Coverage Policy Manual
Policy #: 2008014
Category: Medicine
Initiated: July 2007
Last Review: February 2019
  Physician Assistants

Description: Physician Assistants (PAs) are licensed practitioners with the advanced education and clinical competency necessary for the delivery of primary health and medical care.  Physician Assistants (PAs) must possess a certificate of prescriptive authority. The PA must work in collaboration with the physician to deliver health care services with medical direction and appropriate supervision.

Policy/
Coverage:
PA’s providing services to ABCBS members must comply with the following policy to qualify for reimbursement:
    • The PA must have a written and signed collaborative agreement with a supervising medical doctor (MD) or doctor of osteopathy (DO). The collaborative agreement must be with a physician whose specialty mirrors the practice of the PA (e.g., if the PA is practicing primary care medicine, the collaborative agreement must be with a Family Medicine physician or General Internist).  A copy of the agreement must be provided to ABCBS upon request.
    • The PA adheres to collaborative responsibilities by participating as a team member in the provision of medical and health care, interacting with physicians to provide comprehensive care according to established and documented protocols.
    • Services provided by PA’s are limited to those patients presenting problems of low to moderate severity and the medical decision making involved does not exceed that same level. Patients with more severe problems must be referred to physicians.
    • Current published guidelines for assigning CPT codes to services and documentation to support the “medical necessity” of all services must be met.
    • Services performed in an inpatient/acute facility are not covered, with the exception of assistant at surgery services provided when the collaborative physician is present.
    • PA’s may order diagnostic plain film x-ray studies that are medically indicated for the level of service in accordance with established and documented ;protocols, but may not interpret those tests (i.e., may bill technical component only). (Amended February 2015).
    • The service provided by the PA must be concordant with the specialty of the supervising physician.
    • The PA must present him/herself so the public and other payers are fully aware of the  practitioner’s business operations. This includes items such as signage, letterhead and other marketing elements.
 
The following billing instructions apply to PAs licensed in Arkansas:
    • No payments may be made directly to the PA based on the Arkansas State Medical Board Arkansas Medical Practices Acts & Regulations.
    • The line item or rendering provider is listed in Block 24J on paper claims and in Loop 2310B, segment NM108 (NPI qualifier) and segment NM109 (NPI number) on electronic claims.  
    • The billing/pay to provider is listed in Block 33A on paper claims and in Loop 2010AA (Billing) and in loop 2010AB (Pay To) for electronic claims.
    • Services provided in the provider's office and the collaborative physician is present in the office suite:  
      • Services provided may be billed by the PA or by the collaborative physician (similar to Medicare's "incident to" guidelines).  
      • The collaborative physician's NPI should be used as the line item provider number on CMS 1500 and 837P.
    • Services provided in the provider's office and the collaborative physician is NOT present in the office suite:  
      • Services should be billed by the provider of service.  
      • The PA NPI should be used as the line item provider number on CMS 1500 and 837P.
    • Services provided in the Emergency Room department:  
      • Lower level ER visits may be billed by the provider of service.   
      • This excludes triage and services for patients transferred to an ER physician.  
      • The PA NPI should be used as the line item provider number on CMS 1500 and 837P.
    • Services provided to patients designated as "inpatients" in a facility and the collaborative physician is NOT present or does not see the patient at another time during that day:  
      • Inpatient services are not covered.  All services will be denied.
      • The PA NPI used as line item provider on CMS 1500 and 837P.
    • Services provided to patients designated as “inpatients” in a facility and the collaborative physician sees the patient with the PA or at another time of day
      • Only one E&M service is covered during a 24 hour day.  The collaborative physician must have a brief note on the chart indicating the patient was seen; this visit should be reported under the collaborating physician’s NPI.
    • Services provided when acting as assistant at surgery in an inpatient or outpatient hospital or ambulatory surgery center:    
      • Assistant at surgery is covered only for those CPT surgical codes for which Arkansas Blue Cross Blue Shield allows coverage for Assistant Surgeon.
      • Modifier 'AS' should be used on all line items.
      • The PA NPI should be used as the line item provider number on CMS 1500 and 837P.  
    • Services provided to a patient in a home setting, when the PA is NOT employed by or contracted to a Home Health agency.
      • Lower level home visits may be billed by the provider of service.  
      • The PA NPI should be used as the line item provider number on CMS 1500 and 837P.
 
Reimbursement to PAs when the PA NPI is submitted as the line item provider is based on 75% of the corresponding physician reimbursement.
 
Physician Assistant Psychiatric Procedures Scope of Practice
 
PA applicants who have the following qualifications will be eligible to receive reimbursement for CPT - 90863 (Pharmacologic management, including prescription and review of medication, when performed with psychotherapy services (List separately in addition to the code for primary procedure)
 
1. Maintain a collaborative agreement and Quality Assurance Plan with one or more participating psychiatrists.
 
2. Hold a current, active unrestricted Arkansas PA license with prescriptive authority. State licensure from surrounding states may be considered when applying this requirement.
 
3. Complete the NCCPA Certificate of Added Qualifications (CAQ) in Psychiatry.
 
4. Additional requirements include:
a. Must have practiced 2 years full-time as a Physician Assistant.
b. Have a minimum of 2,000 hours of clinical practice in psychiatric-mental health nursing within the last 3 years.
 
PA applicants who have met the qualifications for CPT – 90863 reimbursement and also have two years of psychiatric clinical experience following completion of NCCPA CAQ will be eligible to receive reimbursement for the following procedures:
 
CPT 90791 - Psychiatric diagnostic evaluation
CPT 90792 – Psychiatric diagnostic evaluation with medical services
CPT 90832 – Psychotherapy, 30 minutes with patient and/or family member
CPT 90833 – Psychotherapy, 30 minutes with patient and/or family member when performed with an evaluation and management service (List separately in addition to the code for primary procedure)
CPT 90834 – Psychotherapy, 45 minutes with patient and/or family member
CPT 90836 - Psychotherapy, 45 minutes with patient and/or family member when performed with an evaluation and management service (List separately in addition to the code for primary procedure)
CPT 90837 – Psychotherapy, 60 minutes with patient and/or family member
CPT 90838 – Psychotherapy, 60 minutes with patient and/or family member when performed with an evaluation and management service (List separately in addition to the code for primary procedure)
CPT 90839 – Psychotherapy for crisis; first 60 minutes
CPT 90853 - Group psychotherapy (other than of a multiple-family group)
 

CPT/HCPCS:
0207TEvacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral
0272TInterrogation device evaluation (in person), carotid sinus baroreflex activation system, including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, lead impedance, pulse amplitude, pulse width, therapy frequency, pathway mode, burst mode, therapy start/stop times each day);
0273TInterrogation device evaluation (in person), carotid sinus baroreflex activation system, including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, lead impedance, pulse amplitude, pulse width, therapy frequency, pathway mode, burst mode, therapy start/stop times each day); with programming
0296TExternal electrocardiographic recording for more than 48 hours up to 21 days by continuous rhythm recording and storage; recording (includes connection and initial recording)
0300TExtracorporeal shock wave for integumentary wound healing, high energy, including topical application and dressing care; each additional wound (List separately in addition to code for primary procedure)
10021Fine needle aspiration; without imaging guidance
10040Acne surgery (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)
10060Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single
10080Incision and drainage of pilonidal cyst; simple
10120Incision and removal of foreign body, subcutaneous tissues; simple
10140Incision and drainage of hematoma, seroma or fluid collection
10160Puncture aspiration of abscess, hematoma, bulla, or cyst
11042Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less
11043Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less
11055Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion
11056Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions
11057Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); more than 4 lesions
11100Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; single lesion
11101Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; each separate/additional lesion (List separately in addition to code for primary procedure)
11102Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion
11103Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); each separate/additional lesion (List separately in addition to code for primary procedure)
11104Punch biopsy of skin (including simple closure, when performed); single lesion
11105Punch biopsy of skin (including simple closure, when performed); each separate/additional lesion (List separately in addition to code for primary procedure)
11106Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion
11107Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); each separate/additional lesion (List separately in addition to code for primary procedure)
11200Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions
11201Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (List separately in addition to code for primary procedure)
11300Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less
11301Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm
11302Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 1.1 to 2.0 cm
11303Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter over 2.0 cm
11305Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less
11306Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm
11307Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm
11308Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm
11310Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less
11311Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm
11400Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less
11401Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm
11420Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less
11421Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm
11719Trimming of nondystrophic nails, any number
11720Debridement of nail(s) by any method(s); 1 to 5
11721Debridement of nail(s) by any method(s); 6 or more
11730Avulsion of nail plate, partial or complete, simple; single
11732Avulsion of nail plate, partial or complete, simple; each additional nail plate (List separately in addition to code for primary procedure)
11740Evacuation of subungual hematoma
11750Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal;
11765Wedge excision of skin of nail fold (eg, for ingrown toenail)
11900Injection, intralesional; up to and including 7 lesions
11901Injection, intralesional; more than 7 lesions
12001Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less
12002Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm
12004Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm
12005Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm
12006Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm
15271Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area
15272Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure)
15792Chemical peel, nonfacial; epidermal
15793Chemical peel, nonfacial; dermal
16000Initial treatment, first degree burn, when no more than local treatment is required
17000Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion
17003Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (List separately in addition to code for first lesion)
17004Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions
17110Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions
17111Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions
17250Chemical cauterization of granulation tissue (ie, proud flesh)
17340Cryotherapy (CO2 slush, liquid N2) for acne
20552Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)
20553Injection(s); single or multiple trigger point(s), 3 or more muscles
21310Closed treatment of nasal bone fracture without manipulation
21315Closed treatment of nasal bone fracture; without stabilization
23500Closed treatment of clavicular fracture; without manipulation
23570Closed treatment of scapular fracture; without manipulation
24650Closed treatment of radial head or neck fracture; without manipulation
25500Closed treatment of radial shaft fracture; without manipulation
25530Closed treatment of ulnar shaft fracture; without manipulation
25600Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation
25630Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); without manipulation, each bone
25650Closed treatment of ulnar styloid fracture
26010Drainage of finger abscess; simple
26341Manipulation, palmar fascial cord (ie, Dupuytren's cord), post enzyme injection (eg, collagenase), single cord
26720Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; without manipulation, each
26750Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each
27200Closed treatment of coccygeal fracture
28400Closed treatment of calcaneal fracture; without manipulation
28470Closed treatment of metatarsal fracture; without manipulation, each
28490Closed treatment of fracture great toe, phalanx or phalanges; without manipulation
28510Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each
28530Closed treatment of sesamoid fracture
29065Application, cast; shoulder to hand (long arm)
29075Application, cast; elbow to finger (short arm)
29085Application, cast; hand and lower forearm (gauntlet)
29086Application, cast; finger (eg, contracture)
29105Application of long arm splint (shoulder to hand)
29125Application of short arm splint (forearm to hand); static
29126Application of short arm splint (forearm to hand); dynamic
29130Application of finger splint; static
29131Application of finger splint; dynamic
29200Strapping; thorax
29240Strapping; shoulder (eg, Velpeau)
29260Strapping; elbow or wrist
29280Strapping; hand or finger
29405Application of short leg cast (below knee to toes);
29425Application of short leg cast (below knee to toes); walking or ambulatory type
29440Adding walker to previously applied cast
29515Application of short leg splint (calf to foot)
29520Strapping; hip
29530Strapping; knee
29540Strapping; ankle and/or foot
29550Strapping; toes
29580Strapping; Unna boot
29581Application of multi-layer compression system; leg (below knee), including ankle and foot
29582Application of multi-layer compression system; thigh and leg, including ankle and foot, when performed
29583Application of multi-layer compression system; upper arm and forearm
29584Application of multi-layer compression system; upper arm, forearm, hand, and fingers
29730Windowing of cast
30300Removal foreign body, intranasal; office type procedure
30901Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method
32552Removal of indwelling tunneled pleural catheter with cuff
32561Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); initial day
32562Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); subsequent day
36415Collection of venous blood by venipuncture
36416Collection of capillary blood specimen (eg, finger, heel, ear stick)
36568Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; younger than 5 years of age
36569Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; age 5 years or older
36584Replacement, complete, of a peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, through same venous access
36589Removal of tunneled central venous catheter, without subcutaneous port or pump
36600Arterial puncture, withdrawal of blood for diagnosis
38220Diagnostic bone marrow; aspiration(s)
46083Incision of thrombosed hemorrhoid, external
46505Chemodenervation of internal anal sphincter
46600Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
51701Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)
57061Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)
57156Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy
57160Fitting and insertion of pessary or other intravaginal support device
57170Diaphragm or cervical cap fitting with instructions
58300Insertion of intrauterine device (IUD)
58301Removal of intrauterine device (IUD)
59025Fetal non-stress test
59425Antepartum care only; 4-6 visits
59426Antepartum care only; 7 or more visits
59430Postpartum care only (separate procedure)
62270Spinal puncture, lumbar, diagnostic
62369Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill
62370Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill (requiring skill of a physician or other qualified health care professional)
64550Application of surface (transcutaneous) neurostimulator (eg, TENS unit)
69200Removal foreign body from external auditory canal; without general anesthesia
69210Removal impacted cerumen requiring instrumentation, unilateral
70030Radiologic examination, eye, for detection of foreign body
70100Radiologic examination, mandible; partial, less than 4 views
70110Radiologic examination, mandible; complete, minimum of 4 views
70120Radiologic examination, mastoids; less than 3 views per side
70130Radiologic examination, mastoids; complete, minimum of 3 views per side
70134Radiologic examination, internal auditory meati, complete
70140Radiologic examination, facial bones; less than 3 views
70150Radiologic examination, facial bones; complete, minimum of 3 views
70160Radiologic examination, nasal bones, complete, minimum of 3 views
70190Radiologic examination; optic foramina
70200Radiologic examination; orbits, complete, minimum of 4 views
70210Radiologic examination, sinuses, paranasal, less than 3 views
70220Radiologic examination, sinuses, paranasal, complete, minimum of 3 views
70240Radiologic examination, sella turcica
70250Radiologic examination, skull; less than 4 views
70260Radiologic examination, skull; complete, minimum of 4 views
70300Radiologic examination, teeth; single view
70310Radiologic examination, teeth; partial examination, less than full mouth
70320Radiologic examination, teeth; complete, full mouth
70328Radiologic examination, temporomandibular joint, open and closed mouth; unilateral
70330Radiologic examination, temporomandibular joint, open and closed mouth; bilateral
70360Radiologic examination; neck, soft tissue
70380Radiologic examination, salivary gland for calculus
71010Radiologic examination, chest; single view, frontal
71015Radiologic examination, chest; stereo, frontal
71020Radiologic examination, chest, 2 views, frontal and lateral;
71030Radiologic examination, chest, complete, minimum of 4 views;
71045Radiologic examination, chest; single view
71046Radiologic examination, chest; 2 views
71047Radiologic examination, chest; 3 views
71048Radiologic examination, chest; 4 or more views
71100Radiologic examination, ribs, unilateral; 2 views
71101Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views
71110Radiologic examination, ribs, bilateral; 3 views
71111Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views
71120Radiologic examination; sternum, minimum of 2 views
71130Radiologic examination; sternoclavicular joint or joints, minimum of 3 views
72020Radiologic examination, spine, single view, specify level
72040Radiologic examination, spine, cervical; 2 or 3 views
72050Radiologic examination, spine, cervical; 4 or 5 views
72052Radiologic examination, spine, cervical; 6 or more views
72070Radiologic examination, spine; thoracic, 2 views
72072Radiologic examination, spine; thoracic, 3 views
72074Radiologic examination, spine; thoracic, minimum of 4 views
72080Radiologic examination, spine; thoracolumbar junction, minimum of 2 views
72081Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view
72082Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views
72083Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views
72084Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views
72100Radiologic examination, spine, lumbosacral; 2 or 3 views
72110Radiologic examination, spine, lumbosacral; minimum of 4 views
72114Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views
72120Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views
72170Radiologic examination, pelvis; 1 or 2 views
72190Radiologic examination, pelvis; complete, minimum of 3 views
72200Radiologic examination, sacroiliac joints; less than 3 views
72202Radiologic examination, sacroiliac joints; 3 or more views
72220Radiologic examination, sacrum and coccyx, minimum of 2 views
73000Radiologic examination; clavicle, complete
73010Radiologic examination; scapula, complete
73020Radiologic examination, shoulder; 1 view
73030Radiologic examination, shoulder; complete, minimum of 2 views
73060Radiologic examination; humerus, minimum of 2 views
73070Radiologic examination, elbow; 2 views
73080Radiologic examination, elbow; complete, minimum of 3 views
73090Radiologic examination; forearm, 2 views
73092Radiologic examination; upper extremity, infant, minimum of 2 views
73100Radiologic examination, wrist; 2 views
73110Radiologic examination, wrist; complete, minimum of 3 views
73120Radiologic examination, hand; 2 views
73130Radiologic examination, hand; minimum of 3 views
73140Radiologic examination, finger(s), minimum of 2 views
73501Radiologic examination, hip, unilateral, with pelvis when performed; 1 view
