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					CPT_CODE
10021
10022
10040
10060
10061
10080
10081
10120
10121
10140
10160
10180
11000
11001
11010
11011
11012
11040
11041
11042
11043
11044
11055
11056
11057
11100
11101
11200
11201
11300
11301
11302
11303
11305
11306
11307
11308
11310
11311
11312
11313
11400
11401
11402
11403
11404
11406
11420
11421
11422
11423
11424
11426
11440
11441
11442
11443
11444
11446
11450
11451
11462
11463
11470
11471
11600
11601
11602
11603
11604
11606
11620
11621
11622
11623
11624
11626
11640
11641
11642
11643
11644
11646
11719
11720
11721
11730
11732
11740
11750
11752
11755
11760
11762
11765
11770
11771
11772
11900
11901
11920
11921
11922
11950
11951
11952
11954
11960
11970
11971
11975
11976
11977
11980
11981
11982
11983
12001
12002
12004
12005
12006
12007
12011
12013
12014
12015
12016
12017
12018
12020
12021
12031
12032
12034
12035
12036
12037
12041
12042
12044
12045
12046
12047
12051
12052
12053
12054
12055
12056
12057
13100
13101
13102
13120
13121
13122
13131
13132
13133
13150
13151
13152
13153
13160
14000
14001
14020
14021
14040
14041
14060
14061
14300
14350
15000
15001
15050
15100
15101
15120
15121
15200
15201
15220
15221
15240
15241
15260
15261
15342
15343
15350
15351
15400
15401
15570
15572
15574
15576
15600
15610
15620
15630
15650
15732
15734
15736
15738
15740
15750
15756
15757
15758
15760
15770
15775
15776
15780
15781
15782
15783
15786
15787
15788
15789
15792
15793
15810
15811
15819
15820
15821
15822
15823
15824
15825
15826
15828
15829
15831
15832
15833
15834
15835
15836
15837
15838
15839
15840
15841
15842
15845
15850
15851
15852
15860
15876
15877
15878
15879
15920
15922
15931
15933
15934
15935
15936
15937
15940
15941
15944
15945
15946
15950
15951
15952
15953
15956
15958
15999
16000
16010
16015
16020
16025
16030
16035
16036
17000
17003
17004
17106
17107
17108
17110
17111
17250
17260
17261
17262
17263
17264
17266
17270
17271
17272
17273
17274
17276
17280
17281
17282
17283
17284
17286
17304
17305
17306
17307
17310
17340
17360
17380
17999
19000
19001
19020
19030
19100
19101
19102
19103
19110
19112
19120
19125
19126
19140
19160
19162
19180
19182
19200
19220
19240
19260
19271
19272
19290
19291
19295
19316
19318
19324
19325
19328
19330
19340
19342
19350
19355
19357
19361
19364
19366
19367
19368
19369
19370
19371
19380
19396
19499
20000
20005
20100
20101
20102
20103
20150
20200
20205
20206
20220
20225
20240
20245
20250
20251
20500
20501
20520
20525
20526
20550
20551
20552
20553
20600
20605
20610
20612
20615
20650
20660
20661
20662
20663
20664
20665
20670
20680
20690
20692
20693
20694
20802
20805
20808
20816
20822
20824
20827
20838
20900
20902
20910
20912
20920
20922
20924
20926
20930
20931
20936
20937
20938
20950
20955
20956
20957
20962
20969
20970
20972
20973
20974
20975
20979
20999
21010
21015
21025
21026
21029
21030
21031
21032
21034
21040
21044
21045
21046
21047
21048
21049
21050
21060
21070
21076
21077
21079
21080
21081
21082
21083
21084
21085
21086
21087
21088
21089
21100
21110
21116
21120
21121
21122
21123
21125
21127
21137
21138
21139
21141
21142
21143
21145
21146
21147
21150
21151
21154
21155
21159
21160
21172
21175
21179
21180
21181
21182
21183
21184
21188
21193
21194
21195
21196
21198
21199
21206
21208
21209
21210
21215
21230
21235
21240
21242
21243
21244
21245
21246
21247
21248
21249
21255
21256
21260
21261
21263
21267
21268
21270
21275
21280
21282
21295
21296
21299
21300
21310
21315
21320
21325
21330
21335
21336
21337
21338
21339
21340
21343
21344
21345
21346
21347
21348
21355
21356
21360
21365
21366
21385
21386
21387
21390
21395
21400
21401
21406
21407
21408
21421
21422
21423
21431
21432
21433
21435
21436
21440
21445
21450
21451
21452
21453
21454
21461
21462
21465
21470
21480
21485
21490
21493
21494
21495
21497
21499
21501
21502
21510
21550
21555
21556
21557
21600
21610
21615
21616
21620
21627
21630
21632
21700
21705
21720
21725
21740
21742
21743
21750
21800
21805
21810
21820
21825
21899
21920
21925
21930
21935
22100
22101
22102
22103
22110
22112
22114
22116
22210
22212
22214
22216
22220
22222
22224
22226
22305
22310
22315
22318
22319
22325
22326
22327
22328
22505
22520
22521
22522
22548
22554
22556
22558
22585
22590
22595
22600
22610
22612
22614
22630
22632
22800
22802
22804
22808
22810
22812
22818
22819
22830
22840
22841
22842
22843
22844
22845
22846
22847
22848
22849
22850
22851
22852
22855
22899
22900
22999
23000
23020
23030
23031
23035
23040
23044
23065
23066
23075
23076
23077
23100
23101
23105
23106
23107
23120
23125
23130
23140
23145
23146
23150
23155
23156
23170
23172
23174
23180
23182
23184
23190
23195
23200
23210
23220
23221
23222
23330
23331
23332
23350
23395
23397
23400
23405
23406
23410
23412
23415
23420
23430
23440
23450
23455
23460
23462
23465
23466
23470
23472
23480
23485
23490
23491
23500
23505
23515
23520
23525
23530
23532
23540
23545
23550
23552
23570
23575
23585
23600
23605
23615
23616
23620
23625
23630
23650
23655
23660
23665
23670
23675
23680
23700
23800
23802
23900
23920
23921
23929
23930
23931
23935
24000
24006
24065
24066
24075
24076
24077
24100
24101
24102
24105
24110
24115
24116
24120
24125
24126
24130
24134
24136
24138
24140
24145
24147
24149
24150
24151
24152
24153
24155
24160
24164
24200
24201
24220
24300
24301
24305
24310
24320
24330
24331
24332
24340
24341
24342
24343
24344
24345
24346
24350
24351
24352
24354
24356
24360
24361
24362
24363
24365
24366
24400
24410
24420
24430
24435
24470
24495
24498
24500
24505
24515
24516
24530
24535
24538
24545
24546
24560
24565
24566
24575
24576
24577
24579
24582
24586
24587
24600
24605
24615
24620
24635
24640
24650
24655
24665
24666
24670
24675
24685
24800
24802
24900
24920
24925
24930
24931
24935
24940
24999
25000
25001
25020
25023
25024
25025
25028
25031
25035
25040
25065
25066
25075
25076
25077
25085
25100
25101
25105
25107
25110
25111
25112
25115
25116
25118
25119
25120
25125
25126
25130
25135
25136
25145
25150
25151
25170
25210
25215
25230
25240
25246
25248
25250
25251
25259
25260
25263
25265
25270
25272
25274
25275
25280
25290
25295
25300
25301
25310
25312
25315
25316
25320
25332
25335
25337
25350
25355
25360
25365
25370
25375
25390
25391
25392
25393
25394
25400
25405
25415
25420
25425
25426
25430
25431
25440
25441
25442
25443
25444
25445
25446
25447
25449
25450
25455
25490
25491
25492
25500
25505
25515
25520
25525
25526
25530
25535
25545
25560
25565
25574
25575
25600
25605
25611
25620
25622
25624
25628
25630
25635
25645
25650
25651
25652
25660
25670
25671
25675
25676
25680
25685
25690
25695
25800
25805
25810
25820
25825
25830
25900
25905
25907
25909
25915
25920
25922
25924
25927
25929
25931
25999
26010
26011
26020
26025
26030
26034
26035
26037
26040
26045
26055
26060
26070
26075
26080
26100
26105
26110
26115
26116
26117
26121
26123
26125
26130
26135
26140
26145
26160
26170
26180
26185
26200
26205
26210
26215
26230
26235
26236
26250
26255
26260
26261
26262
26320
26340
26350
26352
26356
26357
26358
26370
26372
26373
26390
26392
26410
26412
26415
26416
26418
26420
26426
26428
26432
26433
26434
26437
26440
26442
26445
26449
26450
26455
26460
26471
26474
26476
26477
26478
26479
26480
26483
26485
26489
26490
26492
26494
26496
26497
26498
26499
26500
26502
26504
26508
26510
26516
26517
26518
26520
26525
26530
26531
26535
26536
26540
26541
26542
26545
26546
26548
26550
26551
26553
26554
26555
26556
26560
26561
26562
26565
26567
26568
26580
26587
26590
26591
26593
26596
26600
26605
26607
26608
26615
26641
26645
26650
26665
26670
26675
26676
26685
26686
26700
26705
26706
26715
26720
26725
26727
26735
26740
26742
26746
26750
26755
26756
26765
26770
26775
26776
26785
26820
26841
26842
26843
26844
26850
26852
26860
26861
26862
26863
26910
26951
26952
26989
26990
26991
26992
27000
27001
27003
27005
27006
27025
27030
27033
27035
27036
27040
27041
27047
27048
27049
27050
27052
27054
27060
27062
27065
27066
27067
27070
27071
27075
27076
27077
27078
27079
27080
27086
27087
27090
27091
27093
27095
27096
27097
27098
27100
27105
27110
27111
27120
27122
27125
27130
27132
27134
27137
27138
27140
27146
27147
27151
27156
27158
27161
27165
27170
27175
27176
27177
27178
27179
27181
27185
27187
27193
27194
27200
27202
27215
27216
27217
27218
27220
27222
27226
27227
27228
27230
27232
27235
27236
27238
27240
27244
27245
27246
27248
27250
27252
27253
27254
27256
27257
27258
27259
27265
27266
27275
27280
27282
27284
27286
27290
27295
27299
27301
27303
27305
27306
27307
27310
27315
27320
27323
27324
27327
27328
27329
27330
27331
27332
27333
27334
27335
27340
27345
27347
27350
27355
27356
27357
27358
27360
27365
27370
27372
27380
27381
27385
27386
27390
27391
27392
27393
27394
27395
27396
27397
27400
27403
27405
27407
27409
27418
27420
27422
27424
27425
27427
27428
27429
27430
27435
27437
27438
27440
27441
27442
27443
27445
27446
27447
27448
27450
27454
27455
27457
27465
27466
27468
27470
27472
27475
27477
27479
27485
27486
27487
27488
27495
27496
27497
27498
27499
27500
27501
27502
27503
27506
27507
27508
27509
27510
27511
27513
27514
27516
27517
27519
27520
27524
27530
27532
27535
27536
27538
27540
27550
27552
27556
27557
27558
27560
27562
27566
27570
27580
27590
27591
27592
27594
27596
27598
27599
27600
27601
27602
27603
27604
27605
27606
27607
27610
27612
27613
27614
27615
27618
27619
27620
27625
27626
27630
27635
27637
27638
27640
27641
27645
27646
27647
27648
27650
27652
27654
27656
27658
27659
27664
27665
27675
27676
27680
27681
27685
27686
27687
27690
27691
27692
27695
27696
27698
27700
27702
27703
27704
27705
27707
27709
27712
27715
27720
27722
27724
27725
27727
27730
27732
27734
27740
27742
27745
27750
27752
27756
27758
27759
27760
27762
27766
27780
27781
27784
27786
27788
27792
27808
27810
27814
27816
27818
27822
27823
27824
27825
27826
27827
27828
27829
27830
27831
27832
27840
27842
27846
27848
27860
27870
27871
27880
27881
27882
27884
27886
27888
27889
27892
27893
27894
27899
28001
28002
28003
28005
28008
28010
28011
28020
28022
28024
28030
28035
28043
28045
28046
28050
28052
28054
28060
28062
28070
28072
28080
28086
28088
28090
28092
28100
28102
28103
28104
28106
28107
28108
28110
28111
28112
28113
28114
28116
28118
28119
28120
28122
28124
28126
28130
28140
28150
28153
28160
28171
28173
28175
28190
28192
28193
28200
28202
28208
28210
28220
28222
28225
28226
28230
28232
28234
28238
28240
28250
28260
28261
28262
28264
28270
28272
28280
28285
28286
28288
28289
28290
28292
28293
28294
28296
28297
28298
28299
28300
28302
28304
28305
28306
28307
28308
28309
28310
28312
28313
28315
28320
28322
28340
28341
28344
28345
28360
28400
28405
28406
28415
28420
28430
28435
28436
28445
28450
28455
28456
28465
28470
28475
28476
28485
28490
28495
28496
28505
28510
28515
28525
28530
28531
28540
28545
28546
28555
28570
28575
28576
28585
28600
28605
28606
28615
28630
28635
28636
28645
28660
28665
28666
28675
28705
28715
28725
28730
28735
28737
28740
28750
28755
28760
28800
28805
28810
28820
28825
28899
29000
29010
29015
29020
29025
29035
29040
29044
29046
29049
29055
29058
29065
29075
29085
29086
29105
29125
29126
29130
29131
29200
29220
29240
29260
29280
29305
29325
29345
29355
29358
29365
29405
29425
29435
29440
29445
29450
29505
29515
29520
29530
29540
29550
29580
29590
29700
29705
29710
29715
29720
29730
29740
29750
29799
29800
29804
29805
29806
29807
29819
29820
29821
29822
29823
29824
29825
29826
29827
29830
29834
29835
29836
29837
29838
29840
29843
29844
29845
29846
29847
29848
29850
29851
29855
29856
29860
29861
29862
29863
29870
29871
29873
29874
29875
29876
29877
29879
29880
29881
29882
29883
29884
29885
29886
29887
29888
29889
29891
29892
29893
29894
29895
29897
29898
29899
29900
29901
29902
29999
30000
30020
30100
30110
30115
30117
30118
30120
30124
30125
30130
30140
30150
30160
30200
30210
30220
30300
30310
30320
30400
30410
30420
30430
30435
30450
30460
30462
30465
30520
30540
30545
30560
30580
30600
30620
30630
30801
30802
30901
30903
30905
30906
30915
30920
30930
30999
31000
31002
31020
31030
31032
31040
31050
31051
31070
31075
31080
31081
31084
31085
31086
31087
31090
31200
31201
31205
31225
31230
31231
31233
31235
31237
31238
31239
31240
31254
31255
31256
31267
31276
31287
31288
31290
31291
31292
31293
31294
31299
31300
31320
31360
31365
31367
31368
31370
31375
31380
31382
31390
31395
31400
31420
31500
31502
31505
31510
31511
31512
31513
31515
31520
31525
31526
31527
31528
31529
31530
31531
31535
31536
31540
31541
31560
31561
31570
31571
31575
31576
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L6370
L6380
L6382
L6384
L6386
L6388
L6400
L6450
L6500
L6550
L6570
L6580
L6582
L6584
L6586
L6588
L6590
L6600
L6605
L6610
L6615
L6616
L6620
L6623
L6625
L6628
L6629
L6630
L6632
L6635
L6637
L6638
L6640
L6641
L6642
L6645
L6646
L6647
L6648
L6650
L6655
L6660
L6665
L6670
L6672
L6675
L6676
L6680
L6682
L6684
L6686
L6687
L6688
L6689
L6690
L6691
L6692
L6693
L6700
L6705
L6710
L6715
L6720
L6725
L6730
L6735
L6740
L6745
L6750
L6755
L6765
L6770
L6775
L6780
L6790
L6795
L6800
L6805
L6806
L6807
L6808
L6809
L6810
L6825
L6830
L6835
L6840
L6845
L6850
L6855
L6860
L6865
L6867
L6868
L6870
L6872
L6873
L6875
L6880
L6881
L6882
L6890
L6895
L6900
L6905
L6910
L6915
L6920
L6925
L6930
L6935
L6940
L6945
L6950
L6955
L6960
L6965
L6970
L6975
L7010
L7015
L7020
L7025
L7030
L7035
L7040
L7045
L7170
L7180
L7185
L7186
L7190
L7191
L7260
L7261
L7266
L7272
L7274
L7360
L7362
L7364
L7366
L7367
L7368
L7499
L7500
L7510
L7520
L7900
L8000
L8001
L8002
L8010
L8015
L8020
L8030
L8035
L8039
L8040
L8041
L8042
L8043
L8044
L8045
L8046
L8047
L8048
L8049
L8100
L8110
L8120
L8130
L8140
L8150
L8160
L8170
L8180
L8190
L8195
L8200
L8210
L8220
L8230
L8239
L8300
L8310
L8320
L8330
L8400
L8410
L8415
L8417
L8420
L8430
L8435
L8440
L8460
L8465
L8470
L8480
L8485
L8490
L8499
L8500
L8501
L8505
L8507
L8509
L8510
L8600
L8603
L8606
L8610
L8612
L8613
L8614
L8619
L8630
L8641
L8642
L8658
L8670
L8699
L9900
M0064
M0075
M0076
M0100
M0300
M0301
P2028
P2029
P2031
P2033
P2038
P3000
P3001
P7001
P9010
P9011
P9012
P9016
P9017
P9019
P9020
P9021
P9022
P9023
P9031
P9032
P9033
P9034
P9035
P9036
P9037
P9038
P9039
P9040
P9041
P9043
P9044
P9045
P9046
P9047
P9048
P9050
P9603
P9604
P9612
P9615
Q0035
Q0081
Q0083
Q0084
Q0085
Q0086
Q0091
Q0092
Q0111
Q0112
Q0113
Q0114
Q0115
Q0136
Q0144
Q0163
Q0164
Q0165
Q0166
Q0167
Q0168
Q0169
Q0170
Q0171
Q0172
Q0173
Q0174
Q0175
Q0176
Q0177
Q0178
Q0179
Q0180
Q0181
Q0183
Q0184
Q0187
Q1001
Q1002
Q1003
Q1004
Q1005
Q2001
Q2002
Q2003
Q2004
Q2005
Q2006
Q2007
Q2008
Q2009
Q2010
Q2011
Q2012
Q2013
Q2014
Q2017
Q2018
Q2019
Q2020
Q2021
Q2022
Q3000
Q3001
Q3002
Q3003
Q3004
Q3005
Q3006
Q3007
Q3008
Q3009
Q3010
Q3011
Q3012
Q3014
Q3019
Q3020
Q3021
Q3022
Q3023
Q3025
Q3026
Q4001
Q4002
Q4003
Q4004
Q4005
Q4006
Q4007
Q4008
Q4009
Q4010
Q4011
Q4012
Q4013
Q4014
Q4015
Q4016
Q4017
Q4018
Q4019
Q4020
Q4021
Q4022
Q4023
Q4024
Q4025
Q4026
Q4027
Q4028
Q4029
Q4030
Q4031
Q4032
Q4033
Q4034
Q4035
Q4036
Q4037
Q4038
Q4039
Q4040
Q4041
Q4042
Q4043
Q4044
Q4045
Q4046
Q4047
Q4048
Q4049
Q4050
Q4051
Q9920
Q9921
Q9922
Q9923
Q9924
Q9925
Q9926
Q9927
Q9928
Q9929
Q9930
Q9931
Q9932
Q9933
Q9934
Q9935
Q9936
Q9937
Q9938
Q9939
Q9940
R0070
R0075
R0076
S0009
S0012
S0014
S0016
S0017
S0020
S0021
S0023
S0028
S0030
S0032
S0034
S0039
S0040
S0071
S0072
S0073
S0074
S0077
S0078
S0079
S0080
S0081
S0088
S0090
S0091
S0092
S0093
S0104
S0106
S0108
S0114
S0122
S0124
S0126
S0128
S0130
S0132
S0135
S0155
S0156
S0157
S0170
S0171
S0172
S0173
S0174
S0175
S0176
S0177
S0178
S0179
S0181
S0182
S0183
S0187
S0189
S0190
S0191
S0195
S0199
S0201
S0207
S0208
S0209
S0215
S0220
S0221
S0250
S0255
S0260
S0302
S0310
S0315
S0316
S0320
S0340
S0341
S0342
S0390
S0395
S0400
S0500
S0504
S0506
S0508
S0510
S0512
S0514
S0516
S0518
S0580
S0581
S0590
S0592
S0601
S0605
S0610
S0612
S0620
S0621
S0622
S0630
S0800
S0810
S0812
S0820
S0830
S1001
S1002
S1015
S1016
S1025
S1030
S1031
S1040
S2053
S2054
S2055
S2060
S2061
S2065
S2080
S2102
S2103
S2107
S2112
S2115
S2120
S2130
S2140
S2142
S2150
S2202
S2205
S2206
S2207
S2208
S2209
S2211
S2250
S2260
S2262
S2265
S2266
S2267
S2300
S2340
S2341
S2342
S2350
S2351
S2360
S2361
S2370
S2371
S2400
S2401
S2402
S2403
S2404
S2405
S2409
S2411
S3600
S3601
S3620
S3630
S3645
S3650
S3652
S3655
S3701
S3708
S3818
S3819
S3830
S3831
S3835
S3837
S3900
S3902
S3904
S4005
S4011
S4013
S4014
S4015
S4016
S4017
S4018
S4020
S4021
S4022
S4023
S4025
S4026
S4027
S4028
S4030
S4031
S4035
S4036
S4037
S4040
S4981
S4989
S4990
S4991
S4993
S4995
S5000
S5001
S5010
S5011
S5012
S5013
S5014
S5035
S5036
S5100
S5101
S5102
S5105
S5110
S5111
S5115
S5116
S5120
S5121
S5125
S5126
S5130
S5131
S5135
S5136
S5140
S5141
S5145
S5146
S5150
S5151
S5160
S5161
S5162
S5165
S5170
S5175
S5180
S5181
S5185
S5190
S5199
S5497
S5498
S5501
S5502
S5517
S5518
S5520
S5521
S5522
S5523
S8004
S8030
S8035
S8037
S8040
S8042
S8049
S8055
S8080
S8085
S8092
S8095
S8096
S8097
S8100
S8101
S8110
S8180
S8181
S8182
S8183
S8185
S8186
S8189
S8190
S8210
S8260
S8262
S8265
S8415
S8420
S8421
S8422
S8423
S8424
S8425
S8426
S8427
S8428
S8429
S8430
S8431
S8450
S8451
S8452
S8490
S8945
S8950
S8999
S9001
S9007
S9015
S9022
S9024
S9025
S9034
S9055
S9056
S9061
S9075
S9083
S9088
S9090
S9092
S9098
S9109
S9117
S9122
S9123
S9124
S9125
S9126
S9127
S9128
S9129
S9131
S9140
S9141
S9145
S9150
S9208
S9209
S9211
S9212
S9213
S9214
S9325
S9326
S9327
S9328
S9329
S9330
S9331
S9336
S9338
S9339
S9340
S9341
S9342
S9343
S9345
S9346
S9347
S9348
S9349
S9351
S9353
S9355
S9357
S9359
S9361
S9363
S9364
S9365
S9366
S9367
S9368
S9370
S9372
S9373
S9374
S9375
S9376
S9377
S9379
S9381
S9401
S9430
S9435
S9436
S9437
S9438
S9439
S9441
S9442
S9443
S9444
S9445
S9446
S9447
S9449
S9451
S9452
S9453
S9454
S9455
S9460
S9465
S9470
S9472
S9473
S9474
S9475
S9480
S9484
S9485
S9490
S9494
S9497
S9500
S9501
S9502
S9503
S9504
S9524
S9529
S9537
S9538
S9542
S9546
S9558
S9559
S9560
S9562
S9590
S9802
S9803
S9806
S9810
S9900
S9970
S9975
S9981
S9982
S9986
S9989
S9990
S9991
S9992
S9994
S9996
S9999
T1000
T1001
T1002
T1003
T1004
T1005
T1006
T1007
T1008
T1009
T1010
T1011
T1012
T1013
T1014
T1015
T1016
T1017
T1018
T1019
T1020
T1021
T1022
T1023
T1024
T1025
T1026
T1027
T1028
T1029
T1030
T1031
T1500
T1502
T1999
T2001
T2002
T2003
T2004
T2005
T2006
T2007
V2020
V2025
V2100
V2101
V2102
V2103
V2104
V2105
V2106
V2107
V2108
V2109
V2110
V2111
V2112
V2113
V2114
V2115
V2116
V2117
V2118
V2199
V2200
V2201
V2202
V2203
V2204
V2205
V2206
V2207
V2208
V2209
V2210
V2211
V2212
V2213
V2214
V2215
V2216
V2217
V2218
V2219
V2220
V2299
V2300
V2301
V2302
V2303
V2304
V2305
V2306
V2307
V2308
V2309
V2310
V2311
V2312
V2313
V2314
V2315
V2316
V2317
V2318
V2319
V2320
V2399
V2410
V2430
V2499
V2500
V2501
V2502
V2503
V2510
V2511
V2512
V2513
V2520
V2521
V2522
V2523
V2530
V2531
V2599
V2600
V2610
V2615
V2623
V2624
V2625
V2626
V2627
V2628
V2629
V2630
V2631
V2632
V2700
V2710
V2715
V2718
V2730
V2740
V2741
V2742
V2743
V2744
V2750
V2755
V2760
V2770
V2780
V2781
V2785
V2790
V2799
V5008
V5010
V5011
V5014
V5020
V5030
V5040
V5050
V5060
V5070
V5080
V5090
V5095
V5100
V5110
V5120
V5130
V5140
V5150
V5160
V5170
V5180
V5190
V5200
V5210
V5220
V5230
V5240
V5241
V5242
V5243
V5244
V5245
V5246
V5247
V5248
V5249
V5250
V5251
V5252
V5253
V5254
V5255
V5256
V5257
V5258
V5259
V5260
V5261
V5262
V5263
V5264
V5265
V5266
V5267
V5268
V5269
V5270
V5271
V5272
V5273
V5274
V5275
V5298
V5299
V5336
V5362
V5363
V5364
CPT_LONG_DESCRIPTION
FINE NEEDLE ASPIRATION; WITHOUT IMAGING GUIDANCE
FINE NEEDLE ASPIRATION; WITH IMAGING GUIDANCE
ACNE SURGERY (EG, MARSUPIALIZATION, OPENING OR REMOVAL OF MULTIPLE MILIA, COMEDONES, CYSTS, PUST
INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS OR SUBCUTA
INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS OR SUBCUTA
INCISION AND DRAINAGE OF PILONIDAL CYST; SIMPLE
INCISION AND DRAINAGE OF PILONIDAL CYST; COMPLICATED
INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; SIMPLE
INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; COMPLICATED
INCISION AND DRAINAGE OF HEMATOMA, SEROMA OR FLUID COLLECTION
PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST
INCISION AND DRAINAGE, COMPLEX, POSTOPERATIVE WOUND INFECTION
DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; UP TO 10% OF BODY SURFACE
DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; EACH ADDITIONAL 10% OF THE BODY SURFACE
DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOCIATED WITH OPEN FRACTURE(S) AND/OR DIS
DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOCIATED WITH OPEN FRACTURE(S) AND/OR DIS
DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOCIATED WITH OPEN FRACTURE(S) AND/OR DIS
DEBRIDEMENT; SKIN, PARTIAL THICKNESS
DEBRIDEMENT; SKIN, FULL THICKNESS
DEBRIDEMENT; SKIN, AND SUBCUTANEOUS TISSUE
DEBRIDEMENT; SKIN, SUBCUTANEOUS TISSUE, AND MUSCLE
DEBRIDEMENT; SKIN, SUBCUTANEOUS TISSUE, MUSCLE, AND BONE
PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); SINGLE LESION
PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); TWO TO FOUR LESIONS
PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); MORE THAN FOUR LESIONS
BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE (INCLUDING SIMPLE CLOSURE), UNLESS
BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE (INCLUDING SIMPLE CLOSURE),UNLESS O
REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCLUDING 15 LESIONS
REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; EACH ADDITIONAL TEN LESIONS (LIST S
SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 0.5 CM
SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 0.6 TO
SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 1.1 TO
SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER OVER 2
SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION D
SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION D
SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION D
SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION D
SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMB
SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMB
SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMB
SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMB
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NO
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NO
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NO
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NO
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NO
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NO
EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, AXILLARY; WITH SIMPLE OR INTERMEDIATE
EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, AXILLARY; WITH COMPLEX REPAIR
EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, INGUINAL; WITH SIMPLE OR INTERMEDIATE
EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, INGUINAL; WITH COMPLEX REPAIR
EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, PERIANAL, PERINEAL, OR UMBILICAL; WITH S
EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, PERIANAL, PERINEAL, OR UMBILICAL; WITH C
EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS;EXCISED DIAMETER 0.5 CM OR LES
EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS;EXCISED DIAMETER 0.6 TO 1.0 CM
EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS;EXCISED DIAMETER 1.1 TO 2.0 CM
EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS;EXCISED DIAMETER 2.1 TO 3.0 CM
EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS;EXCISED DIAMETER 3.1 TO 4.0 CM
EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS;EXCISED DIAMETER OVER 4.0 CM
EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXCISED DIAMETER
EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXCISED DIAMETER
EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXCISED DIAMETER
EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXCISED DIAMETER
EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXCISED DIAMETER
EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXCISED DIAMETER
EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE,LIPS; EXCISED DIAMETER 0.5 C
EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE,LIPS; EXCISED DIAMETER 0.6 T
EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE,LIPS; EXCISED DIAMETER 1.1 T
EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE,LIPS; EXCISED DIAMETER 2.1 T
EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE,LIPS; EXCISED DIAMETER 3.1 T
EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE,LIPS; EXCISED DIAMETER OVER
TRIMMING OF NONDYSTROPHIC NAILS, ANY NUMBER
DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); ONE TO FIVE
DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); SIX OR MORE
AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE
AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; EACH ADDITIONAL NAIL PLATE (LIST SEPARATELY IN
EVACUATION OF SUBUNGUAL HEMATOMA
EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE, (EG, INGROWN OR DEFORMED NAIL) FOR PERMANE
EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE, (EG, INGROWN OR DEFORMED NAIL) FOR PERMANE
BIOPSY OF NAIL UNIT (EG, PLATE, BED, MATRIX, HYPONYCHIUM, PROXIMAL AND LATERAL NAIL FOLDS) (SEPARAT
REPAIR OF NAIL BED
RECONSTRUCTION OF NAIL BED WITH GRAFT
WEDGE EXCISION OF SKIN OF NAIL FOLD (EG, FOR INGROWN TOENAIL)
EXCISION OF PILONIDAL CYST OR SINUS; SIMPLE
EXCISION OF PILONIDAL CYST OR SINUS; EXTENSIVE
EXCISION OF PILONIDAL CYST OR SINUS; COMPLICATED
INJECTION, INTRALESIONAL; UP TO AND INCLUDING SEVEN LESIONS
INJECTION, INTRALESIONAL; MORE THAN SEVEN LESIONS
TATTOOING, INTRADERMAL INTRODUCTION OF INSOLUBLE OPAQUE PIGMENTS TO CORRECT COLOR DEFECTS O
TATTOOING, INTRADERMAL INTRODUCTION OF INSOLUBLE OPAQUE PIGMENTS TO CORRECT COLOR DEFECTS O
TATTOOING, INTRADERMAL INTRODUCTION OF INSOLUBLE OPAQUE PIGMENTS TO CORRECT COLOR DEFECTS O
TATTOOING, INTRADERMAL INTRODUCTION OF INSOLUBLE OPAQUE PIGMENTS TO CORRECT COLOR DEFECTS O
TATTOOING, INTRADERMAL INTRODUCTION OF INSOLUBLE OPAQUE PIGMENTS TO CORRECT COLOR DEFECTS O
TATTOOING, INTRADERMAL INTRODUCTION OF INSOLUBLE OPAQUE PIGMENTS TO CORRECT COLOR DEFECTS O
TATTOOING, INTRADERMAL INTRODUCTION OF INSOLUBLE OPAQUE PIGMENTS TO CORRECT COLOR DEFECTS O
INSERTION OF TISSUE EXPANDER(S) FOR OTHER THAN BREAST, INCLUDING SUBSEQUENT EXPANSION
REPLACEMENT OF TISSUE EXPANDER WITH PERMANENT PROSTHESIS
REMOVAL OF TISSUE EXPANDER(S) WITHOUT INSERTION OF PROSTHESIS
INSERTION, IMPLANTABLE CONTRACEPTIVE CAPSULES
REMOVAL, IMPLANTABLE CONTRACEPTIVE CAPSULES
REMOVAL WITH REINSERTION, IMPLANTABLE CONTRACEPTIVE CAPSULES
SUBCUTANEOUS HORMONE PELLET IMPLANTATION (IMPLANTATION OF ESTRADIOL AND/OR TESTOSTERONE PEL
INSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT
REMOVAL, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT
REMOVAL WITH REINSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXT
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXT
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXT
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXT
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXT
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXT
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES;
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES;
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES;
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES;
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES;
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES;
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES;
TREATMENT OF SUPERFICIAL WOUND DEHISCENCE; SIMPLE CLOSURE
TREATMENT OF SUPERFICIAL WOUND DEHISCENCE; WITH PACKING
LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET);
LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET);
LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET);
LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET);
LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET);
LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET);
LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 2.5 CM OR LESS
LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 2.6 CM TO 7.5 CM
LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 7.6 CM TO 12.5 CM
LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 12.6 CM TO 20.0 CM
LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 20.1 CM TO 30.0 CM
LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; OVER 30.0 CM
LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 2.5 CM OR LE
LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 2.6 CM TO 5.
LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 5.1 CM TO 7.
LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 7.6 CM TO 12
LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 12.6 CM TO 2
LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 20.1 CM TO 3
LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; OVER 30.0 C
REPAIR, COMPLEX, TRUNK; 1.1 CM TO 2.5 CM
REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM
REPAIR, COMPLEX, TRUNK; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIM
REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; 1.1 CM TO 2.5 CM
REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; 2.6 CM TO 7.5 CM
REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATELY IN ADDITIO
REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; 1.1 CM
REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; 2.6 CM
REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; EACH A
REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 1.0 CM OR LESS
REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 1.1 CM TO 2.5 CM
REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 2.6 CM TO 7.5 CM
REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATELY IN A
SECONDARY CLOSURE OF SURGICAL WOUND OR DEHISCENCE, EXTENSIVE OR COMPLICATED
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10 SQ CM OR LESS
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10.1 SQ CM TO 30.0 SQ CM
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS AND/OR LEGS; DEFECT 10 SQ CM OR LESS
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS AND/OR LEGS; DEFECT 10.1 SQ CM TO 30.0 SQ
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITA
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITA
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10 SQ CM OR L
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10.1 SQ CM TO
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, MORE THAN 30 SQ CM, UNUSUAL OR COMPLICATED, ANY AR
FILLETED FINGER OR TOE FLAP, INCLUDING PREPARATION OF RECIPIENT SITE
SURGICAL PREPARATION OR CREATION OF RECIPIENT SITE BY EXCISION OF OPEN WOUNDS, BURN ESCHAR, OR
SURGICAL PREPARATION OR CREATION OF RECIPIENT SITE BY EXCISION OF OPEN WOUNDS, BURN ESCHAR, OR
PINCH GRAFT, SINGLE OR MULTIPLE, TO COVER SMALL ULCER, TIP OF DIGIT, OR OTHER MINIMAL OPEN AREA (EX
SPLIT GRAFT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM OR LESS, OR ONE PERCENT OF BODY AREA OF INFANTS AN
SPLIT GRAFT, TRUNK, ARMS, LEGS; EACH ADDITIONAL 100 SQ CM, OR EACH ADDITIONAL ONE PERCENT OF BODY
SPLIT GRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET AND/OR MULTIPLE
SPLIT GRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET AND/OR MULTIPLE
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, TRUNK; 20 SQ CM OR LESS
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, TRUNK; EACH ADDITIONAL 20 SQ C
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, SCALP, ARMS, AND/OR LEGS; 20 S
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, SCALP, ARMS, AND/OR LEGS; EAC
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, FOREHEAD, CHEEKS, CHIN, MOUT
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, FOREHEAD, CHEEKS, CHIN, MOUT
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, NOSE, EARS, EYELIDS, AND/OR LIP
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, NOSE, EARS, EYELIDS, AND/OR LIP
APPLICATION OF BILAMINATE SKIN SUBSTITUTE/NEODERMIS; 25 SQ CM
APPLICATION OF BILAMINATE SKIN SUBSTITUTE/NEODERMIS; EACH ADDITIONAL 25 SQ CM (LIST SEPARATELY IN A
APPLICATION OF ALLOGRAFT, SKIN; 100 SQ CM OR LESS
APPLICATION OF ALLOGRAFT, SKIN; EACH ADDITIONAL 100 SQ CM (LIST SEPARATELY IN ADDITION TO CODE FOR
APPLICATION OF XENOGRAFT, SKIN; 100 SQ CM OR LESS
APPLICATION OF XENOGRAFT, SKIN; EACH ADDITIONAL 100 SQ CM (LIST SEPARATELY IN ADDITION TO CODE FOR
FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUT TRANSFER; TRUNK
FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUT TRANSFER; SCALP, ARMS, OR LEGS
FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUT TRANSFER; FOREHEAD, CHEEKS, CHIN, MOUTH,
FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUT TRANSFER; EYELIDS, NOSE, EARS, LIPS, OR INTR
DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); AT TRUNK
DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); AT SCALP, ARMS, OR LEGS
DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); AT FOREHEAD, CHEEKS, CHIN, NECK, AXILLAE, G
DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); AT EYELIDS, NOSE, EARS, OR LIPS
TRANSFER, INTERMEDIATE, OF ANY PEDICLE FLAP (EG, ABDOMEN TO WRIST, "WALKING" TUBE), ANY LOCATION
MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; HEAD AND NECK (EG, TEMPORALIS, MASSETER MUSCL
MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; TRUNK
MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; UPPER EXTREMITY
MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; LOWER EXTREMITY
FLAP; ISLAND PEDICLE
FLAP; NEUROVASCULAR PEDICLE
FREE MUSCLE OR MYOCUTANEOUS FLAP WITH MICROVASCULAR ANASTOMOSIS
FREE SKIN FLAP WITH MICROVASCULAR ANASTOMOSIS
FREE FASCIAL FLAP WITH MICROVASCULAR ANASTOMOSIS
GRAFT; COMPOSITE (EG, FULL THICKNESS OF EXTERNAL EAR OR NASAL ALA), INCLUDING PRIMARY CLOSURE, DO
GRAFT; DERMA-FAT-FASCIA
PUNCH GRAFT FOR HAIR TRANSPLANT; 1 TO 15 PUNCH GRAFTS
PUNCH GRAFT FOR HAIR TRANSPLANT; MORE THAN 15 PUNCH GRAFTS
DERMABRASION; TOTAL FACE (EG, FOR ACNE SCARRING, FINE WRINKLING, RHYTIDS, GENERAL KERATOSIS)
DERMABRASION; SEGMENTAL, FACE
DERMABRASION; REGIONAL, OTHER THAN FACE
DERMABRASION; SUPERFICIAL, ANY SITE, (EG, TATTOO REMOVAL)
ABRASION; SINGLE LESION (EG, KERATOSIS, SCAR)
ABRASION; EACH ADDITIONAL FOUR LESIONS OR LESS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY P
CHEMICAL PEEL, FACIAL; EPIDERMAL
CHEMICAL PEEL, FACIAL; DERMAL
CHEMICAL PEEL, NONFACIAL; EPIDERMAL
CHEMICAL PEEL, NONFACIAL; DERMAL
SALABRASION; 20 SQ CM OR LESS
SALABRASION; OVER 20 SQ CM
CERVICOPLASTY
BLEPHAROPLASTY, LOWER EYELID;
BLEPHAROPLASTY, LOWER EYELID; WITH EXTENSIVE HERNIATED FAT PAD
BLEPHAROPLASTY, UPPER EYELID;
BLEPHAROPLASTY, UPPER EYELID; WITH EXCESSIVE SKIN WEIGHTING DOWN LID
RHYTIDECTOMY; FOREHEAD
RHYTIDECTOMY; NECK WITH PLATYSMAL TIGHTENING (PLATYSMAL FLAP, "P-FLAP")
RHYTIDECTOMY; GLABELLAR FROWN LINES
RHYTIDECTOMY; CHEEK, CHIN, AND NECK
RHYTIDECTOMY; SUPERFICIAL MUSCULOAPONEUROTIC SYSTEM (SMAS) FLAP
EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); ABDOMEN (ABDOMINOPLAST
EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); THIGH
EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); LEG
EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); HIP
EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); BUTTOCK
EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); ARM
EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); FOREARM OR HAND
EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); SUBMENTAL FAT PAD
EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); OTHER AREA
GRAFT FOR FACIAL NERVE PARALYSIS; FREE FASCIA GRAFT (INCLUDING OBTAINING FASCIA)
GRAFT FOR FACIAL NERVE PARALYSIS; FREE MUSCLE GRAFT (INCLUDING OBTAINING GRAFT)
GRAFT FOR FACIAL NERVE PARALYSIS; FREE MUSCLE FLAP BY MICROSURGICAL TECHNIQUE
GRAFT FOR FACIAL NERVE PARALYSIS; REGIONAL MUSCLE TRANSFER
REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LOCAL), SAME SURGEON
REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LOCAL), OTHER SURGEON
DRESSING CHANGE (FOR OTHER THAN BURNS) UNDER ANESTHESIA (OTHER THAN LOCAL)
INTRAVENOUS INJECTION OF AGENT TO TEST VASCULAR FLOW IN FLAP OR GRAFT
SUCTION ASSISTED LIPECTOMY; HEAD AND NECK
SUCTION ASSISTED LIPECTOMY; TRUNK
SUCTION ASSISTED LIPECTOMY; UPPER EXTREMITY
SUCTION ASSISTED LIPECTOMY; LOWER EXTREMITY
EXCISION, COCCYGEAL PRESSURE ULCER, WITH COCCYGECTOMY; WITH PRIMARY SUTURE
EXCISION, COCCYGEAL PRESSURE ULCER, WITH COCCYGECTOMY; WITH FLAP CLOSURE
EXCISION, SACRAL PRESSURE ULCER, WITH PRIMARY SUTURE;
EXCISION, SACRAL PRESSURE ULCER, WITH PRIMARY SUTURE; WITH OSTECTOMY
EXCISION, SACRAL PRESSURE ULCER, WITH SKIN FLAP CLOSURE;
EXCISION, SACRAL PRESSURE ULCER, WITH SKIN FLAP CLOSURE; WITH OSTECTOMY
EXCISION, SACRAL PRESSURE ULCER, IN PREPARATION FOR MUSCLE OR MYOCUTANEOUS FLAP OR SKIN GRAFT
EXCISION, SACRAL PRESSURE ULCER, WITH MUSCLE OR MYOCUTANEOUS FLAP CLOSURE; WITH OSTECTOMY
EXCISION, ISCHIAL PRESSURE ULCER, WITH PRIMARY SUTURE;
EXCISION, ISCHIAL PRESSURE ULCER, WITH PRIMARY SUTURE; WITH OSTECTOMY (ISCHIECTOMY)
EXCISION, ISCHIAL PRESSURE ULCER, WITH SKIN FLAP CLOSURE;
EXCISION, ISCHIAL PRESSURE ULCER, WITH SKIN FLAP CLOSURE; WITH OSTECTOMY
EXCISION, ISCHIAL PRESSURE ULCER, WITH OSTECTOMY, IN PREPARATION FOR MUSCLE OR MYOCUTANEOUS FL
EXCISION, TROCHANTERIC PRESSURE ULCER, WITH PRIMARY SUTURE;
EXCISION, TROCHANTERIC PRESSURE ULCER, WITH PRIMARY SUTURE; WITH OSTECTOMY
EXCISION, TROCHANTERIC PRESSURE ULCER, WITH SKIN FLAP CLOSURE;
EXCISION, TROCHANTERIC PRESSURE ULCER, WITH SKIN FLAP CLOSURE; WITH OSTECTOMY
EXCISION, TROCHANTERIC PRESSURE ULCER, IN PREPARATION FOR MUSCLE OR MYOCUTANEOUS FLAP OR SKIN
EXCISION, TROCHANTERIC PRESSURE ULCER, IN PREPARATION FOR MUSCLE OR MYOCUTANEOUS FLAP OR SKIN
UNLISTED PROCEDURE, EXCISION PRESSURE ULCER
INITIAL TREATMENT, FIRST DEGREE BURN, WHEN NO MORE THAN LOCAL TREATMENT IS REQUIRED
DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUENT; UNDER ANESTHESIA, SMALL
DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUENT; UNDER ANESTHESIA, MEDIUM OR LARGE, OR WITH
DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUENT; WITHOUT ANESTHESIA, OFFICE OR HOSPITAL, SMA
DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUENT; WITHOUT ANESTHESIA, MEDIUM (EG, WHOLE FACE
DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUENT; WITHOUT ANESTHESIA, LARGE (EG, MORE THAN O
ESCHAROTOMY; INITIAL INCISION
ESCHAROTOMY; EACH ADDITIONAL INCISION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDUR
DESTRUCTION, ALL BENIGN OR PREMALIGNANT LESIONS OTHER THAN SKIN TAGS OR CUTANEOUS VASCULAR PR
DESTRUCTION, ALL BENIGN OR PREMALIGNANT LESIONS OTHER THAN SKIN TAGS OR CUTANEOUS VASCULAR PR
