Type of Service (TOS) Indicator 9: Other Medical Items or Services
CPT codes | ||
| Code | Description | |
|---|---|---|
| 0025U | CPT Code | |
| 0026T | CPT Code | |
| 0029T | CPT Code | |
| 0044U | CPT Code | |
| 00450 | CPT Code | |
| 00452 | CPT Code | |
| 00454 | CPT Code | |
| 0089T | CPT Code | |
| 0103T | CPT Code | |
| 0103U | CPT Code | |
| 0104A | CPT Code | |
| 0104T | CPT Code | |
| 0104U | CPT Code | |
| 0105T | CPT Code | |
| 0105U | CPT Code | |
| 0106T | CPT Code | |
| 0106U | CPT Code | |
| 0107T | CPT Code | |
| 0107U | CPT Code | |
| 0108T | CPT Code | |
| 0108U | CPT Code | |
| 0109T | CPT Code | |
| 0109U | CPT Code | |
| 0110T | CPT Code | |
| 0115T | CPT Code | |
| 0115U | CPT Code | |
| 01160 | CPT Code | |
| 0116T | CPT Code | |
| 0116U | CPT Code | |
| 01170 | CPT Code | |
| 01173 | CPT Code | |
| 0117T | CPT Code | |
| 0130T | CPT Code | |
| 0130U | CPT Code | |
| 0131U | CPT Code | |
| 01320 | CPT Code | |
| 0132U | CPT Code | |
| 0133T | CPT Code | |
| 0140T | CPT Code | |
| 0162T | CPT Code | |
| 0183T | CPT Code | |
| 0187T | CPT Code | |
| 0187U | CPT Code | |
| 0188T | CPT Code | |
| 0188U | CPT Code | |
| 0189T | CPT Code | |
| 0189U | CPT Code | |
| 01905 | CPT Code | |
| 0190T | CPT Code | |
| 0208T | CPT Code | |
| 0208U | CPT Code | |
| 0209T | CPT Code | |
| 0209U | CPT Code | |
| 0210T | CPT Code | |
| 0210U | CPT Code | |
| 0211T | CPT Code | |
| 0211U | CPT Code | |
| 0212T | CPT Code | |
| 0212U | CPT Code | |
| 0213T | CPT Code | |
| 0213U | CPT Code | |
| 0214T | CPT Code | |
| 0214U | CPT Code | |
| 0215T | CPT Code | |
| 0215U | CPT Code | |
| 0216T | CPT Code | |
| 0216U | CPT Code | |
| 0217T | CPT Code | |
| 0217U | CPT Code | |
| 0218T | CPT Code | |
| 0218U | CPT Code | |
| 0219T | CPT Code | |
| 0219U | CPT Code | |
| 0220T | CPT Code | |
| 0220U | CPT Code | |
| 0221T | CPT Code | |
| 0221U | CPT Code | |
| 0222T | CPT Code | |
| 0233T | CPT Code | |
| 0239T | CPT Code | |
| 0239U | CPT Code | |
| 0240T | CPT Code | |
| 0240U | CPT Code | |
| 0241T | CPT Code | |
| 0241U | CPT Code | |
| 0242T | CPT Code | |
| 0242U | CPT Code | |
| 0243T | CPT Code | |
| 0243U | CPT Code | |
| 0244T | CPT Code | |
| 0285T | CPT Code | |
| 0285U | CPT Code | |
| 0286T | CPT Code | |
| 0286U | CPT Code | |
| 0287T | CPT Code | |
| 0501F | CPT Code | |
| 90644 | CPT Code | |
| 92640 | CPT Code | |
| 93668 | CPT Code | |
| 94775 | CPT Code | |
| 94776 | CPT Code | |
| 96150 | CPT Code | |
| 96151 | CPT Code | |
| 96152 | CPT Code | |
| 96153 | CPT Code | |
| 96154 | CPT Code | |
| 96155 | CPT Code | |
| 99000 | CPT Code | |
| 99001 | CPT Code | |
| 99002 | CPT Code | |
| 99070 | CPT Code | |
| 99071 | CPT Code | |
| 99450 | CPT Code | |
| 99451 | CPT Code | |
| 99452 | CPT Code | |
| 99453 | CPT Code | |
| 99454 | CPT Code | |
| 99455 | CPT Code | |
| 99456 | CPT Code | |
| 99601 | CPT Code | |
| 99602 | CPT Code | |
| 99605 | CPT Code | |
| 99606 | CPT Code | |
| 99607 | CPT Code | |
HCPCS codes | ||
| Code | Description | |
| A4226 | Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week | |
| A4250 | Urine test or reagent strips or tablets (100 tablets or strips) | |
| A4260 | LEVONORGESTREL (CONTRACEPTIVE) IMPLANTS SYSTEM, INCLUDING IMPLANTS AND SUPPLIES | |
| A4261 | Cervical cap for contraceptive use | |
| A4262 | Temporary, absorbable lacrimal duct implant, each | |
| A4263 | Permanent, long term, non-dissolvable lacrimal duct implant, each | |
| A4264 | Permanent implantable contraceptive intratubal occlusion device(s) and delivery system | |
| A4265 | Paraffin, per pound | |
| A4266 | Diaphragm for contraceptive use | |
| A4267 | Contraceptive supply, condom, male, each | |
| A4268 | Contraceptive supply, condom, female, each | |
| A4269 | Contraceptive supply, spermicide (e.g., foam, gel), each | |
| A4270 | Disposable endoscope sheath, each | |
| A4281 | Tubing for breast pump, replacement | |
| A4282 | Adapter for breast pump, replacement | |
| A4283 | Cap for breast pump bottle, replacement | |
| A4284 | Breast shield and splash protector for use with breast pump, replacement | |
| A4285 | Polycarbonate bottle for use with breast pump, replacement | |
| A4286 | Locking ring for breast pump, replacement | |
| A4287 | Disposable collection and storage bag for breast milk, any size, any type, each | |
| A4290 | Sacral nerve stimulation test lead, each | |
| A4305 | Disposable drug delivery system, flow rate of 50 ml or greater per hour | |
| A4306 | Disposable drug delivery system, flow rate of less than 50 ml per hour | |
| A4360 | Disposable external urethral clamp or compression device, with pad and/or pouch, each | |
| A4458 | Enema bag with tubing, reusable | |
| A4465 | Non-elastic binder for extremity | |
| A4466 | Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, each | |
| A4520 | Incontinence garment, any type, (e.g., brief, diaper), each | |
| A4521 | ADULT-SIZED INCONTINENCE PRODUCT, DIAPER, SMALL SIZE, EACH | |
| A4522 | ADULT-SIZED INCONTINENCE PRODUCT, DIAPER, MEDIUM SIZE, EACH | |
| A4523 | ADULT-SIZED INCONTINENCE PRODUCT, DIAPER, LARGE SIZE, EACH | |
| A4524 | ADULT-SIZED INCONTINENCE PRODUCT, DIAPER, EXTRA LARGE SIZE, EACH | |
| A4525 | ADULT-SIZED INCONTINENCE PRODUCT, BRIEF, SMALL SIZE, EACH | |
| A4526 | ADULT-SIZED INCONTINENCE PRODUCT, BRIEF, MEDIUM SIZE, EACH | |
| A4527 | ADULT-SIZED INCONTINENCE PRODUCT, BRIEF, LARGE SIZE, EACH | |
| A4528 | ADULT-SIZED INCONTINENCE PRODUCT, BRIEF, EXTRA-LARGE SIZE, EACH | |
| A4529 | CHILD-SIZED INCONTINENCE PRODUCT, DIAPER, SMALL/MEDIUM SIZE, EACH | |
| A4530 | CHILD-SIZED INCONTINENCE PRODUCT, DIAPER, LARGE SIZE, EACH | |
| A4531 | CHILD-SIZED INCONTINENCE PRODUCT, BRIEF, SMALL/MEDIUM SIZE, EACH | |
| A4532 | CHILD-SIZED INCONTINENCE PRODUCT, BRIEF, LARGE SIZE, EACH | |
| A4533 | YOUTH-SIZED INCONTINENCE PRODUCT, DIAPER, EACH | |
| A4534 | YOUTH-SIZED INCONTINENCE PRODUCT, BRIEF, EACH | |
| A4535 | DISPOSABLE LINER/SHIELD FOR INCONTINENCE, EACH | |
| A4536 | PROTECTIVE UNDERWEAR, WASHABLE, ANY SIZE, EACH | |
| A4537 | UNDER PAD, REUSABLE/WASHABLE, ANY SIZE, EACH | |
| A4538 | DIAPER, REUSABLE, PROVIDED BY A DIAPER SERVICE, EACH DIAPER | |
| A4540 | Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm | |
| A4541 | Monthly supplies for use of device coded at e0733 | |
| A4542 | Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist | |
| A4543 | Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month | |
| A4544 | Electrode for external lower extremity nerve stimulator for restless legs syndrome | |
| A4545 | Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month | |
| A4550 | Surgical trays | |
| A4553 | Non-disposable underpads, all sizes | |
| A4554 | Disposable underpads, all sizes | |
| A4566 | Shoulder sling or vest design, abduction restrainer, with or without swathe control, prefabricated, includes fitting and adjustment | |
| A4575 | Topical hyperbaric oxygen chamber, disposable | |
| A4580 | Cast supplies (e.g., plaster) | |
| A4590 | Special casting material (e.g., fiberglass) | |
| A4606 | Oxygen probe for use with oximeter device, replacement | |
| A4614 | Peak expiratory flow rate meter, hand held | |
| A4627 | Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler | |
| A4634 | Replacement bulb for therapeutic light box, tabletop model | |
| A4648 | Tissue marker, implantable, any type, each | |
| A4649 | Surgical supply; miscellaneous | |
| A4650 | Implantable radiation dosimeter, each | |
| A4932 | Rectal thermometer, reusable, any type, each | |
| A6025 | Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each | |
| A9150 | Non-prescription drugs | |
| A9152 | Single vitamin/mineral/trace element, oral, per dose, not otherwise specified | |
| A9153 | Multiple vitamins, with or without minerals and trace elements, oral, per dose, not otherwise specified | |
| A9155 | Artificial saliva, 30 ml | |
| A9156 | Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml | |
| A9180 | Pediculosis (lice infestation) treatment, topical, for administration by patient/caretaker | |
| A9268 | Programmer for transient, orally ingested capsule | |
| A9269 | Programable, transient, orally ingested capsule, for use with external programmer, per month | |
| A9270 | Non-covered item or service | |
| A9272 | Wound suction, disposable, includes dressing, all accessories and components, any type, each | |
| A9274 | External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories | |
| A9275 | Home glucose disposable monitor, includes test strips | |
| A9276 | Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply | |
| A9277 | Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system | |
| A9278 | Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system | |
| A9279 | Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified | |
| A9280 | Alert or alarm device, not otherwise classified | |
| A9282 | Wig, any type, each | |
| A9283 | Foot pressure off loading/supportive device, any type, each | |
| A9300 | Exercise equipment | |
| A9700 | Supply of injectable contrast material for use in echocardiography, per study | |
| A9800 | Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie | |
| A9900 | Miscellaneous dme supply, accessory, and/or service component of another hcpcs code | |
| A9901 | Dme delivery, set up, and/or dispensing service component of another hcpcs code | |
| A9999 | Miscellaneous dme supply or accessory, not otherwise specified | |
| C1052 | Hemostatic agent, gastrointestinal, topical | |
| C1062 | Intravertebral body fracture augmentation with implant (e.g., metal, polymer) | |
| C1300 | Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval | |
| C1305 | GRAFTSKIN, PER 44 SQUARE CENTIMETERS | |
| C1600 | Catheter, transluminal intravascular lesion preparation device, bladed, sheathed (insertable) | |
| C1601 | Endoscope, single-use (i.e. disposable), pulmonary, imaging/illumination device (insertable) | |
| C1602 | Orthopedic/device/drug matrix/absorbable bone void filler, antimicrobial-eluting (implantable) | |
| C1603 | Retrieval device, insertable, laser (used to retrieve intravascular inferior vena cava filter) | |
| C1604 | Graft, transmural transvenous arterial bypass (implantable), with all delivery system components | |
| C1605 | Pacemaker, leadless, dual chamber (right atrial and right ventricular implantable components), rate-responsive, including all necessary components for implantation | |
| C1606 | Adapter, single-use (i.e. disposable), for attaching ultrasound system to upper gastrointestinal endoscope | |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | |
| C1714 | Catheter, transluminal atherectomy, directional | |
| C1715 | Brachytherapy needle | |
| C1716 | Brachytherapy source, non-stranded, gold-198, per source | |
| C1717 | Brachytherapy source, non-stranded, high dose rate iridium-192, per source | |
| C1718 | BRACHYTHERAPY SOURCE, IODINE 125, PER SOURCE | |
| C1719 | Brachytherapy source, non-stranded, non-high dose rate iridium-192, per source | |
| C1720 | BRACHYTHERAPY SOURCE, PALLADIUM 103, PER SOURCE | |
| C1721 | Cardioverter-defibrillator, dual chamber (implantable) | |
| C1722 | Cardioverter-defibrillator, single chamber (implantable) | |
| C1724 | Catheter, transluminal atherectomy, rotational | |
| C1725 | Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) | |
| C1726 | Catheter, balloon dilatation, non-vascular | |
| C1727 | Catheter, balloon tissue dissector, non-vascular (insertable) | |
| C1728 | Catheter, brachytherapy seed administration | |
| C1729 | Catheter, drainage | |
| C1730 | Catheter, electrophysiology, diagnostic, other than 3d mapping (19 or fewer electrodes) | |
| C1731 | Catheter, electrophysiology, diagnostic, other than 3d mapping (20 or more electrodes) | |
| C1732 | Catheter, electrophysiology, diagnostic/ablation, 3d or vector mapping | |
| C1733 | Catheter, electrophysiology, diagnostic/ablation, other than 3d or vector mapping, other than cool-tip | |
| C1734 | Orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to bone (implantable) | |
| C1747 | Endoscope, single-use (i.e. disposable), urinary tract, imaging/illumination device (insertable) | |
