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99054
MEDICAL SERVICES-UNUSUAL HRS
CPT
Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes: - 90805 = outpatient psychotherapy - 38221 = bone marrow biopsy, trocar or needle - 38211 = tumor cell depletion - 99261 - 99263 = follow-up inpatient consultation - 99054 = services requested on ...
38211
Tumor cell deplete of harvst
HCPCS
Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes: - 90805 = outpatient psychotherapy - 38221 = bone marrow biopsy, trocar or needle - 38211 = tumor cell depletion - 99261 - 99263 = follow-up inpatient consultation - 99054 = services requested on ...
90805
Psytx off 20-30 min w/e&m
HCPCS
Here are just a few examples of CPT codes: - 90805 = outpatient psychotherapy - 38221 = bone marrow biopsy, trocar or needle - 38211 = tumor cell depletion - 99261 - 99263 = follow-up inpatient consultation - 99054 = services requested on holidays or Sundays HCPCS (Healthcare Common Procedure Coding System). Medical co...
38221
PR DIAGNOSTIC BONE MARROW BIOPSIES
HCPCS
Here are just a few examples of CPT codes: - 90805 = outpatient psychotherapy - 38221 = bone marrow biopsy, trocar or needle - 38211 = tumor cell depletion - 99261 - 99263 = follow-up inpatient consultation - 99054 = services requested on holidays or Sundays HCPCS (Healthcare Common Procedure Coding System). Medical co...
99263
Follow-up inpatient consult
HCPCS
Here are just a few examples of CPT codes: - 90805 = outpatient psychotherapy - 38221 = bone marrow biopsy, trocar or needle - 38211 = tumor cell depletion - 99261 - 99263 = follow-up inpatient consultation - 99054 = services requested on holidays or Sundays HCPCS (Healthcare Common Procedure Coding System). Medical co...
99261
Follow-up inpatient consult
HCPCS
Here are just a few examples of CPT codes: - 90805 = outpatient psychotherapy - 38221 = bone marrow biopsy, trocar or needle - 38211 = tumor cell depletion - 99261 - 99263 = follow-up inpatient consultation - 99054 = services requested on holidays or Sundays HCPCS (Healthcare Common Procedure Coding System). Medical co...
99054
MEDICAL SERVICES-UNUSUAL HRS
CPT
Here are just a few examples of CPT codes: - 90805 = outpatient psychotherapy - 38221 = bone marrow biopsy, trocar or needle - 38211 = tumor cell depletion - 99261 - 99263 = follow-up inpatient consultation - 99054 = services requested on holidays or Sundays HCPCS (Healthcare Common Procedure Coding System). Medical co...
38211
Tumor cell deplete of harvst
HCPCS
Here are just a few examples of CPT codes: - 90805 = outpatient psychotherapy - 38221 = bone marrow biopsy, trocar or needle - 38211 = tumor cell depletion - 99261 - 99263 = follow-up inpatient consultation - 99054 = services requested on holidays or Sundays HCPCS (Healthcare Common Procedure Coding System). Medical co...
J8700
Temozolomide per 5 mg
HCPCS
Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ...
J3490
ZINC SULFATE 220MG 220MG CP
HCPCS
Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ...
P9010
WHOLE BLOOD FOR TRANSFUSION
HCPCS
Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ...
J8700
Temozolomide per 5 mg
HCPCS
Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS cod...
J3490
ZINC SULFATE 220MG 220MG CP
HCPCS
Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS cod...
P9010
WHOLE BLOOD FOR TRANSFUSION
HCPCS
Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS cod...
J8700
Temozolomide per 5 mg
HCPCS
CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes: - J8700 = Temozolmide, oral, 5 mg. - A0030 = Ambulance service, conven...
J3490
ZINC SULFATE 220MG 220MG CP
HCPCS
CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes: - J8700 = Temozolmide, oral, 5 mg. - A0030 = Ambulance service, conven...
P9010
WHOLE BLOOD FOR TRANSFUSION
HCPCS
CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes: - J8700 = Temozolmide, oral, 5 mg. - A0030 = Ambulance service, conven...
J8700
Temozolomide per 5 mg
HCPCS
HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes: - J8700 = Temozolmide, oral, 5 mg. - A0030 = Ambulance service, conventional air service, transport, one way - JO530 = Injection o...
