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G6016
PR DELIVERY COMP IMRT
HCPCS
12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.46 CODE REFERENCET...
G6015
Radiation tx delivery imrt
HCPCS
Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.46 CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. The code(s) liste...
G6016
PR DELIVERY COMP IMRT
HCPCS
Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.46 CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. The code(s) liste...
93784
PR AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R
HCPCS
ABPM is also used for monitoring patients with established hypertension under treatment, evaluating refractory or resistant BP, checking whether symptoms such as lightheadedness correspond with blood pressure changes and also for examining diurnal patterns of BP. However, ABPM is indicated for diagnostic purposes only ...
93786
PR AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY
HCPCS
ABPM is also used for monitoring patients with established hypertension under treatment, evaluating refractory or resistant BP, checking whether symptoms such as lightheadedness correspond with blood pressure changes and also for examining diurnal patterns of BP. However, ABPM is indicated for diagnostic purposes only ...
93788
PR AMBULATORY BP MNTR W/SW 24 HR+ SCANNING A/R
HCPCS
ABPM is also used for monitoring patients with established hypertension under treatment, evaluating refractory or resistant BP, checking whether symptoms such as lightheadedness correspond with blood pressure changes and also for examining diurnal patterns of BP. However, ABPM is indicated for diagnostic purposes only ...
93790
PR AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R
HCPCS
ABPM is also used for monitoring patients with established hypertension under treatment, evaluating refractory or resistant BP, checking whether symptoms such as lightheadedness correspond with blood pressure changes and also for examining diurnal patterns of BP. However, ABPM is indicated for diagnostic purposes only ...
93784
PR AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R
HCPCS
However, ABPM is indicated for diagnostic purposes only and should not be used for maintenance monitoring. Though ABPM does not require authorization or prior authorization, it is critical to use the right CPT, ICD-10 and HCPCS codes. There are four current procedural terminology (CPT) codes related to ambulatory blood...
93786
PR AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY
HCPCS
However, ABPM is indicated for diagnostic purposes only and should not be used for maintenance monitoring. Though ABPM does not require authorization or prior authorization, it is critical to use the right CPT, ICD-10 and HCPCS codes. There are four current procedural terminology (CPT) codes related to ambulatory blood...
93788
PR AMBULATORY BP MNTR W/SW 24 HR+ SCANNING A/R
HCPCS
However, ABPM is indicated for diagnostic purposes only and should not be used for maintenance monitoring. Though ABPM does not require authorization or prior authorization, it is critical to use the right CPT, ICD-10 and HCPCS codes. There are four current procedural terminology (CPT) codes related to ambulatory blood...
93790
PR AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R
HCPCS
However, ABPM is indicated for diagnostic purposes only and should not be used for maintenance monitoring. Though ABPM does not require authorization or prior authorization, it is critical to use the right CPT, ICD-10 and HCPCS codes. There are four current procedural terminology (CPT) codes related to ambulatory blood...
93788
PR AMBULATORY BP MNTR W/SW 24 HR+ SCANNING A/R
HCPCS
Though ABPM does not require authorization or prior authorization, it is critical to use the right CPT, ICD-10 and HCPCS codes. There are four current procedural terminology (CPT) codes related to ambulatory blood pressure monitoring: - 93784: Ambulatory blood pressure monitoring, utilizing a system such as magnetic ta...
93784
PR AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R
HCPCS
Though ABPM does not require authorization or prior authorization, it is critical to use the right CPT, ICD-10 and HCPCS codes. There are four current procedural terminology (CPT) codes related to ambulatory blood pressure monitoring: - 93784: Ambulatory blood pressure monitoring, utilizing a system such as magnetic ta...
93786
PR AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY
HCPCS
Though ABPM does not require authorization or prior authorization, it is critical to use the right CPT, ICD-10 and HCPCS codes. There are four current procedural terminology (CPT) codes related to ambulatory blood pressure monitoring: - 93784: Ambulatory blood pressure monitoring, utilizing a system such as magnetic ta...
