code
stringlengths
4
12
description
stringlengths
2
264
codetype
stringclasses
8 values
context
stringlengths
160
15.5k
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...