| C1748 | Endoscope, single-use (i.e. disposable), upper gi, imaging/illumination device (insertable) | |
| C1749 | Endoscope, retrograde imaging/illumination colonoscope device (implantable) | |
| C1750 | Catheter, hemodialysis/peritoneal, long-term | |
| C1751 | Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) | |
| C1752 | Catheter, hemodialysis/peritoneal, short-term | |
| C1753 | Catheter, intravascular ultrasound | |
| C1754 | Catheter, intradiscal | |
| C1755 | Catheter, intraspinal | |
| C1756 | Catheter, pacing, transesophageal | |
| C1757 | Catheter, thrombectomy/embolectomy | |
| C1758 | Catheter, ureteral | |
| C1759 | Catheter, intracardiac echocardiography | |
| C1760 | Closure device, vascular (implantable/insertable) | |
| C1761 | Catheter, transluminal intravascular lithotripsy, coronary | |
| C1762 | Connective tissue, human (includes fascia lata) | |
| C1763 | Connective tissue, non-human (includes synthetic) | |
| C1764 | Event recorder, cardiac (implantable) | |
| C1765 | Adhesion barrier | |
| C1766 | Introducer/sheath, guiding, intracardiac electrophysiological, steerable, other than peel-away | |
| C1767 | Generator, neurostimulator (implantable), non-rechargeable | |
| C1768 | Graft, vascular | |
| C1769 | Guide wire | |
| C1770 | Imaging coil, magnetic resonance (insertable) | |
| C1771 | Repair device, urinary, incontinence, with sling graft | |
| C1772 | Infusion pump, programmable (implantable) | |
| C1773 | Retrieval device, insertable (used to retrieve fractured medical devices) | |
| C1776 | Joint device (implantable) | |
| C1777 | Lead, cardioverter-defibrillator, endocardial single coil (implantable) | |
| C1778 | Lead, neurostimulator (implantable) | |
| C1779 | Lead, pacemaker, transvenous vdd single pass | |
| C1780 | Lens, intraocular (new technology) | |
| C1781 | Mesh (implantable) | |
| C1782 | Morcellator | |
| C1783 | Ocular implant, aqueous drainage assist device | |
| C1784 | Ocular device, intraoperative, detached retina | |
| C1785 | Pacemaker, dual chamber, rate-responsive (implantable) | |
| C1786 | Pacemaker, single chamber, rate-responsive (implantable) | |
| C1787 | Patient programmer, neurostimulator | |
| C1788 | Port, indwelling (implantable) | |
| C1789 | Prosthesis, breast (implantable) | |
| C1813 | Prosthesis, penile, inflatable | |
| C1814 | Retinal tamponade device, silicone oil | |
| C1815 | Prosthesis, urinary sphincter (implantable) | |
| C1816 | Receiver and/or transmitter, neurostimulator (implantable) | |
| C1817 | Septal defect implant system, intracardiac | |
| C1818 | Integrated keratoprosthesis | |
| C1819 | Surgical tissue localization and excision device (implantable) | |
| C1820 | Generator, neurostimulator (implantable), with rechargeable battery and charging system | |
| C1821 | Interspinous process distraction device (implantable) | |
| C1822 | Generator, neurostimulator (implantable), high frequency, with rechargeable battery and charging system | |
| C1823 | Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads | |
| C1824 | Generator, cardiac contractility modulation (implantable) | |
| C1825 | Generator, neurostimulator (implantable), non-rechargeable with carotid sinus baroreceptor stimulation lead(s) | |
| C1826 | Generator, neurostimulator (implantable), includes closed feedback loop leads and all implantable components, with rechargeable battery and charging system | |
| C1827 | Generator, neurostimulator (implantable), non-rechargeable, with implantable stimulation lead and external paired stimulation controller | |
| C1830 | Powered bone marrow biopsy needle | |
| C1831 | Interbody cage, anterior, lateral or posterior, personalized (implantable) | |
| C1832 | Autograft suspension, including cell processing and application, and all system components | |
| C1833 | Monitor, cardiac, including intracardiac lead and all system components (implantable) | |
| C1834 | Pressure sensor system, includes all components (e.g., introducer, sensor), intramuscular (implantable), excludes mobile (wireless) software application | |
| C1839 | Iris prosthesis | |
| C1840 | Lens, intraocular (telescopic) | |
| C1841 | Retinal prosthesis, includes all internal and external components | |
| C1842 | Retinal prosthesis, includes all internal and external components; add-on to c1841 | |
| C1849 | Skin substitute, synthetic, resorbable, per square centimeter | |
| C1874 | Stent, coated/covered, with delivery system | |
| C1875 | Stent, coated/covered, without delivery system | |
| C1876 | Stent, non-coated/non-covered, with delivery system | |
| C1877 | Stent, non-coated/non-covered, without delivery system | |
| C1878 | Material for vocal cord medialization, synthetic (implantable) | |
| C1879 | Tissue marker (implantable) | |
| C1880 | Vena cava filter | |
| C1881 | Dialysis access system (implantable) | |
| C1882 | Cardioverter-defibrillator, other than single or dual chamber (implantable) | |
| C1883 | Adapter/extension, pacing lead or neurostimulator lead (implantable) | |
| C1884 | Embolization protective system | |
| C1885 | Catheter, transluminal angioplasty, laser | |
| C1886 | Catheter, extravascular tissue ablation, any modality (insertable) | |
| C1887 | Catheter, guiding (may include infusion/perfusion capability) | |
| C1888 | Catheter, ablation, non-cardiac, endovascular (implantable) | |
| C1889 | Implantable/insertable device, not otherwise classified | |
| C1890 | No implantable/insertable device used with device-intensive procedures | |
| C1891 | Infusion pump, non-programmable, permanent (implantable) | |
| C1892 | Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, peel-away | |
| C1893 | Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away | |
| C1894 | Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser | |
| C1895 | Lead, cardioverter-defibrillator, endocardial dual coil (implantable) | |
| C1896 | Lead, cardioverter-defibrillator, other than endocardial single or dual coil (implantable) | |
| C1897 | Lead, neurostimulator test kit (implantable) | |
| C1898 | Lead, pacemaker, other than transvenous vdd single pass | |
| C1899 | Lead, pacemaker/cardioverter-defibrillator combination (implantable) | |
| C1900 | Lead, left ventricular coronary venous system | |
| C1982 | Catheter, pressure-generating, one-way valve, intermittently occlusive | |
| C2596 | Probe, image-guided, robotic, waterjet ablation | |
| C2613 | Lung biopsy plug with delivery system | |
| C2614 | Probe, percutaneous lumbar discectomy | |
| C2615 | Sealant, pulmonary, liquid | |
| C2616 | Brachytherapy source, non-stranded, yttrium-90, per source | |
| C2617 | Stent, non-coronary, temporary, without delivery system | |
| C2618 | Probe/needle, cryoablation | |
| C2619 | Pacemaker, dual chamber, non rate-responsive (implantable) | |
| C2620 | Pacemaker, single chamber, non rate-responsive (implantable) | |
| C2621 | Pacemaker, other than single or dual chamber (implantable) | |
| C2622 | Prosthesis, penile, non-inflatable | |
| C2623 | Catheter, transluminal angioplasty, drug-coated, non-laser | |
| C2624 | Implantable wireless pulmonary artery pressure sensor with delivery catheter, including all system components | |
| C2625 | Stent, non-coronary, temporary, with delivery system | |
| C2626 | Infusion pump, non-programmable, temporary (implantable) | |
| C2627 | Catheter, suprapubic/cystoscopic | |
| C2628 | Catheter, occlusion | |
| C2629 | Introducer/sheath, other than guiding, other than intracardiac electrophysiological, laser | |
| C2630 | Catheter, electrophysiology, diagnostic/ablation, other than 3d or vector mapping, cool-tip | |
| C2631 | Repair device, urinary, incontinence, without sling graft | |
| C2632 | BRACHYTHERAPY SOLUTION, IODINE-125, PER MCI | |
| C2633 | BRACHYTHERAPY SOURCE, CESIUM-131, PER SOURCE | |
| C2634 | Brachytherapy source, non-stranded, high activity, iodine-125, greater than 1.01 mci (nist), per source | |
| C2635 | Brachytherapy source, non-stranded, high activity, palladium-103, greater than 2.2 mci (nist), per source | |
| C2636 | Brachytherapy linear source, non-stranded, palladium-103, per 1 mm | |
| C9033 | Injection, fosnetupitant 235 mg and palonosetron 0.25 mg | |
| C9034 | Injection, dexamethasone 9%, intraocular, 1 mcg | |
| C9040 | Injection, fremanezumab-vfrm, 1mg | |
| C9041 | Injection, coagulation factor xa (recombinant), inactivated (andexxa), 10 mg | |
| C9042 | Injection, bendamustine hcl (belrapzo), 1 mg | |
| C9043 | Injection, levoleucovorin, 1 mg | |
| C9044 | Injection, cemiplimab-rwlc, 1 mg | |
| C9045 | Injection, moxetumomab pasudotox-tdfk, 0.01 mg | |
| C9046 | Cocaine hydrochloride nasal solution for topical administration, 1 mg | |
| C9047 | Injection, caplacizumab-yhdp, 1 mg | |
| C9048 | Dexamethasone, lacrimal ophthalmic insert, 0.1 mg | |
| C9049 | Injection, tagraxofusp-erzs, 10 mcg | |
| C9050 | Injection, emapalumab-lzsg, 1 mg | |
| C9051 | Injection, omadacycline, 1 mg | |
| C9052 | Injection, ravulizumab-cwvz, 10 mg | |
| C9053 | Injection, crizanlizumab-tmca, 1 mg | |
| C9055 | Injection, brexanolone, 1mg | |
| C9056 | Injection, givosiran, 0.5 mg | |
| C9057 | Injection, cetirizine hydrochloride, 1 mg | |
| C9058 | Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo) 0.5 mg | |
| C9059 | Injection, meloxicam, 1 mg | |
| C9060 | Fluoroestradiol f18, diagnostic, 1 mci | |
| C9061 | Injection, teprotumumab-trbw, 10 mg | |
| C9062 | Injection, daratumumab 10 mg and hyaluronidase-fihj | |
| C9063 | Injection, eptinezumab-jjmr, 1 mg | |
| C9064 | Mitomycin pyelocalyceal instillation, 1 mg | |
| C9065 | Injection, romidepsin, non-lyophilized (e.g. liquid), 1mg | |
| C9066 | Injection, sacituzumab govitecan-hziy, 2.5 mg | |
| C9067 | Gallium ga-68, dotatoc, diagnostic, 0.01 mci | |
| C9113 | Injection, pantoprazole sodium, per vial | |
| C9122 | Mometasone furoate sinus implant, 10 micrograms (sinuva) | |
| C9141 | Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl (jivi), 1 i.u. | |
| C9250 | Human plasma fibrin sealant, vapor-heated, solvent-detergent (artiss), 2 ml | |
| C9251 | INJECTION, C1 ESTERASE INHIBITOR (HUMAN), 10 UNITS | |
| C9252 | INJECTION, PLERIXAFOR, 1 MG | |
| C9253 | INJECTION, TEMOZOLOMIDE, 1 MG | |
| C9254 | Injection, lacosamide, 1 mg | |
| C9255 | Injection, paliperidone palmitate, 1 mg | |
| C9256 | Injection, dexamethasone intravitreal implant, 0.1 mg | |
| C9257 | Injection, bevacizumab, 0.25 mg | |
| C9258 | Injection, telavancin, 10 mg | |
| C9259 | Injection, pralatrexate, 1 mg | |
| C9260 | Injection, ofatumumab, 10 mg | |
| C9261 | Injection, ustekinumab, 1 mg | |
| C9262 | Fludarabine phosphate, oral, 1 mg | |
| C9263 | Injection, ecallantide, 1 mg | |
| C9264 | Injection, tocilizumab, 1 mg | |
| C9265 | Injection, romidepsin, 1 mg | |
| C9266 | Injection, collagenase clostridium histolyticum, 0.1 mg | |
| C9267 | Injection, von willebrand factor complex (human), wilate, per 100 iu vwf: rco | |
| C9268 | Capsaicin, patch, 10cm2 | |
| C9269 | Injection, c-1 esterase inhibitor (human), berinert, 10 units | |
| C9270 | Injection, immune globulin (gammaplex), intravenous, non-lyophilized (e.g. liquid), 500 mg | |
| C9271 | Injection, velaglucerase alfa, 100 units | |
| C9272 | Injection, denosumab, 1 mg | |
| C9274 | Crotalidae polyvalent immune fab (ovine), 1 vial | |
| C9276 | Injection, cabazitaxel, 1 mg | |
| C9277 | Injection, alglucosidase alfa (lumizyme), 1 mg | |
| C9278 | Injection, incobotulinumtoxin a, 1 unit | |
| C9352 | Microporous collagen implantable tube (neuragen nerve guide), per centimeter length | |
| C9353 | Microporous collagen implantable slit tube (neurawrap nerve protector), per centimeter length | |
| C9354 | Acellular pericardial tissue matrix of non-human origin (veritas), per square centimeter | |
| C9355 | Collagen nerve cuff (neuromatrix), per 0.5 centimeter length | |
| C9356 | Tendon, porous matrix of cross-linked collagen and glycosaminoglycan matrix (tenoglide tendon protector sheet), per square centimeter | |
| C9357 | DERMAL SUBSTITUTE, GRANULATED CROSS-LINKED COLLAGEN AND GLYCOSAMINOGLYCAN | |