A4670
Automatic bp monitor, dial
HCPCS
Though ABPM does not require authorization or prior authorization, it is critical to use the right CPT, ICD-10 and HCPCS codes. There are four current procedural terminology (CPT) codes related to ambulatory blood pressure monitoring: - 93784: Ambulatory blood pressure monitoring, utilizing a system such as magnetic ta...
93790
PR AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R
HCPCS
Though ABPM does not require authorization or prior authorization, it is critical to use the right CPT, ICD-10 and HCPCS codes. There are four current procedural terminology (CPT) codes related to ambulatory blood pressure monitoring: - 93784: Ambulatory blood pressure monitoring, utilizing a system such as magnetic ta...
93788
PR AMBULATORY BP MNTR W/SW 24 HR+ SCANNING A/R
HCPCS
There are four current procedural terminology (CPT) codes related to ambulatory blood pressure monitoring: - 93784: Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; including recording, scanning analysis, interpretation and report - 93786: Ambu...
93784
PR AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R
HCPCS
There are four current procedural terminology (CPT) codes related to ambulatory blood pressure monitoring: - 93784: Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; including recording, scanning analysis, interpretation and report - 93786: Ambu...
93786
PR AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY
HCPCS
There are four current procedural terminology (CPT) codes related to ambulatory blood pressure monitoring: - 93784: Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; including recording, scanning analysis, interpretation and report - 93786: Ambu...
A4670
Automatic bp monitor, dial
HCPCS
There are four current procedural terminology (CPT) codes related to ambulatory blood pressure monitoring: - 93784: Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; including recording, scanning analysis, interpretation and report - 93786: Ambu...
93790
PR AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R
HCPCS
There are four current procedural terminology (CPT) codes related to ambulatory blood pressure monitoring: - 93784: Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; including recording, scanning analysis, interpretation and report - 93786: Ambu...
93784
PR AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R
HCPCS
It is recommended to use code 93784 when you provide both the technical and professional components. The code 93786 can be used when you provide the technical component only and use the code 93790, when providing the professional component only. Applicable Common Procedure Coding System (HCPCS) code for ABPM for suspec...
93786
PR AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY
HCPCS
It is recommended to use code 93784 when you provide both the technical and professional components. The code 93786 can be used when you provide the technical component only and use the code 93790, when providing the professional component only. Applicable Common Procedure Coding System (HCPCS) code for ABPM for suspec...
A4670
Automatic bp monitor, dial
HCPCS
It is recommended to use code 93784 when you provide both the technical and professional components. The code 93786 can be used when you provide the technical component only and use the code 93790, when providing the professional component only. Applicable Common Procedure Coding System (HCPCS) code for ABPM for suspec...
93790
PR AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R
HCPCS
It is recommended to use code 93784 when you provide both the technical and professional components. The code 93786 can be used when you provide the technical component only and use the code 93790, when providing the professional component only. Applicable Common Procedure Coding System (HCPCS) code for ABPM for suspec...
G6015
Radiation tx delivery imrt
HCPCS
Added policy statement: IMRT is considered investigational for the treatment of prostate cancer when the above criteria are not met. Policy guidelines updated regarding localized prostate cancer. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2...
77386
HC IMRT COMPLEX
HCPCS
Added policy statement: IMRT is considered investigational for the treatment of prostate cancer when the above criteria are not met. Policy guidelines updated regarding localized prostate cancer. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2...
77385
HC IMRT SIMPLE
HCPCS
Added policy statement: IMRT is considered investigational for the treatment of prostate cancer when the above criteria are not met. Policy guidelines updated regarding localized prostate cancer. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2...
G6016
PR DELIVERY COMP IMRT
HCPCS
Added policy statement: IMRT is considered investigational for the treatment of prostate cancer when the above criteria are not met. Policy guidelines updated regarding localized prostate cancer. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2...
G6015
Radiation tx delivery imrt
HCPCS
Policy guidelines updated regarding localized prostate cancer. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: P...
77386
HC IMRT COMPLEX
HCPCS
Policy guidelines updated regarding localized prostate cancer. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: P...