J3490
ZINC SULFATE 220MG 220MG CP
HCPCS
HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes: - J8700 = Temozolmide, oral, 5 mg. - A0030 = Ambulance service, conventional air service, transport, one way - JO530 = Injection o...
P9010
WHOLE BLOOD FOR TRANSFUSION
HCPCS
HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes: - J8700 = Temozolmide, oral, 5 mg. - A0030 = Ambulance service, conventional air service, transport, one way - JO530 = Injection o...
J8700
Temozolomide per 5 mg
HCPCS
Here are several examples of HCPCS codes: - J8700 = Temozolmide, oral, 5 mg. - A0030 = Ambulance service, conventional air service, transport, one way - JO530 = Injection of penicillin - J3490 = Unclassified drugs - P9010 = Blood (whole) for transfusion To meet the standards set by HIPAA (Health Information Portability...
J3490
ZINC SULFATE 220MG 220MG CP
HCPCS
Here are several examples of HCPCS codes: - J8700 = Temozolmide, oral, 5 mg. - A0030 = Ambulance service, conventional air service, transport, one way - JO530 = Injection of penicillin - J3490 = Unclassified drugs - P9010 = Blood (whole) for transfusion To meet the standards set by HIPAA (Health Information Portability...
P9010
WHOLE BLOOD FOR TRANSFUSION
HCPCS
Here are several examples of HCPCS codes: - J8700 = Temozolmide, oral, 5 mg. - A0030 = Ambulance service, conventional air service, transport, one way - JO530 = Injection of penicillin - J3490 = Unclassified drugs - P9010 = Blood (whole) for transfusion To meet the standards set by HIPAA (Health Information Portability...
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 HISTORY4/1993: Approved by Medical Policy Advisory Committee (MPAC) 2/1997: Expanded clinical indications approved by MPAC. Limited to DEXA method only, once every 12 months. 6...
1999
ANESTHESIOLOGY GROUP
CPT
POLICY HISTORY4/1993: Approved by Medical Policy Advisory Committee (MPAC) 2/1997: Expanded clinical indications approved by MPAC. Limited to DEXA method only, once every 12 months. 6/1999: Interim policy revision: Included use of quantitative ultrasound (QUS) as an approved method 8/1999: Addition of QUS approved by M...
1999
ANESTHESIOLOGY GROUP
CPT
Limited to DEXA method only, once every 12 months. 6/1999: Interim policy revision: Included use of quantitative ultrasound (QUS) as an approved method 8/1999: Addition of QUS approved by MPAC 11/2000: Reviewed by MPAC; no changes 5/21/2001: Code Reference section revised; non-covered codes table added 10/15/2001: Verb...
1999
ANESTHESIOLOGY GROUP
CPT
6/1999: Interim policy revision: Included use of quantitative ultrasound (QUS) as an approved method 8/1999: Addition of QUS approved by MPAC 11/2000: Reviewed by MPAC; no changes 5/21/2001: Code Reference section revised; non-covered codes table added 10/15/2001: Verbiage revised under "policy" section; "Reimbursement...
76075
Dxa bone density, axial
HCPCS
2/14/2002: Investigational definition added 4/18/2002: Type of Service and Place of Service deleted 6/12/2002: ICD-9 diagnosis codes 493 and 579 4th/5th digit added 3/2003: Reviewed by MPAC, frequency of all current indications changed to every 2 years except long term glucocortocoid therapy where bone density substant...
76071
Ct bone density, peripheral
HCPCS
2/14/2002: Investigational definition added 4/18/2002: Type of Service and Place of Service deleted 6/12/2002: ICD-9 diagnosis codes 493 and 579 4th/5th digit added 3/2003: Reviewed by MPAC, frequency of all current indications changed to every 2 years except long term glucocortocoid therapy where bone density substant...
76077
Dxa bone density/v-fracture
HCPCS
2/14/2002: Investigational definition added 4/18/2002: Type of Service and Place of Service deleted 6/12/2002: ICD-9 diagnosis codes 493 and 579 4th/5th digit added 3/2003: Reviewed by MPAC, frequency of all current indications changed to every 2 years except long term glucocortocoid therapy where bone density substant...
