
Hpv dna amp probe
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
87622
Hpv dna quant
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
G0141
Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
88147
Cytopath c/v automated
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
G0124
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
88165
Cytopath tbs c/v redo
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
P3000
Screen pap by tech w md supv
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
G0123
SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, SCREENING BY CYTOTECHNOLOGIST UNDER PHYSICIAN SUPERVISION
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
G0145
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
G0147
Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
P3001
Screening pap smear by phys
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...
88164
HC CYTOPATHOLOGY, SLIDES, CERVICAL OR VAGINAL; MANUAL SCREENING
HCPCS
POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC) 8/21/2002: Policy Guidelines revised, CPT codes 88147, 88148, 88153, 88164, 88165 deleted, HCPCS P3000-P3001 deleted, HCPCS G0123-G0124, G0143-G0145 added 10/17/2005: Code reference section updated; CPT-4: 87620, 87621, 87622, 88147, 88148 added...