DESTRUCTION, ALL BENIGN OR PREMALIGNANT LESIONS OTHER THAN SKIN TAGS OR CUTANEOUS VASCULAR PR
DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS (EG, LASER TECHNIQUE); LESS THAN 10 SQ
DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS (EG, LASER TECHNIQUE); 10.0 - 50.0 SQ CM
DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS (EG, LASER TECHNIQUE); OVER 50.0 SQ CM
DESTRUCTION, OF FLAT WARTS, MOLLUSCUM CONTAGIOSUM, OR MILIA; UP TO 14 LESIONS
DESTRUCTION, OF FLAT WARTS, MOLLUSCUM CONTAGIOSUM, OR MILIA; UP TO 15 LESIONS
CHEMICAL CAUTERIZATION OF GRANULATION TISSUE (PROUD FLESH, SINUS OR FISTULA)
DESTRUCTION, MALIGNANT LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 0.5 CM OR LESS
DESTRUCTION, MALIGNANT LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 0.6 TO 1.0 CM
DESTRUCTION, MALIGNANT LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 1.1 TO 2.0 CM
DESTRUCTION, MALIGNANT LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 2.1 TO 3.0 CM
DESTRUCTION, MALIGNANT LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 3.1 TO 4.0 CM
DESTRUCTION, MALIGNANT LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER OVER 4.0 CM
DESTRUCTION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.5 CM OR LESS
DESTRUCTION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.6 TO 1.0 CM
DESTRUCTION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 1.1 TO 2.0 CM
DESTRUCTION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 2.1 TO 3.0 CM
DESTRUCTION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 3.1 TO 4.0 CM
DESTRUCTION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER OVER 4.0 CM
DESTRUCTION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER
DESTRUCTION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER
DESTRUCTION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER
DESTRUCTION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER
DESTRUCTION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER
DESTRUCTION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER
CHEMOSURGERY,INCLUD REMVAL GROSS TUMOR,SURG EXCIS TISSUE SPEC, MAPPING,MICROSCOPIC EXAM SPE
CHEMO, INCLUD REMOVAL GROSS TUMOR,SURG EXCIS TISSUE SPECIMENS, MICROSCOPIC EXAM SPECIMENS SU
CHEMO,INCLUD REMOVAL GROS TUMOR,SURG EXCIS TISSUE SPECI,MAPPING, MICROSCOPIC EXAM OF SPECIME
CHEMO, INCLUD REMOV GROSS TUMOR, SURG EXCIS TISSUE SPECI,MAPPING, MICROSCO EXAMIN SPECIMENS S
CHEMO,INCLUD REMOV ALL GROSS TUMOR,SURG EXCIS TISSUE SPECI,MAPG MICROSCOP EXAM SPECI SURG,& H
CRYOTHERAPY (CO2 SLUSH, LIQUID N2) FOR ACNE
CHEMICAL EXFOLIATION FOR ACNE (EG, ACNE PASTE, ACID)
ELECTROLYSIS EPILATION, EACH 1/2 HOUR
UNLISTED PROCEDURE, SKIN, MUCOUS MEMBRANE AND SUBCUTANEOUS TISSUE
PUNCTURE ASPIRATION OF CYST OF BREAST;
PUNCTURE ASPIRATION OF CYST OF BREAST; EACH ADDITIONAL CYST (LIST SEPARATELY IN ADDITION TO CODE
MASTOTOMY WITH EXPLORATION OR DRAINAGE OF ABSCESS, DEEP
INJECTION PROCEDURE ONLY FOR MAMMARY DUCTOGRAM OR GALACTOGRAM
BIOPSY OF BREAST; PERCUTANEOUS, NEEDLE CORE, NOT USING IMAGING GUIDANCE (SEPARATE PROCEDURE)
BIOPSY OF BREAST; OPEN, INCISIONAL
BIOPSY OF BREAST; PERCUTANEOUS, NEEDLE CORE, USING IMAGING GUIDANCE
BIOPSY OF BREAST; PERCUTANEOUS, AUTOMATED VACUUM ASSISTED OR ROTATING BIOPSY DEVICE, USING IMA
NIPPLE EXPLORATION, WITH OR WITHOUT EXCISION OF A SOLITARY LACTIFEROUS DUCT OR A PAPILLOMA LACTI
EXCISION OF LACTIFEROUS DUCT FISTULA
EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN OR MALIGNANT TUMOR ABERRANT BREAST TISSUE, DUC
EXCISION OF BREAST LESION IDENTIFIED BY PREOPERATIVE PLACEMENT OF RADIOLOGICAL MARKER, OPEN; SIN
EXCISION OF BREAST LESION IDENTIFIED BY PREOP PLACEMENT OF RADIOLOGICAL MARKER, OPEN; EA ADDTL L
MASTECTOMY FOR GYNECOMASTIA
MASTECTOMY, PARTIAL;
MASTECTOMY, PARTIAL; WITH AXILLARY LYMPHADENECTOMY
MASTECTOMY, SIMPLE, COMPLETE
MASTECTOMY, SUBCUTANEOUS
MASTECTOMY, RADICAL, INCLUDING PECTORAL MUSCLES, AXILLARY LYMPH NODES
MASTECTOMY, RADICAL, INCLUDING PECTORAL MUSCLES, AXILLARY AND INTERNAL MAMMARY LYMPH NODES (U
MASTECTOMY, MODIFIED RADICAL, INCLUDING AXILLARY LYMPH NODES, WITH OR WITHOUT PECTORALIS MINOR
EXCISION OF CHEST WALL TUMOR INCLUDING RIBS
EXCISION OF CHEST WALL TUMOR INVOLVING RIBS, WITH PLASTIC RECONSTRUCTION; WITHOUT MEDIASTINAL L
EXCISION OF CHEST WALL TUMOR INVOLVING RIBS, WITH PLASTIC RECONSTRUCTION; WITH MEDIASTINAL LYMP
PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST;
PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST; EACH ADDITIONAL LESION (LIST SEPARAT
IMAGE GUIDED PLACEMENT, METALLIC LOCALIZATION CLIP, PERCUTANEOUS, DURING BREAST BIOPSY (LIST SEP
MASTOPEXY
REDUCTION MAMMAPLASTY
MAMMAPLASTY, AUGMENTATION; WITHOUT PROSTHETIC IMPLANT
MAMMAPLASTY, AUGMENTATION; WITH PROSTHETIC IMPLANT
REMOVAL OF INTACT MAMMARY IMPLANT
REMOVAL OF MAMMARY IMPLANT MATERIAL
IMMEDIATE INSERTION OF BREAST PROSTHESIS FOLLOWING MASTOPEXY, MASTECTOMY OR IN RECONSTRUCTIO
DELAYED INSERTION OF BREAST PROSTHESIS FOLLOWING MASTOPEXY, MASTECTOMY OR IN RECONSTRUCTION
NIPPLE/AREOLA RECONSTRUCTION
CORRECTION OF INVERTED NIPPLES
BREAST RECONSTRUCTION, IMMEDIATE OR DELAYED, WITH TISSUE EXPANDER, INCLUDING SUBSEQUENT EXPAN
BREAST RECONSTRUCTION WITH LATISSIMUS DORSI FLAP, WITH OR WITHOUT PROSTHETIC IMPLANT
BREAST RECONSTRUCTION WITH FREE FLAP
BREAST RECONSTRUCTION WITH OTHER TECHNIQUE
BREAST RECONSTRUCTION WITH TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS FLAP (TRAM), SINGLE PED
BREAST RECONSTRUCTION WITH TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS FLAP (TRAM), SINGLE PED
BREAST RECONSTRUCTION WITH TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS FLAP (TRAM), DOUBLE PED
OPEN PERIPROSTHETIC CAPSULOTOMY, BREAST
PERIPROSTHETIC CAPSULECTOMY, BREAST
REVISION OF RECONSTRUCTED BREAST
PREPARATION OF MOULAGE FOR CUSTOM BREAST IMPLANT
UNLISTED PROCEDURE, BREAST
INCISION OF SOFT TISSUE ABSCESS (EG, SECONDARY TO OSTEOMYELITIS); SUPERFICIAL
INCISION OF SOFT TISSUE ABSCESS (EG, SECONDARY TO OSTEOMYELITIS); DEEP OR COMPLICATED
EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); NECK
EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); CHEST
EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); ABDOMEN/FLANK/BACK
EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); EXTREMITY
EXCISION OF EPIPHYSEAL BAR, WITH OR WITHOUT AUTOGEOUS SOFT TISSUE GRAFT OBTAINED THROUGH SAME
BIOPSY, MUSCLE; SUPERFICIAL
BIOPSY, MUSCLE; DEEP
BIOPSY, MUSCLE, PERCUTANEOUS NEEDLE
BIOPSY, BONE, TROCAR, OR NEEDLE; SUPERFICIAL (EG, ILIUM, STERNUM, SPINOUS PROCESS, RIBS)
BIOPSY, BONE, TROCAR, OR NEEDLE; DEEP
BIOPSY, BONE, EXCISIONAL; SUPERFICIAL (EG, ILIUM, STERNUM, SPINOUS PROCESS, RIBS, TROCHANTER OF FEM
BIOPSY, EXCISIONAL; DEEP (EG, HUMERUS, ISCHIUM, FEMUR)
BIOPSY, VERTEBRAL BODY, OPEN; THORACIC
BIOPSY, VERTEBRAL BODY, OPEN; LUMBAR OR CERVICAL
INJECTION OF SINUS TRACT; THERAPEUTIC (SEPARATE PROCEDURE)
INJECTION OF SINUS TRACT; DIAGNOSTIC (SINOGRAM)
REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; SIMPLE
REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; DEEP OR COMPLICATED
INJECTION, THERAPEUTIC (EG, LOCAL ANESTHETIC, CORTICOSTEROID), CARPAL TUNNEL
INJECTION(S); TENDON SHEATH, LIGAMENT
INJECTION(S); TENDON ORIGIN/INSERTION
INJECTION(S); SINGLE OR MULTIPLE TRIGGER POINT(S), ONE OR TWO MUSCLE(S)
INJECTION(S); SINGLE OR MULTIPLE TRIGGER POINT(S), THREE OR MORE MUSCLE(S)
ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; SMALL JOINT OR BURSA (EG,FINGERS, TOES)
ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; INTERMEDIATE JOINT OR BURSA (EG, TEMPOROMANDIBULA
ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, KNEE JOINT, S
ASPIRATION AND/OR INJECTION OF GANGLION CYST(S) ANY LOCATION
ASPIRATION AND INJECTION FOR TREATMENT OF BONE CYST
INSERTION OF WIRE OR PIN WITH APPLICATION OF SKELETAL TRACTION, INCLUDING REMOVAL (SEPARATE PROC
APPLICATION OF CRANIAL TONGS, CALIPER, OR STEREOTACTIC FRAME, INCLUDING REMOVAL (SEPARATE PROCE
APPLICATION OF HALO, INCLUDING REMOVAL; CRANIAL
APPLICATION OF HALO, INCLUDING REMOVAL; PELVIC
APPLICATION OF HALO, INCLUDING REMOVAL; FEMORAL
APPLICATION OF HALO, INCLUDING REMOVAL, CRANIAL, 6 OR MORE PINS PLACED, FOR THIN SKULL OSTEOLOGY
REMOVAL OF TONGS OR HALO APPLIED BY ANOTHER PHYSICIAN
REMOVAL OF IMPLANT; SUPERFICIAL, (EG, BURIED WIRE, PIN OR ROD) (SEPARATE PROCEDURE)
REMOVAL OF IMPLANT; DEEP (EG, BURIED WIRE, PIN, SCREW, METAL BAND, NAIL, ROD OR PLATE)
APPLICATION OF A UNIPLANE (PINS OR WIRES IN ONE PLANE), UNILATERAL, EXTERNAL FIXATION SYSTEM
APPLICATION OF A MULTIPLANE (PINS OR WIRES IN MORE THAN ONE PLANE), UNILATERAL, EXTERNAL FIXATION S
ADJUSTMENT OR REVISION OF EXTERNAL FIXATION SYSTEM REQUIRING ANESTHESIA (EG, NEW PIN(S) OR WIRE(
REMOVAL, UNDER ANESTHESIA, OF EXTERNAL FIXATION SYSTEM
REPLANTATION, ARM (INCLUDES SURGICAL NECK OF HUMERUS THROUGH ELBOW JOINT); COMPLETE AMPUTATIO
REPLANTATION, FOREARM (INCLUDES RADIUS AND ULNA TO RADIAL CARPAL JOINT); COMPLETE AMPUTATION
REPLANTATION, HAND (INCLUDES HAND THROUGH METACARPOPHALANGEAL JOINTS); COMPLETE AMPUTATION
REPLANTATION, DIGIT, EXCLUDING THUMB (INCLUDES METACARPOPHALANGEAL JOINT TO INSERTION OF FLEXO
REPLANTATION, DIGIT, EXCLUDING THUMB (INCLUDES DISTAL TIP TO SUBLIMIS TENDON INSERTION); COMPLETE
REPLANTATION, THUMB (INCLUDES CARPOMETACARPAL JOINT TO MP JOINT); COMPLETE AMPUTATION
REPLANTATION, THUMB (INCLUDES DISTAL TIP TO MP JOINT); COMPLETE AMPUTATION
REPLANTATION, FOOT; COMPLETE AMPUTATION
BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL (EG, DOWEL OR BUTTON)
BONE GRAFT, ANY DONOR AREA; MAJOR OR LARGE
CARTILAGE GRAFT; COSTOCHONDRAL
CARTILAGE GRAFT; NASAL SEPTUM
FASCIA LATA GRAFT; BY STRIPPER
FASCIA LATA GRAFT; BY INCISION AND AREA EXPOSURE, COMPLEX OR SHEET
TENDON GRAFT, FROM A DISTANCE (EG, PALMARIS, TOE EXTENSOR, PLANTARIS)
TISSUE GRAFTS, OTHER (EG, PARATENON, FAT, DERMIS)
ALLOGRAFT FOR SPINE SURGERY ONLY; MORSELIZED
ALLOGRAFT FOR SPINE SURGERY ONLY; STRUCTURAL
AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); LOCAL (EG, RIBS, SPINOUS PROC
AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); MORSELIZED (THROUGH SEPARA
AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); STRUCTURAL, BICORTICAL OR TR
MONITORING OF INTERSTITIAL FLUID PRESSURE (INCLUDES INSERTION OF DEVICE, EG, WICK CATHETER TECHN
BONE GRAFT WITH MICROVASCULAR ANASTOMOSIS; FIBULA
BONE GRAFT WITH MICROVASCULAR ANASTOMOSIS; ILIAC CREST
BONE GRAFT WITH MICROVASCULAR ANASTOMOSIS; METATARSAL
BONE GRAFT WITH MICROVASCULAR ANASTOMOSIS; OTHER THAN FIBULA, ILIAC CREST OR METATARSAL
FREE OSTEOCUTANEOUS FLAP WITH MICROVASCULAR ANASTOMOSIS; OTHER THAN THE ILIAC CREST, METATAR
FREE OSTEOCUTANEOUS FLAP WITH MICROVASCULAR ANASTOMOSIS; ILIAC CREST
FREE OSTEOCUTANEOUS FLAP WITH MICROVASCULAR ANASTOMOSIS; METATARSAL
FREE OSTEOCUTANEOUS FLAP WITH MICROVASCULAR ANASTOMOSIS; GREAT TOE WITH WEB SPACE
ELECTRICAL STIMULATION TO AID BONE HEALING; NONINVASIVE (NONOPERATIVE)
ELECTRICAL STIMULATION TO AID BONE HEALING; INVASIVE (OPERATIVE)
LOW INTENSITY ULTRASOUND STIMULATION TO AID BONE HEALING, NONINVASIVE (NONOPERATIVE)
UNLISTED PROCEDURE, MUSCULOSKELETAL SYSTEM, GENERAL
ARTHROTOMY, TEMPOROMANDIBULAR JOINT
RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF FACE OR SCALP
EXCISION OF BONE (EG, FOR OSTEOMYELITIS OR BONE ABSCESS); MANDIBLE
EXCISION OF BONE (EG, FOR OSTEOMYELITIS OR BONE ABSCESS); FACIAL BONE(S)
REMOVAL BY CONTOURING OF BENIGN TUMOR OF FACIAL BONE (EG, FIBROUS DYSPLASIA)
EXCISION OF BENIGN TUMOR OR CYST OF MAXILLA OR ZYGOMA BY ENUCLEATION AND CURETTAGE
EXCISION OF TORUS MANDIBULARIS
EXCISION OF MAXILLARY TORUS PALATINUS
EXCISION OF MALIGNANT TUMOR OF MAXILLA OR ZYGOMA
EXCISION OF BENIGN TUMOR OR CYST OF MANDIBLE, BY ENUCLEATION AND/OR CURETTAGE
EXCISION OF MALIGNANT TUMOR OF MANDIBLE;
EXCISION OF MALIGNANT TUMOR OF MANDIBLE; RADICAL RESECTION
EXCISION OF BENIGN TUMOR OR CYST OF MANDIBLE; REQUIRING INTRA-ORAL OSTEOTOMY (EG, LOCALLY AGGR
EXCISION OF BENIGN TUMOR OR CYST OF MANDIBLE; REQUIRING EXTRA-ORAL OSTEOTOMY&PARTIAL MANDIBUL
EXCISION OF BENIGN TUMOR OR CYST OF MAXILLA; REQUIRING INTRA-ORAL OSTEOTOMY (EG, LOCALLY AGGRES
EXCISION OF BENIGN TUMOR OR CYST OF MAXILLA; REQUIRING EXTRA-ORAL OSTEOTOMY AND PARTIAL MAXILLE
CONDYLECTOMY, TEMPOROMANDIBULAR JOINT (SEPARATE PROCEDURE)
MENISCECTOMY, PARTIAL OR COMPLETE, TEMPOROMANDIBULAR JOINT (SEPARATE PROCEDURE)
CORONOIDECTOMY (SEPARATE PROCEDURE)
IMPRESSION AND CUSTOM PREPARATION; SURGICAL OBTURATOR PROSTHESIS
IMPRESSION AND CUSTOM PREPARATION; ORBITAL PROSTHESIS
IMPRESSION AND CUSTOM PREPARATION; INTERIM OBTURATOR PROSTHESIS
IMPRESSION AND CUSTOM PREPARATION; DEFINITIVE OBTURATOR PROSTHESIS
IMPRESSION AND CUSTOM PREPARATION; MANDIBULAR RESECTION PROSTHESIS
IMPRESSION AND CUSTOM PREPARATION; PALATAL AUGMENTATION PROSTHESIS
IMPRESSION AND CUSTOM PREPARATION; PALATAL LIFT PROSTHESIS
IMPRESSION AND CUSTOM PREPARATION; SPEECH AID PROSTHESIS
IMPRESSION AND CUSTOM PREPARATION; ORAL SURGICAL SPLINT
IMPRESSION AND CUSTOM PREPARATION; AURICULAR PROSTHESIS
IMPRESSION AND CUSTOM PREPARATION; NASAL PROSTHESIS
IMPRESSION AND CUSTOM PREPARATION; FACIAL PROSTHESIS
UNLISTED MAXILLOFACIAL PROSTHETIC PROCEDURE
APPLICATION OF HALO TYPE APPLIANCE FOR MAXILLOFACIAL FIXATION, INCLUDES REMOVAL (SEPARATE PROCE
APPLICATION OF INTERDENTAL FIXATION DEVICE FOR CONDITIONS OTHER THAN FRACTURE OR DISLOCATION, IN
INJECTION PROCEDURE FOR TEMPOROMANDIBULAR JOINT ARTHROGRAPHY
GENIOPLASTY; AUGMENTATION (AUTOGRAFT, ALLOGRAFT, PROSTHETIC MATERIAL)
GENIOPLASTY; SLIDING OSTEOTOMY, SINGLE PIECE
GENIOPLASTY; SLIDING OSTEOTOMIES, TWO OR MORE OSTEOTOMIES (EG, WEDGE EXCISION OR BONE WEDGE R
GENIOPLASTY; SLIDING, AUGMENTATION WITH INTERPOSITIONAL BONE GRAFTS (INCLUDES OBTAINING AUTOGR
AUGMENTATION, MANDIBULAR BODY OR ANGLE; PROSTHETIC MATERIAL
AUGMENTATION, MANDIBULAR BODY OR ANGLE; WITH BONE GRAFT, ONLAY OR INTERPOSITIONAL (INCLUDES OB
REDUCTION FOREHEAD; CONTOURING ONLY
REDUCTION FOREHEAD; CONTOURING AND APPLICATION OF PROSTHETIC MATERIAL OR BONE GRAFT (INCLUDES
REDUCTION FOREHEAD; CONTOURING AND SETBACK OF ANTERIOR FRONTAL SINUS WALL
RECONSTRUCTION MIDFACE, LEFORT I; SINGLE PIECE, SEGMENT MOVEMENT IN ANY DIRECTION (EG, FOR LONG
RECONSTRUCTION MIDFACE, LEFORT I; TWO PIECES, SEGMENT MOVEMENT IN ANY DIRECTION, WITHOUT BONE
RECONSTRUCTION MIDFACE, LEFORT I; THREE OR MORE PIECES, SEGMENT MOVEMENT IN ANY DIRECTION, WITH
RECONSTRUCTION MIDFACE, LEFORT I; SINGLE PIECE, SEGMENT MOVEMENT IN ANY DIRECTION, REQUIRING BON
RECONSTRUCTION MIDFACE, LEFORT I; TWO PIECES, SEGMENT MOVEMENT IN ANY DIRECTION, REQUIRING BON
RECONSTRUCTION MIDFACE, LEFORT I; 3 OR MORE PIECES, SEGMENT MOVEMENT IN ANY DIRECTION, REQUIRIN
RECONSTRUCTION MIDFACE, LEFORT II; ANTERIOR INTRUSION (EG, TREACHER-COLLINS SYNDROME)
RECONSTRUCTION MIDFACE, LEFORT II; ANY DIRECTION, REQUIRING BONE GRAFTS (INCLUDES OBTAINING AUTO
RECONSTRUCTION MIDFACE, LEFORT III (EXTRACRANIAL), ANY TYPE, REQUIRING BONE GRAFTS (INCLUDES OBTA
RECONSTRUCTION MIDFACE, LEFORT III (EXTRACRANIAL), ANY TYPE, REQUIRING BONE GRAFTS (INCLUDES OBTA
RECONSTRUCTION MIDFACE, LEFORT III (EXTRA AND INTRACRANIAL) WITH FOREHEAD ADVANCEMENT (EG, MON
RECONSTRUCTION MIDFACE, LEFORT III (EXTRA AND INTRACRANIAL) WITH FOREHEAD ADVANCEMENT (EG, MON
RECONSTRUCTION SUPERIOR-LATERAL ORBITAL RIM AND LOWER FOREHEAD, ADVANCEMENT OR ALTERATION, W
RECONSTRUCTION, BIFRONTAL, SUPERIOR-LATERAL ORBITAL RIMS AND LOWER FOREHEAD, ADVANCEMENT OR
RECONSTRUCTION, ENTIRE OR MAJORITY OF FOREHEAD AND/OR SUPRAORBITAL RIMS; WITH GRAFTS (ALLOGRA
RECONSTRUCTION, ENTIRE OR MAJORITY OF FOREHEAD AND/OR SUPRAORBITAL RIMS; WITH AUTOGRAFT (INCL
RECONSTRUCTION BY CONTOURING OF BENIGN TUMOR OF CRANIAL BONES (EG, FIBROUS DYSPLASIA), EXTRAC
RECONSTRUCTION, ORBITAL WALLS, RIMS, FOREHEAD, NASOETHMOID COMPLEX FOLLOWING INTRA-&EXTRACR
RECONSTRUCTION, ORBITAL WALLS, RIMS, FOREHEAD, NASOETHMOID COMPLEX FOLL INTRA-&EXTRACRANIAL E
RECONSTRUCTION, ORBITAL WALLS, RIMS, FOREHEAD, NASOETHMOID COMPLEX FOLLOWING INTRA-&EXTRACR
RECONSTRUCTION MIDFACE, OSTEOTOMIES (OTHER THAN LEFORT TYPE) AND BONE GRAFTS (INCLUDES OBTAIN
RECONSTRUCTION OF MANDIBULAR RAMI, HORIZONTAL, VERTICAL, "C", OR "L" OSTEOTOMY; WITHOUT BONE GRA
RECONSTRUCTION OF MANDIBULAR RAMUS, HORIZONTAL, VERTICAL, "C", OR "L" OSTEOTOMY; WITH BONE GRAF
RECONSTRUCTION OF MANDIBULAR RAMI AND/OR BODY, SAGITTAL SPLIT; WITHOUT INTERNAL RIGID FIXATION
RECONSTRUCTION OF MANDIBULAR RAMUS AND/OR BODY, SAGITTAL SPLIT; WITH INTERNAL RIGID FIXATION
OSTEOTOMY, MANDIBLE, SEGMENTAL
OSTEOTOMY, MANDIBLE, SEGMENTAL; WITH GENIOGLOSSUS ADVANCEMENT
OSTEOTOMY, MAXILLA, SEGMENTAL (EG, WASSMUND OR SCHUCHARD)
OSTEOPLASTY, FACIAL BONES; AUGMENTATION (AUTOGRAFT, ALLOGRAFT, OR PROSTHETIC IMPLANT)
OSTEOPLASTY, FACIAL BONES; REDUCTION
GRAFT, BONE; NASAL, MAXILLARY OR MALAR AREAS (INCLUDES OBTAINING GRAFT)
GRAFT, BONE; MANDIBLE (INCLUDES OBTAINING GRAFT)
GRAFT; RIB CARTILAGE, AUTOGENOUS, TO FACE, CHIN, NOSE OR EAR (INCLUDES OBTAINING GRAFT)
GRAFT; EAR CARTILAGE, AUTOGENOUS, TO NOSE OR EAR (INCLUDES OBTAINING GRAFT)
ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, WITH OR WITHOUT AUTOGRAFT (INCLUDES OBTAINING GRAFT)
ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, WITH ALLOGRAFT
ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, WITH PROSTHETIC JOINT REPLACEMENT
RECONSTRUCTION OF MANDIBLE, EXTRAORAL, WITH TRANSOSTEAL BONE PLATE (EG, MANDIBULAR STAPLE BON
RECONSTRUCTION OF MANDIBLE OR MAXILLA, SUBPERIOSTEAL IMPLANT; PARTIAL
RECONSTRUCTION OF MANDIBLE OR MAXILLA, SUBPERIOSTEAL IMPLANT; COMPLETE
RECONSTRUCTION OF MANDIBULAR CONDYLE WITH BONE AND CARTILAGE AUTOGRAFTS (INCLUDES OBTAINING
RECONSTRUCTION OF MANDIBLE OR MAXILLA, ENDOSTEAL IMPLANT (EG, BLADE, CYLINDER); PARTIAL
RECONSTRUCTION OF MANDIBLE OR MAXILLA, ENDOSTEAL IMPLANT (EG, BLADE, CYLINDER); COMPLETE
RECONSTRUCTION OF ZYGOMATIC ARCH AND GLENOID FOSSA WITH BONE AND CARTILAGE (INCLUDES OBTAININ
RECONSTRUCTION OF ORBIT WITH OSTEOTOMIES (EXTRACRANIAL) AND WITH BONE GRAFTS (INCLUDES OBTAIN
PERIORBITAL OSTEOTOMIES FOR ORBITAL HYPERTELORISM, WITH BONE GRAFTS; EXTRACRANIAL APPROACH
PERIORBITAL OSTEOTOMIES FOR ORBITAL HYPERTELORISM, WITH BONE GRAFTS; COMBINED INTRA- AND EXTRA
PERIORBITAL OSTEOTOMIES FOR ORBITAL HYPERTELORISM, WITH BONE GRAFTS; WITH FOREHEAD ADVANCEME
ORBITAL REPOSITIONING, PERIORBITAL OSTEOTOMIES, UNILATERAL, WITH BONE GRAFTS; EXTRACRANIAL APPR
ORBITAL REPOSITIONING, PERIORBITAL OSTEOTOMIES, UNILATERAL, WITH BONE GRAFTS; COMBINED INTRA- AN
MALAR AUGMENTATION, PROSTHETIC MATERIAL
SECONDARY REVISION OF ORBITOCRANIOFACIAL RECONSTRUCTION
MEDIAL CANTHOPEXY (SEPARATE PROCEDURE)
LATERAL CANTHOPEXY
REDUCTION OF MASSETER MUSCLE AND BONE (EG, FOR TREATMENT OF BENIGN MASSETERIC HYPERTROPHY);
REDUCTION OF MASSETER MUSCLE AND BONE (EG, FOR TREATMENT OF BENIGN MASSETERIC HYPERTROPHY);
UNLISTED CRANIOFACIAL AND MAXILLOFACIAL PROCEDURE
CLOSED TREATMENT OF SKULL FRACTURE WITHOUT OPERATION
CLOSED TREATMENT OF NASAL BONE FRACTURE WITHOUT MANIPULATION
CLOSED TREATMENT OF NASAL BONE FRACTURE; WITHOUT STABILIZATION
CLOSED TREATMENT OF NASAL BONE FRACTURE; WITH STABILIZATION
OPEN TREATMENT OF NASAL FRACTURE; UNCOMPLICATED
OPEN TREATMENT OF NASAL FRACTURE; COMPLICATED, WITH INTERNAL AND/OR EXTERNAL SKELETAL FIXATION
OPEN TREATMENT OF NASAL FRACTURE; WITH CONCOMITANT OPEN TREATMENT OF FRACTURED SEPTUM
OPEN TREATMENT OF NASAL SEPTAL FRACTURE, WITH OR WITHOUT STABILIZATION
CLOSED TREATMENT OF NASAL SEPTAL FRACTURE, WITH OR WITHOUT STABILIZATION
OPEN TREATMENT OF NASOETHMOID FRACTURE; WITHOUT EXTERNAL FIXATION
OPEN TREATMENT OF NASOETHMOID FRACTURE; WITH EXTERNAL FIXATION
PERCUTANEOUS TREATMENT OF NASOETHMOID COMPLEX FRACTURE, WITH SPLINT, WIRE OR HEADCAP FIXATIO
OPEN TREATMENT OF DEPRESSED FRONTAL SINUS FRACTURE
OPEN TREATMENT OF COMPLICATED (EG, COMMINUTED OR INVOLVING POSTERIOR WALL) FRONTAL SINUS FRAC
CLOSED TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFORT II TYPE), WITH INTERDENTAL WIRE FIXA
OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFORT II TYPE); WITH WIRING AND/OR LOCAL FIX
OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFORT II TYPE); REQUIRING MULTIPLE OPEN APP
OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFORT II TYPE); WITH BONE GRAFTING (INCLUDE
PERCUTANEOUS TREATMENT OF FRACTURE OF MALAR AREA, INCLUDING ZYGOMATIC ARCH AND MALAR TRIPOD
OPEN TREATMENT OF DEPRESSED ZYGOMATIC ARCH FRACTURE (EG, GILLES APPROACH)
OPEN TREATMENT OF DEPRESSED MALAR FRACTURE, INCLUDING ZYGOMATIC ARCH AND MALAR TRIPOD
OPEN TREATMENT OF COMPLICATED (EG, COMMINUTED OR INVOLVING CRANIAL NERVE FORAMINA) FRACTURE(S
OPEN TREATMENT OF COMPLICATED (EG, COMMINUTED OR INVOLVING CRANIAL NERVE FORAMINA) FRACTURE(S
OPEN TREATMENT OF ORBITAL FLOOR "BLOWOUT" FRACTURE; TRANSANTRAL APPROACH (CALDWELL-LUC TYPE
OPEN TREATMENT OF ORBITAL FLOOR "BLOWOUT" FRACTURE; PERIORBITAL APPROACH
OPEN TREATMENT OF ORBITAL FLOOR "BLOWOUT" FRACTURE; COMBINED APPROACH
OPEN TREATMENT OF ORBITAL FLOOR "BLOWOUT" FRACTURE; PERIORBITAL APPROACH, WITH ALLOPLASTIC OR
OPEN TREATMENT OF ORBITAL FLOOR "BLOWOUT" FRACTURE; PERIORBITAL APPROACH WITH BONE GRAFT (INC
CLOSED TREATMENT OF FRACTURE OF ORBIT, EXCEPT "BLOWOUT"; WITHOUT MANIPULATION
CLOSED TREATMENT OF FRACTURE OF ORBIT, EXCEPT "BLOWOUT"; WITH MANIPULATION
OPEN TREATMENT OF FRACTURE OF ORBIT, EXCEPT "BLOWOUT"; WITHOUT IMPLANT
OPEN TREATMENT OF FRACTURE OF ORBIT, EXCEPT "BLOWOUT"; WITH IMPLANT
OPEN TREATMENT OF FRACTURE OF ORBIT, EXCEPT "BLOWOUT"; WITH BONE GRAFTING (INCLUDES OBTAINING
CLOSED TREATMENT OF PALATAL OR MAXILLARY FRACTURE (LEFORT I TYPE), WITH INTERDENTAL WIRE FIXATIO
OPEN TREATMENT OF PALATAL OR MAXILLARY FRACTURE (LEFORT I TYPE);
OPEN TREATMENT OF PALATAL OR MAXILLARY FRACTURE (LEFORT I TYPE); COMPLICATED (COMMINUTED OR INV
CLOSED TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT III TYPE) USING INTERDENTAL WIRE FIXATION OF
OPEN TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT III TYPE); WITH WIRING AND/OR INTERNAL FIXATION
OPEN TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT III TYPE); COMPLICATED (EG, COMMINUTED OR INVO
OPEN TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT III TYPE); COMPLICATED, UTILIZING INTERNAL AND/O
OPEN TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT III TYPE); COMPLICATED, MULTIPLE SURGICAL APPR
CLOSED TREATMENT OF MANDIBULAR OR MAXILLARY ALVEOLAR RIDGE FRACTURE (SEPARATE PROCEDURE)
OPEN TREATMENT OF MANDIBULAR OR MAXILLARY ALVEOLAR RIDGE FRACTURE (SEPARATE PROCEDURE)
CLOSED TREATMENT OF MANDIBULAR FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF MANDIBULAR FRACTURE; WITH MANIPULATION
PERCUTANEOUS TREATMENT OF MANDIBULAR FRACTURE, WITH EXTERNAL FIXATION
CLOSED TREATMENT OF MANDIBULAR FRACTURE WITH INTERDENTAL FIXATION
OPEN TREATMENT OF MANDIBULAR FRACTURE WITH EXTERNAL FIXATION
OPEN TREATMENT OF MANDIBULAR FRACTURE; WITHOUT INTERDENTAL FIXATION
OPEN TREATMENT OF MANDIBULAR FRACTURE; WITH INTERDENTAL FIXATION
OPEN TREATMENT OF MANDIBULAR CONDYLAR FRACTURE
OPEN TREATMENT OF COMPLICATED MANDIBULAR FRACTURE BY MULTIPLE SURGICAL APPROACHES INCLUDING
CLOSED TREATMENT OF TEMPOROMANDIBULAR DISLOCATION; INITIAL OR SUBSEQUENT
CLOSED TREATMENT OF TEMPOROMANDIBULAR DISLOCATION; COMPLICATED (EG, RECURRENT REQUIRING INTE
OPEN TREATMENT OF TEMPOROMANDIBULAR DISLOCATION
CLOSED TREATMENT OF HYOID FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF HYOID FRACTURE; WITH MANIPULATION
OPEN TREATMENT OF HYOID FRACTURE
INTERDENTAL WIRING, FOR CONDITION OTHER THAN FRACTURE
UNLISTED MUSCULOSKELETAL PROCEDURE, HEAD
INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA, SOFT TISSUES OF NECK OR THORAX;
INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA, SOFT TISSUES OF NECK OR THORAX; WITH PARTIAL R
INCISION, DEEP, WITH OPENING OF BONE CORTEX (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), THORAX
BIOPSY, SOFT TISSUE OF NECK OR THORAX
EXCISION TUMOR, SOFT TISSUE OF NECK OR THORAX; SUBCUTANEOUS
EXCISION TUMOR, SOFT TISSUE OF NECK OR THORAX; DEEP, SUBFASCIAL, INTRAMUSCULAR
RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF NECK OR THORAX
EXCISION OF RIB, PARTIAL
COSTOTRANSVERSECTOMY (SEPARATE PROCEDURE)
EXCISION FIRST AND/OR CERVICAL RIB;
EXCISION FIRST AND/OR CERVICAL RIB; WITH SYMPATHECTOMY
OSTECTOMY OF STERNUM, PARTIAL
STERNAL DEBRIDEMENT
RADICAL RESECTION OF STERNUM;
RADICAL RESECTION OF STERNUM; WITH MEDIASTINAL LYMPHADENECTOMY
DIVISION OF SCALENUS ANTICUS; WITHOUT RESECTION OF CERVICAL RIB
DIVISION OF SCALENUS ANTICUS; WITH RESECTION OF CERVICAL RIB
DIVISION OF STERNOCLEIDOMASTOID FOR TORTICOLLIS, OPEN OPERATION; WITHOUT CAST APPLICATION
DIVISION OF STERNOCLEIDOMASTOID FOR TORTICOLLIS, OPEN OPERATION; WITH CAST APPLICATION
RECONSTRUCTIVE REPAIR OF PECTUS EXCAVATUM OR CARINATUM; OPEN
RECONSTRUCTIVE REPAIR OF PECTUS EXCAVATUM OR CARINATUM; MINIMALLY INVASIVE APPROACH (NUSS PRO
RECONSTRUCTIVE REPAIR OF PECTUS EXCAVATUM OR CARINATUM; MINIMALLY INVASIVE APPROACH (NUSS PRO
CLOSURE OF MEDIAN STERNOTOMY SEPARATION WITH OR WITHOUT DEBRIDEMENT
CLOSED TREATMENT OF RIB FRACTURE, UNCOMPLICATED, EACH
OPEN TREATMENT OF RIB FRACTURE WITHOUT FIXATION, EACH
TREATMENT OF RIB FRACTURE REQUIRING EXTERNAL FIXATION ("FLAIL CHEST")
CLOSED TREATMENT OF STERNUM FRACTURE
OPEN TREATMENT OF STERNUM FRACTURE WITH OR WITHOUT SKELETAL FIXATION
UNLISTED PROCEDURE, NECK OR THORAX
BIOPSY, SOFT TISSUE OF BACK OR FLANK; SUPERFICIAL
BIOPSY, SOFT TISSUE OF BACK OR FLANK; DEEP
EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK
RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF BACK OR FLANK
PARTIAL EXCISION OF POSTERIOR VERTEBRAL COMPONENT (EG, SPINOUS PROCESS, LAMINA OR FACET) FOR IN
PARTIAL RESECTION OF VERTEBRAL COMPONENT, SPINOUS PROCESSES; THORACIC
PARTIAL RESECTION OF VERTEBRAL COMPONENT, SPINOUS PROCESSES; LUMBAR
PARTIAL EXCISION OF POSTERIOR VERTEBRAL COMPONENT (EG, SPINOUS PROCESS, LAMINA OR FACET) FOR IN
PARTIAL EXCISION OF VERTEBRAL BODY, FOR INTRINSIC BONY LESION, WITHOUT DECOMPRESSION OF SPINAL C
PARTIAL EXCISION OF VERTEBRAE (EG, FOR OSTEOMYELITIS); THORACIC
PARTIAL EXCISION OF VERTEBRAE (EG, FOR OSTEOMYELITIS); LUMBAR
PARTIAL EXCISION OF VERTEBRAL BODY, FOR INTRINSIC BONY LESION, W/O DECOMPRESSION OF SPINAL CORD
OSTEOTOMY OF SPINE, POSTERIOR OR POSTEROLATERAL APPROACH, ONE VERTEBRAL SEGMENT; CERVICAL
OSTEOTOMY OF SPINE, POSTERIOR OR POSTEROLATERAL APPROACH, ONE VERTEBRAL SEGMENT; THORACIC
OSTEOTOMY OF SPINE, POSTERIOR OR POSTEROLATERAL APPROACH, ONE VERTEBRAL SEGMENT; LUMBAR
OSTEOTOMY OF SPINE, POSTERIOR OR POSTEROLATERAL APPROACH, ONE VERTEBRAL SEGMENT; EACH ADDIT
OSTEOTOMY OF SPINE, INCLUDING DISKECTOMY, ANTERIOR APPROACH, SINGLE VERTEBRAL SEGMENT; CERVIC
OSTEOTOMY OF SPINE, INCLUDING DISKECTOMY, ANTERIOR APPROACH, SINGLE VERTEBRAL SEGMENT; THORAC
OSTEOTOMY OF SPINE, INCLUDING DISKECTOMY, ANTERIOR APPROACH, SINGLE VERTEBRAL SEGMENT; LUMBAR
OSTEOTOMY OF SPINE, INCLUDING DISKECTOMY, ANTERIOR APPROACH, SINGLE VERTEBRAL SEGMENT; EACH A
CLOSED TREATMENT OF VERTEBRAL PROCESS FRACTURE(S)
CLOSED TREATMENT OF VERTEBRAL BODY FRACTURE(S), WITHOUT MANIPULATION, REQUIRING AND INCLUDING
CLOSED TREATMENT OF VERTEBRAL FRACTURE(S) AND/OR DISLOCATION(S) REQUIRING CASTING OR BRACING,
OPEN TREATMENT AND/OR REDUCTION OF ODONTOID FRACTURE(S) AND OR DISLOCATION(S) (INCLUDING OS OD
OPEN TREATMENT AND/OR REDUCTION OF ODONTOID FRACTURE(S) AND OR DISLOCATION(S) (INCLUDING OS OD
OPEN TREATMENT AND/OR REDUCTION OF VERTEBRAL FRACTURE(S) AND/OR DISLOCATION(S), POSTERIOR APP
OPEN TREATMENT AND/OR REDUCTION OF VERTEBRAL FRACTURE(S) AND/OR DISLOCATION(S), POSTERIOR APP
OPEN TREATMENT AND/OR REDUCTION OF VERTEBRAL FRACTURE(S) AND/OR DISLOCATION(S), POSTERIOR APP
OPEN TX &/OR REDUCTION OF VERTEBRAL FRACTURE(S) &/OR DISLOCATION(S), POSTERIOR APPROACH, ONE FR
MANIPULATION OF SPINE REQUIRING ANESTHESIA, ANY REGION
PERCUTANEOUS VERTEBROPLASTY, ONE VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION; THORACIC
PERCUTANEOUS VERTEBROPLASTY, ONE VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION; LUMBAR
PERCUTANEOUS VERTEBROPLASTY, ONE VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION; EACH ADDIT
ARTHRODESIS, ANTERIOR TRANSORAL OR EXTRAORAL TECHNIQUE, CLIVUS-C1-C2 (ATLAS-AXIS), WITH OR WITHO
ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMAL DISKECTOMY TO PREPARE INTERSPACE
ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMAL DISKECTOMY TO PREPARE INTERSPACE
ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMAL DISKECTOMY TO PREPARE INTERSPACE
ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMAL DISKECTOMY TO PREPARE INTERSPACE
ARTHRODESIS, POSTERIOR TECHNIQUE, CRANIOCERVICAL (OCCIPUT-C2)
ARTHRODESIS, POSTERIOR TECHNIQUE, ATLAS-AXIS (C1-C2)
ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL; CERVICAL BELOW C2 SEGMENT
ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL; THORACIC (WITH OR WITHOUT LA
ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL; LUMBAR (WITH OR WITHOUT LATE
ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL; EACH ADDITIONAL VERTEBRAL SE
ARTHRODESIS, POSTERIOR INTERBODY TECHNIQUE, INCLUDING LAMINECTOMY AND/OR DISKECTOMY TO PREPA
ARTHRODESIS, POSTERIOR INTERBODY TECHNIQUE, SINGLE INTERSPACE; EACH ADDITIONAL INTERSPACE (LIST
ARTHRODESIS, POSTERIOR, FOR SPINAL DEFORMITY, WITH OR WITHOUT CAST; UP TO 6 VERTEBRAL SEGMENTS
ARTHRODESIS, POSTERIOR, FOR SPINAL DEFORMITY, WITH OR WITHOUT CAST; 7 TO 12 VERTEBRAL SEGMENTS
ARTHRODESIS, POSTERIOR, FOR SPINAL DEFORMITY, WITH OR WITHOUT CAST; 13 OR MORE VERTEBRAL SEGME
ARTHRODESIS, ANTERIOR, FOR SPINAL DEFORMITY, WITH OR WITHOUT CAST; 2 TO 3 VERTEBRAL SEGMENTS
ARTHRODESIS, ANTERIOR, FOR SPINAL DEFORMITY, WITH OR WITHOUT CAST; 4 TO 7 VERTEBRAL SEGMENTS
ARTHRODESIS, ANTERIOR, FOR SPINAL DEFORMITY, WITH OR WITHOUT CAST; 8 OR MORE VERTEBRAL SEGMENT
KYPHECTOMY, CIRCUMFERENTIAL EXPOSURE OF SPINE AND RESECTION OF VERTEBRAL SEGMENT(S) (INCLUDIN
KYPHECTOMY, CIRCUMFERENTIAL EXPOSURE OF SPINE AND RESECTION OF VERTEBRAL SEGMENT(S) (INCLUDIN
EXPLORATION OF SPINAL FUSION
POSTERIOR NON-SEGMENTAL INSTRUMENTATION
INTERNAL SPINAL FIXATION BY WIRING OF SPINOUS PROCESSES
POSTERIOR SEGMENTAL INSTRUMENTATION (EG, PEDICLE FIXATION, DUAL RODS WITH MULTIPLE HOOKS AND SU
POSTERIOR SEGMENTAL INSTRUMENTATION (EG, PEDICLE FIXATION, DUAL RODS WITH MULTIPLE HOOKS AND SU
POSTERIOR SEGMENTAL INSTRUMENTATION (EG, PEDICLE FIXATION, DUAL RODS WITH MULTIPLE HOOKS AND SU
ANTERIOR INSTRUMENTATION; 2 TO 3 VERTEBRAL SEGMENTS
ANTERIOR INSTRUMENTATION; 4 TO 7 VERTEBRAL SEGMENTS
ANTERIOR INSTRUMENTATION; 8 OR MORE VERTEBRAL SEGMENTS
PELVIC FIXATION (ATTACHMENT OF CAUDAL END OF INSTRUMENTATION TO PELVIC BONY STRUCTURES) OTHER
REINSERTION OF SPINAL FIXATION DEVICE
REMOVAL OF POSTERIOR NONSEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD)
APPLICATION OF INTERVERTEBRAL BIOMECHANICAL DEVICE(S) (EG, SYNTHETIC CAGE(S), THREADED BONE DOW
REMOVAL OF POSTERIOR SEGMENTAL INSTRUMENTATION
REMOVAL OF ANTERIOR INSTRUMENTATION
UNLISTED PROCEDURE, SPINE
EXCISION, ABDOMINAL WALL TUMOR, SUBFASCIAL (EG, DESMOID)
UNLISTED PROCEDURE, ABDOMEN, MUSCULOSKELETAL SYSTEM
REMOVAL OF SUBDELTOID CALCAREOUS DEPOSITS, OPEN
CAPSULAR CONTRACTURE RELEASE (EG, SEVER TYPE PROCEDURE)
INCISION AND DRAINAGE, SHOULDER AREA; DEEP ABSCESS OR HEMATOMA
INCISION AND DRAINAGE, SHOULDER AREA; INFECTED BURSA
INCISION, BONE CORTEX (EG, OSTEOMYELITIS OR BONE ABSCESS), SHOULDER AREA
ARTHROTOMY, GLENOHUMERAL JOINT, INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY
ARTHROTOMY, ACROMIOCLAVICULAR, STERNOCLAVICULAR JOINT, INCLUDING EXPLORATION, DRAINAGE, OR RE
BIOPSY, SOFT TISSUE OF SHOULDER AREA; SUPERFICIAL
BIOPSY, SOFT TISSUE OF SHOULDER AREA; DEEP
EXCISION, SOFT TISSUE TUMOR, SHOULDER AREA; SUBCUTANEOUS
EXCISION, TUMOR, SHOULDER AREA; DEEP, SUBFASCIAL OR INTRAMUSCULAR
RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF SHOULDER AREA
ARTHROTOMY, GLENOHUMERAL JOINT, INCLUDING BIOPSY
ARTHROTOMY, ACROMIOCLAVICULAR JOINT OR STERNOCLAVICULAR JOINT, INCLUDING BIOPSY AND/OR EXCISIO
ARTHROTOMY; GLENOHUMERAL JOINT, WITH SYNOVECTOMY, WITH OR WITHOUT BIOPSY
ARTHROTOMY; STERNOCLAVICULAR JOINT, WITH SYNOVECTOMY, WITH OR WITHOUT BIOPSY
ARTHROTOMY, GLENOHUMERAL JOINT, WITH JOINT EXPLORATION, WITH OR WITHOUT REMOVAL OF LOOSE OR F
CLAVICULECTOMY; PARTIAL
CLAVICULECTOMY; TOTAL
ACROMIOPLASTY OR ACROMIONECTOMY, PARTIAL, WITH OR WITHOUT CORACOACROMIAL LIGAMENT RELEASE
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CLAVICLE OR SCAPULA;
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CLAVICLE OR SCAPULA; WITH AUTOGRAFT (INC
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CLAVICLE OR SCAPULA; WITH ALLOGRAFT
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF PROXIMAL HUMERUS;
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF PROXIMAL HUMERUS; WITH AUTOGRAFT (INCLU
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF PROXIMAL HUMERUS; WITH ALLOGRAFT
SEQUESTRECTOMY (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), CLAVICLE
SEQUESTRECTOMY (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), SCAPULA
SEQUESTRECTOMY (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), HUMERAL HEAD TO SURGICAL NECK
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS), CLAVIC
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS), SCAPU
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS), PROXIM
OSTECTOMY OF SCAPULA, PARTIAL (EG, SUPERIOR MEDIAL ANGLE)
RESECTION HUMERAL HEAD
RADICAL RESECTION FOR TUMOR; CLAVICLE
RADICAL RESECTION FOR TUMOR; SCAPULA
RADICAL RESECTION OF BONE TUMOR, PROXIMAL HUMERUS
RADICAL RESECTION FOR TUMOR, PROXIMAL HUMERUS; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)
RADICAL RESECTION FOR TUMOR, PROXIMAL HUMERUS; WITH PROSTHETIC REPLACEMENT
REMOVAL OF FOREIGN BODY, SHOULDER; SUBCUTANEOUS
REMOVAL OF FOREIGN BODY, SHOULDER; DEEP (EG, NEER HEMIARTHROPLASTY REMOVAL)
REMOVAL OF FOREIGN BODY, SHOULDER; COMPLICATED (EG, TOTAL SHOULDER)
INJECTION PROCEDURE FOR SHOULDER ARTHROGRAPHY OR ENHANCED CT/MRI SHOULDER ARTHROGRAPHY
MUSCLE TRANSFER, ANY TYPE, SHOULDER OR UPPER ARM; SINGLE
MUSCLE TRANSFER, ANY TYPE, SHOULDER OR UPPER ARM; MULTIPLE
SCAPULOPEXY (EG, SPRENGEL'S DEFORMITY OR FOR PARALYSIS)
TENOTOMY, SHOULDER AREA; SINGLE TENDON
TENOTOMY, SHOULDER AREA; MULTIPLE TENDONS THROUGH SAME INCISION
REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF) OPEN; ACUTE
REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF) OPEN; CHRONIC
CORACOACROMIAL LIGAMENT RELEASE, WITH OR WITHOUT ACROMIOPLASTY
RECONSTRUCTION OF COMPLETE SHOULDER (ROTATOR) CUFF AVULSION, CHRONIC (INCLUDES ACROMIOPLAST
TENODESIS OF LONG TENDON OF BICEPS
RESECTION OR TRANSPLANTATION OF LONG TENDON OF BICEPS
CAPSULORRHAPHY, ANTERIOR; PUTTI-PLATT PROCEDURE OR MAGNUSON TYPE OPERATION
CAPSULORRHAPHY, ANTERIOR; WITH LABRAL REPAIR (EG, BANKART PROCEDURE)
CAPSULORRHAPHY, ANTERIOR, ANY TYPE; WITH BONE BLOCK
CAPSULORRHAPHY, ANTERIOR, ANY TYPE; WITH CORACOID PROCESS TRANSFER
CAPSULORRHAPHY, GLENOHUMERAL JOINT, POSTERIOR, WITH OR WITHOUT BONE BLOCK
CAPSULORRHAPHY, GLENOHUMERAL JOINT, ANY TYPE MULTI-DIRECTIONAL INSTABILITY
ARTHROPLASTY, GLENOHUMERAL JOINT; HEMIARTHROPLASTY
ARTHROPLASTY, GLENOHUMERAL JOINT; TOTAL SHOULDER (GLENOID AND PROXIMAL HUMERAL REPLACEMENT
OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXATION;
OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXATION; WITH BONE GRAFT FOR NONUNION OR MALUNI
PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT METHYLMETHACRYLAT
PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT METHYLMETHACRYLAT
CLOSED TREATMENT OF CLAVICULAR FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF CLAVICULAR FRACTURE; WITH MANIPULATION
OPEN TREATMENT OF CLAVICULAR FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
CLOSED TREATMENT OF STERNOCLAVICULAR DISLOCATION; WITHOUT MANIPULATION
CLOSED TREATMENT OF STERNOCLAVICULAR DISLOCATION; WITH MANIPULATION
OPEN TREATMENT OF STERNOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC;
OPEN TREATMENT OF STERNOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC; WITH FASCIAL GRAFT (INCLUDES
CLOSED TREATMENT OF ACROMIOCLAVICULAR DISLOCATION; WITHOUT MANIPULATION
CLOSED TREATMENT OF ACROMIOCLAVICULAR DISLOCATION; WITH MANIPULATION
OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC;
OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC; WITH FASCIAL GRAFT (INCLUDE
CLOSED TREATMENT OF SCAPULAR FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF SCAPULAR FRACTURE; WITH MANIPULATION, WITH OR WITHOUT SKELETAL TRACTION (
OPEN TREATMENT OF SCAPULAR FRACTURE (BODY, GLENOID OR ACROMION) WITH OR WITHOUT INTERNAL FIXA
CLOSED TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE; WITHOUT MANIPUL
CLOSED TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE; WITH MANIPULATIO
OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, WITH OR WITHOUT IN
OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, WITH OR W/O INTERN
CLOSED TREATMENT OF GREATER HUMERAL TUBEROSITY FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF GREATER TUBEROSITY FRACTURE; WITH MANIPULATION
OPEN TREATMENT OF GREATER HUMERAL TUBEROSITY FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL
CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION; WITHOUT ANESTHESIA
CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION; REQUIRING ANESTHESIA
OPEN TREATMENT OF ACUTE SHOULDER DISLOCATION
CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH FRACTURE OF GREATER HUMERAL TUBEROSITY, WITH
OPEN TREATMENT OF SHOULDER DISLOCATION, WITH FRACTURE OF GREATER HUMERAL TUBEROSITY, WITH OR
CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH SURGICAL OR ANATOMICAL NECK FRACTURE, WITH MA
OPEN TREATMENT OF SHOULDER DISLOCATION, WITH SURGICAL OR ANATOMICAL NECK FRACTURE, WITH OR W
MANIPULATION UNDER ANESTHESIA, SHOULDER JOINT, INCLUDING APPLICATION OF FIXATION APPARATUS (DISL
ARTHRODESIS, GLENOHUMERAL JOINT
ARTHRODESIS, GLENOHUMERAL JOINT; WITH AUTOGENOUS GRAFT (INCLUDES OBTAINING GRAFT)
INTERTHORACOSCAPULAR AMPUTATION (FOREQUARTER)
DISARTICULATION OF SHOULDER;
DISARTICULATION OF SHOULDER; SECONDARY CLOSURE OR SCAR REVISION
UNLISTED PROCEDURE, SHOULDER
INCISION AND DRAINAGE, UPPER ARM OR ELBOW AREA; DEEP ABSCESS OR HEMATOMA
INCISION AND DRAINAGE, UPPER ARM OR ELBOW AREA; BURSA
INCISION, DEEP, WITH OPENING OF BONE CORTEX (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), HUMERUS OR
ARTHROTOMY, ELBOW, INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY
ARTHROTOMY OF THE ELBOW, WITH CAPSULAR EXCISION FOR CAPSULAR RELEASE (SEPARATE PROCEDURE)
BIOPSY, SOFT TISSUE OF UPPER ARM OR ELBOW AREA; SUPERFICIAL
BIOPSY, SOFT TISSUE OF UPPER ARM OR ELBOW AREA; DEEP (SUBFASCIAL OR INTRAMUSCULAR)
EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA; SUBCUTANEOUS
EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA; DEEP
RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF UPPER ARM OR ELBOW AREA
ARTHROTOMY, ELBOW; WITH SYNOVIAL BIOPSY ONLY
ARTHROTOMY, ELBOW; WITH JOINT EXPLORATION, WITH OR WITHOUT BIOPSY, WITH OR WITHOUT REMOVAL OF
ARTHROTOMY, ELBOW; WITH SYNOVECTOMY
EXCISION, OLECRANON BURSA
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, HUMERUS;
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, HUMERUS; WITH AUTOGRAFT (INCLUDES OBTAINI
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, HUMERUS; WITH ALLOGRAFT
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF HEAD OR NECK OF RADIUS OR OLECRANON PR
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF HEAD OR NECK OF RADIUS OR OLECRANON PR
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF HEAD OR NECK OF RADIUS OR OLECRANON PR
EXCISION, RADIAL HEAD
SEQUESTRECTOMY (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), SHAFT OR DISTAL HUMERUS
SEQUESTRECTOMY (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), RADIAL HEAD OR NECK
SEQUESTRECTOMY (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), OLECRANON PROCESS
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS), HUMER
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS), RADIAL
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS), OLECR
RADICAL RESECTION OF CAPSULE, SOFT TISSUE, AND HETEROTOPIC BONE, ELBOW, WITH CONTRACTURE RELEA
RADICAL RESECTION FOR TUMOR, SHAFT OR DISTAL HUMERUS;
RADICAL RESECTION FOR TUMOR, SHAFT OR DISTAL HUMERUS; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT
RADICAL RESECTION FOR TUMOR, RADIAL HEAD OR NECK;
RADICAL RESECTION FOR TUMOR, RADIAL HEAD OR NECK; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)
RESECTION OF ELBOW JOINT (ARTHRECTOMY)
IMPLANT REMOVAL; ELBOW JOINT
IMPLANT REMOVAL; RADIAL HEAD
REMOVAL OF FOREIGN BODY, UPPER ARM OR ELBOW AREA; SUBCUTANEOUS
REMOVAL OF FOREIGN BODY, UPPER ARM OR ELBOW AREA; DEEP (SUBFASCIAL OR INTRAMUSCULAR)
INJECTION PROCEDURE FOR ELBOW ARTHROGRAPHY
MANIPULATION, ELBOW, UNDER ANESTHESIA
MUSCLE OR TENDON TRANSFER, ANY TYPE, UPPER ARM OR ELBOW, SINGLE (EXCLUDING 24320-24331)
TENDON LENGTHENING, UPPER ARM OR ELBOW, EACH TENDON
TENOTOMY, OPEN, ELBOW TO SHOULDER, EACH TENDON
TENOPLASTY, WITH MUSCLE TRANSFER, WITH OR WITHOUT FREE GRAFT, ELBOW TO SHOULDER, SINGLE (SEDD
FLEXOR-PLASTY, ELBOW (EG, STEINDLER TYPE ADVANCEMENT);
FLEXOR-PLASTY, ELBOW (EG, STEINDLER TYPE ADVANCEMENT); WITH EXTENSOR ADVANCEMENT
TENOLYSIS, TRICEPS
TENODESIS OF BICEPS TENDON AT ELBOW (SEPARATE PROCEDURE)
REPAIR, TENDON OR MUSCLE, UPPER ARM OR ELBOW, EACH TENDON OR MUSCLE, PRIMARY OR SECONDARY (EX
REINSERTION OF RUPTURED BICEPS OR TRICEPS TENDON, DISTAL, WITH OR WITHOUT TENDON GRAFT
REPAIR LATERAL COLLATERAL LIGAMENT, ELBOW, WITH LOCAL TISSUE
RECONSTRUCTION LATERAL COLLATERAL LIGAMENT, ELBOW, WITH TENDON GRAFT (INCLUDES HARVESTING OF
REPAIR MEDIAL COLLATERAL LIGAMENT, ELBOW, WITH LOCAL TISSUE
RECONSTRUCTION MEDIAL COLLATERAL LIGAMENT, ELBOW, WITH TENDON GRAFT (INCLUDES HARVESTING OF G
FASCIOTOMY, LATERAL OR MEDIAL (EG, "TENNIS ELBOW" OR EPICONDYLITIS);
FASCIOTOMY, LATERAL OR MEDIAL (EG, "TENNIS ELBOW" OR EPICONDYLITIS); WITH EXTENSOR ORIGIN DETACHM
FASCIOTOMY, LATERAL OR MEDIAL (EG, "TENNIS ELBOW" OR EPICONDYLITIS); WITH ANNULAR LIGAMENT RESECT
FASCIOTOMY, LATERAL OR MEDIAL (EG, "TENNIS ELBOW" OR EPICONDYLITIS); WITH STRIPPING
FASCIOTOMY, LATERAL OR MEDIAL (EG, "TENNIS ELBOW" OR EPICONDYLITIS); WITH PARTIAL OSTECTOMY
ARTHROPLASTY, ELBOW; WITH MEMBRANE (EG, FASCIAL)
ARTHROPLASTY, ELBOW; WITH DISTAL HUMERAL PROSTHETIC REPLACEMENT
ARTHROPLASTY, ELBOW; WITH IMPLANT AND FASCIA LATA LIGAMENT RECONSTRUCTION
ARTHROPLASTY, ELBOW; WITH DISTAL HUMERUS AND PROXIMAL ULNAR PROSTHETIC REPLACEMENT (EG, TOTA
ARTHROPLASTY, RADIAL HEAD;
ARTHROPLASTY, RADIAL HEAD; WITH IMPLANT
OSTEOTOMY, HUMERUS, WITH OR WITHOUT INTERNAL FIXATION
MULTIPLE OSTEOTOMIES WITH REALIGNMENT ON INTRAMEDULLARY ROD, HUMERAL SHAFT (SOFIELD TYPE PRO
OSTEOPLASTY, HUMERUS (EG, SHORTENING OR LENGTHENING) (EXCLUDING 64876)
REPAIR OF NONUNION OR MALUNION, HUMERUS; WITHOUT GRAFT (EG, COMPRESSION TECHNIQUE)
REPAIR OF NONUNION OR MALUNION, HUMERUS; WITH ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRA
HEMIEPIPHYSEAL ARREST (EG, FOR CUBITUS VARUS OR VALGUS, DISTAL HUMERUS)
DECOMPRESSION FASCIOTOMY, FOREARM, WITH BRACHIAL ARTERY EXPLORATION
PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING), WITH OR WITHOUT METHYLMETHACRYLAT
CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE; WITH MANIPULATION, WITH OR WITHOUT SKELETAL TRAC
OPEN TREATMENT OF HUMERAL SHAFT FRACTURE WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE
TREATMENT OF HUMERAL SHAFT FRACTURE, WITH INSERTION OF INTRAMEDULLARY IMPLANT, WITH OR WITHOU
CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR HUMERAL FRACTURE, WITH OR WITHOUT INTE
CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR HUMERAL FRACTURE, WITH OR WITHOUT INTE
PERCUTANEOUS SKELETAL FIXATION OF SUPRACONDYLAR OR TRANSCONDYLAR HUMERAL FRACTURE, WITH OR
OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE, WITH OR WITHOUT INTERN
OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE, WITH OR WITHOUT INTERN
CLOSED TREATMENT OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR LATERAL; WITHOUT MANIPULATION
CLOSED TREATMENT OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR LATERAL; WITH MANIPULATION
PERCUTANEOUS SKELETAL FIXATION OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR LATERAL, WITH MANIP
OPEN TREATMENT OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR LATERAL, WITH OR WITHOUT INTERNAL O
CLOSED TREATMENT OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL; WITHOUT MANIPULATION
CLOSED TREATMENT OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL; WITH MANIPULATION
OPEN TREATMENT OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL, WITH OR WITHOUT INTERNAL OR E
PERCUTANEOUS SKELETAL FIXATION OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL, WITH MANIPULA
OPEN TREATMENT OF PERIARTICULAR FRACTURE AND/OR DISLOCATION OF THE ELBOW (FRACTURE DISTAL HUM
OPEN TREATMENT OF PERIARTICULAR FRACTURE AND/OR DISLOCATION OF THE ELBOW (FRACTURE DISTAL HUM
TREATMENT OF CLOSED ELBOW DISLOCATION; WITHOUT ANESTHESIA
TREATMENT OF CLOSED ELBOW DISLOCATION; REQUIRING ANESTHESIA
OPEN TREATMENT OF ACUTE OR CHRONIC ELBOW DISLOCATION
CLOSED TREATMENT OF MONTEGGIA TYPE OF FRACTURE DISLOCATION AT ELBOW (FRACTURE PROXIMAL END O
OPEN TREATMENT OF MONTEGGIA TYPE OF FRACTURE DISLOCATION AT ELBOW (FRACTURE PROXIMAL END OF
CLOSED TREATMENT OF RADIAL HEAD SUBLUXATION IN CHILD, "NURSEMAID ELBOW", WITH MANIPULATION
CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE; WITH MANIPULATION
OPEN TREATMENT OF RADIAL HEAD OR NECK FRACTURE, WITH OR WITHOUT INTERNAL FIXATION OR RADIAL HE
OPEN TREATMENT OF RADIAL HEAD OR NECK FRACTURE, WITH OR WITHOUT INTERNAL FIXATION OR RADIAL HE
CLOSED TREATMENT OF ULNAR FRACTURE, PROXIMAL END (OLECRANON PROCESS); WITHOUT MANIPULATION
CLOSED TREATMENT OF ULNAR FRACTURE, PROXIMAL END (OLECRANON PROCESS); WITH MANIPULATION
OPEN TREATMENT OF ULNAR FRACTURE PROXIMAL END (OLECRANON PROCESS), WITH OR WITHOUT INTERNAL
ARTHRODESIS, ELBOW JOINT; LOCAL
ARTHRODESIS, ELBOW JOINT; WITH AUTOGENOUS GRAFT (INCLUDES OBTAINING GRAFT)
AMPUTATION, ARM THROUGH HUMERUS; WITH PRIMARY CLOSURE
AMPUTATION, ARM THROUGH HUMERUS; OPEN, CIRCULAR (GUILLOTINE)
AMPUTATION, ARM THROUGH HUMERUS; SECONDARY CLOSURE OR SCAR REVISION
AMPUTATION, ARM THROUGH HUMERUS; RE-AMPUTATION
AMPUTATION, ARM THROUGH HUMERUS; WITH IMPLANT
STUMP ELONGATION, UPPER EXTREMITY
CINEPLASTY, UPPER EXTREMITY, COMPLETE PROCEDURE
UNLISTED PROCEDURE, HUMERUS OR ELBOW
INCISION, EXTENSOR TENDON SHEATH, WRIST (EG, DEQUERVAIN'S DISEASE)
INCISION, FLEXOR TENDON SHEATH, WRIST (EG, FLEXOR CARPI RADIALIS)
DECOMPRESSION FASCIOTOMY, FOREARM AND/OR WRIST, FLEXOR OR EXTENSOR COMPARTMENT; WITHOUT DE
DECOMPRESSION FASCIOTOMY, FOREARM AND/OR WRIST, FLEXOR OR EXTENSOR
DECOMPRESSION FASCIOTOMY, FOREARM AND/OR WRIST, FLEXOR AND EXTENSOR COMPARTMENT; WITHOUT D
DECOMPRESSION FASCIOTOMY, FOREARM AND/OR WRIST, FLEXOR AND EXTENSOR COMPARTMENT; WITH DEBR
INCISION AND DRAINAGE, FOREARM AND/OR WRIST; DEEP ABSCESS OR HEMATOMA
INCISION AND DRAINAGE, FOREARM AND/OR WRIST; BURSA
INCISION, DEEP, BONE CORTEX, FOREARM AND/OR WRIST (EG, OSTEOMYELITIS OR BONE ABSCESS)
ARTHROTOMY, RADIOCARPAL OR MIDCARPAL JOINT, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN
BIOPSY, SOFT TISSUE OF FOREARM AND/OR WRIST; SUPERFICIAL
BIOPSY, SOFT TISSUE OF FOREARM AND/OR WRIST; DEEP (SUBFASCIAL OR INTRAMUSCULAR)
EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST AREA; SUBCUTANEOUS
EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST AREA; DEEP
RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF FOREARM AND/OR WRIST AREA
CAPSULOTOMY, WRIST (EG, CONTRACTURE)
ARTHROTOMY, WRIST JOINT; WITH BIOPSY
ARTHROTOMY, WRIST JOINT; WITH JOINT EXPLORATION, WITH OR WITHOUT BIOPSY, WITH OR WITHOUT REMOV
ARTHROTOMY, WRIST JOINT; WITH SYNOVECTOMY
ARTHROTOMY, DISTAL RADIOULNAR JOINT INCLUDING REPAIR OF TRIANGULAR CARTILAGE, COMPLEX
EXCISION, LESION OF TENDON SHEATH, FOREARM AND/OR WRIST
EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); PRIMARY
EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); RECURRENT
RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FOREARM TENDON SHEATHS (EG, TENOSYNOVITIS, FUNG
RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FOREARM TENDON SHEATHS (EG, TENOSYNOVITIS, FUNG
SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE COMPARTMENT;
SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE COMPARTMENT; WITH RESECTION OF DISTAL ULN
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF RADIUS OR ULNA (EXCLUDING HEAD OR NECK O
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF RADIUS OR ULNA (EXCLUDING HEAD OR NECK O
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF RADIUS OR ULNA (EXCLUDING HEAD OR NECK O
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CARPAL BONES;
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CARPAL BONES; WITH AUTOGRAFT (INCLUDES
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CARPAL BONES; WITH ALLOGRAFT
SEQUESTRECTOMY (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), FOREARM AND/OR WRIST
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION OR DIAPHYSECTOMY) OF BONE (EG, FOR OSTEOMYELITIS)
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION OR DIAPHYSECTOMY) OF BONE (EG, FOR OSTEOMYELITIS)
RADICAL RESECTION FOR TUMOR, RADIUS OR ULNA
CARPECTOMY; ONE BONE
CARPECTOMY; ALL BONES OF PROXIMAL ROW
RADIAL STYLOIDECTOMY (SEPARATE PROCEDURE)
EXCISION DISTAL ULNA PARTIAL OR COMPLETE (EG, DARRACH TYPE OR MATCHED RESECTION)
INJECTION PROCEDURE FOR WRIST ARTHROGRAPHY
EXPLORATION WITH REMOVAL OF DEEP FOREIGN BODY, FOREARM OR WRIST
REMOVAL OF WRIST PROSTHESIS; (SEPARATE PROCEDURE)
REMOVAL OF WRIST PROSTHESIS; COMPLICATED, INCLUDING "TOTAL WRIST"
MANIPULATION, WRIST, UNDER ANESTHESIA
REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST; PRIMARY, SINGLE, EACH TENDON OR MUSCLE
REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST; SECONDARY, SINGLE, EACH TENDON OR MUSC
REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST; SECONDARY, WITH FREE GRAFT (INCLUDES O
REPAIR, TENDON OR MUSCLE, EXTENSOR, FOREARM AND/OR WRIST; PRIMARY, SINGLE, EACH TENDON OR MUSC
REPAIR, TENDON OR MUSCLE, EXTENSOR, FOREARM AND/OR WRIST; SECONDARY, SINGLE, EACH TENDON OR M
REPAIR, TENDON OR MUSCLE, EXTENSOR, FOREARM AND/OR WRIST; SECONDARY, WITH FREE GRAFT, EACH TEN
REPAIR, TENDON SHEATH, EXTENSOR, FOREARM AND/OR WRIST, WITH FREE GRAFT (INCLUDES OBTAINING GRA
LENGTHENING OR SHORTENING OF FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR WRIST, SINGLE, EACH TE
TENOTOMY, OPEN, FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR WRIST, SINGLE, EACH TENDON
TENOLYSIS, FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR WRIST, SINGLE, EACH TENDON
TENODESIS AT WRIST; FLEXORS OF FINGERS
TENODESIS AT WRIST; EXTENSORS OF FINGERS
TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTENSOR, FOREARM AND/OR WRIST, SINGLE; EACH TE
TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTENSOR, FOREARM AND/OR WRIST, SINGLE; WITH TE
FLEXOR ORIGIN SLIDE (EG, FOR CEREBRAL PALSY, VOLKMANN CONTRACTURE), FOREARM AND/OR WRIST;
FLEXOR ORIGIN SLIDE (EG, FOR CEREBRAL PALSY, VOLKMANN CONTRACTURE), FOREARM AND/OR WRIST; WITH
CAPSULORRHAPHY OR RECONSTRUCTION, WRIST, OPEN (EG, CAPSULODESIS,LIGAMENT REPAIR, TENDON TRAN
ARTHOPLASTY, WRIST, WITH OR WITHOUT INTERPOSITION, WITH OR WITHOUT EXTERNAL OR INTERNAL FIXATIO
CENTRALIZATION OF WRIST ON ULNA (EG, RADIAL CLUB HAND)
RECONSTRUCTION FOR STABILIZATION OF UNSTABLE DISTAL ULNA OR DISTAL RADIOULNAR JOINT, SECONDARY
OSTEOTOMY, RADIUS; DISTAL THIRD
OSTEOTOMY, RADIUS; MIDDLE OR PROXIMAL THIRD
OSTEOTOMY; ULNA
OSTEOTOMY; RADIUS AND ULNA
MULTIPLE OSTEOTOMIES, WITH REALIGNMENT ON INTRAMEDULLARY ROD (SOFIELD TYPE PROCEDURE); RADIUS
MULTIPLE OSTEOTOMIES, WITH REALIGNMENT ON INTRAMEDULLARY ROD (SOFIELD TYPE PROCEDURE); RADIUS
OSTEOPLASTY, RADIUS OR ULNA; SHORTENING
OSTEOPLASTY, RADIUS OR ULNA; LENGTHENING WITH AUTOGRAFT
OSTEOPLASTY, RADIUS AND ULNA; SHORTENING (EXCLUDING 64876)
OSTEOPLASTY, RADIUS AND ULNA; LENGTHENING WITH AUTOGRAFT
OSTEOPLASTY, CARPAL BONE, SHORTENING
REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; WITHOUT GRAFT (EG, COMPRESSION TECHNIQUE)
REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; WITH AUTOGRAFT
REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; WITHOUT GRAFT (EG, COMPRESSION TECHNIQUE)
REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; WITH AUTOGRAFT
REPAIR OF DEFECT WITH AUTOGRAFT; RADIUS OR ULNA
REPAIR OF DEFECT WITH AUTOGRAFT; RADIUS AND ULNA
INSERTION OF VASCULAR PEDICLE INTO CARPAL BONE (EG, HORI PROCEDURE)
REPAIR OF NONUNION OF CARPAL BONE (EXCLUDING CARPAL SCAPHOID (NAVICULAR)) (INCLUDES OBTAINING G
REPAIR OF NONUNION, SCAPHOID CARPALBONE, WITH OR WITHOUT RADIAL STYLOIDECTOMY
ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; DISTAL RADIUS
ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; DISTAL ULNA
ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; SCAPHOID CARPAL
ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; LUNATE
ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; TRAPEZIUM
ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; DISTAL RADIUS AND PARTIAL OR ENTIRE CARPUS ("TOTAL W
ARTHROPLASTY, INTERPOSITION, INTERCARPAL OR CARPOMETACARPAL JOINTS
REVISION OF ARTHROPLASTY, INCLUDING REMOVAL OF IMPLANT, WRIST JOINT
EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; DISTAL RADIUS OR ULNA
EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; DISTAL RADIUS AND ULNA
PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT METHYLMETHACRYLAT
PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT METHYLMETHACRYLAT
PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT METHYLMETHACRYLAT
CLOSED TREATMENT OF RADIAL SHAFT FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF RADIAL SHAFT FRACTURE; WITH MANIPULATION
OPEN TREATMENT OF RADIAL SHAFT FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
CLOSED TREATMENT OF RADIAL SHAFT FRACTURE AND CLOSED TREATMENT OF DISLOCATION OF DISTAL RADIO
OPEN TREATMENT OF RADIAL SHAFT FRACTURE, WITH INTERNAL AND/ OR EXTERNAL FIXATION AND CLOSED TR
OPEN TREATMENT, RADIAL SHAFT FRACTURE, W INTERNAL &/ EXTERNAL FIXATION&OPEN TREATMENT, WWO INT
CLOSED TREATMENT OF ULNAR SHAFT FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF ULNAR SHAFT FRACTURE; WITH MANIPULATION
OPEN TREATMENT OF ULNAR SHAFT FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
CLOSED TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES; WITHOUT MANIPULATION
CLOSED TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES; WITH MANIPULATION
OPEN TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES, WITH INTERNAL OR EXTERNAL FIXATION; OF RAD
OPEN TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES, WITH INTERNAL OR EXTERNAL FIXATION; OF RAD
CLOSED TREATMENT OF DISTAL RADIAL FRACTURE (EG, COLLES OR SMITH TYPE) OR EPIPHYSEAL SEPARATION,
CLOSED TREATMENT OF DISTAL RADIAL FRACTURE (EG, COLLES OR SMITH TYPE) OR EPIPHYSEAL SEPARATION,
PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIAL FRACTURE (EG, COLLES OR SMITH TYPE) OR EPIPHYSEA
OPEN TREATMENT OF DISTAL RADIAL FRACTURE (EG, COLLES OR SMITH TYPE) OR EPIPHYSEAL SEPARATION, W
CLOSED TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE; WITH MANIPULATION
OPEN TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL
CLOSED TREATMENT OF CARPAL BONE FRACTURE (EXCLUDING CARPAL SCAPHOID (NAVICULAR)); WITHOUT MAN
CLOSED TREATMENT OF CARPAL BONE FRACTURE (EXCLUDING CARPAL SCAPHOID (NAVICULAR)); WITH MANIPU
OPEN TREATMENT OF CARPAL BONE FRACTURE, EACH BONE
CLOSED TREATMENT OF ULNAR STYLOID FRACTURE
PERCUTANEOUS SKELETAL FIXATION OF ULNAR STYLOID FRACTURE
OPEN TREATMENT OF ULNAR STYLOID FRACTURE
CLOSED TREATMENT OF RADIOCARPAL OR INTERCARPAL DISLOCATION, ONE OR MORE BONES, WITH MANIPULA
OPEN TREATMENT OF RADIOCARPAL OR INTERCARPAL DISLOCATION, ONE OR MORE BONES
PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIOULNAR DISLOCATION
CLOSED TREATMENT OF DISTAL RADIOULNAR DISLOCATION WITH MANIPULATION
OPEN TREATMENT OF DISTAL RADIOULNAR DISLOCATION, ACUTE OR CHRONIC
CLOSED TREATMENT OF TRANS-SCAPHOPERILUNAR TYPE OF FRACTURE DISLOCATION, WITH MANIPULATION
OPEN TREATMENT OF TRANS-SCAPHOPERILUNAR TYPE OF FRACTURE DISLOCATION
CLOSED TREATMENT OF LUNATE DISLOCATION, WITH MANIPULATION
OPEN TREATMENT OF LUNATE DISLOCATION
ARTHRODESIS, WRIST; COMPLETE, WITHOUT BONE GRAFT (INCLUDES RADIOCARPAL AND/OR INTERCARPAL AND
ARTHRODESIS, WRIST JOINT (INCLUDING RADIOCARPAL AND/OR ULNOCARPAL FUSION); WITH SLIDING GRAFT
ARTHRODESIS, WRIST JOINT (INCLUDING RADIOCARPAL AND/OR ULNOCARPAL FUSION); WITH ILIAC OR OTHER A
ARTHRODESIS, WRIST; LIMITED, WITHOUT BONE GRAFT (EG, INTERCARPAL OR RADIOCARPAL)
INTERCARPAL FUSION; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)
ARTHRODESIS, DISTAL RADIOULNAR JOINT WITH SEGMENTAL RESECTION OF ULNA, WITH OR WITHOUT BONE GR
AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA;
AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA; OPEN, CIRCULAR (GUILLOTINE)
AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA; SECONDARY CLOSURE OR SCAR REVISION
AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA; RE-AMPUTATION
KRUKENBERG PROCEDURE
DISARTICULATION THROUGH WRIST;
DISARTICULATION THROUGH WRIST; SECONDARY CLOSURE OR SCAR REVISION
DISARTICULATION THROUGH WRIST; RE-AMPUTATION
TRANSMETACARPAL AMPUTATION;
TRANSMETACARPAL AMPUTATION; SECONDARY CLOSURE OR SCAR REVISION
TRANSMETACARPAL AMPUTATION; RE-AMPUTATION
UNLISTED PROCEDURE, FOREARM OR WRIST
DRAINAGE OF FINGER ABSCESS; SIMPLE
DRAINAGE OF FINGER ABSCESS; COMPLICATED (EG, FELON)
DRAINAGE OF TENDON SHEATH, DIGIT AND/OR PALM, EACH
DRAINAGE OF PALMAR BURSA; SINGLE, BURSA
DRAINAGE OF PALMAR BURSA; MULTIPLE BURSA
INCISION, BONE CORTEX, HAND OR FINGER (EG, OSTEOMYELITIS OR BONE ABSCESS)
DECOMPRESSION FINGERS AND/OR HAND, INJECTION INJURY (EG, GREASE GUN)
DECOMPRESSIVE FASCIOTOMY, HAND (EXCLUDES 26035)
FASCIOTOMY, PALMAR (EG, DUPUYTREN'S CONTRACTURE); PERCUTANEOUS
FASCIOTOMY, PALMAR, FOR DUPUYTREN'S CONTRACTURE; OPEN, PARTIAL
TENDON SHEATH INCISION (EG, FOR TRIGGER FINGER)
TENOTOMY, PERCUTANEOUS, SINGLE, EACH DIGIT
ARTHROTOMY, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY; CARPOMETACARPA
ARTHROTOMY, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY; METACARPOPHALA
ARTHROTOMY, FOR INFECTION, WITH EXPLORATION, DRAINAGE OR REMOVAL OF FOREIGN BODY; INTERPHALAN
ARTHROTOMY WITH BIOPSY; CARPOMETACARPAL JOINT, EACH
ARTHROTOMY WITH BIOPSY; METACARPOPHALANGEAL JOINT, EACH
ARTHROTOMY WITH SYNOVIAL BIOPSY; INTERPHALANGEAL JOINT, EACH
EXCISION, TUMOR OR VASCULAR MALFORMATION, SOFT TISSUE OF HAND OR FINGER; SUBCUTANEOUS
EXCISION, TUMOR OR VASCULAR MALFORMATION, SOFT TISSUE OF HAND OR FINGER; DEEP
RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF HAND OR FINGER
FASCIECTOMY, PALM ONLY, WITH OR WITHOUT Z-PLASTY, OTHER LOCAL TISSUE REARRANGEMENT, OR SKIN GR
FASCIECTOMY, PARTIAL PALMAR WITH RELEASE OF SINGLE DIGIT INCL.PROXIMAL INTERPHALANGEAL JOINT, W/
FASCIECTMY, PRTL PALMAR W/REL.OF SNGL DGT INCL. PROX. INTPHALNGL JOINT, W/,W/O Z-PLASTY, OTHR LCL T
SYNOVECTOMY, CARPOMETACARPAL JOINT
SYNOVECTOMY, METACARPOPHALANGEAL JOINT INCLUDING INTRINSIC RELEASE AND EXTENSOR HOOD RECON
SYNOVECTOMY, PROXIMAL INTERPHALANGEAL JOINT, INCLUDING EXTENSOR RECONSTRUCTION, EACH INTERPH
SYNOVECTOMY, TENDON SHEATH, RADICAL (TENOSYNOVECTOMY), FLEXOR TENDON, PALM AND/OR FINGER, EAC
EXCISION OF LESION OF TENDON SHEATH OR JOINT CAPSULE, HAND OR FINGER
EXCISION OF TENDON, PALM, FLEXOR, SINGLE (SEPARATE PROCEDURE), EACH
EXCISION OF TENDON, FINGER, FLEXOR (SEPARATE PROCEDURE), EACH TENDON
SESAMOIDECTOMY, THUMB OR FINGER (SEPARATE PROCEDURE)
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF METACARPAL;
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF METACARPAL; WITH AUTOGRAFT (INCLUDES OB
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF PROXIMAL, MIDDLE OR DISTAL PHALANX OF FIN
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF PROXIMAL, MIDDLE OR DISTAL PHALANX OF FIN
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS); METAC
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR OSTEOMYELITIS)
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR OSTEOMYELITIS)
RADICAL RESECTION, METACARPAL;
RADICAL RESECTION, METACARPAL; WITH AUTOGRAFT
RADICAL RESECTION, PROXIMAL OR MIDDLE PHALANX OF FINGER (EG, TUMOR)
RADICAL RESECTION (OSTECTOMY) FOR TUMOR, PROXIMAL OR MIDDLE PHALANX OF FINGER; WITH AUTOGRAFT
RADICAL RESECTION, DISTAL PHALANX OF FINGER (EG, TUMOR)
REMOVAL OF IMPLANT FROM FINGER OR HAND
MANIPULATION, FINGER JOINT, UNDER ANESTHESIA, EACH JOINT
REPAIR OR ADVANCEMENT, FLEXOR TENDON, NOT IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH; PRIMARY OR SE
REPAIR OR ADVANCEMENT, FLEXOR TENDON, NOT IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH; SECONDARY W
REPAIR OR ADVANCEMENT, FLEXOR TENDON, IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH; PRIMARY OR SECON
REPAIR OR ADVANCEMENT, FLEXOR TENDON, IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH; SECONDARY, EACH T
REPAIR OR ADVANCEMENT, FLEXOR TENDON, IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH; SECONDARY WITH F
REPAIR OR ADVANCEMENT OF PROFUNDUS TENDON, WITH INTACT SUPERFICIALIS TENDON; PRIMARY, EACH TEN
REPAIR OR ADVANCEMENT OF PROFUNDUS TENDON, WITH INTACT SUPERFICIALIS TENDON; SECONDARY WITH F
REPAIR OR ADVANCEMENT OF PROFUNDUS TENDON, WITH INTACT SUPERFICIALIS TENDON; SECONDARY WITHO
EXCISION FLEXOR TENDON, WITH IMPLANTATION OF SYNTHETIC ROD FOR DELAYED TENDON GRAFT, HAND OR F
REMOVAL OF SYNTHETIC ROD AND INSERTION OF FLEXOR TENDON GRAFT, HAND OR FINGER, EACH ROD
REPAIR, EXTENSOR TENDON, HAND, PRIMARY OR SECONDARY; WITHOUT FREE GRAFT, EACH TENDON
EXTENSOR TENDON REPAIR, DORSUM OF HAND, SINGLE, PRIMARY OR SECONDARY; WITH FREE GRAFT (INCLUDE
EXCISION OF EXTENSOR TENDON, WITH IMPLANTATION OF SYNTHETIC ROD FOR DELAYED TENDON GRAFT, HAN
REMOVAL OF SYNTHETIC ROD AND INSERTION OF EXTENSOR TENDON GRAFT, HAND OR FINGER, EACH ROD
REPAIR, EXTENSOR TENDON, FINGER, PRIMARY OR SECONDARY; WITHOUT FREE GRAFT, EACH TENDON
EXTENSOR TENDON REPAIR, DORSUM OF FINGER, SINGLE, PRIMARY OR SECONDARY; WITH FREE GRAFT (INCLU
REPAIR OF EXTENSOR TENDON, CENTRAL SLIP, SECONDARY; USING LOCAL TISSUE(S), INCLUDING LATERAL BAN
REPAIR OF EXTENSOR TENDON, CENTRAL SLIP, SECONDARY; WITH FREE GRAFT, EACH FINGER
CLOSED TREATMENT OF DISTAL EXTENSOR TENDON INSERTION, WITH OR WITHOUT PERCUTANEOUS PINNING (E
REPAIR OF EXTENSOR TENDON, DISTAL INSERTION, PRIMARY OR SECONDARY; WITHOUT GRAFT (EG, MALLET FIN
EXTENSOR TENDON REPAIR, DISTAL INSERTION ("MALLET FINGER"), OPEN, PRIMARY OR SECONDARY REPAIR; W
REALIGNMENT OF EXTENSOR TENDON, HAND, EACH TENDON
TENOLYSIS, FLEXOR TENDON; PALM OR FINGER; EACH TENDON
TENOLYSIS, SIMPLE, FLEXOR TENDON; PALM AND FINGER, EACH TENDON
TENOLYSIS, EXTENSOR TENDON, HAND OR FINGER; EACH TENDON
TENOLYSIS, COMPLEX, EXTENSOR TENDON, FINGER, INCLUDING FOREARM, EACH TENDON
TENOTOMY, FLEXOR, PALM, OPEN, EACH TENDON
TENOTOMY, FLEXOR, FINGER, OPEN, EACH TENDON
TENOTOMY, EXTENSOR, HAND OR FINGER, OPEN, EACH TENDON
TENODESIS; OF PROXIMAL INTERPHALANGEAL JOINT, EACH JOINT
TENODESIS; OF DISTAL JOINT, EACH JOINT
LENGTHENING OF TENDON, EXTENSOR, HAND OR FINGER, EACH TENDON
SHORTENING OF TENDON, EXTENSOR, HAND OR FINGER, EACH TENDON
LENGTHENING OF TENDON, FLEXOR, HAND OR FINGER, EACH TENDON
SHORTENING OF TENDON, FLEXOR, HAND OR FINGER, EACH TENDON
TRANSFER OR TRANSPLANT OF TENDON, CARPOMETACARPAL AREA OR DORSUM OF HAND; WITHOUT FREE GRA
TENDON TRANSFER OR TRANSPLANT, CARPOMETACARPAL AREA OR DORSUM OF HAND, SINGLE; WITH FREE TEN
TRANSFER OR TRANSPLANT OF TENDON, PALMAR; WITHOUT FREE TENDON GRAFT, EACH TENDON
TENDON TRANSFER OR TRANSPLANT, PALMAR, SINGLE, EACH TENDON; WITH FREE TENDON GRAFT (INCLUDES O
OPPONENSPLASTY; SUPERFICIALIS TENDON TRANSFER TYPE, EACH TENDON
OPPONENSPLASTY; TENDON TRANSFER WITH GRAFT (INCLUDES OBTAINING GRAFT), EACH TENDON
OPPONENSPLASTY; HYPOTHENAR MUSCLE TRANSFER
OPPONENSPLASTY; OTHER METHODS
TRANSFER OF TENDON TO RESTORE INTRINSIC FUNCTION; RING AND SMALL FINGER
TENDON TRANSFER TO RESTORE INTRINSIC FUNCTION; ALL FOUR FINGERS
CORRECTION CLAW FINGER, OTHER METHODS
RECONSTRUCTION OF TENDON PULLEY, EACH TENDON; WITH LOCAL TISSUES (SEPARATE PROCEDURE)
TENDON PULLEY RECONSTRUCTION; WITH TENDON OR FASCIAL GRAFT (INCLUDES OBTAINING GRAFT) (SEPARA
TENDON PULLEY RECONSTRUCTION; WITH TENDON PROSTHESIS (SEPARATE PROCEDURE)
RELEASE OF THENAR MUSCLE(S) (EG, THUMB CONTRACTURE)
CROSS INTRINSIC TRANSFER, EACH TENDON
CAPSULODESIS, METACARPOPHALANGEAL JOINT; SINGLE DIGIT
CAPSULODESIS FOR M-P JOINT STABILIZATION; TWO DIGITS
CAPSULODESIS FOR M-P JOINT STABILIZATION; THREE OR FOUR DIGITS
CAPSULECTOMY OR CAPSULOTOMY; METACARPOPHALANGEAL JOINT, EACH JOINT
CAPSULECTOMY OR CAPSULOTOMY; INTERPHALANGEAL JOINT, EACH JOINT
ARTHROPLASTY, METACARPOPHALANGEAL JOINT; EACH JOINT
ARTHROPLASTY, METACARPOPHALANGEAL JOINT; WITH PROSTHETIC IMPLANT, EACH JOINT
ARTHROPLASTY, INTERPHALANGEAL JOINT; EACH JOINT
ARTHROPLASTY, INTERPHALANGEAL JOINT; WITH PROSTHETIC IMPLANT, EACH JOINT
REPAIR OF COLLATERAL LIGAMENT, METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT
REPAIR OF COLLATERAL LIGAMENT, METACARPOPHALANGEAL JOINT, SINGLE, WITH TENDON OR FASCIAL GRAFT
PRIMARY REPAIR OF COLLATERAL LIGAMENT, METACARPOPHALANGEAL JOINT; WITH LOCAL TISSUE (EG, ADDUC
RECONSTRUCTION, COLLATERAL LIGAMENT, INTERPHALANGEAL JOINT, SINGLE, INCLUDING GRAFT, EACH JOINT
REPAIR NON-UNION, METACARPAL OR PHALANX, (INCLUDES OBTAINING BONE GRAFT WITH OR WITHOUT EXTERN
REPAIR AND RECONSTRUCTION, FINGER, VOLAR PLATE, INTERPHALANGEAL JOINT
POLLICIZATION OF A DIGIT
TRANSFER, TOE-TO-HAND WITH MICROVASCULAR ANASTOMOSIS; GREAT TOE "WRAP-AROUND" WITH BONE GRA
TOE-TO-HAND TRANSFER WITH MICROVASCULAR ANASTOMOSIS; OTHER THAN GREAT TOE, SINGLE
TOE-TO-HAND TRANSFER WITH MICROVASCULAR ANASTOMOSIS; OTHER THAN GREAT TOE, DOUBLE
TRANSFER, FINGER TO ANOTHER POSITION WITHOUT MICROVASCULAR ANASTOMOSIS
TRANSFER, FREE TOE JOINT, WITH MICROVASCULAR ANASTOMOSIS
REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE; WITH SKIN FLAPS
REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE; WITH SKIN FLAPS AND GRAFTS
REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE; COMPLEX (EG, INVOLVING BONE, NAILS)
OSTEOTOMY; METACARPAL, EACH
OSTEOTOMY; PHALANX OF FINGER, EACH
OSTEOPLASTY, LENGTHENING, METACARPAL OR PHALANX
REPAIR CLEFT HAND
RECONSTRUCTION OF POLYDACTYLOUS DIGIT, SOFT TISSUE AND BONE
REPAIR MACRODACTYLIA, EACH DIGIT
REPAIR, INTRINSIC MUSCLES OF HAND, EACH MUSCLE
RELEASE, INTRINSIC MUSCLES OF HAND, EACH MUSCLE
EXCISION OF CONSTRICTING RING OF FINGER, WITH MULTIPLE Z-PLASTIES
CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITHOUT MANIPULATION, EACH BONE
CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITH MANIPULATION, EACH BONE
CLOSED TREATMENT OF METACARPAL FRACTURE, WITH MANIPULATION, WITH EXTERNAL FIXATION, EACH BONE
PERCUTANEOUS SKELETAL FIXATION OF METACARPAL FRACTURE, EACH BONE
OPEN TREATMENT OF METACARPAL FRACTURE, SINGLE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION,
CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION, THUMB, WITH MANIPULATION
CLOSED TREATMENT OF CARPOMETACARPAL FRACTURE DISLOCATION, THUMB (BENNETT FRACTURE), WITH MA
PERCUTANEOUS SKELETAL FIXATION OF CARPOMETACARPAL FRACTURE DISLOCATION, THUMB (BENNETT FRAC
OPEN TREATMENT OF CARPOMETACARPAL FRACTURE DISLOCATION, THUMB (BENNETT FRACTURE), WITH OR W
CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB, WITH MANIPULATION, EACH J
CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB, WITH MANIPULATION, EACH J
PERCUTANEOUS SKELETAL FIXATION OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB, WITH MANIPU
OPEN TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB; WITH OR WITHOUT INTERNAL O
OPEN TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB; COMPLEX, MULTIPLE OR DELAYE
CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE, WITH MANIPULATION; WITHOUT ANES
CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE, WITH MANIPULATION; REQUIRING ANE
PERCUTANEOUS SKELETAL FIXATION OF METACARPOPHALANGEAL DISLOCATION, SINGLE, WITH MANIPULATION
OPEN TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE, WITH OR WITHOUT INTERNAL OR EXTER
CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR THUMB; W
CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR THUMB; W
PERCUTANEOUS SKELETAL FIXATION OF UNSTABLE PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHA
OPEN TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR THUMB, WIT
CLOSED TREATMENT OF ARTICULAR FRACTURE, INVOLVING METACARPOPHALANGEAL OR INTERPHALANGEAL JO
CLOSED TREATMENT OF ARTICULAR FRACTURE, INVOLVING METACARPOPHALANGEAL OR INTERPHALANGEAL JO
OPEN TREATMENT OF ARTICULAR FRACTURE, INVOLVING METACARPOPHALANGEAL OR INTERPHALANGEAL JOIN
CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB; WITHOUT MANIPULATION, EACH
CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB; WITH MANIPULATION, EACH
PERCUTANEOUS SKELETAL FIXATION OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB, EACH
OPEN TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB, WITH OR WITHOUT INTERNAL OR EX
CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, SINGLE, WITH MANIPULATION; WITHOUT ANES
CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, SINGLE, WITH MANIPULATION; REQUIRING ANE
PERCUTANEOUS SKELETAL FIXATION OF INTERPHALANGEAL JOINT DISLOCATION, SINGLE, WITH MANIPULATION
OPEN TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXA
FUSION IN OPPOSITION, THUMB, WITH AUTOGENOUS GRAFT (INCLUDES OBTAINING GRAFT)
ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, WITH OR WITHOUT INTERNAL FIXATION;
ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, WITH OR WITHOUT INTERNAL FIXATION; WITH AUTOGRAFT (
ARTHRODESIS, CARPOMETACARPAL JOINT, DIGIT, OTHER THAN THUMB, EACH;
ARTHRODESIS, CARPOMETACARPAL JOINT, DIGIT, OTHER THAN THUMB, EACH; WITH AUTOGRAFT
ARTHRODESIS, METACARPOPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION;
ARTHRODESIS, METACARPOPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION; WITH AUTOGRAFT (INC
ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION;
ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION; EACH ADDITIONAL INTERPHAL
ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION; WITH AUTOGRAFT (INCLUDES
ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION; WITH AUTOGRAFT (INCLUDES
AMPUTATION, METACARPAL, WITH FINGER OR THUMB (RAY AMPUTATION), SINGLE, WITH OR WITHOUT INTEROSS
AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLUDING NEUR
AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLUDING NEUR
UNLISTED PROCEDURE, HANDS OR FINGERS
INCISION AND DRAINAGE, PELVIS OR HIP JOINT AREA; DEEP ABSCESS OR HEMATOMA
INCISION AND DRAINAGE, PELVIS OR HIP JOINT AREA; INFECTED BURSA
INCISION, BONE CORTEX, PELVIS AND/OR HIP JOINT (EG, OSTEOMYELITIS OR BONE ABSCESS)
TENOTOMY, ADDUCTOR OF HIP, PERCUTANEOUS (SEPARATE PROCEDURE)
TENOTOMY, ADDUCTOR OF HIP, OPEN
TENOTOMY, ADDUCTOR, SUBCUTANEOUS, OPEN, WITH OBTURATOR NEURECTOMY
TENOTOMY, HIP FLEXOR(S), OPEN (SEPARATE PROCEDURE)
TENOTOMY, ABDUCTORS AND/OR EXTENSOR(S) OF HIP, OPEN (SEPARATE PROCEDURE)
FASCIOTOMY, HIP OR THIGH, ANY TYPE
ARTHROTOMY, HIP, WITH DRAINAGE (EG, INFECTION)
ARTHROTOMY, HIP, INCLUDING EXPLORATION OR REMOVAL OF LOOSE OR FOREIGN BODY
DENERVATION, HIP JOINT, INTRAPELVIC OR EXTRAPELVIC INTRA-ARTICULAR BRANCHES OF SCIATIC, FEMORAL, O
CAPSULECTOMY OR CAPSULOTOMY, HIP, WITH OR WITHOUT EXCISION OF HETEROTOPIC BONE, WITH RELEASE
BIOPSY, SOFT TISSUE OF PELVIS AND HIP AREA; SUPERFICIAL
BIOPSY, SOFT TISSUE OF PELVIS AND HIP AREA; DEEP, SUBFASCIAL OR INTRAMUSCULAR
EXCISION, TUMOR, PELVIS AND HIP AREA; SUBCUTANEOUS TISSUE
EXCISION, TUMOR, PELVIS AND HIP AREA; DEEP, SUBFASCIAL, INTRAMUSCULAR
RADICAL RESECTION OF TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA (EG, MALIGNANT NEOPLASM)
ARTHROTOMY, WITH BIOPSY; SACROILIAC JOINT
ARTHROTOMY, WITH BIOPSY; HIP JOINT
ARTHROTOMY WITH SYNOVECTOMY, HIP JOINT
EXCISION; ISCHIAL BURSA
EXCISION; TROCHANTERIC BURSA OR CALCIFICATION
EXCISION OF BONE CYST OR BENIGN TUMOR; SUPERFICIAL (WING OF ILIUM, SYMPHYSIS PUBIS, OR GREATER TR
EXCISION OF BONE CYST OR BENIGN TUMOR; DEEP, WITH OR WITHOUT AUTOGRAFT
EXCISION OF BONE CYST OR BENIGN TUMOR; WITH AUTOGRAFT REQUIRING SEPARATE INCISION
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION) (EG, OSTEOMYELITIS OR BONE ABSCESS); SUPERFICIAL (E
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION) (EG, OSTEOMYELITIS OR BONE ABSCESS); DEEP (SUBFASC
RADICAL RESECTION OF TUMOR OR INFECTION; WING OF ILIUM, ONE PUBIC OR ISCHIAL RAMUS OR SYMPHYSIS P
RADICAL RESECTION OF TUMOR OR INFECTION; ILIUM, INCLUDING ACETABULUM, BOTH PUBIC RAMI, OR ISCHIUM
RADICAL RESECTION OF TUMOR OR INFECTION; INNOMINATE BONE, TOTAL
RADICAL RESECTION OF TUMOR OR INFECTION; ISCHIAL TUBEROSITY AND GREATER TROCHANTER OF FEMUR
RADICAL RESECTION OF TUMOR OR INFECTION; ISCHIAL TUBEROSITY AND GREATER TROCHANTER OF FEMUR, W
COCCYGECTOMY, PRIMARY
REMOVAL OF FOREIGN BODY, PELVIS OR HIP; SUBCUTANEOUS TISSUE
REMOVAL OF FOREIGN BODY, PELVIS OR HIP; DEEP (SUBFASCIAL OR INTRAMUSCULAR)
REMOVAL OF HIP PROSTHESIS; (SEPARATE PROCEDURE)
REMOVAL OF HIP PROSTHESIS; COMPLICATED, INCLUDING TOTAL HIP PROSTHESIS, METHYLMETHACRYLATE WIT
INJECTION PROCEDURE FOR HIP ARTHROGRAPHY; WITHOUT ANESTHESIA
INJECTION PROCEDURE FOR HIP ARTHROGRAPHY; WITH ANESTHESIA
INJECTION PROCEDURE FOR SACROILIAC JOINT, ARTHROGRAPHY AND/OR ANESTHETIC/STEROID
RELEASE OR RECESSION, HAMSTRING, PROXIMAL
TRANSFER, ADDUCTOR TO ISCHIUM
TRANSFER EXTERNAL OBLIQUE MUSCLE TO GREATER TROCHANTER INCLUDING FASCIAL OR TENDON EXTENSIO
TRANSFER PARASPINAL MUSCLE TO HIP (INCLUDES FASCIAL OR TENDON EXTENSION GRAFT)
TRANSFER ILIOPSOAS; TO GREATER TROCHANTER OF FEMUR
TRANSFER ILIOPSOAS; TO FEMORAL NECK
ACETABULOPLASTY; (EG, WHITMAN, COLONNA, HAYGROVES, OR CUP TYPE)
ACETABULOPLASTY; RESECTION, FEMORAL HEAD (EG, GIRDLESTONE PROCEDURE)
HEMIARTHROPLASTY, HIP, PARTIAL (EG, FEMORAL STEM PROSTHESIS, BIPOLAR ARTHROPLASTY)
ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT, WITH OR WITHOUT AUTO
CONVERSION OF PREVIOUS HIP SURGERY TO TOTAL HIP ARTHROPLASTY, WITH OR WITHOUT AUTOGRAFT OR AL
REVISION OF TOTAL HIP ARTHROPLASTY; BOTH COMPONENTS, WITH OR WITHOUT AUTOGRAFT OR ALLOGRAFT
REVISION OF TOTAL HIP ARTHROPLASTY; ACETABULAR COMPONENT ONLY, WITH OR WITHOUT AUTOGRAFT OR A
REVISION OF TOTAL HIP ARTHROPLASTY; FEMORAL COMPONENT ONLY, WITH OR WITHOUT ALLOGRAFT
OSTEOTOMY AND TRANSFER OF GREATER TROCHANTER OF FEMUR
OSTEOTOMY, ILIAC, ACETABULAR OR INNOMINATE BONE;
OSTEOTOMY, ILIAC, ACETABULAR OR INNOMINATE BONE; WITH OPEN REDUCTION OF HIP
OSTEOTOMY, ILIAC, ACETABULAR OR INNOMINATE BONE; WITH FEMORAL OSTEOTOMY
OSTEOTOMY, ILIAC, ACETABULAR OR INNOMINATE BONE; WITH FEMORAL OSTEOTOMY AND WITH OPEN REDUCT
OSTEOTOMY, PELVIS, BILATERAL (EG, CONGENITAL MALFORMATION)
OSTEOTOMY, FEMORAL NECK (SEPARATE PROCEDURE)
OSTEOTOMY, INTERTROCHANTERIC OR SUBTROCHANTERIC INCLUDING INTERNAL OR EXTERNAL FIXATION AND/
BONE GRAFT, FEMORAL HEAD, NECK, INTERTROCHANTERIC OR SUBTROCHANTERIC AREA (INCLUDES OBTAINING
TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; BY TRACTION, WITHOUT REDUCTION
TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; BY SINGLE OR MULTIPLE PINNING, IN SITU
OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; SINGLE OR MULTIPLE PINNING OR BONE GRAFT (INCLUDES
OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; CLOSED MANIPULATION WITH SINGLE OR MULTIPLE PINNIN
OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; OSTEOPLASTY OF FEMORAL NECK (HEYMAN TYPE PROCED
OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; OSTEOTOMY AND INTERNAL FIXATION
EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING, GREATER TROCHANTER OF FEMUR
PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT METHYLMETHACRYLAT
CLOSED TREATMENT OF PELVIC RING FRACTURE, DISLOCATION, DIASTASIS OR SUBLUXATION; WITHOUT MANIPU
CLOSED TREATMENT OF PELVIC RING FRACTURE, DISLOCATION, DIASTASIS OR SUBLUXATION; WITH MANIPULAT
CLOSED TREATMENT OF COCCYGEAL FRACTURE
OPEN TREATMENT OF COCCYGEAL FRACTURE
OPEN TREATMENT OF ILIAC SPINE(S), TUBEROSITY AVULSION, OR ILIAC WING FRACTURE(S) (EG, PELVIC FRACTU
PERCUTANEOUS SKELETAL FIXATION OF POSTERIOR PELVIC RING FRACTURE AND/OR DISLOCATION (INCLUDES
OPEN TREATMENT OF ANTERIOR RING FRACTURE AND/OR DISLOCATION WITH INTERNAL FIXATION, (INCLUDES P
OPEN TREATMENT OF POSTERIOR RING FRACTURE AND/OR DISLOCATION WITH INTERNAL FIXATION (INCLUDES
CLOSED TREATMENT OF ACETABULUM (HIP SOCKET) FRACTURE(S); WITHOUT MANIPULATION