73502Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views
73503Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views
73521Radiologic examination, hips, bilateral, with pelvis when performed; 2 views
73522Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views
73523Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views
73551Radiologic examination, femur; 1 view
73552Radiologic examination, femur; minimum 2 views
73560Radiologic examination, knee; 1 or 2 views
73562Radiologic examination, knee; 3 views
73564Radiologic examination, knee; complete, 4 or more views
73565Radiologic examination, knee; both knees, standing, anteroposterior
73590Radiologic examination; tibia and fibula, 2 views
73592Radiologic examination; lower extremity, infant, minimum of 2 views
73600Radiologic examination, ankle; 2 views
73610Radiologic examination, ankle; complete, minimum of 3 views
73620Radiologic examination, foot; 2 views
73630Radiologic examination, foot; complete, minimum of 3 views
73650Radiologic examination; calcaneus, minimum of 2 views
73660Radiologic examination; toe(s), minimum of 2 views
74000Radiologic examination, abdomen; single anteroposterior view
74010Radiologic examination, abdomen; anteroposterior and additional oblique and cone views
74018Radiologic examination, abdomen; 1 view
74019Radiologic examination, abdomen; 2 views
74020Radiologic examination, abdomen; complete, including decubitus and/or erect views
74021Radiologic examination, abdomen; 3 or more views
74022Radiologic examination, abdomen; complete acute abdomen series, including supine, erect, and/or decubitus views, single view chest
76010Radiologic examination from nose to rectum for foreign body, single view, child
76499Unlisted diagnostic radiographic procedure
76818Fetal biophysical profile; with non-stress testing
76819Fetal biophysical profile; without non-stress testing
78267Urea breath test, C-14 (isotopic); acquisition for analysis
78268Urea breath test, C-14 (isotopic); analysis
80047Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium (84132) Sodium (84295) Urea Nitrogen (BUN) (84520)
80048Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium (84132) Sodium (84295) Urea nitrogen (BUN) (84520)
80050General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated (85027) and appropriate manual differential WBC count (85007 or 85009) Thyroid stimulating hormone (TSH) (84443)
80051Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295)
80053Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphatase, alkaline (84075) Potassium (84132) Protein, total (84155) Sodium (84295) Transferase, alanine amino (ALT) (SGPT) (84460) Transferase, aspartate amino (AST) (SGOT) (84450) Urea nitrogen (BUN) (84520)
80055Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated (85027) and appropriate manual differential WBC count (85007 or 85009) Hepatitis B surface antigen (HBsAg) (87340) Antibody, rubella (86762) Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) (86592) Antibody screen, RBC, each serum technique (86850) Blood typing, ABO (86900) AND Blood typing, Rh (D) (86901)
80061Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478)
80069Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus inorganic (phosphate) (84100) Potassium (84132) Sodium (84295) Urea nitrogen (BUN) (84520)
80074Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsAg) (87340) Hepatitis C antibody (86803)
80076Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alanine amino (ALT) (SGPT) (84460) Transferase, aspartate amino (AST) (SGOT) (84450)
80081Obstetric panel (includes HIV testing)
80150Amikacin
80156Carbamazepine; total
80157Carbamazepine; free
80158Cyclosporine
80162Digoxin; total
80164Valproic acid (dipropylacetic acid); total
80168Ethosuximide
80170Gentamicin
80173Haloperidol
80176Lidocaine
80178Lithium
80184Phenobarbital
80185Phenytoin; total
80186Phenytoin; free
80188Primidone
80190Procainamide;
80192Procainamide; with metabolites (eg, n-acetyl procainamide)
80194Quinidine
80195Sirolimus
80197Tacrolimus
80198Theophylline
80200Tobramycin
80201Topiramate
80202Vancomycin
80299Quantitation of therapeutic drug, not elsewhere specified
80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when performed, per date of service
80306Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when performed, per date of service
80400ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2)
80402ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2)
80406ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2)
80408Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2)
80410Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3)
80412Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6) Adrenocorticotropic hormone (ACTH) (82024 x 6)
80414Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples)
80415Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol (82670 x 2 on 3 pooled blood samples)
80416Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6)
80417Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2)
80418Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82024 x 4) Luteinizing hormone (LH) (83002 x 4) Follicle stimulating hormone (FSH) (83001 x 4) Prolactin (84146 x 4) Human growth hormone (HGH) (83003 x 4) Cortisol (82533 x 4) Thyroid stimulating hormone (TSH) (84443 x 4)
80420Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2) Cortisol (82533 x 2) Volume measurement for timed collection (81050 x 2)
80422Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3)
80424Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2)
80426Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (83001 x 4) Luteinizing hormone (LH) (83002 x 4)
80428Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4)
80430Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3) Human growth hormone (HGH) (83003 x 4)
80432Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x 5) Glucose (82947 x 5)
80434Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose (82947 x 5)
80435Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5) Human growth hormone (HGH) (83003 x 5)
80436Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2)
80438Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 3)
80439Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4)
81000Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy
81001Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy
81002Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy
81003Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy
81005Urinalysis; qualitative or semiquantitative, except immunoassays
81007Urinalysis; bacteriuria screen, except by culture or dipstick
81015Urinalysis; microscopic only
81020Urinalysis; 2 or 3 glass test
81025Urine pregnancy test, by visual color comparison methods
81050Volume measurement for timed collection, each
81099Unlisted urinalysis procedure
81105Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa], antigen CD61 [GPIIIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-1a/b (L33P)
81106Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib [platelet], alpha polypeptide [GPIba]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-2a/b (T145M)
81107Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex], antigen CD41 [GPIIb]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-3a/b (I843S)
81108Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa], antigen CD61 [GPIIIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-4a/b (R143Q)
81109Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 [CD49B, alpha 2 subunit of VLA-2 receptor] [GPIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant (eg, HPA-5a/b (K505E))
81110Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa, antigen CD61] [GPIIIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-6a/b (R489Q)
81111Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex, antigen CD41] [GPIIb]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-9a/b (V837M)
81112Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-15a/b (S682Y)
81120IDH1 (isocitrate dehydrogenase 1 [NADP+], soluble) (eg, glioma), common variants (eg, R132H, R132C)
81121IDH2 (isocitrate dehydrogenase 2 [NADP+], mitochondrial) (eg, glioma), common variants (eg, R140W, R172M)
81162BRCA1, BRCA2 (breast cancer 1 and 2) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis
81163BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis
81164BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)
81165BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis
81166BRCA1 (BRCA1, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)
81167BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)
81171AFF2 (AF4/FMR2 family, member 2 [FMR2]) (eg, fragile X mental retardation 2 [FRAXE]) gene analysis; evaluation to detect abnormal (eg, expanded) alleles
81172AFF2 (AF4/FMR2 family, member 2 [FMR2]) (eg, fragile X mental retardation 2 [FRAXE]) gene analysis; characterization of alleles (eg, expanded size and methylation status)
81173AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; full gene sequence
81174AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant
81175ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence
81176ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis (eg, exon 12)
81177ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles
81178ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles
81179ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles
81180ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles
81181ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles
81182ATXN8OS (ATXN8 opposite strand [non-protein coding]) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles
81183ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles
81184CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles
81185CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; full gene sequence
81186CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; known familial variant
81187CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles
81188CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles
81189CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence
81190CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial variant(s)
81200ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg, E285A, Y231X)
81201APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis [FAP], attenuated FAP) gene analysis; full gene sequence
81202APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis [FAP], attenuated FAP) gene analysis; known familial variants
81203APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis [FAP], attenuated FAP) gene analysis; duplication/deletion variants
81204AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status)
81205BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, R183P, G278S, E422X)
81206BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative
81207BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative
81208BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative
81209BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis, 2281del6ins7 variant
81210BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, V600 variant(s)
81211BRCA1, BRCA2 (breast cancer 1 and 2) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants in BRCA1 (ie, exon 13 del 3.835kb, exon 13 dup 6kb, exon 14-20 del 26kb, exon 22 del 510bp, exon 8-9 del 7.1kb)
81212BRCA1, BRCA2 (breast cancer 1 and 2) (eg, hereditary breast and ovarian cancer) gene analysis; 185delAG, 5385insC, 6174delT variants
81213BRCA1, BRCA2 (breast cancer 1 and 2) (eg, hereditary breast and ovarian cancer) gene analysis; uncommon duplication/deletion variants
81214BRCA1 (breast cancer 1) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants (ie, exon 13 del 3.835kb, exon 13 dup 6kb, exon 14-20 del 26kb, exon 22 del 510bp, exon 8-9 del 7.1kb)
81215BRCA1 (breast cancer 1) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant
81216BRCA2 (breast cancer 2) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis
81217BRCA2 (breast cancer 2) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant
81220CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines)
81221CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants
81222CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants
81223CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence
81224CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility)
81225CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17)
81226CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN)
81227CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6)
81228Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number variants (eg, bacterial artificial chromosome [BAC] or oligo-based comparative genomic hybridization [CGH] microarray analysis)
81229Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants for chromosomal abnormalities
81230CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22)
81231CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7)
81232DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6)
81233BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F)
81234DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles
81235EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q)
81236EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence
81237EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large B-cell lymphoma) gene analysis, common variant(s) (eg, codon 646)
81238F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence
81239DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size)
81240F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant
81241F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant
81242FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T)
81243FMR1 (fragile X mental retardation 1) (eg, fragile X mental retardation) gene analysis; evaluation to detect abnormal (eg, expanded) alleles
81244FMR1 (fragile X mental retardation 1) (eg, fragile X mental retardation) gene analysis; characterization of alleles (eg, expanded size and methylation status)
81245FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15)
81247G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-)
81248G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s)
81249G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence
81250G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, R83C, Q347X)
81251GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants (eg, N370S, 84GG, L444P, IVS2+1G>A)
81252GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence
81253GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants
81254GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb [del(GJB6-D13S1830)] and 232kb [del(GJB6-D13S1854)])
81255HEXA (hexosaminidase A [alpha polypeptide]) (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278insTATC, 1421+1G>C, G269S)
81256HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common variants (eg, C282Y, H63D)
81257HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, Mediterranean, alpha3.7, alpha4.2, alpha20.5, Constant Spring)
81258HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant
81259HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence
81260IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6T>C, R696P)
81261IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction)
81262IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot)
81263IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis
81264IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s)
81265Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient germline [eg, buccal swab or other germline tissue sample] and donor testing, twin zygosity testing, or maternal cell contamination of fetal cells)
81266Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in multiple birth pregnancies) (List separately in addition to code for primary procedure)
81267Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection
81268Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each cell type
81269HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants
81270JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant
81271HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles
81274HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles (eg, expanded size)
81275KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13)
81276KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146)
81283IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant
81284FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles
81285FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size)
81286FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence
81289FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s)
81290MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants (eg, IVS3-2A>G, del6.4kb)
81291MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677T, 1298C)
81292MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis
81293MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants
81294MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants
81295MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis
81296MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants
81297MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants
81298MSH6 (mutS homolog 6 [E. coli]) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis
81299MSH6 (mutS homolog 6 [E. coli]) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants
81300MSH6 (mutS homolog 6 [E. coli]) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants
81301Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and normal tissue, if performed
81302MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis
81303MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known familial variant
81304MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; duplication/deletion variants
81305MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.Leu265Pro (L265P) variant
81306NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6)
81310NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants
81312PABPN1 (poly[A] binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles
81315PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quantitative
81316PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative or quantitative
81317PMS2 (postmeiotic segregation increased 2 [S. cerevisiae]) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis
81318PMS2 (postmeiotic segregation increased 2 [S. cerevisiae]) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants
81319PMS2 (postmeiotic segregation increased 2 [S. cerevisiae]) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants
81320PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, R665W, S707F, L845F)
81321PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis
81322PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant
81323PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant
81324PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis
81325PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis
81326PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant
81328SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5)
81329SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes SMN2 (survival of motor neuron 2, centromeric) analysis, if performed
81330SMPD1(sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick disease, Type A) gene analysis, common variants (eg, R496L, L302P, fsP330)
81331SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis
81332SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *S and *Z)
81333TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, R124H, R124C, R124L, R555W, R555Q)
81334RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy), gene analysis, targeted sequence analysis (eg, exons 3-8)
81335TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3)
81336SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence
81337SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s)
81340TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction)
81341TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot)
81342TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s)
81343PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles
81344TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles
81345TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region)
81346TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant)
81350UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, irinotecan metabolism), gene analysis, common variants (eg, *28, *36, *37)
81355VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+1000C>T)
81361HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HbS, HbC, HbE)
81362HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s)
81363HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s)
81364HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence
81370HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1
81371HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing)
81372HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B, and -C)
81373HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each
81374HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each
81375HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and -DQB1
81376HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each
81377HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each
81378HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C, and -DRB1
81379HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A, -B, and -C)
81380HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each
81381HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each
81382HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each
81383HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each
81400MOLECULAR PATHOLOGY PROCEDURE LEVEL 1
81401MOLECULAR PATHOLOGY PROCEDURE LEVEL 2
81402MOLECULAR PATHOLOGY PROCEDURE LEVEL 3
81403MOLECULAR PATHOLOGY PROCEDURE LEVEL 4
81404MOLECULAR PATHOLOGY PROCEDURE LEVEL 5
81405MOLECULAR PATHOLOGY PROCEDURE LEVEL 6
81406MOLECULAR PATHOLOGY PROCEDURE LEVEL 7
81407MOLECULAR PATHOLOGY PROCEDURE LEVEL 8
81408MOLECULAR PATHOLOGY PROCEDURE LEVEL 9
81443Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders [eg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher disease, Tay-Sachs disease], beta hemoglobinopathies, phenylketonuria, galactosemia), genomic sequence analysis panel, must include sequencing of at least 15 genes (eg, ACADM, ARSA, ASPA, ATP7B, BCKDHA, BCKDHB, BLM, CFTR, DHCR7, FANCC, G6PC, GAA, GALT, GBA, GBE1, HBB, HEXA, IKBKAP, MCOLN1, PAH)