| C9358 | Dermal substitute, native, non-denatured collagen, fetal bovine origin (surgimend collagen matrix), per 0.5 square centimeters | |
| C9359 | Porous purified collagen matrix bone void filler (integra mozaik osteoconductive scaffold putty, integra os osteoconductive scaffold putty), per 0.5 cc | |
| C9360 | Dermal substitute, native, non-denatured collagen, neonatal bovine origin (surgimend collagen matrix), per 0.5 square centimeters | |
| C9361 | Collagen matrix nerve wrap (neuromend collagen nerve wrap), per 0.5 centimeter length | |
| C9362 | Porous purified collagen matrix bone void filler (integra mozaik osteoconductive scaffold strip), per 0.5 cc | |
| C9363 | Skin substitute, integra meshed bilayer wound matrix, per square centimeter | |
| C9364 | Porcine implant, permacol, per square centimeter | |
| C9365 | Oasis ultra tri-layer matrix, per square centimeter | |
| C9366 | Epifix, per square centimeter | |
| C9367 | Skin substitute, endoform dermal template, per square centimeter | |
| C9462 | Injection, delafloxacin, 1 mg | |
| C9463 | Injection, aprepitant, 1 mg | |
| C9464 | Injection, rolapitant, 0.5 mg | |
| C9465 | Hyaluronan or derivative, durolane, for intra-articular injection, per dose | |
| C9466 | Injection, benralizumab, 1 mg | |
| C9467 | Injection, rituximab and hyaluronidase, 10 mg | |
| C9468 | Injection, factor ix (antihemophilic factor, recombinant), glycopegylated, rebinyn, 1 i.u. | |
| C9469 | Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg | |
| C9489 | Injection, nusinersen, 0.1 mg | |
| C9490 | Injection, bezlotoxumab, 10 mg | |
| C9491 | Injection, avelumab, 10 mg | |
| C9492 | Injection, durvalumab, 10 mg | |
| C9493 | Injection, edaravone, 1 mg | |
| C9494 | Injection, ocrelizumab, 1 mg | |
| C9761 | Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if applicable (must use a steerable ureteral catheter) | |
| C9768 | Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure) | |
| C9769 | Cystourethroscopy, with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts | |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | |
| E0190 | Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories | |
| E0203 | Therapeutic lightbox, minimum 10,000 lux, table top model | |
| E0240 | Bath/shower chair, with or without wheels, any size | |
| E0350 | Control unit for electronic bowel irrigation/evacuation system | |
| E0352 | Disposable pack (water reservoir bag, speculum, valving mechanism and collection bag/box) for use with the electronic bowel irrigation/evacuation system | |
| E0445 | Oximeter device for measuring blood oxygen levels non-invasively | |
| E0446 | Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories | |
| E0590 | DISPENSING FEE COVERED DRUG ADMINISTERED THROUGH DME NEBULIZER | |
| E0602 | Breast pump, manual, any type | |
| E0603 | Breast pump, electric (ac and/or dc), any type | |
| E0604 | Breast pump, hospital grade, electric (ac and / or dc), any type | |
| E0616 | Implantable cardiac event recorder with memory, activator and programmer | |
| E0617 | External defibrillator with integrated electrocardiogram analysis | |
| E0639 | Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories | |
| E0640 | Patient lift, fixed system, includes all components/accessories | |
| E0749 | Osteogenesis stimulator, electrical, surgically implanted | |
| E0761 | Non-thermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device | |
| E0769 | Electrical stimulation or electromagnetic wound treatment device, not otherwise classified | |
| E0781 | Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient | |
| E0786 | Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter) | |
| E0787 | External ambulatory infusion pump, insulin, dosage rate adjustment using therapeutic continuous glucose sensing | |
| E1340 | REPAIR OR NONROUTINE SERVICE FOR DURABLE MEDICAL EQUIPMENT REQUIRING THE SKILL OF A TECHNICIAN, LABOR COMPONENT, PER 15 MINUTES | |
| E8000 | Gait trainer, pediatric size, posterior support, includes all accessories and components | |
| E8001 | Gait trainer, pediatric size, upright support, includes all accessories and components | |
| E8002 | Gait trainer, pediatric size, anterior support, includes all accessories and components | |
| G0369 | PHARMACY SUPPLY FEE FOR INITIAL IMMUNOSUPPRESSIVE DRUG(S) FIRST MONTH FOLLOWING | |
| G0370 | PHARMACY SUPPLY FEE FOR ORAL ANTI-CANCER, ORAL ANTI-EMETIC OR IMMUNOSUPPRESSIVE | |
| G0371 | PHARMACY DISPENSING FEE FOR INHALATION DRUG(S); PER 30 DAYS | |
| G0374 | PHARMACY DISPENSING FEE FOR INHALATION DRUG(S); PER 90 DAYS | |
| G0375 | SMOKING AND TOBACCO USE CESSATION COUNSELING VISIT; INTERMEDIATE, GREATER THAN 3 MINUTES UP TO 10 MINUTES | |
| G0376 | SMOKING AND TOBACCO USE CESSATION COUNSELING VISIT: INTENSIVE, GREATER THAN 3 MINUTES UP TO 10 MINUTES | |
| G0435 | Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening | |
| G9147 | Outpatient intravenous insulin treatment (oivit) either pulsatile or continuous, by any means, guided by the results of measurements for: respiratory quotient; and/or, urine urea nitrogen (uun); and/or, arterial, venous or capillary glucose; and/or potassium concentration | |
| H0001 | Alcohol and/or drug assessment | |
| H0002 | Behavioral health screening to determine eligibility for admission to treatment program | |
| H0003 | Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs | |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | |
| H0006 | Alcohol and/or drug services; case management | |
| H0007 | Alcohol and/or drug services; crisis intervention (outpatient) | |
| H0008 | Alcohol and/or drug services; sub-acute detoxification (hospital inpatient) | |
| H0009 | Alcohol and/or drug services; acute detoxification (hospital inpatient) | |
| H0010 | Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) | |
| H0011 | Alcohol and/or drug services; acute detoxification (residential addiction program inpatient) | |
| H0012 | Alcohol and/or drug services; sub-acute detoxification (residential addiction program outpatient) | |
| H0013 | Alcohol and/or drug services; acute detoxification (residential addiction program outpatient) | |
| H0014 | Alcohol and/or drug services; ambulatory detoxification | |
| H0015 | Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education | |
| H0016 | Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) | |
| H0017 | Behavioral health; residential (hospital residential treatment program), without room and board, per diem | |
| H0018 | Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem | |
| H0019 | Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem | |
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | |
| H0021 | Alcohol and/or drug training service (for staff and personnel not employed by providers) | |
| H0022 | Alcohol and/or drug intervention service (planned facilitation) | |
| H0023 | Behavioral health outreach service (planned approach to reach a targeted population) | |
| H0024 | Behavioral health prevention information dissemination service (one-way direct or non-direct contact with service audiences to affect knowledge and attitude) | |
| H0025 | Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) | |
| H0026 | Alcohol and/or drug prevention process service, community-based (delivery of services to develop skills of impactors) | |
| H0027 | Alcohol and/or drug prevention environmental service (broad range of external activities geared toward modifying systems in order to mainstream prevention through policy and law) | |
| H0028 | Alcohol and/or drug prevention problem identification and referral service (e.g., student assistance and employee assistance programs), does not include assessment | |
| H0029 | Alcohol and/or drug prevention alternatives service (services for populations that exclude alcohol and other drug use e.g., alcohol free social events) | |
| H0030 | Behavioral health hotline service | |
| H0031 | Mental health assessment, by non-physician | |
| H0032 | Mental health service plan development by non-physician | |
| H0033 | Oral medication administration, direct observation | |
| H0034 | Medication training and support, per 15 minutes | |
| H0035 | Mental health partial hospitalization, treatment, less than 24 hours | |
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | |
| H0037 | Community psychiatric supportive treatment program, per diem | |
| H0038 | Self-help/peer services, per 15 minutes | |
| H0039 | Assertive community treatment, face-to-face, per 15 minutes | |
| H0040 | Assertive community treatment program, per diem | |
| H0041 | Foster care, child, non-therapeutic, per diem | |
| H0042 | Foster care, child, non-therapeutic, per month | |
| H0043 | Supported housing, per diem | |
| H0044 | Supported housing, per month | |
| H0045 | Respite care services, not in the home, per diem | |
| H0046 | Mental health services, not otherwise specified | |
| H0047 | Alcohol and/or other drug abuse services, not otherwise specified | |
| H0048 | Alcohol and/or other drug testing: collection and handling only, specimens other than blood | |
| H0049 | Alcohol and/or drug screening | |
| H0050 | Alcohol and/or drug services, brief intervention, per 15 minutes | |
| H0051 | Traditional healing service | |
| H1000 | Prenatal care, at-risk assessment | |
| H1001 | Prenatal care, at-risk enhanced service; antepartum management | |
| H1002 | Prenatal care, at risk enhanced service; care coordination | |
| H1003 | Prenatal care, at-risk enhanced service; education | |
| H1004 | Prenatal care, at-risk enhanced service; follow-up home visit | |
| H1005 | Prenatal care, at-risk enhanced service package (includes h1001-h1004) | |
| H1010 | Non-medical family planning education, per session | |
| H1011 | Family assessment by licensed behavioral health professional for state defined purposes | |
| H2000 | Comprehensive multidisciplinary evaluation | |
| H2001 | Rehabilitation program, per 1/2 day | |
| H2010 | Comprehensive medication services, per 15 minutes | |
| H2011 | Crisis intervention service, per 15 minutes | |
| H2012 | Behavioral health day treatment, per hour | |
| H2013 | Psychiatric health facility service, per diem | |
| H2014 | Skills training and development, per 15 minutes | |
| H2015 | Comprehensive community support services, per 15 minutes | |
| H2016 | Comprehensive community support services, per diem | |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | |
| H2018 | Psychosocial rehabilitation services, per diem | |
| H2019 | Therapeutic behavioral services, per 15 minutes | |
| H2020 | Therapeutic behavioral services, per diem | |
| H2021 | Community-based wrap-around services, per 15 minutes | |
| H2022 | Community-based wrap-around services, per diem | |
| H2023 | Supported employment, per 15 minutes | |
| H2024 | Supported employment, per diem | |
| H2025 | Ongoing support to maintain employment, per 15 minutes | |
| H2026 | Ongoing support to maintain employment, per diem | |
| H2027 | Psychoeducational service, per 15 minutes | |
| H2028 | Sexual offender treatment service, per 15 minutes | |
| H2029 | Sexual offender treatment service, per diem | |
| H2030 | Mental health clubhouse services, per 15 minutes | |
| H2031 | Mental health clubhouse services, per diem | |
| H2032 | Activity therapy, per 15 minutes | |
| H2033 | Multisystemic therapy for juveniles, per 15 minutes | |
| H2034 | Alcohol and/or drug abuse halfway house services, per diem | |
| H2035 | Alcohol and/or other drug treatment program, per hour | |
| H2036 | Alcohol and/or other drug treatment program, per diem | |
| H2037 | Developmental delay prevention activities, dependent child of client, per 15 minutes | |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | |
| J3396 | Injection, verteporfin, 0.1 mg | |
| J7300 | Intrauterine copper contraceptive | |
| J7301 | Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg | |
| J7302 | Levonorgestrel-releasing intrauterine contraceptive system, 52 mg | |
| J7303 | Contraceptive supply, hormone containing vaginal ring, each | |
| J7304 | Contraceptive supply, hormone containing patch, each | |
| J7306 | Levonorgestrel (contraceptive) implant system, including implants and supplies | |