CLOSED TREATMENT OF ACETABULUM (HIP SOCKET) FRACTURE(S); WITH MANIPULATION, WITH OR WITHOUT SK
OPEN TREATMENT OF POSTERIOR OR ANTERIOR ACETABULAR WALL FRACTURE, WITH INTERNAL FIXATION
OPEN TREATMENT OF ACETABULAR FRACTURE(S) INVOLVING ANTERIOR OR POSTERIOR (ONE) COLUMN, OR A FR
OPEN TREATMENT OF ACETABULAR FRACTURE(S) INVOLVING ANT & POST (TWO) COLUMNS, INC T-FRACTURE AN
CLOSED TREATMENT OF FEMORAL FRACTURE, PROXIMAL END, NECK; WITHOUT MANIPULATION
CLOSED TREATMENT OF FEMORAL FRACTURE, PROXIMAL END, NECK; WITH MANIPULATION, WITH OR WITHOUT S
PERCUTANEOUS SKELETAL FIXATION OF FEMORAL FRACTURE, PROXIMAL END, NECK
OPEN TREATMENT OF FEMORAL FRACTURE, PROXIMAL END, NECK, INTERNAL FIXATION OR PROSTHETIC REPLAC
CLOSED TREATMENT OF INTERTROCHANTERIC, PERTROCHANTERIC, OR SUBTROCHANTERIC FEMORAL FRACTU
CLOSED TREATMENT OF INTERTROCHANTERIC, PERTROCHANTERIC, OR SUBTROCHANTERIC FEMORAL FRACTU
TREATMENT OF INTERTROCHANTERIC, PERTROCHANTERIC, OR SUBTROCHANTERIC FEMORAL FRACTURE; WITH
TREATMENT OF INTERTROCHANTERIC, PERTROCHANTERIC, OR SUBTROCHANTERIC FEMORAL FRACTURE; WITH
CLOSED TREATMENT OF GREATER TROCHANTERIC FRACTURE, WITHOUT MANIPULATION
OPEN TREATMENT OF GREATER TROCHANTERIC FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATI
CLOSED TREATMENT OF HIP DISLOCATION, TRAUMATIC; WITHOUT ANESTHESIA
CLOSED TREATMENT OF HIP DISLOCATION, TRAUMATIC; REQUIRING ANESTHESIA
OPEN TREATMENT OF HIP DISLOCATION, TRAUMATIC, WITHOUT INTERNAL FIXATION
OPEN TREATMENT OF HIP DISLOCATION, TRAUMATIC, WITH ACETABULAR WALL AND FEMORAL HEAD FRACTURE
TREATMENT OF SPONTANEOUS HIP DISLOCATION (DEVELOPMENTAL, INCLUDING CONGENITAL OR PATHOLOGICA
TREATMENT OF SPONTANEOUS HIP DISLOCATION (DEVELOPMENTAL, INCLUDING CONGENITAL OR PATHOLOGICA
OPEN TREATMENT OF SPONTANEOUS HIP DISLOCATION (DEVELOPMENTAL, INCLUDING CONGENITAL OR PATHOL
OPEN TREATMENT OF SPONTANEOUS HIP DISLOCATION (DEVELOPMENTAL, INCLUDING CONGENITAL OR PATHOL
CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION; WITHOUT ANESTHESIA
CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION; REQUIRING REGIONAL OR GENERAL ANESTHE
MANIPULATION, HIP JOINT, REQUIRING GENERAL ANESTHESIA
ARTHRODESIS, SACROILIAC JOINT (INCLUDING OBTAINING GRAFT)
ARTHRODESIS, SYMPHYSIS PUBIS (INCLUDING OBTAINING GRAFT)
ARTHRODESIS, HIP JOINT (INCLUDING OBTAINING GRAFT)
ARTHRODESIS, HIP JOINT (INCLUDES OBTAINING GRAFT); WITH SUBTROCHANTERIC OSTEOTOMY
INTERPELVIABDOMINAL AMPUTATION (HINDQUARTER AMPUTATION)
DISARTICULATION OF HIP
UNLISTED PROCEDURE, PELVIS OR HIP JOINT
INCISION AND DRAINAGE, DEEP ABSCESS, BURSA, OR HEMATOMA, THIGH OR KNEE REGION
INCISION, DEEP, WITH OPENING OF BONE CORTEX, FEMUR OR KNEE (EG, OSTEOMYELITIS OR BONE ABSCESS)
FASCIOTOMY, ILIOTIBIAL (TENOTOMY), OPEN
TENOTOMY, PERCUTANEOUS, ADDUCTOR OR HAMSTRING; SINGLE TENDON (SEPARATE PROCEDURE)
TENOTOMY, PERCUTANEOUS, ADDUCTOR OR HAMSTRING; MULTIPLE TENDONS
ARTHROTOMY, KNEE, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY (EG, INFECTION)
NEURECTOMY, HAMSTRING MUSCLE
NEURECTOMY, POPLITEAL (GASTROCNEMIUS)
BIOPSY, SOFT TISSUE OF THIGH OR KNEE AREA; SUPERFICIAL
BIOPSY, SOFT TISSUE OF THIGH OR KNEE AREA; DEEP (SUBFASCIAL OR INTRAMUSCULAR)
EXCISION, TUMOR, THIGH OR KNEE AREA; SUBCUTANEOUS
EXCISION, TUMOR, THIGH OR KNEE AREA; DEEP, SUBFASCIAL, OR INTRAMUSCULAR
RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF THIGH OR KNEE AREA
ARTHROTOMY, KNEE; WITH SYNOVIAL BIOPSY ONLY
ARTHROTOMY, KNEE; INCLUDING JOINT EXPLORATION, BIOPSY, OR REMOVAL OF LOOSE OR FOREIGN BODIES
ARTHROTOMY, WITH EXCISION OF SEMILUNAR CARTILAGE (MENISCECTOMY) KNEE; MEDIAL OR LATERAL
ARTHROTOMY, KNEE, WITH EXCISION OF SEMILUNAR CARTILAGE (MENISCECTOMY); MEDIAL AND LATERAL
ARTHROTOMY, WITH SYNOVECTOMY, KNEE; ANTERIOR OR POSTERIOR
ARTHROTOMY, KNEE, WITH SYNOVECTOMY; ANTERIOR AND POSTERIOR INCLUDING POPLITEAL AREA
EXCISION, PREPATELLAR BURSA
EXCISION OF SYNOVIAL CYST OF POPLITEAL SPACE (EG, BAKER'S CYST)
EXCISION OF LESION OF MENISCUS OR CAPSULE (EG, CYST, GANGLION), KNEE
PATELLECTOMY OR HEMIPATELLECTOMY
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF FEMUR;
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF FEMUR; WITH ALLOGRAFT
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF FEMUR; WITH AUTOGRAFT (INCLUDES OBTAININ
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF FEMUR; WITH INTERNAL FIXATION (LIST IN ADD
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE, FEMUR, PROXIMAL TIBIA AND
RADICAL RESECTION OF TUMOR, BONE, FEMUR OR KNEE
INJECTION PROCEDURE FOR KNEE ARTHROGRAPHY
REMOVAL OF FOREIGN BODY, DEEP, THIGH REGION OR KNEE AREA
SUTURE OF INFRAPATELLAR TENDON; PRIMARY
SUTURE OF INFRAPATELLAR TENDON; SECONDARY RECONSTRUCTION, INCLUDING FASCIAL OR TENDON GRAFT
SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE; PRIMARY
SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE; SECONDARY RECONSTRUCTION, INCLUDING FASC
TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; SINGLE TENDON
TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; MULTIPLE TENDONS, ONE LEG
TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; MULTIPLE TENDONS, BILATERAL
LENGTHENING OF HAMSTRING TENDON; SINGLE TENDON
LENGTHENING OF HAMSTRING TENDON; MULTIPLE TENDONS, ONE LEG
LENGTHENING OF HAMSTRING TENDON; MULTIPLE TENDONS, BILATERAL
TRANSPLANT, HAMSTRING TENDON TO PATELLA; SINGLE TENDON
TRANSPLANT, HAMSTRING TENDON TO PATELLA; MULTIPLE TENDONS
TRANSFER, TENDON OR MUSCLE, HAMSTRINGS TO FEMUR (EG, EGGER'S TYPE PROCEDURE)
ARTHROTOMY WITH MENISCUS REPAIR, KNEE
REPAIR, PRIMARY, TORN LIGAMENT AND/OR CAPSULE, KNEE; COLLATERAL
REPAIR, PRIMARY, TORN LIGAMENT AND/OR CAPSULE, KNEE; CRUCIATE
REPAIR, PRIMARY, TORN LIGAMENT AND/OR CAPSULE, KNEE; COLLATERAL AND CRUCIATE LIGAMENTS
ANTERIOR TIBIAL TUBERCLEPLASTY (EG, MAQUET TYPE PROCEDURE)
RECONSTRUCTION OF DISLOCATING PATELLA; (EG, HAUSER TYPE PROCEDURE)
RECONSTRUCTION OF DISLOCATING PATELLA; WITH EXTENSOR REALIGNMENT AND/OR MUSCLE ADVANCEMENT
RECONSTRUCTION FOR RECURRENT DISLOCATING PATELLA; WITH PATELLECTOMY
LATERAL RETINACULAR RELEASE OPEN
LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE; EXTRA-ARTICULAR
LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE; INTRA-ARTICULAR (OPEN)
LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE; INTRA-ARTICULAR (OPEN) AND EXTRA-ARTICULAR
QUADRICEPSPLASTY (EG, BENNETT OR THOMPSON TYPE)
CAPSULOTOMY, POSTERIOR CAPSULAR RELEASE, KNEE
ARTHROPLASTY, PATELLA; WITHOUT PROSTHESIS
ARTHROPLASTY, PATELLA; WITH PROSTHESIS
ARTHROPLASTY, KNEE, TIBIAL PLATEAU;
ARTHROPLASTY, KNEE, TIBIAL PLATEAU; WITH DEBRIDEMENT AND PARTIAL SYNOVECTOMY
ARTHROPLASTY, FEMORAL CONDYLES OR TIBIAL PLATEAU(S), KNEE
ARTHROPLASTY, KNEE, FEMORAL CONDYLES OR TIBIAL PLATEAUS; WITH DEBRIDEMENT AND PARTIAL SYNOVEC
ARTHROPLASTY, KNEE, HINGE PROSTHESIS (EG, WALLDIUS TYPE)
ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL OR LATERAL COMPARTMENT
ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS WITH OR WITHOUT PAT
OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR; WITHOUT FIXATION
OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR; WITH FIXATION
OSTEOTOMY, MULTIPLE, WITH REALIGNMENT ON INTRAMEDULLARY ROD, FEMORAL SHAFT (EG, SOFIELD TYPE P
OSTEOTOMY, PROXIMAL TIBIA, INCLUDING FIBULAR EXCISION OR OSTEOTOMY (INCLUDES CORRECTION OF GEN
OSTEOTOMY, PROXIMAL TIBIA, INCLUDING FIBULAR EXCISION OR OSTEOTOMY (INCLUDES CORRECTION OF GEN
OSTEOPLASTY, FEMUR; SHORTENING (EXCLUDING 64876)
OSTEOPLASTY, FEMUR; LENGTHENING
OSTEOPLASTY, FEMUR; COMBINED, LENGTHENING AND SHORTENING WITH FEMORAL SEGMENT TRANSFER
REPAIR, NONUNION OR MALUNION, FEMUR, DISTAL TO HEAD AND NECK; WITHOUT GRAFT (EG, COMPRESSION TE
REPAIR, NONUNION OR MALUNION, FEMUR, DISTAL TO HEAD AND NECK; WITH ILIAC OR OTHER AUTOGENOUS BO
ARREST, EPIPHYSEAL, ANY METHOD (EG, EPIPHYSIODESIS); DISTAL FEMUR
ARREST, EPIPHYSEAL, ANY METHOD; TIBIA AND FIBULA, PROXIMAL
ARREST, EPIPHYSEAL, ANY METHOD; COMBINED DISTAL FEMUR, PROXIMAL TIBIA AND FIBULA
ARREST, HEMIEPIPHYSEAL, DISTAL FEMUR OR PROXIMAL TIBIA OR FIBULA (EG, GENU VARUS OR VALGUS)
REVISION OF TOTAL KNEE ARTHROPLASTY, WITH OR WITHOUT ALLOGRAFT; ONE COMPONENT
REVISION OF TOTAL KNEE ARTHROPLASTY, WITH OR WITHOUT ALLOGRAFT; FEMORAL AND ENTIRE TIBIAL COMP
REMOVAL OF PROSTHESIS, INCLUDING TOTAL KNEE PROSTHESIS, METHYLMETHACRYLATE WITH OR WITHOUT IN
PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT METHYLMETHACRYLAT
DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, ONE COMPARTMENT (FLEXOR OR EXTENSOR OR ADDUCT
DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, ONE COMPARTMENT (FLEXOR OR EXTENSOR OR ADDUCT
DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, MULTIPLE COMPARTMENTS;
DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, MULTIPLE COMPARTMENTS; WITH DEBRIDEMENT OF NONV
CLOSED TREATMENT OF FEMORAL SHAFT FRACTURE, WITHOUT MANIPULATION
CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR FEMORAL FRACTURE WITH OR WITHOUT INTER
CLOSED TREATMENT OF FEMORAL SHAFT FRACTURE, WITH MANIPULATION, WITH OR WITHOUT SKIN OR SKELET
CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR FEMORAL FRACTURE WITH OR WITHOUT INTER
OPEN TREATMENT OF FEMORAL SHAFT FRACTURE, WITH OR WITHOUT EXTERNAL FIXATION, WITH INSERTION OF
OPEN TREATMENT OF FEMORAL SHAFT FRACTURE WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE
CLOSED TREATMENT OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL CONDYLE, WITHOUT MANIPULA
PERCUTANEOUS SKELETAL FIXATION OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL CONDYLE, SUP
CLOSED TREATMENT OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL CONDYLE, WITH MANIPULATION
OPEN TREATMENT OF FEMORAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE WITHOUT INTERCONDYLAR
OPEN TREATMENT OF FEMORAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE WITH INTERCONDYLAR EXT
OPEN TREATMENT OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL CONDYLE, WITH OR WITHOUT INT
CLOSED TREATMENT OF DISTAL FEMORAL EPIPHYSEAL SEPARATION; WITHOUT MANIPULATION
CLOSED TREATMENT OF DISTAL FEMORAL EPIPHYSEAL SEPARATION; WITH MANIPULATION, WITH OR WITHOUT S
OPEN TREATMENT OF DISTAL FEMORAL EPIPHYSEAL SEPARATION, WITH OR WITHOUT INTERNAL OR EXTERNAL
CLOSED TREATMENT OF PATELLAR FRACTURE, WITHOUT MANIPULATION
OPEN TREATMENT OF PATELLAR FRACTURE, WITH INTERNAL FIXATION AND/OR PARTIAL OR COMPLETE PATELLE
CLOSED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); WITHOUT MANIPULATION
CLOSED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); WITH OR WITHOUT MANIPULATION, WITH SKEL
OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); UNICONDYLAR, WITH OR WITHOUT INTERNAL OR
OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); BICONDYLAR, WITH OR WITHOUT INTERNAL FIXA
CLOSED TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF KNEE, WITH OR WITH
OPEN TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF THE KNEE, WITH OR WIT
CLOSED TREATMENT OF KNEE DISLOCATION; WITHOUT ANESTHESIA
CLOSED TREATMENT OF KNEE DISLOCATION; REQUIRING ANESTHESIA
OPEN TREATMENT OF KNEE DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION; WITHOUT PRIM
OPEN TREATMENT OF KNEE DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION; WITH PRIMAR
OPEN TREATMENT OF KNEE DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION; WITH PRIMAR
CLOSED TREATMENT OF PATELLAR DISLOCATION; WITHOUT ANESTHESIA
CLOSED TREATMENT OF PATELLAR DISLOCATION; REQUIRING ANESTHESIA
OPEN TREATMENT OF PATELLAR DISLOCATION, WITH OR WITHOUT PARTIAL OR TOTAL PATELLECTOMY
MANIPULATION OF KNEE JOINT UNDER GENERAL ANESTHESIA (INCLUDES APPLICATION OF TRACTION OR OTHER
ARTHRODESIS, KNEE, ANY TECHNIQUE
AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL;
AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; IMMEDIATE FITTING TECHNIQUE INCLUDING FIRST CAST
AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; OPEN, CIRCULAR (GUILLOTINE)
AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; SECONDARY CLOSURE OR SCAR REVISION
AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; RE-AMPUTATION
DISARTICULATION AT KNEE
UNLISTED PROCEDURE, FEMUR OR KNEE
DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL COMPARTMENTS ONLY
DECOMPRESSION FASCIOTOMY, LEG; POSTERIOR COMPARTMENT(S) ONLY
DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL, AND POSTERIOR COMPARTMENT(S)
INCISION AND DRAINAGE, LEG OR ANKLE; DEEP ABSCESS OR HEMATOMA
INCISION AND DRAINAGE, LEG OR ANKLE; INFECTED BURSA
TENOTOMY, PERCUTANEOUS, ACHILLES TENDON (SEPARATE PROCEDURE); LOCAL ANESTHESIA
TENOTOMY, ACHILLES TENDON, SUBCUTANEOUS (SEPARATE PROCEDURE); GENERAL ANESTHESIA
INCISION (EG, OSTEOMYELITIS OR BONE ABSCESS), LEG OR ANKLE
ARTHROTOMY, ANKLE, INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY
ARTHROTOMY, POSTERIOR CAPSULAR RELEASE, ANKLE, WITH OR WITHOUT ACHILLES TENDON LENGTHENING
BIOPSY, SOFT TISSUE OF LEG OR ANKLE AREA; SUPERFICIAL
BIOPSY, SOFT TISSUE OF LEG OR ANKLE AREA; DEEP (SUBFASCIAL OR INTRAMUSCULAR)
RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF LEG OR ANKLE AREA
EXCISION, TUMOR, LEG OR ANKLE AREA; SUBCUTANEOUS TISSUE
EXCISION, TUMOR, LEG OR ANKLE AREA; DEEP (SUBFASCIAL OR INTRAMUSCULAR)
ARTHROTOMY, ANKLE, WITH JOINT EXPLORATION, WITH OR WITHOUT BIOPSY, WITH OR WITHOUT REMOVAL OF
ARTHROTOMY, ANKLE, WITH SYNOVECTOMY;
ARTHROTOMY, ANKLE, WITH SYNOVECTOMY; INCLUDING TENOSYNOVECTOMY
EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (EG, CYST OR GANGLION), LEG AND/OR ANKLE
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TIBIA OR FIBULA;
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TIBIA OR FIBULA; WITH AUTOGRAFT (INCLUDES OB
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TIBIA OR FIBULA; WITH ALLOGRAFT
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR EXO
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR OSTEOMYELITIS
RADICAL RESECTION OF TUMOR, BONE; TIBIA
RADICAL RESECTION OF TUMOR, BONE; FIBULA
RADICAL RESECTION OF TUMOR, BONE; TALUS OR CALCANEUS
INJECTION PROCEDURE FOR ANKLE ARTHROGRAPHY
REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLES TENDON;
REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLES TENDON; WITH GRAFT (INCLUDES OBTAININ
REPAIR, SECONDARY, ACHILLES TENDON, WITH OR WITHOUT GRAFT
REPAIR, FASCIAL DEFECT OF LEG
REPAIR, FLEXOR TENDON, LEG; PRIMARY, WITHOUT GRAFT, EACH TENDON
REPAIR, FLEXOR TENDON, LEG; SECONDARY, WITH OR WITHOUT GRAFT, EACH TENDON
REPAIR, EXTENSOR TENDON, LEG; PRIMARY, WITHOUT GRAFT, EACH TENDON
REPAIR, EXTENSOR TENDON, LEG; SECONDARY, WITH OR WITHOUT GRAFT, EACH TENDON
REPAIR, DISLOCATING PERONEAL TENDON; WITHOUT FIBULAR OSTEOTOMY
REPAIR FOR DISLOCATING PERONEAL TENDONS; WITH FIBULAR OSTEOTOMY
TENOLYSIS, FLEXOR OR EXTENSOR TENDON, LEG AND/OR ANKLE; SINGLE, EACH TENDON
TENOLYSIS, FLEXOR OR EXTENSOR TENDON, LEG AND/OR ANKLE; MULTIPLE TENDONS (THROUGH SEPARATE INC
LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE; SINGLE TENDON (SEPARATE PROCEDURE)
LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE; MULTIPLE TENDONS (THROUGH SAME INCISION), EA
GASTROCNEMIUS RECESSION (EG, STRAYER PROCEDURE)
TRANSFER OR TRANSPLANT OF SINGLE TENDON (WITH MUSCLE REDIRECTION OR REROUTING); SUPERFICIAL (E
TRANSFER/TRANSPLANT SINGLE TENDON (W/MUSCLE REDIRECTION/REROUTING); DEEP (EG, ANT/POST TIBIAL TH
TRANSFER OR TRANSPLANT OF SINGLE TENDON (WITH MUSCLE REDIRECTION OR REROUTING); EACH ADDITION
REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; COLLATERAL
SUTURE, PRIMARY, TORN, RUPTURED OR SEVERED LIGAMENT, ANKLE; BOTH COLLATERAL LIGAMENTS
REPAIR, SECONDARY DISRUPTED LIGAMENT, ANKLE, COLLATERAL (EG, WATSON-JONES PROCEDURE)
ARTHROPLASTY, ANKLE;
ARTHROPLASTY, ANKLE; WITH IMPLANT ("TOTAL ANKLE")
ARTHROPLASTY, ANKLE; REVISION, TOTAL ANKLE
REMOVAL OF ANKLE IMPLANT
OSTEOTOMY; TIBIA
OSTEOTOMY; FIBULA
OSTEOTOMY; TIBIA AND FIBULA
OSTEOTOMY; MULTIPLE, WITH REALIGNMENT ON INTRAMEDULLARY ROD (EG, SOFIELD TYPE PROCEDURE)
OSTEOPLASTY, TIBIA AND FIBULA, LENGTHENING OR SHORTENING
REPAIR OF NONUNION OR MALUNION, TIBIA; WITHOUT GRAFT, (EG, COMPRESSION TECHNIQUE)
REPAIR OF NONUNION OR MALUNION, TIBIA; WITH SLIDING GRAFT
REPAIR OF NONUNION OR MALUNION, TIBIA; WITH ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT)
REPAIR OF NONUNION OR MALUNION, TIBIA; BY SYNOSTOSIS, WITH FIBULA, ANY METHOD
REPAIR OF CONGENITAL PSEUDARTHROSIS, TIBIA
ARREST, EPIPHYSEAL (EPIPHYSIODESIS), OPEN; DISTAL TIBIA
ARREST, EPIPHYSEAL (EPIPHYSIODESIS), OPEN; DISTAL FIBULA
ARREST, EPIPHYSEAL (EPIPHYSIODESIS), OPEN; DISTAL TIBIA AND FIBULA
ARREST, EPIPHYSEAL (EPIPHYSIODESIS), ANY METHOD, COMBINED, PROXIMAL AND DISTAL TIBIA AND FIBULA
EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING, COMBINED, PROXIMAL AND DISTAL TIBIA AND FIBULA; AN
PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT METHYLMETHACRYLAT
CLOSED TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE); WITHOUT MANIPULA
CLOSED TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE); WITH MANIPULATION
PERCUTANEOUS SKELETAL FIXATION OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) (EG,
OPEN TREATMENT OF TIBIAL SHAFT FRACTURE, (WITH OR WITHOUT FIBULAR FRACTURE) WITH PLATE/SCREWS,
TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) BY INTRAMEDULLARY IMPLAN
CLOSED TREATMENT OF MEDIAL MALLEOLUS FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF MEDIAL MALLEOLUS FRACTURE; WITH MANIPULATION, WITH OR WITHOUT SKIN OR SKE
OPEN TREATMENT OF MEDIAL MALLEOLUS FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
CLOSED TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE; WITH MANIPULATION
OPEN TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXA
CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS); WITHOUT MANIPULATION
CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS); WITH MANIPULATION
OPEN TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS), WITH OR WITHOUT INTERNAL OR EXT
CLOSED TREATMENT OF BIMALLEOLAR ANKLE FRACTURE, (INCLUDING POTTS); WITHOUT MANIPULATION
CLOSED TREATMENT OF BIMALLEOLAR ANKLE FRACTURE, (INCLUDING POTTS); WITH MANIPULATION
OPEN TREATMENT OF BIMALLEOLAR ANKLE FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
CLOSED TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE; WITH MANIPULATION
OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION,
OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION,
CLOSED TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR PORTION OF DISTAL TIBIA (EG, PILON OR T
CLOSED TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR PORTION OF DISTAL TIBIA (EG, PILON OR T
OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR SURFACE/PORTION OF DISTAL TIBIA (EG, PILO
OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR SURFACE/PORTION OF DISTAL TIBIA (EG, PILO
OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR SURFACE/PORTION OF DISTAL TIBIA (EG, PILO
OPEN TREATMENT OF DISTAL TIBIOFIBULAR JOINT (SYNDESMOSIS) DISRUPTION, WITH OR WITHOUT INTERNAL O
CLOSED TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOCATION; WITHOUT ANESTHESIA
CLOSED TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOCATION; REQUIRING ANESTHESIA
OPEN TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL
CLOSED TREATMENT OF ANKLE DISLOCATION; WITHOUT ANESTHESIA
CLOSED TREATMENT OF ANKLE DISLOCATION; REQUIRING ANESTHESIA, WITH OR WITHOUT PERCUTANEOUS SK
OPEN TREATMENT OF ANKLE DISLOCATION, WITH OR WITHOUT PERCUTANEOUS SKELETAL FIXATION; WITHOUT
OPEN TREATMENT OF ANKLE DISLOCATION, WITH OR WITHOUT PERCUTANEOUS SKELETAL FIXATION; WITH REP
MANIPULATION OF ANKLE UNDER GENERAL ANESTHESIA (INCLUDES APPLICATION OF TRACTION OR OTHER FIXA
ARTHRODESIS, ANKLE, OPEN
ARTHRODESIS, TIBIOFIBULAR JOINT, PROXIMAL OR DISTAL
AMPUTATION, LEG, THROUGH TIBIA AND FIBULA;
AMPUTATION, LEG, THROUGH TIBIA AND FIBULA; WITH IMMEDIATE FITTING TECHNIQUE INCLUDING APPLICATION
AMPUTATION, LEG, THROUGH TIBIA AND FIBULA; OPEN, CIRCULAR (GUILLOTINE)
AMPUTATION, LEG, THROUGH TIBIA AND FIBULA; SECONDARY CLOSURE OR SCAR REVISION
AMPUTATION, LEG, THROUGH TIBIA AND FIBULA; RE-AMPUTATION
AMPUTATION, ANKLE, THROUGH MALLEOLI OF TIBIA AND FIBULA (EG, SYME, PIROGOFF TYPE PROCEDURES), WIT
ANKLE DISARTICULATION
DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL COMPARTMENTS ONLY, WITH DEBRIDEMENT O
DECOMPRESSION FASCIOTOMY, LEG; POSTERIOR COMPARTMENT(S) ONLY, WITH DEBRIDEMENT OF NONVIABLE
DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL, AND POSTERIOR COMPARTMENT(S), WITH DE
UNLISTED PROCEDURE, LEG OR ANKLE
INCISION AND DRAINAGE, BURSA, FOOT
INCISION AND DRAINAGE BELOW FASCIA, WITH OR WITHOUT TENDON SHEATH INVOLVEMENT, FOOT; SINGLE BUR
DEEP DISSECTION BELOW FASCIA, FOR DEEP INFECTION OF FOOT, WITH OR WITHOUT TENDON SHEATH INVOLV
INCISION, BONE CORTEX (EG, OSTEOMYELITIS OR BONE ABSCESS), FOOT
FASCIOTOMY, FOOT AND/OR TOE
TENOTOMY, PERCUTANEOUS, TOE; SINGLE TENDON
TENOTOMY, PERCUTANEOUS, TOE; MULTIPLE TENDONS
ARTHROTOMY, INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY; INTERTARSAL
ARTHROTOMY, WITH EXPLORATION, DRAINAGE OR REMOVAL OF LOOSE OR FOREIGN BODY; METATARSOPHALAN
ARTHROTOMY, WITH EXPLORATION, DRAINAGE OR REMOVAL OF LOOSE OR FOREIGN BODY; INTERPHALANGEAL
NEURECTOMY, INTRINSIC MUSCULATURE OF FOOT
RELEASE, TARSAL TUNNEL (POSTERIOR TIBIAL NERVE DECOMPRESSION)
EXCISION, TUMOR, FOOT; SUBCUTANEOUS TISSUE
EXCISION, TUMOR, FOOT; DEEP, SUBFASCIAL, INTRAMUSCULAR
RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF FOOT
ARTHROTOMY WITH BIOPSY; INTERTARSAL OR TARSOMETATARSAL JOINT
ARTHROTOMY FOR SYNOVIAL BIOPSY; METATARSOPHALANGEAL JOINT
ARTHROTOMY FOR SYNOVIAL BIOPSY; INTERPHALANGEAL JOINT
FASCIECTOMY, PLANTAR FASCIA; PARTIAL (SEPARATE PROCEDURE)
FASCIECTOMY, EXCISION OF PLANTAR FASCIA; RADICAL (SEPARATE PROCEDURE)
SYNOVECTOMY; INTERTARSAL OR TARSOMETATARSAL JOINT, EACH
SYNOVECTOMY; METATARSOPHALANGEAL JOINT, EACH
EXCISION, INTERDIGITAL (MORTON) NEUROMA, SINGLE, EACH
SYNOVECTOMY, TENDON SHEATH, FOOT; FLEXOR
SYNOVECTOMY, TENDON SHEATH, FOOT; EXTENSOR
EXCISION OF LESION, TENDON, TENDON SHEATH, OR CAPSULE (INCLUDING SYNOVECTOMY) (EG, CYST OR GANG
EXCISION OF LESION, TENDON, TENDON SHEATH, OR CAPSULE (INCLUDING SYNOVECTOMY) (EG, CYST OR GANG
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TALUS OR CALCANEUS;
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TALUS OR CALCANEUS; WITH ILIAC OR OTHER AUT
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TALUS OR CALCANEUS; WITH ALLOGRAFT
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TARSAL OR METATARSAL, EXCEPT TALUS OR CAL
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TARSAL OR METATARSAL, EXCEPT TALUS OR CAL
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TARSAL OR METATARSAL, EXCEPT TALUS OR CAL
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, PHALANGES OF FOOT
OSTECTOMY, PARTIAL EXCISION, FIFTH METATARSAL HEAD (BUNIONETTE) (SEPARATE PROCEDURE)
OSTECTOMY, COMPLETE EXCISION; FIRST METATARSAL HEAD
OSTECTOMY, COMPLETE EXCISION; OTHER METATARSAL HEAD (SECOND, THIRD OR FOURTH)
OSTECTOMY, COMPLETE EXCISION; FIFTH METATARSAL HEAD
OSTECTOMY, COMPLETE EXCISION; ALL METATARSAL HEADS, WITH PARTIAL PROXIMAL PHALANGECTOMY, EXCL
OSTECTOMY, EXCISION OF TARSAL COALITION
OSTECTOMY, CALCANEUS;
OSTECTOMY, CALCANEUS; FOR SPUR, WITH OR WITHOUT PLANTAR FASCIAL RELEASE
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OST
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OST
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OST
RESECTION, PARTIAL OR COMPLETE, PHALANGEAL BASE, EACH TOE
TALECTOMY (ASTRAGALECTOMY)
METATARSECTOMY
PHALANGECTOMY, TOE, EACH TOE
RESECTION, CONDYLE(S), DISTAL END OF PHALANX, EACH TOE
HEMIPHALANGECTOMY OR INTERPHALANGEAL JOINT EXCISION, TOE, PROXIMAL END OF PHALANX, EACH
RADICAL RESECTION OF TUMOR, BONE; TARSAL (EXCEPT TALUS OR CALCANEUS)
RADICAL RESECTION OF TUMOR, BONE; METATARSAL
RADICAL RESECTION OF TUMOR, BONE; PHALANX OF TOE
REMOVAL OF FOREIGN BODY, FOOT; SUBCUTANEOUS
REMOVAL OF FOREIGN BODY, FOOT; DEEP
REMOVAL OF FOREIGN BODY, FOOT; COMPLICATED
REPAIR, TENDON, FLEXOR, FOOT; PRIMARY OR SECONDARY, WITHOUT FREE GRAFT, EACH TENDON
REPAIR OR SUTURE OF TENDON, FOOT, FLEXOR, SINGLE; SECONDARY WITH FREE GRAFT, EACH TENDON (INCLU
REPAIR, TENDON, EXTENSOR, FOOT; PRIMARY OR SECONDARY, EACH TENDON
REPAIR OR SUTURE OF TENDON, FOOT, EXTENSOR, SINGLE; SECONDARY WITH FREE GRAFT, EACH TENDON (INC
TENOLYSIS, FLEXOR, FOOT; SINGLE TENDON
TENOLYSIS, FLEXOR, FOOT; MULTIPLE TENDONS
TENOLYSIS, EXTENSOR, FOOT; SINGLE TENDON
TENOLYSIS, EXTENSOR, FOOT; MULTIPLE TENDONS
TENOTOMY, OPEN, TENDON FLEXOR; FOOT, SINGLE OR MULTIPLE TENDON(S) (SEPARATE PROCEDURE)
TENOTOMY, OPEN, TENDON FLEXOR; TOE, SINGLE TENDON (SEPARATE PROCEDURE)
TENOTOMY, OPEN, EXTENSOR, FOOT OR TOE, EACH TENDON
RECONSTRUCTION, POSTERIOR TIBIAL TENDON WITH EXCISION OF ACCESSORY TARSAL NAVICULAR BONE
TENOTOMY, LENGTHENING, OR RELEASE, ABDUCTOR HALLUCIS MUSCLE
DIVISION OF PLANTAR FASCIA AND MUSCLE (EG, STEINDLER STRIPPING) (SEPARATE PROCEDURE)
CAPSULOTOMY, MIDFOOT; MEDIAL RELEASE ONLY (SEPARATE PROCEDURE)
CAPSULOTOMY, MIDFOOT; WITH TENDON LENGTHENING
CAPSULOTOMY, MIDFOOT; EXTENSIVE, INCLUDING POSTERIOR TALOTIBIAL CAPSULOTOMY AND TENDON(S) LENG
CAPSULOTOMY, MIDTARSAL (EG, HEYMAN TYPE PROCEDURE)
CAPSULOTOMY; METATARSOPHALANGEAL JOINT, WITH OR WITHOUT TENORRHAPHY, EACH JOINT (SEPARATE PR
CAPSULOTOMY; INTERPHALANGEAL JOINT, EACH JOINT (SEPARATE PROCEDURE)
SYNDACTYLIZATION, TOES (EG, WEBBING OR KELIKIAN TYPE PROCEDURE)
CORRECTION, HAMMERTOE (EG, INTERPHALANGEAL FUSION, PARTIAL OR TOTAL PHALANGECTOMY)
CORRECTION, COCK-UP FIFTH TOE, WITH PLASTIC SKIN CLOSURE (EG, RUIZ-MORA TYPE PROCEDURE)
OSTECTOMY, PARTIAL, EXOSTECTOMY OR CONDYLECTOMY, METATARSAL HEAD, EACH METATARSAL HEAD
HALLUX RIGIDUS CORRECTION WITH CHEILECTOMY, DEBRIDEMENT AND CAPSULAR RELEASE OF THE FIRST MET
CORRECTION, HALLUX VALGUS (BUNION), WITH OR WITHOUT SESAMOIDECTOMY; SIMPLE EXOSTECTOMY (EG, SI
HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT SESAMOIDECTOMY; KELLER, MCBRIDE OR MAYO TY
HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT SESAMOIDECTOMY; RESECTION OF JOINT WITH IMP
CORRECTION, HALLUX VALGUS (BUNION), WITH OR WITHOUT SESAMOIDECTOMY; WITH TENDON TRANSPLANTS (
HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT SESAMOIDECTOMY; WITH METATARSAL OSTEOTOM
HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT SESAMOIDECTOMY; LAPIDUS TYPE PROCEDURE
HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT SESAMOIDECTOMY; BY PHALANX OSTEOTOMY
CORRECTION, HALLUX VALGUS, WITH OR WITHOUT SESAMOIDECTOMY; BY DOUBLE OSTEOTOMY
OSTEOTOMY; CALCANEUS (EG, DWYER OR CHAMBERS TYPE PROCEDURE), WITH OR WITHOUT INTERNAL FIXATIO
OSTEOTOMY; TALUS
OSTEOTOMY, TARSAL BONES, OTHER THAN CALCANEUS OR TALUS
OSTEOTOMY, TARSAL BONES, OTHER THAN CALCANEUS OR TALUS; WITH AUTOGRAFT (INCLUDES OBTAINING GR
OSTEOTOMY, WITH OR WITHOUT LENGTHENING, SHORTENING OR ANGULAR CORRECTION, METATARSAL; FIRST
OSTEOTOMY, WITH OR WITHOUT LENGTHENING, SHORTENING OR ANGULAR CORRECTION, METATARSAL; FIRST
OSTEOTOMY, WITH OR WITHOUT LENGTHENING, SHORTENING OR ANGULAR CORRECTION, METATARSAL; OTHER
OSTEOTOMY, WITH OR WITHOUT LENGTHENING, SHORTENING OR ANGULAR CORRECTION, METATARSAL; MULTI
OSTEOTOMY, SHORTENING, ANGULAR OR ROTATIONAL CORRECTION; PROXIMAL PHALANX, FIRST TOE (SEPARAT
OSTEOTOMY FOR SHORTENING, ANGULAR OR ROTATIONAL CORRECTION; OTHER PHALANGES, ANY TOE
RECONSTRUCTION, ANGULAR DEFORMITY OF TOE, SOFT TISSUE PROCEDURES ONLY (EG, OVERLAPPING SECON
SESAMOIDECTOMY, FIRST TOE (SEPARATE PROCEDURE)
REPAIR, NONUNION OR MALUNION; TARSAL BONES
REPAIR OF NONUNION OR MALUNION; METATARSAL, WITH OR WITHOUT BONE GRAFT (INCLUDES OBTAINING GRA
RECONSTRUCTION, TOE, MACRODACTYLY; SOFT TISSUE RESECTION
RECONSTRUCTION, TOE, MACRODACTYLY; REQUIRING BONE RESECTION
RECONSTRUCTION, TOE(S); POLYDACTYLY
RECONSTRUCTION, TOE(S); SYNDACTYLY, WITH OR WITHOUT SKIN GRAFT(S), EACH WEB
RECONSTRUCTION, CLEFT FOOT
CLOSED TREATMENT OF CALCANEAL FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF CALCANEAL FRACTURE; WITH MANIPULATION
PERCUTANEOUS SKELETAL FIXATION OF CALCANEAL FRACTURE, WITH MANIPULATION
OPEN TREATMENT OF CALCANEAL FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION;
OPEN TREATMENT OF CALCANEAL FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION; WITH PRIM
CLOSED TREATMENT OF TALUS FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF TALUS FRACTURE; WITH MANIPULATION
PERCUTANEOUS SKELETAL FIXATION OF TALUS FRACTURE, WITH MANIPULATION
OPEN TREATMENT OF TALUS FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT MANIPULATION, EACH
TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITH MANIPULATION, EACH
PERCUTANEOUS SKELETAL FIXATION OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS), WITH MAN
OPEN TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS), WITH OR WITHOUT INTERNA
CLOSED TREATMENT OF METATARSAL FRACTURE; WITHOUT MANIPULATION, EACH
CLOSED TREATMENT OF METATARSAL FRACTURE; WITH MANIPULATION, EACH
PERCUTANEOUS SKELETAL FIXATION OF METATARSAL FRACTURE, WITH MANIPULATION, EACH
OPEN TREATMENT OF METATARSAL FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION, EACH
CLOSED TREATMENT OF FRACTURE GREAT TOE, PHALANX OR PHALANGES; WITHOUT MANIPULATION
CLOSED TREATMENT OF FRACTURE GREAT TOE, PHALANX OR PHALANGES; WITH MANIPULATION
PERCUTANEOUS SKELETAL FIXATION OF FRACTURE GREAT TOE, PHALANX OR PHALANGES, WITH MANIPULATION
OPEN TREATMENT OF FRACTURE GREAT TOE, PHALANX OR PHALANGES, WITH OR WITHOUT INTERNAL OR EXTE
CLOSED TREATMENT OF FRACTURE, PHALANX OR PHALANGES, OTHER THAN GREAT TOE; WITHOUT MANIPULATI
CLOSED TREATMENT OF FRACTURE, PHALANX OR PHALANGES, OTHER THAN GREAT TOE; WITH MANIPULATION,
OPEN TREATMENT OF FRACTURE, PHALANX OR PHALANGES, OTHER THAN GREAT TOE, WITH OR WITHOUT INTER
CLOSED TREATMENT OF SESAMOID FRACTURE
OPEN TREATMENT OF SESAMOID FRACTURE, WITH OR WITHOUT INTERNAL FIXATION
CLOSED TREATMENT OF TARSAL BONE DISLOCATION, OTHER THAN TALOTARSAL; WITHOUT ANESTHESIA
CLOSED TREATMENT OF TARSAL BONE DISLOCATION, OTHER THAN TALOTARSAL; REQUIRING ANESTHESIA
PERCUTANEOUS SKELETAL FIXATION OF TARSAL BONE DISLOCATION, OTHER THAN TALOTARSAL, WITH MANIPU
OPEN TREATMENT OF TARSAL BONE DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
CLOSED TREATMENT OF TALOTARSAL JOINT DISLOCATION; WITHOUT ANESTHESIA
CLOSED TREATMENT OF TALOTARSAL JOINT DISLOCATION; REQUIRING ANESTHESIA
PERCUTANEOUS SKELETAL FIXATION OF TALOTARSAL JOINT DISLOCATION, WITH MANIPULATION
OPEN TREATMENT OF TALOTARSAL JOINT DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
CLOSED TREATMENT OF TARSOMETATARSAL JOINT DISLOCATION; WITHOUT ANESTHESIA
CLOSED TREATMENT OF TARSOMETATARSAL JOINT DISLOCATION; REQUIRING ANESTHESIA
PERCUTANEOUS SKELETAL FIXATION OF TARSOMETATARSAL JOINT DISLOCATION, WITH MANIPULATION
OPEN TREATMENT OF TARSOMETATARSAL JOINT DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL FIX
CLOSED TREATMENT OF METATARSOPHALANGEAL JOINT DISLOCATION; WITHOUT ANESTHESIA
CLOSED TREATMENT OF METATARSOPHALANGEAL JOINT DISLOCATION; REQUIRING ANESTHESIA
PERCUTANEOUS SKELETAL FIXATION OF METATARSOPHALANGEAL JOINT DISLOCATION, WITH MANIPULATION
OPEN TREATMENT OF METATARSOPHALANGEAL JOINT DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNA
CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION; WITHOUT ANESTHESIA
CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION; REQUIRING ANESTHESIA
PERCUTANEOUS SKELETAL FIXATION OF INTERPHALANGEAL JOINT DISLOCATION, WITH MANIPULATION
OPEN TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXA
ARTHRODESIS; PANTALAR
ARTHRODESIS; TRIPLE
ARTHRODESIS; SUBTALAR
ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE OR TRANSVERSE;
ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE OR TRANSVERSE; WITH OSTEOTOMY (EG, FLATFO
ARTHRODESIS, WITH TENDON LENGTHENING AND ADVANCEMENT, MIDTARSAL, TARSAL NAVICULAR-CUNEIFORM
ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE JOINT
ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT
ARTHRODESIS, GREAT TOE; INTERPHALANGEAL JOINT
ARTHRODESIS, WITH EXTENSOR HALLUCIS LONGUS TRANSFER TO FIRST METATARSAL NECK, GREAT TOE, INTER
AMPUTATION, FOOT; MIDTARSAL (EG, CHOPART TYPE PROCEDURE)
AMPUTATION, FOOT; TRANSMETATARSAL
AMPUTATION, METATARSAL, WITH TOE, SINGLE
AMPUTATION, TOE; METATARSOPHALANGEAL JOINT
AMPUTATION, TOE; INTERPHALANGEAL JOINT
UNLISTED PROCEDURE, FOOT OR TOES
APPLICATION OF HALO TYPE BODY CAST (SEE 20661-20663 FOR INSERTION)
APPLICATION OF RISSER JACKET, LOCALIZER, BODY; ONLY
APPLICATION OF RISSER JACKET, LOCALIZER, BODY; INCLUDING HEAD
APPLICATION OF TURNBUCKLE JACKET, BODY; ONLY
APPLICATION OF TURNBUCKLE JACKET, BODY; INCLUDING HEAD
APPLICATION OF BODY CAST, SHOULDER TO HIPS;
APPLICATION OF BODY CAST, SHOULDER TO HIPS; INCLUDING HEAD, MINERVA TYPE
APPLICATION OF BODY CAST, SHOULDER TO HIPS; INCLUDING ONE THIGH
APPLICATION OF BODY CAST, SHOULDER TO HIPS; INCLUDING BOTH THIGHS
APPLICATION, CAST; FIGURE-OF-EIGHT
APPLICATION, CAST; SHOULDER SPICA
APPLICATION, CAST; PLASTER VELPEAU
APPLICATION, CAST; SHOULDER TO HAND
APPLICATION, CAST; ELBOW TO FINGER
APPLICATION, CAST; HAND AND LOWER FOREARM
APPLICATION, CAST; FINGER (EG, CONTRACTURE)
APPLICATION OF LONG ARM SPLINT (SHOULDER TO HAND)
APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND); STATIC
APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND); DYNAMIC
APPLICATION OF FINGER SPLINT; STATIC
APPLICATION OF FINGER SPLINT; DYNAMIC
STRAPPING; THORAX
STRAPPING; LOW BACK
STRAPPING; SHOULDER (EG, VELPEAU)
STRAPPING; ELBOW OR WRIST
STRAPPING; HAND OR FINGER
APPLICATION OF HIP SPICA CAST; ONE LEG
APPLICATION OF HIP SPICA CAST; ONE AND ONE-HALF SPICA OR BOTH LEGS
APPLICATION OF LONG LEG CAST (THIGH TO TOES);
APPLICATION OF LONG LEG CAST (THIGH TO TOES); WALKER OR AMBULATORY TYPE
APPLICATION OF LONG LEG CAST BRACE
APPLICATION OF CYLINDER CAST (THIGH TO ANKLE)
APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES);
APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES); WALKING OR AMBULATORY TYPE
APPLICATION OF PATELLAR TENDON BEARING (PTB) CAST
ADDING WALKER TO PREVIOUSLY APPLIED CAST
APPLICATION OF RIGID TOTAL CONTACT LEG CAST
APPLICATION OF CLUBFOOT CAST WITH MOLDING OR MANIPULATION, LONG OR SHORT LEG
APPLICATION OF LONG LEG SPLINT (THIGH TO ANKLE OR TOES)
APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)
STRAPPING; HIP
STRAPPING; KNEE
STRAPPING; ANKLE AND/OR FOOT
STRAPPING; TOES
STRAPPING; UNNA BOOT
DENIS-BROWNE SPLINT STRAPPING
REMOVAL OR BIVALVING; GAUNTLET, BOOT OR BODY CAST
REMOVAL OR BIVALVING; FULL ARM OR FULL LEG CAST
REMOVAL OR BIVALVING; SHOULDER OR HIP SPICA, MINERVA, OR RISSER JACKET, ETC.
REMOVAL OR BIVALVING; TURNBUCKLE JACKET
REPAIR OF SPICA, BODY CAST OR JACKET
WINDOWING OF CAST
WEDGING OF CAST (EXCEPT CLUBFOOT CASTS)
WEDGING OF CLUBFOOT CAST
UNLISTED PROCEDURE, CASTING OR STRAPPING
ARTHROSCOPY, TEMPOROMANDIBULAR JOINT, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE P
ARTHROSCOPY, TEMPOROMANDIBULAR JOINT, SURGICAL
ARTHROSCOPY, SHOULDER, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)
ARTHROSCOPY, SHOULDER, SURGICAL; CAPSULORRHAPHY
ARTHROSCOPY, SHOULDER, SURGICAL; REPAIR OF SLAP LESION
ARTHROSCOPY, SHOULDER, SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY
ARTHROSCOPY, SHOULDER, SURGICAL; SYNOVECTOMY, PARTIAL
ARTHROSCOPY, SHOULDER, SURGICAL; SYNOVECTOMY, COMPLETE
ARTHROSCOPY, SHOULDER, SURGICAL; DEBRIDEMENT, LIMITED
ARTHROSCOPY, SHOULDER, SURGICAL; DEBRIDEMENT, EXTENSIVE
ARTHROSCOPY, SHOULDER, SURGICAL; DISTAL CLAVICULECTOMY INCLUDING DISTAL ARTICULAR SURFACE (MUM
ARTHROSCOPY, SHOULDER, SURGICAL; WITH LYSIS AND RESECTION OF ADHESIONS, WITH OR WITHOUT MANIPU
ARTHROSCOPY, SHOULDER, SURGICAL; DECOMPRESSION OF SUBACROMIAL SPACE WITH PARTIAL ACROMIOPLA
ARTHROSCOPY, SHOULDER, SURGICAL; WITH ROTATOR CUFF REPAIR
ARTHROSCOPY, ELBOW, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)
ARTHROSCOPY, ELBOW, SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY
ARTHROSCOPY, ELBOW, SURGICAL; SYNOVECTOMY, PARTIAL
ARTHROSCOPY, ELBOW, SURGICAL; SYNOVECTOMY, COMPLETE
ARTHROSCOPY, ELBOW, SURGICAL; DEBRIDEMENT, LIMITED
ARTHROSCOPY, ELBOW, SURGICAL; DEBRIDEMENT, EXTENSIVE
ARTHROSCOPY, WRIST, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)
ARTHROSCOPY, WRIST, SURGICAL; FOR INFECTION, LAVAGE AND DRAINAGE
ARTHROSCOPY, WRIST, SURGICAL; SYNOVECTOMY, PARTIAL
ARTHROSCOPY, WRIST, SURGICAL; SYNOVECTOMY, COMPLETE
ARTHROSCOPY, WRIST, SURGICAL; EXCISION AND/OR REPAIR OF TRIANGULAR FIBROCARTILAGE AND/OR JOINT D
ARTHROSCOPY, WRIST, SURGICAL; INTERNAL FIXATION FOR FRACTURE OR INSTABILITY
ENDOSCOPY, WRIST, SURGICAL, WITH RELEASE OF TRANSVERSE CARPAL LIGAMENT
ARTHROSCOPICALLY AIDED TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF T
ARTHROSCOPICALLY AIDED TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF T
ARTHROSCOPICALLY AIDED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); UNICONDYLAR, WITH OR W
ARTHROSCOPICALLY AIDED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); BICONDYLAR, WITH OR WIT
ARTHROSCOPY, HIP, DIAGNOSTIC WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)
ARTHROSCOPY, HIP, SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY
ARTHROSCOPY, HIP, SURGICAL; WITH DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY), A
ARTHROSCOPY, HIP, SURGICAL; WITH SYNOVECTOMY
ARTHROSCOPY, KNEE, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)
ARTHROSCOPY, KNEE, SURGICAL; FOR INFECTION, LAVAGE AND DRAINAGE
ARTHROSCOPY, KNEE, SURGICAL; WITH LATERAL RELEASE
ARTHROSCOPY, KNEE, SURGICAL; FOR REMOVAL OF LOOSE BODY OR FOREIGN BODY (EG, OSTEOCHONDRITIS D
ARTHROSCOPY, KNEE, SURGICAL; SYNOVECTOMY, LIMITED (EG, PLICA OR SHELF RESECTION) (SEPARATE PROC
ARTHROSCOPY, KNEE, SURGICAL; SYNOVECTOMY, MAJOR, TWO OR MORE COMPARTMENTS (EG, MEDIAL OR LAT
ARTHROSCOPY, KNEE, SURGICAL; DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY)
ARTHROSCOPY, KNEE, SURGICAL; ABRASION ARTHROPLASTY (INCLUDES CHONDROPLASTY WHERE NECESSARY
ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL AND LATERAL, INCLUDING ANY MENISCAL SHAV
ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LATERAL, INCLUDING ANY MENISCAL SHAV
ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCUS REPAIR (MEDIAL OR LATERAL)
ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCUS REPAIR (MEDIAL AND LATERAL)
ARTHROSCOPY, KNEE, SURGICAL; WITH LYSIS OF ADHESIONS, WITH OR WITHOUT MANIPULATION (SEPARATE PR