81448Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2, GJB1, MFN2, MPZ, REEP1, SPAST, SPG11, SPTLC1)
81479Unlisted molecular pathology procedure
81518Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage risk for metastatic recurrence and likelihood of benefit from extended endocrine therapy
81520Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence risk score
81521Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk of distant metastasis
81541Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease-specific mortality risk score
81551Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a likelihood of prostate cancer detection on repeat biopsy
81596Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic algorithm reported as scores for fibrosis and necroinflammatory activity in liver
82009Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative
82010Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative
82013Acetylcholinesterase
82016Acylcarnitines; qualitative, each specimen
82017Acylcarnitines; quantitative, each specimen
82024Adrenocorticotropic hormone (ACTH)
82030Adenosine, 5-monophosphate, cyclic (cyclic AMP)
82040Albumin; serum, plasma or whole blood
82042Albumin; other source, quantitative, each specimen
82043Albumin; urine (eg, microalbumin), quantitative
82044Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay)
82045Albumin; ischemia modified
82075Alcohol (ethanol), breath
82085Aldolase
82088Aldosterone
82103Alpha-1-antitrypsin; total
82104Alpha-1-antitrypsin; phenotype
82105Alpha-fetoprotein (AFP); serum
82106Alpha-fetoprotein (AFP); amniotic fluid
82107Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio)
82108Aluminum
82120Amines, vaginal fluid, qualitative
82127Amino acids; single, qualitative, each specimen
82128Amino acids; multiple, qualitative, each specimen
82131Amino acids; single, quantitative, each specimen
82135Aminolevulinic acid, delta (ALA)
82136Amino acids, 2 to 5 amino acids, quantitative, each specimen
82139Amino acids, 6 or more amino acids, quantitative, each specimen
82140Ammonia
82143Amniotic fluid scan (spectrophotometric)
82150Amylase
82154Androstanediol glucuronide
82157Androstenedione
82160Androsterone
82163Angiotensin II
82164Angiotensin I - converting enzyme (ACE)
82172Apolipoprotein, each
82175Arsenic
82180Ascorbic acid (Vitamin C), blood
82190Atomic absorption spectroscopy, each analyte
82232Beta-2 microglobulin
82239Bile acids; total
82240Bile acids; cholylglycine
82247Bilirubin; total
82248Bilirubin; direct
82252Bilirubin; feces, qualitative
82261Biotinidase, each specimen
82270Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)
82271Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources
82272Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening
82274Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations
82286Bradykinin
82300Cadmium
82306Vitamin D; 25 hydroxy, includes fraction(s), if performed
82308Calcitonin
82310Calcium; total
82330Calcium; ionized
82331Calcium; after calcium infusion test
82340Calcium; urine quantitative, timed specimen
82355Calculus; qualitative analysis
82360Calculus; quantitative analysis, chemical
82365Calculus; infrared spectroscopy
82370Calculus; X-ray diffraction
82373Carbohydrate deficient transferrin
82374Carbon dioxide (bicarbonate)
82375Carboxyhemoglobin; quantitative
82376Carboxyhemoglobin; qualitative
82378Carcinoembryonic antigen (CEA)
82379Carnitine (total and free), quantitative, each specimen
82380Carotene
82382Catecholamines; total urine
82383Catecholamines; blood
82384Catecholamines; fractionated
82387Cathepsin-D
82390Ceruloplasmin
82397Chemiluminescent assay
82415Chloramphenicol
82435Chloride; blood
82436Chloride; urine
82438Chloride; other source
82441Chlorinated hydrocarbons, screen
82465Cholesterol, serum or whole blood, total
82480Cholinesterase; serum
82482Cholinesterase; RBC
82485Chondroitin B sulfate, quantitative
82495Chromium
82507Citrate
82523Collagen cross links, any method
82525Copper
82528Corticosterone
82530Cortisol; free
82533Cortisol; total
82540Creatine
82542Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen
82550Creatine kinase (CK), (CPK); total
82552Creatine kinase (CK), (CPK); isoenzymes
82553Creatine kinase (CK), (CPK); MB fraction only
82554Creatine kinase (CK), (CPK); isoforms
82565Creatinine; blood
82570Creatinine; other source
82575Creatinine; clearance
82585Cryofibrinogen
82595Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit)
82600Cyanide
82607Cyanocobalamin (Vitamin B-12);
82608Cyanocobalamin (Vitamin B-12); unsaturated binding capacity
82610Cystatin C
82615Cystine and homocystine, urine, qualitative
82626Dehydroepiandrosterone (DHEA)
82627Dehydroepiandrosterone-sulfate (DHEA-S)
82633Desoxycorticosterone, 11-
82634Deoxycortisol, 11-
82638Dibucaine number
82642Dihydrotestosterone (DHT)
82652Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed
82656Elastase, pancreatic (EL-1), fecal, qualitative or semi-quantitative
82657Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen
82658Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen
82664Electrophoretic technique, not elsewhere specified
82668Erythropoietin
82670Estradiol
82671Estrogens; fractionated
82672Estrogens; total
82677Estriol
82679Estrone
82693Ethylene glycol
82696Etiocholanolone
82705Fat or lipids, feces; qualitative
82710Fat or lipids, feces; quantitative
82715Fat differential, feces, quantitative
82725Fatty acids, nonesterified
82726Very long chain fatty acids
82728Ferritin
82731Fetal fibronectin, cervicovaginal secretions, semi-quantitative
82735Fluoride
82746Folic acid; serum
82747Folic acid; RBC
82757Fructose, semen
82759Galactokinase, RBC
82760Galactose
82775Galactose-1-phosphate uridyl transferase; quantitative
82776Galactose-1-phosphate uridyl transferase; screen
82784Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each
82785Gammaglobulin (immunoglobulin); IgE
82787Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each
82800Gases, blood, pH only
82803Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation);
82805Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry
82810Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry
82820Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen)
82930Gastric acid analysis, includes pH if performed, each specimen
82938Gastrin after secretin stimulation
82941Gastrin
82943Glucagon
82945Glucose, body fluid, other than blood
82946Glucagon tolerance test
82947Glucose; quantitative, blood (except reagent strip)
82948Glucose; blood, reagent strip
82950Glucose; post glucose dose (includes glucose)
82951Glucose; tolerance test (GTT), 3 specimens (includes glucose)
82952Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure)
82955Glucose-6-phosphate dehydrogenase (G6PD); quantitative
82960Glucose-6-phosphate dehydrogenase (G6PD); screen
82962Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use
82963Glucosidase, beta
82965Glutamate dehydrogenase
82977Glutamyltransferase, gamma (GGT)
82978Glutathione
82979Glutathione reductase, RBC
82985Glycated protein
83001Gonadotropin; follicle stimulating hormone (FSH)
83002Gonadotropin; luteinizing hormone (LH)
83003Growth hormone, human (HGH) (somatotropin)
83009Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13)
83010Haptoglobin; quantitative
83012Haptoglobin; phenotypes
83013Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13)
83014Helicobacter pylori; drug administration
83015Heavy metal (eg, arsenic, barium, beryllium, bismuth, antimony, mercury); qualitative, any number of analytes
83018Heavy metal (eg, arsenic, barium, beryllium, bismuth, antimony, mercury); quantitative, each, not elsewhere specified
83020Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F)
83021Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F)
83026Hemoglobin; by copper sulfate method, non-automated
83030Hemoglobin; F (fetal), chemical
83033Hemoglobin; F (fetal), qualitative
83036Hemoglobin; glycosylated (A1C)
83037Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use
83045Hemoglobin; methemoglobin, qualitative
83050Hemoglobin; methemoglobin, quantitative
83051Hemoglobin; plasma
83060Hemoglobin; sulfhemoglobin, quantitative
83065Hemoglobin; thermolabile
83068Hemoglobin; unstable, screen
83069Hemoglobin; urine
83070Hemosiderin, qualitative
83080b-Hexosaminidase, each assay
83088Histamine
83090Homocysteine
83150Homovanillic acid (HVA)
83491Hydroxycorticosteroids, 17- (17-OHCS)
83497Hydroxyindolacetic acid, 5-(HIAA)
83498Hydroxyprogesterone, 17-d
83499Hydroxyprogesterone, 20-
83500Hydroxyproline; free
83505Hydroxyproline; total
83516Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method
83518Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip)
83519Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA)
83520Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified
83525Insulin; total
83527Insulin; free
83528Intrinsic factor
83540Iron
83550Iron binding capacity
83570Isocitric dehydrogenase (IDH)
83582Ketogenic steroids, fractionation
83586Ketosteroids, 17- (17-KS); total
83593Ketosteroids, 17- (17-KS); fractionation
83605Lactate (lactic acid)
83615Lactate dehydrogenase (LD), (LDH);
83625Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation
83630Lactoferrin, fecal; qualitative
83631Lactoferrin, fecal; quantitative
83632Lactogen, human placental (HPL) human chorionic somatomammotropin
83633Lactose, urine, qualitative
83655Lead
83661Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio
83662Fetal lung maturity assessment; foam stability test
83663Fetal lung maturity assessment; fluorescence polarization
83664Fetal lung maturity assessment; lamellar body density
83670Leucine aminopeptidase (LAP)
83690Lipase
83695Lipoprotein (a)
83698Lipoprotein-associated phospholipase A2 (Lp-PLA2)
83700Lipoprotein, blood; electrophoretic separation and quantitation
83701Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation)
83704Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed
83718Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol)
83719Lipoprotein, direct measurement; VLDL cholesterol
83721Lipoprotein, direct measurement; LDL cholesterol
83722Lipoprotein, direct measurement; small dense LDL cholesterol
83727Luteinizing releasing factor (LRH)
83735Magnesium
83775Malate dehydrogenase
83785Manganese
83789Mass spectrometry and tandem mass spectrometry (eg, MS, MS/MS, MALDI, MS-TOF, QTOF), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen
83825Mercury, quantitative
83835Metanephrines
83857Methemalbumin
83861Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity
83864Mucopolysaccharides, acid, quantitative
83872Mucin, synovial fluid (Ropes test)
83873Myelin basic protein, cerebrospinal fluid
83874Myoglobin
83876Myeloperoxidase (MPO)
83880Natriuretic peptide
83883Nephelometry, each analyte not elsewhere specified
83885Nickel
83915Nucleotidase 5'-
83916Oligoclonal immune (oligoclonal bands)
83918Organic acids; total, quantitative, each specimen
83919Organic acids; qualitative, each specimen
83921Organic acid, single, quantitative
83930Osmolality; blood
83935Osmolality; urine
83937Osteocalcin (bone g1a protein)
83945Oxalate
83950Oncoprotein; HER-2/neu
83951Oncoprotein; des-gamma-carboxy-prothrombin (DCP)
83970Parathormone (parathyroid hormone)
83986pH; body fluid, not otherwise specified
83987pH; exhaled breath condensate
83992Phencyclidine (PCP)
83993Calprotectin, fecal
84030Phenylalanine (PKU), blood
84035Phenylketones, qualitative
84060Phosphatase, acid; total
84061Phosphatase, acid; forensic examination
84066Phosphatase, acid; prostatic
84075Phosphatase, alkaline;
84078Phosphatase, alkaline; heat stable (total not included)
84080Phosphatase, alkaline; isoenzymes
84081Phosphatidylglycerol
84085Phosphogluconate, 6-, dehydrogenase, RBC
84087Phosphohexose isomerase
84100Phosphorus inorganic (phosphate);
84105Phosphorus inorganic (phosphate); urine
84106Porphobilinogen, urine; qualitative
84110Porphobilinogen, urine; quantitative
84112Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 [PAMG-1], placental protein 12 [PP12], alpha-fetoprotein), qualitative, each specimen
84119Porphyrins, urine; qualitative
84120Porphyrins, urine; quantitation and fractionation
84126Porphyrins, feces, quantitative
84132Potassium; serum, plasma or whole blood
84133Potassium; urine
84134Prealbumin
84135Pregnanediol
84138Pregnanetriol
84140Pregnenolone
8414317-hydroxypregnenolone
84144Progesterone
84145Procalcitonin (PCT)
84146Prolactin
84150Prostaglandin, each
84152Prostate specific antigen (PSA); complexed (direct measurement)
84153Prostate specific antigen (PSA); total
84154Prostate specific antigen (PSA); free
84155Protein, total, except by refractometry; serum, plasma or whole blood
84156Protein, total, except by refractometry; urine
84157Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)
84160Protein, total, by refractometry, any source
84163Pregnancy-associated plasma protein-A (PAPP-A)
84165Protein; electrophoretic fractionation and quantitation, serum
84166Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF)
84181Protein; Western Blot, with interpretation and report, blood or other body fluid
84182Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each
84202Protoporphyrin, RBC; quantitative
84203Protoporphyrin, RBC; screen
84206Proinsulin
84207Pyridoxal phosphate (Vitamin B-6)
84210Pyruvate
84220Pyruvate kinase
84228Quinine
84233Receptor assay; estrogen
84234Receptor assay; progesterone
84235Receptor assay; endocrine, other than estrogen or progesterone (specify hormone)
84238Receptor assay; non-endocrine (specify receptor)
84244Renin
84252Riboflavin (Vitamin B-2)
84255Selenium
84260Serotonin
84270Sex hormone binding globulin (SHBG)
84275Sialic acid
84285Silica
84295Sodium; serum, plasma or whole blood
84300Sodium; urine
84302Sodium; other source
84305Somatomedin
84307Somatostatin
84311Spectrophotometry, analyte not elsewhere specified
84315Specific gravity (except urine)
84375Sugars, chromatographic, TLC or paper chromatography
84376Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen
84377Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen
84378Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen
84379Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen
84392Sulfate, urine
84402Testosterone; free
84403Testosterone; total
84425Thiamine (Vitamin B-1)
84430Thiocyanate
84431Thromboxane metabolite(s), including thromboxane if performed, urine
84432Thyroglobulin
84436Thyroxine; total
84437Thyroxine; requiring elution (eg, neonatal)
84439Thyroxine; free
84442Thyroxine binding globulin (TBG)
84443Thyroid stimulating hormone (TSH)
84445Thyroid stimulating immune globulins (TSI)
84446Tocopherol alpha (Vitamin E)
84449Transcortin (cortisol binding globulin)
84450Transferase; aspartate amino (AST) (SGOT)
84460Transferase; alanine amino (ALT) (SGPT)
84466Transferrin
84478Triglycerides
84479Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR)
84480Triiodothyronine T3; total (TT-3)
84481Triiodothyronine T3; free
84482Triiodothyronine T3; reverse
84484Troponin, quantitative
84485Trypsin; duodenal fluid
84488Trypsin; feces, qualitative
84490Trypsin; feces, quantitative, 24-hour collection
84510Tyrosine
84512Troponin, qualitative
84520Urea nitrogen; quantitative
84525Urea nitrogen; semiquantitative (eg, reagent strip test)
84540Urea nitrogen, urine
84545Urea nitrogen, clearance
84550Uric acid; blood
84560Uric acid; other source
84577Urobilinogen, feces, quantitative
84578Urobilinogen, urine; qualitative
84580Urobilinogen, urine; quantitative, timed specimen
84583Urobilinogen, urine; semiquantitative
84585Vanillylmandelic acid (VMA), urine
84586Vasoactive intestinal peptide (VIP)
84588Vasopressin (antidiuretic hormone, ADH)
84590Vitamin A
84591Vitamin, not otherwise specified
84597Vitamin K
84600Volatiles (eg, acetic anhydride, diethylether)
84620Xylose absorption test, blood and/or urine
84630Zinc
84681C-peptide
84702Gonadotropin, chorionic (hCG); quantitative
84703Gonadotropin, chorionic (hCG); qualitative
84704Gonadotropin, chorionic (hCG); free beta chain
84830Ovulation tests, by visual color comparison methods for human luteinizing hormone
84999Unlisted chemistry procedure
85002Bleeding time
85004Blood count; automated differential WBC count
85007Blood count; blood smear, microscopic examination with manual differential WBC count
85008Blood count; blood smear, microscopic examination without manual differential WBC count
85009Blood count; manual differential WBC count, buffy coat
85013Blood count; spun microhematocrit
85014Blood count; hematocrit (Hct)
85018Blood count; hemoglobin (Hgb)
85025Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count
85027Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)
85032Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each
85041Blood count; red blood cell (RBC), automated
85044Blood count; reticulocyte, manual
85045Blood count; reticulocyte, automated
85046Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content [CHr], immature reticulocyte fraction [IRF], reticulocyte volume [MRV], RNA content), direct measurement
85048Blood count; leukocyte (WBC), automated
85049Blood count; platelet, automated
85055Reticulated platelet assay
85130Chromogenic substrate assay
85170Clot retraction
85175Clot lysis time, whole blood dilution
85210Clotting; factor II, prothrombin, specific
85220Clotting; factor V (AcG or proaccelerin), labile factor
85230Clotting; factor VII (proconvertin, stable factor)
85240Clotting; factor VIII (AHG), 1-stage
85244Clotting; factor VIII related antigen
85245Clotting; factor VIII, VW factor, ristocetin cofactor
85246Clotting; factor VIII, VW factor antigen
85247Clotting; factor VIII, von Willebrand factor, multimetric analysis
85250Clotting; factor IX (PTC or Christmas)
85260Clotting; factor X (Stuart-Prower)
85270Clotting; factor XI (PTA)
85280Clotting; factor XII (Hageman)
85290Clotting; factor XIII (fibrin stabilizing)
85291Clotting; factor XIII (fibrin stabilizing), screen solubility
85292Clotting; prekallikrein assay (Fletcher factor assay)
85293Clotting; high molecular weight kininogen assay (Fitzgerald factor assay)
85300Clotting inhibitors or anticoagulants; antithrombin III, activity
85301Clotting inhibitors or anticoagulants; antithrombin III, antigen assay
85302Clotting inhibitors or anticoagulants; protein C, antigen
85303Clotting inhibitors or anticoagulants; protein C, activity
85305Clotting inhibitors or anticoagulants; protein S, total
85306Clotting inhibitors or anticoagulants; protein S, free
85307Activated Protein C (APC) resistance assay
85335Factor inhibitor test
85337Thrombomodulin
85345Coagulation time; Lee and White
85347Coagulation time; activated
85348Coagulation time; other methods
85360Euglobulin lysis
85362Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative
85366Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation
85370Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative
85378Fibrin degradation products, D-dimer; qualitative or semiquantitative
85379Fibrin degradation products, D-dimer; quantitative
85380Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative
85384Fibrinogen; activity
85385Fibrinogen; antigen
85390Fibrinolysins or coagulopathy screen, interpretation and report
85396Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day
85397Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte
85400Fibrinolytic factors and inhibitors; plasmin
85410Fibrinolytic factors and inhibitors; alpha-2 antiplasmin
85415Fibrinolytic factors and inhibitors; plasminogen activator
85420Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay
85421Fibrinolytic factors and inhibitors; plasminogen, antigenic assay
85441Heinz bodies; direct
85445Heinz bodies; induced, acetyl phenylhydrazine
85460Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke)
85461Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette
85475Hemolysin, acid
85520Heparin assay
85525Heparin neutralization
85530Heparin-protamine tolerance test
85536Iron stain, peripheral blood
85540Leukocyte alkaline phosphatase with count
85547Mechanical fragility, RBC
85549Muramidase
85555Osmotic fragility, RBC; unincubated
85557Osmotic fragility, RBC; incubated
85576Platelet, aggregation (in vitro), each agent
85597Phospholipid neutralization; platelet
85598Phospholipid neutralization; hexagonal phospholipid
85610Prothrombin time;
85611Prothrombin time; substitution, plasma fractions, each
85612Russell viper venom time (includes venom); undiluted
85613Russell viper venom time (includes venom); diluted
85635Reptilase test
85651Sedimentation rate, erythrocyte; non-automated
85652Sedimentation rate, erythrocyte; automated
85660Sickling of RBC, reduction
85670Thrombin time; plasma
85675Thrombin time; titer
85705Thromboplastin inhibition, tissue
85730Thromboplastin time, partial (PTT); plasma or whole blood
85732Thromboplastin time, partial (PTT); substitution, plasma fractions, each
85810Viscosity
85999Unlisted hematology and coagulation procedure
86000Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen
86001Allergen specific IgG quantitative or semiquantitative, each allergen
86003Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each
86005Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card)
86008Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each
86021Antibody identification; leukocyte antibodies
86022Antibody identification; platelet antibodies
86023Antibody identification; platelet associated immunoglobulin assay
86038Antinuclear antibodies (ANA);
86039Antinuclear antibodies (ANA); titer
86060Antistreptolysin 0; titer
86063Antistreptolysin 0; screen
86140C-reactive protein;
86141C-reactive protein; high sensitivity (hsCRP)
86146Beta 2 Glycoprotein I antibody, each
86147Cardiolipin (phospholipid) antibody, each Ig class
86148Anti-phosphatidylserine (phospholipid) antibody
86155Chemotaxis assay, specify method
86156Cold agglutinin; screen
86157Cold agglutinin; titer
86160Complement; antigen, each component
86161Complement; functional activity, each component
86162Complement; total hemolytic (CH50)
86171Complement fixation tests, each antigen
86185Counterimmunoelectrophoresis, each antigen
86200Cyclic citrullinated peptide (CCP), antibody
86215Deoxyribonuclease, antibody
86225Deoxyribonucleic acid (DNA) antibody; native or double stranded
86226Deoxyribonucleic acid (DNA) antibody; single stranded
86235Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody
86243Fc receptor
86255Fluorescent noninfectious agent antibody; screen, each antibody
86256Fluorescent noninfectious agent antibody; titer, each antibody
86277Growth hormone, human (HGH), antibody