| J7307 | Etonogestrel (contraceptive) implant system, including implant and supplies | |
| J7309 | Methyl aminolevulinate (mal) for topical administration, 16.8%, 1 gram | |
| J7310 | Ganciclovir, 4.5 mg, long-acting implant | |
| J7335 | Capsaicin 8% patch, per 10 square centimeters | |
| J8562 | Fludarabine phosphate, oral, 10 mg | |
| J8565 | Gefitinib, oral, 250 mg | |
| K0462 | Temporary replacement for patient owned equipment being repaired, any type | |
| K0553 | Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | |
| K0739 | Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes | |
| K0740 | Repair or nonroutine service for oxygen equipment requiring the skill of a technician, labor component, per 15 minutes | |
| K1006 | Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system | |
| K1007 | Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors | |
| K1009 | Speech volume modulation system, any type, including all components and accessories | |
| K1010 | Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each | |
| K1011 | Activation device for intraurethral drainage device with valve, replacement only, each | |
| K1012 | Charger and base station for intraurethral activation device, replacement only | |
| P9012 | Cryoprecipitate, each unit | |
| P9017 | Fresh frozen plasma (single donor), frozen within 8 hours of collection, each unit | |
| P9019 | Platelets, each unit | |
| P9020 | Platelet rich plasma, each unit | |
| P9023 | Plasma, pooled multiple donor, solvent/detergent treated, frozen, each unit | |
| P9025 | Plasma, cryoprecipitate reduced, pathogen reduced, each unit | |
| P9026 | Cryoprecipitated fibrinogen complex, pathogen reduced, each unit | |
| P9027 | Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit | |
| P9031 | Platelets, leukocytes reduced, each unit | |
| P9032 | Platelets, irradiated, each unit | |
| P9033 | Platelets, leukocytes reduced, irradiated, each unit | |
| P9034 | Platelets, pheresis, each unit | |
| P9035 | Platelets, pheresis, leukocytes reduced, each unit | |
| P9036 | Platelets, pheresis, irradiated, each unit | |
| P9037 | Platelets, pheresis, leukocytes reduced, irradiated, each unit | |
| P9041 | Infusion, albumin (human), 5%, 50 ml | |
| P9043 | Infusion, plasma protein fraction (human), 5%, 50 ml | |
| P9044 | Plasma, cryoprecipitate reduced, each unit | |
| P9045 | Infusion, albumin (human), 5%, 250 ml | |
| P9046 | Infusion, albumin (human), 25%, 20 ml | |
| P9047 | Infusion, albumin (human), 25%, 50 ml | |
| P9048 | Infusion, plasma protein fraction (human), 5%, 250 ml | |
| P9050 | Granulocytes, pheresis, each unit | |
| P9052 | Platelets, hla-matched leukocytes reduced, apheresis/pheresis, each unit | |
| P9053 | Platelets, pheresis, leukocytes reduced, cmv-negative, irradiated, each unit | |
| P9055 | Platelets, leukocytes reduced, cmv-negative, apheresis/pheresis, each unit | |
| P9059 | Fresh frozen plasma between 8-24 hours of collection, each unit | |
| P9060 | Fresh frozen plasma, donor retested, each unit | |
| Q0090 | Levonorgestrel-releasing intrauterine contraceptive system, (skyla), 13.5 mg | |
| Q0136 | INJECTION, EPOETIN ALPHA, (FOR NON ESRD USE), PER 1000 UNITS | |
| Q0510 | Pharmacy supply fee for initial immunosuppressive drug(s), first month following transplant | |
| Q0511 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period | |
| Q0512 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period | |
| Q0513 | Pharmacy dispensing fee for inhalation drug(s); per 30 days | |
| Q0514 | Pharmacy dispensing fee for inhalation drug(s); per 90 days | |
| Q2025 | Fludarabine phosphate, oral, 1 mg | |
| Q2026 | Injection, radiesse, 0.1 ml | |
| Q2027 | Injection, sculptra, 0.1 ml | |
| Q2028 | Injection, sculptra, 0.5 mg | |
| Q2042 | Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose | |
| Q2044 | Injection, belimumab, 10 mg | |
| Q2050 | Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg | |
| Q2051 | Injection, zoledronic acid, not otherwise specified, 1mg | |
| Q3014 | Telehealth originating site facility fee | |
| Q9984 | Levonorgestrel-releasing intrauterine contraceptive system (kyleena), 19.5 mg | |
| Q9988 | Platelets, pheresis, pathogen-reduced, each unit | |
| S0088 | Imatinib, 100 mg | |
| S0091 | Granisetron hydrochloride, 1 mg (for circumstances falling under the medicare statute, use q0166) | |
| S0092 | Injection, hydromorphone hydrochloride, 250 mg (loading dose for infusion pump) | |
| S0093 | Injection, morphine sulfate, 500 mg (loading dose for infusion pump) | |
| S0106 | Bupropion hcl sustained release tablet, 150 mg, per bottle of 60 tablets | |
| S0107 | INJECTION, OMALIZUMAB, 25 MG | |
| S0108 | Mercaptopurine, oral, 50 mg | |
| S0114 | INJECTION, TREPROSTINIL SODIUM, 0.5 MG | |
| S0115 | BORTEZOMIB, 3.5 MG | |
| S0116 | BEVACIZUMAB, 100 MG | |
| S0117 | Tretinoin, topical, 5 grams | |
| S0118 | INJECTION, ZICONOTIDE, FOR INTRATHECAL INFUSION, 1 MCG | |
| S0119 | Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) | |
| S0133 | HISTRELIN, IMPLANT, 50 MG | |
| S0136 | Clozapine, 25 mg | |
| S0137 | Didanosine (ddi), 25 mg | |
| S0138 | Finasteride, 5 mg | |
| S0139 | Minoxidil, 10 mg | |
| S0140 | Saquinavir, 200 mg | |
| S0141 | ZALCITABINE (DDC), 0.375 MG | |
| S0142 | Colistimethate sodium, inhalation solution administered through dme, concentrated form, per mg | |
| S0143 | AZTREONAM, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, PER | |
| S0144 | Injection, propofol, 10 mg | |
| S0145 | Injection, pegylated interferon alfa-2a, 180 mcg per ml | |
| S0146 | Injection, pegylated interferon alfa-2b, 10 mcg per 0.5 ml | |
| S0147 | INJECTION, ALGLUCOSIDASE ALFA, 20 MG | |
| S0148 | Injection, pegylated interferon alfa-2b, 10 mcg | |
| S0155 | Sterile dilutant for epoprostenol, 50 ml | |
| S0156 | Exemestane, 25 mg | |
| S0157 | Becaplermin gel 0.01%, 0.5 gm | |
| S0158 | INJECTION, LARONIDASE, 0.58 MG | |
| S0159 | INJECTION, AGALSIDASE BETA, 35 MG | |
| S0160 | Dextroamphetamine sulfate, 5 mg | |
| S0161 | Calcitrol, 0.25 mg | |
| S0162 | INJECTION, EFALIZUMAB, 125 MG | |
| S0163 | INJECTION, RISPERIDONE, LONG ACTING, 12.5 MG | |
| S0164 | Injection, pantoprazole sodium, 40 mg | |
| S0165 | INJECTION, ABARELIX, 100 MG | |
| S0166 | Injection, olanzapine, 2.5 mg | |
| S0167 | INJECTION, APOMORPHINE HYDROCHLORIDE, 1 MG | |
| S0168 | INJECTION, AZACITIDINE, 100 MG | |
| S0169 | Calcitrol, 0.25 microgram | |
| S0171 | Injection, bumetanide, 0.5 mg | |
| S0172 | Chlorambucil, oral, 2 mg | |
| S0173 | DEXAMETHASONE, ORAL, 4MG | |
| S0174 | Dolasetron mesylate, oral 50 mg (for circumstances falling under the medicare statute, use q0180) | |
| S0175 | Flutamide, oral, 125 mg | |
| S0176 | Hydroxyurea, oral, 500 mg | |
| S0177 | Levamisole hydrochloride, oral, 50 mg | |
| S0178 | Lomustine, oral, 10 mg | |
| S0181 | Ondansetron hydrochloride, oral, 4mg (for circumstances falling under the medicare statute, use q0179) | |
| S0182 | Procarbazine hydrochloride, oral, 50 mg | |
| S0183 | Prochlorperazine maleate, oral, 5 mg (for circumstances falling under the medicare statute, use q0164) | |
| S0187 | Tamoxifen citrate, oral, 10 mg | |
| S0190 | Mifepristone, oral, 200 mg | |
| S0191 | Misoprostol, oral, 200 mcg | |
| S0194 | Dialysis/stress vitamin supplement, oral, 100 capsules | |
| S0195 | Pneumococcal conjugate vaccine, polyvalent, intramuscular, for children from five years to nine years of age who have not previously received the vaccine | |
| S0196 | Injectable poly-l-lactic acid, restorative implant, 1 ml, face (deep dermis, subcutaneous layers) | |
| S0197 | Prenatal vitamins, 30-day supply | |
| S0198 | INJECTION, PEGAPTANIB SODIUM, 0.3 MG | |
| S0199 | Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs | |
| S0201 | Partial hospitalization services, less than 24 hours, per diem | |
| S0207 | Paramedic intercept, non-hospital-based als service (non-voluntary), non-transport | |
| S0220 | Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 30 minutes | |
| S0221 | Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 60 minutes | |
| S0250 | Comprehensive geriatric assessment and treatment planning performed by assessment team | |
| S0255 | Hospice referral visit (advising patient and family of care options) performed by nurse, social worker, or other designated staff | |
| S0257 | Counseling and discussion regarding advance directives or end of life care planning and decisions, with patient and/or surrogate (list separately in addition to code for appropriate evaluation and management service) | |
| S0260 | History and physical (outpatient or office) related to surgical procedure (list separately in addition to code for appropriate evaluation and management service) | |
| S0265 | Genetic counseling, under physician supervision, each 15 minutes | |
| S0270 | Physician management of patient home care, standard monthly case rate (per 30 days) | |
| S0271 | Physician management of patient home care, hospice monthly case rate (per 30 days) | |
| S0272 | Physician management of patient home care, episodic care monthly case rate (per 30 days) | |
| S0273 | Physician visit at member's home, outside of a capitation arrangement | |
| S0274 | Nurse practitioner visit at member's home, outside of a capitation arrangement | |
| S0280 | Medical home program, comprehensive care coordination and planning, initial plan | |
| S0281 | Medical home program, comprehensive care coordination and planning, maintenance of plan | |
| S0285 | Colonoscopy consultation performed prior to a screening colonoscopy procedure | |
| S0302 | Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) | |
| S0310 | Hospitalist services (list separately in addition to code for appropriate evaluation and management service) | |
| S0311 | Comprehensive management and care coordination for advanced illness, per calendar month | |
| S0315 | Disease management program; initial assessment and initiation of the program | |
| S0316 | Disease management program, follow-up/reassessment | |
| S0317 | Disease management program; per diem | |
| S0320 | Telephone calls by a registered nurse to a disease management program member for monitoring purposes; per month | |
| S0340 | Lifestyle modification program for management of coronary artery disease, including all supportive services; first quarter / stage | |
| S0341 | Lifestyle modification program for management of coronary artery disease, including all supportive services; second or third quarter / stage | |
| S0342 | Lifestyle modification program for management of coronary artery disease, including all supportive services; fourth quarter / stage | |
| S0345 | ELECTROCARDIOGRAPHIC MONITORING UTILIZING A HOME COMPUTERIZED TELEMETRY STATION WITH AUTOMATIC ACTIVATION AND REAL-TIME NOTIFICATION OF MONITORING STATION, 24-HOUR ATTENDED MONITORING, INCLUDING RECORDING, MONITORING, RECEIPT OF TRANSMISSIONS, ANALYSIS, AND PHYSICIAN REVIEW AND INTERPRETATION; PER 24-HOUR PERIOD | |
| S0346 | ELECTROCARDIOGRAPHIC MONITORING UTILIZING A HOME COMPUTERIZED TELEMETRY STATION WITH AUTOMATIC ACTIVATION AND REAL-TIME NOTIFICATION OF MONITORING STATION, 24-HOUR ATTENDED MONITORING, INCLUDING RECORDING, MONITORING, RECEIPT OF TRANSMISSIONS, AND ANALYSIS; PER 24-HOUR PERIOD | |
| S0347 | ELECTROCARDIOGRAPHIC MONITORING UTILIZING A HOME COMPUTERIZED TELEMETRY STATION WITH AUTOMATIC ACTIVATION AND REAL-TIME NOTIFICATION OF MONITORING STATION, 24-HOUR ATTENDED MONITORING, INCLUDING PHYSICIAN REVIEW AND INTERPRETATION; 24-HOUR PERIOD | |
| S0353 | Treatment planning and care coordination management for cancer, initial treatment | |
| S0354 | Treatment planning and care coordination management for cancer, established patient with a change of regimen | |
| S0390 | Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit | |
| S0395 | Impression casting of a foot performed by a practitioner other than the manufacturer of the orthotic | |
| S0400 | Global fee for extracorporeal shock wave lithotripsy treatment of kidney stone(s) | |
| S0595 | Dispensing new spectacle lenses for patient supplied frame | |
| S0596 | Phakic intraocular lens for correction of refractive error | |