ARTHROSCOPY, KNEE, SURGICAL; DRILLING FOR OSTEOCHONDRITIS DISSECANS WITH BONE GRAFTING, WITH O
ARTHROSCOPY, KNEE, SURGICAL; DRILLING FOR INTACT OSTEOCHONDRITIS DISSECANS LESION
ARTHROSCOPY, KNEE, SURGICAL; DRILLING FOR INTACT OSTEOCHONDRITIS DISSECANS LESION WITH INTERNAL
ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE LIGAMENT REPAIR/AUGMENTATION OR RECONSTRUCTION
ARTHROSCOPICALLY AIDED POSTERIOR CRUCIATE LIGAMENT REPAIR/AUGMENTATION OR RECONSTRUCTION
ARTHROSCOPY, ANKLE, SURGICAL; EXCISION OF OSTEOCHONDRAL DEFECT OF TALUS AND/OR TIBIA, INCLUDING
ARTHROSCOPICALLY AIDED REPAIR OF LARGE OSTEOCHONDRITIS DISSECANS LESION, TALAR DOME FRACTURE
ENDOSCOPIC PLANTAR FASCIOTOMY
ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; WITH REMOVAL OF LOOSE BODY OR
ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; SYNOVECTOMY, PARTIAL
ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; DEBRIDEMENT, LIMITED
ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; DEBRIDEMENT, EXTENSIVE
ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; WITH ANKLE ARTHRODESIS
ARTHROSCOPY, METACARPOPHALANGEAL JOINT, DIAGNOSTIC, INCLUDES SYNOVIAL BIOPSY
ARTHROSCOPY, METACARPOPHALANGEAL JOINT, SURGICAL; WITH DEBRIDEMENT
ARTHROSCOPY, METACARPOPHALANGEAL JOINT, SURGICAL; WITH REDUCTION OF DISPLACED ULNAR COLLATER
UNLISTED PROCEDURE, ARTHROSCOPY
DRAINAGE ABSCESS OR HEMATOMA, NASAL, INTERNAL APPROACH
DRAINAGE ABSCESS OR HEMATOMA, NASAL SEPTUM
BIOPSY, INTRANASAL
EXCISION, NASAL POLYP(S), SIMPLE
EXCISION, NASAL POLYP(S), EXTENSIVE
EXCISION OR DESTRUCTION, INTRANASAL LESION; INTERNAL APPROACH
EXCISION OR DESTRUCTION, INTRANASAL LESION; EXTERNAL APPROACH
EXCISION OR SURGICAL PLANING OF SKIN OF NOSE FOR RHINOPHYMA
EXCISION DERMOID CYST, NOSE; SIMPLE, SKIN, SUBCUTANEOUS
EXCISION DERMOID CYST, NOSE; COMPLEX, UNDER BONE OR CARTILAGE
EXCISION TURBINATE, PARTIAL OR COMPLETE, ANY METHOD
SUBMUCOUS RESECTION TURBINATE, PARTIAL OR COMPLETE, ANY METHOD
RHINECTOMY; PARTIAL
RHINECTOMY; TOTAL
INJECTION INTO TURBINATE(S), THERAPEUTIC
DISPLACEMENT THERAPY (PROETZ TYPE)
INSERTION, NASAL SEPTAL PROSTHESIS (BUTTON)
REMOVAL FOREIGN BODY, INTRANASAL; OFFICE TYPE PROCEDURE
REMOVAL FOREIGN BODY, INTRANASAL; REQUIRING GENERAL ANESTHESIA
REMOVAL FOREIGN BODY, INTRANASAL; BY LATERAL RHINOTOMY
RHINOPLASTY, PRIMARY; LATERAL AND ALAR CARTILAGES AND/OR ELEVATION OF NASAL TIP
RHINOPLASTY, PRIMARY; COMPLETE, EXTERNAL PARTS INCLUDING BONY PYRAMID, LATERAL AND ALAR CARTILA
RHINOPLASTY, PRIMARY; INCLUDING MAJOR SEPTAL REPAIR
RHINOPLASTY, SECONDARY; MINOR REVISION (SMALL AMOUNT OF NASAL TIP WORK)
RHINOPLASTY, SECONDARY; INTERMEDIATE REVISION (BONY WORK WITH OSTEOTOMIES)
RHINOPLASTY, SECONDARY; MAJOR REVISION (NASAL TIP WORK AND OSTEOTOMIES)
RHINOPLASTY FOR NASAL DEFORMITY SECONDARY TO CONGENITAL CLEFT LIP AND/OR PALATE, INCLUDING COL
RHINOPLASTY FOR NASAL DEFORMITY SECONDARY TO CONGENITAL CLEFT LIP AND/OR PALATE, INCLUDING COL
REPAIR OF NASAL VESTIBULAR STENOSIS (EG, SPREADER GRAFTING, LATERAL NASAL WALL RECONSTRUCTION)
SEPTOPLASTY OR SUBMUCOUS RESECTION, WITH OR WITHOUT CARTILAGE SCORING, CONTOURING OR REPLAC
REPAIR CHOANAL ATRESIA; INTRANASAL
REPAIR CHOANAL ATRESIA; TRANSPALATINE
LYSIS INTRANASAL SYNECHIA
REPAIR FISTULA; OROMAXILLARY (COMBINE WITH 31030 IF ANTROTOMY IS INCLUDED)
REPAIR FISTULA; ORONASAL
SEPTAL OR OTHER INTRANASAL DERMATOPLASTY (DOES NOT INCLUDE OBTAINING GRAFT)
REPAIR NASAL SEPTAL PERFORATIONS
CAUTERY AND/OR ABLATION, MUCOSA OF TURBINATES, UNILATERAL OR BILATERAL, ANY METHOD,; SUPERFICIAL
CAUTERY AND/OR ABLATION, MUCOSA OF TURBINATES, UNILATERAL OR BILATERAL, ANY METHOD; INTRAMURAL
CONTROL NASAL HEMORRHAGE, ANTERIOR, SIMPLE (LIMITED CAUTERY AND/OR PACKING) ANY METHOD
CONTROL NASAL HEMORRHAGE, ANTERIOR, COMPLEX (EXTENSIVE CAUTERY AND/OR PACKING) ANY METHOD
CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIOR NASAL PACKS AND/OR CAUTERY, ANY METHOD;
CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIOR NASAL PACKS AND/OR CAUTERY, ANY METHOD;
LIGATION ARTERIES; ETHMOIDAL
LIGATION ARTERIES; INTERNAL MAXILLARY ARTERY, TRANSANTRAL
FRACTURE NASAL TURBINATE(S), THERAPEUTIC
UNLISTED PROCEDURE, NOSE
LAVAGE BY CANNULATION; MAXILLARY SINUS (ANTRUM PUNCTURE OR NATURAL OSTIUM)
LAVAGE BY CANNULATION; SPHENOID SINUS
SINUSOTOMY, MAXILLARY (ANTROTOMY); INTRANASAL
SINUSOTOMY, MAXILLARY (ANTROTOMY); RADICAL (CALDWELL-LUC) WITHOUT REMOVAL OF ANTROCHOANAL PO
SINUSOTOMY, MAXILLARY (ANTROTOMY); RADICAL (CALDWELL-LUC) WITH REMOVAL OF ANTROCHOANAL POLYPS
PTERYGOMAXILLARY FOSSA SURGERY, ANY APPROACH
SINUSOTOMY, SPHENOID, WITH OR WITHOUT BIOPSY;
SINUSOTOMY, SPHENOID, WITH OR WITHOUT BIOPSY; WITH MUCOSAL STRIPPING OR REMOVAL OF POLYP(S)
SINUSOTOMY FRONTAL; EXTERNAL, SIMPLE (TREPHINE OPERATION)
SINUSOTOMY FRONTAL; TRANSORBITAL, UNILATERAL (FOR MUCOCELE OR OSTEOMA, LYNCH TYPE)
SINUSOTOMY FRONTAL; OBLITERATIVE WITHOUT OSTEOPLASTIC FLAP, BROW INCISION (INCLUDES ABLATION)
SINUSOTOMY FRONTAL; OBLITERATIVE, WITHOUT OSTEOPLASTIC FLAP, CORONAL INCISION (INCLUDES ABLATIO
SINUSOTOMY FRONTAL; OBLITERATIVE, WITH OSTEOPLASTIC FLAP, BROW INCISION
SINUSOTOMY FRONTAL; OBLITERATIVE, WITH OSTEOPLASTIC FLAP, CORONAL INCISION
SINUSOTOMY FRONTAL; NONOBLITERATIVE, WITH OSTEOPLASTIC FLAP, BROW INCISION
SINUSOTOMY FRONTAL; NONOBLITERATIVE, WITH OSTEOPLASTIC FLAP, CORONAL INCISION
SINUSOTOMY, UNILATERAL, THREE OR MORE PARANASAL SINUSES (FRONTAL, MAXILLARY, ETHMOID, SPHENOID)
ETHMOIDECTOMY; INTRANASAL, ANTERIOR
ETHMOIDECTOMY; INTRANASAL, TOTAL
ETHMOIDECTOMY; EXTRANASAL, TOTAL
MAXILLECTOMY; WITHOUT ORBITAL EXENTERATION
MAXILLECTOMY; WITH ORBITAL EXENTERATION (EN BLOC)
NASAL ENDOSCOPY, DIAGNOSTIC, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE)
NASAL/SINUS ENDOSCOPY, DIAGNOSTIC WITH MAXILLARY SINUSOSCOPY (VIA INFERIOR MEATUS OR CANINE FOS
NASAL/SINUS ENDOSCOPY, DIAGNOSTIC WITH SPHENOID SINUSOSCOPY (VIA PUNCTURE OF SPHENOIDAL FACE O
NASAL/SINUS ENDOSCOPY, SURGICAL; WITH BIOPSY, POLYPECTOMY OR DEBRIDEMENT (SEPARATE PROCEDURE
NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONTROL OF NASAL HEMORRHAGE
NASAL/SINUS ENDOSCOPY, SURGICAL; WITH DACRYOCYSTORHINOSTOMY
NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONCHA BULLOSA RESECTION
NASAL/SINUS ENDOSCOPY, SURGICAL; WITH ETHMOIDECTOMY, PARTIAL (ANTERIOR)
NASAL/SINUS ENDOSCOPY, SURGICAL; WITH ETHMOIDECTOMY, TOTAL (ANTERIOR AND POSTERIOR)
NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY;
NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY; WITH REMOVAL OF TISSUE FROM MAXILL
NASAL/SINUS ENDOSCOPY, SURGICAL WITH FRONTAL SINUS EXPLORATION, WITH OR WITHOUT REMOVAL OF TIS
NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOMY;
NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOMY; WITH REMOVAL OF TISSUE FROM THE SPHENOID
NASAL/SINUS ENDOSCOPY, SURGICAL, WITH REPAIR OF CEREBROSPINAL FLUID LEAK; ETHMOID REGION
NASAL/SINUS ENDOSCOPY, SURGICAL, WITH REPAIR OF CEREBROSPINAL FLUID LEAK; SPHENOID REGION
NASAL/SINUS ENDOSCOPY, SURGICAL; WITH MEDIAL OR INFERIOR ORBITAL WALL DECOMPRESSION
NASAL/SINUS ENDOSCOPY, SURGICAL; WITH MEDIAL ORBITAL WALL AND INFERIOR ORBITAL WALL DECOMPRESS
NASAL/SINUS ENDOSCOPY, SURGICAL; WITH OPTIC NERVE DECOMPRESSION
UNLISTED PROCEDURE, ACCESSORY SINUSES
LARYNGOTOMY (THYROTOMY, LARYNGOFISSURE); WITH REMOVAL OF TUMOR OR LARYNGOCELE, CORDECTOMY
LARYNGOTOMY (THYROTOMY, LARYNGOFISSURE); DIAGNOSTIC
LARYNGECTOMY; TOTAL, WITHOUT RADICAL NECK DISSECTION
LARYNGECTOMY; TOTAL, WITH RADICAL NECK DISSECTION
LARYNGECTOMY; SUBTOTAL SUPRAGLOTTIC, WITHOUT RADICAL NECK DISSECTION
LARYNGECTOMY; SUBTOTAL SUPRAGLOTTIC, WITH RADICAL NECK DISSECTION
PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); HORIZONTAL
PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); LATEROVERTICAL
PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); ANTEROVERTICAL
PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); ANTERO-LATERO-VERTICAL
PHARYNGOLARYNGECTOMY, WITH RADICAL NECK DISSECTION; WITHOUT RECONSTRUCTION
PHARYNGOLARYNGECTOMY, WITH RADICAL NECK DISSECTION; WITH RECONSTRUCTION
ARYTENOIDECTOMY OR ARYTENOIDOPEXY, EXTERNAL APPROACH
EPIGLOTTIDECTOMY
INTUBATION, ENDOTRACHEAL, EMERGENCY PROCEDURE
TRACHEOTOMY TUBE CHANGE PRIOR TO ESTABLISHMENT OF FISTULA TRACT
LARYNGOSCOPY, INDIRECT; DIAGNOSTIC (SEPARATE PROCEDURE)
LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH BIOPSY
LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH REMOVAL OF FOREIGN BODY
LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH REMOVAL OF LESION
LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH VOCAL CORD INJECTION
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; FOR ASPIRATION
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; DIAGNOSTIC, NEWBORN
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; DIAGNOSTIC, EXCEPT NEWBORN
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; DIAGNOSTIC, WITH OPERATING MICROSCOPE
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH INSERTION OF OBTURATOR
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH DILATION, INITIAL
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH DILATION, SUBSEQUENT
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH FOREIGN BODY REMOVAL;
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH FOREIGN BODY REMOVAL; WITH OPERATING MICROSCOPE
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY;
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY; WITH OPERATING MICROSCOPE
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMOR AND/OR STRIPPING OF VOCAL CORDS OR EPIG
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMOR AND/OR STRIPPING OF VOCAL CORDS OR EPIG
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH ARYTENOIDECTOMY;
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH ARYTENOIDECTOMY; WITH OPERATING MICROSCOPE
LARYNGOSCOPY, DIRECT, WITH INJECTION INTO VOCAL CORD(S), THERAPEUTIC;
LARYNGOSCOPY, DIRECT, WITH INJECTION INTO VOCAL CORD(S), THERAPEUTIC; WITH OPERATING MICROSCOPE
LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; DIAGNOSTIC
LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; WITH BIOPSY
LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; WITH REMOVAL OF FOREIGN BODY
LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; WITH REMOVAL OF LESION
LARYNGOSCOPY, FLEXIBLE OR RIGID FIBEROPTIC, WITH STROBOSCOPY
LARYNGOPLASTY; FOR LARYNGEAL WEB, TWO STAGE, WITH KEEL INSERTION AND REMOVAL
LARYNGOPLASTY; FOR LARYNGEAL STENOSIS, WITH GRAFT OR CORE MOLD, INCLUDING TRACHEOTOMY
LARYNGOPLASTY; WITH OPEN REDUCTION OF FRACTURE
TREATMENT OF CLOSED LARYNGEAL FRACTURE; WITHOUT MANIPULATION
TREATMENT OF CLOSED LARYNGEAL FRACTURE; WITH CLOSED MANIPULATIVE REDUCTION
LARYNGOPLASTY, CRICOID SPLIT
LARYNGOPLASTY, NOT OTHERWISE SPECIFIED (EG, FOR BURNS, RECONSTRUCTION AFTER PARTIAL LARYNGECT
LARYNGEAL REINNERVATION BY NEUROMUSCULAR PEDICLE
SECTION RECURRENT LARYNGEAL NERVE, THERAPEUTIC (SEPARATE PROCEDURE), UNILATERAL
UNLISTED PROCEDURE, LARYNX
TRACHEOSTOMY, PLANNED (SEPARATE PROCEDURE);
TRACHEOSTOMY, PLANNED (SEPARATE PROCEDURE); UNDER TWO YEARS
TRACHEOSTOMY, EMERGENCY PROCEDURE; TRANSTRACHEAL
TRACHEOSTOMY, EMERGENCY PROCEDURE; CRICOTHYROID MEMBRANE
TRACHEOSTOMY, FENESTRATION PROCEDURE WITH SKIN FLAPS
CONSTRUCTION OF TRACHEOESOPHAGEAL FISTULA AND SUBSEQUENT INSERTION OF AN ALARYNGEAL SPEECH
TRACHEAL PUNCTURE, PERCUTANEOUS WITH TRANSTRACHEAL ASPIRATION AND/OR INJECTION
TRACHEOSTOMA REVISION; SIMPLE, WITHOUT FLAP ROTATION
TRACHEOSTOMA REVISION; COMPLEX, WITH FLAP ROTATION
TRACHEOBRONCHOSCOPY THROUGH ESTABLISHED TRACHEOSTOMY INCISION
BRONCHOSCOPY, (RIGID OR FLEXIBLE); DIAGNOSTIC, WITH OR WITHOUT CELL WASHING (SEPARATE PROCEDUR
BRONCHOSCOPY; WITH BRUSHING OR PROTECTED BRUSHINGS
BRONCHOSCOPY; WITH BRONCHIAL ALVEOLAR LAVAGE
BRONCHOSCOPY; WITH BIOPSY
BRONCHOSCOPY; WITH TRANSBRONCHIAL LUNG BIOPSY, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE
BRONCHOSCOPY; WITH TRANSBRONCHIAL NEEDLE ASPIRATION BIOPSY
BRONCHOSCOPY; WITH TRACHEAL OR BRONCHIAL DILATION OR CLOSED REDUCTION OF FRACTURE
BRONCHOSCOPY; WITH TRACHEAL DILATION AND PLACEMENT OF TRACHEAL STENT
BRONCHOSCOPY; WITH REMOVAL OF FOREIGN BODY
BRONCHOSCOPY; WITH EXCISION OF TUMOR
BRONCHOSCOPY,; WITH DESTRUCTION OF TUMOR OR RELIEF OF STENOSIS BY ANY METHOD OTHER THAN EXCIS
BRONCHOSCOPY; WITH PLACEMENT OF CATHETER(S) FOR INTRACAVITARY RADIOELEMENT APPLICATION
BRONCHOSCOPY; WITH THERAPEUTIC ASPIRATION OF TRACHEOBRONCHIAL TREE, INITIAL
BRONCHOSCOPY; WITH THERAPEUTIC ASPIRATION OF TRACHEOBRONCHIAL TREE, SUBSEQUENT
BRONCHOSCOPY; WITH INJECTION OF CONTRAST MATERIAL FOR SEGMENTAL BRONCHOGRAPHY
CATHETERIZATION, TRANSGLOTTIC (SEPARATE PROCEDURE)
INSTILLATION OF CONTRAST MATERIAL FOR LARYNGOGRAPHY OR BRONCHOGRAPHY, WITHOUT CATHETERIZAT
CATHETERIZATION FOR BRONCHOGRAPHY, WITH OR WITHOUT INSTILLATION OF CONTRAST MATERIAL
TRANSTRACHEAL INJECTION FOR BRONCHOGRAPHY
CATHETERIZATION WITH BRONCHIAL BRUSH BIOPSY
CATHETER ASPIRATION (SEPARATE PROCEDURE); NASOTRACHEAL
CATHETER ASPIRATION (SEPARATE PROCEDURE); TRACHEOBRONCHIAL WITH FIBERSCOPE, BEDSIDE
TRANSTRACHEAL (PERCUTANEOUS) INTRODUCTION OF NEEDLE WIRE DILATOR/STENT OR INDWELLING TUBE FO
TRACHEOPLASTY; CERVICAL
TRACHEOPLASTY; TRACHEOPHARYNGEAL FISTULIZATION, EACH STAGE
TRACHEOPLASTY; INTRATHORACIC
CARINAL RECONSTRUCTION
BRONCHOPLASTY; GRAFT REPAIR
BRONCHOPLASTY; EXCISION STENOSIS AND ANASTOMOSIS
EXCISION TRACHEAL STENOSIS AND ANASTOMOSIS; CERVICAL
EXCISION TRACHEAL STENOSIS AND ANASTOMOSIS; CERVICOTHORACIC
EXCISION OF TRACHEAL TUMOR OR CARCINOMA; CERVICAL
EXCISION OF TRACHEAL TUMOR OR CARCINOMA; THORACIC
SUTURE OF TRACHEAL WOUND OR INJURY; CERVICAL
SUTURE OF TRACHEAL WOUND OR INJURY; INTRATHORACIC
SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITHOUT PLASTIC REPAIR
SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITH PLASTIC REPAIR
REVISION OF TRACHEOSTOMY SCAR
UNLISTED PROCEDURE, TRACHEA, BRONCHI
THORACENTESIS, PUNCTURE OF PLEURAL CAVITY FOR ASPIRATION, INITIAL OR SUBSEQUENT
THORACENTESIS WITH INSERTION OF TUBE WITH OR WITHOUT WATER SEAL (EG, FOR PNEUMOTHORAX) (SEPAR
CHEMICAL PLEURODESIS (EG, FOR RECURRENT OR PERSISTENT PNEUMOTHORAX)
TUBE THORACOSTOMY WITH OR WITHOUT WATER SEAL (EG, FOR ABSCESS, HEMOTHORAX, EMPYEMA) (SEPARA
THORACOSTOMY; WITH RIB RESECTION FOR EMPYEMA
THORACOSTOMY; WITH OPEN FLAP DRAINAGE FOR EMPYEMA
THORACOTOMY, LIMITED, FOR BIOPSY OF LUNG OR PLEURA
THORACOTOMY, MAJOR; WITH EXPLORATION AND BIOPSY
THORACOTOMY, MAJOR; WITH CONTROL OF TRAUMATIC HEMORRHAGE AND/OR REPAIR OF LUNG TEAR
THORACOTOMY, MAJOR; FOR POSTOPERATIVE COMPLICATIONS
THORACOTOMY, MAJOR; WITH OPEN INTRAPLEURAL PNEUMONOLYSIS
THORACOTOMY, MAJOR; WITH CYST(S) REMOVAL, WITH OR WITHOUT A PLEURAL PROCEDURE
THORACOTOMY, MAJOR; WITH EXCISION-PLICATION OF BULLAE, WITH OR WITHOUT ANY PLEURAL PROCEDURE
THORACOTOMY, MAJOR; WITH REMOVAL OF INTRAPLEURAL FOREIGN BODY OR FIBRIN DEPOSIT
THORACOTOMY, MAJOR; WITH REMOVAL OF INTRAPULMONARY FOREIGN BODY
THORACOTOMY, MAJOR; WITH CARDIAC MASSAGE
PNEUMONOSTOMY, WITH OPEN DRAINAGE OF ABSCESS OR CYST
PNEUMONOSTOMY; WITH PERCUTANEOUS DRAINAGE OF ABSCESS OR CYST
PLEURAL SCARIFICATION FOR REPEAT PNEUMOTHORAX
DECORTICATION, PULMONARY, (SEPARATE PROCEDURE); TOTAL
DECORTICATION, PULMONARY, (SEPARATE PROCEDURE); PARTIAL
PLEURECTOMY, PARIETAL (SEPARATE PROCEDURE)
DECORTICATION AND PARIETAL PLEURECTOMY
BIOPSY, PLEURA; PERCUTANEOUS NEEDLE
BIOPSY, PLEURA; OPEN
BIOPSY, LUNG OR MEDIASTINUM, PERCUTANEOUS NEEDLE
PNEUMOCENTESIS, PUNCTURE OF LUNG FOR ASPIRATION
REMOVAL OF LUNG, TOTAL PNEUMONECTOMY;
REMOVAL OF LUNG, TOTAL PNEUMONECTOMY; WITH RESECTION OF SEGMENT OF TRACHEA FOLLOWED BY BRO
REMOVAL OF LUNG, TOTAL PNEUMONECTOMY; EXTRAPLEURAL
REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY; SINGLE LOBE (LOBECTOMY)
REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY; TWO LOBES (BILOBECTOMY)
REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY; SINGLE SEGMENT (SEGMENTECTOMY)
REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY; WITH CIRCUMFERENTIAL RESECTION OF SEGMENT
REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY; ALL REMAINING LUNG FOLLOWING PREVIOUS REMO
RMVL OF LUNG, OTHR THN TOTAL PNEUMONECTOMY; EXCISION-PLICATION OF EMPHYSEMATOUS LUNG(S) (BULL
REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY; WEDGE RESECTION, SINGLE OR MULTIPLE
RESECTION AND REPAIR OF PORTION OF BRONCHUS (BRONCHOPLASTY) WHEN PERFORMED AT TIME OF LOBEC
RESECTION OF LUNG; WITH RESECTION OF CHEST WALL
RESECTION OF LUNG; WITH RECONSTRUCTION OF CHEST WALL, WITHOUT PROSTHESIS
RESECTION OF LUNG; WITH MAJOR RECONSTRUCTION OF CHEST WALL, WITH PROSTHESIS
EXTRAPLEURAL ENUCLEATION OF EMPYEMA (EMPYEMECTOMY)
THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); LUNGS AND PLEURAL SPACE, WITHOUT BIOPSY
THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); LUNGS AND PLEURAL SPACE, WITH BIOPSY
THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); PERICARDIAL SAC, WITHOUT BIOPSY
THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); PERICARDIAL SAC, WITH BIOPSY
THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); MEDIASTINAL SPACE, WITHOUT BIOPSY
THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); MEDIASTINAL SPACE, WITH BIOPSY
THORACOSCOPY, SURGICAL; WITH PLEURODESIS
THORACOSCOPY, SURGICAL; WITH PARTIAL PULMONARY DECORTICATION
THORACOSCOPY, SURGICAL; WITH TOTAL PULMONARY DECORTICATION, INCLUDING INTRAPLEURAL PNEUMONO
THORACOSCOPY, SURGICAL; WITH REMOVAL OF INTRAPLEURAL FOREIGN BODY OR FIBRIN DEPOSIT
THORACOSCOPY, SURGICAL; WITH CONTROL OF TRAUMATIC HEMORRHAGE
THORACOSCOPY, SURGICAL; WITH EXCISION-PLICATION OF BULLAE, INCLUDING ANY PLEURAL PROCEDURE
THORACOSCOPY, SURGICAL; WITH PARIETAL PLEURECTOMY
THORACOSCOPY, SURGICAL; WITH WEDGE RESECTION OF LUNG, SINGLE OR MULTIPLE
THORACOSCOPY, SURGICAL; WITH REMOVAL OF CLOT OR FOREIGN BODY FROM PERICARDIAL SAC
THORACOSCOPY, SURGICAL; WITH CREATION OF PERICARDIAL WINDOW OR PARTIAL RESECTION OF PERICARDI
THORACOSCOPY, SURGICAL; WITH TOTAL PERICARDIECTOMY
THORACOSCOPY, SURGICAL; WITH EXCISION OF PERICARDIAL CYST, TUMOR, OR MASS
THORACOSCOPY, SURGICAL; WITH EXCISION OF MEDIASTINAL CYST, TUMOR, OR MASS
THORACOSCOPY, SURGICAL; WITH LOBECTOMY, TOTAL OR SEGMENTAL
THORACOSCOPY, SURGICAL; WITH THORACIC SYMPATHECTOMY
THORACOSCOPY, SURGICAL; WITH ESOPHAGOMYOTOMY
REPAIR LUNG HERNIA THROUGH CHEST WALL
CLOSURE OF CHEST WALL FOLLOWING OPEN FLAP DRAINAGE FOR EMPYEMA (CLAGETT TYPE PROCEDURE)
OPEN CLOSURE OF MAJOR BRONCHIAL FISTULA
MAJOR RECONSTRUCTION, CHEST WALL (POST-TRAUMATIC)
DONOR PNEUMONECTOMY(IES) WITH PREPARATION AND MAINTENANCE OF ALLOGRAFT (CADAVER)
LUNG TRANSPLANT, SINGLE; WITHOUT CARDIOPULMONARY BYPASS
LUNG TRANSPLANT, SINGLE; WITH CARDIOPULMONARY BYPASS
LUNG TRANSPLANT, DOUBLE (BILATERAL SEQUENTIAL OR EN BLOC); WITHOUT CARDIOPULMONARY BYPASS
LUNG TRANSPLANT, DOUBLE (BILATERAL SEQUENTIAL OR EN BLOC); WITH CARDIOPULMONARY BYPASS
RESECTION OF RIBS, EXTRAPLEURAL, ALL STAGES
THORACOPLASTY, SCHEDE TYPE OR EXTRAPLEURAL (ALL STAGES);
THORACOPLASTY, SCHEDE TYPE OR EXTRAPLEURAL (ALL STAGES); WITH CLOSURE OF BRONCHOPLEURAL FIST
PNEUMONOLYSIS, EXTRAPERIOSTEAL, INCLUDING FILLING OR PACKING PROCEDURES
PNEUMOTHORAX, THERAPEUTIC, INTRAPLEURAL INJECTION OF AIR
TOTAL LUNG LAVAGE (UNILATERAL)
UNLISTED PROCEDURE, LUNGS AND PLEURA
PERICARDIOCENTESIS; INITIAL
PERICARDIOCENTESIS; SUBSEQUENT
TUBE PERICARDIOSTOMY
PERICARDIOTOMY FOR REMOVAL OF CLOT OR FOREIGN BODY (PRIMARY PROCEDURE)
CREATION OF PERICARDIAL WINDOW OR PARTIAL RESECTION FOR DRAINAGE
PERICARDIECTOMY, SUBTOTAL OR COMPLETE; WITHOUT CARDIOPULMONARY BYPASS
PERICARDIECTOMY, SUBTOTAL OR COMPLETE; WITH CARDIOPULMONARY BYPASS
EXCISION OF PERICARDIAL CYST OR TUMOR
EXCISION OF INTRACARDIAC TUMOR, RESECTION WITH CARDIOPULMONARY BYPASS
RESECTION OF EXTERNAL CARDIAC TUMOR
TRANSMYOCARDIAL LASER REVASCULARIZATION, BY THORACOTOMY (SEPARATE PROCEDURE)
TRANSMYOCARDIAL LASER REVASCULARIZATION, BY THORACOTOMY; PERFORMED AT THE TIME OF OTHER OPE
INSERTION OF PERMANENT PACEMAKER WITH EPICARDIAL ELECTRODE(S); BY THORACOTOMY
INSERTION OF PERMANENT PACEMAKER WITH EPICARDIAL ELECTRODE(S); BY XIPHOID APPROACH
INSERTION OR REPLACEMENT OF PERMANENT PACEMAKER WITH TRANSVENOUS ELECTRODE(S); ATRIAL
INSERTION OR REPLACEMENT OF PERMANENT PACEMAKER WITH TRANSVENOUS ELECTRODE(S); VENTRICULAR
INSERTION OR REPLACEMENT OF PERMANENT PACEMAKER WITH TRANSVENOUS ELECTRODE(S); ATRIAL AND VE
INSERTION OR REPLACEMENT OF TEMPORARY TRANSVENOUS SINGLE CHAMBER CARDIAC ELECTRODE OR PACE
INSERTION OR REPLACEMENT OF TEMPORARY TRANSVENOUS DUAL CHAMBER PACING ELECTRODES (SEPARAT
INSERTION OR REPLACEMENT OF PACEMAKER PULSE GENERATOR ONLY; SINGLE CHAMBER, ATRIAL OR VENTRIC
INSERTION OR REPLACEMENT OF PACEMAKER PULSE GENERATOR ONLY; DUAL CHAMBER
UPGRADE OF IMPLANTED PACEMAKER SYSTEM, CONVERSION SINGLE CHAMBER SYS TO DUAL SYS (INC REMOVA
REPOSITIONING OF PREVIOUSLY IMPLANTED TRANSVENOUS PACEMAKER OR PACING CARDIOVERTER-DEFIBRILL
INSERTION OF A TRANSVENOUS ELECTRODE; SINGLE CHAMBER (ONE ELECTRODE) PERMANENT PACEMAKER OR
INSERTION OF A TRANSVENOUS ELECTRODE; DUAL CHAMBER (TWO ELECTRODES) PERMANENT PACEMAKER OR
REPAIR OF SINGLE TRANSVENOUS ELECTRODE FOR A SINGLE CHAMBER, PERMANENT PACEMAKER OR SINGLE C
REPAIR OF TWO TRANSVENOUS ELECTRODES FOR A DUAL CHAMBER PERMANENT PACEMAKER OR DUAL CHAMB
REVISION OR RELOCATION OF SKIN POCKET FOR PACEMAKER
REVISION OF SKIN POCKET FOR SINGLE OR DUAL CHAMBER PACING CARDIOVERTER-DEFIBRILLATOR
INSRT, PACING ELECTRDE, CARD VEN SYST, LEFT VENTRICULAR PACING, W ATTACH PREVIOUSLY PLACED PACE
INSERTION OF PACING ELECTRODE, CARDIAC VENOUS SYSTEM, FOR LEFT VENTRICULAR PACING, AT TIME OF IN
REPOSITIONING OF PREVIOUSLY IMPLANTED CARDIAC VENOUS SYSTEM (LEFT VENTRICULAR) ELECTRODE (INCL
REMOVAL OF PERMANENT PACEMAKER PULSE GENERATOR
REMOVAL OF TRANSVENOUS PACEMAKER ELECTRODE(S); SINGLE LEAD SYSTEM, ATRIAL OR VENTRICULAR
REMOVAL OF TRANSVENOUS PACEMAKER ELECTRODE(S); DUAL LEAD SYSTEM
REMOVAL OF PERMANENT EPICARDIAL PACEMAKER AND ELECTRODES BY THORACOTOMY; SINGLE LEAD SYSTEM
REMOVAL OF PERMANENT EPICARDIAL PACEMAKER AND ELECTRODES BY THORACOTOMY; DUAL LEAD SYSTEM
REMOVAL OF PERMANENT TRANSVENOUS ELECTRODE(S) BY THORACOTOMY
INSERTION OF SINGLE OR DUAL CHAMBER PACING CARDIOVERTER-DEFIBRILLATOR PULSE GENERATOR
SUBCUTANEOUS REMOVAL OF SINGLE OR DUAL CHAMBER PACING CARDIOVERTER-DEFIBRILLATOR PULSE GENE
REMOVAL OF SINGLE OR DUAL CHAMBER PACING CARDIOVERTER-DEFIBRILLATOR ELECTRODE(S); BY THORACO
REMOVAL OF SINGLE OR DUAL CHAMBER PACING CARDIOVERTER-DEFIBRILLATOR ELECTRODE(S); BY TRANSVEN
INSERTION OF EPICARDIAL SINGLE OR DUAL CHAMBER PACING CARDIOVERTER-DEFIBRILLATOR ELECTRODES BY
INSERTION OF EPICARDIAL SINGLE OR DUAL CHAMBER PACING CARDIOVERTER-DEFIBRILLATOR ELECTRODES BY
INSERTION OR REPOSITIONING OF ELECTRODE LEAD(S) FOR SINGLE OR DUAL CHAMBER PACING CARDIOVERTER
OPERATIVE ABLATION OF SUPRAVENTRICULAR ARRHYTHMOGENIC FOCUS OR PATHWAY, TRACT(S) AND/OR FOC
OPERATIVE ABLATION OF SUPRAVENTRICULAR ARRHYTHMOGENIC FOCUS OR PATHWAY, TRACT(S) AND/OR FOC
OPERATIVE INCISIONS AND RECONSTRUCTION OF ATRIA FOR TREATMENT OF ATRIAL FIBRILLATION OR ATRIAL F
OPERATIVE ABLATION OF VENTRICULAR ARRHYTHMOGENIC FOCUS WITH CARDIOPULMONARY BYPASS
IMPLANTATION OF PATIENT-ACTIVATED CARDIAC EVENT RECORDER
REMOVAL OF AN IMPLANTABLE, PATIENT-ACTIVATED CARDIAC EVENT RECORDER
REPAIR OF CARDIAC WOUND; WITHOUT BYPASS
REPAIR OF CARDIAC WOUND; WITH CARDIOPULMONARY BYPASS
CARDIOTOMY, EXPLORATORY (INCLUDES REMOVAL OF FOREIGN BODY); WITHOUT BYPASS
CARDIOTOMY, EXPLORATORY (INCLUDES REMOVAL OF FOREIGN BODY); WITH CARDIOPULMONARY BYPASS
SUTURE REPAIR OF AORTA OR GREAT VESSELS; WITHOUT SHUNT OR CARDIOPULMONARY BYPASS
SUTURE REPAIR OF AORTA OR GREAT VESSELS; WITH SHUNT BYPASS
SUTURE REPAIR OF AORTA OR GREAT VESSELS; WITH CARDIOPULMONARY BYPASS
INSERTION OF GRAFT, AORTA OR GREAT VESSELS; WITHOUT SHUNT, OR CARDIOPULMONARY BYPASS
INSERTION OF GRAFT, AORTA OR GREAT VESSELS; WITH SHUNT BYPASS
INSERTION OF GRAFT, AORTA OR GREAT VESSELS; WITH CARDIOPULMONARY BYPASS
VALVULOPLASTY, AORTIC VALVE; OPEN, WITH CARDIOPULMONARY BYPASS
VALVULOPLASTY, AORTIC VALVE; OPEN, WITH INFLOW OCCLUSION
VALVULOPLASTY, AORTIC VALVE; USING TRANSVENTRICULAR DILATION, WITH CARDIOPULMONARY BYPASS
CONSTRUCTION OF APICAL-AORTIC CONDUIT
REPLACEMENT, AORTIC VALVE, WITH CARDIOPULMONARY BYPASS; WITH PROSTHETIC VALVE OTHER THAN HOM
REPLACEMENT, AORTIC VALVE, WITH CARDIOPULMONARY BYPASS; WITH ALLOGRAFT VALVE
REPLACEMENT, AORTIC VALVE, WITH CARDIOPULMONARY BYPASS; WITH STENTLESS TISSUE VALVE
REPLACEMENT, AORTIC VALVE; WITH AORTIC ANNULUS ENLARGEMENT, NONCORONARY CUSP
REPLACEMENT, AORTIC VALVE; WITH TRANSVENTRICULAR AORTIC ANNULUS ENLARGEMENT (KONNO PROCEDU
REPLACEMENT, AORTIC VALVE; BY TRANSLOCATION OF AUTOLOGOUS PULMONARY VALVE WITH ALLOGRAFT RE
REPAIR OF LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION BY PATCH ENLARGEMENT OF THE OUTFLOW TR
RESECTION OR INCISION OF SUBVALVULAR TISSUE FOR DISCRETE SUBVALVULAR AORTIC STENOSIS
VENTRICULOMYOTOMY (-MYECTOMY) FOR IDIOPATHIC HYPERTROPHIC SUBAORTIC STENOSIS (EG, ASYMMETRIC
AORTOPLASTY (GUSSET) FOR SUPRAVALVULAR STENOSIS
VALVOTOMY, MITRAL VALVE; CLOSED HEART
VALVOTOMY, MITRAL VALVE; OPEN HEART, WITH CARDIOPULMONARY BYPASS
VALVULOPLASTY, MITRAL VALVE, WITH CARDIOPULMONARY BYPASS;
VALVULOPLASTY, MITRAL VALVE, WITH CARDIOPULMONARY BYPASS; WITH PROSTHETIC RING
VALVULOPLASTY, MITRAL VALVE, WITH CARDIOPULMONARY BYPASS; RADICAL RECONSTRUCTION, WITH OR WIT
REPLACEMENT, MITRAL VALVE, WITH CARDIOPULMONARY BYPASS
VALVECTOMY, TRICUSPID VALVE, WITH CARDIOPULMONARY BYPASS
VALVULOPLASTY, TRICUSPID VALVE; WITHOUT RING INSERTION
VALVULOPLASTY, TRICUSPID VALVE; WITH RING INSERTION
REPLACEMENT, TRICUSPID VALVE, WITH CARDIOPULMONARY BYPASS
TRICUSPID VALVE REPOSITIONING AND PLICATION FOR EBSTEIN ANOMALY
VALVOTOMY, PULMONARY VALVE, CLOSED HEART; TRANSVENTRICULAR
VALVOTOMY, PULMONARY VALVE, CLOSED HEART; VIA PULMONARY ARTERY
VALVOTOMY, PULMONARY VALVE, OPEN HEART; WITH INFLOW OCCLUSION
VALVOTOMY, PULMONARY VALVE, OPEN HEART; WITH CARDIOPULMONARY BYPASS
REPLACEMENT, PULMONARY VALVE
RIGHT VENTRICULAR RESECTION FOR INFUNDIBULAR STENOSIS, WITH OR WITHOUT COMMISSUROTOMY
OUTFLOW TRACT AUGMENTATION (GUSSET), WITH OR WITHOUT COMMISSUROTOMY OR INFUNDIBULAR RESECT
REPAIR OF NON-STRUCTURAL PROSTHETIC VALVE DYSFUNCTION WITH CARDIOPULMONARY BYPASS (SEPARATE
REPAIR OF CORONARY ARTERIOVENOUS OR ARTERIOCARDIAC CHAMBER FISTULA; WITH CARDIOPULMONARY BY
REPAIR OF CORONARY ARTERIOVENOUS OR ARTERIOCARDIAC CHAMBER FISTULA; WITHOUT CARDIOPULMONAR
REPAIR OF ANOMALOUS CORONARY ARTERY; BY LIGATION
REPAIR OF ANOMALOUS CORONARY ARTERY; BY GRAFT, WITHOUT CARDIOPULMONARY BYPASS
REPAIR OF ANOMALOUS CORONARY ARTERY; BY GRAFT, WITH CARDIOPULMONARY BYPASS
REPAIR OF ANOMALOUS CORONARY ARTERY; WITH CONSTRUCTION OF INTRAPULMONARY ARTERY TUNNEL (TAK
REPAIR OF ANOMALOUS CORONARY ARTERY; BY TRANSLOCATION FROM PULMONARY ARTERY TO AORTA
ENDOSCOPY, SURGICAL, INCLUDING VIDEO-ASSISTED HARVEST OF VEIN(S) FOR CORONARY ARTERY BYPASS PR
CORONARY ARTERY BYPASS, VEIN ONLY; SINGLE CORONARY VENOUS GRAFT
CORONARY ARTERY BYPASS, VEIN ONLY; TWO CORONARY VENOUS GRAFTS
CORONARY ARTERY BYPASS, VEIN ONLY; THREE CORONARY VENOUS GRAFTS
CORONARY ARTERY BYPASS, VEIN ONLY; FOUR CORONARY VENOUS GRAFTS
CORONARY ARTERY BYPASS, VEIN ONLY; FIVE CORONARY VENOUS GRAFTS
CORONARY ARTERY BYPASS, VEIN ONLY; SIX OR MORE CORONARY VENOUS GRAFTS
CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND ARTERIAL GRAFT(S); SINGLE VEIN GRAFT (LIST SEPA
CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND ARTERIAL GRAFT(S); TWO VENOUS GRAFTS (LIST SE
CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND ARTERIAL GRAFT(S); THREE VENOUS GRAFTS (LIST
CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND ARTERIAL GRAFT(S); FOUR VENOUS GRAFTS (LIST S
CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND ARTERIAL GRAFT(S); FIVE VENOUS GRAFTS (LIST SE
CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND ARTERIAL GRAFT(S); SIX OR MORE VENOUS GRAFTS
REOPERATION, CORONARY ARTERY BYPASS PROCEDURE OR VALVE PROCEDURE, MORE THAN ONE MONTH AFT
CORONARY ARTERY BYPASS, USING ARTERIAL GRAFT(S); SINGLE ARTERIAL GRAFT
CORONARY ARTERY BYPASS, USING ARTERIAL GRAFT(S); TWO CORONARY ARTERIAL GRAFTS
CORONARY ARTERY BYPASS, USING ARTERIAL GRAFT(S); THREE CORONARY ARTERIAL GRAFTS
CORONARY ARTERY BYPASS, USING ARTERIAL GRAFT(S); FOUR OR MORE CORONARY ARTERIAL GRAFTS
MYOCARDIAL RESECTION (EG, VENTRICULAR ANEURYSMECTOMY)
REPAIR OF POSTINFARCTION VENTRICULAR SEPTAL DEFECT, WITH OR WITHOUT MYOCARDIAL RESECTION
CORONARY ENDARTERECTOMY, OPEN, ANY METHOD, OF LEFT ANTERIOR DESCENDING, CIRCUMFLEX, OR RIGHT
CLOSURE OF ATRIOVENTRICULAR VALVE (MITRAL OR TRICUSPID) BY SUTURE OR PATCH
CLOSURE OF SEMILUNAR VALVE (AORTIC OR PULMONARY) BY SUTURE OR PATCH
ANASTOMOSIS OF PULMONARY ARTERY TO AORTA (DAMUS-KAYE-STANSEL PROCEDURE)
REPAIR OF COMPLEX CARDIAC ANOMALY OTHER THAN PULMONARY ATRESIA WITH VENTRICULAR SEPTAL DEFEC
REPAIR OF COMPLEX CARDIAC ANOMALIES BY SURGICAL ENLARGEMENT OF VENTRICULAR SEPTAL DEFECT
REPAIR OF DOUBLE OUTLET RIGHT VENTRICLE WITH INTRAVENTRICULAR TUNNEL REPAIR;
REPAIR OF DOUBLE OUTLET RIGHT VENTRICLE WITH INTRAVENTRICULAR TUNNEL REPAIR; WITH REPAIR OF RIGH
REPAIR OF COMPLEX CARDIAC ANOMALIES (EG, TRICUSPID ATRESIA) BY CLOSURE OF ATRIAL SEPTAL DEFECT A
REPAIR OF COMPLEX CARDIAC ANOMALIES (EG, SINGLE VENTRICLE) BY MODIFIED FONTAN PROCEDURE
REPAIR OF SINGLE VENTRICLE WITH AORTIC OUTFLOW OBSTRUCTION AND AORTIC ARCH HYPOPLASIA (HYPOPL
REPAIR ATRIAL SEPTAL DEFECT, SECUNDUM, WITH CARDIOPULMONARY BYPASS, WITH OR WITHOUT PATCH
DIRECT OR PATCH CLOSURE, SINUS VENOSUS, WITH OR WITHOUT ANOMALOUS PULMONARY VENOUS DRAINAGE
REPAIR OF ATRIAL SEPTAL DEFECT AND VENTRICULAR SEPTAL DEFECT, WITH DIRECT OR PATCH CLOSURE
REPAIR OF INCOMPLETE OR PARTIAL ATRIOVENTRICULAR CANAL (OSTIUM PRIMUM ATRIAL SEPTAL DEFECT), WIT
REPAIR OF INTERMEDIATE OR TRANSITIONAL ATRIOVENTRICULAR CANAL, WITH OR WITHOUT ATRIOVENTRICULA
REPAIR OF COMPLETE ATRIOVENTRICULAR CANAL, WITH OR WITHOUT PROSTHETIC VALVE
CLOSURE OF VENTRICULAR SEPTAL DEFECT, WITH OR WITHOUT PATCH
CLOSURE OF VENTRICULAR SEPTAL DEFECT, WITH OR WITHOUT PATCH WITH PULMONARY VALVOTOMY OR INFU
CLOSURE OF VENTRICULAR SEPTAL DEFECT, WITH OR WITHOUT PATCH WITH REMOVAL OF PULMONARY ARTER
BANDING OF PULMONARY ARTERY
COMPLETE REPAIR TETRALOGY OF FALLOT WITHOUT PULMONARY ATRESIA;
COMPLETE REPAIR TETRALOGY OF FALLOT WITHOUT PULMONARY ATRESIA; WITH TRANSANNULAR PATCH
COMPLETE REPAIR TETRALOGY OF FALLOT WITH PULMONARY ATRESIA INCLUDING CONSTRUCTION OF CONDUIT
REPAIR SINUS OF VALSALVA FISTULA, WITH CARDIOPULMONARY BYPASS;
REPAIR SINUS OF VALSALVA FISTULA, WITH CARDIOPULMONARY BYPASS; WITH REPAIR OF VENTRICULAR SEPTA
REPAIR SINUS OF VALSALVA ANEURYSM, WITH CARDIOPULMONARY BYPASS
CLOSURE OF AORTICO-LEFT VENTRICULAR TUNNEL
COMPLETE REPAIR OF ANOMALOUS VENOUS RETURN (SUPRACARDIAC, INTRACARDIAC, OR INFRACARDIAC TYPE
REPAIR OF COR TRIATRIATUM OR SUPRAVALVULAR MITRAL RING BY RESECTION OF LEFT ATRIAL MEMBRANE
ATRIAL SEPTECTOMY OR SEPTOSTOMY; CLOSED HEART (BLALOCK-HANLON TYPE OPERATION)
ATRIAL SEPTECTOMY OR SEPTOSTOMY; OPEN HEART WITH CARDIOPULMONARY BYPASS
ATRIAL SEPTECTOMY OR SEPTOSTOMY; OPEN HEART, WITH INFLOW OCCLUSION
SHUNT; SUBCLAVIAN TO PULMONARY ARTERY (BLALOCK-TAUSSIG TYPE OPERATION)
SHUNT; ASCENDING AORTA TO PULMONARY ARTERY (WATERSTON TYPE OPERATION)
SHUNT; DESCENDING AORTA TO PULMONARY ARTERY (POTTS-SMITH TYPE OPERATION)
SHUNT; CENTRAL, WITH PROSTHETIC GRAFT
SHUNT; SUPERIOR VENA CAVA TO PULMONARY ARTERY FOR FLOW TO ONE LUNG (CLASSICAL GLENN PROCEDUR
SHUNT; SUPERIOR VENA CAVA TO PULMONARY ARTERY FOR FLOW TO BOTH LUNGS (BIDIRECTIONAL GLENN PRO
REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES WITH VENTRICULAR SEPTAL DEFECT AND SUBPULMONAR
REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES WITH VENTRICULAR SEPTAL DEFECT AND SUBPULMONAR
REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, ATRIAL BAFFLE PROCEDURE (EG, MUSTARD OR SENNING
REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, ATRIAL BAFFLE PROCEDURE (EG, MUSTARD OR SENNING
REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, ATRIAL BAFFLE PROCEDURE (EG, MUSTARD OR SENNING
REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, ATRIAL BAFFLE PROCEDURE (EG, MUSTARD OR SENNING
REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, AORTIC PULMONARY ARTERY RECONSTRUCTION (EG, JAT
REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, AORTIC PULMONARY ARTERY RECONSTRUCTION (EG, JAT
REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, AORTIC PULMONARY ARTERY RECONSTRUCTION (EG, JAT
REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, AORTIC PULMONARY ARTERY RECONSTRUCTION (EG, JAT
TOTAL REPAIR, TRUNCUS ARTERIOSUS (RASTELLI TYPE OPERATION)
REIMPLANTATION OF AN ANOMALOUS PULMONARY ARTERY
AORTIC SUSPENSION (AORTOPEXY) FOR TRACHEAL DECOMPRESSION (EG, FOR TRACHEOMALACIA) (SEPARATE
DIVISION OF ABERRANT VESSEL (VASCULAR RING);
DIVISION OF ABERRANT VESSEL (VASCULAR RING); WITH REANASTOMOSIS
OBLITERATION OF AORTOPULMONARY SEPTAL DEFECT; WITHOUT CARDIOPULMONARY BYPASS
OBLITERATION OF AORTOPULMONARY SEPTAL DEFECT; WITH CARDIOPULMONARY BYPASS
REPAIR OF PATENT DUCTUS ARTERIOSUS; BY LIGATION
REPAIR OF PATENT DUCTUS ARTERIOSUS; BY DIVISION, UNDER 18 YEARS
REPAIR OF PATENT DUCTUS ARTERIOSUS; BY DIVISION, 18 YEARS AND OLDER
EXCISION OF COARCTATION OF AORTA, WITH OR WITHOUT ASSOCIATED PATENT DUCTUS ARTERIOSUS; WITH D
EXCISION OF COARCTATION OF AORTA, WITH OR WITHOUT ASSOCIATED PATENT DUCTUS ARTERIOSUS; WITH G
EXCISION OF COARCTATION OF AORTA, WITH OR WITHOUT ASSOCIATED PATENT DUCTUS ARTERIOSUS; REPAIR
REPAIR OF HYPOPLASTIC OR INTERRUPTED AORTIC ARCH USING AUTOGENOUS OR PROSTHETIC MATERIAL; WIT
REPAIR OF HYPOPLASTIC OR INTERRUPTED AORTIC ARCH USING AUTOGENOUS OR PROSTHETIC MATERIAL; WIT
ASCENDING AORTA GRAFT, WITH CARDIOPULMONARY BYPASS, WITH OR WITHOUT VALVE SUSPENSION;
ASCENDING AORTA GRAFT, WITH CARDIOPULMONARY BYPASS, WITH OR WITHOUT VALVE SUSPENSION; WITH CO
ASCENDING AORTA GRAFT, WITH CARDIOPULMONARY BYPASS, WITH OR WITHOUT VALVE SUSPENSION; WITH AO
TRANSVERSE ARCH GRAFT, WITH CARDIOPULMONARY BYPASS
DESCENDING THORACIC AORTA GRAFT, WITH OR WITHOUT BYPASS
REPAIR OF THORACOABDOMINAL AORTIC ANEURYSM WITH GRAFT, WITH OR WITHOUT CARDIOPULMONARY BYP
PULMONARY ARTERY EMBOLECTOMY; WITH CARDIOPULMONARY BYPASS
PULMONARY ARTERY EMBOLECTOMY; WITHOUT CARDIOPULMONARY BYPASS
PULMONARY ENDARTERECTOMY, WITH OR WITHOUT EMBOLECTOMY, WITH CARDIOPULMONARY BYPASS
REPAIR OF PULMONARY ARTERY STENOSIS BY RECONSTRUCTION WITH PATCH OR GRAFT
REPAIR OF PULMONARY ATRESIA WITH VENTRICULAR SEPTAL DEFECT, BY UNIFOCALIZATION OF PULMONARY AR
REPAIR OF PULMONARY ATRESIA WITH VENTRICULAR SEPTAL DEFECT, BY UNIFOCALIZATION OF PULMONARY AR
REPAIR OF PULMONARY ATRESIA WITH VENTRICULAR SEPTAL DEFECT, BY CONSTRUCTION OR REPLACEMENT O
TRANSECTION OF PULMONARY ARTERY WITH CARDIOPULMONARY BYPASS
LIGATION AND TAKEDOWN OF A SYSTEMIC-TO-PULMONARY ARTERY SHUNT, PERFORMED IN CONJUNCTION WITH
DONOR CARDIECTOMY-PNEUMONECTOMY, WITH PREPARATION AND MAINTENANCE OF ALLOGRAFT
HEART-LUNG TRANSPLANT WITH RECIPIENT CARDIECTOMY-PNEUMONECTOMY
DONOR CARDIECTOMY, WITH PREPARATION AND MAINTENANCE OF ALLOGRAFT
HEART TRANSPLANT, WITH OR WITHOUT RECIPIENT CARDIECTOMY
PROLONGED EXTRACORPOREAL CIRCULATION FOR CARDIOPULMONARY INSUFFICIENCY; INITIAL 24 HOURS
PROLONGED EXTRACORPOREAL CIRCULATION FOR CARDIOPULMONARY INSUFFICIENCY; EACH ADDITIONAL 24 H
INSERTION OF INTRA-AORTIC BALLOON ASSIST DEVICE, PERCUTANEOUS
REMOVAL OF INTRA-AORTIC BALLOON ASSIST DEVICE, PERCUTANEOUS
INSERTION OF INTRA-AORTIC BALLOON ASSIST DEVICE THROUGH THE FEMORAL ARTERY, OPEN APPROACH
REMOVAL OF INTRA-AORTIC BALLOON ASSIST DEVICE INCLUDING REPAIR OF FEMORAL ARTERY, WITH OR WITHO
INSERTION OF INTRA-AORTIC BALLOON ASSIST DEVICE THROUGH THE ASCENDING AORTA
REMOVAL OF INTRA-AORTIC BALLOON ASSIST DEVICE FROM THE ASCENDING AORTA, INCLUDING REPAIR OF THE
INSERTION OF VENTRICULAR ASSIST DEVICE; EXTRACORPOREAL, SINGLE VENTRICLE
INSERTION OF VENTRICULAR ASSIST DEVICE; EXTRACORPOREAL, BIVENTRICULAR
REMOVAL OF VENTRICULAR ASSIST DEVICE; EXTRACORPOREAL, SINGLE VENTRICLE
REMOVAL OF VENTRICULAR ASSIST DEVICE; EXTRACORPOREAL, BIVENTRICULAR
INSERTION OF VENTRICULAR ASSIST DEVICE, IMPLANTABLE INTRACORPOREAL, SINGLE VENTRICLE
REMOVAL OF VENTRICULAR ASSIST DEVICE, IMPLANTABLE INTRACORPOREAL, SINGLE VENTRICLE
UNLISTED PROCEDURE, CARDIAC SURGERY
EMBOLECTOMY OR THROMBECTOMY, WITH OR WITHOUT CATHETER; CAROTID, SUBCLAVIAN OR INNOMINATE AR
EMBOLECTOMY OR THROMBECTOMY, WITH OR WITHOUT CATHETER; INNOMINATE, SUBCLAVIAN ARTERY, BY THO
EMBOLECTOMY OR THROMBECTOMY, WITH OR WITHOUT CATHETER; AXILLARY, BRACHIAL, INNOMINATE, SUBCLA
EMBOLECTOMY OR THROMBECTOMY, WITH OR WITHOUT CATHETER; RADIAL OR ULNAR ARTERY, BY ARM INCISIO
EMBOLECTOMY OR THROMBECTOMY, WITH OR WITHOUT CATHETER; RENAL, CELIAC, MESENTERY, AORTOILIAC
EMBOLECTOMY OR THROMBECTOMY, WITH OR WITHOUT CATHETER; FEMOROPOPLITEAL, AORTOILIAC ARTERY,
EMBOLECTOMY OR THROMBECTOMY, WITH OR WITHOUT CATHETER; POPLITEAL-TIBIO-PERONEAL ARTERY, BY L
THROMBECTOMY, DIRECT OR WITH CATHETER; VENA CAVA, ILIAC VEIN, BY ABDOMINAL INCISION
THROMBECTOMY, DIRECT OR WITH CATHETER; VENA CAVA, ILIAC, FEMOROPOPLITEAL VEIN, BY LEG INCISION
THROMBECTOMY, DIRECT OR WITH CATHETER; VENA CAVA, ILIAC, FEMOROPOPLITEAL VEIN, BY ABDOMINAL AND
THROMBECTOMY, DIRECT OR WITH CATHETER; SUBCLAVIAN VEIN, BY NECK INCISION
THROMBECTOMY, DIRECT OR WITH CATHETER; AXILLARY AND SUBCLAVIAN VEIN, BY ARM INCISION
VALVULOPLASTY, FEMORAL VEIN
RECONSTRUCTION OF VENA CAVA, ANY METHOD
VENOUS VALVE TRANSPOSITION, ANY VEIN DONOR
CROSS-OVER VEIN GRAFT TO VENOUS SYSTEM
SAPHENOPOPLITEAL VEIN ANASTOMOSIS
ENDOVASCULAR REPAIR OF INFRARENAL ABDOMINAL AORTIC ANEURYSM OR DISSECTION; USING AORTO-AORTI
ENDOVASCULAR REPAIR OF INFRARENAL ABDOMINAL AORTIC ANEURYSM OR DISSECTION; USING MODULAR BIFU
ENDOVASCULAR REPAIR OF INFRARENAL ABDOMINAL AORTIC ANEURYSM OR DISSECTION; USING UNIBODY BIFU
ENDOVASCULAR PLACEMENT OF ILIAC ARTERY OCCLUSION DEVICE (LIST SEPARATELY IN ADDITION TO CODE FO
OPEN FEMORAL ARTERY EXPOSURE FOR DELIVERY OF ENDOVASCULAR PROSTHESIS, BY GROIN INCISION, UNILA
PLACEMENT OF FEMORAL-FEMORAL PROSTHETIC GRAFT DURING ENDOVASCULAR AORTIC ANEURYSM REPAIR (
OPEN ILIAC ARTERY EXPOSURE FOR DELIVERY OF ENDOVASCULAR PROSTHESIS OR ILIAC OCCLUSION DURING E
PLACEMENT OF PROXIMAL OR DISTAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAIR OF INFRARENAL AB
