code stringlengths 4 12 | description stringlengths 2 264 | codetype stringclasses 8
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82465 | HC CHOLESTEROL LEVEL W/DIRECT LDL | HCPCS | Code 33871’s descriptor better describes the way the procedure is performed now. Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Beh... |
33871 | Transvrs a-arch grf hypthrm | HCPCS | Code 33871’s descriptor better describes the way the procedure is performed now. Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Beh... |
80061 | TTH LIPID-SP | HCPCS | Code 33871’s descriptor better describes the way the procedure is performed now. Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Beh... |
G0446 | PR INTENS BEHAVE THER CARDIO DX | HCPCS | Code 33871’s descriptor better describes the way the procedure is performed now. Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Beh... |
83718 | LIPOPROTEIN, DIRECT MEASUREMENT_ HIGH DENSITY CHOLESTEROL (HDL CHOLESTEROL) | HCPCS | Code 33871’s descriptor better describes the way the procedure is performed now. Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Beh... |
82465 | HC CHOLESTEROL LEVEL W/DIRECT LDL | HCPCS | Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD).”
If you are a Medicare pa... |
80061 | TTH LIPID-SP | HCPCS | Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD).”
If you are a Medicare pa... |
83718 | LIPOPROTEIN, DIRECT MEASUREMENT_ HIGH DENSITY CHOLESTEROL (HDL CHOLESTEROL) | HCPCS | Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD).”
If you are a Medicare pa... |
G0446 | PR INTENS BEHAVE THER CARDIO DX | HCPCS | Medicare Coverage of Screening for Heart Disease
There are two Medicare-covered preventative services for heart disease screening per national coverage determination (NCD) 210.11: “Cardiovascular Disease Screening Tests” and “Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD).”
If you are a Medicare pa... |
82465 | HC CHOLESTEROL LEVEL W/DIRECT LDL | HCPCS | These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, othe... |
8006 | CT and CTA with Contrast | APC | These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, othe... |
80061 | TTH LIPID-SP | HCPCS | These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, othe... |
G0446 | PR INTENS BEHAVE THER CARDIO DX | HCPCS | These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, othe... |
83718 | LIPOPROTEIN, DIRECT MEASUREMENT_ HIGH DENSITY CHOLESTEROL (HDL CHOLESTEROL) | HCPCS | These tests are reported using CPT® code:
80061 Lipid panel
This panel must include the following:
Cholesterol, serum, total (82465)
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) (83718)
ICD-10-CM code Z13.6 Encounter for screening for cardiovascular disorders supports 80061; however, othe... |
G0446 | PR INTENS BEHAVE THER CARDIO DX | HCPCS | To see Change Requests (CRs) specific to individual ICD-10 codes for screening for cardiovascular disorders, go to the Centers for Medicare & Medicaid Services’ (CMS) Medicare Coverage – General Information ICD-10 webpage. According to NCD 210.11, IBT for CVD is covered annually for Medicare patients “who are competent... |
97533 | Therapy procedure using sensory experiences | HCPCS | Studies of sensory-based interventions suggested that they may not be effective; however, they did not follow recommended protocols or target sensory processing problems. The authors concluded that although small RCTs resulted in positive effects for SIT, additional rigorous trials using manualized protocols for SIT ar... |
97533 | Therapy procedure using sensory experiences | HCPCS | The authors concluded that although small RCTs resulted in positive effects for SIT, additional rigorous trials using manualized protocols for SIT are needed to evaluate effects for children with ASDs and sensory processing problems. |CPT Codes / HCPCS Codes / ICD-9 Codes|
|CPT codes not covered for indications listed ... |
86891 | HC AUTOLOGOUS BLOOD SALVAGED | HCPCS | The authors concluded that these findings support the notion that the IOCS-LDF combination works effectively in eliminating tumor cells from salvaged blood, so this technique can be applied successfully in spine tumor surgery. They stated that this concept can then further be extended to whole musculoskeletal tumor sur... |
86890 | HC AUTOLOGOUS BLOOD PRE-DEPOSITED | HCPCS | The authors concluded that these findings support the notion that the IOCS-LDF combination works effectively in eliminating tumor cells from salvaged blood, so this technique can be applied successfully in spine tumor surgery. They stated that this concept can then further be extended to whole musculoskeletal tumor sur... |
86891 | HC AUTOLOGOUS BLOOD SALVAGED | HCPCS | They stated that this concept can then further be extended to whole musculoskeletal tumor surgery and other oncologic surgeries with further appropriate clinical studies. |CPT Codes / HCPCS Codes / ICD-9 Codes|
|CPT codes covered if selection criteria are met:|
|86890||Autologous blood or component, collection processi... |
86890 | HC AUTOLOGOUS BLOOD PRE-DEPOSITED | HCPCS | They stated that this concept can then further be extended to whole musculoskeletal tumor surgery and other oncologic surgeries with further appropriate clinical studies. |CPT Codes / HCPCS Codes / ICD-9 Codes|
|CPT codes covered if selection criteria are met:|