76076
Dxa bone density/peripheral
HCPCS
2/14/2002: Investigational definition added 4/18/2002: Type of Service and Place of Service deleted 6/12/2002: ICD-9 diagnosis codes 493 and 579 4th/5th digit added 3/2003: Reviewed by MPAC, frequency of all current indications changed to every 2 years except long term glucocortocoid therapy where bone density substant...
76077
Dxa bone density/v-fracture
HCPCS
556.8, 556.9, 558.9, 564.2, 571.49, 714.0 deleted 9/27/2004: Under Policy “chronic” renal failure specified, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556...
76077
Dxa bone density/v-fracture
HCPCS
Note: V58.65 Long-term (current) use of steroids,” The examples of conditions listed are covered in addition to other chronic illnesses requiring the long term (current) use of glucocorticoid. Note “but not limited to” - coding has been listed in the Code Reference section for the examples listed in the Policy section ...
76077
Dxa bone density/v-fracture
HCPCS
Note “but not limited to” - coding has been listed in the Code Reference section for the examples listed in the Policy section only, ICD-9 diagnosis code 242.00, 242.01, 242.10, 242.11, 242.20, 242.21, 242.30, 242.31, 242.40, 242.41, 242.80, 242.81, 756.10, 756.9 added to covered codes, ICD-9 diagnosis code 252.0 5th d...
G0130
Single energy x-ray study
HCPCS
Note “but not limited to” - coding has been listed in the Code Reference section for the examples listed in the Policy section only, ICD-9 diagnosis code 242.00, 242.01, 242.10, 242.11, 242.20, 242.21, 242.30, 242.31, 242.40, 242.41, 242.80, 242.81, 756.10, 756.9 added to covered codes, ICD-9 diagnosis code 252.0 5th d...
76077
Dxa bone density/v-fracture
HCPCS
HCPCS 2006 revisions added to policy 09/13/2006: Coding updated. ICD9 2006 revisions added to policy 09/25/2006: Policy clarified and partially rewritten 10/25/2006: Code reference section updated. CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table 12/21/2006: Policy clarified. Added "inc...
G0130
Single energy x-ray study
HCPCS
HCPCS 2006 revisions added to policy 09/13/2006: Coding updated. ICD9 2006 revisions added to policy 09/25/2006: Policy clarified and partially rewritten 10/25/2006: Code reference section updated. CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table 12/21/2006: Policy clarified. Added "inc...
76077
Dxa bone density/v-fracture
HCPCS
ICD9 2006 revisions added to policy 09/25/2006: Policy clarified and partially rewritten 10/25/2006: Code reference section updated. CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table 12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to wo...
G0130
Single energy x-ray study
HCPCS
ICD9 2006 revisions added to policy 09/25/2006: Policy clarified and partially rewritten 10/25/2006: Code reference section updated. CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table 12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to wo...
76075
Dxa bone density, axial
HCPCS
CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table 12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause 12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions 12/17/2007:...
76077
Dxa bone density/v-fracture
HCPCS
CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table 12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause 12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions 12/17/2007:...
G0130
Single energy x-ray study
HCPCS
CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table 12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause 12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions 12/17/2007:...
76076
Dxa bone density/peripheral
HCPCS
CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table 12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause 12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions 12/17/2007:...
76075
Dxa bone density, axial
HCPCS
HCPC code G0130 added to non-covered table 12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause 12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions 12/17/2007: Coding updated.CPT/HCPCS 2008 revision...
Q9952
Inj Gad-base MR contrast,1ml
HCPCS
HCPC code G0130 added to non-covered table 12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause 12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions 12/17/2007: Coding updated.CPT/HCPCS 2008 revision...
G0130
Single energy x-ray study
HCPCS
HCPC code G0130 added to non-covered table 12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause 12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions 12/17/2007: Coding updated.CPT/HCPCS 2008 revision...
76076
Dxa bone density/peripheral
HCPCS
HCPC code G0130 added to non-covered table 12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause 12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions 12/17/2007: Coding updated.CPT/HCPCS 2008 revision...
76075
Dxa bone density, axial
HCPCS
Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause 12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions 12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy 9/17/2008: Annual ICD-9 updates effective 10-1-2008 app...