PLACEMENT, PROXIMAL/DISTAL EXTEN PROSTHESIS, ENDOVASCULAR REPAIR, INFRARENAL ABDOMINAL AORTIC
OPEN REPAIR OF INFRARENAL AORTIC ANEURYSM OR DISSECTION, PLUS REPAIR OF ASSOCIATED ARTERIAL TRA
OPEN REPAIR OF INFRARENAL AORTIC ANEURYSM OR DISSECTION, PLUS REPAIR OF ASSOCIATED ARTERIAL TRA
OPEN REPAIR OF INFRARENAL AORTIC ANEURYSM OR DISSECTION, PLUS REPAIR OF ASSOCIATED ARTERIAL TRA
OPEN ILIAC ARTERY EXPOSURE WITH CREATION, CONDUIT FOR DELIVERY, INFRARENAL AORTIC OR ILIAC ENDOV
OPEN BRACHIAL ARTERY EXPOSURE TO ASSIST IN THE DEPLOYMENT OF INFRARENAL AORTIC OR ILIAC ENDOVA
ENDOVASCULAR GRAFT REPLACEMENT FOR REPAIR OF ILIAC ARTERY (EG, ANEURYSM,PSEUDOANEURYSM, ART
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR,ANEURYSM,PSEUDOANEURYSM, OR EXCISION&GRAFT INSERTION, WITH/WITHOUT PATCH GRAFT
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR, ANEURYSM, PSEUDOANEURYSM/EXCISION&GRAFT INSERTION, WITH/WITHOUT PATCH GRAFT; F
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR, ANEURYSM, PSEUDOANEURYSM, OR EXCISION&GRAFT INSERTION, WITH OR WITHOUT PATCH G
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR, ANEURYSM, PSEUDOANEURYSM/EXCISION&GRAFT INSERTION, WITH/WITHOUT PATCH GRAFT; F
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
DIRECT REPAIR OF ANEURYSM, PSEUDOANEURYSM, OR EXCISION AND GRAFT INSERTION, WITH OR WITHOUT PA
REPAIR, CONGENITAL ARTERIOVENOUS FISTULA; HEAD AND NECK
REPAIR, CONGENITAL ARTERIOVENOUS FISTULA; THORAX AND ABDOMEN
REPAIR, CONGENITAL ARTERIOVENOUS FISTULA; EXTREMITIES
REPAIR, ACQUIRED OR TRAUMATIC ARTERIOVENOUS FISTULA; HEAD AND NECK
REPAIR, ACQUIRED OR TRAUMATIC ARTERIOVENOUS FISTULA; THORAX AND ABDOMEN
REPAIR, ACQUIRED OR TRAUMATIC ARTERIOVENOUS FISTULA; EXTREMITIES
REPAIR BLOOD VESSEL, DIRECT; NECK
REPAIR BLOOD VESSEL, DIRECT; UPPER EXTREMITY
REPAIR BLOOD VESSEL, DIRECT; HAND, FINGER
REPAIR BLOOD VESSEL, DIRECT; INTRATHORACIC, WITH BYPASS
REPAIR BLOOD VESSEL, DIRECT; INTRATHORACIC, WITHOUT BYPASS
REPAIR BLOOD VESSEL, DIRECT; INTRA-ABDOMINAL
REPAIR BLOOD VESSEL, DIRECT; LOWER EXTREMITY
REPAIR BLOOD VESSEL WITH VEIN GRAFT; NECK
REPAIR BLOOD VESSEL WITH VEIN GRAFT; UPPER EXTREMITY
REPAIR BLOOD VESSEL WITH VEIN GRAFT; INTRATHORACIC, WITH BYPASS
REPAIR BLOOD VESSEL WITH VEIN GRAFT; INTRATHORACIC, WITHOUT BYPASS
REPAIR BLOOD VESSEL WITH VEIN GRAFT; INTRA-ABDOMINAL
REPAIR BLOOD VESSEL WITH VEIN GRAFT; LOWER EXTREMITY
REPAIR BLOOD VESSEL WITH GRAFT OTHER THAN VEIN; NECK
REPAIR BLOOD VESSEL WITH GRAFT OTHER THAN VEIN; UPPER EXTREMITY
REPAIR BLOOD VESSEL WITH GRAFT OTHER THAN VEIN; INTRATHORACIC, WITH BYPASS
REPAIR BLOOD VESSEL WITH GRAFT OTHER THAN VEIN; INTRATHORACIC, WITHOUT BYPASS
REPAIR BLOOD VESSEL WITH GRAFT OTHER THAN VEIN; INTRA-ABDOMINAL
REPAIR BLOOD VESSEL WITH GRAFT OTHER THAN VEIN; LOWER EXTREMITY
THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT; CAROTID, VERTEBRAL, SUBCLAVIAN, BY NECK
THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT; SUBCLAVIAN, INNOMINATE, BY THORACIC INCIS
THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT; AXILLARY-BRACHIAL
THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT; ABDOMINAL AORTA
THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT; MESENTERIC, CELIAC, OR RENAL
THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT; ILIAC
THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT; ILIOFEMORAL
THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT; COMBINED AORTOILIAC
THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT; COMBINED AORTOILIOFEMORAL
THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT; COMMON FEMORAL
THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT; DEEP (PROFUNDA) FEMORAL
THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT; FEMORAL AND/OR POPLITEAL, AND/OR TIBIOPE
REOPERATION, CAROTID, THROMBOENDARTERECTOMY, MORE THAN ONE MONTH AFTER ORIGINAL OPERATION
ANGIOSCOPY (NON-CORONARY VESSELS OR GRAFTS) DURING THERAPEUTIC INTERVENTION (LIST SEPARATELY
TRANSLUMINAL BALLOON ANGIOPLASTY, OPEN; RENAL OR OTHER VISCERAL ARTERY
TRANSLUMINAL BALLOON ANGIOPLASTY, OPEN; AORTIC
TRANSLUMINAL BALLOON ANGIOPLASTY, OPEN; ILIAC
TRANSLUMINAL BALLOON ANGIOPLASTY, OPEN; FEMORAL-POPLITEAL
TRANSLUMINAL BALLOON ANGIOPLASTY, OPEN; BRACHIOCEPHALIC TRUNK OR BRANCHES, EACH VESSEL
TRANSLUMINAL BALLOON ANGIOPLASTY, OPEN; TIBIOPERONEAL TRUNK AND BRANCHES
TRANSLUMINAL BALLOON ANGIOPLASTY, OPEN; VENOUS
TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS; TIBIOPERONEAL TRUNK OR BRANCHES, EACH VESSE
TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS; RENAL OR VISCERAL ARTERY
TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS; AORTIC
TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS; ILIAC
TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS; FEMORAL-POPLITEAL
TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS; BRACHIOCEPHALIC TRUNK OR BRANCHES, EACH VES
TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS; VENOUS
TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; RENAL OR OTHER VISCERAL ARTERY
TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; AORTIC
TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; ILIAC
TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; FEMORAL-POPLITEAL
TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; BRACHIOCEPHALIC TRUNK OR BRANCHES, EACH VESSEL
TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; TIBIOPERONEAL TRUNK AND BRANCHES
TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS; RENAL OR OTHER VISCERAL ARTERY
TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS; AORTIC
TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS; ILIAC
TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS; FEMORAL-POPLITEAL
TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS; BRACHIOCEPHALIC TRUNK OR BRANCHES, EACH
TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS; TIBIOPERONEAL TRUNK AND BRANCHES
HARVEST OF UPPER EXTREMITY VEIN, ONE SEGMENT, FOR LOWER EXTREMITY OR CORONARY ARTERY BYPASS
BYPASS GRAFT, WITH VEIN; CAROTID
BYPASS GRAFT, WITH VEIN; CAROTID-SUBCLAVIAN
BYPASS GRAFT, WITH VEIN; SUBCLAVIAN-CAROTID
BYPASS GRAFT, WITH VEIN; CAROTID-VERTEBRAL
BYPASS GRAFT, WITH VEIN; CAROTID-CAROTID
BYPASS GRAFT, WITH VEIN; SUBCLAVIAN-SUBCLAVIAN
BYPASS GRAFT, WITH VEIN; SUBCLAVIAN-VERTEBRAL
BYPASS GRAFT, WITH VEIN; SUBCLAVIAN-AXILLARY
BYPASS GRAFT, WITH VEIN; AXILLARY-AXILLARY
BYPASS GRAFT, WITH VEIN; AXILLARY-FEMORAL
BYPASS GRAFT, WITH VEIN; AORTOSUBCLAVIAN OR CAROTID
BYPASS GRAFT, WITH VEIN; AORTOCELIAC OR AORTOMESENTERIC
BYPASS GRAFT, WITH VEIN; AXILLARY-FEMORAL-FEMORAL
BYPASS GRAFT, WITH VEIN; SPLENORENAL
BYPASS GRAFT, WITH VEIN; AORTOILIAC OR BI-ILIAC
BYPASS GRAFT, WITH VEIN; AORTOFEMORAL OR BIFEMORAL
BYPASS GRAFT, WITH VEIN; AORTOILIOFEMORAL, UNILATERAL
BYPASS GRAFT, WITH VEIN; AORTOILIOFEMORAL, BILATERAL
BYPASS GRAFT, WITH VEIN; AORTOFEMORAL-POPLITEAL
BYPASS GRAFT, WITH VEIN; FEMORAL-POPLITEAL
BYPASS GRAFT, WITH VEIN; FEMORAL-FEMORAL
BYPASS GRAFT, WITH VEIN; AORTORENAL
BYPASS GRAFT, WITH VEIN; ILIOILIAC
BYPASS GRAFT, WITH VEIN; ILIOFEMORAL
BYPASS GRAFT, WITH VEIN; FEMORAL-ANTERIOR TIBIAL, POSTERIOR TIBIAL, PERONEAL ARTERY OR OTHER DIST
BYPASS GRAFT, WITH VEIN; POPLITEAL-TIBIAL, -PERONEAL ARTERY OR OTHER DISTAL VESSELS
HARVEST OF FEMOROPOPLITEAL VEIN, ONE SEGMENT, FOR VASCULAR RECONSTRUCTION PROCEDURE (EG, AO
IN-SITU VEIN BYPASS; AORTOFEMORAL-POPLITEAL (ONLY FEMORAL-POPLITEAL PORTION IN-SITU)
IN-SITU VEIN BYPASS; FEMORAL-POPLITEAL
IN-SITU VEIN BYPASS; FEMORAL-ANTERIOR TIBIAL, POSTERIOR TIBIAL, OR PERONEAL ARTERY
IN-SITU VEIN BYPASS; POPLITEAL-TIBIAL, PERONEAL
HARVEST OF UPPER EXTREMITY ARTERY, ONE SEGMENT, FOR CORONARY ARTERY BYPASS PROCEDURE
BYPASS GRAFT, WITH OTHER THAN VEIN; CAROTID
BYPASS GRAFT, WITH OTHER THAN VEIN; CAROTID-SUBCLAVIAN
BYPASS GRAFT, WITH OTHER THAN VEIN; SUBCLAVIAN-SUBCLAVIAN
BYPASS GRAFT, WITH OTHER THAN VEIN; SUBCLAVIAN-AXILLARY
BYPASS GRAFT, WITH OTHER THAN VEIN; AXILLARY-FEMORAL
BYPASS GRAFT, WITH OTHER THAN VEIN; AXILLARY-POPLITEAL OR -TIBIAL
BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOSUBCLAVIAN OR CAROTID
BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOCELIAC, AORTOMESENTERIC, AORTORENAL
BYPASS GRAFT, WITH OTHER THAN VEIN; SPLENORENAL (SPLENIC TO RENAL ARTERIAL ANASTOMOSIS)
BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOILIAC OR BI-ILIAC
BYPASS GRAFT, WITH OTHER THAN VEIN; CAROTID-VERTEBRAL
BYPASS GRAFT, WITH OTHER THAN VEIN; SUBCLAVIAN-VERTEBRAL
BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOBIFEMORAL
BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOFEMORAL
BYPASS GRAFT, WITH OTHER THAN VEIN; AXILLARY-AXILLARY
BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOFEMORAL-POPLITEAL
BYPASS GRAFT, WITH OTHER THAN VEIN; AXILLARY-FEMORAL-FEMORAL
BYPASS GRAFT, WITH OTHER THAN VEIN; FEMORAL-POPLITEAL
BYPASS GRAFT, WITH OTHER THAN VEIN; FEMORAL-FEMORAL
BYPASS GRAFT, WITH OTHER THAN VEIN; ILIOILIAC
BYPASS GRAFT, WITH OTHER THAN VEIN; ILIOFEMORAL
BYPASS GRAFT, WITH OTHER THAN VEIN; FEMORAL-ANTERIOR TIBIAL, POSTERIOR TIBIAL, OR PERONEAL ARTERY
BYPASS GRAFT, WITH OTHER THAN VEIN; POPLITEAL-TIBIAL OR -PERONEAL ARTERY
BYPASS GRAFT; COMPOSITE, PROSTHETIC AND VEIN (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PR
BYPASS GRAFT; AUTOGENOUS COMPOSITE, TWO SEGMENTS OF VEINS FROM TWO LOCATIONS (LIST SEPARATEL
BYPASS GRAFT; AUTOGENOUS COMPOSITE, THREE OR MORE SEGMENTS OF VEIN FROM TWO OR MORE LOCATIO
PLACEMENT OF VEIN PATCH OR CUFF AT DISTAL ANASTOMOSIS OF BYPASS GRAFT, SYNTHETIC CONDUIT (LIST S
CREATION OF DISTAL ARTERIOVENOUS FISTULA DURING LOWER EXTREMITY BYPASS SURGERY (NON-HEMODIAL
TRANSPOSITION AND/OR REIMPLANTATION; VERTEBRAL TO CAROTID ARTERY
TRANSPOSITION AND/OR REIMPLANTATION; VERTEBRAL TO SUBCLAVIAN ARTERY
TRANSPOSITION AND/OR REIMPLANTATION; SUBCLAVIAN TO CAROTID ARTERY
TRANSPOSITION AND/OR REIMPLANTATION; CAROTID TO SUBCLAVIAN ARTERY
REOPERATION, FEMORAL-POPLITEAL OR FEMORAL (POPLITEAL) -ANTERIOR TIBIAL, POSTERIOR TIBIAL, PERONEA
EXPLORATION (NOT FOLLOWED BY SURGICAL REPAIR), WITH OR WITHOUT LYSIS OF ARTERY; CAROTID ARTERY
EXPLORATION (NOT FOLLOWED BY SURGICAL REPAIR), WITH OR WITHOUT LYSIS OF ARTERY; FEMORAL ARTERY
EXPLORATION (NOT FOLLOWED BY SURGICAL REPAIR), WITH OR WITHOUT LYSIS OF ARTERY; POPLITEAL ARTER
EXPLORATION (NOT FOLLOWED BY SURGICAL REPAIR), WITH OR WITHOUT LYSIS OF ARTERY; OTHER VESSELS
EXPLORATION FOR POSTOPERATIVE HEMORRHAGE, THROMBOSIS OR INFECTION; NECK
EXPLORATION FOR POSTOPERATIVE HEMORRHAGE, THROMBOSIS OR INFECTION; CHEST
EXPLORATION FOR POSTOPERATIVE HEMORRHAGE, THROMBOSIS OR INFECTION; ABDOMEN
EXPLORATION FOR POSTOPERATIVE HEMORRHAGE, THROMBOSIS OR INFECTION; EXTREMITY
REPAIR OF GRAFT-ENTERIC FISTULA
THROMBECTOMY OF ARTERIAL OR VENOUS GRAFT (OTHER THAN HEMODIALYSIS GRAFT OR FISTULA)
THROMBECTOMY OF ARTERIAL OR VENOUS GRAFT; WITH REVISION OF ARTERIAL OR VENOUS GRAFT
REVISION, LOWER EXTREMITY ARTERIAL BYPASS, WITHOUT THROMBECTOMY, OPEN; WITH VEIN PATCH ANGIOPL
REVISION, LOWER EXTREMITY ARTERIAL BYPASS, WITHOUT THROMBECTOMY, OPEN; WITH SEGMENTAL VEIN INT
EXCISION OF INFECTED GRAFT; NECK
EXCISION OF INFECTED GRAFT; EXTREMITY
EXCISION OF INFECTED GRAFT; THORAX
EXCISION OF INFECTED GRAFT; ABDOMEN
INTRODUCTION OF NEEDLE OR INTRACATHETER, VEIN
INJECTION PROCEDURES (EG, THROMBIN) FOR PERCUTANEOUS TREATMENT OF EXTREMITY PSEUDOANEURYSM
INJECTION PROCEDURE FOR EXTREMITY VENOGRAPHY
INTRODUCTION OF CATHETER, SUPERIOR OR INFERIOR VENA CAVA
SELECTIVE CATHETER PLACEMENT, VENOUS SYSTEM; FIRST ORDER BRANCH (EG, RENAL VEIN, JUGULAR VEIN)
SELECTIVE CATHETER PLACEMENT, VENOUS SYSTEM; SECOND ORDER, OR MORE SELECTIVE, BRANCH (EG, LEFT
INTRODUCTION OF CATHETER, RIGHT HEART OR MAIN PULMONARY ARTERY
SELECTIVE CATHETER PLACEMENT, LEFT OR RIGHT PULMONARY ARTERY
SELECTIVE CATHETER PLACEMENT, SEGMENTAL OR SUBSEGMENTAL PULMONARY ARTERY
INTRODUCTION OF NEEDLE OR INTRACATHETER, CAROTID OR VERTEBRAL ARTERY
INTRODUCTION OF NEEDLE OR INTRACATHETER; RETROGRADE BRACHIAL ARTERY
INTRODUCTION OF NEEDLE OR INTRACATHETER; EXTREMITY ARTERY
INTRODUCTION OF NEEDLE OR INTRACATHETER; ARTERIOVENOUS SHUNT CREATED FOR DIALYSIS (CANNULA, F
INTRODUCTION OF NEEDLE OR INTRACATHETER, AORTIC, TRANSLUMBAR
INTRODUCTION OF CATHETER, AORTA
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; EACH FIRST ORDER THORACIC OR BRACHIOCEPHALIC B
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIAL SECOND ORDER THORACIC OR BRACHIOCEPHAL
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIAL THIRD ORDER OR MORE SELECTIVE THORACIC O
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; ADD SECOND ORDER, THIRD ORDER, & BEYOND, THORAC
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; EACH FIRST ORDER ABDOMINAL, PELVIC, OR LOWER EXT
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIAL SECOND ORDER ABDOMINAL, PELVIC, OR LOWER
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIAL THIRD ORDER OR MORE SELECTIVE ABDOMINAL,
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; ADD 2ND, 3RD ORDER, & BEYOND, ABDOM, PELVIC/LOWE
INSERTION OF IMPLANTABLE INTRA-ARTERIAL INFUSION PUMP (EG, FOR CHEMOTHERAPY OF LIVER)
REVISION OF IMPLANTED INTRA-ARTERIAL INFUSION PUMP
REMOVAL OF IMPLANTED INTRA-ARTERIAL INFUSION PUMP
UNLISTED PROCEDURE, VASCULAR INJECTION
VENIPUNCTURE, UNDER AGE 3 YEARS; FEMORAL OR JUGULAR
VENIPUNCTURE, UNDER AGE 3 YEARS; SCALP VEIN
VENIPUNCTURE, UNDER AGE 3 YEARS; OTHER VEIN
VENIPUNCTURE, CHILD OVER AGE 3 YEARS OR ADULT, NECESSITATING PHYSICIAN'S SKILL (SEPARATE PROCEDU
COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE
COLLECTION OF CAPILLARY BLOOD SPECIMEN (EG, FINGER, HEEL, EAR STICK)
VENIPUNCTURE, CUTDOWN; UNDER AGE 1 YEAR
VENIPUNCTURE, CUTDOWN; AGE 1 OR OVER
TRANSFUSION, BLOOD OR BLOOD COMPONENTS
PUSH TRANSFUSION, BLOOD, 2 YEARS OR UNDER
EXCHANGE TRANSFUSION, BLOOD; NEWBORN
EXCHANGE TRANSFUSION, BLOOD; OTHER THAN NEWBORN
TRANSFUSION, INTRAUTERINE, FETAL
SINGLE OR MULTIPLE INJECTIONS OF SCLEROSING SOLUTIONS, SPIDER VEINS (TELANGIECTASIA); LIMB OR TRUN
SINGLE OR MULTIPLE INJECTIONS OF SCLEROSING SOLUTIONS, SPIDER VEINS (TELANGIECTASIA); FACE
INJECTION OF SCLEROSING SOLUTION; SINGLE VEIN
INJECTION OF SCLEROSING SOLUTION; MULTIPLE VEINS, SAME LEG
PERCUTANEOUS PORTAL VEIN CATHETERIZATION BY ANY METHOD
PLACEMENT OF CENTRAL VENOUS CATHETER (SUBCLAVIAN, JUGULAR, OR OTHER VEIN) (EG, FOR CENTRAL VEN
PLACEMENT OF CENTRAL VENOUS CATHETER (SUBCLAVIAN, JUGULAR, OR OTHER VEIN) (EG, FOR CENTRAL VEN
PLACEMENT OF CENTRAL VENOUS CATHETER (SUBCLAVIAN, JUGULAR, OR OTHER VEIN) (EG, FOR CENTRAL VEN
PLACEMENT OF CENTRAL VENOUS CATHETER (SUBCLAVIAN, JUGULAR, OR OTHER VEIN) (EG, FOR CENTRAL VEN
REPOSITIONING OF PREVIOUSLY PLACED CENTRAL VENOUS CATHETER UNDER FLUOROSCOPIC GUIDANCE
VENOUS CATHETERIZATION FOR SELECTIVE ORGAN BLOOD SAMPLING
CATHETERIZATION OF UMBILICAL VEIN FOR DIAGNOSIS OR THERAPY, NEWBORN
THERAPEUTIC APHERESIS; FOR WHITE BLOOD CELLS
THERAPEUTIC APHERESIS; FOR RED BLOOD CELLS
THERAPEUTIC APHERESIS; FOR PLATELETS
THERAPEUTIC APHERESIS; FOR PLASMA PHERESIS
THERAPEUTIC APHERESIS; WITH EXTRACORPOREAL IMMUNOADSORPTION AND PLASMA REINFUSION
THERAPEUTIC APHERESIS; WITH EXTRACORPOREAL SELECTIVE ADSORPTION OR SELECTIVE FILTRATION AND P
PHOTOPHERESIS, EXTRACORPOREAL
INSERTION OF IMPLANTABLE INTRAVENOUS INFUSION PUMP
REVISION OF IMPLANTABLE INTRAVENOUS INFUSION PUMP
REMOVAL OF IMPLANTABLE INTRAVENOUS INFUSION PUMP
INSERTION OF IMPLANTABLE VENOUS ACCESS DEVICE, WITH OR WITHOUT SUBCUTANEOUS RESERVOIR
REVISION OF IMPLANTABLE VENOUS ACCESS DEVICE, AND/OR SUBCUTANEOUS RESERVOIR
REMOVAL OF IMPLANTABLE VENOUS ACCESS DEVICE, AND/OR SUBCUTANEOUS RESERVOIR
MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTIVE MATERIAL (EG, FIBRIN SHEATH) FROM CENTRAL VENO
MECHANICAL REMOVAL OF INTRALUMINAL (INTRACATHETER) OBSTRUCTIVE MATERIAL FROM CENTRAL VENOUS
COLLECTION OF BLOOD SPECIMEN FROM A COMPLETELY IMPLANTABLE VENOUS ACCESS DEVICE
DECLOTTING BY THROMBOLYTIC AGENT OF IMPLANTED VASCULAR ACCESS DEVICE OR CATHETER
ARTERIAL PUNCTURE, WITHDRAWAL OF BLOOD FOR DIAGNOSIS
ARTERIAL CATHETERIZATION OR CANNULATION FOR SAMPLING, MONITORING OR TRANSFUSION (SEPARATE PRO
ARTERIAL CATHETERIZATION OR CANNULATION FOR SAMPLING, MONITORING OR TRANSFUSION (SEPARATE PRO
ARTERIAL CATHETERIZATION FOR PROLONGED INFUSION THERAPY (CHEMOTHERAPY), CUTDOWN
CATHETERIZATION, UMBILICAL ARTERY, NEWBORN, FOR DIAGNOSIS OR THERAPY
PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION
INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPOSE (SEPARATE PROCEDURE); VEIN TO VEIN
INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPOSE (SEPARATE PROCEDURE); ARTERIOVENOUS, EXT
INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPOSE (SEPARATE PROCEDURE); ARTERIOVENOUS, EXT
ARTERIOVENOUS ANASTOMOSIS, OPEN; BY UPPER ARM BASILIC VEIN TRANSPOSITION
ARTERIOVENOUS ANASTOMOSIS, OPEN; BY FOREARM VEIN TRANSPOSITION
ARTERIOVENOUS ANASTOMOSIS, OPEN; DIRECT, ANY SITE
INSERTION OF CANNULA(S) FOR PROLONGED EXTRACORPOREAL CIRCULATION FOR CARDIOPULMONARY INSUFF
INSERTION, ARTERIAL&VENOUS CANNULA(S), ISOLATED EXTRACORPOREAL CIRCULATION INCL REGIONAL CHEM
CREATION OF ARTERIOVENOUS FISTULA BY OTHER THAN DIRECT ARTERIOVENOUS ANASTOMOSIS (SEPARATE P
CREATION OF ARTERIOVENOUS FISTULA BY OTHER THAN DIRECT ARTERIOVENOUS ANASTOMOSIS (SEPARATE P
THROMBECTOMY, OPEN, ARTERIOVENOUS FISTULA WITHOUT REVISION, AUTOGENOUS OR NONAUTOGENOUS D
REVISION, OPEN, ARTERIOVENOUS FISTULA; WITHOUT THROMBECTOMY, AUTOGENOUS OR NONAUTOGENOUS D
REVISION, OPEN, ARTERIOVENOUS FISTULA; WITH THROMBECTOMY, AUTOGENOUS OR NONAUTOGENOUS DIALY
PLASTIC REPAIR OF ARTERIOVENOUS ANEURYSM (SEPARATE PROCEDURE)
INSERTION OF THOMAS SHUNT (SEPARATE PROCEDURE)
EXTERNAL CANNULA DECLOTTING (SEPARATE PROCEDURE); WITHOUT BALLOON CATHETER
CANNULA DECLOTTING (SEPARATE PROCEDURE); WITH BALLOON CATHETER
THROMBECTOMY, PERCUTANEOUS, ARTERIOVENOUS FISTULA, AUTOGENOUS OR NONAUTOGENOUS GRAFT (INC
VENOUS ANASTOMOSIS, OPEN; PORTOCAVAL
VENOUS ANASTOMOSIS, OPEN; RENOPORTAL
VENOUS ANASTOMOSIS, OPEN; CAVAL-MESENTERIC
VENOUS ANASTOMOSIS, OPEN; SPLENORENAL, PROXIMAL
VENOUS ANASTOMOSIS, OPEN; SPLENORENAL, DISTAL (SELECTIVE DECOMPRESSION OF ESOPHAGOGASTRIC VA
INS, TRANSVEN INTRAHEP PORTOSYSTIC SHNT(S) (TIPS) (INCL VEN ACCSS, HEP&PORTAL VEIN CATHIZATION,POR
REVISION OF TRANSVENOUS INTRAHEPATIC PORTOSYSTEMIC SHUNT(S)
THROMBOLYSIS, CEREBRAL, BY INTRAVENOUS INFUSION
TRANSCATHETER BIOPSY
TRANSCATHETER THERAPY, INFUSION FOR THROMBOLYSIS OTHER THAN CORONARY
TRANSCATHETER THERAPY, INFUSION OTHER THAN FOR THROMBOLYSIS, ANY TYPE (EG, SPASMOLYTIC, VASOCO
TRANSCATHETER RETRIEVAL, PERCUTANEOUS, OF INTRAVASCULAR FOREIGN BODY (EG, FRACTURED VENOUS O
TRANSCATHETER OCCLUSION OR EMBOLIZATION (EG, FOR TUMOR DESTRUCTION, TO ACHIEVE HEMOSTASIS, TO
TRANSCATHETER PLACEMENT OF AN INTRAVASCULAR STENT(S), (NON-CORONARY VESSEL), PERCUTANEOUS; IN
TRANSCATHETER PLACEMENT OF AN INTRAVASCULAR STENT(S), (NON-CORONARY VESSEL), PERCUTANEOUS; E
TRANSCATHETER PLACEMENT OF AN INTRAVASCULAR STENT(S), (NON-CORONARY VESSEL), OPEN; INITIAL VESS
TRANSCATHETER PLACEMENT OF AN INTRAVASCULAR STENT(S), (NON-CORONARY VESSEL), OPEN; EACH ADDIT
EXCHANGE OF A PREVIOUSLY PLACED ARTERIAL CATHETER DURING THROMBOLYTIC THERAPY
INTRAVASCULAR ULTRASOUND (NON-CORONARY VESSEL) DURING DIAGNOSTIC EVALUATION AND/OR THERAPEU
INTRAVASCULAR ULTRASOUND (NON-CORONARY VESSEL) DURING THERAPEUTIC INTERVENTION; EACH ADDITIO
VASCULAR ENDOSCOPY, SURGICAL, WITH LIGATION OF PERFORATOR VEINS, SUBFASCIAL (SEPS)
UNLISTED VASCULAR ENDOSCOPY PROCEDURE
LIGATION, INTERNAL JUGULAR VEIN
LIGATION; EXTERNAL CAROTID ARTERY
LIGATION; INTERNAL OR COMMON CAROTID ARTERY
LIGATION; INTERNAL OR COMMON CAROTID ARTERY, WITH GRADUAL OCCLUSION, AS WITH SELVERSTONE OR CR
LIGATION OR BANDING OF ANGIOACCESS ARTERIOVENOUS FISTULA
LIGATION OR BIOPSY, TEMPORAL ARTERY
LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTURE); NECK
LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTURE); CHEST
LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTURE); ABDOMEN
LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTURE); EXTREMITY
INTERRUPTION, PARTIAL OR COMPLETE, OF INFERIOR VENA CAVA BY SUTURE, LIGATION, PLICATION, CLIP, EXTR
LIGATION OF FEMORAL VEIN
LIGATION OF COMMON ILIAC VEIN
LIGATION AND DIVISION OF LONG SAPHENOUS VEIN AT SAPHENOFEMORAL JUNCTION, OR DISTAL INTERRUPTION
LIGATION AND DIVISION AND COMPLETE STRIPPING OF LONG OR SHORT SAPHENOUS VEINS
LIGATION AND DIVISION AND COMPLETE STRIPPING OF LONG AND SHORT SAPHENOUS VEINS
LIGATION AND DIVISION AND COMPLETE STRIPPING OF LONG OR SHORT SAPHENOUS VEINS WITH RADICAL EXCI
LIGATION OF PERFORATOR VEINS, SUBFASCIAL, RADICAL (LINTON TYPE), WITH OR WITHOUT SKIN GRAFT, OPEN
LIGATION AND DIVISION OF SHORT SAPHENOUS VEIN AT SAPHENOPOPLITEAL JUNCTION (SEPARATE PROCEDUR
LIGATION, DIVISION, AND/OR EXCISION OF RECURRENT OR SECONDARY VARICOSE VEINS (CLUSTERS), ONE LEG
PENILE REVASCULARIZATION, ARTERY, WITH OR WITHOUT VEIN GRAFT
PENILE VENOUS OCCLUSIVE PROCEDURE
UNLISTED PROCEDURE, VASCULAR SURGERY
SPLENECTOMY; TOTAL (SEPARATE PROCEDURE)
SPLENECTOMY; PARTIAL(SEPARATE PROCEDURE)
SPLENECTOMY; TOTAL, EN BLOC FOR EXTENSIVE DISEASE, IN CONJUNCTION WITH OTHER PROCEDURE (LIST IN
REPAIR OF RUPTURED SPLEEN (SPLENORRHAPHY) WITH OR WITHOUT PARTIAL SPLENECTOMY
LAPAROSCOPY, SURGICAL, SPLENECTOMY
UNLISTED LAPAROSCOPY PROCEDURE, SPLEEN
INJECTION PROCEDURE FOR SPLENOPORTOGRAPHY
MANAGEMENT OF RECIPIENT HEMATOPOIETIC PROGENITOR CELL DONOR SEARCH AND CELL ACQUISITION
BLOOD-DERIVED HEMATOPOIETIC PROGENITOR CELL HARVESTING FOR TRANSPLANTATION, PER COLLECTION; A
BLOOD-DERIVED HEMATOPOIETIC PROGENITOR CELL HARVESTING FOR TRANSPLANTATION, PER COLLECTION; A
TRANSPLANT PREPARATION OF HEMATOPOIETIC PROGENITOR CELLS;CRYOPRESERVATION AND STORAGE
TRANSPLANT PREPARATION OF HEMATOPOIETIC PROGENITOR CELLS; THAWING OF PREVIOUSLY FROZEN HARV
TRANSPLANT PREPARATION OF HEMATOPOIETIC PROGENITOR CELLS; WASHING OF HARVEST
TRANSPLANT PREPARATION OF HEMATOPOIETIC PROGENITOR CELLS; SPECIFIC CELL DEPLETION WITHIN HARVE
TRANSPLANT PREPARATION OF HEMATOPOIETIC PROGENITOR CELLS; TUMOR CELL DEPLETION
TRANSPLANT PREPARATION OF HEMATOPOIETIC PROGENITOR CELLS; RED BLOOD CELL REMOVAL
TRANSPLANT PREPARATION OF HEMATOPOIETIC PROGENITOR CELLS; PLATELET DEPLETION
TRANSPLANT PREPARATION OF HEMATOPOIETIC PROGENITOR CELLS; PLASMA (VOLUME) DEPLETION
TRANSPLANT PREPARATION OF HEMATOPOIETIC PROGENITOR CELLS; CELL CONCENTRATION IN PLASMA, MONO
BONE MARROW; ASPIRATION ONLY
BONE MARROW; BIOPSY, NEEDLE OR TROCAR
BONE MARROW HARVESTING FOR TRANSPLANTATION
BONE MARROW OR BLOOD-DERIVED PERIPHERAL STEM CELL TRANSPLANTATION; ALLOGENIC
BONE MARROW TRANSPLANTATION; AUTOLOGOUS
BONE MARROW OR BLOOD-DERIVED PERIPHERAL STEM CELL TRANSPLANTATION; ALLOGENEIC DONOR LYMPHO
DRAINAGE OF LYMPH NODE ABSCESS OR LYMPHADENITIS; SIMPLE
DRAINAGE OF LYMPH NODE ABSCESS OR LYMPHADENITIS; EXTENSIVE
LYMPHANGIOTOMY OR OTHER OPERATIONS ON LYMPHATIC CHANNELS
SUTURE AND/OR LIGATION OF THORACIC DUCT; CERVICAL APPROACH
SUTURE AND/OR LIGATION OF THORACIC DUCT; THORACIC APPROACH
SUTURE AND/OR LIGATION OF THORACIC DUCT; ABDOMINAL APPROACH
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, SUPERFICIAL
BIOPSY OR EXCISION OF LYMPH NODE(S); BY NEEDLE, SUPERFICIAL (EG, CERVICAL, INGUINAL, AXILLARY)
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP CERVICAL NODE(S)
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP CERVICAL NODE(S) WITH EXCISION SCALENE FAT PAD
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP AXILLARY NODE(S)
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, INTERNAL MAMMARY NODE(S)
DISSECTION, DEEP JUGULAR NODE(S)
EXCISION OF CYSTIC HYGROMA, AXILLARY OR CERVICAL; WITHOUT DEEP NEUROVASCULAR DISSECTION
EXCISION OF CYSTIC HYGROMA, AXILLARY OR CERVICAL; WITH DEEP NEUROVASCULAR DISSECTION
LIMITED LYMPHADENECTOMY FOR STAGING (SEPARATE PROCEDURE); PELVIC AND PARA-AORTIC
LIMITED LYMPHADENECTOMY FOR STAGING (SEPARATE PROCEDURE); RETROPERITONEAL (AORTIC AND/OR SPL
LAPAROSCOPY, SURGICAL; WITH RETROPERITONEAL LYMPH NODE SAMPLING (BIOPSY), SINGLE OR MULTIPLE
LAPAROSCOPY, SURGICAL; WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY
LAPAROSCOPY, SURGICAL; WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PERI-AORTIC LYMPH NODE
UNLISTED LAPAROSCOPY PROCEDURE, LYMPHATIC SYSTEM
SUPRAHYOID LYMPHADENECTOMY
CERVICAL LYMPHADENECTOMY (COMPLETE)
CERVICAL LYMPHADENECTOMY (MODIFIED RADICAL NECK DISSECTION)
AXILLARY LYMPHADENECTOMY; SUPERFICIAL
AXILLARY LYMPHADENECTOMY; COMPLETE
THORACIC LYMPHADENECTOMY, REGIONAL, INCLUDING MEDIASTINAL AND PERITRACHEAL NODES (LIST IN ADDIT
ABDOMINAL LYMPHADENECTOMY, REGIONAL, INCLUDING CELIAC, GASTRIC, PORTAL, PERIPANCREATIC, WITH OR
INGUINOFEMORAL LYMPHADENECTOMY, SUPERFICIAL, INCLUDING CLOQUET'S NODE (SEPARATE PROCEDURE)
INGUINOFEMORAL LYMPHADENECTOMY, SUPERFICIAL, IN CONTINUITY WITH PELVIC LYMPHADENECTOMY, INCLU
PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIAC, HYPOGASTRIC, AND OBTURATOR NODES (SEPARATE
RETROPERITONEAL TRANSABDOMINAL LYMPHADENECTOMY, EXTENSIVE, INCLUDING PELVIC, AORTIC, AND RENA
INJECTION PROCEDURE; LYMPHANGIOGRAPHY
INJECTION PROCEDURE; FOR IDENTIFICATION OF SENTINEL NODE
CANNULATION, THORACIC DUCT
UNLISTED PROCEDURE, HEMIC OR LYMPHATIC SYSTEM
MEDIASTINOTOMY WITH EXPLORATION, DRAINAGE, REMOVAL OF FOREIGN BODY, OR BIOPSY; CERVICAL APPROA
MEDIASTINOTOMY WITH EXPLORATION, DRAINAGE, REMOVAL OF FOREIGN BODY, OR BIOPSY; TRANSTHORACIC A
EXCISION OF MEDIASTINAL CYST
EXCISION OF MEDIASTINAL TUMOR
MEDIASTINOSCOPY, WITH OR WITHOUT BIOPSY
UNLISTED PROCEDURE, MEDIASTINUM
REPAIR, LACERATION OF DIAPHRAGM, ANY APPROACH
REPAIR, PARAESOPHAGEAL HIATUS HERNIA, TRANSABDOMINAL, WITH OR WITHOUT FUNDOPLASTY, VAGOTOMY,
REPAIR, NEONATAL DIAPHRAGMATIC HERNIA, WITH OR WITHOUT CHEST TUBE INSERTION AND WITH OR WITHOU
REPAIR, DIAPHRAGMATIC HERNIA (ESOPHAGEAL HIATAL); TRANSTHORACIC
REPAIR, DIAPHRAGMATIC HERNIA (ESOPHAGEAL HIATAL); COMBINED, THORACOABDOMINAL
REPAIR, DIAPHRAGMATIC HERNIA (ESOPHAGEAL HIATAL); COMBINED, THORACOABDOMINAL, WITH DILATION OF S
REPAIR, DIAPHRAGMATIC HERNIA (OTHER THAN NEONATAL), TRAUMATIC; ACUTE
REPAIR, DIAPHRAGMATIC HERNIA (OTHER THAN NEONATAL), TRAUMATIC; CHRONIC
IMBRICATION OF DIAPHRAGM FOR EVENTRATION, TRANSTHORACIC OR TRANSABDOMINAL, PARALYTIC OR NONP
RESECTION, DIAPHRAGM; WITH SIMPLE REPAIR (EG, PRIMARY SUTURE)
RESECTION, DIAPHRAGM; WITH COMPLEX REPAIR (EG, PROSTHETIC MATERIAL, LOCAL MUSCLE FLAP)
UNLISTED PROCEDURE, DIAPHRAGM
BIOPSY OF LIP
VERMILIONECTOMY (LIP SHAVE), WITH MUCOSAL ADVANCEMENT
EXCISION OF LIP; TRANSVERSE WEDGE EXCISION WITH PRIMARY CLOSURE
EXCISION OF LIP; V-EXCISION WITH PRIMARY DIRECT LINEAR CLOSURE
EXCISION OF LIP; FULL THICKNESS, RECONSTRUCTION WITH LOCAL FLAP (EG, ESTLANDER OR FAN)
EXCISION OF LIP; FULL THICKNESS, RECONSTRUCTION WITH CROSS LIP FLAP (ABBE-ESTLANDER)
RESECTION OF LIP, MORE THAN ONE-FOURTH, WITHOUT RECONSTRUCTION
REPAIR LIP, FULL THICKNESS; VERMILION ONLY
REPAIR LIP, FULL THICKNESS; UP TO HALF VERTICAL HEIGHT
REPAIR LIP, FULL THICKNESS; OVER ONE-HALF VERTICAL HEIGHT, OR COMPLEX
PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; PRIMARY, PARTIAL OR COMPLETE, UNILATERAL
PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; PRIMARY BILATERAL, ONE STAGE PROCEDURE
PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; PRIMARY BILATERAL, ONE OF TWO STAGES
PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; SECONDARY, BY RECREATION OF DEFECT AND RECLOSURE
PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; WITH CROSS LIP PEDICLE FLAP (ABBE-ESTLANDER TYPE), INC
UNLISTED PROCEDURE, LIPS
DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OF MOUTH; SIMPLE
DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OF MOUTH; COMPLICATED
REMOVAL OF EMBEDDED FOREIGN BODY, VESTIBULE OF MOUTH; SIMPLE
REMOVAL OF EMBEDDED FOREIGN BODY, VESTIBULE OF MOUTH; COMPLICATED
INCISION OF LABIAL FRENUM (FRENOTOMY)
BIOPSY, VESTIBULE OF MOUTH
EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OF MOUTH; WITHOUT REPAIR
EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OF MOUTH; WITH SIMPLE REPAIR
EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OF MOUTH; WITH COMPLEX REPAIR
EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OF MOUTH; COMPLEX, WITH EXCISION OF UNDE
EXCISION OF MUCOSA OF VESTIBULE OF MOUTH AS DONOR GRAFT
EXCISION OF FRENUM, LABIAL OR BUCCAL (FRENUMECTOMY, FRENULECTOMY, FRENECTOMY)
DESTRUCTION OF LESION OR SCAR OF VESTIBULE OF MOUTH BY PHYSICAL METHODS (EG, LASER, THERMAL, CR
CLOSURE OF LACERATION, VESTIBULE OF MOUTH; 2.5 CM OR LESS
CLOSURE OF LACERATION, VESTIBULE OF MOUTH; OVER 2.5 CM OR COMPLEX
VESTIBULOPLASTY; ANTERIOR
VESTIBULOPLASTY; POSTERIOR, UNILATERAL
VESTIBULOPLASTY; POSTERIOR, BILATERAL
VESTIBULOPLASTY; ENTIRE ARCH
VESTIBULOPLASTY; COMPLEX (INCLUDING RIDGE EXTENSION, MUSCLE REPOSITIONING)
UNLISTED PROCEDURE, VESTIBULE OF MOUTH
INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH; LIN
INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH; SUB
INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH; SUB
INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH; SUB
INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH; SUB
INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH; MAS
INCISION OF LINGUAL FRENUM (FRENOTOMY)
EXTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF FLOOR OF MOUTH; SUBLINGUAL
EXTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF FLOOR OF MOUTH; SUBMENTAL
EXTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF FLOOR OF MOUTH; SUBMANDIBULA
EXTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF FLOOR OF MOUTH; MASTICATOR SP
BIOPSY OF TONGUE; ANTERIOR TWO-THIRDS
BIOPSY OF TONGUE; POSTERIOR ONE-THIRD
BIOPSY OF FLOOR OF MOUTH
EXCISION OF LESION OF TONGUE WITHOUT CLOSURE
EXCISION OF LESION OF TONGUE WITH CLOSURE; ANTERIOR TWO-THIRDS
EXCISION OF LESION OF TONGUE WITH CLOSURE; POSTERIOR ONE-THIRD
EXCISION OF LESION OF TONGUE WITH CLOSURE; WITH LOCAL TONGUE FLAP
EXCISION OF LINGUAL FRENUM (FRENECTOMY)
EXCISION, LESION OF FLOOR OF MOUTH
GLOSSECTOMY; LESS THAN ONE-HALF TONGUE
GLOSSECTOMY; HEMIGLOSSECTOMY
GLOSSECTOMY; PARTIAL, WITH UNILATERAL RADICAL NECK DISSECTION
GLOSSECTOMY; COMPLETE OR TOTAL, WITH OR WITHOUT TRACHEOSTOMY, WITHOUT RADICAL NECK DISSECTIO
GLOSSECTOMY; COMPLETE OR TOTAL, WITH OR WITHOUT TRACHEOSTOMY, WITH UNILATERAL RADICAL NECK D
GLOSSECTOMY; COMPOSITE PROCEDURE WITH RESECTION FLOOR OF MOUTH AND MANDIBULAR RESECTION, W
GLOSSECTOMY; COMPOSITE PROCEDURE WITH RESECTION FLOOR OF MOUTH, WITH SUPRAHYOID NECK DISSEC
GLOSSECTOMY; COMPOSITE PROCEDURE WITH RESECTION FLOOR OF MOUTH, MANDIBULAR RESECTION, AND R
REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO-THIRDS OF TONGUE
REPAIR OF LACERATION 2.5 CM OR LESS; POSTERIOR ONE-THIRD OF TONGUE
REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX
FIXATION OF TONGUE, MECHANICAL, OTHER THAN SUTURE (EG, K-WIRE)
SUTURE OF TONGUE TO LIP FOR MICROGNATHIA (DOUGLAS TYPE PROCEDURE)
FRENOPLASTY (SURGICAL REVISION OF FRENUM, EG, WITH Z-PLASTY)
UNLISTED PROCEDURE, TONGUE, FLOOR OF MOUTH
DRAINAGE OF ABSCESS, CYST, HEMATOMA FROM DENTOALVEOLAR STRUCTURES
REMOVAL OF EMBEDDED FOREIGN BODY FROM DENTOALVEOLAR STRUCTURES; SOFT TISSUES
REMOVAL OF EMBEDDED FOREIGN BODY FROM DENTOALVEOLAR STRUCTURES; BONE
GINGIVECTOMY, EXCISION GINGIVA, EACH QUADRANT
OPERCULECTOMY, EXCISION PERICORONAL TISSUES
EXCISION OF FIBROUS TUBEROSITIES, DENTOALVEOLAR STRUCTURES
EXCISION OF OSSEOUS TUBEROSITIES, DENTOALVEOLAR STRUCTURES
EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE), DENTOALVEOLAR STRUCTURES; WITHOUT REPAIR
EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE), DENTOALVEOLAR STRUCTURES; WITH SIMPLE REPAIR
EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE), DENTOALVEOLAR STRUCTURES; WITH COMPLEX REPA
EXCISION OF HYPERPLASTIC ALVEOLAR MUCOSA, EACH QUADRANT (SPECIFY)
ALVEOLECTOMY, INCLUDING CURETTAGE OF OSTEITIS OR SEQUESTRECTOMY
DESTRUCTION OF LESION (EXCEPT EXCISION), DENTOALVEOLAR STRUCTURES
PERIODONTAL MUCOSAL GRAFTING
GINGIVOPLASTY, EACH QUADRANT (SPECIFY)
ALVEOLOPLASTY, EACH QUADRANT (SPECIFY)
UNLISTED PROCEDURE, DENTOALVEOLAR STRUCTURES
DRAINAGE OF ABSCESS OF PALATE, UVULA
BIOPSY OF PALATE, UVULA
EXCISION, LESION OF PALATE, UVULA; WITHOUT CLOSURE
EXCISION, LESION OF PALATE, UVULA; WITH SIMPLE PRIMARY CLOSURE
EXCISION, LESION OF PALATE, UVULA; WITH LOCAL FLAP CLOSURE
RESECTION OF PALATE OR EXTENSIVE RESECTION OF LESION
UVULECTOMY, EXCISION OF UVULA
PALATOPHARYNGOPLASTY (EG, UVULOPALATOPHARYNGOPLASTY, UVULOPHARYNGOPLASTY)
DESTRUCTION OF LESION, PALATE OR UVULA (THERMAL, CRYO OR CHEMICAL)
REPAIR, LACERATION OF PALATE; UP TO 2 CM
REPAIR, LACERATION OF PALATE; OVER 2 CM OR COMPLEX
PALATOPLASTY FOR CLEFT PALATE, SOFT AND/OR HARD PALATE ONLY
PALATOPLASTY FOR CLEFT PALATE, WITH CLOSURE OF ALVEOLAR RIDGE; SOFT TISSUE ONLY
PALATOPLASTY FOR CLEFT PALATE, WITH CLOSURE OF ALVEOLAR RIDGE; WITH BONE GRAFT TO ALVEOLAR RID
PALATOPLASTY FOR CLEFT PALATE; MAJOR REVISION
PALATOPLASTY FOR CLEFT PALATE; SECONDARY LENGTHENING PROCEDURE
PALATOPLASTY FOR CLEFT PALATE; ATTACHMENT PHARYNGEAL FLAP
LENGTHENING OF PALATE, AND PHARYNGEAL FLAP
LENGTHENING OF PALATE, WITH ISLAND FLAP
REPAIR OF ANTERIOR PALATE, INCLUDING VOMER FLAP
REPAIR OF NASOLABIAL FISTULA
MAXILLARY IMPRESSION FOR PALATAL PROSTHESIS
INSERTION OF PIN-RETAINED PALATAL PROSTHESIS
UNLISTED PROCEDURE, PALATE, UVULA
DRAINAGE OF ABSCESS; PAROTID, SIMPLE
DRAINAGE OF ABSCESS; PAROTID, COMPLICATED
DRAINAGE OF ABSCESS; SUBMAXILLARY OR SUBLINGUAL, INTRAORAL
DRAINAGE OF ABSCESS; SUBMAXILLARY, EXTERNAL
FISTULIZATION OF SUBLINGUAL SALIVARY CYST (RANULA);
FISTULIZATION OF SUBLINGUAL SALIVARY CYST (RANULA); WITH PROSTHESIS
SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAXILLARY), SUBLINGUAL OR PAROTID, UNCOMPLICATED, INTRAORAL
SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAXILLARY), COMPLICATED, INTRAORAL
SIALOLITHOTOMY; PAROTID, EXTRAORAL OR COMPLICATED INTRAORAL
BIOPSY OF SALIVARY GLAND; NEEDLE
BIOPSY OF SALIVARY GLAND; INCISIONAL
EXCISION OF SUBLINGUAL SALIVARY CYST (RANULA)
MARSUPIALIZATION OF SUBLINGUAL SALIVARY CYST (RANULA)
EXCISION OF PAROTID TUMOR OR PAROTID GLAND; LATERAL LOBE, WITHOUT NERVE DISSECTION
EXCISION OF PAROTID TUMOR OR PAROTID GLAND; LATERAL LOBE, WITH DISSECTION AND PRESERVATION OF F
EXCISION OF PAROTID TUMOR OR PAROTID GLAND; TOTAL, WITH DISSECTION AND PRESERVATION OF FACIAL NE
EXCISION OF PAROTID TUMOR OR PAROTID GLAND; TOTAL, EN BLOC REMOVAL WITH SACRIFICE OF FACIAL NERV
EXCISION OF PAROTID TUMOR OR PAROTID GLAND; TOTAL, WITH UNILATERAL RADICAL NECK DISSECTION
EXCISION OF SUBMANDIBULAR (SUBMAXILLARY) GLAND
EXCISION OF SUBLINGUAL GLAND
PLASTIC REPAIR OF SALIVARY DUCT, SIALODOCHOPLASTY; PRIMARY OR SIMPLE
PLASTIC REPAIR OF SALIVARY DUCT, SIALODOCHOPLASTY; SECONDARY OR COMPLICATED
PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROCEDURE);
PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROCEDURE); WITH EXCISION OF ONE SUBMANDIBULAR GLA
PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROCEDURE); WITH EXCISION OF BOTH SUBMANDIBULAR G
PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROCEDURE); WITH LIGATION OF BOTH SUBMANDIBULAR (W
INJECTION PROCEDURE FOR SIALOGRAPHY
CLOSURE SALIVARY FISTULA
DILATION SALIVARY DUCT
DILATION AND CATHETERIZATION OF SALIVARY DUCT, WITH OR WITHOUT INJECTION
LIGATION SALIVARY DUCT, INTRAORAL
UNLISTED PROCEDURE, SALIVARY GLANDS OR DUCTS
INCISION AND DRAINAGE ABSCESS; PERITONSILLAR
INCISION AND DRAINAGE ABSCESS; RETROPHARYNGEAL OR PARAPHARYNGEAL, INTRAORAL APPROACH
INCISION AND DRAINAGE ABSCESS; RETROPHARYNGEAL OR PARAPHARYNGEAL, EXTERNAL APPROACH
BIOPSY; OROPHARYNX
BIOPSY; HYPOPHARYNX
BIOPSY; NASOPHARYNX, VISIBLE LESION, SIMPLE
BIOPSY; NASOPHARYNX, SURVEY FOR UNKNOWN PRIMARY LESION
EXCISION OR DESTRUCTION OF LESION OF PHARYNX, ANY METHOD
REMOVAL OF FOREIGN BODY FROM PHARYNX
EXCISION BRANCHIAL CLEFT CYST OR VESTIGE, CONFINED TO SKIN AND SUBCUTANEOUS TISSUES
EXCISION BRANCHIAL CLEFT CYST, VESTIGE, OR FISTULA, EXTENDING BENEATH SUBCUTANEOUS TISSUES AND/O
TONSILLECTOMY AND ADENOIDECTOMY; UNDER AGE 12
TONSILLECTOMY AND ADENOIDECTOMY; AGE 12 OR OVER
TONSILLECTOMY, PRIMARY OR SECONDARY; UNDER AGE 12
TONSILLECTOMY, PRIMARY OR SECONDARY; AGE 12 OR OVER
ADENOIDECTOMY, PRIMARY; UNDER AGE 12
ADENOIDECTOMY, PRIMARY; AGE 12 OR OVER
ADENOIDECTOMY, SECONDARY; UNDER AGE 12
ADENOIDECTOMY, SECONDARY; AGE 12 OR OVER
RADICAL RESECTION OF TONSIL, TONSILLAR PILLARS, AND/OR RETROMOLAR TRIGONE; WITHOUT CLOSURE
RADICAL RESECTION OF TONSIL, TONSILLAR PILLARS, AND/OR RETROMOLAR TRIGONE; CLOSURE WITH LOCAL F
RADICAL RESECTION OF TONSIL, TONSILLAR PILLARS, AND/OR RETROMOLAR TRIGONE; CLOSURE WITH OTHER F
EXCISION OF TONSIL TAGS
EXCISION OR DESTRUCTION LINGUAL TONSIL, ANY METHOD (SEPARATE PROCEDURE)
LIMITED PHARYNGECTOMY
RESECTION OF LATERAL PHARYNGEAL WALL OR PYRIFORM SINUS, DIRECT CLOSURE BY ADVANCEMENT OF LATE
RESECTION OF PHARYNGEAL WALL REQUIRING CLOSURE WITH MYOCUTANEOUS FLAP
SUTURE PHARYNX FOR WOUND OR INJURY
PHARYNGOPLASTY (PLASTIC OR RECONSTRUCTIVE OPERATION ON PHARYNX)
PHARYNGOESOPHAGEAL REPAIR
PHARYNGOSTOMY (FISTULIZATION OF PHARYNX, EXTERNAL FOR FEEDING)
CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POSTTONSILLECTOMY); SIMPLE
CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POSTTONSILLECTOMY); COMPLICAT
CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POSTTONSILLECTOMY); WITH SECON
CONTROL OF NASOPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY; SIMPLE, WITH POSTERIOR NASAL PA
CONTROL OF NASOPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY; COMPLICATED, REQUIRING HOSPITA
CONTROL OF NASOPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY; WITH SECONDARY SURGICAL INTER
UNLISTED PROCEDURE, PHARYNX, ADENOIDS, OR TONSILS
ESOPHAGOTOMY, CERVICAL APPROACH, WITH REMOVAL OF FOREIGN BODY
CRICOPHARYNGEAL MYOTOMY
CRICOPHARYNGEAL MYOTOMY ESOPHAGOTOMY, THORACIC APPROACH, WITH REMOVAL OF FOREIGN BODY
EXCISION OF LESION, ESOPHAGUS, WITH PRIMARY REPAIR; CERVICAL APPROACH
EXCISION OF LESION, ESOPHAGUS, WITH PRIMARY REPAIR; THORACIC OR ABDOMINAL APPROACH
TOTAL OR NEAR TOTAL ESOPHAGECTOMY, WITHOUT THORACOTOMY; WITH PHARYNGOGASTROSTOMY OR CERV
TOTAL OR NEAR TOTAL ESOPHAGECTOMY, WITHOUT THORACOTOMY; WITH COLON INTERPOSITION OR SMALL IN
TOTAL OR NEAR TOTAL ESOPHAGECTOMY, WITH THORACOTOMY; WITH PHARYNGOGASTROSTOMY OR CERVICA
TOTAL OR NEAR TOTAL ESOPHAGECTOMY, WITH THORACOTOMY; WITH COLON INTERPOSITION OR SMALL INTES