|86890||Autologous blood or component, collection processi... |
E0755 | Electronic salivary reflex s | HCPCS | There is insufficient evidence to determine the effects of electrostimulation devices on dry mouth symptoms or saliva production in patients with Sjogren's syndrome. Reported adverse effects of acupuncture are mild and of short duration, and there were no reported adverse effects from electrostimulation. |CPT Codes / H... |
E0755 | Electronic salivary reflex s | HCPCS | Reported adverse effects of acupuncture are mild and of short duration, and there were no reported adverse effects from electrostimulation. |CPT Codes / HCPCS Codes / ICD-9 Codes|
|HCPCS codes not covered for indications listed in the CPB:|
|E0755||Electronic salivary reflex stimulator (intraoral/noninvasive)|
|ICD-9 c... |
G0206 | Dx mammo incl cad uni | 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... |
77062 | MM MAMMO TOMOSYNTHESIS BILATERAL | 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... |
77063 | Screening 3D breast mammography | 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... |
G0204 | Dx mammo incl cad bi | 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... |
77061 | HC DIGITAL BREAST TOMOSYNTHESIS UNILATERAL | 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... |
G0206 | Dx mammo incl cad uni | 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 HISTORY4/9/2007: Policy added
5/11/2007: Bancorp South (C427, C445, C458, and C550) policy exception added
7/19/2007: Reviewed and approved by the Medical Policy Advisory Commi... |
77062 | MM MAMMO TOMOSYNTHESIS BILATERAL | 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 HISTORY4/9/2007: Policy added
5/11/2007: Bancorp South (C427, C445, C458, and C550) policy exception added
7/19/2007: Reviewed and approved by the Medical Policy Advisory Commi... |
77063 | Screening 3D breast mammography | 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 HISTORY4/9/2007: Policy added
5/11/2007: Bancorp South (C427, C445, C458, and C550) policy exception added
7/19/2007: Reviewed and approved by the Medical Policy Advisory Commi... |
G0204 | Dx mammo incl cad bi | 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 HISTORY4/9/2007: Policy added
5/11/2007: Bancorp South (C427, C445, C458, and C550) policy exception added
7/19/2007: Reviewed and approved by the Medical Policy Advisory Commi... |
77061 | HC DIGITAL BREAST TOMOSYNTHESIS UNILATERAL | 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 HISTORY4/9/2007: Policy added
5/11/2007: Bancorp South (C427, C445, C458, and C550) policy exception added
7/19/2007: Reviewed and approved by the Medical Policy Advisory Commi... |
G0206 | Dx mammo incl cad uni | HCPCS | POLICY HISTORY4/9/2007: Policy added
5/11/2007: Bancorp South (C427, C445, C458, and C550) policy exception added
7/19/2007: Reviewed and approved by the Medical Policy Advisory Committee (MPAC)
5/9/2008: Policy reviewed, no changes
05/08/2013: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT c... |
77062 | MM MAMMO TOMOSYNTHESIS BILATERAL | HCPCS | POLICY HISTORY4/9/2007: Policy added
5/11/2007: Bancorp South (C427, C445, C458, and C550) policy exception added
7/19/2007: Reviewed and approved by the Medical Policy Advisory Committee (MPAC)
5/9/2008: Policy reviewed, no changes
05/08/2013: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT c... |
77063 | Screening 3D breast mammography | HCPCS | POLICY HISTORY4/9/2007: Policy added
5/11/2007: Bancorp South (C427, C445, C458, and C550) policy exception added
7/19/2007: Reviewed and approved by the Medical Policy Advisory Committee (MPAC)
5/9/2008: Policy reviewed, no changes
05/08/2013: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT c... |
G0204 | Dx mammo incl cad bi | HCPCS | POLICY HISTORY4/9/2007: Policy added
5/11/2007: Bancorp South (C427, C445, C458, and C550) policy exception added
7/19/2007: Reviewed and approved by the Medical Policy Advisory Committee (MPAC)
5/9/2008: Policy reviewed, no changes
05/08/2013: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT c... |
77061 | HC DIGITAL BREAST TOMOSYNTHESIS UNILATERAL | HCPCS | POLICY HISTORY4/9/2007: Policy added
5/11/2007: Bancorp South (C427, C445, C458, and C550) policy exception added
7/19/2007: Reviewed and approved by the Medical Policy Advisory Committee (MPAC)
5/9/2008: Policy reviewed, no changes
05/08/2013: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT c... |
G0206 | Dx mammo incl cad uni | HCPCS | 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77061, 77062, and 77063. Revised the description of the following HCPCS codes with an effective date of 01/01/2015: G0204 and G0206. 04/27/2015: Removed CPT codes 77061, 77062, and 77063 from the Code Reference section. These procedures a... |
77062 | MM MAMMO TOMOSYNTHESIS BILATERAL | HCPCS | 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77061, 77062, and 77063. Revised the description of the following HCPCS codes with an effective date of 01/01/2015: G0204 and G0206. 04/27/2015: Removed CPT codes 77061, 77062, and 77063 from the Code Reference section. These procedures a... |
77063 | Screening 3D breast mammography | HCPCS | 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77061, 77062, and 77063. Revised the description of the following HCPCS codes with an effective date of 01/01/2015: G0204 and G0206. 04/27/2015: Removed CPT codes 77061, 77062, and 77063 from the Code Reference section. These procedures a... |