Q9952
Inj Gad-base MR contrast,1ml
HCPCS
Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause 12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions 12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy 9/17/2008: Annual ICD-9 updates effective 10-1-2008 app...
76076
Dxa bone density/peripheral
HCPCS
Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause 12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions 12/17/2007: Coding updated.CPT/HCPCS 2008 revisions added to policy 9/17/2008: Annual ICD-9 updates effective 10-1-2008 app...
G0358
IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG
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...
G0360
Each additional hr 1-8 hrs
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...
G0363
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
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...
J9000
INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG
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...
G0364
HC BONE MARROW ASPIRATE & BIOPSY
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...
G0362
Each add sequential infusion
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...
J9999
Not otherwise classified, antineoplastic drugs
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...
G0359
Chemotherapy IV one hr initi
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...
38230
PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC
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...
G0361
Prolong chemo infuse>8hrs pu
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...
G0357
IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG
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...
G0356
HORMONAL ANTINEOPLASTIC
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...
G0355
CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC
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...
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: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewe...
86826
Hla x-match noncytotoxc addl
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: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewe...
86825
X-MATCHAHG
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: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewe...
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: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewe...
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: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewe...
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: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewe...
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: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewe...
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: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewe...
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: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewe...
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: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewe...
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: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewe...
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: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewe...
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: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewe...
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: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewe...
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: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewe...
G0358
IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG
HCPCS
POLICY HISTORY3/25/2004: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no changes 10/26/2005: Code Reference section updated, CPT-4 codes 38230 added; HCPCS codes G0355, G0356, G0357, G0358, G0359,...
86826
Hla x-match noncytotoxc addl
HCPCS
POLICY HISTORY3/25/2004: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no changes 10/26/2005: Code Reference section updated, CPT-4 codes 38230 added; HCPCS codes G0355, G0356, G0357, G0358, G0359,...
86825
X-MATCHAHG
HCPCS
POLICY HISTORY3/25/2004: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no changes 10/26/2005: Code Reference section updated, CPT-4 codes 38230 added; HCPCS codes G0355, G0356, G0357, G0358, G0359,...
G0360
Each additional hr 1-8 hrs
HCPCS
POLICY HISTORY3/25/2004: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no changes 10/26/2005: Code Reference section updated, CPT-4 codes 38230 added; HCPCS codes G0355, G0356, G0357, G0358, G0359,...
G0363
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
HCPCS
POLICY HISTORY3/25/2004: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no changes 10/26/2005: Code Reference section updated, CPT-4 codes 38230 added; HCPCS codes G0355, G0356, G0357, G0358, G0359,...
J9000
INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG
HCPCS
POLICY HISTORY3/25/2004: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no changes 10/26/2005: Code Reference section updated, CPT-4 codes 38230 added; HCPCS codes G0355, G0356, G0357, G0358, G0359,...
G0364
HC BONE MARROW ASPIRATE & BIOPSY
HCPCS
POLICY HISTORY3/25/2004: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no changes 10/26/2005: Code Reference section updated, CPT-4 codes 38230 added; HCPCS codes G0355, G0356, G0357, G0358, G0359,...
G0362
Each add sequential infusion
HCPCS
POLICY HISTORY3/25/2004: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no changes 10/26/2005: Code Reference section updated, CPT-4 codes 38230 added; HCPCS codes G0355, G0356, G0357, G0358, G0359,...
J9999
Not otherwise classified, antineoplastic drugs
HCPCS
POLICY HISTORY3/25/2004: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no changes 10/26/2005: Code Reference section updated, CPT-4 codes 38230 added; HCPCS codes G0355, G0356, G0357, G0358, G0359,...
G0359
Chemotherapy IV one hr initi
HCPCS
POLICY HISTORY3/25/2004: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no changes 10/26/2005: Code Reference section updated, CPT-4 codes 38230 added; HCPCS codes G0355, G0356, G0357, G0358, G0359,...
38230
PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC
HCPCS
POLICY HISTORY3/25/2004: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no changes 10/26/2005: Code Reference section updated, CPT-4 codes 38230 added; HCPCS codes G0355, G0356, G0357, G0358, G0359,...