77385
HC IMRT SIMPLE
HCPCS
Policy guidelines updated regarding localized prostate cancer. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: P...
G6016
PR DELIVERY COMP IMRT
HCPCS
Policy guidelines updated regarding localized prostate cancer. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: P...
G6015
Radiation tx delivery imrt
HCPCS
12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: Policy description updated regarding IMRT systems. Policy statem...
77386
HC IMRT COMPLEX
HCPCS
12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: Policy description updated regarding IMRT systems. Policy statem...
77385
HC IMRT SIMPLE
HCPCS
12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: Policy description updated regarding IMRT systems. Policy statem...
G6016
PR DELIVERY COMP IMRT
HCPCS
12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: Policy description updated regarding IMRT systems. Policy statem...
G6015
Radiation tx delivery imrt
HCPCS
Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: Policy description updated regarding IMRT systems. Policy statements unchanged. Policy Guidelines section updated to add medically necessary and investigative defi...
G6016
PR DELIVERY COMP IMRT
HCPCS
Added the following new 2015 HCPCS codes to the Code Reference section: G6015 and G6016. 08/28/2015: Medical policy revised to add ICD-10 codes. 09/16/2015: Policy description updated regarding IMRT systems. Policy statements unchanged. Policy Guidelines section updated to add medically necessary and investigative defi...
1999
ANESTHESIOLOGY GROUP
CPT
- Ophthalmic Technology Assessment Committee Cornea Panel American Academy of Ophthalmology. Corneal topography. Ophthalmology 1999; 106(8-Jan):1628-38. |CPT||92025||Computerized corneal topography, unilateral or bilateral, with interpretation and report| |92002–92014||General ophthalmological services| |ICD-9 Procedur...
1999
ANESTHESIOLOGY GROUP
CPT
Corneal topography. Ophthalmology 1999; 106(8-Jan):1628-38. |CPT||92025||Computerized corneal topography, unilateral or bilateral, with interpretation and report| |92002–92014||General ophthalmological services| |ICD-9 Procedure||95.02||Comprehensive eye examination| |95.09||Eye examination, not otherwise specified| |I...
1999
ANESTHESIOLOGY GROUP
CPT
Ophthalmology 1999; 106(8-Jan):1628-38. |CPT||92025||Computerized corneal topography, unilateral or bilateral, with interpretation and report| |92002–92014||General ophthalmological services| |ICD-9 Procedure||95.02||Comprehensive eye examination| |95.09||Eye examination, not otherwise specified| |ICD-9 Diagnosis||Not ...
53899
HC UNLISTED PROCEDURE, URINARY SYSTEM
HCPCS
Revisions approved per Medical Policy Advisory Committee (MPAC) 6/21/2006.Coding reference section updated, 76940 added to covered table, 50549, 50592, 53899, 55.39 moved to non-covered table. 85.20 added to non-covered table. 189.0 deleted. 9/22/2006: Coding updated. ICD9 2006 revisions added to policy 1/3/2007: Code ...
50592
PR ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY
HCPCS
Revisions approved per Medical Policy Advisory Committee (MPAC) 6/21/2006.Coding reference section updated, 76940 added to covered table, 50549, 50592, 53899, 55.39 moved to non-covered table. 85.20 added to non-covered table. 189.0 deleted. 9/22/2006: Coding updated. ICD9 2006 revisions added to policy 1/3/2007: Code ...
50549
Unlisted laps px renal
HCPCS
Revisions approved per Medical Policy Advisory Committee (MPAC) 6/21/2006.Coding reference section updated, 76940 added to covered table, 50549, 50592, 53899, 55.39 moved to non-covered table. 85.20 added to non-covered table. 189.0 deleted. 9/22/2006: Coding updated. ICD9 2006 revisions added to policy 1/3/2007: Code ...