86280Hemagglutination inhibition test (HAI)
86294Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen)
86300Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29)
86301Immunoassay for tumor antigen, quantitative; CA 19-9
86304Immunoassay for tumor antigen, quantitative; CA 125
86305Human epididymis protein 4 (HE4)
86308Heterophile antibodies; screening
86309Heterophile antibodies; titer
86310Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney
86316Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each
86317Immunoassay for infectious agent antibody, quantitative, not otherwise specified
86318Immunoassay for infectious agent antibody, qualitative or semiquantitative, single step method (eg, reagent strip)
86320Immunoelectrophoresis; serum
86325Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration
86327Immunoelectrophoresis; crossed (2-dimensional assay)
86329Immunodiffusion; not elsewhere specified
86331Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody
86332Immune complex assay
86334Immunofixation electrophoresis; serum
86335Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF)
86336Inhibin A
86337Insulin antibodies
86340Intrinsic factor antibodies
86341Islet cell antibody
86343Leukocyte histamine release test (LHR)
86344Leukocyte phagocytosis
86352Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP)
86353Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis
86355B cells, total count
86356Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen
86357Natural killer (NK) cells, total count
86359T cells; total count
86360T cells; absolute CD4 and CD8 count, including ratio
86361T cells; absolute CD4 count
86367Stem cells (ie, CD34), total count
86376Microsomal antibodies (eg, thyroid or liver-kidney), each
86378Migration inhibitory factor test (MIF)
86382Neutralization test, viral
86384Nitroblue tetrazolium dye test (NTD)
86386Nuclear Matrix Protein 22 (NMP22), qualitative
86403Particle agglutination; screen, each antibody
86406Particle agglutination; titer, each antibody
86430Rheumatoid factor; qualitative
86431Rheumatoid factor; quantitative
86480Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon
86481Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in cell suspension
86485Skin test; candida
86490Skin test; coccidioidomycosis
86510Skin test; histoplasmosis
86580Skin test; tuberculosis, intradermal
86590Streptokinase, antibody
86592Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART)
86593Syphilis test, non-treponemal antibody; quantitative
86602Antibody; actinomyces
86603Antibody; adenovirus
86606Antibody; Aspergillus
86609Antibody; bacterium, not elsewhere specified
86611Antibody; Bartonella
86612Antibody; Blastomyces
86615Antibody; Bordetella
86617Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot)
86618Antibody; Borrelia burgdorferi (Lyme disease)
86619Antibody; Borrelia (relapsing fever)
86622Antibody; Brucella
86625Antibody; Campylobacter
86628Antibody; Candida
86631Antibody; Chlamydia
86632Antibody; Chlamydia, IgM
86635Antibody; Coccidioides
86638Antibody; Coxiella burnetii (Q fever)
86641Antibody; Cryptococcus
86644Antibody; cytomegalovirus (CMV)
86645Antibody; cytomegalovirus (CMV), IgM
86648Antibody; Diphtheria
86651Antibody; encephalitis, California (La Crosse)
86652Antibody; encephalitis, Eastern equine
86653Antibody; encephalitis, St. Louis
86654Antibody; encephalitis, Western equine
86658Antibody; enterovirus (eg, coxsackie, echo, polio)
86663Antibody; Epstein-Barr (EB) virus, early antigen (EA)
86664Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA)
86665Antibody; Epstein-Barr (EB) virus, viral capsid (VCA)
86666Antibody; Ehrlichia
86668Antibody; Francisella tularensis
86671Antibody; fungus, not elsewhere specified
86674Antibody; Giardia lamblia
86677Antibody; Helicobacter pylori
86682Antibody; helminth, not elsewhere specified
86684Antibody; Haemophilus influenza
86687Antibody; HTLV-I
86688Antibody; HTLV-II
86689Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot)
86692Antibody; hepatitis, delta agent
86694Antibody; herpes simplex, non-specific type test
86695Antibody; herpes simplex, type 1
86696Antibody; herpes simplex, type 2
86698Antibody; histoplasma
86701Antibody; HIV-1
86702Antibody; HIV-2
86703Antibody; HIV-1 and HIV-2, single result
86704Hepatitis B core antibody (HBcAb); total
86705Hepatitis B core antibody (HBcAb); IgM antibody
86706Hepatitis B surface antibody (HBsAb)
86707Hepatitis Be antibody (HBeAb)
86708Hepatitis A antibody (HAAb)
86709Hepatitis A antibody (HAAb), IgM antibody
86710Antibody; influenza virus
86713Antibody; Legionella
86717Antibody; Leishmania
86720Antibody; Leptospira
86723Antibody; Listeria monocytogenes
86727Antibody; lymphocytic choriomeningitis
86729Antibody; lymphogranuloma venereum
86732Antibody; mucormycosis
86735Antibody; mumps
86738Antibody; mycoplasma
86741Antibody; Neisseria meningitidis
86744Antibody; Nocardia
86747Antibody; parvovirus
86750Antibody; Plasmodium (malaria)
86753Antibody; protozoa, not elsewhere specified
86756Antibody; respiratory syncytial virus
86757Antibody; Rickettsia
86759Antibody; rotavirus
86762Antibody; rubella
86765Antibody; rubeola
86768Antibody; Salmonella
86771Antibody; Shigella
86774Antibody; tetanus
86777Antibody; Toxoplasma
86778Antibody; Toxoplasma, IgM
86780Antibody; Treponema pallidum
86784Antibody; Trichinella
86787Antibody; varicella-zoster
86788Antibody; West Nile virus, IgM
86789Antibody; West Nile virus
86790Antibody; virus, not elsewhere specified
86793Antibody; Yersinia
86794Antibody; Zika virus, IgM
86800Thyroglobulin antibody
86803Hepatitis C antibody;
86804Hepatitis C antibody; confirmatory test (eg, immunoblot)
86805Lymphocytotoxicity assay, visual crossmatch; with titration
86806Lymphocytotoxicity assay, visual crossmatch; without titration
86807Serum screening for cytotoxic percent reactive antibody (PRA); standard method
86808Serum screening for cytotoxic percent reactive antibody (PRA); quick method
86812HLA typing; A, B, or C (eg, A10, B7, B27), single antigen
86813HLA typing; A, B, or C, multiple antigens
86816HLA typing; DR/DQ, single antigen
86817HLA typing; DR/DQ, multiple antigens
86821HLA typing; lymphocyte culture, mixed (MLC)
86822HLA typing; lymphocyte culture, primed (PLC)
86825Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution
86826Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (List separately in addition to primary procedure)
86849Unlisted immunology procedure
86850Antibody screen, RBC, each serum technique
86860Antibody elution (RBC), each elution
86870Antibody identification, RBC antibodies, each panel for each serum technique
86880Antihuman globulin test (Coombs test); direct, each antiserum
86885Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell
86886Antihuman globulin test (Coombs test); indirect, each antibody titer
86890Autologous blood or component, collection processing and storage; predeposited
86891Autologous blood or component, collection processing and storage; intra- or postoperative salvage
86900Blood typing, serologic; ABO
86901Blood typing, serologic; Rh (D)
86902Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test
86904Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened
86905Blood typing, serologic; RBC antigens, other than ABO or Rh (D), each
86906Blood typing, serologic; Rh phenotyping, complete
86910Blood typing, for paternity testing, per individual; ABO, Rh and MN
86911Blood typing, for paternity testing, per individual; each additional antigen system
86920Compatibility test each unit; immediate spin technique
86921Compatibility test each unit; incubation technique
86922Compatibility test each unit; antiglobulin technique
86923Compatibility test each unit; electronic
86927Fresh frozen plasma, thawing, each unit
86930Frozen blood, each unit; freezing (includes preparation)
86931Frozen blood, each unit; thawing
86932Frozen blood, each unit; freezing (includes preparation) and thawing
86940Hemolysins and agglutinins; auto, screen, each
86941Hemolysins and agglutinins; incubated
86945Irradiation of blood product, each unit
86950Leukocyte transfusion
86960Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit
86965Pooling of platelets or other blood products
86970Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each
86971Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each
86972Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation
86975Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each
86976Pretreatment of serum for use in RBC antibody identification; by dilution
86977Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each
86978Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption
86985Splitting of blood or blood products, each unit
86999Unlisted transfusion medicine procedure
87015Concentration (any type), for infectious agents
87040Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate)
87045Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species
87046Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate
87070Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates
87071Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool
87073Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool
87075Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates
87076Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate
87077Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate
87081Culture, presumptive, pathogenic organisms, screening only;
87084Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart
87086Culture, bacterial; quantitative colony count, urine
87088Culture, bacterial; with isolation and presumptive identification of each isolate, urine
87101Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail
87102Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood)
87103Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood
87106Culture, fungi, definitive identification, each organism; yeast
87107Culture, fungi, definitive identification, each organism; mold
87109Culture, mycoplasma, any source
87110Culture, chlamydia, any source
87116Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates
87118Culture, mycobacterial, definitive identification, each isolate
87140Culture, typing; immunofluorescent method, each antiserum
87143Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method
87147Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum
87149Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed
87150Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed
87152Culture, typing; identification by pulse field gel typing
87153Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene)
87158Culture, typing; other methods
87164Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection
87166Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection
87168Macroscopic examination; arthropod
87169Macroscopic examination; parasite
87172Pinworm exam (eg, cellophane tape prep)
87176Homogenization, tissue, for culture
87177Ova and parasites, direct smears, concentration and identification
87181Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)
87184Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents)
87185Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme
87186Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration [MIC] or breakpoint), each multi-antimicrobial, per plate
87187Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure)
87188Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent
87190Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent
87197Serum bactericidal titer (Schlichter test)
87205Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types
87206Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types
87207Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses)
87209Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites
87210Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps)
87220Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)
87230Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin)
87250Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection
87252Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect
87253Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate
87254Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus
87255Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity)
87260Infectious agent antigen detection by immunofluorescent technique; adenovirus
87265Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis
87267Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA)
87269Infectious agent antigen detection by immunofluorescent technique; giardia
87270Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis
87271Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA)
87272Infectious agent antigen detection by immunofluorescent technique; cryptosporidium
87273Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2
87274Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1
87275Infectious agent antigen detection by immunofluorescent technique; influenza B virus
87276Infectious agent antigen detection by immunofluorescent technique; influenza A virus
87277Infectious agent antigen detection by immunofluorescent technique; Legionella micdadei
87278Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila
87279Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type
87280Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus
87281Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii
87283Infectious agent antigen detection by immunofluorescent technique; Rubeola
87285Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum
87290Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus
87299Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism
87300Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum
87301Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; adenovirus enteric types 40/41
87305Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Aspergillus
87320Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Chlamydia trachomatis
87324Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Clostridium difficile toxin(s)
87327Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Cryptococcus neoformans
87328Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; cryptosporidium
87329Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; giardia
87332Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; cytomegalovirus
87335Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Escherichia coli 0157
87336Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Entamoeba histolytica dispar group
87337Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Entamoeba histolytica group
87338Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Helicobacter pylori, stool
87339Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Helicobacter pylori
87340Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; hepatitis B surface antigen (HBsAg)
87341Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; hepatitis B surface antigen (HBsAg) neutralization
87350Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; hepatitis Be antigen (HBeAg)
87380Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; hepatitis, delta agent
87385Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Histoplasma capsulatum
87389Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result
87390Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; HIV-1
87391Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; HIV-2
87400Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Influenza, A or B, each
87420Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; respiratory syncytial virus
87425Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; rotavirus
87427Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Shiga-like toxin
87430Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Streptococcus, group A
87449Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative; multiple-step method, not otherwise specified, each organism
87450Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative; single step method, not otherwise specified, each organism
87451Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative; multiple step method, polyvalent for multiple organisms, each polyvalent antiserum
87470Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, direct probe technique
87471Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique
87472Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification
87475Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique
87476Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique
87477Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, quantification
87480Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique
87481Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique
87482Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification
87483Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus agalactiae, enterovirus, human parechovirus, herpes simplex virus type 1 and 2, human herpesvirus 6, cytomegalovirus, varicella zoster virus, Cryptococcus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 12-25 targets
87485Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique
87486Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique
87487Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification
87490Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique
87491Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique
87492Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification
87493Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique
87495Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique
87496Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique
87497Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification
87498Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed
87500Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified probe technique
87501Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype
87502Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, first 2 types or sub-types
87503Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, each additional influenza virus type or sub-type beyond 2 (List separately in addition to code for primary procedure)
87510Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique
87511Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique
87512Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification
87515Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, direct probe technique
87516Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique
87517Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification
87520Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique
87521Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed
87522Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed
87525Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique
87526Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique
87527Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification
87528Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique
87529Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique
87530Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification
87531Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique
87532Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique
87533Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification
87534Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique
87535Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed
87536Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed
87537Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique
87538Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed
87539Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when performed
87540Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique
87541Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique
87542Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification
87550Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique
87551Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique
87552Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification
87555Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique
87556Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique
87557Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification
87560Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique
87561Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique
87562Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification
87580Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique
87581Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique
87582Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification
87590Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique
87591Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique
87592Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification
87634Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, amplified probe technique
87640Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique
87641Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique
87650Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique
87651Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique
87652Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification
87653Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique
87660Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique
87662Infectious agent detection by nucleic acid (DNA or RNA); Zika virus, amplified probe technique
87797Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism
87798Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism
87799Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism
87800Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique
87801Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique
87802Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus, group B
87803Infectious agent antigen detection by immunoassay with direct optical observation; Clostridium difficile toxin A
87804Infectious agent antigen detection by immunoassay with direct optical observation; Influenza
87807Infectious agent antigen detection by immunoassay with direct optical observation; respiratory syncytial virus
87808Infectious agent antigen detection by immunoassay with direct optical observation; Trichomonas vaginalis
87809Infectious agent antigen detection by immunoassay with direct optical observation; adenovirus
87810Infectious agent antigen detection by immunoassay with direct optical observation; Chlamydia trachomatis
87850Infectious agent antigen detection by immunoassay with direct optical observation; Neisseria gonorrhoeae