| S0601 | Screening proctoscopy | |
| S0605 | DIGITAL RECTAL EXAMINATION, MALE, ANNUAL | |
| S0610 | Annual gynecological examination, new patient | |
| S0612 | Annual gynecological examination, established patient | |
| S0613 | Annual gynecological examination; clinical breast examination without pelvic evaluation | |
| S0618 | Audiometry for hearing aid evaluation to determine the level and degree of hearing loss | |
| S0620 | Routine ophthalmological examination including refraction; new patient | |
| S0621 | Routine ophthalmological examination including refraction; established patient | |
| S0622 | Physical exam for college, new or established patient (list separately in addition to appropriate evaluation and management code) | |
| S0625 | Retinal telescreening by digital imaging of multiple different fundus areas to screen for vision-threatening conditions, including imaging, interpretation and report | |
| S0630 | Removal of sutures; by a physician other than the physician who originally closed the wound | |
| S0800 | Laser in situ keratomileusis (lasik) | |
| S0810 | Photorefractive keratectomy (prk) | |
| S0820 | COMPUTERIZED CORNEAL TOPOGRAPHY, UNILATERAL | |
| S0830 | ULTRASOUND PACHYMETRY TO DETERMINE CORNEAL THICKNESS, WITH INTERPRETATION AND REPORT, UNILATERAL | |
| S1015 | Iv tubing extension set | |
| S1016 | Non-pvc (polyvinyl chloride) intravenous administration set, for use with drugs that are not stable in pvc e.g., paclitaxel | |
| S1090 | Mometasone furoate sinus implant, 370 micrograms | |
| S2053 | Transplantation of small intestine and liver allografts | |
| S2054 | Transplantation of multivisceral organs | |
| S2055 | Harvesting of donor multivisceral organs, with preparation and maintenance of allografts; from cadaver donor | |
| S2060 | Lobar lung transplantation | |
| S2061 | Donor lobectomy (lung) for transplantation, living donor | |
| S2068 | Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral | |
| S2070 | Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with endoscopic laser treatment of ureteral calculi (includes ureteral catheterization) | |
| S2075 | LAPAROSCOPY, SURGICAL; REPAIR INCISIONAL OR VENTRAL HERNIA | |
| S2076 | LAPAROSCOPY, SURGICAL; REPAIR UMBILICAL HERNIA | |
| S2077 | LAPAROSCOPY, SURGICAL; IMPLANTATION OF MESH OR OTHER PROSTHESIS FOR INCISIONAL | |
| S2078 | LAPAROSCOPIC SUPRACERVICAL HYSTERECTOMY (SUBTOTAL HYSTERECTOMY), WITH OR WITHOUT REMOVAL OF TUBE(S), WITH OR WITHOUT REMOVAL OF OVARY(S) | |
| S2079 | Laparoscopic esophagomyotomy (heller type) | |
| S2080 | Laser-assisted uvulopalatoplasty (laup) | |
| S2082 | LAPAROSCOPY, SURGICAL; GASTRIC RESTRICTIVE PROCEDURE, ADJUSTABLE GASTRIC BAND (INCLUDES PLACEMENT OF SUBCUTANEOUS PORT) | |
| S2083 | Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline | |
| S2085 | LAPAROSCOPY, GASTRIC RESTRICTIVE PROCEDURE, WITH GASTRIC BYPASS FOR MORBID OBESITY, WITH SHORT LIMB (LESS THAN 100 CM) ROUX-EN-Y GASTROENTEROSTOMY | |
| S2090 | ABLATION, OPEN, ONE OR MORE RENAL TUMOR(S); CRYOSURGICAL | |
| S2091 | ABLATION, PERCUTANEOUS, ONE OR MORE RENAL TUMOR(S); CRYOSURGICAL | |
| S2095 | Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres | |
| S2102 | Islet cell tissue transplant from pancreas; allogeneic | |
| S2103 | Adrenal tissue transplant to brain | |
| S2107 | Adoptive immunotherapy i.e. development of specific anti-tumor reactivity (e.g., tumor-infiltrating lymphocyte therapy) per course of treatment | |
| S2113 | ARTHROSCOPY, KNEE, SURGICAL FOR IMPLANTATION OF CULTURED ANALOGOUS CHONDROCYTES | |
| S2114 | ARTHROSCOPY, SHOULDER, SURGICAL; TENODESIS OF BICEPS | |
| S2115 | Osteotomy, periacetabular, with internal fixation | |
| S2117 | Arthroereisis, subtalar | |
| S2118 | Metal-on-metal total hip resurfacing, including acetabular and femoral components | |
| S2120 | Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation | |
| S2130 | ENDOLUMINAL RADIOFREQUENCY ABLATION OF REFLUXING SAPHENOUS VEINS | |
| S2131 | ENDOVASCULAR LASER ABLATION OF LONG OR SHORT SAPHENOUS VEIN, WITH OR WITHOUT PROXIMAL LIGATION OR DIVISION | |
| S2135 | NEUROLYSIS, BY INJECTION, OF METATARSAL NEUROMA/INTERDIGITAL NEURITIS, ANY | |
| S2140 | Cord blood harvesting for transplantation, allogeneic | |
| S2142 | Cord blood-derived stem-cell transplantation, allogeneic | |
| S2150 | Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; marrow ablative therapy; drugs, supplies, hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services; and the number of days of pre-and post-transplant care in the global definition | |
| S2152 | Solid organ(s), complete or segmental, single organ or combination of organs; deceased or living donor(s), procurement, transplantation, and related complications; including: drugs; supplies; hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services, and the number of days of pre- and post-transplant care in the global definition | |
| S2202 | Echosclerotherapy | |
| S2205 | Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), single coronary arterial graft | |
| S2206 | Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), two coronary arterial grafts | |
| S2207 | Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using venous graft only, single coronary venous graft | |
| S2208 | Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and venous graft(s), single venous graft | |
| S2209 | Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using two arterial grafts and single venous graft | |
| S2211 | TRANSCATHETER PLACEMENT OF INTRAVASCULAR STENT(S), CAROTID ARTERY, PERCUTANEOUS, UNILATERAL (IF PERFORMED BILATERALLY, USE-50 MODIFIER) | |
| S2213 | IMPLANTATION OF GASTRIC ELECTRICAL STIMULATION DEVICE | |
| S2215 | UPPER GASTROINTESTINAL ENDOSCOPY, INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; WITH INJECTION OF IMPLANT MATERIAL INTO AND ALONG THE MUSCLE OF THE LOWER ESOPHAGEAL SPHINCTER FOR TREATMENT OF GASTROESOPHAGEAL REFLUX | |
| S2225 | Myringotomy, laser-assisted | |
| S2230 | Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear | |
| S2235 | Implantation of auditory brain stem implant | |
| S2250 | UTERINE ARTERY EMBOLIZATION FOR UTERINE FIBROIDS | |
| S2255 | HYSTEROSCOPY, SURGICAL; WITH OCCLUSION OF OVIDUCTS BILATERALLY BY MICRO-INSERTS FOR PERMANENT STERILIZATION | |
| S2260 | Induced abortion, 17 to 24 weeks | |
| S2262 | ABORTION FOR MATERNAL INDICATION, 25 WEEKS OR GREATER | |
| S2265 | Induced abortion, 25 to 28 weeks | |
| S2266 | Induced abortion, 29 to 31 weeks | |
| S2267 | Induced abortion, 32 weeks or greater | |
| S2270 | Insertion of vaginal cylinder for application of radiation source or clinical brachytherapy (report separately in addition to radiation source delivery) | |
| S2300 | Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy | |
| S2325 | Hip core decompression | |
| S2340 | Chemodenervation of abductor muscle(s) of vocal cord | |
| S2341 | Chemodenervation of adductor muscle(s) of vocal cord | |
| S2342 | Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(s), unilateral or bilateral | |
| S2344 | Nasal/sinus endoscopy, surgical; with enlargement of sinus ostium opening using inflatable device (i.e., balloon sinuplasty) | |
| S2348 | Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar | |
| S2350 | Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace | |
| S2351 | Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure) | |
| S2360 | Percutaneous vertebroplasty, one vertebral body, unilateral or bilateral injection; cervical | |
| S2361 | Each additional cervical vertebral body (list separately in addition to code for primary procedure) | |
| S2362 | KYPHOPLASTY, ONE VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION | |
| S2363 | KYPHOPLASTY, ONE VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION; EACH ADDITIONAL VERTEBRAL BODY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) | |
| S2370 | INTRADISCAL ELECTROTHERMAL THERAPY; SINGLE INTERSPACE | |
| S2371 | EACH ADDITIONAL INTERSPACE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) | |
| S2405 | Repair of sacrococcygeal teratoma in the fetus, procedure performed in utero | |
| S2411 | Fetoscopic laser therapy for treatment of twin-to-twin transfusion syndrome | |
| S2900 | Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) | |
| S3000 | Diabetic indicator; retinal eye exam, dilated, bilateral | |
| S3005 | Performance measurement, evaluation of patient self assessment, depression | |
| S3600 | Stat laboratory request (situations other than s3601) | |
| S3601 | Emergency stat laboratory charge for patient who is homebound or residing in a nursing facility | |
| S3618 | BLOOD CHEMISTRY FOR FREE BETA HUMAN CHORIONIC GONADOTROPIN (HCG) | |
| S3620 | Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) | |
| S3625 | Maternal serum triple marker screen including alpha-fetoprotein (afp), estriol, and human chorionic gonadotropin (hcg) | |
| S3626 | Maternal serum quadruple marker screen including alpha-fetoprotein (afp), estriol, human chorionic gonadotropin (hcg) and inhibin a | |
| S3628 | Placental alpha microglobulin-1 rapid immunoassay for detection of rupture of fetal membranes | |
| S3630 | Eosinophil count, blood, direct | |
| S3645 | Hiv-1 antibody testing of oral mucosal transudate | |
| S3650 | Saliva test, hormone level; during menopause | |
| S3652 | Saliva test, hormone level; to assess preterm labor risk | |
| S3655 | Antisperm antibodies test (immunobead) | |
| S3701 | IMMUNOASSAY FOR NUCLEAR MATRIX PROTEIN 22 (NMP-22), QUANTITATIVE | |
| S3708 | Gastrointestinal fat absorption study | |
| S3711 | Circulating tumor cell test | |
| S3713 | Kras mutation analysis testing | |
| S3721 | Prostate cancer antigen 3 (pca3) testing | |
| S3722 | Dose optimization by area under the curve (auc) analysis, for infusional 5-fluorouracil | |
| S3800 | Genetic testing for amyotrophic lateral sclerosis (als) | |
| S3820 | Complete brca1 and brca2 gene sequence analysis for susceptibility to breast and ovarian cancer | |
| S3822 | Single mutation analysis (in individual with a known brca1 or brca2 mutation in the family) for susceptibility to breast and ovarian cancer | |
| S3823 | Three-mutation brca1 and brca2 analysis for susceptibility to breast and ovarian cancer in ashkenazi individuals | |
| S3828 | Complete gene sequence analysis; mlh1 gene | |
| S3829 | Complete gene sequence analysis; msh2 gene | |
| S3830 | Complete mlh1 and msh2 gene sequence analysis for hereditary nonpolyposis colorectal cancer (hnpcc) genetic testing | |
| S3831 | Single-mutation analysis (in individual with a known mlh1 and msh2 mutation in the family) for hereditary nonpolyposis colorectal cancer (hnpcc) genetic testing | |
| S3833 | Complete apc gene sequence analysis for susceptibility to familial adenomatous polyposis (fap) and attenuated fap | |
| S3834 | Single-mutation analysis (in individual with a known apc mutation in the family) for susceptibility to familial adenomatous polyposis (fap) and attenuated fap | |
| S3835 | Complete gene sequence analysis for cystic fibrosis genetic testing | |
| S3837 | Complete gene sequence analysis for hemochromatosis genetic testing | |
| S3840 | Dna analysis for germline mutations of the ret proto-oncogene for susceptibility to multiple endocrine neoplasia type 2 | |
| S3841 | Genetic testing for retinoblastoma | |
| S3842 | Genetic testing for von hippel-lindau disease | |
| S3843 | Dna analysis of the f5 gene for susceptibility to factor v leiden thrombophilia | |
| S3844 | Dna analysis of the connexin 26 gene (gjb2) for susceptibility to congenital, profound deafness | |
| S3845 | Genetic testing for alpha-thalassemia | |
| S3846 | Genetic testing for hemoglobin e beta-thalassemia | |
| S3847 | Genetic testing for tay-sachs disease | |
| S3848 | Genetic testing for gaucher disease | |
| S3849 | Genetic testing for niemann-pick disease | |
| S3850 | Genetic testing for sickle cell anemia | |
| S3851 | Genetic testing for canavan disease | |
| S3852 | Dna analysis for apoe epsilon 4 allele for susceptibility to alzheimer's disease | |
| S3853 | Genetic testing for myotonic muscular dystrophy | |