PARTIAL ESOPHAGECTOMY, CERVICAL, WITH FREE INTESTINAL GRAFT, INCLUDING MICROVASCULAR ANASTOMO
PARTIAL ESOPHAGECTOMY, DISTAL TWO-THIRDS, WITH THORACOTOMY AND SEPARATE ABDOMINAL INCISION, W
PARTIAL ESOPHAGECTOMY, DISTAL 2-3RDS, W THORACOTOMY&SEPARATE ABDOMINAL INCIS, WWO PROX GAST
PARTIAL ESOPHAGECTOMY, DISTAL TWO-THIRDS, WITH THORACOTOMY ONLY, WITH OR WITHOUT PROXIMAL GA
PARTIAL ESOPHAGECTOMY, THORACOABDOMINAL OR ABDOMINAL APPROACH, WITH OR WITHOUT PROXIMAL GA
PARTIAL ESOPHAGECTOMY, THORACOABDOMINAL/ABDOMINAL APPROACH, WWO PROXIMAL GASTRECTOMY; W C
TOTAL OR PARTIAL ESOPHAGECTOMY, WITHOUT RECONSTRUCTION (ANY APPROACH), WITH CERVICAL ESOPHAG
DIVERTICULECTOMY OF HYPOPHARYNX OR ESOPHAGUS, WITH OR WITHOUT MYOTOMY; CERVICAL APPROACH
DIVERTICULECTOMY OF HYPOPHARYNX OR ESOPHAGUS, WITH OR WITHOUT MYOTOMY; THORACIC APPROACH
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUS
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH DIRECTED SUBMUCOSAL INJECTION(S),ANY SUBSTANCE
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH INJECTION SCLEROSIS OF ESOPHAGEAL VARICES
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH BAND LIGATION OF ESOPHAGEAL VARICES
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH REMOVAL OF FOREIGN BODY
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT B
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH INSERTION OF PLASTIC TUBE OR STENT
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH BALLOON DILATION (LESS THAN 30 MM DIAMETER)
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH INSERTION OF GUIDE WIRE FOLLOWED BY DILATION OVER GUIDE W
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH CONTROL OF BLEEDING (EG, INJECTION, BIPOLAR CAUTERY, UNIPO
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S), NOT AME
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH ENDOSCOPIC ULTRASOUND EXAMINATION
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH TRANSENDOSCOPIC ULTRASOUND-GUIDED INTRAMURAL OR TRAN
UPPER GASTROINTESTINAL ENDOSCOPY, SIMPLE PRIMARY EXAM (EG, WITH SMALL DIAMETER FLEXIBLE ENDOSC
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GI ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS A
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); DIAGNOSTIC, WITH OR WITHOUT COLLECT
ERCP; WITH BIOPSY, SINGLE OR MULTIPLE
ERCP; WITH SPHINCTEROTOMY/PAPILLOTOMY
ERCP; WITH PRESSURE MEASUREMENT OF SPHINCTER OF ODDI
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ENDOSCOPIC RETROGRADE REMOV
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ENDOSCOPIC RETROGRADE DESTRU
ERCP; WITH ENDOSCOPIC RETROGRADE INSERTION OF NASOBILIARY OR NASOPANCREATIC DRAINAGE TUBE
ERCP; WITH ENDOSCOPIC RETROGRADE INSERTION OF TUBE OR STENT INTO BILE OR PANCREATIC DUCT
ERCP; WITH ENDOSCOPIC RETROGRADE REMOVAL OF FOREIGN BODY AND/OR CHANGE OF TUBE OR STENT
ERCP; WITH ENDOSCOPIC RETROGRADE BALLOON DILATION OF AMPULLA, BILIARY AND/OR PANCREATIC DUCT(S
ERCP; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO REMOVAL BY HOT BIOP
LAPAROSCOPY, SURGICAL, ESOPHAGOGASTRIC FUNDOPLASTY (EG, NISSEN, TOUPET PROCEDURES)
UNLISTED LAPAROSCOPY PROCEDURE, ESOPHAGUS
ESOPHAGOPLASTY, (PLASTIC REPAIR OR RECONSTRUCTION), CERVICAL APPROACH; WITHOUT REPAIR OF TRAC
ESOPHAGOPLASTY, (PLASTIC REPAIR OR RECONSTRUCTION), CERVICAL APPROACH; WITH REPAIR OF TRACHEO
ESOPHAGOPLASTY, (PLASTIC REPAIR OR RECONSTRUCTION), THORACIC APPROACH; WITHOUT REPAIR OF TRAC
ESOPHAGOPLASTY, (PLASTIC REPAIR OR RECONSTRUCTION), THORACIC APPROACH; WITH REPAIR OF TRACHEO
ESOPHAGOPLASTY FOR CONGENITAL DEFECT, (PLASTIC REPAIR OR RECONSTRUCTION), THORACIC APPROACH;
ESOPHAGOPLASTY FOR CONGENITAL DEFECT, (PLASTIC REPAIR OR RECONSTRUCTION), THORACIC APPROACH;
ESOPHAGOGASTROSTOMY (CARDIOPLASTY), WITH OR WITHOUT VAGOTOMY AND PYLOROPLASTY, TRANSABDOM
ESOPHAGOGASTRIC FUNDOPLASTY (EG, NISSEN, BELSEY IV, HILL PROCEDURES)
ESOPHAGOGASTRIC FUNDOPLASTY; WITH FUNDIC PATCH (THAL-NISSEN PROCEDURE)
ESOPHAGOGASTRIC FUNDOPLASTY; WITH GASTROPLASTY (EG, COLLIS)
ESOPHAGOMYOTOMY (HELLER TYPE); ABDOMINAL APPROACH
ESOPHAGOMYOTOMY (HELLER TYPE); THORACIC APPROACH
ESOPHAGOJEJUNOSTOMY (WITHOUT TOTAL GASTRECTOMY); ABDOMINAL APPROACH
ESOPHAGOJEJUNOSTOMY (WITHOUT TOTAL GASTRECTOMY); THORACIC APPROACH
ESOPHAGOSTOMY, FISTULIZATION OF ESOPHAGUS, EXTERNAL; ABDOMINAL APPROACH
ESOPHAGOSTOMY, FISTULIZATION OF ESOPHAGUS, EXTERNAL; THORACIC APPROACH
ESOPHAGOSTOMY, FISTULIZATION OF ESOPHAGUS, EXTERNAL; CERVICAL APPROACH
GASTROINTESTINAL RECONSTRUCTION FOR PREVIOUS ESOPHAGECTOMY, FOR OBSTRUCTING ESOPHAGEAL LE
GASTROINTSTINAL RECONS, PREVIOUS ESOPHAGECTOMY, OBSTRUCTING ESOPHAG LES/FIST,/FOR PREVIOUS E
LIGATION, DIRECT, ESOPHAGEAL VARICES
TRANSECTION OF ESOPHAGUS WITH REPAIR, FOR ESOPHAGEAL VARICES
LIGATION OR STAPLING AT GASTROESOPHAGEAL JUNCTION FOR PRE-EXISTING ESOPHAGEAL PERFORATION
SUTURE OF ESOPHAGEAL WOUND OR INJURY; CERVICAL APPROACH
SUTURE OF ESOPHAGEAL WOUND OR INJURY; TRANSTHORACIC OR TRANSABDOMINAL APPROACH
CLOSURE OF ESOPHAGOSTOMY OR FISTULA; CERVICAL APPROACH
CLOSURE OF ESOPHAGOSTOMY OR FISTULA; TRANSTHORACIC OR TRANSABDOMINAL APPROACH
DILATION OF ESOPHAGUS, BY UNGUIDED SOUND OR BOUGIE, SINGLE OR MULTIPLE PASSES
DILATION OF ESOPHAGUS, OVER GUIDE WIRE
DILATION OF ESOPHAGUS, BY BALLOON OR DILATOR, RETROGRADE
DILATION OF ESOPHAGUS WITH BALLOON (30 MM DIAMETER OR LARGER) FOR ACHALASIA
ESOPHAGOGASTRIC TAMPONADE, WITH BALLOON (SENGSTAAKEN TYPE)
FREE JEJUNUM TRANSFER WITH MICROVASCULAR ANASTOMOSIS
UNLISTED PROCEDURE, ESOPHAGUS
GASTROTOMY; WITH EXPLORATION OR FOREIGN BODY REMOVAL
GASTROTOMY; WITH SUTURE REPAIR OF BLEEDING ULCER
GASTROTOMY; WITH SUTURE REPAIR OF PRE-EXISTING ESOPHAGOGASTRIC LACERATION (EG, MALLORY-WEISS
GASTROTOMY; WITH ESOPHAGEAL DILATION AND INSERTION OF PERMANENT INTRALUMINAL TUBE (EG, CELESTI
PYLOROMYOTOMY, CUTTING OF PYLORIC MUSCLE (FREDET-RAMSTEDT TYPE OPERATION)
BIOPSY OF STOMACH; BY CAPSULE, TUBE, PERORAL (ONE OR MORE SPECIMENS)
BIOPSY OF STOMACH; BY LAPAROTOMY
EXCISION, LOCAL; ULCER OR BENIGN TUMOR OF STOMACH
EXCISION, LOCAL; MALIGNANT TUMOR OF STOMACH
GASTRECTOMY, TOTAL; WITH ESOPHAGOENTEROSTOMY
GASTRECTOMY, TOTAL; WITH ROUX-EN-Y RECONSTRUCTION
GASTRECTOMY, TOTAL; WITH FORMATION OF INTESTINAL POUCH, ANY TYPE
GASTRECTOMY, PARTIAL, DISTAL; WITH GASTRODUODENOSTOMY
GASTRECTOMY, PARTIAL, DISTAL; WITH GASTROJEJUNOSTOMY
GASTRECTOMY, PARTIAL, DISTAL; WITH ROUX-EN-Y RECONSTRUCTION
GASTRECTOMY, PARTIAL, DISTAL; WITH FORMATION OF INTESTINAL POUCH
VAGOTOMY WHEN PERFORMED WITH PARTIAL DISTAL GASTRECTOMY (LIST SEPARATELY IN ADDITION TO CODE(
GASTRECTOMY, PARTIAL, PROXIMAL, THORACIC OR ABDOMINAL APPROACH INCLUDING ESOPHAGOGASTROSTO
GASTRECTOMY, PARTIAL, PROXIMAL, THORACIC OR ABDOMINAL APPROACH INCLUDING ESOPHAGOGASTROSTO
VAGOTOMY INCLUDING PYLOROPLASTY, WITH OR WITHOUT GASTROSTOMY; TRUNCAL OR SELECTIVE
VAGOTOMY INCLUDING PYLOROPLASTY, WITH OR WITHOUT GASTROSTOMY; PARIETAL CELL (HIGHLY SELECTIVE
LAPAROSCOPY, SURGICAL; TRANSECTION OF VAGUS NERVES, TRUNCAL
LAPAROSCOPY, SURGICAL; TRANSECTION OF VAGUS NERVES, SELECTIVE OR HIGHLY SELECTIVE
LAPAROSCOPY, SURGICAL; GASTROSTOMY, WITHOUT CONSTRUCTION OF GASTRIC TUBE (EG, STAMM PROCEDU
UNLISTED LAPAROSCOPY PROCEDURE, STOMACH
PERCUTANEOUS PLACEMENT OF GASTROSTOMY TUBE
NASO- OR ORO-GASTRIC TUBE PLACEMENT, NECESSITATING PHYSICIAN'S SKILL
CHANGE OF GASTROSTOMY TUBE
REPOSITIONING OF THE GASTRIC FEEDING TUBE, ANY METHOD, THROUGH THE DUODENUM FOR ENTERIC NUTRI
PYLOROPLASTY
GASTRODUODENOSTOMY
GASTROJEJUNOSTOMY; WITHOUT VAGOTOMY
GASTROJEJUNOSTOMY; WITH VAGOTOMY, ANY TYPE
GASTROSTOMY, OPEN; WITHOUT CONSTRUCTION OF GASTRIC TUBE (EG, STAMM PROCEDURE) (SEPARATE PRO
GASTROSTOMY, TEMPORARY (TUBE, RUBBER OR PLASTIC) (SEPARATE PROCEDURE); NEONATAL, FOR FEEDING
GASTROSTOMY, OPEN; WITH CONSTRUCTION OF GASTRIC TUBE (EG, JANEWAY PROCEDURE)
GASTRORRHAPHY, SUTURE OF PERFORATED DUODENAL OR GASTRIC ULCER, WOUND, OR INJURY
GASTRIC RESTRICTIVE PROCEDURE, WITHOUT GASTRIC BYPASS, FOR MORBID OBESITY; VERTICAL-BANDED GAS
GASTRIC RESTRICTIVE PROCEDURE, WITHOUT GASTRIC BYPASS, FOR MORBID OBESITY; OTHER THAN VERTICAL
GASTRIC RESTRICTIVE PROCEDURE, WITH GASTRIC BYPASS FOR MORBID OBESITY; WITH SHORT LIMB (LESS TH
GASTRIC RESTRICTIVE PROCEDURE, WITH GASTRIC BYPASS FOR MORBID OBESITY; WITH SMALL INTESTINE REC
REVISION OF GASTRIC RESTRICTIVE PROCEDURE FOR MORBID OBESITY (SEPARATE PROCEDURE)
REVISION OF GASTRODUODENAL ANASTOMOSIS (GASTRODUODENOSTOMY) WITH RECONSTRUCTION; WITHOUT
REVISION OF GASTRODUODENAL ANASTOMOSIS (GASTRODUODENOSTOMY) WITH RECONSTRUCTION; WITH VAG
REVISION OF GASTROJEJUNAL ANASTOMOSIS (GASTROJEJUNOSTOMY) WITH RECONSTRUCTION, WITH OR WITH
REVISION OF GASTROJEJUNAL ANASTOMOSIS (GASTROJEJUNOSTOMY) WITH RECONSTRUCTION, WITH OR WITH
CLOSURE OF GASTROSTOMY, SURGICAL
CLOSURE OF GASTROCOLIC FISTULA
UNLISTED PROCEDURE, STOMACH
ENTEROLYSIS (FREEING OF INTESTINAL ADHESION) (SEPARATE PROCEDURE)
DUODENOTOMY, FOR EXPLORATION, BIOPSY(S), OR FOREIGN BODY REMOVAL
TUBE OR NEEDLE CATHETER JEJUNOSTOMY FOR ENTERAL ALIMENTATION, INTRAOPERATIVE, ANY METHOD (LIST
ENTEROTOMY, SMALL INTESTINE, OTHER THAN DUODENUM; FOR EXPLORATION, BIOPSY(S), OR FOREIGN BODY R
ENTEROTOMY, SMALL INTESTINE, OTHER THAN DUODENUM; FOR DECOMPRESSION (EG, BAKER TUBE)
COLOTOMY, FOR EXPLORATION, BIOPSY(S), OR FOREIGN BODY REMOVAL
REDUCTION OF VOLVULUS, INTUSSUSCEPTION, INTERNAL HERNIA, BY LAPAROTOMY
CORRECTION OF MALROTATION BY LYSIS OF DUODENAL BANDS AND/OR REDUCTION OF MIDGUT VOLVULUS (EG
BIOPSY OF INTESTINE BY CAPSULE, TUBE, PERORAL (ONE OR MORE SPECIMENS)
EXCISION OF ONE OR MORE LESIONS OF SMALL OR LARGE INTESTINE NOT REQUIRING ANASTOMOSIS, EXTERIOR
EXCISION OF ONE OR MORE LESIONS OF SMALL OR LARGE INTESTINE NOT REQUIRING ANASTOMOSIS, EXTERIOR
ENTERECTOMY, RESECTION OF SMALL INTESTINE; SINGLE RESECTION AND ANASTOMOSIS
ENTERECTOMY, RESECTION OF SMALL INTESTINE; EACH ADDITIONAL RESECTION AND ANASTOMOSIS (LIST SEPA
ENTERECTOMY, RESECTION OF SMALL INTESTINE; WITH ENTEROSTOMY
ENTERECTOMY, RESECTION OF SMALL INTESTINE FOR CONGENITAL ATRESIA, SINGLE RESECTION AND ANASTOM
ENTERECTOMY, RESECTION OF SMALL INTESTINE FOR CONGENITAL ATRESIA, SINGLE RESECTION AND ANASTOM
ENTERECTOMY, RESECTION, SMALL INTESTINE, CONGENITAL ATRESIA, 1 RESECTION&ANASTOMOSIS, PROXIMAL
ENTEROENTEROSTOMY, ANASTOMOSIS OF INTESTINE, WITH OR WITHOUT CUTANEOUS ENTEROSTOMY (SEPARA
DONOR ENTERECTOMY, OPEN, WITH PREPARATION AND MAINTENANCE OF ALLOGRAFT; FROM CADAVER DONOR
DONOR ENTERECTOMY, OPEN, WITH PREPARATION AND MAINTENANCE OF ALLOGRAFT; PARTIAL, FROM LIVING D
INTESTINAL ALLOTRANSPLANTATION; FROM CADAVER DONOR
INTESTINAL ALLOTRANSPLANTATION; FROM LIVING DONOR
MOBILIZATION (TAKE-DOWN) OF SPLENIC FLEXURE PERFORMED IN CONJUNCTION WITH PARTIAL COLECTOMY (L
COLECTOMY, PARTIAL; WITH ANASTOMOSIS
COLECTOMY, PARTIAL; WITH SKIN LEVEL CECOSTOMY OR COLOSTOMY
COLECTOMY, PARTIAL; WITH END COLOSTOMY AND CLOSURE OF DISTAL SEGMENT (HARTMANN TYPE PROCEDU
COLECTOMY, PARTIAL; WITH RESECTION, WITH COLOSTOMY OR ILEOSTOMY AND CREATION OF MUCOFISTULA
COLECTOMY, PARTIAL; WITH COLOPROCTOSTOMY (LOW PELVIC ANASTOMOSIS)
COLECTOMY, PARTIAL; WITH COLOPROCTOSTOMY (LOW PELVIC ANASTOMOSIS), WITH COLOSTOMY
COLECTOMY, PARTIAL; ABDOMINAL AND TRANSANAL APPROACH
COLECTOMY, TOTAL, ABDOMINAL, WITHOUT PROCTECTOMY; WITH ILEOSTOMY OR ILEOPROCTOSTOMY
COLECTOMY, TOTAL, ABDOMINAL, WITHOUT PROCTECTOMY; WITH CONTINENT ILEOSTOMY
COLECTOMY, TOTAL, ABDOMINAL, WITHOUT PROCTECTOMY; WITH RECTAL MUCOSECTOMY, ILEOANAL ANASTOM
COLECTOMY, TOTAL, ABDOMINAL, WITHOUT PROCTECTOMY; WITH RECTAL MUCOSECTOMY, ILEOANAL ANASTOM
COLECTOMY, TOTAL, ABDOMINAL, WITH PROCTECTOMY; WITH ILEOSTOMY
COLECTOMY, TOTAL, ABDOMINAL, WITH PROCTECTOMY; WITH CONTINENT ILEOSTOMY
COLECTOMY, PARTIAL, WITH REMOVAL OF TERMINAL ILEUM WITH ILEOCOLOSTOMY
LAPAROSCOPY, SURGICAL; ENTEROLYSIS (FREEING OF INTESTINAL ADHESION) (SEPARATE PROCEDURE)
LAPAROSCOPY, SURGICAL; JEJUNOSTOMY (EG, FOR DECOMPRESSION OR FEEDING)
LAPAROSCOPY, SURGICAL; ENTERECTOMY, RESECTION OF SMALL INTESTINE, SINGLE RESECTION AND ANASTOM
LAPAROSCOPY, SURGICAL; EACH ADDITIONAL SMALL INTESTINE RESECTION AND ANASTOMOSIS (LIST SEPARATE
LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH ANASTOMOSIS
LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH REMOVAL OF TERMINAL ILEUM WITH ILEOCOLOSTOMY
LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH END COLOSTOMY AND CLOSURE OF DISTAL SEGMENT (
LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH ANASTOMOSIS, WITH COLOPROCTOSTOMY (LOW PELVI
LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH ANASTOMOSIS, WITH COLOPROCTOSTOMY (LOW PELVI
LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH ANASTOMOSIS, WITH COLOPROCTOSTOMY (LOW PELVI
LAPAROSCOPY, SURGICAL; COLECTOMY, TOTAL, ABDOMINAL, WITH PROCTECTOMY, WITH ILEOANAL ANASTOMO
LAPAROSCOPY, SURGICAL; COLECTOMY, TOTAL, ABDOMINAL, WITH PROCTECTOMY, WITH ILEOSTOMY
UNLISTED LAPAROSCOPY PROCEDURE, INTESTINE (EXCEPT RECTUM)
UNLISTED LAPAROSCOPY PROCEDURE, RECTUM
ENTEROSTOMY OR CECOSTOMY, TUBE (EG, FOR DECOMPRESSION OR FEEDING) (SEPARATE PROCEDURE)
ILEOSTOMY OR JEJUNOSTOMY, NON-TUBE (SEPARATE PROCEDURE)
REVISION OF ILEOSTOMY; SIMPLE (RELEASE OF SUPERFICIAL SCAR) (SEPARATE PROCEDURE)
REVISION OF ILEOSTOMY; COMPLICATED (RECONSTRUCTION IN-DEPTH) (SEPARATE PROCEDURE)
CONTINENT ILEOSTOMY (KOCK PROCEDURE) (SEPARATE PROCEDURE)
COLOSTOMY OR SKIN LEVEL CECOSTOMY; (SEPARATE PROCEDURE)
COLOSTOMY OR SKIN LEVEL CECOSTOMY; WITH MULTIPLE BIOPSIES (EG, FOR CONGENITAL MEGACOLON) (SEPA
REVISION OF COLOSTOMY; SIMPLE (RELEASE OF SUPERFICIAL SCAR) (SEPARATE PROCEDURE)
REVISION OF COLOSTOMY; COMPLICATED (RECONSTRUCTION IN-DEPTH) (SEPARATE PROCEDURE)
REVISION OF COLOSTOMY; WITH REPAIR OF PARACOLOSTOMY HERNIA (SEPARATE PROCEDURE)
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILE
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILE
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILE
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILE
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILE
SM INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND 2ND PORTN, DUODENUM, NO INCL ILEUM; W CONTROL, BL
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILE
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILE
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILE
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILE
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, INCLUDING ILEUM;
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, INCLUDING ILEUM;
SM INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND 2ND PORTION, DUODENUM, INCL ILEUM; W CONTROL, BLE
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, INCLUDING ILEUM;
ILEOSCOPY, THROUGH STOMA; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR
ILEOSCOPY, THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLE
ILEOSCOPY, THROUGH STOMA; WITH TRANSENDOSCOPIC STENT PLACEMENT (INCLUDES PREDILATION)
ENDOSCOPIC EVALUATION OF SMALL INTESTINAL (ABDOMINAL OR PELVIC) POUCH; DIAGNOSTIC, WITH OR WITHO
ENDOSCOPIC EVALUATION OF SMALL INTESTINAL (ABDOMINAL OR PELVIC) POUCH; WITH BIOPSY, SINGLE OR MU
COLONOSCOPY THROUGH STOMA; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING
COLONOSCOPY THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLE
COLONOSCOPY THROUGH STOMA; WITH REMOVAL OF FOREIGN BODY
COLONOSCOPY THROUGH STOMA; WITH CONTROL OF BLEEDING (EG, INJECTION, BIPOLAR CAUTERY, UNIPOLAR
COLONOSCOPY THROUGH STOMA; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPS
COLONOSCOPY THROUGH STOMA; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABL
COLONOSCOPY THROUGH STOMA; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TEC
COLONOSCOPY THROUGH STOMA; WITH TRANSENDOSCOPIC STENT PLACEMENT (INCLUDES PREDILATION)
INTRODUCTION OF LONG GASTROINTESTINAL TUBE (EG, MILLER-ABBOTT) (SEPARATE PROCEDURE)
SUTURE OF SMALL INTESTINE (ENTERORRHAPHY) FOR PERFORATED ULCER, DIVERTICULUM, WOUND, INJURY O
SUTURE OF SMALL INTESTINE (ENTERORRHAPHY) FOR PERFORATED ULCER, DIVERTICULUM, WOUND, INJURY O
SUTURE OF LARGE INTESTINE (COLORRHAPHY) FOR PERFORATED ULCER, DIVERTICULUM, WOUND, INJURY OR R
SUTURE OF LARGE INTESTINE (COLORRHAPHY) FOR PERFORATED ULCER, DIVERTICULUM, WOUND, INJURY OR R
INTESTINAL STRICTUROPLASTY (ENTEROTOMY AND ENTERORRHAPHY) WITH OR WITHOUT DILATION, FOR INTES
CLOSURE OF ENTEROSTOMY, LARGE OR SMALL INTESTINE;
CLOSURE OF ENTEROSTOMY, LARGE OR SMALL INTESTINE; WITH RESECTION AND ANASTOMOSIS OTHER THAN C
CLOSURE OF ENTEROSTOMY, LARGE OR SMALL INTESTINE; WITH RESECTION AND COLORECTAL ANASTOMOSIS
CLOSURE OF INTESTINAL CUTANEOUS FISTULA
CLOSURE OF ENTEROENTERIC OR ENTEROCOLIC FISTULA
CLOSURE OF ENTEROVESICAL FISTULA; WITHOUT INTESTINAL OR BLADDER RESECTION
CLOSURE OF ENTEROVESICAL FISTULA; WITH INTESTINE AND/OR BLADDER RESECTION
INTESTINAL PLICATION (SEPARATE PROCEDURE)
EXCLUSION OF SMALL INTESTINE FROM PELVIS BY MESH OR OTHER PROSTHESIS, OR NATIVE TISSUE (EG, BLADD
INTRAOPERATIVE COLONIC LAVAGE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
UNLISTED PROCEDURE, INTESTINE
EXCISION OF MECKEL'S DIVERTICULUM (DIVERTICULECTOMY) OR OMPHALOMESENTERIC DUCT
EXCISION OF LESION OF MESENTERY (SEPARATE PROCEDURE)
SUTURE OF MESENTERY (SEPARATE PROCEDURE)
UNLISTED PROCEDURE, MECKEL'S DIVERTICULUM AND THE MESENTERY
INCISION AND DRAINAGE OF APPENDICEAL ABSCESS; OPEN
INCISION AND DRAINAGE OF APPENDICEAL ABSCESS; PERCUTANEOUS
APPENDECTOMY
APPENDECTOMY; WHEN DONE FOR INDICATED PURPOSE AT TIME OF OTHER MAJOR PROCEDURE (NOT AS SEPA
APPENDECTOMY; FOR RUPTURED APPENDIX WITH ABSCESS OR GENERALIZED PERITONITIS
LAPAROSCOPY, SURGICAL, APPENDECTOMY
UNLISTED LAPAROSCOPY PROCEDURE, APPENDIX
TRANSRECTAL DRAINAGE OF PELVIC ABSCESS
INCISION AND DRAINAGE OF SUBMUCOSAL ABSCESS, RECTUM
INCISION AND DRAINAGE OF DEEP SUPRALEVATOR, PELVIRECTAL, OR RETRORECTAL ABSCESS
BIOPSY OF ANORECTAL WALL, ANAL APPROACH (EG, CONGENITAL MEGACOLON)
ANORECTAL MYOMECTOMY
PROCTECTOMY; COMPLETE, COMBINED ABDOMINOPERINEAL, WITH COLOSTOMY
PROCTECTOMY; PARTIAL RESECTION OF RECTUM, TRANSABDOMINAL APPROACH
PROCTECTOMY, COMBINED ABDOMINOPERINEAL, PULL-THROUGH PROCEDURE (EG, COLO-ANAL ANASTOMOSIS)
PROCTECTOMY, PARTIAL, WITH RECTAL MUCOSECTOMY, ILEOANAL ANASTOMOSIS, CREATION OF ILEAL RESERV
PROCTECTOMY, PARTIAL, WITH ANASTOMOSIS; ABDOMINAL AND TRANSSACRAL APPROACH
PROCTECTOMY, PARTIAL, WITH ANASTOMOSIS; TRANSACRAL APPROACH ONLY (KRASKE TYPE)
PROCTECTOMY, COMBINED ABDOMINOPERINEAL PULL-THROUGH PROCEDURE (EG, COLO-ANAL ANASTOMOSIS),
PROCTECTOMY, COMPLETE (FOR CONGENITAL MEGACOLON), ABDOMINAL AND PERINEAL APPROACH; WITH PUL
PROCTECTOMY, COMPLETE (FOR CONGENITAL MEGACOLON), ABDOMINAL AND PERINEAL APPROACH; WITH SUB
PROCTECTOMY, PARTIAL, WITHOUT ANASTOMOSIS, PERINEAL APPROACH
PELVIC EXENTERATION FOR COLORECTAL MALIG, W PROCTECTOMY (WWO COLOSTOMY), W REMOVAL OF BLADD
EXCISION OF RECTAL PROCIDENTIA, WITH ANASTOMOSIS; PERINEAL APPROACH
EXCISION OF RECTAL PROCIDENTIA, WITH ANASTOMOSIS; ABDOMINAL AND PERINEAL APPROACH
EXCISION OF ILEOANAL RESERVOIR WITH ILEOSTOMY
DIVISION OF STRICTURE OF RECTUM
EXCISION OF RECTAL TUMOR BY PROCTOTOMY, TRANSACRAL OR TRANSCOCCYGEAL APPROACH
EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH
DESTRUCTION OF RECTAL TUMOR (EG, ELECTRODESSICATION, ELECTROSURGERY, LASER ABLATION, LASER RE
PROCTOSIGMOIDOSCOPY, RIGID; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING O
PROCTOSIGMOIDOSCOPY, RIGID; WITH DILATION (EG, BALLOON, GUIDE WIRE, BOUGIE)
PROCTOSIGMOIDOSCOPY, RIGID; WITH BIOPSY, SINGLE OR MULTIPLE
PROCTOSIGMOIDOSCOPY, RIGID; WITH REMOVAL OF FOREIGN BODY
PROCTOSIGMOIDOSCOPY, RIGID; WITH REMOVAL OF SINGLE TUMOR, POLYP, OR OTHER LESION BY HOT BIOPSY
PROCTOSIGMOIDOSCOPY, RIGID; WITH REMOVAL OF SINGLE TUMOR, POLYP, OR OTHER LESION BY SNARE TECH
PROCTOSIGMOIDOSCOPY, RIGID; WITH REMOVAL OF MULTIPLE TUMORS, POLYPS, OR OTHER LESIONS BY HOT B
PROCTOSIGMOIDOSCOPY, RIGID; WITH CONTROL OF BLEEDING (EG, INJECTION, BIPOLAR CAUTERY, UNIPOLAR C
PROCTOSIGMOIDOSCOPY, RIGID; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE
PROCTOSIGMOIDOSCOPY, RIGID; WITH DECOMPRESSION OF VOLVULUS
PROCTOSIGMOIDOSCOPY, RIGID; WITH TRANSENDOSCOPIC STENT PLACEMENT (INCLUDES PREDILATION)
SIGMOIDOSCOPY, FLEXIBLE; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR W
SIGMOIDOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE
SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF FOREIGN BODY
SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FOR
SIGMOIDOSCOPY, FLEXIBLE; WITH CONTROL OF BLEEDING (EG, INJECTION, BIPOLAR CAUTERY, UNIPOLAR CAUTE
SIGMOIDOSCOPY, FLEXIBLE; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE
SIGMOIDOSCOPY, FLEXIBLE; WITH DECOMPRESSION OF VOLVULUS, ANY METHOD
SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQU
SIGMOIDOSCOPY, FLEXIBLE; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO R
SIGMOIDOSCOPY, FLEXIBLE; WITH DILATION BY BALLOON, 1 OR MORE STRICTURES
SIGMOIDOSCOPY, FLEXIBLE; WITH ENDOSCOPIC ULTRASOUND EXAMINATION
SIGMOIDOSCOPY, FLEXIBLE; WITH TRANSENDOSCOPIC ULTRASOUND GUIDED INTRAMURAL OR TRANSMURAL FIN
SIGMOIDOSCOPY, FLEXIBLE; WITH TRANSENDOSCOPIC STENT PLACEMENT (INCLUDES PREDILATION)
COLONOSCOPY, RIGID OR FLEXIBLE, TRANSABDOMINAL VIA COLOTOMY, SINGLE OR MULTIPLE
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF S
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH REMOVAL OF FOREIGN BODY
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH BIOPSY, SINGLE OR MULTIPLE
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY S
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH CONTROL OF BLEEDING (EG, INJECTION, BIPO
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH DILATION BY BALLOON, 1 OR MORE STRICTUR
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH TRANSENDOSCOPIC STENT PLACEMENT (INCL
PROCTOPLASTY; FOR STENOSIS
PROCTOPLASTY; FOR PROLAPSE OF MUCOUS MEMBRANE
PERIRECTAL INJECTION OF SCLEROSING SOLUTION FOR PROLAPSE
PROCTOPEXY FOR PROLAPSE; ABDOMINAL APPROACH
PROCTOPEXY FOR PROLAPSE; PERINEAL APPROACH
PROCTOPEXY COMBINED WITH SIGMOID RESECTION, ABDOMINAL APPROACH
REPAIR OF RECTOCELE (SEPARATE PROCEDURE)
EXPLORATION, REPAIR, AND PRESACRAL DRAINAGE FOR RECTAL INJURY;
EXPLORATION, REPAIR, AND PRESACRAL DRAINAGE FOR RECTAL INJURY; WITH COLOSTOMY
CLOSURE OF RECTOVESICAL FISTULA;
CLOSURE OF RECTOVESICAL FISTULA; WITH COLOSTOMY
CLOSURE OF RECTOURETHRAL FISTULA;
CLOSURE OF RECTOURETHRAL FISTULA; WITH COLOSTOMY
REDUCTION OF PROCIDENTIA (SEPARATE PROCEDURE) UNDER ANESTHESIA
DILATION OF ANAL SPHINCTER (SEPARATE PROCEDURE) UNDER ANESTHESIA OTHER THAN LOCAL
DILATION OF RECTAL STRICTURE (SEPARATE PROCEDURE) UNDER ANESTHESIA OTHER THAN LOCAL
REMOVAL OF FECAL IMPACTION OR FOREIGN BODY (SEPARATE PROCEDURE) UNDER ANESTHESIA
UNLISTED PROCEDURE, RECTUM
PLACEMENT OF SETON
REMOVAL OF ANAL SETON, OTHER MARKER
INCISION AND DRAINAGE OF ISCHIORECTAL AND/OR PERIRECTAL ABSCESS (SEPARATE PROCEDURE)
INCISION AND DRAINAGE OF INTRAMURAL, INTRAMUSCULAR OR SUBMUCOSAL ABSCESS, TRANSANAL, UNDER AN
INCISION AND DRAINAGE, PERIANAL ABSCESS, SUPERFICIAL
INCISION AND DRAINAGE OF ISCHIORECTAL OR INTRAMURAL ABSCESS, WITH FISTULECTOMY OR FISTULOTOMY,
INCISION, ANAL SEPTUM (INFANT)
SPHINCTEROTOMY, ANAL, DIVISION OF SPHINCTER (SEPARATE PROCEDURE)
INCISION OF THROMBOSED HEMORRHOID, EXTERNAL
FISSURECTOMY, WITH OR WITHOUT SPHINCTEROTOMY
CRYPTECTOMY; SINGLE
CRYPTECTOMY; MULTIPLE (SEPARATE PROCEDURE)
PAPILLECTOMY OR EXCISION OF SINGLE TAG, ANUS (SEPARATE PROCEDURE)
HEMORRHOIDECTOMY, BY SIMPLE LIGATURE (EG, RUBBER BAND)
EXCISION OF EXTERNAL HEMORRHOID TAGS AND/OR MULTIPLE PAPILLAE
HEMORRHOIDECTOMY, EXTERNAL, COMPLETE
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SIMPLE;
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SIMPLE; WITH FISSURECTOMY
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SIMPLE; WITH FISTULECTOMY, WITH OR WITHOUT FISSURECT
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, COMPLEX OR EXTENSIVE;
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, COMPLEX OR EXTENSIVE; WITH FISSURECTOMY
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, COMPLEX OR EXTENSIVE; WITH FISTULECTOMY, WITH OR WIT
SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); SUBCUTANEOUS
SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); SUBMUSCULAR
SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); COMPLEX OR MULTIPLE, WITH OR WIT
SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); SECOND STAGE
CLOSURE OF ANAL FISTULA WITH RECTAL ADVANCEMENT FLAP
ENUCLEATION OR EXCISION OF EXTERNAL THROMBOTIC HEMORRHOID
INJECTION OF SCLEROSING SOLUTION, HEMORRHOIDS
ANOSCOPY; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARA
ANOSCOPY; WITH DILATION (EG, BALLOON, GUIDE WIRE, BOUGIE)
ANOSCOPY; WITH BIOPSY, SINGLE OR MULTIPLE
ANOSCOPY; WITH REMOVAL OF FOREIGN BODY
ANOSCOPY; WITH REMOVAL OF SINGLE TUMOR, POLYP, OR OTHER LESION BY HOT BIOPSY FORCEPS OR BIPOLA
ANOSCOPY; WITH REMOVAL OF SINGLE TUMOR, POLYP, OR OTHER LESION BY SNARE TECHNIQUE
ANOSCOPY; WITH REMOVAL OF MULTIPLE TUMORS, POLYPS, OR OTHER LESIONS BY HOT BIOPSY FORCEPS, BIPO
ANOSCOPY; WITH CONTROL OF BLEEDING (EG, INJECTION, BIPOLAR CAUTERY, UNIPOLAR CAUTERY, LASER, HEA
ANOSCOPY; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO REMOVAL BY HOT
ANOPLASTY, PLASTIC OPERATION FOR STRICTURE; ADULT
ANOPLASTY, PLASTIC OPERATION FOR STRICTURE; INFANT
REPAIR OF ANAL FISTULA WITH FIBRIN GLUE
REPAIR OF LOW IMPERFORATE ANUS; WITH ANOPERINEAL FISTULA ("CUT-BACK" PROCEDURE)
REPAIR OF LOW IMPERFORATE ANUS; WITH TRANSPOSITION OF ANOPERINEAL OR ANOVESTIBULAR FISTULA
REPAIR OF HIGH IMPERFORATE ANUS WITHOUT FISTULA; PERINEAL OR SACROPERINEAL APPROACH
REPAIR OF HIGH IMPERFORATE ANUS WITHOUT FISTULA; COMBINED TRANSABDOMINAL AND SACROPERINEAL AP
REPAIR OF HIGH IMPERFORATE ANUS WITH RECTOURETHRAL OR RECTOVAGINAL FISTULA; PERINEAL OR SACRO
REPAIR OF HIGH IMPERFORATE ANUS WITH RECTOURETHRAL OR RECTOVAGINAL FISTULA; COMBINED TRANSAB
REPAIR OF CLOACAL ANOMALY BY ANORECTOVAGINOPLASTY AND URETHROPLASTY, SACROPERINEAL APPROAC
REPAIR OF CLOACAL ANOMALY BY ANORECTOVAGINOPLASTY AND URETHROPLASTY, COMBINED ABDOMINAL AN
REPAIR OF CLOACAL ANOMALY BY ANORECTOVAGINOPLASTY AND URETHROPLASTY, COMBINED ABDOMINAL AN
SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE OR PROLAPSE; ADULT
SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE OR PROLAPSE; CHILD
GRAFT (THIERSCH OPERATION) FOR RECTAL INCONTINENCE AND/OR PROLAPSE
REMOVAL OF THIERSCH WIRE OR SUTURE, ANAL CANAL
SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT; MUSCLE TRANSPLANT
SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT; LEVATOR MUSCLE IMBRICATION (PARK POSTERIOR ANA
SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT; IMPLANTATION ARTIFICIAL SPHINCTER
DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESIC
DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESIC
DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESIC
DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESIC
DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESIC
DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESIC
DESTRUCTION OF HEMORRHOIDS, ANY METHOD; INTERNAL
DESTRUCTION OF HEMORRHOIDS, ANY METHOD; EXTERNAL
DESTRUCTION OF HEMORRHOIDS, ANY METHOD; INTERNAL AND EXTERNAL
CRYOSURGERY OF RECTAL TUMOR; BENIGN
CRYOSURGERY OF RECTAL TUMOR; MALIGNANT
CURETTAGE OR CAUTERY OF ANAL FISSURE, INCLUDING DILATION OF ANAL SPHINCTER (SEPARATE PROCEDURE
CURETTAGE OR CAUTERY OF ANAL FISSURE, INCLUDING DILATION OF ANAL SPHINCTER (SEPARATE PROCEDURE
LIGATION OF INTERNAL HEMORRHOIDS; SINGLE PROCEDURE
LIGATION OF INTERNAL HEMORRHOIDS; MULTIPLE PROCEDURES
UNLISTED PROCEDURE, ANUS
BIOPSY OF LIVER, NEEDLE; PERCUTANEOUS
BIOPSY OF LIVER, NEEDLE; WHEN DONE FOR INDICATED PURPOSE AT TIME OF OTHER MAJOR PROCEDURE (LIST
HEPATOTOMY; FOR OPEN DRAINAGE OF ABSCESS OR CYST, ONE OR TWO STAGES
HEPATOTOMY; FOR PERCUTANEOUS DRAINAGE OF ABSCESS OR CYST, ONE OR TWO STAGES
LAPAROTOMY, WITH ASPIRATION AND/OR INJECTION OF HEPATIC PARASITIC (EG, AMOEBIC OR ECHINOCOCCAL)
BIOPSY OF LIVER, WEDGE
HEPATECTOMY, RESECTION OF LIVER; PARTIAL LOBECTOMY
HEPATECTOMY, RESECTION OF LIVER; TRISEGMENTECTOMY
HEPATECTOMY, RESECTION OF LIVER; TOTAL LEFT LOBECTOMY
HEPATECTOMY, RESECTION OF LIVER; TOTAL RIGHT LOBECTOMY
DONOR HEPATECTOMY, WITH PREPARATION AND MAINTENANCE OF ALLOGRAFT; FROM CADAVER DONOR
DONOR HEPATECTOMY, WITH PREPARATION AND MAINTENANCE OF ALLOGRAFT; PARTIAL, FROM LIVING DONOR
LIVER ALLOTRANSPLANTATION; ORTHOTOPIC, PARTIAL OR WHOLE, FROM CADAVER OR LIVING DONOR, ANY AGE
LIVER ALLOTRANSPLANTATION; HETEROTOPIC, PARTIAL OR WHOLE, FROM CADAVER OR LIVING DONOR, ANY AG
MARSUPIALIZATION OF CYST OR ABSCESS OF LIVER
MANAGEMENT OF LIVER HEMORRHAGE; SIMPLE SUTURE OF LIVER WOUND OR INJURY
MANAGEMENT OF LIVER HEMORRHAGE; COMPLEX SUTURE OF LIVER WOUND OR INJURY, WITH OR WITHOUT HEP
MANAGEMENT OF LIVER HEMORRHAGE; EXPLORATION OF HEPATIC WOUND, EXTENSIVE DEBRIDEMENT, COAGUL
MANAGEMENT OF LIVER HEMORRHAGE; RE-EXPLORATION OF HEPATIC WOUND FOR REMOVAL OF PACKING
LAPAROSCOPY, SURGICAL, ABLATION OF ONE OR MORE LIVER TUMOR(S); RADIOFREQUENCY
LAPAROSCOPY, SURGICAL, ABLATION OF ONE OR MORE LIVER TUMOR(S); CRYOSURGICAL
UNLISTED LAPAROSCOPIC PROCEDURE, LIVER
ABLATION, OPEN, OF ONE OR MORE LIVER TUMOR(S); RADIOFREQUENCY
ABLATION, OPEN, OF ONE OR MORE LIVER TUMOR(S); CRYOSURGICAL
ABLATION, ONE OR MORE LIVER TUMOR(S), PERCUTANEOUS, RADIOFREQUENCY
UNLISTED PROCEDURE, LIVER
HEPATICOTOMY OR HEPATICOSTOMY WITH EXPLORATION, DRAINAGE, OR REMOVAL OF CALCULUS
CHOLEDOCHOTOMY OR CHOLEDOCHOSTOMY WITH EXPLORATION, DRAINAGE, OR REMOVAL OF CALCULUS, WIT
CHOLEDOCHOTOMY OR CHOLEDOCHOSTOMY WITH EXPLORATION, DRAINAGE, OR REMOVAL OF CALCULUS, WIT
TRANSDUODENAL SPHINCTEROTOMY OR SPHINCTEROPLASTY, WITH OR WITHOUT TRANSDUODENAL EXTRACTIO
CHOLECYSTOTOMY OR CHOLECYSTOSTOMY WITH EXPLORATION, DRAINAGE, OR REMOVAL OF CALCULUS (SEPA
PERCUTANEOUS CHOLECYSTOSTOMY
INJECTION PROCEDURE FOR PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY
INJECTION PROCEDURE FOR CHOLANGIOGRAPHY THROUGH AN EXISTING CATHETER (EG, PERCUTANEOUS TRAN
INTRODUCTION OF PERCUTANEOUS TRANSHEPATIC CATHETER FOR BILIARY DRAINAGE
INTRODUCTION OF PERCUTANEOUS TRANSHEPATIC STENT FOR INTERNAL AND EXTERNAL BILIARY DRAINAGE
CHANGE OF PERCUTANEOUS BILIARY DRAINAGE CATHETER
REVISION AND/OR REINSERTION OF TRANSHEPATIC TUBE
BILIARY ENDOSCOPY, INTRAOPERATIVE (CHOLEDOCHOSCOPY) (LIST SEPARATELY IN ADDITION TO CODE FOR PR
BILIARY ENDOSCOPY, PERCUTANEOUS VIA T-TUBE OR OTHER TRACT; DIAGNOSTIC, WITH OR WITHOUT COLLECT
BILIARY ENDOSCOPY, PERCUTANEOUS VIA T-TUBE OR OTHER TRACT; WITH BIOPSY, SINGLE OR MULTIPLE
BILIARY ENDOSCOPY, PERCUTANEOUS VIA T-TUBE OR OTHER TRACT; WITH REMOVAL OF CALCULUS/CALCULI
BILIARY ENDOSCOPY, PERCUTANEOUS VIA T-TUBE OR OTHER TRACT; WITH DILATION OF BILIARY DUCT STRICTU
BILIARY ENDOSCOPY, PERCUTANEOUS VIA T-TUBE OR OTHER TRACT; WITH DILATION OF BILIARY DUCT STRICTU
LAPAROSCOPY, SURGICAL; WITH GUIDED TRANSHEPATIC CHOLANGIOGRAPHY, WITHOUT BIOPSY
LAPAROSCOPY, SURGICAL; WITH GUIDED TRANSHEPATIC CHOLANGIOGRAPHY WITH BIOPSY
LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY
LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY WITH CHOLANGIOGRAPHY
LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY WITH EXPLORATION OF COMMON DUCT
LAPAROSCOPY, SURGICAL; CHOLECYSTOENTEROSTOMY
UNLISTED LAPAROSCOPY PROCEDURE, BILIARY TRACT
CHOLECYSTECTOMY;
CHOLECYSTECTOMY; WITH CHOLANGIOGRAPHY
CHOLECYSTECTOMY WITH EXPLORATION OF COMMON DUCT;
CHOLECYSTECTOMY WITH EXPLORATION OF COMMON DUCT; WITH CHOLEDOCHOENTEROSTOMY
CHOLECYSTECTOMY WITH EXPLORATION OF COMMON DUCT; WITH TRANSDUODENAL SPHINCTEROTOMY OR SP
BILIARY DUCT STONE EXTRACTION, PERCUTANEOUS VIA T-TUBE TRACT, BASKET OR SNARE (EG, BURHENNE TEC
EXPLORATION FOR CONGENITAL ATRESIA OF BILE DUCTS, WITHOUT REPAIR, WITH OR WITHOUT LIVER BIOPSY, W
PORTOENTEROSTOMY (EG, KASAI PROCEDURE)
EXCISION OF BILE DUCT TUMOR, WITH OR WITHOUT PRIMARY REPAIR OF BILE DUCT; EXTRAHEPATIC
EXCISION OF BILE DUCT TUMOR, WITH OR WITHOUT PRIMARY REPAIR OF BILE DUCT; INTRAHEPATIC
EXCISION OF CHOLEDOCHAL CYST
ANASTOMOSIS, CHOLEDOCHAL CYST, WITHOUT EXCISION
CHOLECYSTOENTEROSTOMY; DIRECT
CHOLECYSTOENTEROSTOMY; WITH GASTROENTEROSTOMY
CHOLECYSTOENTEROSTOMY; ROUX-EN-Y
CHOLECYSTOENTEROSTOMY; ROUX-EN-Y WITH GASTROENTEROSTOMY
ANASTOMOSIS, OF EXTRAHEPATIC BILIARY DUCTS AND GASTROINTESTINAL TRACT
ANASTOMOSIS, OF INTRAHEPATIC DUCTS AND GASTROINTESTINAL TRACT
ANASTOMOSIS, ROUX-EN-Y, OF EXTRAHEPATIC BILIARY DUCTS AND GASTROINTESTINAL TRACT
ANASTOMOSIS, ROUX-EN-Y, OF INTRAHEPATIC BILIARY DUCTS AND GASTROINTESTINAL TRACT
RECONSTRUCTION, PLASTIC, OF EXTRAHEPATIC BILIARY DUCTS WITH END-TO-END ANASTOMOSIS
PLACEMENT OF CHOLEDOCHAL STENT
U-TUBE HEPATICOENTEROSTOMY
SUTURE OF EXTRAHEPATIC BILIARY DUCT FOR PRE-EXISTING INJURY (SEPARATE PROCEDURE)
UNLISTED PROCEDURE, BILIARY TRACT
PLACEMENT OF DRAINS, PERIPANCREATIC, FOR ACUTE PANCREATITIS;
PLACEMENT OF DRAINS, PERIPANCREATIC, FOR ACUTE PANCREATITIS; WITH CHOLECYSTOSTOMY, GASTROSTO
RESECTION OR DEBRIDEMENT OF PANCREAS AND PERIPANCREATIC TISSUE FOR ACUTE NECROTIZING PANCREA
REMOVAL OF PANCREATIC CALCULUS
BIOPSY OF PANCREAS, OPEN (EG, FINE NEEDLE ASPIRATION, NEEDLE CORE BIOPSY, WEDGE BIOPSY)
BIOPSY OF PANCREAS, PERCUTANEOUS NEEDLE
EXCISION OF LESION OF PANCREAS (EG, CYST, ADENOMA)
PANCREATECTOMY, DISTAL SUBTOTAL, WITH OR WITHOUT SPLENECTOMY; WITHOUT PANCREATICOJEJUNOSTO
PANCREATECTOMY, DISTAL SUBTOTAL, WITH OR WITHOUT SPLENECTOMY; WITH PANCREATICOJEJUNOSTOMY
PANCREATECTOMY, DISTAL, NEAR-TOTAL WITH PRESERVATION OF DUODENUM (CHILD-TYPE PROCEDURE)
EXCISION OF AMPULLA OF VATER
PANCREATECTOMY, PROXIMAL SUBTOTAL WITH TOTAL DUODENECTOMY, PARTIAL GASTRECTOMY, CHOLEDOCH
PANCREATECTOMY, PROXIMAL SUBTOTAL WITH TOTAL DUODENECTOMY, PARTIAL GASTRECTOMY, CHOLEDOCH
PANCREATECTOMY, PROXIMAL SUBTOTAL WITH NEAR-TOTAL DUODENECTOMY, CHOLEDOCHOENTEROSTOMY A
PANCREATECTOMY, PROXIMAL SUBTOTAL WITH NEAR-TOTAL DUODENECTOMY, CHOLEDOCHOENTEROSTOMY A
PANCREATECTOMY, TOTAL
PANCREATECTOMY, TOTAL OR SUBTOTAL, WITH AUTOLOGOUS TRANSPLANTATION OF PANCREAS OR PANCREAT
PANCREATICOJEJUNOSTOMY, SIDE-TO-SIDE ANASTOMOSIS (PUESTOW-TYPE OPERATION)
INJECTION PROCEDURE FOR INTRAOPERATIVE PANCREATOGRAPHY (LIST SEPARATELY IN ADDITION TO CODE FO
MARSUPIALIZATION OF PANCREATIC CYST
EXTERNAL DRAINAGE, PSEUDOCYST OF PANCREAS
EXTERNAL DRAINAGE, PSEUDOCYST OF PANCREAS;PERCUTANEOUS
INTERNAL ANASTOMOSIS OF PANCREATIC CYST TO GASTROINTESTINAL TRACT; DIRECT
INTERNAL ANASTOMOSIS OF PANCREATIC CYST TO GASTROINTESTINAL TRACT; ROUX-EN-Y
PANCREATORRHAPHY FOR INJURY
DUODENAL EXCLUSION WITH GASTROJEJUNOSTOMY FOR PANCREATIC INJURY
DONOR PANCREATECTOMY, WITH PREPARATION AND MAINTENANCE OF ALLOGRAFT FROM CADAVER DONOR, W
TRANSPLANTATION OF PANCREATIC ALLOGRAFT
REMOVAL OF TRANSPLANTED PANCREATIC ALLOGRAFT
UNLISTED PROCEDURE, PANCREAS
EXPLORATORY LAPAROTOMY, EXPLORATORY CELIOTOMY WITH OR WITHOUT BIOPSY(S) (SEPARATE PROCEDUR
REOPENING OF RECENT LAPAROTOMY
EXPLORATION, RETROPERITONEAL AREA WITH OR WITHOUT BIOPSY(S) (SEPARATE PROCEDURE)
DRAINAGE OF PERITONEAL ABSCESS OR LOCALIZED PERITONITIS, EXCLUSIVE OF APPENDICEAL ABSCESS; OPEN
DRAINAGE OF PERITONEAL ABSCESS OR LOCALIZED PERITONITIS, EXCLUSIVE OF APPENDICEAL ABSCESS; PERC
DRAINAGE OF SUBDIAPHRAGMATIC OR SUBPHRENIC ABSCESS
DRAINAGE OF SUBDIAPHRAGMATICOR SUBPHRENIC ABSCESS;PERCUTANEOUS
DRAINAGE OF RETROPERITONEAL ABSCESS
DRAINAGE OF RETROPERITONEAL ABSCESS;PERCUTANEOUS
DRAINAGE OF EXTRAPERITONEAL LYMPHOCELE TO PERITONEAL CAVITY, OPEN
PERITONEOCENTESIS, ABDOMINAL PARACENTESIS, OR PERITONEAL LAVAGE (DIAGNOSTIC OR THERAPEUTIC); IN
PERITONEOCENTESIS, ABDOMINAL PARACENTESIS, OR PERITONEAL LAVAGE (DIAGNOSTIC OR THERAPEUTIC); S
REMOVAL OF PERITONEAL FOREIGN BODY FROM PERITONEAL CAVITY
BIOPSY, ABDOMINAL OR RETROPERITONEAL MASS, PERCUTANEOUS NEEDLE
EXCISION OR DESTRUCTION, OPEN, INTRA-ABDOMINAL OR RETROPERITONEAL TUMORS OR CYSTS OR ENDOMET
EXCISION OR DESTRUCTION, OPEN, INTRA-ABDOMINAL OR RETROPERITONEAL TUMORS OR CYSTS OR ENDOMET
EXCISION OF PRESACRAL OR SACROCOCCYGEAL TUMOR
STAGING LAPAROTOMY, HODGKINS DISEASE/LYMPHOMA (INCL SPLENECTOMY, NEEDLE/OPN BIOPSIES, BOTH LIV
UMBILECTOMY, OMPHALECTOMY, EXCISION OF UMBILICUS (SEPARATE PROCEDURE)
OMENTECTOMY, EPIPLOECTOMY, RESECTION OF OMENTUM (SEPARATE PROCEDURE)
LAPAROSCOPY, ABDOMEN, PERITONEUM, AND OMENTUM, DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPE
LAPAROSCOPY, SURGICAL; WITH BIOPSY (SINGLE OR MULTIPLE)
LAPAROSCOPY, SURGICAL; WITH ASPIRATION OF CAVITY OR CYST (EG, OVARIAN CYST) (SINGLE OR MULTIPLE)
LAPAROSCOPY, SURGICAL; WITH DRAINAGE OF LYMPHOCELE TO PERITONEAL CAVITY
UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM
INJECTION OF AIR OR CONTRAST INTO PERITONEAL CAVITY (SEPARATE PROCEDURE)
INSERTION OF INTRAPERITONEAL CANNULA OR CATHETER, WITH SUBCUTANEOUS RESERVOIR, PERMANENT (IE,
INSERTION OF INTRAPERITONEAL CANNULA OR CATHETER FOR DRAINAGE OR DIALYSIS; TEMPORARY
INSERTION OF INTRAPERITONEAL CANNULA OR CATHETER FOR DRAINAGE OR DIALYSIS; PERMANENT
REMOVAL OF PERMANENT INTRAPERITONEAL CANNULA OR CATHETER
EXCHANGE OF PREVIOUSLY PLACED ABSCESS OR CYST DRAINAGE CATHETER UNDER RADIOLOGICAL GUIDANCE
CONTRAST INJECTION FOR ASSESSMENT OF ABSCESS OR CYST VIA PREVIOUSLY PLACED DRAINAGE CATHETER
INSERTION OF PERITONEAL-VENOUS SHUNT
REVISION OF PERITONEAL-VENOUS SHUNT
INJECTION PROCEDURE (EG, CONTRAST MEDIA) FOR EVALUATION OF PREVIOUSLY PLACED PERITONEAL-VENOU
LIGATION OF PERITONEAL-VENOUS SHUNT
REMOVAL OF PERITONEAL-VENOUS SHUNT
REPAIR, INITIAL INGUINAL HERNIA, PRETERM INFANT (LESS THAN 37 WEEKS GESTATION AT BIRTH), PERFORMED
REPAIR, INITIAL INGUINAL HERNIA, PRETERM INFANT (LESS THAN 37 WEEKS GESTATION AT BIRTH), PERFORMED,
REPAIR, INITIAL INGUINAL HERNIA, FULL TERM INFANT UNDER AGE 6 MONTHS,/PRETERM INFANT OVER 50 WEEKS
REPR, INT INGUIN HERNIA, FULL TERM INFANT UNDER AGE 6 MONTHS,/PRETERM INFANT OVER 50 WEEKS PSTCO
REPAIR INITIAL INGUINAL HERNIA, AGE 6 MONTHS TO UNDER 5 YEARS, WITH OR WITHOUT HYDROCELECTOMY; R
REPAIR INITIAL INGUINAL HERNIA, AGE 6 MONTHS TO UNDER 5 YEARS, WITH OR WITHOUT HYDROCELECTOMY; IN
REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OVER; REDUCIBLE
REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OVER; INCARCERATED OR STRANGULATED
REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; REDUCIBLE
REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; INCARCERATED OR STRANGULATED
REPAIR INGUINAL HERNIA, SLIDING, ANY AGE