87880Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus, group A
87899Infectious agent antigen detection by immunoassay with direct optical observation; not otherwise specified
87900Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics
87901Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions
87902Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus
87903Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested
87904Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary procedure)
87905Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid)
87906Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion)
87999Unlisted microbiology procedure
88000Necropsy (autopsy), gross examination only; without CNS
88005Necropsy (autopsy), gross examination only; with brain
88007Necropsy (autopsy), gross examination only; with brain and spinal cord
88012Necropsy (autopsy), gross examination only; infant with brain
88014Necropsy (autopsy), gross examination only; stillborn or newborn with brain
88016Necropsy (autopsy), gross examination only; macerated stillborn
88020Necropsy (autopsy), gross and microscopic; without CNS
88025Necropsy (autopsy), gross and microscopic; with brain
88027Necropsy (autopsy), gross and microscopic; with brain and spinal cord
88028Necropsy (autopsy), gross and microscopic; infant with brain
88029Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain
88036Necropsy (autopsy), limited, gross and/or microscopic; regional
88037Necropsy (autopsy), limited, gross and/or microscopic; single organ
88040Necropsy (autopsy); forensic examination
88045Necropsy (autopsy); coroner's call
88099Unlisted necropsy (autopsy) procedure
88104Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation
88106Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation
88108Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique)
88112Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal
88125Cytopathology, forensic (eg, sperm)
88130Sex chromatin identification; Barr bodies
88140Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks
88141Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician
88142Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision
88143Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision
88147Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision
88148Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision
88150Cytopathology, slides, cervical or vaginal; manual screening under physician supervision
88152Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision
88153Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision
88154Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening using cell selection and review under physician supervision
88155Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (List separately in addition to code[s] for other technical and interpretation services)
88160Cytopathology, smears, any other source; screening and interpretation
88161Cytopathology, smears, any other source; preparation, screening and interpretation
88162Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains
88164Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision
88165Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervision
88166Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under physician supervision
88167Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision
88174Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision
88175Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under physician supervision
88199Unlisted cytopathology procedure
88230Tissue culture for non-neoplastic disorders; lymphocyte
88233Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy
88235Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells
88237Tissue culture for neoplastic disorders; bone marrow, blood cells
88239Tissue culture for neoplastic disorders; solid tumor
88240Cryopreservation, freezing and storage of cells, each cell line
88241Thawing and expansion of frozen cells, each aliquot
88371Protein analysis of tissue by Western Blot, with interpretation and report;
88372Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each
88720Bilirubin, total, transcutaneous
88738Hemoglobin (Hgb), quantitative, transcutaneous
88740Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin
88741Hemoglobin, quantitative, transcutaneous, per day; methemoglobin
89050Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood;
89051Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count
89055Leukocyte assessment, fecal, qualitative or semiquantitative
89060Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine)
89125Fat stain, feces, urine, or respiratory secretions
89160Meat fibers, feces
89190Nasal smear for eosinophils
89220Sputum, obtaining specimen, aerosol induced technique (separate procedure)
89230Sweat collection by iontophoresis
89250Culture of oocyte(s)/embryo(s), less than 4 days;
89251Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos
89253Assisted embryo hatching, microtechniques (any method)
89254Oocyte identification from follicular fluid
89255Preparation of embryo for transfer (any method)
89257Sperm identification from aspiration (other than seminal fluid)
89258Cryopreservation; embryo(s)
89259Cryopreservation; sperm
89260Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis
89261Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis
89264Sperm identification from testis tissue, fresh or cryopreserved
89268Insemination of oocytes
89272Extended culture of oocyte(s)/embryo(s), 4-7 days
89280Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes
89281Assisted oocyte fertilization, microtechnique; greater than 10 oocytes
89300Semen analysis; presence and/or motility of sperm including Huhner test (post coital)
89310Semen analysis; motility and count (not including Huhner test)
89320Semen analysis; volume, count, motility, and differential
89321Semen analysis; sperm presence and motility of sperm, if performed
89322Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger)
89325Sperm antibodies
89329Sperm evaluation; hamster penetration test
89330Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test
89331Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated)
89335Cryopreservation, reproductive tissue, testicular
89352Thawing of cryopreserved; embryo(s)
89353Thawing of cryopreserved; sperm/semen, each aliquot
89354Thawing of cryopreserved; reproductive tissue, testicular/ovarian
89356Thawing of cryopreserved; oocytes, each aliquot
90399Unlisted immune globulin
90460Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered
90461Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered (List separately in addition to code for primary procedure)
90471Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)
90472Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure)
90473Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)
90474Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure)
90476Adenovirus vaccine, type 4, live, for oral use
90630Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for intradermal use
90632Hepatitis A vaccine (HepA), adult dosage, for intramuscular use
90633Hepatitis A vaccine (HepA), pediatric/adolescent dosage-2 dose schedule, for intramuscular use
90634Hepatitis A vaccine (HepA), pediatric/adolescent dosage-3 dose schedule, for intramuscular use
90636Hepatitis A and hepatitis B vaccine (HepA-HepB), adult dosage, for intramuscular use
90644Meningococcal conjugate vaccine, serogroups C & Y and Haemophilus influenzae type b vaccine (Hib-MenCY), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use
90647Haemophilus influenzae type b vaccine (Hib), PRP-OMP conjugate, 3 dose schedule, for intramuscular use
90648Haemophilus influenzae type b vaccine (Hib), PRP-T conjugate, 4 dose schedule, for intramuscular use
90649Human Papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vHPV), 3 dose schedule, for intramuscular use
90650Human Papillomavirus vaccine, types 16, 18, bivalent (2vHPV), 3 dose schedule, for intramuscular use
90654Influenza virus vaccine, trivalent (IIV3), split virus, preservative-free, for intradermal use
90655Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.25 mL dosage, for intramuscular use
90656Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use
90657Influenza virus vaccine, trivalent (IIV3), split virus, 0.25 mL dosage, for intramuscular use
90658Influenza virus vaccine, trivalent (IIV3), split virus, 0.5 mL dosage, for intramuscular use
90660Influenza virus vaccine, trivalent, live (LAIV3), for intranasal use
90661Influenza virus vaccine, trivalent (ccIIV3), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use
90662Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use
90664Influenza virus vaccine, live (LAIV), pandemic formulation, for intranasal use
90666Influenza virus vaccine (IIV), pandemic formulation, split virus, preservative free, for intramuscular use
90667Influenza virus vaccine (IIV), pandemic formulation, split virus, adjuvanted, for intramuscular use
90668Influenza virus vaccine (IIV), pandemic formulation, split virus, for intramuscular use
90670Pneumococcal conjugate vaccine, 13 valent (PCV13), for intramuscular use
90672Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use
90673Influenza virus vaccine, trivalent (RIV3), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use
90674Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use
90680Rotavirus vaccine, pentavalent (RV5), 3 dose schedule, live, for oral use
90681Rotavirus vaccine, human, attenuated (RV1), 2 dose schedule, live, for oral use
90682Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use
90685Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.25 mL, for intramuscular use
90686Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use
90687Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL dosage, for intramuscular use
90688Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use
90689Influenza virus vaccine, quadrivalent (IIV4), inactivated, adjuvanted, preservative free, 0.25 mL dosage, for intramuscular use
90690Typhoid vaccine, live, oral
90691Typhoid vaccine, Vi capsular polysaccharide (ViCPs), for intramuscular use
90696Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (DTaP-IPV), when administered to children 4 through 6 years of age, for intramuscular use
90698Diphtheria, tetanus toxoids, acellular pertussis vaccine, Haemophilus influenzae type b, and inactivated poliovirus vaccine, (DTaP-IPV/Hib), for intramuscular use
90700Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, for intramuscular use
90702Diphtheria and tetanus toxoids adsorbed (DT) when administered to individuals younger than 7 years, for intramuscular use
90707Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use
90710Measles, mumps, rubella, and varicella vaccine (MMRV), live, for subcutaneous use
90713Poliovirus vaccine, inactivated (IPV), for subcutaneous or intramuscular use
90714Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use
90715Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use
90716Varicella virus vaccine (VAR), live, for subcutaneous use
90717Yellow fever vaccine, live, for subcutaneous use
90723Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis B, and inactivated poliovirus vaccine (DTaP-HepB-IPV), for intramuscular use
90732Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use
90733Meningococcal polysaccharide vaccine, serogroups A, C, Y, W-135, quadrivalent (MPSV4), for subcutaneous use
90734Meningococcal conjugate vaccine, serogroups A, C, Y and W-135, quadrivalent (MCV4 or MenACWY), for intramuscular use
90736Zoster (shingles) vaccine (HZV), live, for subcutaneous injection
90738Japanese encephalitis virus vaccine, inactivated, for intramuscular use
90740Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 3 dose schedule, for intramuscular use
90743Hepatitis B vaccine (HepB), adolescent, 2 dose schedule, for intramuscular use
90744Hepatitis B vaccine (HepB), pediatric/adolescent dosage, 3 dose schedule, for intramuscular use
90746Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscular use
90747Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 4 dose schedule, for intramuscular use
90748Hepatitis B and Haemophilus influenzae type b vaccine (Hib-HepB), for intramuscular use
90749Unlisted vaccine/toxoid
90750Zoster (shingles) vaccine (HZV), recombinant, sub-unit, adjuvanted, for intramuscular injection
90756Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5mL dosage, for intramuscular use
90791Psychiatric diagnostic evaluation
90792Psychiatric diagnostic evaluation with medical services
90832Psychotherapy, 30 minutes with patient
90833Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)
90834Psychotherapy, 45 minutes with patient
90836Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)
90837Psychotherapy, 60 minutes with patient
90838Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)
90839Psychotherapy for crisis; first 60 minutes
90840Psychotherapy for crisis; each additional 30 minutes (List separately in addition to code for primary service)
90853Group psychotherapy (other than of a multiple-family group)
90863Pharmacologic management, including prescription and review of medication, when performed with psychotherapy services (List separately in addition to the code for primary procedure)
91200Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report
92071Fitting of contact lens for treatment of ocular surface disease
92072Fitting of contact lens for management of keratoconus, initial fitting
92132Scanning computerized ophthalmic diagnostic imaging, anterior segment, with interpretation and report, unilateral or bilateral
92133Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; optic nerve
92134Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; retina
92227Remote imaging for detection of retinal disease (eg, retinopathy in a patient with diabetes) with analysis and report under physician supervision, unilateral or bilateral
92228Remote imaging for monitoring and management of active retinal disease (eg, diabetic retinopathy) with physician review, interpretation and report, unilateral or bilateral
92540Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tracking test, with recording
92558Evoked otoacoustic emissions, screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis
92618Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (List separately in addition to code for primary procedure)
93005Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report
93981Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study
93982Noninvasive physiologic study of implanted wireless pressure sensor in aneurysmal sac following endovascular repair, complete study including recording, analysis of pressure and waveform tracings, interpretation and report
93990Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)
93998Unlisted noninvasive vascular diagnostic study
94011Measurement of spirometric forced expiratory flows in an infant or child through 2 years of age
94012Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age
94013Measurement of lung volumes (ie, functional residual capacity [FRC], forced vital capacity [FVC], and expiratory reserve volume [ERV]) in an infant or child through 2 years of age
94150Vital capacity, total (separate procedure)
94375Respiratory flow volume loop
94640Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (IPPB) device
94642Aerosol inhalation of pentamidine for pneumocystis carinii pneumonia treatment or prophylaxis
94664Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device
94667Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; initial demonstration and/or evaluation
94668Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent
94726Plethysmography for determination of lung volumes and, when performed, airway resistance
94727Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes
94728Airway resistance by impulse oscillometry
94729Diffusing capacity (eg, carbon monoxide, membrane) (List separately in addition to code for primary procedure)
94760Noninvasive ear or pulse oximetry for oxygen saturation; single determination
94761Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise)
94780Car seat/bed testing for airway integrity, neonate, with continual nursing observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; 60 minutes
94781Car seat/bed testing for airway integrity, neonate, with continual nursing observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; each additional full 30 minutes (List separately in addition to code for primary procedure)
95004Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests
95024Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests
95027Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report, specify number of tests
95028Intracutaneous (intradermal) tests with allergenic extracts, delayed type reaction, including reading, specify number of tests
95044Patch or application test(s) (specify number of tests)
95052Photo patch test(s) (specify number of tests)
95056Photo tests
95070Inhalation bronchial challenge testing (not including necessary pulmonary function tests); with histamine, methacholine, or similar compounds
95115Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection
95117Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections
95885Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (List separately in addition to code for primary procedure)
95886Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (List separately in addition to code for primary procedure)
95887Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (List separately in addition to code for primary procedure)
95905Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes F-wave study when performed, with interpretation and report
95938Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs
95939Central motor evoked potential study (transcranial motor stimulation); in upper and lower limbs
96150Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; initial assessment
96151Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; re-assessment
96152Health and behavior intervention, each 15 minutes, face-to-face; individual
96153Health and behavior intervention, each 15 minutes, face-to-face; group (2 or more patients)
96154Health and behavior intervention, each 15 minutes, face-to-face; family (with the patient present)
96155Health and behavior intervention, each 15 minutes, face-to-face; family (without the patient present)
96360Intravenous infusion, hydration; initial, 31 minutes to 1 hour
96361Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary procedure)
96365Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
96366Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)
96367Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (List separately in addition to code for primary procedure)
96368Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (List separately in addition to code for primary procedure)
96369Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); initial, up to 1 hour, including pump set-up and establishment of subcutaneous infusion site(s)
96370Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)
96371Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); additional pump set-up with establishment of new subcutaneous infusion site(s) (List separately in addition to code for primary procedure)
96372Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
96374Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug
96375Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)
96376Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)
96379Unlisted therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injection or infusion
96401Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic
96402Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic
96405Chemotherapy administration; intralesional, up to and including 7 lesions
96406Chemotherapy administration; intralesional, more than 7 lesions
96409Chemotherapy administration; intravenous, push technique, single or initial substance/drug
96411Chemotherapy administration; intravenous, push technique, each additional substance/drug (List separately in addition to code for primary procedure)
96413Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
96415Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)
96416Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump
96417Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up to 1 hour (List separately in addition to code for primary procedure)
96446Chemotherapy administration into the peritoneal cavity via indwelling port or catheter
96521Refilling and maintenance of portable pump
96523Irrigation of implanted venous access device for drug delivery systems
96567Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day
97597Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; first 20 sq cm or less
97598Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)
97602Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion, larval therapy), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session
97605Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters
97606Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters
98960Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient
98961Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 2-4 patients
98962Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 5-8 patients
98966Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
98967Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion
98968Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion
98969Online assessment and management service provided by a qualified nonphysician health care professional to an established patient or guardian, not originating from a related assessment and management service provided within the previous 7 days, using the Internet or similar electronic communications network
99000Handling and/or conveyance of specimen for transfer from the office to a laboratory
99001Handling and/or conveyance of specimen for transfer from the patient in other than an office to a laboratory (distance may be indicated)
99173Screening test of visual acuity, quantitative, bilateral
99175Ipecac or similar administration for individual emesis and continued observation until stomach adequately emptied of poison
99201Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99202Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 20 minutes are spent face-to-face with the patient and/or family.