| S3854 | Gene expression profiling panel for use in the management of breast cancer treatment | |
| S3855 | Genetic testing for detection of mutations in the presenilin - 1 gene | |
| S3860 | Genetic testing, comprehensive cardiac ion channel analysis, for variants in 5 major cardiac ion channel genes for individuals with high index of suspicion for familial long qt syndrome (lqts) or related syndromes | |
| S3861 | Genetic testing, sodium channel, voltage-gated, type v, alpha subunit (scn5a) and variants for suspected brugada syndrome | |
| S3862 | Genetic testing, family-specific ion channel analysis, for blood-relatives of individuals (index case) who have previously tested positive for a genetic variant of a cardiac ion channel syndrome using either one of the above test configurations or confirmed results from another laboratory | |
| S3865 | Comprehensive gene sequence analysis for hypertrophic cardiomyopathy | |
| S3866 | Genetic analysis for a specific gene mutation for hypertrophic cardiomyopathy (hcm) in an individual with a known hcm mutation in the family | |
| S3870 | Comparative genomic hybridization (cgh) microarray testing for developmental delay, autism spectrum disorder and/or intellectual disability | |
| S3890 | Dna analysis, fecal, for colorectal cancer screening | |
| S3900 | Surface electromyography (emg) | |
| S3902 | Ballistocardiogram | |
| S3904 | Masters two step | |
| S3905 | Non-invasive electrodiagnostic testing with automatic computerized hand-held device to stimulate and measure neuromuscular signals in diagnosing and evaluating systemic and entrapment neuropathies | |
| S4005 | Interim labor facility global (labor occurring but not resulting in delivery) | |
| S4011 | In vitro fertilization; including but not limited to identification and incubation of mature oocytes, fertilization with sperm, incubation of embryo(s), and subsequent visualization for determination of development | |
| S4013 | Complete cycle, gamete intrafallopian transfer (gift), case rate | |
| S4014 | Complete cycle, zygote intrafallopian transfer (zift), case rate | |
| S4015 | Complete in vitro fertilization cycle, not otherwise specified, case rate | |
| S4016 | Frozen in vitro fertilization cycle, case rate | |
| S4017 | Incomplete cycle, treatment cancelled prior to stimulation, case rate | |
| S4018 | Frozen embryo transfer procedure cancelled before transfer, case rate | |
| S4020 | In vitro fertilization procedure cancelled before aspiration, case rate | |
| S4021 | In vitro fertilization procedure cancelled after aspiration, case rate | |
| S4022 | Assisted oocyte fertilization, case rate | |
| S4023 | Donor egg cycle, incomplete, case rate | |
| S4025 | Donor services for in vitro fertilization (sperm or embryo), case rate | |
| S4026 | Procurement of donor sperm from sperm bank | |
| S4027 | Storage of previously frozen embryos | |
| S4028 | Microsurgical epididymal sperm aspiration (mesa) | |
| S4030 | Sperm procurement and cryopreservation services; initial visit | |
| S4031 | Sperm procurement and cryopreservation services; subsequent visit | |
| S4035 | Stimulated intrauterine insemination (iui), case rate | |
| S4036 | INTRAVAGINAL CULTURE (IVC), CASE RATE | |
| S4037 | Cryopreserved embryo transfer, case rate | |
| S4040 | Monitoring and storage of cryopreserved embryos, per 30 days | |
| S4042 | Management of ovulation induction (interpretation of diagnostic tests and studies, non-face-to-face medical management of the patient), per cycle | |
| S4989 | Contraceptive intrauterine device (e.g., progestacert iud), including implants and supplies | |
| S4990 | Nicotine patches, legend | |
| S4991 | Nicotine patches, non-legend | |
| S4993 | Contraceptive pills for birth control | |
| S4995 | Smoking cessation gum | |
| S5000 | Prescription drug, generic | |
| S5001 | Prescription drug, brand name | |
| S5010 | 5% dextrose and 0.45% normal saline, 1000 ml | |
| S5011 | 5% dextrose in lactated ringer's, 1000 ml | |
| S5012 | 5% dextrose with potassium chloride, 1000 ml | |
| S5013 | 5% dextrose/0.45% normal saline with potassium chloride and magnesium sulfate, 1000 ml | |
| S5014 | 5% dextrose/0.45% normal saline with potassium chloride and magnesium sulfate, 1500 ml | |
| S5035 | Home infusion therapy, routine service of infusion device (e.g., pump maintenance) | |
| S5036 | Home infusion therapy, repair of infusion device (e.g., pump repair) | |
| S5100 | Day care services, adult; per 15 minutes | |
| S5101 | Day care services, adult; per half day | |
| S5102 | Day care services, adult; per diem | |
| S5105 | Day care services, center-based; services not included in program fee, per diem | |
| S5108 | Home care training to home care client, per 15 minutes | |
| S5109 | Home care training to home care client, per session | |
| S5110 | Home care training, family; per 15 minutes | |
| S5111 | Home care training, family; per session | |
| S5115 | Home care training, non-family; per 15 minutes | |
| S5116 | Home care training, non-family; per session | |
| S5120 | Chore services; per 15 minutes | |
| S5121 | Chore services; per diem | |
| S5125 | Attendant care services; per 15 minutes | |
| S5126 | Attendant care services; per diem | |
| S5130 | Homemaker service, nos; per 15 minutes | |
| S5131 | Homemaker service, nos; per diem | |
| S5135 | Companion care, adult (e.g., iadl/adl); per 15 minutes | |
| S5136 | Companion care, adult (e.g., iadl/adl); per diem | |
| S5140 | Foster care, adult; per diem | |
| S5141 | Foster care, adult; per month | |
| S5145 | Foster care, therapeutic, child; per diem | |
| S5146 | Foster care, therapeutic, child; per month | |
| S5150 | Unskilled respite care, not hospice; per 15 minutes | |
| S5151 | Unskilled respite care, not hospice; per diem | |
| S5160 | Emergency response system; installation and testing | |
| S5161 | Emergency response system; service fee, per month (excludes installation and testing) | |
| S5162 | Emergency response system; purchase only | |
| S5165 | Home modifications; per service | |
| S5170 | Home delivered meals, including preparation; per meal | |
| S5175 | Laundry service, external, professional; per order | |
| S5180 | Home health respiratory therapy, initial evaluation | |
| S5181 | Home health respiratory therapy, nos, per diem | |
| S5185 | Medication reminder service, non-face-to-face; per month | |
| S5190 | Wellness assessment, performed by non-physician | |
| S5199 | Personal care item, nos, each | |
| S5497 | Home infusion therapy, catheter care / maintenance, not otherwise classified; includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S5498 | Home infusion therapy, catheter care / maintenance, simple (single lumen), includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem | |
| S5501 | Home infusion therapy, catheter care / maintenance, complex (more than one lumen), includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S5502 | Home infusion therapy, catheter care / maintenance, implanted access device, includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem (use this code for interim maintenance of vascular access not currently in use) | |
| S5517 | Home infusion therapy, all supplies necessary for restoration of catheter patency or declotting | |
| S5518 | Home infusion therapy, all supplies necessary for catheter repair | |
| S5520 | Home infusion therapy, all supplies (including catheter) necessary for a peripherally inserted central venous catheter (picc) line insertion | |
| S5521 | Home infusion therapy, all supplies (including catheter) necessary for a midline catheter insertion | |
| S5522 | Home infusion therapy, insertion of peripherally inserted central venous catheter (picc), nursing services only (no supplies or catheter included) | |
| S5523 | Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included) | |
| S5550 | Insulin, rapid onset, 5 units | |
| S5551 | Insulin, most rapid onset (lispro or aspart); 5 units | |
| S5552 | Insulin, intermediate acting (nph or lente); 5 units | |
| S5553 | Insulin, long acting; 5 units | |
| S5560 | Insulin delivery device, reusable pen; 1.5 ml size | |
| S5561 | Insulin delivery device, reusable pen; 3 ml size | |
| S5565 | Insulin cartridge for use in insulin delivery device other than pump; 150 units | |
| S5566 | Insulin cartridge for use in insulin delivery device other than pump; 300 units | |
| S5570 | Insulin delivery device, disposable pen (including insulin); 1.5 ml size | |
| S5571 | Insulin delivery device, disposable pen (including insulin); 3 ml size | |
| S8004 | RADIOIMMUNOPHARMACEUTICAL LOCALIZATION OF TARGETED CELLS; WHOLE BODY | |
| S8030 | Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy | |
| S8032 | Low-dose computed tomography for lung cancer screening | |
| S8035 | Magnetic source imaging | |
| S8040 | Topographic brain mapping | |
| S8042 | Magnetic resonance imaging (mri), low-field | |
| S8049 | Intraoperative radiation therapy (single administration) | |
| S8055 | Ultrasound guidance for multifetal pregnancy reduction(s), technical component (only to be used when the physician doing the reduction procedure does not perform the ultrasound, guidance is included in the cpt code for multifetal pregnancy reduction - 59866) | |
| S8075 | COMPUTER ANALYSIS OF FULL-FIELD DIGITAL MAMMOGRAM AND FURTHER PHYSICIAN REVIEW FOR INTERPRETATION, MAMMOGRAPHY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) | |
| S8080 | Scintimammography (radioimmunoscintigraphy of the breast), unilateral, including supply of radiopharmaceutical | |
| S8085 | Fluorine-18 fluorodeoxyglucose (f-18 fdg) imaging using dual-head coincidence detection system (non-dedicated pet scan) | |
| S8092 | Electron beam computed tomography (also known as ultrafast ct, cine ct) | |
| S8093 | COMPUTED TOMOGRAPHIC ANGIOGRAPHY, CORONARY ARTERIES, WITH CONTRAST MATERIAL(S) | |
| S8095 | WIG (FOR MEDICALLY-INDUCED OR CONGENITAL HAIR LOSS) | |
| S8096 | Portable peak flow meter | |
| S8097 | Asthma kit (including but not limited to portable peak expiratory flow meter, instructional video, brochure, and/or spacer) | |
| S8100 | Holding chamber or spacer for use with an inhaler or nebulizer; without mask | |
| S8101 | Holding chamber or spacer for use with an inhaler or nebulizer; with mask | |
| S8110 | Peak expiratory flow rate (physician services) | |
| S8120 | Oxygen contents, gaseous, 1 unit equals 1 cubic foot | |
| S8121 | Oxygen contents, liquid, 1 unit equals 1 pound | |
| S8130 | Interferential current stimulator, 2 channel | |
| S8131 | Interferential current stimulator, 4 channel | |
| S8182 | HUMIDIFIER, HEATED, USED WITH VENTILATOR, NON-SERVO-CONTROLLED | |
| S8183 | HUMIDIFIER, HEATED, USED WITH VENTILATOR, DUAL SERVO-CONTROLLED WITH TEMPERATURE MONITORING | |
| S8185 | Flutter device | |
| S8186 | Swivel adapter | |
| S8189 | Tracheostomy supply, not otherwise classified | |
| S8190 | ELECTRONIC SPIROMETER (OR MICROSPIROMETER) | |
| S8210 | Mucus trap | |
| S8262 | Mandibular orthopedic repositioning device, each | |
| S8265 | Haberman feeder for cleft lip/palate | |
| S8270 | Enuresis alarm, using auditory buzzer and/or vibration device | |
| S8301 | Infection control supplies, not otherwise specified | |
| S8415 | Supplies for home delivery of infant | |
| S8420 | Gradient pressure aid (sleeve and glove combination), custom made | |
| S8421 | Gradient pressure aid (sleeve and glove combination), ready made | |
| S8422 | Gradient pressure aid (sleeve), custom made, medium weight | |
| S8423 | Gradient pressure aid (sleeve), custom made, heavy weight | |
| S8424 | Gradient pressure aid (sleeve), ready made | |
| S8425 | Gradient pressure aid (glove), custom made, medium weight | |
| S8426 | Gradient pressure aid (glove), custom made, heavy weight | |
| S8427 | Gradient pressure aid (glove), ready made | |
| S8428 | Gradient pressure aid (gauntlet), ready made | |
| S8429 | Gradient pressure exterior wrap | |
| S8430 | Padding for compression bandage, roll | |
| S8431 | Compression bandage, roll | |
| S8434 | INTERIM POST-OPERATIVE ORTHOTIC DEVICE FOR UPPER EXTREMITY, CUSTOM MADE | |