76940
HC ULTRASOUND GUIDANCE FOR, AND MONITORING OF, PARENCHYMAL TISSU
HCPCS
Revisions approved per Medical Policy Advisory Committee (MPAC) 6/21/2006.Coding reference section updated, 76940 added to covered table, 50549, 50592, 53899, 55.39 moved to non-covered table. 85.20 added to non-covered table. 189.0 deleted. 9/22/2006: Coding updated. ICD9 2006 revisions added to policy 1/3/2007: Code ...
1999
ANESTHESIOLOGY GROUP
CPT
POLICY GUIDELINESInvestigative 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 conditio...
S2120
Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation
HCPCS
POLICY GUIDELINESInvestigative 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 conditio...
36511
PR THERAPEUTIC APHERESIS WHITE BLOOD CELLS
HCPCS
POLICY GUIDELINESInvestigative 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 conditio...
36513
PR THERAPEUTIC APHERESIS PLATELETS
HCPCS
POLICY GUIDELINESInvestigative 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 conditio...
36512
PR THERAPEUTIC APHERESIS RED BLOOD CELLS
HCPCS
POLICY GUIDELINESInvestigative 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 conditio...
36521
USE 36516
HCPCS
POLICY GUIDELINESInvestigative 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 conditio...
36520
SEE 36511-36512
HCPCS
POLICY GUIDELINESInvestigative 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 conditio...
1999
ANESTHESIOLOGY GROUP
CPT
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY6/1993: Therapeutic Apheresis approved by Medical Policy Advisory Committee (MPAC) 11/1993: Extracorporeal Immunoadsorption Using Protein A Columns approved by MPAC 5/19...
S2120
Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation
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 HISTORY6/1993: Therapeutic Apheresis approved by Medical Policy Advisory Committee (MPAC) 11/1993: Extracorporeal Immunoadsorption Using Protein A Columns approved by MPAC 5/19...
36511
PR THERAPEUTIC APHERESIS WHITE BLOOD CELLS
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 HISTORY6/1993: Therapeutic Apheresis approved by Medical Policy Advisory Committee (MPAC) 11/1993: Extracorporeal Immunoadsorption Using Protein A Columns approved by MPAC 5/19...
36513
PR THERAPEUTIC APHERESIS PLATELETS
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 HISTORY6/1993: Therapeutic Apheresis approved by Medical Policy Advisory Committee (MPAC) 11/1993: Extracorporeal Immunoadsorption Using Protein A Columns approved by MPAC 5/19...
36512
PR THERAPEUTIC APHERESIS RED BLOOD CELLS
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 HISTORY6/1993: Therapeutic Apheresis approved by Medical Policy Advisory Committee (MPAC) 11/1993: Extracorporeal Immunoadsorption Using Protein A Columns approved by MPAC 5/19...
36521
USE 36516
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 HISTORY6/1993: Therapeutic Apheresis approved by Medical Policy Advisory Committee (MPAC) 11/1993: Extracorporeal Immunoadsorption Using Protein A Columns approved by MPAC 5/19...
36520
SEE 36511-36512
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 HISTORY6/1993: Therapeutic Apheresis approved by Medical Policy Advisory Committee (MPAC) 11/1993: Extracorporeal Immunoadsorption Using Protein A Columns approved by MPAC 5/19...
1999
ANESTHESIOLOGY GROUP
CPT
POLICY HISTORY6/1993: Therapeutic Apheresis approved by Medical Policy Advisory Committee (MPAC) 11/1993: Extracorporeal Immunoadsorption Using Protein A Columns approved by MPAC 5/1999: MPAC reviewed policies; updated, combined and renamed 12/1999: Interim revision; new FDA-approved indication added for some stages of...
S2120
Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation
HCPCS
POLICY HISTORY6/1993: Therapeutic Apheresis approved by Medical Policy Advisory Committee (MPAC) 11/1993: Extracorporeal Immunoadsorption Using Protein A Columns approved by MPAC 5/1999: MPAC reviewed policies; updated, combined and renamed 12/1999: Interim revision; new FDA-approved indication added for some stages of...