99203Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
99211Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these services.
99212Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99213Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99214Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99224Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: Problem focused interval history; Problem focused examination; Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is stable, recovering, or improving. Typically, 15 minutes are spent at the bedside and on the patient's hospital floor or unit.
99225Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Typically, 25 minutes are spent at the bedside and on the patient's hospital floor or unit.
99281Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor.
99282Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity.
99283Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity.
99304Initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of low severity. Typically, 25 minutes are spent at the bedside and on the patient's facility floor or unit.
99305Initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of moderate severity. Typically, 35 minutes are spent at the bedside and on the patient's facility floor or unit.
99307Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is stable, recovering, or improving. Typically, 10 minutes are spent at the bedside and on the patient's facility floor or unit.
99308Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Typically, 15 minutes are spent at the bedside and on the patient's facility floor or unit.
99315Nursing facility discharge day management; 30 minutes or less
99316Nursing facility discharge day management; more than 30 minutes
99334Domiciliary or rest home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self-limited or minor. Typically, 15 minutes are spent with the patient and/or family or caregiver.
99335Domiciliary or rest home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 25 minutes are spent with the patient and/or family or caregiver.
99341Home visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low severity. Typically, 20 minutes are spent face-to-face with the patient and/or family.
99342Home visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
99343Home visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99347Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99348Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99354Prolonged evaluation and management or psychotherapy service(s) (beyond the typical service time of the primary procedure) in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour (List separately in addition to code for office or other outpatient Evaluation and Management or psychotherapy service)
99355Prolonged evaluation and management or psychotherapy service(s) (beyond the typical service time of the primary procedure) in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (List separately in addition to code for prolonged service)
99381Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age younger than 1 year)
99382Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood (age 1 through 4 years)
99383Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (age 5 through 11 years)
99384Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age 12 through 17 years)
99385Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years
99386Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years
99387Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and older
99391Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infant (age younger than 1 year)
99392Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early childhood (age 1 through 4 years)
99393Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late childhood (age 5 through 11 years)
99394Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adolescent (age 12 through 17 years)
99395Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39 years
99396Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64 years
99397Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 years and older
99401Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes
99402Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes
99403Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes
99404Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes
99406Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes
99407Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes
99408Alcohol and/or substance (other than tobacco) abuse structured screening (eg, AUDIT, DAST), and brief intervention (SBI) services; 15 to 30 minutes
99409Alcohol and/or substance (other than tobacco) abuse structured screening (eg, AUDIT, DAST), and brief intervention (SBI) services; greater than 30 minutes
99411Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes
99412Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes
99453Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment
99454Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days
99457Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month
99460Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant
99461Initial care, per day, for evaluation and management of normal newborn infant seen in other than hospital or birthing center
99462Subsequent hospital care, per day, for evaluation and management of normal newborn
99463Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and discharged on the same date
99465Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output
99492Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outreach to and engagement in treatment of a patient directed by the treating physician or other qualified health care professional; initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan; review by the psychiatric consultant with modifications of the plan if recommended; entering patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatric consultant; and provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies.
99493Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking patient follow-up and progress using the registry, with appropriate documentation; participation in weekly caseload consultation with the psychiatric consultant; ongoing collaboration with and coordination of the patient's mental health care with the treating physician or other qualified health care professional and any other treating mental health providers; additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatric consultant; provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies; monitoring of patient outcomes using validated rating scales; and relapse prevention planning with patients as they achieve remission of symptoms and/or other treatment goals and are prepared for discharge from active treatment.
99494Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (List separately in addition to code for primary procedure)
99495Transitional Care Management Services with the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge Medical decision making of at least moderate complexity during the service period Face-to-face visit, within 14 calendar days of discharge
99496Transitional Care Management Services with the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge Medical decision making of high complexity during the service period Face-to-face visit, within 7 calendar days of discharge
99497Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surrogate
99498Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (List separately in addition to code for primary procedure)
99503Home visit for respiratory therapy care (eg, bronchodilator, oxygen therapy, respiratory assessment, apnea evaluation)
99504Home visit for mechanical ventilation care
99505Home visit for stoma care and maintenance including colostomy and cystostomy
99506Home visit for intramuscular injections
99507Home visit for care and maintenance of catheter(s) (eg, urinary, drainage, and enteral)
99509Home visit for assistance with activities of daily living and personal care
99510Home visit for individual, family, or marriage counseling
99511Home visit for fecal impaction management and enema administration
99512Home visit for hemodialysis
99601Home infusion/specialty drug administration, per visit (up to 2 hours);
99602Home infusion/specialty drug administration, per visit (up to 2 hours); each additional hour (List separately in addition to code for primary procedure)
G0008Administration of influenza virus vaccine
G0009Administration of pneumococcal vaccine
G0010Administration of hepatitis B vaccine
G0027Semen analysis; presence and/or motility of sperm excluding Huhner
G0068Professional services for the administration of anti-infective, pain management, chelation, pulmonary hypertension, and/or inotropic infusion drug(s) for each infusion drug administration calendar day in the individual's home, each 15 minutes
G0069Professional services for the administration of subcutaneous immunotherapy for each infusion drug administration calendar day in the individual's home, each 15 minutes
G0070Professional services for the administration of chemotherapy for each infusion drug administration calendar day in the individual's home, each 15 minutes
G0071Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only
G0076Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
G0077Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
G0078Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
G0079Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
G0080Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
G0081Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
G0082Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
G0083Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
G0084Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
G0085Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
G0086Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
G0087Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility)
G0101Cervical or vaginal cancer screening; pelvic and clinical breast examination
G0102Prostate cancer screening; digital rectal examination
G0103Prostate cancer screening; prostate specific antigen test (PSA)
G0108Diabetes outpatient self-management training services, individual, per 30 minutes
G0109Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes
G0123Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision
G0127Trimming of dystrophic nails, any number
G0143Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision
G0144Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision
G0145Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision
G0147Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision
G0148Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening
G0168Wound closure utilizing tissue adhesive(s) only
G0239Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, 2 or more individuals (includes monitoring)
G0245Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (LOPS) which must include: (1) the diagnosis of LOPS, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot, and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (4) patient education
G0246Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (LOPS) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot, and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education
G0247Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (LOPS) to include the local care of superficial wounds (i.e., superficial to muscle and fascia) and at least the following, if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails
G0248Demonstration, prior to initiation of home INR monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the INR monitor, obtaining at least one blood sample, provision of instructions for reporting home INR test results, and documentation of patient's ability to perform testing and report results
G0250Physician review, interpretation, and patient management of home INR testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests
G0268Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing
G0270Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face-to-face with the patient, each 15 minutes
G0271Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes
G0296Counseling visit to discuss need for lung cancer screening using low dose CT scan (LDCT) (service is for eligibility determination and shared decision making)
G0297Low dose CT scan (LDCT) for lung cancer screening
G0306Complete CBC, automated (HgB, HCT, RBC, WBC, without platelet count) and automated WBC differential count
G0307Complete (CBC), automated (HgB, Hct, RBC, WBC; without platelet count)
G0328Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous determinations
G0402Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of Medicare enrollment
G0404Electrocardiogram, routine ECG with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination
G0420Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour
G0421Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour
G0422Intensive cardiac rehabilitation; with or without continuous ECG monitoring with exercise, per session
G0423Intensive cardiac rehabilitation; with or without continuous ECG monitoring; without exercise, per session
G0424Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to 2 sessions per day
G0432Infectious agent antibody detection by enzyme immunoassay (EIA) technique, HIV-1 and/or HIV-2, screening
G0433Infectious agent antibody detection by enzyme-linked immunosorbent assay (ELISA) technique, HIV-1 and/or HIV-2, screening
G0435Infectious agent antigen detection by rapid antibody test of oral mucosa transudate, HIV-1 or HIV-2, screening
G0438Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
G0442Annual alcohol misuse screening, 15 minutes
G0443Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes
G0444Annual depression screening, 15 minutes
G0445Semiannual high intensity behavioral counseling to prevent STIs, individual, face-to-face, includes education skills training & guidance on how to change sexual behavior
G0446Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes
G0447Face-to-face behavioral counseling for obesity, 15 minutes
G0452Molecular pathology procedure; physician interpretation and report
G0472Hepatitis C antibody screening for individual at high risk and other covered indication(s)
G0473Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes
G0475Hiv antigen/antibody, combination assay, screening
G0476Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test
J0120Injection, tetracycline, up to 250 mg
J0129Injection, abatacept, 10 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)
J0130Injection abciximab, 10 mg
J0131Injection, acetaminophen, 10 mg
J0132Injection, acetylcysteine, 100 mg
J0133Injection, acyclovir, 5 mg
J0135Injection, adalimumab, 20 mg
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)
J0171Injection, Adrenalin, epinephrine, 0.1 mg
J0180Injection, agalsidase beta, 1 mg
J0190Injection, biperiden lactate, per 5 mg
J0200Injection, alatrofloxacin mesylate, 100 mg
J0202Injection, alemtuzumab, 1 mg
J0205Injection, alglucerase, per 10 units
J0207Injection, amifostine, 500 mg
J0210Injection, methyldopate HCl, up to 250 mg
J0215Injection, alefacept, 0.5 mg
J0220Injection, alglucosidase alfa, 10 mg, not otherwise specified
J0221Injection, alglucosidase alfa, (Lumizyme), 10 mg
J0256Injection, alpha 1-proteinase inhibitor (human), not otherwise specified, 10 mg
J0257Injection, alpha 1 proteinase inhibitor (human), (GLASSIA), 10 mg
J0270Injection, alprostadil, 1.25 mcg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)
J0275Alprostadil urethral suppository (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)
J0278Injection, amikacin sulfate, 100 mg
J0280Injection, aminophyllin, up to 250 mg
J0282Injection, amiodarone HCl, 30 mg
J0285Injection, amphotericin B, 50 mg
J0287Injection, amphotericin B lipid complex, 10 mg
J0288Injection, amphotericin B cholesteryl sulfate complex, 10 mg
J0289Injection, amphotericin B liposome, 10 mg
J0290Injection, ampicillin sodium, 500 mg
J0295Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm
J0300Injection, amobarbital, up to 125 mg
J0330Injection, succinylcholine chloride, up to 20 mg
J0348Injection, anidulafungin, 1 mg
J0350Injection, anistreplase, per 30 units
J0360Injection, hydralazine HCl, up to 20 mg
J0364Injection, apomorphine HCl, 1 mg
J0365Injection, aprotinin, 10,000 kiu
J0380Injection, metaraminol bitartrate, per 10 mg
J0390Injection, chloroquine HCl, up to 250 mg
J0395Injection, arbutamine HCl, 1 mg
J0400Injection, aripiprazole, intramuscular, 0.25 mg
J0456Injection, azithromycin, 500 mg
J0461Injection, atropine sulfate, 0.01 mg
J0470Injection, dimercaprol, per 100 mg
J0475Injection, baclofen, 10 mg
J0476Injection, baclofen, 50 mcg for intrathecal trial
J0480Injection, basiliximab, 20 mg
J0490Injection, belimumab, 10 mg
J0500Injection, dicyclomine HCl, up to 20 mg
J0515Injection, benztropine mesylate, per 1 mg
J0520Injection, bethanechol chloride, Myotonachol or Urecholine, up to 5 mg
J0558Injection, penicillin G benzathine and penicillin G procaine, 100,000 units
J0561Injection, penicillin G benzathine, 100,000 units
J0583Injection, bivalirudin, 1 mg
J0585Injection, onabotulinumtoxinA, 1 unit
J0586Injection, abobotulinumtoxinA, 5 units
J0587Injection, rimabotulinumtoxinB, 100 units
J0588Injection, incobotulinumtoxinA, 1 unit