G0204 | Dx mammo incl cad bi | HCPCS | 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77061, 77062, and 77063. Revised the description of the following HCPCS codes with an effective date of 01/01/2015: G0204 and G0206. 04/27/2015: Removed CPT codes 77061, 77062, and 77063 from the Code Reference section. These procedures a... |
77061 | HC DIGITAL BREAST TOMOSYNTHESIS UNILATERAL | HCPCS | 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77061, 77062, and 77063. Revised the description of the following HCPCS codes with an effective date of 01/01/2015: G0204 and G0206. 04/27/2015: Removed CPT codes 77061, 77062, and 77063 from the Code Reference section. These procedures a... |
83015 | Heavy metal qual any anal | HCPCS | The authors concluded that given prior reports of serious adverse events, such as hypocalcaemia, renal impairment and reported death, the risks of using chelation for ASD currently outweigh proven benefits. Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heav... |
96365 | PR IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR | HCPCS | The authors concluded that given prior reports of serious adverse events, such as hypocalcaemia, renal impairment and reported death, the risks of using chelation for ASD currently outweigh proven benefits. Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heav... |
J0895 | INJECTION, DEFEROXAMINE MESYLATE, 500 MG | HCPCS | The authors concluded that given prior reports of serious adverse events, such as hypocalcaemia, renal impairment and reported death, the risks of using chelation for ASD currently outweigh proven benefits. Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heav... |
J0470 | Injection, dimercaprol, per 100 mg | HCPCS | The authors concluded that given prior reports of serious adverse events, such as hypocalcaemia, renal impairment and reported death, the risks of using chelation for ASD currently outweigh proven benefits. Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heav... |
J0600 | Injection, edetate calcium disodium, up to 1000 mg | HCPCS | The authors concluded that given prior reports of serious adverse events, such as hypocalcaemia, renal impairment and reported death, the risks of using chelation for ASD currently outweigh proven benefits. Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heav... |
J3520 | EDETATE DISODIUM POWDER | HCPCS | The authors concluded that given prior reports of serious adverse events, such as hypocalcaemia, renal impairment and reported death, the risks of using chelation for ASD currently outweigh proven benefits. Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heav... |
96368 | THER/DIAG CONCURRENT INF | HCPCS | The authors concluded that given prior reports of serious adverse events, such as hypocalcaemia, renal impairment and reported death, the risks of using chelation for ASD currently outweigh proven benefits. Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heav... |
S9355 | HIT chelation diem | HCPCS | The authors concluded that given prior reports of serious adverse events, such as hypocalcaemia, renal impairment and reported death, the risks of using chelation for ASD currently outweigh proven benefits. Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heav... |
M0300 | Iv chelationtherapy | HCPCS | The authors concluded that given prior reports of serious adverse events, such as hypocalcaemia, renal impairment and reported death, the risks of using chelation for ASD currently outweigh proven benefits. Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heav... |
83015 | Heavy metal qual any anal | HCPCS | Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heavy metals and autism and methods that ensure the safety of participants are needed. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Cod... |
96365 | PR IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR | HCPCS | Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heavy metals and autism and methods that ensure the safety of participants are needed. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Cod... |
J0895 | INJECTION, DEFEROXAMINE MESYLATE, 500 MG | HCPCS | Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heavy metals and autism and methods that ensure the safety of participants are needed. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Cod... |
J0470 | Injection, dimercaprol, per 100 mg | HCPCS | Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heavy metals and autism and methods that ensure the safety of participants are needed. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Cod... |
J0600 | Injection, edetate calcium disodium, up to 1000 mg | HCPCS | Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heavy metals and autism and methods that ensure the safety of participants are needed. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Cod... |
J3520 | EDETATE DISODIUM POWDER | HCPCS | Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heavy metals and autism and methods that ensure the safety of participants are needed. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Cod... |