| S8460 | Camisole, post-mastectomy | |
| S8930 | Electrical stimulation of auricular acupuncture points; each 15 minutes of personal one-on-one contact with the patient | |
| S8940 | Equestrian/hippotherapy, per session | |
| S8948 | Application of a modality (requiring constant provider attendance) to one or more areas; low-level laser; each 15 minutes | |
| S8950 | Complex lymphedema therapy, each 15 minutes | |
| S8990 | Physical or manipulative therapy performed for maintenance rather than restoration | |
| S8999 | Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event) | |
| S9001 | Home uterine monitor with or without associated nursing services | |
| S9002 | Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device | |
| S9007 | Ultrafiltration monitor | |
| S9015 | Automated eeg monitoring | |
| S9022 | DIGITAL SUBTRACTION ANGIOGRAPHY (USE IN ADDITION TO CPT CODE FOR THE PROCEDURE FOR FURTHER IDENTIFICATION) | |
| S9024 | Paranasal sinus ultrasound | |
| S9025 | Omnicardiogram/cardiointegram | |
| S9034 | Extracorporeal shockwave lithotripsy for gall stones (if performed with ercp, use 43265) | |
| S9055 | Procuren or other growth factor preparation to promote wound healing | |
| S9056 | Coma stimulation per diem | |
| S9061 | Home administration of aerosolized drug therapy (e.g., pentamidine); administrative services, professional pharmacy services, care coordination, all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9075 | Smoking cessation treatment | |
| S9083 | Global fee urgent care centers | |
| S9088 | Services provided in an urgent care center (list in addition to code for service) | |
| S9090 | Vertebral axial decompression, per session | |
| S9092 | CANOLITH REPOSITIONING, PER VISIT | |
| S9097 | Home visit for wound care | |
| S9098 | Home visit, phototherapy services (e.g., bili-lite), including equipment rental, nursing services, blood draw, supplies, and other services, per diem | |
| S9109 | Congestive heart failure telemonitoring, equipment rental, including telescale, computer system and software, telephone connections, and maintenance, per month | |
| S9110 | Telemonitoring of patient in their home, including all necessary equipment; computer system, connections, and software; maintenance; patient education and support; per month | |
| S9117 | Back school, per visit | |
| S9122 | Home health aide or certified nurse assistant, providing care in the home; per hour | |
| S9123 | Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used) | |
| S9124 | Nursing care, in the home; by licensed practical nurse, per hour | |
| S9125 | Respite care, in the home, per diem | |
| S9126 | Hospice care, in the home, per diem | |
| S9127 | Social work visit, in the home, per diem | |
| S9128 | Speech therapy, in the home, per diem | |
| S9129 | Occupational therapy, in the home, per diem | |
| S9131 | Physical therapy; in the home, per diem | |
| S9140 | Diabetic management program, follow-up visit to non-md provider | |
| S9141 | Diabetic management program, follow-up visit to md provider | |
| S9145 | Insulin pump initiation, instruction in initial use of pump (pump not included) | |
| S9150 | Evaluation by ocularist | |
| S9152 | Speech therapy, re-evaluation | |
| S9208 | Home management of preterm labor, including administrative services, professional pharmacy services, care coordination, and all necessary supplies or equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code) | |
| S9209 | Home management of preterm premature rupture of membranes (pprom), including administrative services, professional pharmacy services, care coordination, and all necessary supplies or equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code) | |
| S9211 | Home management of gestational hypertension, includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code) | |
| S9212 | Home management of postpartum hypertension, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code) | |
| S9213 | Home management of preeclampsia, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing services coded separately); per diem (do not use this code with any home infusion per diem code) | |
| S9214 | Home management of gestational diabetes, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code) | |
| S9325 | Home infusion therapy, pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem (do not use this code with s9326, s9327 or s9328) | |
| S9326 | Home infusion therapy, continuous (twenty-four hours or more) pain management infusion; administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9327 | Home infusion therapy, intermittent (less than twenty-four hours) pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9328 | Home infusion therapy, implanted pump pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9329 | Home infusion therapy, chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with s9330 or s9331) | |
| S9330 | Home infusion therapy, continuous (twenty-four hours or more) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9331 | Home infusion therapy, intermittent (less than twenty-four hours) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9335 | Home therapy, hemodialysis; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing services coded separately), per diem | |
| S9336 | Home infusion therapy, continuous anticoagulant infusion therapy (e.g., heparin), administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9338 | Home infusion therapy, immunotherapy, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9339 | Home therapy; peritoneal dialysis, administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9340 | Home therapy; enteral nutrition; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem | |
| S9341 | Home therapy; enteral nutrition via gravity; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem | |
| S9342 | Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem | |
| S9343 | Home therapy; enteral nutrition via bolus; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem | |
| S9345 | Home infusion therapy, anti-hemophilic agent infusion therapy (e.g., factor viii); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9346 | Home infusion therapy, alpha-1-proteinase inhibitor (e.g., prolastin); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9347 | Home infusion therapy, uninterrupted, long-term, controlled rate intravenous or subcutaneous infusion therapy (e.g., epoprostenol); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9348 | Home infusion therapy, sympathomimetic/inotropic agent infusion therapy (e.g., dobutamine); administrative services, professional pharmacy services, care coordination, all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9349 | Home infusion therapy, tocolytic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9351 | Home infusion therapy, continuous or intermittent anti-emetic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and visits coded separately), per diem | |
| S9353 | Home infusion therapy, continuous insulin infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9355 | Home infusion therapy, chelation therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9357 | Home infusion therapy, enzyme replacement intravenous therapy; (e.g., imiglucerase); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9359 | Home infusion therapy, anti-tumor necrosis factor intravenous therapy; (e.g., infliximab); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9361 | Home infusion therapy, diuretic intravenous therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9363 | Home infusion therapy, anti-spasmotic therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9364 | Home infusion therapy, total parenteral nutrition (tpn); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem (do not use with home infusion codes s9365-s9368 using daily volume scales) | |
| S9365 | Home infusion therapy, total parenteral nutrition (tpn); one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem | |
| S9366 | Home infusion therapy, total parenteral nutrition (tpn); more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem | |
| S9367 | Home infusion therapy, total parenteral nutrition (tpn); more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem | |
| S9368 | Home infusion therapy, total parenteral nutrition (tpn); more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem | |
| S9370 | Home therapy, intermittent anti-emetic injection therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9372 | Home therapy; intermittent anticoagulant injection therapy (e.g., heparin); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code for flushing of infusion devices with heparin to maintain patency) | |
| S9373 | Home infusion therapy, hydration therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use with hydration therapy codes s9374-s9377 using daily volume scales) | |
| S9374 | Home infusion therapy, hydration therapy; one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9375 | Home infusion therapy, hydration therapy; more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9376 | Home infusion therapy, hydration therapy; more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9377 | Home infusion therapy, hydration therapy; more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies (drugs and nursing visits coded separately), per diem | |
| S9379 | Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9381 | Delivery or service to high risk areas requiring escort or extra protection, per visit | |
| S9401 | Anticoagulation clinic, inclusive of all services except laboratory tests, per session | |
| S9430 | Pharmacy compounding and dispensing services | |
| S9432 | Medical foods for non-inborn errors of metabolism | |
| S9433 | Medical food nutritionally complete, administered orally, providing 100% of nutritional intake | |
| S9434 | Modified solid food supplements for inborn errors of metabolism | |
| S9435 | Medical foods for inborn errors of metabolism | |
| S9436 | Childbirth preparation/lamaze classes, non-physician provider, per session | |
| S9437 | Childbirth refresher classes, non-physician provider, per session | |
| S9438 | Cesarean birth classes, non-physician provider, per session | |
| S9439 | Vbac (vaginal birth after cesarean) classes, non-physician provider, per session | |
| S9441 | Asthma education, non-physician provider, per session | |
| S9442 | Birthing classes, non-physician provider, per session | |
| S9443 | Lactation classes, non-physician provider, per session | |
| S9444 | Parenting classes, non-physician provider, per session | |
| S9445 | Patient education, not otherwise classified, non-physician provider, individual, per session | |
| S9446 | Patient education, not otherwise classified, non-physician provider, group, per session | |
| S9447 | Infant safety (including cpr) classes, non-physician provider, per session | |
| S9449 | Weight management classes, non-physician provider, per session | |
| S9451 | Exercise classes, non-physician provider, per session | |
| S9452 | Nutrition classes, non-physician provider, per session | |
| S9453 | Smoking cessation classes, non-physician provider, per session | |
| S9454 | Stress management classes, non-physician provider, per session | |
| S9455 | Diabetic management program, group session | |
| S9460 | Diabetic management program, nurse visit | |
| S9465 | Diabetic management program, dietitian visit | |
| S9470 | Nutritional counseling, dietitian visit | |
| S9472 | Cardiac rehabilitation program, non-physician provider, per diem | |
| S9473 | Pulmonary rehabilitation program, non-physician provider, per diem | |
| S9474 | Enterostomal therapy by a registered nurse certified in enterostomal therapy, per diem | |
| S9475 | Ambulatory setting substance abuse treatment or detoxification services, per diem | |
| S9476 | Vestibular rehabilitation program, non-physician provider, per diem | |
| S9480 | Intensive outpatient psychiatric services, per diem | |
| S9482 | Family stabilization services, per 15 minutes | |
| S9484 | Crisis intervention mental health services, per hour | |