J0592Injection, buprenorphine HCl, 0.1 mg
J0594Injection, busulfan, 1 mg
J0595Injection, butorphanol tartrate, 1 mg
J0596Injection, c1 esterase inhibitor (recombinant), ruconest, 10 units
J0597Injection, C-1 esterase inhibitor (human), Berinert, 10 units
J0598Injection, C-1 esterase inhibitor (human), Cinryze, 10 units
J0600Injection, edetate calcium disodium, up to 1,000 mg
J0610Injection, calcium gluconate, per 10 ml
J0620Injection, calcium glycerophosphate and calcium lactate, per 10 ml
J0630Injection, calcitonin salmon, up to 400 units
J0636Injection, calcitriol, 0.1 mcg
J0637Injection, caspofungin acetate, 5 mg
J0638Injection, canakinumab, 1 mg
J0640Injection, leucovorin calcium, per 50 mg
J0641Injection, levoleucovorin calcium, 0.5 mg
J0670Injection, mepivacaine HCl, per 10 ml
J0690Injection, cefazolin sodium, 500 mg
J0692Injection, cefepime HCl, 500 mg
J0694Injection, cefoxitin sodium, 1 g
J0695Injection, ceftolozane 50 mg and tazobactam 25 mg
J0696Injection, ceftriaxone sodium, per 250 mg
J0697Injection, sterile cefuroxime sodium, per 750 mg
J0698Injection, cefotaxime sodium, per g
J0702Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg
J0706Injection, caffeine citrate, 5 mg
J0710Injection, cephapirin sodium, up to 1 g
J0712Injection, ceftaroline fosamil, 10 mg
J0713Injection, ceftazidime, per 500 mg
J0714Injection, ceftazidime and avibactam, 0.5 g/0.125 g
J0715Injection, ceftizoxime sodium, per 500 mg
J0720Injection, chloramphenicol sodium succinate, up to 1 g
J0725Injection, chorionic gonadotropin, per 1,000 USP units
J0735Injection, clonidine HCl, 1 mg
J0740Injection, cidofovir, 375 mg
J0743Injection, cilastatin sodium; imipenem, per 250 mg
J0744Injection, ciprofloxacin for intravenous infusion, 200 mg
J0745Injection, codeine phosphate, per 30 mg
J0770Injection, colistimethate sodium, up to 150 mg
J0775Injection, collagenase, clostridium histolyticum, 0.01 mg
J0780Injection, prochlorperazine, up to 10 mg
J0795Injection, corticorelin ovine triflutate, 1 mcg
J0800Injection, corticotropin, up to 40 units
J0833Injection, cosyntropin, not otherwise specified, 0.25 mg
J0834Injection, cosyntropin, 0.25 mg
J0840Injection, crotalidae polyvalent immune fab (ovine), up to 1 g
J0850Injection, cytomegalovirus immune globulin intravenous (human), per vial
J0875Injection, dalbavancin, 5mg
J0878Injection, daptomycin, 1 mg
J0881Injection, darbepoetin alfa, 1 mcg (non-ESRD use)
J0882Injection, darbepoetin alfa, 1 mcg (for ESRD on dialysis)
J0885Injection, epoetin alfa, (for non-ESRD use), 1000 units
J0887Injection, epoetin beta, 1 microgram, (for ESRD on dialysis)
J0888Injection, epoetin beta, 1 microgram, (for non-ESRD use)
J0894Injection, decitabine, 1 mg
J0895Injection, deferoxamine mesylate, 500 mg
J0897Injection, denosumab, 1 mg
J0945Injection, brompheniramine maleate, per 10 mg
J1000Injection, depo-estradiol cypionate, up to 5 mg
J1020Injection, methylprednisolone acetate, 20 mg
J1030Injection, methylprednisolone acetate, 40 mg
J1040Injection, methylprednisolone acetate, 80 mg
J1050Injection, medroxyprogesterone acetate, 1 mg
J1071Injection, testosterone cypionate, 1 mg
J1094Injection, dexamethasone acetate, 1 mg
J1100Injection, dexamethasone sodium phosphate, 1 mg
J1110Injection, dihydroergotamine mesylate, per 1 mg
J1120Injection, acetazolamide sodium, up to 500 mg
J1160Injection, digoxin, up to 0.5 mg
J1162Injection, digoxin immune fab (ovine), per vial
J1165Injection, phenytoin sodium, per 50 mg
J1170Injection, hydromorphone, up to 4 mg
J1180Injection, dyphylline, up to 500 mg
J1190Injection, dexrazoxane HCl, per 250 mg
J1200Injection, diphenhydramine HCl, up to 50 mg
J1205Injection, chlorothiazide sodium, per 500 mg
J1212Injection, DMSO, dimethyl sulfoxide, 50%, 50 ml
J1230Injection, methadone HCl, up to 10 mg
J1240Injection, dimenhydrinate, up to 50 mg
J1245Injection, dipyridamole, per 10 mg
J1250Injection, Dobutamine HCl, per 250 mg
J1260Injection, dolasetron mesylate, 10 mg
J1265Injection, dopamine HCl, 40 mg
J1267Injection, doripenem, 10 mg
J1270Injection, doxercalciferol, 1 mcg
J1290Injection, ecallantide, 1 mg
J1300Injection, eculizumab, 10 mg
J1320Injection, amitriptyline HCl, up to 20 mg
J1324Injection, enfuvirtide, 1 mg
J1325Injection, epoprostenol, 0.5 mg
J1327Injection, eptifibatide, 5 mg
J1330Injection, ergonovine maleate, up to 0.2 mg
J1335Injection, ertapenem sodium, 500 mg
J1364Injection, erythromycin lactobionate, per 500 mg
J1380Injection, estradiol valerate, up to 10 mg
J1410Injection, estrogen conjugated, per 25 mg
J1428Injection, eteplirsen, 10 mg
J1430Injection, ethanolamine oleate, 100 mg
J1435Injection, estrone, per 1 mg
J1436Injection, etidronate disodium, per 300 mg
J1438Injection, etanercept, 25 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)
J1443Injection, ferric pyrophosphate citrate solution, 0.1 mg of iron
J1447Injection, tbo-filgrastim, 1 microgram
J1450Injection, fluconazole, 200 mg
J1451Injection, fomepizole, 15 mg
J1452Injection, fomivirsen sodium, intraocular, 1.65 mg
J1453Injection, fosaprepitant, 1 mg
J1455Injection, foscarnet sodium, per 1,000 mg
J1457Injection, gallium nitrate, 1 mg
J1458Injection, galsulfase, 1 mg
J1459Injection, immune globulin (Privigen), intravenous, nonlyophilized (e.g., liquid), 500 mg
J1460Injection, gamma globulin, intramuscular, 1 cc
J1557Injection, immune globulin, (Gammaplex), intravenous, nonlyophilized (e.g., liquid), 500 mg
J1559Injection, immune globulin (Hizentra), 100 mg
J1560Injection, gamma globulin, intramuscular, over 10 cc
J1561Injection, immune globulin, (Gamunex/Gamunex-C/Gammaked), nonlyophilized (e.g., liquid), 500 mg
J1562Injection, immune globulin (Vivaglobin), 100 mg
J1566Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg
J1568Injection, immune globulin, (Octagam), intravenous, nonlyophilized (e.g., liquid), 500 mg
J1569Injection, immune globulin, (Gammagard liquid), nonlyophilized, (e.g., liquid), 500 mg
J1570Injection, ganciclovir sodium, 500 mg
J1571Injection, hepatitis B immune globulin (Hepagam B), intramuscular, 0.5 ml
J1572Injection, immune globulin, (Flebogamma/Flebogamma Dif), intravenous, nonlyophilized (e.g., liquid), 500 mg
J1573Injection, hepatitis B immune globulin (Hepagam B), intravenous, 0.5 ml
J1575Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin
J1580Injection, garamycin, gentamicin, up to 80 mg
J1595Injection, glatiramer acetate, 20 mg
J1599Injection, immune globulin, intravenous, nonlyophilized (e.g., liquid), not otherwise specified, 500 mg
J1600Injection, gold sodium thiomalate, up to 50 mg
J1610Injection, glucagon HCl, per 1 mg
J1620Injection, gonadorelin HCl, per 100 mcg
J1626Injection, granisetron HCl, 100 mcg
J1627Injection, granisetron, extended-release, 0.1 mg
J1630Injection, haloperidol, up to 5 mg
J1631Injection, haloperidol decanoate, per 50 mg
J1640Injection, hemin, 1 mg
J1642Injection, heparin sodium, (heparin lock flush), per 10 units
J1644Injection, Heparin sodium, per 1000 units
J1645Injection, dalteparin sodium, per 2500 IU
J1650Injection, enoxaparin sodium, 10 mg
J1652Injection, fondaparinux sodium, 0.5 mg
J1655Injection, tinzaparin sodium, 1000 IU
J1670Injection, tetanus immune globulin, human, up to 250 units
J1675Injection, histrelin acetate, 10 mcg
J1700Injection, hydrocortisone acetate, up to 25 mg
J1710Injection, hydrocortisone sodium phosphate, up to 50 mg
J1720Injection, hydrocortisone sodium succinate, up to 100 mg
J1725Injection, hydroxyprogesterone caproate, 1 mg
J1726Injection, hydroxyprogesterone caproate, (makena), 10 mg
J1729Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg
J1730Injection, diazoxide, up to 300 mg
J1740Injection, ibandronate sodium, 1 mg
J1741Injection, ibuprofen, 100 mg
J1742Injection, ibutilide fumarate, 1 mg
J1743Injection, idursulfase, 1 mg
J1745Injection, infliximab, excludes biosimilar, 10 mg
J1750Injection, iron dextran, 50 mg
J1756Injection, iron sucrose, 1 mg
J1786Injection, imiglucerase, 10 units
J1790Injection, droperidol, up to 5 mg
J1800Injection, propranolol HCl, up to 1 mg
J1810Injection, droperidol and fentanyl citrate, up to 2 ml ampule
J1815Injection, insulin, per 5 units
J1826Injection, interferon beta-1a, 30 mcg
J1830Injection interferon beta-1b, 0.25 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)
J1833Injection, isavuconazonium, 1 mg
J1835Injection, itraconazole, 50 mg
J1840Injection, kanamycin sulfate, up to 500 mg
J1850Injection, kanamycin sulfate, up to 75 mg
J1885Injection, ketorolac tromethamine, per 15 mg
J1890Injection, cephalothin sodium, up to 1 g
J1930Injection, lanreotide, 1 mg
J1931Injection, laronidase, 0.1 mg
J1940Injection, furosemide, up to 20 mg
J1945Injection, lepirudin, 50 mg
J1950Injection, leuprolide acetate (for depot suspension), per 3.75 mg
J1953Injection, levetiracetam, 10 mg
J1955Injection, levocarnitine, per 1 g
J1956Injection, levofloxacin, 250 mg
J1960Injection, levorphanol tartrate, up to 2 mg
J1980Injection, hyoscyamine sulfate, up to 0.25 mg
J1990Injection, chlordiazepoxide HCl, up to 100 mg
J2001Injection, lidocaine HCl for intravenous infusion, 10 mg
J2010Injection, lincomycin HCl, up to 300 mg
J2020Injection, linezolid, 200 mg
J2060Injection, lorazepam, 2 mg
J2150Injection, mannitol, 25% in 50 ml
J2170Injection, mecasermin, 1 mg
J2175Injection, meperidine HCl, per 100 mg
J2180Injection, meperidine and promethazine HCl, up to 50 mg
J2185Injection, meropenem, 100 mg
J2210Injection, methylergonovine maleate, up to 0.2 mg
J2248Injection, micafungin sodium, 1 mg
J2250Injection, midazolam HCl, per 1 mg
J2260Injection, milrinone lactate, 5 mg
J2265Injection, minocycline HCl, 1 mg
J2270Injection, morphine sulfate, up to 10 mg
J2274Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg
J2278Injection, ziconotide, 1 mcg
J2280Injection, moxifloxacin, 100 mg
J2300Injection, nalbuphine HCl, per 10 mg
J2310Injection, naloxone HCl, per 1 mg
J2315Injection, naltrexone, depot form, 1 mg
J2320Injection, nandrolone decanoate, up to 50 mg
J2323Injection, natalizumab, 1 mg
J2325Injection, nesiritide, 0.1 mg
J2326Injection, nusinersen, 0.1 mg
J2350Injection, ocrelizumab, 1 mg
J2353Injection, octreotide, depot form for intramuscular injection, 1 mg
J2354Injection, octreotide, nondepot form for subcutaneous or intravenous injection, 25 mcg
J2355Injection, oprelvekin, 5 mg
J2357Injection, omalizumab, 5 mg
J2358Injection, olanzapine, long-acting, 1 mg
J2360Injection, orphenadrine citrate, up to 60 mg
J2370Injection, phenylephrine HCl, up to 1 ml
J2400Injection, chloroprocaine HCl, per 30 ml
J2405Injection, ondansetron HCl, per 1 mg
J2407Injection, oritavancin, 10 mg
J2410Injection, oxymorphone HCl, up to 1 mg
J2425Injection, palifermin, 50 mcg
J2426Injection, paliperidone palmitate extended release, 1 mg
J2430Injection, pamidronate disodium, per 30 mg
J2440Injection, papaverine HCl, up to 60 mg
J2460Injection, oxytetracycline HCl, up to 50 mg
J2469Injection, palonosetron HCl, 25 mcg
J2501Injection, paricalcitol, 1 mcg
J2502Injection, pasireotide long acting, 1 mg
J2503Injection, pegaptanib sodium, 0.3 mg
J2504Injection, pegademase bovine, 25 IU
J2505Injection, pegfilgrastim, 6 mg
J2507Injection, pegloticase, 1 mg
J2510Injection, penicillin G procaine, aqueous, up to 600,000 units
J2513Injection, pentastarch, 10% solution, 100 ml
J2515Injection, pentobarbital sodium, per 50 mg
J2540Injection, penicillin G potassium, up to 600,000 units
J2543Injection, piperacillin sodium/tazobactam sodium, 1 g/0.125 g (1.125 g)
J2545Pentamidine isethionate, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose form, per 300 mg
J2547Injection, peramivir, 1 mg
J2550Injection, promethazine HCl, up to 50 mg
J2560Injection, phenobarbital sodium, up to 120 mg
J2562Injection, plerixafor, 1 mg
J2590Injection, oxytocin, up to 10 units
J2597Injection, desmopressin acetate, per 1 mcg
J2650Injection, prednisolone acetate, up to 1 ml
J2670Injection, tolazoline HCl, up to 25 mg
J2675Injection, progesterone, per 50 mg
J2680Injection, fluphenazine decanoate, up to 25 mg
J2690Injection, procainamide HCl, up to 1 g
J2700Injection, oxacillin sodium, up to 250 mg
J2710Injection, neostigmine methylsulfate, up to 0.5 mg
J2720Injection, protamine sulfate, per 10 mg
J2724Injection, protein C concentrate, intravenous, human, 10 IU
J2725Injection, protirelin, per 250 mcg
J2730Injection, pralidoxime chloride, up to 1 g
J2760Injection, phentolamine mesylate, up to 5 mg
J2765Injection, metoclopramide HCl, up to 10 mg
J2770Injection, quinupristin/dalfopristin, 500 mg (150/350)
J2778Injection, ranibizumab, 0.1 mg
J2780Injection, ranitidine HCl, 25 mg
J2783Injection, rasburicase, 0.5 mg
J2785Injection, regadenoson, 0.1 mg
J2788Injection, Rho D immune globulin, human, minidose, 50 mcg (250 i.u.)
J2790Injection, Rho D immune globulin, human, full dose, 300 mcg (1500 i.u.)
J2791Injection, Rho( D) immune globulin (human), (Rhophylac), intramuscular or intravenous, 100 IU
J2792Injection, Rho D immune globulin, intravenous, human, solvent detergent, 100 IU
J2793Injection, rilonacept, 1 mg
J2794Injection, risperidone, long acting, 0.5 mg
J2795Injection, ropivacaine HCl, 1 mg
J2796Injection, romiplostim, 10 mcg
J2797Injection, rolapitant, 0.5 mg
J2800Injection, methocarbamol, up to 10 ml
J2805Injection, sincalide, 5 mcg
J2810Injection, theophylline, per 40 mg
J2820Injection, sargramostim (GM-CSF), 50 mcg
J2850Injection, secretin, synthetic, human, 1 mcg
J2860Injection, siltuximab, 10 mg
J2910Injection, aurothioglucose, up to 50 mg
J2916Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg
J2920Injection, methylprednisolone sodium succinate, up to 40 mg
J2930Injection, methylprednisolone sodium succinate, up to 125 mg
J2940Injection, somatrem, 1 mg
J2941Injection, somatropin, 1 mg
J2950Injection, promazine HCl, up to 25 mg
J2993Injection, reteplase, 18.1 mg
J2995Injection, streptokinase, per 250,000 IU
J2997Injection, alteplase recombinant, 1 mg
J3000Injection, streptomycin, up to 1 g
J3010Injection, fentanyl citrate, 0.1 mg
J3030Injection, sumatriptan succinate, 6 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)
J3070Injection, pentazocine, 30 mg
J3090Injection, tedizolid phosphate, 1 mg
J3095Injection, telavancin, 10 mg
J3101Injection, tenecteplase, 1 mg
J3105Injection, terbutaline sulfate, up to 1 mg
J3110Injection, teriparatide, 10 mcg
J3121Injection, testosterone enanthate, 1 mg
J3145Injection, testosterone undecanoate, 1 mg
J3230Injection, chlorpromazine HCl, up to 50 mg
J3240Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial
J3243Injection, tigecycline, 1 mg
J3246Injection, tirofiban HCl, 0.25 mg
J3250Injection, trimethobenzamide HCl, up to 200 mg
J3260Injection, tobramycin sulfate, up to 80 mg
J3262Injection, tocilizumab, 1 mg
J3265Injection, torsemide, 10 mg/ml
J3280Injection, thiethylperazine maleate, up to 10 mg
J3285Injection, treprostinil, 1 mg
J3300Injection, triamcinolone acetonide, preservative free, 1 mg
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg
J3302Injection, triamcinolone diacetate, per 5 mg
J3303Injection, triamcinolone hexacetonide, per 5 mg
J3305Injection, trimetrexate glucuronate, per 25 mg
J3310Injection, perphenazine, up to 5 mg
J3315Injection, triptorelin pamoate, 3.75 mg
J3320Injection, spectinomycin dihydrochloride, up to 2 g
J3350Injection, urea, up to 40 g
J3355Injection, urofollitropin, 75 IU
J3357Ustekinumab, for subcutaneous injection, 1 mg
J3360Injection, diazepam, up to 5 mg
J3364Injection, urokinase, 5,000 IU vial
J3365Injection, IV, urokinase, 250,000 IU vial
J3370Injection, vancomycin HCl, 500 mg
J3380Injection, vedolizumab, 1 mg
J3385Injection, velaglucerase alfa, 100 units
J3396Injection, verteporfin, 0.1 mg
J3400Injection, triflupromazine HCl, up to 20 mg
J3410Injection, hydroxyzine HCl, up to 25 mg
J3411Injection, thiamine HCl, 100 mg
J3415Injection, pyridoxine HCl, 100 mg
J3420Injection, vitamin B-12 cyanocobalamin, up to 1,000 mcg
J3430Injection, phytonadione (vitamin K), per 1 mg
J3465Injection, voriconazole, 10 mg
J3470Injection, hyaluronidase, up to 150 units
J3471Injection, hyaluronidase, ovine, preservative free, per 1 USP unit (up to 999 USP units)
J3472Injection, hyaluronidase, ovine, preservative free, per 1,000 USP units
J3473Injection, hyaluronidase, recombinant, 1 USP unit
J3475Injection, magnesium sulfate, per 500 mg
J3480Injection, potassium chloride, per 2 mEq
J3485Injection, zidovudine, 10 mg
J3486Injection, ziprasidone mesylate, 10 mg
J3490Unclassified drugs
J3520Edetate disodium, per 150 mg
J3530Nasal vaccine inhalation
J3535Drug administered through a metered dose inhaler
J3570Laetrile, amygdalin, vitamin B-17
J3590Unclassified biologics
J7030Infusion, normal saline solution, 1,000 cc
J7040Infusion, normal saline solution, sterile (500 ml=1 unit)
J70425% dextrose/normal saline (500 ml = 1 unit)
J7050Infusion, normal saline solution, 250 cc
J70605% dextrose/water (500 ml = 1 unit)
J7070Infusion, D-5-W, 1,000 cc
J7100Infusion, dextran 40, 500 ml
J7110Infusion, dextran 75, 500 ml
J7120Ringers lactate infusion, up to 1,000 cc
J71215% dextrose in lactated ringers infusion, up to 1000 cc
J7131Hypertonic saline solution, 1 ml
J7180Injection, factor XIII (antihemophilic factor, human), 1 IU
J7181Injection, factor XIII A-subunit, (recombinant), per IU
J7182Injection, factor VIII, (antihemophilic factor, recombinant), (NovoEight), per IU
J7183Injection, von Willebrand factor complex (human), Wilate, 1 IU vWF:RCo
J7185Injection, factor VIII (antihemophilic factor, recombinant) (XYNTHA), per IU
J7186Injection, antihemophilic factor VIII/von Willebrand factor complex (human), per factor VIII i.u.