G0361
Prolong chemo infuse>8hrs pu
HCPCS
POLICY HISTORY3/25/2004: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no changes 10/26/2005: Code Reference section updated, CPT-4 codes 38230 added; HCPCS codes G0355, G0356, G0357, G0358, G0359,...
G0357
IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG
HCPCS
POLICY HISTORY3/25/2004: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no changes 10/26/2005: Code Reference section updated, CPT-4 codes 38230 added; HCPCS codes G0355, G0356, G0357, G0358, G0359,...
G0356
HORMONAL ANTINEOPLASTIC
HCPCS
POLICY HISTORY3/25/2004: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no changes 10/26/2005: Code Reference section updated, CPT-4 codes 38230 added; HCPCS codes G0355, G0356, G0357, G0358, G0359,...
G0355
CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC
HCPCS
POLICY HISTORY3/25/2004: Approved by Medical Policy Advisory Committee (MPAC) to be aligned with BCBSA policy # 8.01.31 6/25/2004: Code Reference section completed 11/18/2004: Reviewed by MPAC; no changes 10/26/2005: Code Reference section updated, CPT-4 codes 38230 added; HCPCS codes G0355, G0356, G0357, G0358, G0359,...
G0267
Bone marrow or psc harvest
CPT
10/05/2011: Policy reviwed; no changes. 11/30/2012: Policy reviwed; no changes. 04/29/2013: Deleted ICD-9 procedure codes 41.02, 41.03, 41.05, and 41.08 from the Code Reference section. 08/25/2015: Code Reference section updated to add ICD-10 codes. Revised the descriptions for CPT codes 38240, 38241, and 38242; remove...
38241
Transplt autol hct/donor
HCPCS
10/05/2011: Policy reviwed; no changes. 11/30/2012: Policy reviwed; no changes. 04/29/2013: Deleted ICD-9 procedure codes 41.02, 41.03, 41.05, and 41.08 from the Code Reference section. 08/25/2015: Code Reference section updated to add ICD-10 codes. Revised the descriptions for CPT codes 38240, 38241, and 38242; remove...
G0363
IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS
HCPCS
10/05/2011: Policy reviwed; no changes. 11/30/2012: Policy reviwed; no changes. 04/29/2013: Deleted ICD-9 procedure codes 41.02, 41.03, 41.05, and 41.08 from the Code Reference section. 08/25/2015: Code Reference section updated to add ICD-10 codes. Revised the descriptions for CPT codes 38240, 38241, and 38242; remove...
38240
Transplt allo hct/donor
HCPCS
10/05/2011: Policy reviwed; no changes. 11/30/2012: Policy reviwed; no changes. 04/29/2013: Deleted ICD-9 procedure codes 41.02, 41.03, 41.05, and 41.08 from the Code Reference section. 08/25/2015: Code Reference section updated to add ICD-10 codes. Revised the descriptions for CPT codes 38240, 38241, and 38242; remove...
G0265
Cryopresevation Freeze+stora
CPT
10/05/2011: Policy reviwed; no changes. 11/30/2012: Policy reviwed; no changes. 04/29/2013: Deleted ICD-9 procedure codes 41.02, 41.03, 41.05, and 41.08 from the Code Reference section. 08/25/2015: Code Reference section updated to add ICD-10 codes. Revised the descriptions for CPT codes 38240, 38241, and 38242; remove...
38242
Transplt allo lymphocytes
HCPCS
10/05/2011: Policy reviwed; no changes. 11/30/2012: Policy reviwed; no changes. 04/29/2013: Deleted ICD-9 procedure codes 41.02, 41.03, 41.05, and 41.08 from the Code Reference section. 08/25/2015: Code Reference section updated to add ICD-10 codes. Revised the descriptions for CPT codes 38240, 38241, and 38242; remove...
G0266
Thawing + expansion froz cel
CPT
10/05/2011: Policy reviwed; no changes. 11/30/2012: Policy reviwed; no changes. 04/29/2013: Deleted ICD-9 procedure codes 41.02, 41.03, 41.05, and 41.08 from the Code Reference section. 08/25/2015: Code Reference section updated to add ICD-10 codes. Revised the descriptions for CPT codes 38240, 38241, and 38242; remove...