code stringlengths 4 12 | description stringlengths 2 264 | codetype stringclasses 8
values | context stringlengths 160 15.5k |
|---|---|---|---|
61795 | Brain surgery using computer | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated a... |
31254 | PR NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY | 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 HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton ... |
31294 | PR NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN | 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 HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton ... |
61548 | Removal of pituitary gland | 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 HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton ... |
31288 | PR NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS | 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 HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton ... |
1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | 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 HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton ... |
G0340 | Robt lin-radsurg fractx 2-5 | 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 HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton ... |
31287 | PR NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY | 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 HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton ... |
G0339 | Robot lin-radsurg com, first | 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 HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton ... |
31276 | PR NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS | 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 HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton ... |
S8030 | Tantalum ring application | 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 HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton ... |
31290 | PR NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID | 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 HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton ... |
31256 | PR NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY | 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 HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton ... |
31267 | PR NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS | 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 HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton ... |
61795 | Brain surgery using computer | 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 HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton ... |
31254 | PR NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY | HCPCS | POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary... |
31294 | PR NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN | HCPCS | POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary... |
61548 | Removal of pituitary gland | HCPCS | POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary... |
31288 | PR NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS | HCPCS | POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary... |
1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | HCPCS | POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary... |
G0340 | Robt lin-radsurg fractx 2-5 | HCPCS | POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary... |
31287 | PR NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY | HCPCS | POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary... |
G0339 | Robot lin-radsurg com, first | HCPCS | POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary... |
31276 | PR NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS | HCPCS | POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary... |
S8030 | Tantalum ring application | HCPCS | POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary... |
31290 | PR NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID | HCPCS | POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary... |
31256 | PR NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY | HCPCS | POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary... |
31267 | PR NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS | HCPCS | POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary... |
61795 | Brain surgery using computer | HCPCS | POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary... |
31254 | PR NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY | HCPCS | 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/20... |
31294 | PR NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN | HCPCS | 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/20... |
61548 | Removal of pituitary gland | HCPCS | 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/20... |
31288 | PR NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS | HCPCS | 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/20... |
G0340 | Robt lin-radsurg fractx 2-5 | HCPCS | 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/20... |
31287 | PR NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY | HCPCS | 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/20... |
G0339 | Robot lin-radsurg com, first | HCPCS | 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/20... |
31276 | PR NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS | HCPCS | 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/20... |
S8030 | Tantalum ring application | HCPCS | 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/20... |
31290 | PR NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID | HCPCS | 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/20... |
31256 | PR NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY | HCPCS | 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/20... |
31267 | PR NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS | HCPCS | 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/20... |
61795 | Brain surgery using computer | HCPCS | 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/20... |
31254 | PR NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY | HCPCS | Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to poli... |
31294 | PR NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN | HCPCS | Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to poli... |
61548 | Removal of pituitary gland | HCPCS | Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to poli... |
31288 | PR NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS | HCPCS | Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to poli... |
31287 | PR NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY | HCPCS | Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to poli... |
31276 | PR NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS | HCPCS | Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to poli... |
31290 | PR NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID | HCPCS | Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to poli... |
S8030 | Tantalum ring application | HCPCS | Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to poli... |
31256 | PR NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY | HCPCS | Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to poli... |
31267 | PR NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS | HCPCS | Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to poli... |
61795 | Brain surgery using computer | HCPCS | Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to poli... |
S8030 | Tantalum ring application | HCPCS | HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated. CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 del... |
61795 | Brain surgery using computer | HCPCS | HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated. CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 del... |
77372 | Srs linear based | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
77432 | Stereotactic radiation trmt | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
77522 | Proton trmt simple w/comp | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
63621 | Srs spinal lesion addl | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
77371 | HC RADIATION DELIVERY STEREOTACTIC CRANIAL COBALT | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
61795 | Brain surgery using computer | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
G0243 | MX-SRC PHOTON STERO RADIOSURG DEL W/COLLMTR CHGS | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
77373 | Sbrt delivery | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
77299 | HC UNLIS PX THER RADIOL CLINICAL TX PLANNING | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
77416 | Radiation treatment delivery | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
77523 | Proton trmt intermediate | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
63620 | Srs spinal lesion | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
77435 | HC STEREOTACTIC BODY RADIATION MANAGEMENT | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
77399 | HC UNLIS MEDICAL RADJ DOSIM TX DEV SPEC SVCS | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
61793 | Focus Radiation Beam | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
77520 | Proton trmt simple w/o comp | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
61799 | Srs cran les complex addl | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
20660 | PR APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
77402 | HC RAD TX> 1MEV, SIMPLE | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
77525 | Proton treatment complex | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
S8030 | Tantalum ring application | HCPCS | CPT code 61795 deleted. ICD9 procedure codes 92.31, 92.32, 92.33, 92.39 deleted. ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy re... |
77372 | Srs linear based | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
77432 | Stereotactic radiation trmt | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
77522 | Proton trmt simple w/comp | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
63621 | Srs spinal lesion addl | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
77371 | HC RADIATION DELIVERY STEREOTACTIC CRANIAL COBALT | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
61795 | Brain surgery using computer | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
G0243 | MX-SRC PHOTON STERO RADIOSURG DEL W/COLLMTR CHGS | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
77373 | Sbrt delivery | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
77299 | HC UNLIS PX THER RADIOL CLINICAL TX PLANNING | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
77416 | Radiation treatment delivery | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
77523 | Proton trmt intermediate | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
63620 | Srs spinal lesion | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
77435 | HC STEREOTACTIC BODY RADIATION MANAGEMENT | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
77399 | HC UNLIS MEDICAL RADJ DOSIM TX DEV SPEC SVCS | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
61793 | Focus Radiation Beam | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
77520 | Proton trmt simple w/o comp | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
61799 | Srs cran les complex addl | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
20660 | PR APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
77402 | HC RAD TX> 1MEV, SIMPLE | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
77525 | Proton treatment complex | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
S8030 | Tantalum ring application | HCPCS | ICD9 diagnosis codes 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 197.0, 231.2, 237.0, 237.1, 253.0, 255.0, 332.0, 333.1, HCPC S8030 deleted
1/4/2007: Code reference section updated per the 2007 CPT/HCPCS revisions
9/18/2007: Policy reviewed, no changes
12/19/2007: Coding updated per 2008 CPT/HCPCS revisions
12/31/... |
77372 | Srs linear based | HCPCS | Coding Section revised to include coding information guidelines for describing the procedure and delivery reporting, added verbiage to CPT4 code 20660 "(this code may have been used previous to 1-1-2009 to code the attachment of the head frame), added verbiage to CPT 4 codes 61795- 61799 "(Use for clinical treatment ma... |
77432 | Stereotactic radiation trmt | HCPCS | Coding Section revised to include coding information guidelines for describing the procedure and delivery reporting, added verbiage to CPT4 code 20660 "(this code may have been used previous to 1-1-2009 to code the attachment of the head frame), added verbiage to CPT 4 codes 61795- 61799 "(Use for clinical treatment ma... |
77522 | Proton trmt simple w/comp | HCPCS | Coding Section revised to include coding information guidelines for describing the procedure and delivery reporting, added verbiage to CPT4 code 20660 "(this code may have been used previous to 1-1-2009 to code the attachment of the head frame), added verbiage to CPT 4 codes 61795- 61799 "(Use for clinical treatment ma... |
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