J7187Injection, von Willebrand factor complex (Humate-P), per IU VWF:RCO
J7188Injection, factor VIII (antihemophilic factor, recombinant), per IU
J7189Factor VIIa (antihemophilic factor, recombinant), per 1 mcg
J7190Factor VIII (antihemophilic factor, human) per IU
J7191Factor VIII (antihemophilic factor (porcine)), per IU
J7192Factor VIII (antihemophilic factor, recombinant) per IU, not otherwise specified
J7193Factor IX (antihemophilic factor, purified, nonrecombinant) per IU
J7194Factor IX complex, per IU
J7195Injection, factor IX (antihemophilic factor, recombinant) per IU, not otherwise specified
J7196Injection, antithrombin recombinant, 50 IU
J7197Antithrombin III (human), per IU
J7198Antiinhibitor, per IU
J7199Hemophilia clotting factor, not otherwise classified
J7200Injection, factor IX, (antihemophilic factor, recombinant), Rixubis, per IU
J7201Injection, factor ix, fc fusion protein, (recombinant), alprolix, 1 i.u.
J7205Injection, factor viii fc fusion protein (recombinant), per iu
J7210Injection, factor viii, (antihemophilic factor, recombinant), (afstyla), 1 i.u.
J7211Injection, factor viii, (antihemophilic factor, recombinant), (kovaltry), 1 i.u.
J7296Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg
J7297Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg
J7298Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg
J7300Intrauterine copper contraceptive
J7303Contraceptive supply, hormone containing vaginal ring, each
J7306Levonorgestrel (contraceptive) implant system, including implants and supplies
J7307Etonogestrel (contraceptive) implant system, including implant and supplies
J7309Methyl aminolevulinate (MAL) for topical administration, 16.8%, 1 g
J7310Ganciclovir, 4.5 mg, long-acting implant
J7313Injection, fluocinolone acetonide, intravitreal implant, 0.01 mg
J7325Hyaluronan or derivative, Synvisc or Synvisc-One, for intra-articular injection, 1 mg
J7326Hyaluronan or derivative, Gel-One, for intra-articular injection, per dose
J7340Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml
J7501Azathioprine, parenteral, 100 mg
J7503Tacrolimus, extended release, oral, 0.25 mg
J7504Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg
J7505Muromonab-CD3, parenteral, 5 mg
J7509Methylprednisolone, oral, per 4 mg
J7510Prednisolone, oral, per 5 mg
J7511Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg
J7512Prednisone, immediate release or delayed release, oral, 1 mg
J7513Daclizumab, parenteral, 25 mg
J7516Cyclosporine, parenteral, 250 mg
J7525Tacrolimus, parenteral, 5 mg
J7599Immunosuppressive drug, not otherwise classified
J8498Antiemetic drug, rectal/suppository, not otherwise specified
J8499Prescription drug, oral, nonchemotherapeutic, NOS
J8540Dexamethasone, oral, 0.25 mg
J8597Antiemetic drug, oral, not otherwise specified
J8655Netupitant 300 mg and palonosetron 0.5 mg, oral
J9000Injection, doxorubicin HCl, 10 mg
J9015Injection, aldesleukin, per single use vial
J9017Injection, arsenic trioxide, 1 mg
J9020Injection, asparaginase, not otherwise specified, 10,000 units
J9025Injection, azacitidine, 1 mg
J9027Injection, clofarabine, 1 mg
J9032Injection, belinostat, 10 mg
J9033Injection, bendamustine hcl (treanda), 1 mg
J9035Injection, bevacizumab, 10 mg
J9039Injection, blinatumomab, 1 microgram
J9040Injection, bleomycin sulfate, 15 units
J9041Injection, bortezomib (velcade), 0.1 mg
J9043Injection, cabazitaxel, 1 mg
J9045Injection, carboplatin, 50 mg
J9050Injection, carmustine, 100 mg
J9055Injection, cetuximab, 10 mg
J9060Injection, cisplatin, powder or solution, 10 mg
J9065Injection, cladribine, per 1 mg
J9070Cyclophosphamide, 100 mg
J9098Injection, cytarabine liposome, 10 mg
J9100Injection, cytarabine, 100 mg
J9120Injection, dactinomycin, 0.5 mg
J9130Dacarbazine, 100 mg
J9150Injection, daunorubicin, 10 mg
J9151Injection, daunorubicin citrate, liposomal formulation, 10 mg
J9153Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine
J9155Injection, degarelix, 1 mg
J9160Injection, denileukin diftitox, 300 mcg
J9165Injection, diethylstilbestrol diphosphate, 250 mg
J9171Injection, docetaxel, 1 mg
J9175Injection, Elliotts' B solution, 1 ml
J9178Injection, epirubicin HCl, 2 mg
J9179Injection, eribulin mesylate, 0.1 mg
J9181Injection, etoposide, 10 mg
J9185Injection, fludarabine phosphate, 50 mg
J9190Injection, fluorouracil, 500 mg
J9200Injection, floxuridine, 500 mg
J9201Injection, gemcitabine HCl, 200 mg
J9202Goserelin acetate implant, per 3.6 mg
J9206Injection, irinotecan, 20 mg
J9207Injection, ixabepilone, 1 mg
J9208Injection, ifosfamide, 1 g
J9209Injection, mesna, 200 mg
J9211Injection, idarubicin HCl, 5 mg
J9212Injection, interferon alfacon-1, recombinant, 1 mcg
J9213Injection, interferon, alfa-2a, recombinant, 3 million units
J9214Injection, interferon, alfa-2b, recombinant, 1 million units
J9215Injection, interferon, alfa-N3, (human leukocyte derived), 250,000 IU
J9216Injection, interferon, gamma 1-b, 3 million units
J9217Leuprolide acetate (for depot suspension), 7.5 mg
J9218Leuprolide acetate, per 1 mg
J9219Leuprolide acetate implant, 65 mg
J9225Histrelin implant (Vantas), 50 mg
J9226Histrelin implant (Supprelin LA), 50 mg
J9228Injection, ipilimumab, 1 mg
J9230Injection, mechlorethamine HCl, (nitrogen mustard), 10 mg
J9245Injection, melphalan HCl, 50 mg
J9250Methotrexate sodium, 5 mg
J9260Methotrexate sodium, 50 mg
J9261Injection, nelarabine, 50 mg
J9263Injection, oxaliplatin, 0.5 mg
J9264Injection, paclitaxel protein-bound particles, 1 mg
J9266Injection, pegaspargase, per single dose vial
J9267Injection, paclitaxel, 1 mg
J9268Injection, pentostatin, 10 mg
J9270Injection, plicamycin, 2.5 mg
J9271Injection, pembrolizumab, 1 mg
J9280Injection, mitomycin, 5 mg
J9293Injection, mitoxantrone HCl, per 5 mg
J9295Injection, necitumumab, 1 mg
J9299Injection, nivolumab, 1 mg
J9300Injection, gemtuzumab ozogamicin, 5 mg
J9301Injection, obinutuzumab, 10 mg
J9302Injection, ofatumumab, 10 mg
J9303Injection, panitumumab, 10 mg
J9305Injection, pemetrexed, 10 mg
J9307Injection, pralatrexate, 1 mg
J9308Injection, ramucirumab, 5 mg
J9310Injection, rituximab, 100 mg
J9311Injection, rituximab 10 mg and hyaluronidase
J9312Injection, rituximab, 10 mg
J9315Injection, romidepsin, 1 mg
J9320Injection, streptozocin, 1 g
J9328Injection, temozolomide, 1 mg
J9330Injection, temsirolimus, 1 mg
J9340Injection, thiotepa, 15 mg
J9351Injection, topotecan, 0.1 mg
J9355Injection, trastuzumab, 10 mg
J9357Injection, valrubicin, intravesical, 200 mg
J9360Injection, vinblastine sulfate, 1 mg
J9370Vincristine sulfate, 1 mg
J9390Injection, vinorelbine tartrate, 10 mg
J9395Injection, fulvestrant, 25 mg
J9600Injection, porfimer sodium, 75 mg
J9999Not otherwise classified, antineoplastic drugs
P2038Mucoprotein, blood (seromucoid) (medical necessity procedure)
P3000Screening Papanicolaou smear, cervical or vaginal, up to 3 smears, by technician under physician supervision
P9612Catheterization for collection of specimen, single patient, all places of service
P9615Catheterization for collection of specimen(s) (multiple patients)
Q0111Wet mounts, including preparations of vaginal, cervical or skin specimens
Q0112All potassium hydroxide (KOH) preparations
Q0113Pinworm examinations
Q0114Fern test
Q0115Postcoital direct, qualitative examinations of vaginal or cervical mucous
Q0138Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-ESRD use)
Q0139Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for ESRD on dialysis)
Q0162Ondansetron 1 mg, oral, FDA approved prescription antiemetic, for use as a complete therapeutic substitute for an IV antiemetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Q2026Injection, Radiesse, 0.1 ml
Q2035Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (AFLURIA)
Q2036Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (FLULAVAL)
Q2037Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (FLUVIRIN)
Q2038Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluzone)
Q2039Influenza virus vaccine, not otherwise specified
Q2043Sipuleucel-T, minimum of 50 million autologous cd54+ cells activated with PAP-GM-CSF, including leukapheresis and all other preparatory procedures, per infusion
Q3014Telehealth originating site facility fee
Q5010Hospice home care provided in a hospice facility
Q9968Injection, nonradioactive, noncontrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg
S0012Butorphanol tartrate, nasal spray, 25 mg
S0014Tacrine HCl, 10 mg
S0017Injection, aminocaproic acid, 5 g
S0020Injection, bupivicaine HCl, 30 ml
S0021Injection, cefoperazone sodium, 1 g
S0023Injection, cimetidine HCl, 300 mg
S0028Injection, famotidine, 20 mg
S0030Injection, metronidazole, 500 mg
S0032Injection, nafcillin sodium, 2 g
S0034Injection, ofloxacin, 400 mg
S0039Injection, sulfamethoxazole and trimethoprim, 10 ml
S0040Injection, ticarcillin disodium and clavulanate potassium, 3.1 g
S0073Injection, aztreonam, 500 mg
S0074Injection, cefotetan disodium, 500 mg
S0077Injection, clindamycin phosphate, 300 mg
S0078Injection, fosphenytoin sodium, 750 mg
S0080Injection, pentamidine isethionate, 300 mg
S0081Injection, piperacillin sodium, 500 mg
S0088Imatinib, 100 mg
S0090Sildenafil citrate, 25 mg
S0117Tretinoin, topical, 5 g
S0119Ondansetron, oral, 4 mg (for circumstances falling under the Medicare statute, use HCPCS Q code)
S0122Injection, menotropins, 75 IU
S0126Injection, follitropin alfa, 75 IU
S0128Injection, follitropin beta, 75 IU
S0132Injection, ganirelix acetate, 250 mcg
S0136Clozapine, 25 mg
S0137Didanosine (ddI), 25 mg
S0138Finasteride, 5 mg
S0139Minoxidil, 10 mg
S0140Saquinavir, 200 mg
S0145Injection, pegylated interferon alfa-2a, 180 mcg per ml
S0148Injection, pegylated interferon alfa-2B, 10 mcg
S0155Sterile dilutant for epoprostenol, 50 ml
S0156Exemestane, 25 mg
S0157Becaplermin gel 0.01%, 0.5 gm
S0160Dextroamphetamine sulfate, 5 mg
S0164Injection, pantoprazole sodium, 40 mg
S0166Injection, olanzapine, 2.5 mg
S0169Calcitrol, 0.25 mcg
S0171Injection, bumetanide, 0.5 mg
S0189Testosterone pellet, 75 mg
S0199Medically 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
S0280Medical home program, comprehensive care coordination and planning, initial plan
S0281Medical home program, comprehensive care coordination and planning, maintenance of plan
S3722Dose optimization by area under the curve (AUC) analysis, for infusional 5-fluorouracil
S4981Insertion of levonorgestrel-releasing intrauterine system
S4989Contraceptive intrauterine device (e.g., Progestacert IUD), including implants and supplies
S5550Insulin, rapid onset, 5 units
S5551Insulin, most rapid onset (Lispro or Aspart); 5 units
S5552Insulin, intermediate acting (NPH or LENTE); 5 units
S5553Insulin, long acting; 5 units
S8130Interferential current stimulator, 2 channel
S8131Interferential current stimulator, 4 channel
S9097Home visit for wound care
S9098Home visit, phototherapy services (e.g., Bili-lite), including equipment rental, nursing services, blood draw, supplies, and other services, per diem
S9126Hospice care, in the home, per diem
S9140Diabetic management program, follow-up visit to non-MD provider
S9452Nutrition classes, nonphysician provider, per session
S9460Diabetic management program, nurse visit
S9472Cardiac rehabilitation program, nonphysician provider, per diem
S9474Enterostomal therapy by a registered nurse certified in enterostomal therapy, per diem
S9529Routine venipuncture for collection of specimen(s), single homebound, nursing home, or skilled nursing facility patient

Group specific policy will supersede this policy when applicable. This policy does not apply to the Wal-Mart Associates Group Health Plan participants or to the Tyson Group Health Plan participants.
CPT Codes Copyright © 2019 American Medical Association.