96368 | THER/DIAG CONCURRENT INF | HCPCS | Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heavy metals and autism and methods that ensure the safety of participants are needed. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Cod... |
S9355 | HIT chelation diem | HCPCS | Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heavy metals and autism and methods that ensure the safety of participants are needed. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Cod... |
M0300 | Iv chelationtherapy | HCPCS | Moreover, they stated that before further trials are conducted, evidence that supports a causal link between heavy metals and autism and methods that ensure the safety of participants are needed. |CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Cod... |
G0358 | IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
G0360 | Each additional hr 1-8 hrs | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
J9000 | INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
G0364 | HC BONE MARROW ASPIRATE & BIOPSY | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
G0362 | Each add sequential infusion | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
J9999 | Not otherwise classified, antineoplastic drugs | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
G0359 | Chemotherapy IV one hr initi | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
38230 | PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
G0361 | Prolong chemo infuse>8hrs pu | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
G0357 | IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
G0356 | HORMONAL ANTINEOPLASTIC | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
G0355 | CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC | HCPCS | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology mus... |
G0358 | IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA... |
G0360 | Each additional hr 1-8 hrs | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA... |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA... |
J9000 | INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA... |
G0364 | HC BONE MARROW ASPIRATE & BIOPSY | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA... |
G0362 | Each add sequential infusion | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA... |
J9999 | Not otherwise classified, antineoplastic drugs | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA... |
G0359 | Chemotherapy IV one hr initi | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA... |
38230 | PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA... |
G0361 | Prolong chemo infuse>8hrs pu | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA... |
G0357 | IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA... |
G0356 | HORMONAL ANTINEOPLASTIC | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA... |
G0355 | CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA... |
G0358 | IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG | HCPCS | POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC)
7/13/2004: Code Reference section completed
7/1/2004: Reviewed... |
G0267 | Bone marrow or psc harvest | CPT | POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC)
7/13/2004: Code Reference section completed
7/1/2004: Reviewed... |
G0360 | Each additional hr 1-8 hrs | HCPCS | POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC)
7/13/2004: Code Reference section completed
7/1/2004: Reviewed... |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC)
7/13/2004: Code Reference section completed
7/1/2004: Reviewed... |
J9000 | INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG | HCPCS | POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC)
7/13/2004: Code Reference section completed
7/1/2004: Reviewed... |
S2140 | Cord blood harvesting for transplantation, allogeneic | HCPCS | POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC)
7/13/2004: Code Reference section completed
7/1/2004: Reviewed... |
G0364 | HC BONE MARROW ASPIRATE & BIOPSY | HCPCS | POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC)
7/13/2004: Code Reference section completed
7/1/2004: Reviewed... |
G0265 | Cryopresevation Freeze+stora | CPT | POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC)
7/13/2004: Code Reference section completed
7/1/2004: Reviewed... |
G0362 | Each add sequential infusion | HCPCS | POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC)
7/13/2004: Code Reference section completed
7/1/2004: Reviewed... |
J9999 | Not otherwise classified, antineoplastic drugs | HCPCS | POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC)
7/13/2004: Code Reference section completed
7/1/2004: Reviewed... |
G0359 | Chemotherapy IV one hr initi | HCPCS | POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC)
7/13/2004: Code Reference section completed
7/1/2004: Reviewed... |
38230 | PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC | HCPCS | POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC)
7/13/2004: Code Reference section completed
7/1/2004: Reviewed... |
G0361 | Prolong chemo infuse>8hrs pu | HCPCS | POLICY HISTORY3/25/2004: See policy "High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Malignancies" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.26 per approval by Medical Policy Advisory Committee (MPAC)
7/13/2004: Code Reference section completed
7/1/2004: Reviewed... |
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