36511
PR THERAPEUTIC APHERESIS WHITE BLOOD CELLS
HCPCS
POLICY HISTORY6/1993: Therapeutic Apheresis approved by Medical Policy Advisory Committee (MPAC) 11/1993: Extracorporeal Immunoadsorption Using Protein A Columns approved by MPAC 5/1999: MPAC reviewed policies; updated, combined and renamed 12/1999: Interim revision; new FDA-approved indication added for some stages of...
36513
PR THERAPEUTIC APHERESIS PLATELETS
HCPCS
POLICY HISTORY6/1993: Therapeutic Apheresis approved by Medical Policy Advisory Committee (MPAC) 11/1993: Extracorporeal Immunoadsorption Using Protein A Columns approved by MPAC 5/1999: MPAC reviewed policies; updated, combined and renamed 12/1999: Interim revision; new FDA-approved indication added for some stages of...
36512
PR THERAPEUTIC APHERESIS RED BLOOD CELLS
HCPCS
POLICY HISTORY6/1993: Therapeutic Apheresis approved by Medical Policy Advisory Committee (MPAC) 11/1993: Extracorporeal Immunoadsorption Using Protein A Columns approved by MPAC 5/1999: MPAC reviewed policies; updated, combined and renamed 12/1999: Interim revision; new FDA-approved indication added for some stages of...
36521
USE 36516
HCPCS
POLICY HISTORY6/1993: Therapeutic Apheresis approved by Medical Policy Advisory Committee (MPAC) 11/1993: Extracorporeal Immunoadsorption Using Protein A Columns approved by MPAC 5/1999: MPAC reviewed policies; updated, combined and renamed 12/1999: Interim revision; new FDA-approved indication added for some stages of...
36520
SEE 36511-36512
HCPCS
POLICY HISTORY6/1993: Therapeutic Apheresis approved by Medical Policy Advisory Committee (MPAC) 11/1993: Extracorporeal Immunoadsorption Using Protein A Columns approved by MPAC 5/1999: MPAC reviewed policies; updated, combined and renamed 12/1999: Interim revision; new FDA-approved indication added for some stages of...
36522
PR PHOTOPHERESIS EXTRACORPOREAL
HCPCS
IgA or IgG paraproteinemia polyneuropathy added as a medically necessary indication. Inclusion body myositis and asthma added as investigational. Code reference section reviewed; CPT codes 36515, 36516, 36522, 86960 removed; ICD-9 procedure codes 99.76, 99.88 removed; ICD-9 diagnosis codes 202.20-202.28, 272.0-272.2, 7...
S2120
Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation
HCPCS
IgA or IgG paraproteinemia polyneuropathy added as a medically necessary indication. Inclusion body myositis and asthma added as investigational. Code reference section reviewed; CPT codes 36515, 36516, 36522, 86960 removed; ICD-9 procedure codes 99.76, 99.88 removed; ICD-9 diagnosis codes 202.20-202.28, 272.0-272.2, 7...
86960
HC VOL REDUC BLD/PRD EA UN
HCPCS
IgA or IgG paraproteinemia polyneuropathy added as a medically necessary indication. Inclusion body myositis and asthma added as investigational. Code reference section reviewed; CPT codes 36515, 36516, 36522, 86960 removed; ICD-9 procedure codes 99.76, 99.88 removed; ICD-9 diagnosis codes 202.20-202.28, 272.0-272.2, 7...
36516
PR THER APHERESIS W/EXTRACORPOREAL IMMUNOADSORPTION
HCPCS
IgA or IgG paraproteinemia polyneuropathy added as a medically necessary indication. Inclusion body myositis and asthma added as investigational. Code reference section reviewed; CPT codes 36515, 36516, 36522, 86960 removed; ICD-9 procedure codes 99.76, 99.88 removed; ICD-9 diagnosis codes 202.20-202.28, 272.0-272.2, 7...
36515
Apheresis adsorp/reinfuse
HCPCS
IgA or IgG paraproteinemia polyneuropathy added as a medically necessary indication. Inclusion body myositis and asthma added as investigational. Code reference section reviewed; CPT codes 36515, 36516, 36522, 86960 removed; ICD-9 procedure codes 99.76, 99.88 removed; ICD-9 diagnosis codes 202.20-202.28, 272.0-272.2, 7...