| S9485 | Crisis intervention mental health services, per diem | |
| S9490 | Home infusion therapy, corticosteroid infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9494 | Home infusion therapy, antibiotic, antiviral, or antifungal therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with home infusion codes for hourly dosing schedules s9497-s9504) | |
| S9497 | Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 3 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9500 | Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9501 | Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 12 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9502 | Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 8 hours, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9503 | Home infusion therapy, antibiotic, antiviral, or antifungal; once every 6 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9504 | Home infusion therapy, antibiotic, antiviral, or antifungal; once every 4 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9537 | Home therapy; hematopoietic hormone injection therapy (e.g., erythropoietin, g-csf, gm-csf); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9538 | Home transfusion of blood product(s); administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (blood products, drugs, and nursing visits coded separately), per diem | |
| S9542 | Home injectable therapy, not otherwise classified, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9558 | Home injectable therapy; growth hormone, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9559 | Home injectable therapy, interferon, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9560 | Home injectable therapy; hormonal therapy (e.g.; leuprolide, goserelin), including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9562 | Home injectable therapy, palivizumab or other monoclonal antibody for rsv, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9563 | Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9590 | Home therapy, irrigation therapy (e.g., sterile irrigation of an organ or anatomical cavity); including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | |
| S9810 | Home therapy; professional pharmacy services for provision of infusion, specialty drug administration, and/or disease state management, not otherwise classified, per hour (do not use this code with any per diem code) | |
| S9900 | Services by a journal-listed christian science practitioner for the purpose of healing, per diem | |
| S9901 | Services by a journal-listed christian science nurse, per hour | |
| S9970 | Health club membership, annual | |
| S9975 | Transplant related lodging, meals and transportation, per diem | |
| S9976 | Lodging, per diem, not otherwise classified | |
| S9977 | Meals, per diem, not otherwise specified | |
| S9981 | Medical records copying fee, administrative | |
| S9982 | Medical records copying fee, per page | |
| S9986 | Not medically necessary service (patient is aware that service not medically necessary) | |
| S9988 | Services provided as part of a phase i clinical trial | |
| S9989 | Services provided outside of the United States of America (list in addition to code(s) for service(s)) | |
| S9990 | Services provided as part of a phase ii clinical trial | |
| S9991 | Services provided as part of a phase iii clinical trial | |
| S9992 | Transportation costs to and from trial location and local transportation costs (e.g., fares for taxicab or bus) for clinical trial participant and one caregiver/companion | |
| S9994 | Lodging costs (e.g., hotel charges) for clinical trial participant and one caregiver/companion | |
| S9996 | Meals for clinical trial participant and one caregiver/companion | |
| S9999 | Sales tax | |
| T1000 | Private duty / independent nursing service(s) - licensed, up to 15 minutes | |
| T1001 | Nursing assessment / evaluation | |
| T1002 | Rn services, up to 15 minutes | |
| T1003 | Lpn/lvn services, up to 15 minutes | |
| T1004 | Services of a qualified nursing aide, up to 15 minutes | |
| T1005 | Respite care services, up to 15 minutes | |
| T1006 | Alcohol and/or substance abuse services, family/couple counseling | |
| T1007 | Alcohol and/or substance abuse services, treatment plan development and/or modification | |
| T1009 | Child sitting services for children of the individual receiving alcohol and/or substance abuse services | |
| T1010 | Meals for individuals receiving alcohol and/or substance abuse services (when meals not included in the program) | |
| T1012 | Alcohol and/or substance abuse services, skills development | |
| T1013 | Sign language or oral interpretive services, per 15 minutes | |
| T1014 | Telehealth transmission, per minute, professional services bill separately | |
| T1016 | Case management, each 15 minutes | |
| T1017 | Targeted case management, each 15 minutes | |
| T1018 | School-based individualized education program (iep) services, bundled | |
| T1019 | Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant) | |
| T1020 | Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant) | |
| T1021 | Home health aide or certified nurse assistant, per visit | |
| T1022 | Contracted home health agency services, all services provided under contract, per day | |
| T1023 | Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter | |
| T1024 | Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter | |
| T1025 | Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per diem | |
| T1026 | Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per hour | |
| T1027 | Family training and counseling for child development, per 15 minutes | |
| T1028 | Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs | |
| T1029 | Comprehensive environmental lead investigation, not including laboratory analysis, per dwelling | |
| T1030 | Nursing care, in the home, by registered nurse, per diem | |
| T1031 | Nursing care, in the home, by licensed practical nurse, per diem | |
| T1032 | Services performed by a doula birth worker, per 15 minutes | |
| T1033 | Services performed by a doula birth worker, per diem | |
| T1040 | Medicaid certified community behavioral health clinic services, per diem | |
| T1041 | Medicaid certified community behavioral health clinic services, per month | |
| T1500 | DIAPER/INCONTINENT PANT, REUSABLE/WASHABLE, ANY SIZE, EACH | |
| T1502 | Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit | |
| T1503 | Administration of medication, other than oral and/or injectable, by a health care agency/professional, per visit | |
| T1505 | Electronic medication compliance management device, includes all components and accessories, not otherwise classified | |
| T1999 | Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" | |
| T2001 | Non-emergency transportation; patient attendant/escort | |
| T2002 | Non-emergency transportation; per diem | |
| T2003 | Non-emergency transportation; encounter/trip | |
| T2004 | Non-emergency transport; commercial carrier, multi-pass | |
| T2005 | Non-emergency transportation; stretcher van | |
| T2006 | AMBULANCE RESPONSE AND TREATMENT, NO TRANSPORT | |
| T2007 | Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments | |
| T2010 | Preadmission screening and resident review (pasrr) level i identification screening, per screen | |
| T2011 | Preadmission screening and resident review (pasrr) level ii evaluation, per evaluation | |
| T2012 | Habilitation, educational; waiver, per diem | |
| T2013 | Habilitation, educational, waiver; per hour | |
| T2014 | Habilitation, prevocational, waiver; per diem | |
| T2015 | Habilitation, prevocational, waiver; per hour | |
| T2016 | Habilitation, residential, waiver; per diem | |
| T2017 | Habilitation, residential, waiver; 15 minutes | |
| T2018 | Habilitation, supported employment, waiver; per diem | |
| T2019 | Habilitation, supported employment, waiver; per 15 minutes | |
| T2020 | Day habilitation, waiver; per diem | |
| T2021 | Day habilitation, waiver; per 15 minutes | |
| T2022 | Case management, per month | |
| T2023 | Targeted case management; per month | |
| T2024 | Service assessment/plan of care development, waiver | |
| T2025 | Waiver services; not otherwise specified (nos) | |
| T2026 | Specialized childcare, waiver; per diem | |
| T2027 | Specialized childcare, waiver; per 15 minutes | |
| T2028 | Specialized supply, not otherwise specified, waiver | |
| T2029 | Specialized medical equipment, not otherwise specified, waiver | |
| T2030 | Assisted living, waiver; per month | |
| T2031 | Assisted living; waiver, per diem | |
| T2032 | Residential care, not otherwise specified (nos), waiver; per month | |
| T2033 | Residential care, not otherwise specified (nos), waiver; per diem | |
| T2034 | Crisis intervention, waiver; per diem | |
| T2035 | Utility services to support medical equipment and assistive technology/devices, waiver | |
| T2036 | Therapeutic camping, overnight, waiver; each session | |
| T2037 | Therapeutic camping, day, waiver; each session | |
| T2038 | Community transition, waiver; per service | |
| T2039 | Vehicle modifications, waiver; per service | |
| T2040 | Financial management, self-directed, waiver; per 15 minutes | |
| T2041 | Supports brokerage, self-directed, waiver; per 15 minutes | |
| T2042 | Hospice routine home care; per diem | |
| T2043 | Hospice continuous home care; per hour | |
| T2044 | Hospice inpatient respite care; per diem | |
| T2045 | Hospice general inpatient care; per diem | |
| T2046 | Hospice long term care, room and board only; per diem | |
| T2047 | Habilitation, prevocational, waiver; per 15 minutes | |
| T2048 | Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem | |
| T2049 | Non-emergency transportation; stretcher van, mileage; per mile | |
| T2050 | Financial management, self-directed, waiver; per diem | |
| T2051 | Supports brokerage, self-directed, waiver; per diem | |
| T2101 | Human breast milk processing, storage and distribution only | |
| T4521 | Adult sized disposable incontinence product, brief/diaper, small, each | |
| T4522 | Adult sized disposable incontinence product, brief/diaper, medium, each | |
| T4523 | Adult sized disposable incontinence product, brief/diaper, large, each | |
| T4524 | Adult sized disposable incontinence product, brief/diaper, extra large, each | |
| T4525 | Adult sized disposable incontinence product, protective underwear/pull-on, small size, each | |
| T4526 | Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each | |
| T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | |
| T4528 | Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each | |
| T4529 | Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each | |
| T4530 | Pediatric sized disposable incontinence product, brief/diaper, large size, each | |
| T4531 | Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each | |
| T4532 | Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each | |
| T4533 | Youth sized disposable incontinence product, brief/diaper, each | |
| T4534 | Youth sized disposable incontinence product, protective underwear/pull-on, each | |
| T4535 | Disposable liner/shield/guard/pad/undergarment, for incontinence, each | |
| T4536 | Incontinence product, protective underwear/pull-on, reusable, any size, each | |
| T4537 | Incontinence product, protective underpad, reusable, bed size, each | |
| T4538 | Diaper service, reusable diaper, each diaper | |
| T4539 | Incontinence product, diaper/brief, reusable, any size, each | |
| T4540 | Incontinence product, protective underpad, reusable, chair size, each | |
| T4541 | Incontinence product, disposable underpad, large, each | |
| T4542 | Incontinence product, disposable underpad, small size, each | |
| T4543 | Adult sized disposable incontinence product, protective brief/diaper, above extra large, each | |
| T4544 | Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each | |
| T5001 | Positioning seat for persons with special orthopedic needs | |
| T5999 | Supply, not otherwise specified | |
| V2524 | Contact lens, hydrophilic, spherical, photochromic additive, per lens | |
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