36522
PR PHOTOPHERESIS EXTRACORPOREAL
HCPCS
Inclusion body myositis and asthma added as investigational. Code reference section reviewed; CPT codes 36515, 36516, 36522, 86960 removed; ICD-9 procedure codes 99.76, 99.88 removed; ICD-9 diagnosis codes 202.20-202.28, 272.0-272.2, 714.0-714.9 removed; HCPCS S2120 removed. ICD-9 diagnosis codes 203.00, 203.01, 341.0,...
S2120
Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation
HCPCS
Inclusion body myositis and asthma added as investigational. Code reference section reviewed; CPT codes 36515, 36516, 36522, 86960 removed; ICD-9 procedure codes 99.76, 99.88 removed; ICD-9 diagnosis codes 202.20-202.28, 272.0-272.2, 714.0-714.9 removed; HCPCS S2120 removed. ICD-9 diagnosis codes 203.00, 203.01, 341.0,...
86960
HC VOL REDUC BLD/PRD EA UN
HCPCS
Inclusion body myositis and asthma added as investigational. Code reference section reviewed; CPT codes 36515, 36516, 36522, 86960 removed; ICD-9 procedure codes 99.76, 99.88 removed; ICD-9 diagnosis codes 202.20-202.28, 272.0-272.2, 714.0-714.9 removed; HCPCS S2120 removed. ICD-9 diagnosis codes 203.00, 203.01, 341.0,...
36516
PR THER APHERESIS W/EXTRACORPOREAL IMMUNOADSORPTION
HCPCS
Inclusion body myositis and asthma added as investigational. Code reference section reviewed; CPT codes 36515, 36516, 36522, 86960 removed; ICD-9 procedure codes 99.76, 99.88 removed; ICD-9 diagnosis codes 202.20-202.28, 272.0-272.2, 714.0-714.9 removed; HCPCS S2120 removed. ICD-9 diagnosis codes 203.00, 203.01, 341.0,...
36515
Apheresis adsorp/reinfuse
HCPCS
Inclusion body myositis and asthma added as investigational. Code reference section reviewed; CPT codes 36515, 36516, 36522, 86960 removed; ICD-9 procedure codes 99.76, 99.88 removed; ICD-9 diagnosis codes 202.20-202.28, 272.0-272.2, 714.0-714.9 removed; HCPCS S2120 removed. ICD-9 diagnosis codes 203.00, 203.01, 341.0,...
E0472
Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pre
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
A7035
Pos airway press headgear
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
A7038
Pos airway pressure filter
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
A7032
Replacement nasal cushion
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
A7028
Repl oral cushion combo mask
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
A7045
Repl exhalation port for PAP
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
A7044
PAP oral interface
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
A4604
Tubing with integrated heating element for use with positive airway pressure device
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
E1399
ITEM 6664
CPT
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
A7029
Repl nasal pillow comb mask
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
E0562
Humidifier heated used w PAP
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
E0601
Continuous positive airway pressure (cpap) device
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
E0471
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive air
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
A7031
Replacement facemask interfa
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
A7039
Filter, non disposable w pap
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
A7037
Tubing used with positive airway pressure device
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
A7033
Replacement nasal pillows
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
A7046
Water chamber for humidifier, used with positive airway pressure device, replacement, each
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
E0470
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive a
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
A7027
Combination oral/nasal mask, used with continuous positive airway pressure device, each
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
E0561
Humidifier nonheated w PAP
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
A7034
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap
HCPCS
Insurance policies vary. Be sure to check with your specific provider before making any purchases. Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Ye...
E0472
Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pre
HCPCS
Below is a list of the HCPCS Codes and medicare guidelines for replacement schedule: HCPCS Code Product Replacement Schedule E0601 CPAP/APAP machine 1 per 5 Years E0470 BiPAP machine without backup rate feature 1 per 5 Years E0471 BiPAP-ST machine with backup rate feature 1 per 5 Years E0472 Respiratory assist device, ...