REPAIR LUMBAR HERNIA
REPAIR INITIAL FEMORAL HERNIA, ANY AGE; REDUCIBLE
REPAIR INITIAL FEMORAL HERNIA, ANY AGE, REDUCIBLE; INCARCERATED OR STRANGULATED
REPAIR RECURRENT FEMORAL HERNIA; REDUCIBLE
REPAIR RECURRENT FEMORAL HERNIA; INCARCERATED OR STRANGULATED
REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; REDUCIBLE
REPAIR INITIAL INCISIONAL HERNIA; INCARCERATED OR STRANGULATED
REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; REDUCIBLE
REPAIR RECURRENT INCISIONAL HERNIA; INCARCERATED OR STRANGULATED
IMPLANTATION OF MESH OR OTHER PROSTHESIS FOR INCISIONAL OR VENTRAL HERNIA REPAIR (LIST SEPARATE
REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); REDUCIBLE (SEPARATE PROCEDURE)
REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); INCARCERATED OR STRANGULATED
REPAIR UMBILICAL HERNIA, UNDER AGE 5 YEARS; REDUCIBLE
REPAIR UMBILICAL HERNIA, UNDER AGE 5 YEARS; INCARCERATED OR STRANGULATED
REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OVER; REDUCIBLE
REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OVER; INCARCERATED OR STRANGULATED
REPAIR SPIGELIAN HERNIA
REPAIR OF SMALL OMPHALOCELE, WITH PRIMARY CLOSURE
REPAIR OF LARGE OMPHALOCELE OR GASTROSCHISIS; WITH OR WITHOUT PROSTHESIS
REPAIR OF LARGE OMPHALOCELE OR GASTROSCHISIS; WITH REMOVAL OF PROSTHESIS, FINAL REDUCTION AND
REPAIR OF OMPHALOCELE (GROSS TYPE OPERATION); FIRST STAGE
REPAIR OF OMPHALOCELE (GROSS TYPE OPERATION); SECOND STAGE
LAPAROSCOPY, SURGICAL; REPAIR INITIAL INGUINAL HERNIA
LAPAROSCOPY, SURGICAL; REPAIR RECURRENT INGUINAL HERNIA
UNLISTED LAPAROSCOPY PROCEDURE, HERNIOPLASTY, HERNIORRHAPHY, HERNIOTOMY
SUTURE, SECONDARY, OF ABDOMINAL WALL FOR EVISCERATION OR DEHISCENCE
OMENTAL FLAP, EXTRA-ABDOMINAL (EG, FOR RECONSTRUCTION OF STERNAL AND CHEST WALL DEFECTS)
OMENTAL FLAP, INTRA-ABDOMINAL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
FREE OMENTAL FLAP WITH MICROVASCULAR ANASTOMOSIS
UNLISTED PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM
RENAL EXPLORATION, NOT NECESSITATING OTHER SPECIFIC PROCEDURES
DRAINAGE OF PERIRENAL OR RENAL ABSCESS (SEPARATE PROCEDURE)
DRAINAGE OF PERIRENAL OR RENAL ABSCESS; PERCUTANEOUS
NEPHROSTOMY, NEPHROTOMY WITH DRAINAGE
NEPHROTOMY, WITH EXPLORATION
NEPHROLITHOTOMY; REMOVAL OF CALCULUS
NEPHROLITHOTOMY; SECONDARY SURGICAL OPERATION FOR CALCULUS
NEPHROLITHOTOMY; COMPLICATED BY CONGENITAL KIDNEY ABNORMALITY
NEPHROLITHOTOMY; REMOVAL OF LARGE STAGHORN CALCULUS FILLING RENAL PELVIS AND CALYCES (INCLUDI
PERCUTANEOUS NEPHROSTOLITHOTOMY OR PYELOSTOLITHOTOMY, WITH OR WITHOUT DILATION, ENDOSCOPY
PERCUTANEOUS NEPHROSTOLITHOTOMY OR PYELOSTOLITHOTOMY, WITH OR WITHOUT DILATION, ENDOSCOPY
TRANSECTION OR REPOSITIONING OF ABERRANT RENAL VESSELS (SEPARATE PROCEDURE)
PYELOTOMY; WITH EXPLORATION
PYELOTOMY; WITH DRAINAGE, PYELOSTOMY
PYELOTOMY; WITH REMOVAL OF CALCULUS (PYELOLITHOTOMY, PELVIOLITHOTOMY, INCLUDING COAGULUM PYE
PYELOTOMY; COMPLICATED (EG, SECONDARY OPERATION, CONGENITAL KIDNEY ABNORMALITY)
RENAL BIOPSY; PERCUTANEOUS, BY TROCAR OR NEEDLE
RENAL BIOPSY; BY SURGICAL EXPOSURE OF KIDNEY
NEPHRECTOMY, INCLUDING PARTIAL URETERECTOMY, ANY OPEN APPROACH INCLUDING RIB RESECTION;
NEPHRECTOMY, INCLUDING PARTIAL URETERECTOMY, ANY OPEN APPROACH INCLUDING RIB RESECTION; COMP
NEPHRECTOMY, INCLUDING PARTIAL URETERECTOMY, ANY OPEN APPROACH INCLUDING RIB RESECTION; RADIC
NEPHRECTOMY WITH TOTAL URETERECTOMY AND BLADDER CUFF; THROUGH SAME INCISION
NEPHRECTOMY WITH TOTAL URETERECTOMY AND BLADDER CUFF; THROUGH SEPARATE INCISION
NEPHRECTOMY, PARTIAL
EXCISION OR UNROOFING OF CYST(S) OF KIDNEY
EXCISION OF PERINEPHRIC CYST
DONOR NEPHRECTOMY, WITH PREPARATION AND MAINTENANCE OF ALLOGRAFT, FROM CADAVER DONOR, UNILA
DONOR NEPHRECTOMY, OPEN FROM LIVING DONOR (EXCLUDING PREPARATION AND MAINTENANCE OF ALLOGR
RECIPIENT NEPHRECTOMY (SEPARATE PROCEDURE)
RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT; EXCLUDING DONOR AND RECIPIENT NEPHRECTOMY
RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT; WITH RECIPIENT NEPHRECTOMY
REMOVAL OF TRANSPLANTED RENAL ALLOGRAFT
RENAL AUTOTRANSPLANTATION, REIMPLANTATION OF KIDNEY
ASPIRATION AND/OR INJECTION OF RENAL CYST OR PELVIS BY NEEDLE, PERCUTANEOUS
INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PER
INTRODUCTION OF URETERAL CATHETER OR STENT INTO URETER THROUGH RENAL PELVIS FOR DRAINAGE AND
INJECTION PROCEDURE FOR PYELOGRAPHY (AS NEPHROSTOGRAM, PYELOSTOGRAM, ANTEGRADE PYELOURETE
INTRODUCTION OF GUIDE INTO RENAL PELVIS AND/OR URETER WITH DILATION TO ESTABLISH NEPHROSTOMY TR
MANOMETRIC STUDIES THROUGH NEPHROSTOMY OR PYELOSTOMY TUBE, OR INDWELLING URETERAL CATHETE
CHANGE OF NEPHROSTOMY OR PYELOSTOMY TUBE
PYELOPLASTY (FOLEY Y-PYELOPLASTY), PLASTIC OPERATION ON RENAL PELVIS, W W/O PLASTIC OPERATION ON
PYELOPLASTY (FOLEY Y-PYELOPLASTY), PLASTIC OPERATION ON RENAL PELVIS, W W/O PLASTIC OPERATION ON
NEPHRORRHAPHY, SUTURE OF KIDNEY WOUND OR INJURY
CLOSURE OF NEPHROCUTANEOUS OR PYELOCUTANEOUS FISTULA
CLOSURE OF NEPHROVISCERAL FISTULA (EG, RENOCOLIC), INCLUDING VISCERAL REPAIR; ABDOMINAL APPROAC
CLOSURE OF NEPHROVISCERAL FISTULA (EG, RENOCOLIC), INCLUDING VISCERAL REPAIR; THORACIC APPROACH
SYMPHYSIOTOMY FOR HORSESHOE KIDNEY WITH OR WITHOUT PYELOPLASTY AND/OR OTHER PLASTIC PROCED
LAPAROSCOPY, SURGICAL; ABLATION OF RENAL CYSTS
LAPAROSCOPY, SURGICAL; ABLATION OF RENAL MASS LESION(S)
LAPAROSCOPY, SURGICAL; PARTIAL NEPHRECTOMY
LAPAROSCOPY, SURGICAL; PYELOPLASTY
LAPAROSCOPY, SURGICAL; RADICAL NEPHRECTOMY (INCLUDES REMOVAL OF GEROTA'S FASCIA AND SURROUND
LAPAROSCOPY, SURGICAL; NEPHRECTOMY, INCLUDING PARTIAL URETERECTOMY
LAPAROSCOPY, SURGICAL; DONOR NEPHRECTOMY FROM LIVING DONOR (EXCLUDING PREPARATION AND MAINT
LAPAROSCOPY, SURGICAL; NEPHRECTOMY WITH TOTAL URETERECTOMY
UNLISTED LAPAROSCOPY PROCEDURE, RENAL
RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, W W/O IRRIGATION, INSTILLATIO
RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, W W/O IRRIGATION, INSTILLATIO
RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, W W/O IRRIGATION, INSTILLATIO
RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, W W/O IRRIGATION, INSTILLATIO
RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, W W/O IRRIGATION, INSTILLATIO
RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, W W/O IRRIGATION, INSTILLATIO
RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, WITH OR WITHOUT IRRIGATION,
RENAL ENDOSCOPY THROUGH NEPHROTOMY OR PYELOTOMY, W W/O IRRIGATION, INSTILLATION, OR URETEROP
RENAL ENDOSCOPY THROUGH NEPHROTOMY OR PYELOTOMY, W W/O IRRIGATION, INSTILLATION, OR URETEROP
RENAL ENDOSCOPY THROUGH NEPHROTOMY OR PYELOTOMY, W W/O IRRIGATION, INSTILLATION, OR URETEROP
RENAL ENDOSCOPY THROUGH NEPHROTOMY OR PYELOTOMY, W W/O IRRIGATION, INSTILLATION, OR URETEROP
RENAL ENDOSCOPY THROUGH NEPHROTOMY OR PYELOTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION, O
RENAL ENDOSCOPY THROUGH NEPHROTOMY OR PYELOTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION, O
RENAL ENDOSCOPY THROUGH NEPHROTOMY OR PYELOTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION, O
LITHOTRIPSY, EXTRACORPOREAL SHOCK WAVE
URETEROTOMY WITH EXPLORATION OR DRAINAGE (SEPARATE PROCEDURE)
URETEROTOMY FOR INSERTION OF INDWELLING STENT, ALL TYPES
URETEROLITHOTOMY; UPPER ONE-THIRD OF URETER
URETEROLITHOTOMY; MIDDLE ONE-THIRD OF URETER
URETEROLITHOTOMY; LOWER ONE-THIRD OF URETER
URETERECTOMY, WITH BLADDER CUFF (SEPARATE PROCEDURE)
URETERECTOMY, TOTAL, ECTOPIC URETER, COMBINATION ABDOMINAL, VAGINAL AND/OR PERINEAL APPROACH
INJECTION PROCEDURE FOR URETEROGRAPHY OR URETEROPYELOGRAPHY THROUGH URETEROSTOMY OR IND
MANOMETRIC STUDIES THROUGH URETEROSTOMY OR INDWELLING URETERAL CATHETER
CHANGE OF URETEROSTOMY TUBE
INJECTION PROCEDURE FOR VISUALIZATION OF ILEAL CONDUIT AND/OR URETEROPYELOGRAPHY, EXCLUSIVE OF
URETEROPLASTY, PLASTIC OPERATION ON URETER (EG, STRICTURE)
URETEROLYSIS, WITH OR WITHOUT REPOSITIONING OF URETER FOR RETROPERITONEAL FIBROSIS
URETEROLYSIS FOR OVARIAN VEIN SYNDROME
URETEROLYSIS FOR RETROCAVAL URETER, WITH REANASTOMOSIS OF UPPER URINARY TRACT OR VENA CAVA
REVISION OF URINARY-CUTANEOUS ANASTOMOSIS (ANY TYPE UROSTOMY);
REVISION OF URINARY-CUTANEOUS ANASTOMOSIS (ANY TYPE UROSTOMY); WITH REPAIR OF FASCIAL DEFECT A
URETEROPYELOSTOMY, ANASTOMOSIS OF URETER AND RENAL PELVIS
URETEROCALYCOSTOMY, ANASTOMOSIS OF URETER TO RENAL CALYX
URETEROURETEROSTOMY
TRANSURETEROURETEROSTOMY, ANASTOMOSIS OF URETER TO CONTRALATERAL URETER
URETERONEOCYSTOSTOMY; ANASTOMOSIS OF SINGLE URETER TO BLADDER
URETERONEOCYSTOSTOMY; ANASTOMOSIS OF DUPLICATED URETER TO BLADDER
URETERONEOCYSTOSTOMY; WITH EXTENSIVE URETERAL TAILORING
URETERONEOCYSTOSTOMY; WITH VESICO-PSOAS HITCH OR BLADDER FLAP
URETEROENTEROSTOMY, DIRECT ANASTOMOSIS OF URETER TO INTESTINE
URETEROSIGMOIDOSTOMY, WITH CREATION OF SIGMOID BLADDER AND ESTABLISHMENT OF ABDOMINAL OR PER
URETEROCOLON CONDUIT, INCLUDING INTESTINE ANASTOMOSIS
URETEROILEAL CONDUIT (ILEAL BLADDER), INCLUDING INTESTINE ANASTOMOSIS (BRICKER OPERATION)
CONTINENT DIVERSION, INCLUDING INTESTINE ANASTOMOSIS USING ANY SEGMENT OF SMALL AND/OR LARGE IN
URINARY UNDIVERSION (EG, TAKING DOWN OF URETEROILEAL CONDUIT, URETEROSIGMOIDOSTOMY OR URETER
REPLACEMENT OF ALL OR PART OF URETER BY INTESTINE SEGMENT, INCLUDING INTESTINE ANASTOMOSIS
CUTANEOUS APPENDICO-VESICOSTOMY
URETEROSTOMY, TRANSPLANTATION OF URETER TO SKIN
URETERORRHAPHY, SUTURE OF URETER (SEPARATE PROCEDURE)
CLOSURE OF URETEROCUTANEOUS FISTULA
CLOSURE OF URETEROVISCERAL FISTULA (INCLUDING VISCERAL REPAIR)
DELIGATION OF URETER
LAPAROSCOPY, SURGICAL; URETEROLITHOTOMY
LAPAROSCOPY, SURGICAL; URETERONEOCYSTOSTOMY WITH CYSTOSCOPY AND URETERAL STENT PLACEMENT
LAPAROSCOPY, SURGICAL; URETERONEOCYSTOSTOMY WITHOUT CYSTOSCOPY AND URETERAL STENT PLACEM
UNLISTED LAPAROSCOPY PROCEDURE, URETER
URETERAL ENDOSCOPY THROUGH ESTABLISHED URETEROSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATIO
URETERAL ENDOSCOPY THROUGH ESTABLISHED URETEROSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATIO
URETERAL ENDOSCOPY THROUGH ESTABLISHED URETEROSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATIO
URETERAL ENDOSCOPY THROUGH ESTABLISHED URETEROSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATIO
URETERAL ENDOSCOPY THROUGH ESTABLISHED URETEROSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATIO
URETERAL ENDOSCOPY THROUGH ESTABLISHED URETEROSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATIO
URETERAL ENDOSCOPY THROUGH URETEROTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION, OR URETERO
URETERAL ENDOSCOPY THROUGH URETEROTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION, OR URETERO
URETERAL ENDOSCOPY THROUGH URETEROTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION, OR URETERO
URETERAL ENDOSCOPY THROUGH URETEROTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION, OR URETERO
URETERAL ENDOSCOPY THROUGH URETEROTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION, OR URETERO
URETERAL ENDOSCOPY THROUGH URETEROTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION, OR URETERO
ASPIRATION OF BLADDER BY NEEDLE
ASPIRATION OF BLADDER; BY TROCAR OR INTRACATHETER
ASPIRATION OF BLADDER; WITH INSERTION OF SUPRAPUBIC CATHETER
CYSTOTOMY OR CYSTOSTOMY; WITH FULGURATION AND/OR INSERTION OF RADIOACTIVE MATERIAL
CYSTOTOMY OR CYSTOSTOMY; WITH CRYOSURGICAL DESTRUCTION OF INTRAVESICAL LESION
CYSTOSTOMY, CYSTOTOMY WITH DRAINAGE
CYSTOTOMY, WITH INSERTION OF URETERAL CATHETER OR STENT (SEPARATE PROCEDURE)
CYSTOLITHOTOMY, CYSTOTOMY WITH REMOVAL OF CALCULUS, WITHOUT VESICAL NECK RESECTION
TRANSVESICAL URETEROLITHOTOMY
CYSTOTOMY, WITH CALCULUS BASKET EXTRACTION AND/OR ULTRASONIC OR ELECTROHYDRAULIC FRAGMENTA
DRAINAGE OF PERIVESICAL OR PREVESICAL SPACE ABSCESS
EXCISION OF URACHAL CYST OR SINUS, WITH OR WITHOUT UMBILICAL HERNIA REPAIR
CYSTOTOMY; FOR SIMPLE EXCISION OF VESICAL NECK (SEPARATE PROCEDURE)
CYSTOTOMY; FOR EXCISION OF BLADDER DIVERTICULUM, SINGLE OR MULTIPLE (SEPARATE PROCEDURE)
CYSTOTOMY; FOR EXCISION OF BLADDER TUMOR
CYSTOTOMY FOR EXCISION, INCISION, OR REPAIR OF URETEROCELE
CYSTECTOMY, PARTIAL; SIMPLE
CYSTECTOMY, PARTIAL; COMPLICATED (EG, POSTRADIATION, PREVIOUS SURGERY, DIFFICULT LOCATION)
CYSTECTOMY, PARTIAL, WITH REIMPLANTATION OF URETER(S) INTO BLADDER (URETERONEOCYSTOSTOMY)
CYSTECTOMY, COMPLETE; (SEPARATE PROCEDURE)
CYSTECTOMY, COMPLETE; WITH BILATERAL PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIAC, HYPOGAS
CYSTECTOMY, COMPLETE, WITH URETEROSIGMOIDOSTOMY OR URETEROCUTANEOUS TRANSPLANTATIONS;
CYSTECTOMY, COMPLETE, WITH URETEROSIGMOIDOSTOMY OR URETEROCUTANEOUS TRANSPLANTATIONS; WIT
CYSTECTOMY, COMPLETE, WITH URETEROILEAL CONDUIT OR SIGMOID BLADDER, INCLUDING INTESTINE ANASTO
CYSTECTOMY, COMPLETE, WITH URETEROILEAL CONDUIT OR SIGMOID BLADDER, INCLUDING INTESTINE ANASTO
CYSTECTOMY, COMPLETE, WITH CONTINENT DIVERSION, ANY OPEN TECHNIQUE, USING ANY SEGMENT OF SMAL
PELVIC EXENTERATION, COMPLETE, VESICAL, PROSTATIC OR URETHRAL MALIGNANCY, WITH REMOVAL BLADDER
INJECTION PROCEDURE FOR CYSTOGRAPHY OR VOIDING URETHROCYSTOGRAPHY
INJECTION PROCEDURE AND PLACEMENT OF CHAIN FOR CONTRAST AND/OR CHAIN URETHROCYSTOGRAPHY
INJECTION PROCEDURE FOR RETROGRADE URETHROCYSTOGRAPHY
BLADDER IRRIGATION, SIMPLE, LAVAGE AND/OR INSTILLATION
INSERTION OF NON-INDWELLING BLADDER CATHETER (EG, STRAIGHT CATHETERIZATION FOR RESIDUAL URINE)
INSERTION OF TEMPORARY INDWELLING BLADDER CATHETER; SIMPLE (EG, FOLEY)
INSERTION OF TEMPORARY INDWELLING BLADDER CATHETER; COMPLICATED (EG, ALTERED ANATOMY, FRACTU
CHANGE OF CYSTOSTOMY TUBE; SIMPLE
CHANGE OF CYSTOSTOMY TUBE; COMPLICATED
ENDOSCOPIC INJECTION OF IMPLANT MATERIAL INTO THE SUBMUCOSAL TISSUES OF THE URETHRA AND/OR BLA
BLADDER INSTILLATION OF ANTICARCINOGENIC AGENT (INCLUDING DETENTION TIME)
SIMPLE CYSTOMETROGRAM (CMG) (EG, SPINAL MANOMETER)
COMPLEX CYSTOMETROGRAM (EG, CALIBRATED ELECTRONIC EQUIPMENT)
SIMPLE UROFLOWMETRY (UFR) (EG, STOP-WATCH FLOW RATE, MECHANICAL UROFLOWMETER)
COMPLEX UROFLOWMETRY (EG, CALIBRATED ELECTRONIC EQUIPMENT)
URETHRAL PRESSURE PROFILE STUDIES (UPP) (URETHRAL CLOSURE PRESSURE PROFILE), ANY TECHNIQUE
ELECTROMYOGRAPHY STUDIES (EMG) OF ANAL OR URETHRAL SPHINCTER, OTHER THAN NEEDLE, ANY TECHNIQ
NEEDLE ELECTROMYOGRAPHY STUDIES (EMG) OF ANAL OR URETHRAL SPHINCTER, ANY TECHNIQUE
STIMULUS EVOKED RESPONSE (EG, MEASUREMENT OF BULBOCAVERNOSUS REFLEX LATENCY TIME)
VOIDING PRESSURE STUDIES (VP); BLADDER VOIDING PRESSURE, ANY TECHNIQUE
VOIDING PRESSURE STUDIES (VP); INTRA-ABDOMINAL VOIDING PRESSURE (AP) (RECTAL, GASTRIC, INTRAPERITO
MEASUREMENT OF POST-VOIDING RESIDUAL URINE AND/OR BLADDER CAPACITY BY ULTRASOUND, NON-IMAGING
CYSTOPLASTY OR CYSTOURETHROPLASTY, PLASTIC OPERATION ON BLADDER AND/OR VESICAL NECK (ANTERIO
CYSTOURETHROPLASTY WITH UNILATERAL OR BILATERAL URETERONEOCYSTOSTOMY
ANTERIOR VESICOURETHROPEXY, OR URETHROPEXY (EG, MARSHALL-MARCHETTI-KRANTZ, BURCH); SIMPLE
ANTERIOR VESICOURETHROPEXY, OR URETHROPEXY (MARSHALL-MARCHETTI-KRANTZ TYPE); COMPLICATED (EG
ABDOMINO-VAGINAL VESICAL NECK SUSPENSION, WITH OR WITHOUT ENDOSCOPIC CONTROL (EG, STAMEY, RAZ
CYSTORRHAPHY, SUTURE OF BLADDER WOUND, INJURY OR RUPTURE; SIMPLE
CYSTORRHAPHY, SUTURE OF BLADDER WOUND, INJURY OR RUPTURE; COMPLICATED
CLOSURE OF CYSTOSTOMY (SEPARATE PROCEDURE)
CLOSURE OF VESICOVAGINAL FISTULA, ABDOMINAL APPROACH
CLOSURE OF VESICOUTERINE FISTULA;
CLOSURE OF VESICOUTERINE FISTULA; WITH HYSTERECTOMY
CLOSURE, EXSTROPHY OF BLADDER
ENTEROCYSTOPLASTY, INCLUDING INTESTINAL ANASTOMOSIS
CUTANEOUS VESICOSTOMY
LAPAROSCOPY, SURGICAL; URETHRAL SUSPENSION FOR STRESS INCONTINENCE
LAPAROSCOPY, SURGICAL; SLING OPERATION FOR STRESS INCONTINENCE (EG, FASCIA OR SYNTHETIC)
CYSTOURETHROSCOPY (SEPARATE PROCEDURE)
CYSTOURETHROSCOPY WITH IRRIGATION AND EVACUATION OF MULTIPLE OBSTRUCTING CLOTS
CYSTOURETHROSCOPY, WITH URETERAL CATHETERIZATION, WITH OR WITHOUT IRRIGATION, INSTILLATION, OR
CYSTOURETHROSCOPY, WITH URETERAL CATHETERIZATION, W W/O IRRIGATION, INSTILLATION, OR URETEROPY
CYSTOURETHROSCOPY, WITH EJACULATORY DUCT CATHETERIZATION, WITH OR WITHOUT IRRIGATION, INSTILLA
CYSTOURETHROSCOPY, WITH BIOPSY
CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) OF TRIGONE, BL
CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) OR TREATMENT
CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) AND/OR RESECT
CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) AND/OR RESECT
CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) AND/OR RESECT
CYSTOURETHROSCOPY WITH INSERTION OF RADIOACTIVE SUBSTANCE, WITH OR WITHOUT BIOPSY OR FULGUR
CYSTOURETHROSCOPY, WITH DILATION OF BLADDER FOR INTERSTITIAL CYSTITIS; GENERAL OR CONDUCTION (S
CYSTOURETHROSCOPY, WITH DILATION OF BLADDER FOR INTERSTITIAL CYSTITIS; LOCAL ANESTHESIA
CYSTOURETHROSCOPY, WITH INTERNAL URETHROTOMY; FEMALE
CYSTOURETHROSCOPY, WITH INTERNAL URETHROTOMY; MALE
CYSTOURETHROSCOPY WITH DIRECT VISION INTERNAL URETHROTOMY
CYSTOURETHROSCOPY, WITH RESECTION OF EXTERNAL SPHINCTER (SPHINCTEROTOMY)
CYSTOURETHROSCOPY, WITH CALIBRATION AND/OR DILATION OF URETHRAL STRICTURE OR STENOSIS, WITH O
CYSTOURETHROSCOPY, WITH INSERTION OF URETHRAL STENT
CYSTOURETHROSCOPY, WITH STEROID INJECTION INTO STRICTURE
CYSTOURETHROSCOPY FOR TREATMENT OF FEMALE URETHRAL SYNDROME: URETHRAL MEATOTOMY, URETHRA
CYSTOURETHROSCOPY; WITH URETERAL MEATOTOMY, UNILATERAL OR BILATERAL
CYSTOURETHROSCOPY; WITH RESECTION OR FULGURATION OF ORTHOTOPIC URETEROCELE(S), UNILATERAL O
CYSTOURETHROSCOPY; WITH RESECTION OR FULGURATION OF ECTOPIC URETEROCELE(S), UNILATERAL OR BIL
CYSTOURETHROSCOPY; WITH INCISION OR RESECTION OF ORIFICE OF BLADDER DIVERTICULUM, SINGLE OR MU
CYSTOURETHROSCOPY, WITH REMOVAL OF FOREIGN BODY, CALCULUS, OR URETERAL STENT FROM URETHRA O
CYSTOURETHROSCOPY, WITH REMOVAL OF FOREIGN BODY, CALCULUS, OR URETERAL STENT FROM URETHRA O
LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY ANY MEANS IN BLADDER AND REMOVAL OF FRA
LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY ANY MEANS IN BLADDER AND REMOVAL OF FRA
CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH REMOVAL OF URETERAL CALCULUS
CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH FRAGMENTATION OF URETERAL CALC
CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH SUBURETERIC INJECTION OF IMPLANT
CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH MANIPULATION, WITHOUT REMOVAL O
CYSTOURETHROSCOPY, WITH INSERTION OF INDWELLING URETERAL STENT (EG, GIBBONS OR DOUBLE-J TYPE)
CYSTOURETHROSCOPY WITH INSERTION OF URETERAL GUIDE WIRE THROUGH KIDNEY TO ESTABLISH A PERCUT
CYSTOURETHROSCOPY; WITH TREATMENT OF URETERAL STRICTURE (EG, BALLOON DILATION, LASER, ELECTRO
CYSTOURETHROSCOPY; WITH TREATMENT OF URETEROPELVIC JUNCTION STRICTURE (EG, BALLOON DILATION,
CYSTOURETHROSCOPY; WITH TREATMENT OF INTRA-RENAL STRICTURE (EG, BALLOON DILATION, LASER, ELECT
CYSTOURETHROSCOPY WITH URETEROSCOPY; WITH TREATMENT OF URETERAL STRICTURE (EG, BALLOON DILA
CYSTOURETHROSCOPY WITH URETEROSCOPY; WITH TREATMENT OF URETEROPELVIC JUNCTION STRICTURE (E
CYSTOURETHROSCOPY WITH URETEROSCOPY; WITH TREATMENT OF INTRA-RENAL STRICTURE (EG, BALLOON D
CYSTOURETHROSCOPY WITH TRANSURETHRAL RESECTION OR INCISION OF EJACULATORY DUCTS
CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY; DIAGNOSTIC
CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY; WITH REMOVAL OR MANIPULATION OF CA
CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY; WITH LITHOTRIPSY (URETERAL CATHETE
CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY; WITH BIOPSY AND/OR FULGURATION OF U
CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY; WITH RESECTION OF URETERAL OR RENA
CYSTOURETHROSCOPY WITH INCISION, FULGURATION, OR RESECTION OF CONGENITAL POSTERIOR URETHRAL
TRANSURETHRAL INCISION OF PROSTATE
TRANSURETHRAL RESECTION OF BLADDER NECK (SEPARATE PROCEDURE)
TRANSURETHRAL BALLOON DILATION OF THE PROSTATIC URETHRA
TRANSURETHRAL ELECTROSURGICAL RESECTION PROSTATE, INC CONTROL OF POSTOPERATIVE BLEEDING, CO
TRANSURETHRAL FULGURATION FOR POSTOPERATIVE BLEEDING OCCURRING AFTER THE USUAL FOLLOW-UP T
TRANSURETHRAL RESECTION OF PROSTATE; FIRST STAGE OF TWO-STAGE RESECTION (PARTIAL RESECTION)
TRANSURETHRAL RESECTION OF PROSTATE; SECOND STAGE OF TWO-STAGE RESECTION (RESECTION COMPLE
TRANSURETHRAL RESECTION; OF RESIDUAL OBSTRUCTIVE TISSUE AFTER 90 DAYS POSTOPERATIVE
TRANSURETHRAL RESECTION; OF REGROWTH OF OBSTRUCTIVE TISSUE LONGER THAN ONE YEAR POSTOPERAT
TRANSURETHRAL RESECTION; OF POSTOPERATIVE BLADDER NECK CONTRACTURE
NON-CONTACT LASER COAGULATION OF PROSTATE, INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, COMP
CONTACT LASER VAPORIZATION W W/O TRANSURETHRAL RESECTION PROSTATE, INC CONTROL POSTOPERATIV
TRANSURETHRAL DRAINAGE OF PROSTATIC ABSCESS
URETHROTOMY OR URETHROSTOMY, EXTERNAL (SEPARATE PROCEDURE); PENDULOUS URETHRA
URETHROTOMY OR URETHROSTOMY, EXTERNAL (SEPARATE PROCEDURE); PERINEAL URETHRA, EXTERNAL
MEATOTOMY, CUTTING OF MEATUS (SEPARATE PROCEDURE); EXCEPT INFANT
MEATOTOMY, CUTTING OF MEATUS (SEPARATE PROCEDURE); INFANT
DRAINAGE OF DEEP PERIURETHRAL ABSCESS
DRAINAGE OF SKENE'S GLAND ABSCESS OR CYST
DRAINAGE OF PERINEAL URINARY EXTRAVASATION; UNCOMPLICATED (SEPARATE PROCEDURE)
DRAINAGE OF PERINEAL URINARY EXTRAVASATION; COMPLICATED
BIOPSY OF URETHRA
URETHRECTOMY, TOTAL, INCLUDING CYSTOSTOMY; FEMALE
URETHRECTOMY, TOTAL, INCLUDING CYSTOSTOMY; MALE
EXCISION OR FULGURATION OF CARCINOMA OF URETHRA
EXCISION OF URETHRAL DIVERTICULUM (SEPARATE PROCEDURE); FEMALE
EXCISION OF URETHRAL DIVERTICULUM (SEPARATE PROCEDURE); MALE
MARSUPIALIZATION OF URETHRAL DIVERTICULUM, MALE OR FEMALE
EXCISION OF BULBOURETHRAL GLAND (COWPER'S GLAND)
EXCISION OR FULGURATION; URETHRAL POLYP(S), DISTAL URETHRA
EXCISION OR FULGURATION; URETHRAL CARUNCLE
EXCISION OR FULGURATION; SKENE'S GLANDS
EXCISION OR FULGURATION; URETHRAL PROLAPSE
URETHROPLASTY; FIRST STAGE, FOR FISTULA, DIVERTICULUM, OR STRICTURE (EG, JOHANNSEN TYPE)
URETHROPLASTY; SECOND STAGE (FORMATION OF URETHRA), INCLUDING URINARY DIVERSION
URETHROPLASTY, ONE-STAGE RECONSTRUCTION OF MALE ANTERIOR URETHRA
URETHROPLASTY, TRANSPUBIC OR PERINEAL, ONE STAGE, FOR RECONSTRUCTION OR REPAIR OF PROSTATIC O
URETHROPLASTY, TWO-STAGE RECONSTRUCTION OR REPAIR OF PROSTATIC OR MEMBRANOUS URETHRA; FIRS
URETHROPLASTY, TWO-STAGE RECONSTRUCTION OR REPAIR OF PROSTATIC OR MEMBRANOUS URETHRA; SECO
URETHROPLASTY, RECONSTRUCTION OF FEMALE URETHRA
URETHROPLASTY WITH TUBULARIZATION OF POSTERIOR URETHRA AND/OR LOWER BLADDER FOR INCONTINENC
SLING OPERATION FOR CORRECTION OF MALE URINARY INCONTINENCE (EG, FASCIA OR SYNTHETIC)
REMOVAL OR REVISION OF SLING FOR MALE URINARY INCONTINENCE (EG, FASCIA OR SYNTHETIC)
INSERTION OF TANDEM CUFF (DUAL CUFF)
INSERTION OF INFLATABLE URETHRAL/BLADDER NECK SPHINCTER, INCLUDING PLACEMENT OF PUMP, RESERVO
REMOVAL OF INFLATABLE URETHRAL/BLADDER NECK SPHINCTER, INCLUDING PUMP, RESERVOIR, AND CUFF
REMOVAL AND REPLACEMENT OF INFLATABLE URETHRAL/BLADDER NECK SPHINCTER INCLUDING PUMP, RESERV
REMOVAL&REPLACEMENT, INFLATABLE URETHRAL/BLADDER NECK SPHINCTER INCLUDING PUMP, RESERVOIR,&C
REPAIR OF INFLATABLE URETHRAL/BLADDER NECK SPHINCTER, INCLUDING PUMP, RESERVOIR, AND CUFF
URETHROMEATOPLASTY, WITH MUCOSAL ADVANCEMENT
URETHROMEATOPLASTY, WITH PARTIAL EXCISION OF DISTAL URETHRAL SEGMENT (RICHARDSON TYPE PROCED
URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY, FEMALE
URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY; PENILE
URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY; PERINEAL
URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY; PROSTATOMEMBRANOUS
CLOSURE OF URETHROSTOMY OR URETHROCUTANEOUS FISTULA, MALE (SEPARATE PROCEDURE)
DILATION OF URETHRAL STRICTURE BY PASSAGE OF SOUND OR URETHRAL DILATOR, MALE; INITIAL
DILATION OF URETHRAL STRICTURE BY PASSAGE OF SOUND OR URETHRAL DILATOR, MALE; SUBSEQUENT
DILATION OF URETHRAL STRICTURE OR VESICAL NECK BY PASSAGE OF SOUND OR URETHRAL DILATOR, MALE, G
DILATION OF URETHRAL STRICTURE BY PASSAGE OF FILIFORM AND FOLLOWER, MALE; INITIAL
DILATION OF URETHRAL STRICTURE BY PASSAGE OF FILIFORM AND FOLLOWER, MALE; SUBSEQUENT
DILATION OF FEMALE URETHRA INCLUDING SUPPOSITORY AND/OR INSTILLATION; INITIAL
DILATION OF FEMALE URETHRA INCLUDING SUPPOSITORY AND/OR INSTILLATION; SUBSEQUENT
DILATION OF FEMALE URETHRA, GENERAL OR CONDUCTION (SPINAL) ANESTHESIA
TRANSURETHRAL DESTRUCTION OF PROSTATE TISSUE; BY MICROWAVE THERMOTHERAPY
TRANSURETHRAL DESTRUCTION OF PROSTATE TISSUE; BY RADIOFREQUENCY THERMOTHERAPY
TRANSURETHRAL DESTRUCTION OF PROSTATE TISSUE; BY WATER-INDUCED THERMOTHERAPY
UNLISTED PROCEDURE, URINARY SYSTEM
SLITTING OF PREPUCE, DORSAL OR LATERAL (SEPARATE PROCEDURE); NEWBORN
SLITTING OF PREPUCE, DORSAL OR LATERAL (SEPARATE PROCEDURE); EXCEPT NEWBORN
INCISION AND DRAINAGE OF PENIS, DEEP
DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESI
DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESI
DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESI
DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESI
DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESI
DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESI
BIOPSY OF PENIS (SEPARATE PROCEDURE)
BIOPSY OF PENIS; DEEP STRUCTURES
EXCISION OF PENILE PLAQUE (PEYRONIE DISEASE);
EXCISION OF PENILE PLAQUE (PEYRONIE DISEASE); WITH GRAFT TO 5 CM IN LENGTH
EXCISION OF PENILE PLAQUE (PEYRONIE DISEASE); WITH GRAFT GREATER THAN 5 CM IN LENGTH
REMOVAL FOREIGN BODY FROM DEEP PENILE TISSUE (EG, PLASTIC IMPLANT)
AMPUTATION OF PENIS; PARTIAL
AMPUTATION OF PENIS; COMPLETE
AMPUTATION OF PENIS, RADICAL; WITH BILATERAL INGUINOFEMORAL LYMPHADENECTOMY
AMPUTATION OF PENIS, RADICAL; IN CONTINUITY WITH BILATERAL PELVIC LYMPHADENECTOMY, INCLUDING EXT
CIRCUMCISION, USING CLAMP OR OTHER DEVICE; NEWBORN
CIRCUMCISION, USING CLAMP OR OTHER DEVICE; EXCEPT NEWBORN
CIRCUMCISION, SURGICAL EXCISION OTHER THAN CLAMP, DEVICE OR DORSAL SLIT; NEWBORN
CIRCUMCISION, SURGICAL EXCISION OTHER THAN CLAMP, DEVICE OR DORSAL SLIT; EXCEPT NEWBORN
LYSIS OR EXCISION OF PENILE POST-CIRCUMCISION ADHESIONS
REPAIR INCOMPLETE CIRCUMCISION
FRENULOTOMY OF PENIS
INJECTION PROCEDURE FOR PEYRONIE DISEASE;
INJECTION PROCEDURE FOR PEYRONIE DISEASE; WITH SURGICAL EXPOSURE OF PLAQUE
IRRIGATION OF CORPORA CAVERNOSA FOR PRIAPISM
INJECTION PROCEDURE FOR CORPORA CAVERNOSOGRAPHY
DYNAMIC CAVERNOSOMETRY, INCLUDING INTRACAVERNOSAL INJECTION OF VASOACTIVE DRUGS (EG, PAPAVER
INJECTION OF CORPORA CAVERNOSA WITH PHARMACOLOGIC AGENT(S) (EG, PAPAVERINE, PHENTOLAMINE)
PENILE PLETHYSMOGRAPHY
NOCTURNAL PENILE TUMESCENCE AND/OR RIGIDITY TEST
PLASTIC OPERATION OF PENIS FOR STRAIGHTENING OF CHORDEE (EG, HYPOSPADIAS), WITH OR WITHOUT MOB
PLASTIC OPERATION ON PENIS FOR CORRECTION OF CHORDEE OR FOR FIRST STAGE HYPOSPADIAS REPAIR WIT
URETHROPLASTY FOR SECOND STAGE HYPOSPADIAS REPAIR (INCLUDING URINARY DIVERSION); LESS THAN 3 CM
URETHROPLASTY FOR SECOND STAGE HYPOSPADIAS REPAIR (INCLUDING URINARY DIVERSION); GREATER THAN
URETHROPLASTY FOR SECOND STAGE HYPOSPADIAS REPAIR (INCLUDING URINARY DIVERSION) WITH FREE SKIN
URETHROPLASTY FOR THIRD STAGE HYPOSPADIAS REPAIR TO RELEASE PENIS FROM SCROTUM (EG, THIRD STA
ONE STAGE DISTAL HYPOSPADIAS REPAIR (WITH OR WITHOUT CHORDEE OR CIRCUMCISION); WITH SIMPLE MEAT
ONE STAGE DISTAL HYPOSPADIAS REPAIR (WITH OR WITHOUT CHORDEE OR CIRCUMCISION); WITH URETHROPL
ONE STAGE DISTAL HYPOSPADIAS REPAIR (WITH OR WITHOUT CHORDEE OR CIRCUMCISION); WITH URETHROPL
ONE STAGE DISTAL HYPOSPADIAS REPAIR (WITH OR WITHOUT CHORDEE OR CIRCUMCISION); WITH EXTENSIVE D
ONE STAGE PROXIMAL PENILE OR PENOSCROTAL HYPOSPADIAS REPAIR REQUIRING EXTENSIVE DISSECTION TO
ONE STAGE PERINEAL HYPOSPADIAS REPAIR REQUIRING EXTENSIVE DISSECTION TO CORRECT CHORDEE AND U
REPAIR OF HYPOSPADIAS COMPLICATIONS (IE, FISTULA, STRICTURE, DIVERTICULA); BY CLOSURE, INCISION, OR E
REPAIR OF HYPOSPADIAS COMPLICATIONS (IE, FISTULA, STRICTURE, DIVERTICULA); REQUIRING MOBILIZATION O
REPAIR OF HYPOSPADIAS COMPLICATIONS (IE, FISTULA, STRICTURE, DIVERTICULA); REQUIRING EXTENSIVE DISS
REPAIR OF HYPOSPADIAS CRIPPLE REQUIRING EXTENSIVE DISSECTION & EXCISION OF PREVIOUSLY CONSTRUC
PLASTIC OPERATION ON PENIS TO CORRECT ANGULATION
PLASTIC OPERATION ON PENIS FOR EPISPADIAS DISTAL TO EXTERNAL SPHINCTER;
PLASTIC OPERATION ON PENIS FOR EPISPADIAS DISTAL TO EXTERNAL SPHINCTER; WITH INCONTINENCE
PLASTIC OPERATION ON PENIS FOR EPISPADIAS DISTAL TO EXTERNAL SPHINCTER; WITH EXSTROPHY OF BLADD
INSERTION OF PENILE PROSTHESIS; NON-INFLATABLE (SEMI-RIGID)
INSERTION OF PENILE PROSTHESIS; INFLATABLE (SELF-CONTAINED)
INSERTION OF MULTI-COMPONENT, INFLATABLE PENILE PROSTHESIS, INCLUDING PLACEMENT OF PUMP, CYLIND
REMOVAL OF ALL COMPONENTS OF A MULTI-COMPONENT, INFLATABLE PENILE PROSTHESIS WITHOUT REPLACE
REPAIR OF COMPONENT(S) OF A MULTI-COMPONENT, INFLATABLE PENILE PROSTHESIS
REMOVAL AND REPLACEMENT OF ALL COMPONENT(S) OF A MULTI-COMPONENT, INFLATABLE PENILE PROSTHES
REMOVAL&REPLACEMENT OF ALL COMPONENTS OF MULTI-COMPONENT INFLATABLE PENILE PROSTHESIS THRO
REMOVAL OF NON-INFLATABLE (SEMI-RIGID) OR INFLATABLE (SELF-CONTAINED) PENILE PROSTHESIS, WITHOUT R
REMOVAL AND REPLACEMENT OF NON-INFLATABLE (SEMI-RIGID) OR INFLATABLE (SELF-CONTAINED) PENILE PRO
REMOVAL&REPLACEMENT, NON-INFLATABLE (SEMI-RIGID)/INFLATABLE (SELF-CONTAINED) PENILE PROSTHESIS T
CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT (PRIAPISM OPERATION), UNILATERAL OR BILATERAL
CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT (PRIAPISM OPERATION), UNILATERAL OR BILATERAL
CORPORA CAVERNOSA-GLANS PENIS FISTULIZATION (EG, BIOPSY NEEDLE, WINTER PROCEDURE, RONGEUR, OR
PLASTIC OPERATION OF PENIS FOR INJURY
FORESKIN MANIPULATION INCLUDING LYSIS OF PREPUTIAL ADHESIONS AND STRETCHING
BIOPSY OF TESTIS, NEEDLE (SEPARATE PROCEDURE)
BIOPSY OF TESTIS, INCISIONAL (SEPARATE PROCEDURE)
EXCISION OF EXTRAPARENCHYMAL LESION OF TESTIS
ORCHIECTOMY, SIMPLE (INCLUDING SUBCAPSULAR), WITH OR WITHOUT TESTICULAR PROSTHESIS, SCROTAL OR
ORCHIECTOMY, PARTIAL
ORCHIECTOMY, RADICAL, FOR TUMOR; INGUINAL APPROACH
ORCHIECTOMY, RADICAL, FOR TUMOR; WITH ABDOMINAL EXPLORATION
EXPLORATION FOR UNDESCENDED TESTIS (INGUINAL OR SCROTAL AREA)
EXPLORATION FOR UNDESCENDED TESTIS WITH ABDOMINAL EXPLORATION
REDUCTION OF TORSION OF TESTIS, SURGICAL, WITH OR WITHOUT FIXATION OF CONTRALATERAL TESTIS
FIXATION OF CONTRALATERAL TESTIS (SEPARATE PROCEDURE)
ORCHIOPEXY, INGUINAL APPROACH, WITH OR WITHOUT HERNIA REPAIR
ORCHIOPEXY, ABDOMINAL APPROACH, FOR INTRA-ABDOMINAL TESTIS (EG, FOWLER-STEPHENS)
INSERTION OF TESTICULAR PROSTHESIS (SEPARATE PROCEDURE)
SUTURE OR REPAIR OF TESTICULAR INJURY
TRANSPLANTATION OF TESTIS(ES) TO THIGH (BECAUSE OF SCROTAL DESTRUCTION)
LAPAROSCOPY, SURGICAL; ORCHIECTOMY
LAPAROSCOPY, SURGICAL; ORCHIOPEXY FOR INTRA-ABDOMINAL TESTIS
UNLISTED LAPAROSCOPY PROCEDURE, TESTIS
INCISION AND DRAINAGE OF EPIDIDYMIS, TESTIS AND/OR SCROTAL SPACE (EG, ABSCESS OR HEMATOMA)
BIOPSY OF EPIDIDYMIS, NEEDLE
EXPLORATION OF EPIDIDYMIS, WITH OR WITHOUT BIOPSY
EXCISION OF LOCAL LESION OF EPIDIDYMIS
EXCISION OF SPERMATOCELE, WITH OR WITHOUT EPIDIDYMECTOMY
EPIDIDYMECTOMY; UNILATERAL
EPIDIDYMECTOMY; BILATERAL
EPIDIDYMOVASOSTOMY, ANASTOMOSIS OF EPIDIDYMIS TO VAS DEFERENS; UNILATERAL
EPIDIDYMOVASOSTOMY, ANASTOMOSIS OF EPIDIDYMIS TO VAS DEFERENS; BILATERAL
PUNCTURE ASPIRATION OF HYDROCELE, TUNICA VAGINALIS, WITH OR WITHOUT INJECTION OF MEDICATION
EXCISION OF HYDROCELE; UNILATERAL
EXCISION OF HYDROCELE; BILATERAL
REPAIR OF TUNICA VAGINALIS HYDROCELE (BOTTLE TYPE)
DRAINAGE OF SCROTAL WALL ABSCESS
SCROTAL EXPLORATION
REMOVAL OF FOREIGN BODY IN SCROTUM
RESECTION OF SCROTUM
SCROTOPLASTY; SIMPLE
SCROTOPLASTY; COMPLICATED
VASOTOMY, CANNULIZATION WITH OR WITHOUT INCISION OF VAS, UNILATERAL OR BILATERAL (SEPARATE PROC
VASECTOMY, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE), INCLUDING POSTOPERATIVE SEMEN EXAM(S
VASOTOMY FOR VASOGRAMS, SEMINAL VESICULOGRAMS, OR EPIDIDYMOGRAMS, UNILATERAL OR BILATERAL
VASOVASOSTOMY, VASOVASORRHAPHY
LIGATION (PERCUTANEOUS) OF VAS DEFERENS, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE)
EXCISION OF HYDROCELE OF SPERMATIC CORD, UNILATERAL (SEPARATE PROCEDURE)
EXCISION OF LESION OF SPERMATIC CORD (SEPARATE PROCEDURE)
EXCISION OF VARICOCELE OR LIGATION OF SPERMATIC VEINS FOR VARICOCELE; (SEPARATE PROCEDURE)
EXCISION OF VARICOCELE OR LIGATION OF SPERMATIC VEINS FOR VARICOCELE; ABDOMINAL APPROACH
EXCISION OF VARICOCELE OR LIGATION OF SPERMATIC VEINS FOR VARICOCELE; WITH HERNIA REPAIR
LAPAROSCOPY, SURGICAL, WITH LIGATION OF SPERMATIC VEINS FOR VARICOCELE
UNLISTED LAPAROSCOPY PROCEDURE, SPERMATIC CORD
VESICULOTOMY;
VESICULOTOMY; COMPLICATED
VESICULECTOMY, ANY APPROACH
EXCISION OF MULLERIAN DUCT CYST
BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH
BIOPSY, PROSTATE; INCISIONAL, ANY APPROACH
PROSTATOTOMY, EXTERNAL DRAINAGE OF PROSTATIC ABSCESS, ANY APPROACH; SIMPLE
PROSTATOTOMY, EXTERNAL DRAINAGE OF PROSTATIC ABSCESS, ANY APPROACH; COMPLICATED
PROSTATECTOMY, PERINEAL, SUBTOTAL (INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, VASECTOMY, ME
PROSTATECTOMY, PERINEAL RADICAL;
PROSTATECTOMY, PERINEAL RADICAL; WITH LYMPH NODE BIOPSY(S) (LIMITED PELVIC LYMPHADENECTOMY)
PROSTATECTOMY, PERINEAL RADICAL; WITH BILATERAL PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIA
PROSTATECTOMY (INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, VASECTOMY, MEATOTOMY, URETHRAL
PROSTATECTOMY (INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, VASECTOMY, MEATOTOMY, URETHRAL
PROSTATECTOMY, RETROPUBIC RADICAL, WITH OR WITHOUT NERVE SPARING;
PROSTATECTOMY, RETROPUBIC RADICAL, WITH OR WITHOUT NERVE SPARING; WITH LYMPH NODE BIOPSY(S) (LI
PROSTATECTOMY, RETROPUBIC RADICAL, WITH OR WITHOUT NERVE SPARING; WITH BILATERAL PELVIC LYMPHA
TRANSPERINEAL PLACEMENT OF NEEDLES OR CATHETERS INTO PROSTATE FOR INTERSTITIAL RADIOELEMENT A
EXPOSURE OF PROSTATE, ANY APPROACH, FOR INSERTION OF RADIOACTIVE SUBSTANCE;
EXPOSURE OF PROSTATE, ANY APPROACH, FOR INSERTION OF RADIOACTIVE SUBSTANCE; WITH LYMPH NODE B
EXPOSURE OF PROSTATE, ANY APPROACH, FOR INSERTION OF RADIOACTIVE SUBSTANCE; WITH BILATERAL PEL
LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICAL, INCLUDING NERVE SPARING
ELECTROEJACULATION
CRYOSURGICAL ABLATION OF THE PROSTATE (INCLUDES ULTRASONIC GUIDANCE FOR INTERSTITIAL CRYOSURG
UNLISTED PROCEDURE, MALE GENITAL SYSTEM
INTERSEX SURGERY; MALE TO FEMALE
INTERSEX SURGERY; FEMALE TO MALE
INCISION AND DRAINAGE OF VULVA OR PERINEAL ABSCESS
INCISION AND DRAINAGE OF BARTHOLIN'S GLAND ABSCESS
MARSUPIALIZATION OF BARTHOLIN'S GLAND CYST
LYSIS OF LABIAL ADHESIONS
DESTRUCTION OF LESION(S), VULVA; SIMPLE (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CHEMO
DESTRUCTION OF LESION(S), VULVA; EXTENSIVE (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CH
BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); ONE LESION
BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); EACH SEPARATE ADDITIONAL LESION (LIST SEPARAT
VULVECTOMY SIMPLE; PARTIAL
VULVECTOMY SIMPLE; COMPLETE
VULVECTOMY, RADICAL, PARTIAL;
VULVECTOMY, RADICAL, PARTIAL; WITH UNILATERAL INGUINOFEMORAL LYMPHADENECTOMY
VULVECTOMY, RADICAL, PARTIAL; WITH BILATERAL INGUINOFEMORAL LYMPHADENECTOMY
VULVECTOMY, RADICAL, COMPLETE;
VULVECTOMY, RADICAL, COMPLETE; WITH UNILATERAL INGUINOFEMORAL LYMPHADENECTOMY
VULVECTOMY, RADICAL, COMPLETE; WITH BILATERAL INGUINOFEMORAL LYMPHADENECTOMY
VULVECTOMY, RADICAL, COMPLETE, WITH INGUINOFEMORAL, ILIAC, AND PELVIC LYMPHADENECTOMY
PARTIAL HYMENECTOMY OR REVISION OF HYMENAL RING
HYMENOTOMY, SIMPLE INCISION
EXCISION OF BARTHOLIN'S GLAND OR CYST
PLASTIC REPAIR OF INTROITUS
CLITOROPLASTY FOR INTERSEX STATE
PERINEOPLASTY, REPAIR OF PERINEUM, NON-OBSTETRICAL (SEPARATE PROCEDURE)
COLPOSCOPY OF THE VULVA
COLPOSCOPY OF THE VULVA; WITH BIOPSY(S)
COLPOTOMY; WITH EXPLORATION
COLPOTOMY; WITH DRAINAGE OF PELVIC ABSCESS
COLPOCENTESIS (SEPARATE PROCEDURE)
INCISION AND DRAINAGE OF VAGINAL HEMATOMA; OBSTETRICAL/POSTPARTUM
INCISION AND DRAINAGE OF VAGINAL HEMATOMA; NON-OBSTETRICAL (EG, POST-TRAUMA, SPONTANEOUS BLEED
DESTRUCTION OF VAGINAL LESION(S); SIMPLE (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CHEM
DESTRUCTION OF VAGINAL LESION(S); EXTENSIVE (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, C
BIOPSY OF VAGINAL MUCOSA; SIMPLE (SEPARATE PROCEDURE)
BIOPSY OF VAGINAL MUCOSA; EXTENSIVE, REQUIRING SUTURE (INCLUDING CYSTS)
VAGINECTOMY, PARTIAL REMOVAL OF VAGINAL WALL
VAGINECTOMY, PARTIAL REMOVAL OF VAGINAL WALL; WITH REMOVAL OF PARAVAGINAL TISSUE (RADICAL VAGIN
VAGINECTOMY, PARTIAL REMOVAL OF VAGINAL WALL; WITH REMOVAL OF PARAVAGINAL TISSUE (RADICAL VAGIN
VAGINECTOMY, COMPLETE REMOVAL OF VAGINAL WALL
VAGINECTOMY, COMPLETE REMOVAL OF VAGINAL WALL; WITH REMOVAL OF PARAVAGINAL TISSUE (RADICAL VAG
VAGINECTOMY, COMPLETE REMOVAL OF VAGINAL WALL; WITH REMOVAL OF PARAVAGINAL TISSUE (RADICAL VAG
COLPOCLEISIS (LE FORT TYPE)
EXCISION OF VAGINAL SEPTUM
EXCISION OF VAGINAL CYST OR TUMOR
IRRIGATION OF VAGINA AND/OR APPLICATION OF MEDICAMENT FOR TREATMENT OF BACTERIAL, PARASITIC, OR
INSERTION OF UTERINE TANDEMS AND/OR VAGINAL OVOIDS FOR CLINICAL BRACHYTHERAPY
FITTING AND INSERTION OF PESSARY OR OTHER INTRAVAGINAL SUPPORT DEVICE
DIAPHRAGM OR CERVICAL CAP FITTING WITH INSTRUCTIONS
INTRODUCTION OF ANY HEMOSTATIC AGENT OR PACK FOR SPONTANEOUS OR TRAUMATIC NONOBSTETRICAL VA
COLPORRHAPHY, SUTURE OF INJURY OF VAGINA (NONOBSTETRICAL)
COLPOPERINEORRHAPHY, SUTURE OF INJURY OF VAGINA AND/OR PERINEUM (NONOBSTETRICAL)
PLASTIC OPERATION ON URETHRAL SPHINCTER, VAGINAL APPROACH (EG, KELLY URETHRAL PLICATION)
PLASTIC REPAIR OF URETHROCELE
ANTERIOR COLPORRHAPHY, REPAIR OF CYSTOCELE WITH OR WITHOUT REPAIR OF URETHROCELE
POSTERIOR COLPORRHAPHY, REPAIR OF RECTOCELE WITH OR WITHOUT PERINEORRHAPHY
COMBINED ANTEROPOSTERIOR COLPORRHAPHY;
COMBINED ANTEROPOSTERIOR COLPORRHAPHY; WITH ENTEROCELE REPAIR
REPAIR OF ENTEROCELE, VAGINAL APPROACH (SEPARATE PROCEDURE)
REPAIR OF ENTEROCELE, ABDOMINAL APPROACH (SEPARATE PROCEDURE)
COLPOPEXY, ABDOMINAL APPROACH
SACROSPINOUS LIGAMENT FIXATION FOR PROLAPSE OF VAGINA
PARAVAGINAL DEFECT REPAIR (INCLUDING REPAIR OF CYSTOCELE, STRESS URINARY INCONTINENCE, AND/OR IN
REMOVAL OR REVISION OF SLING FOR STRESS INCONTINENCE (EG, FASCIA OR SYNTHETIC)
SLING OPERATION FOR STRESS INCONTINENCE (EG, FASCIA OR SYNTHETIC)
PEREYRA PROCEDURE, INCLUDING ANTERIOR COLPORRHAPHY
CONSTRUCTION OF ARTIFICIAL VAGINA; WITHOUT GRAFT
CONSTRUCTION OF ARTIFICIAL VAGINA; WITH GRAFT
CLOSURE OF RECTOVAGINAL FISTULA; VAGINAL OR TRANSANAL APPROACH
CLOSURE OF RECTOVAGINAL FISTULA; ABDOMINAL APPROACH
CLOSURE OF RECTOVAGINAL FISTULA; ABDOMINAL APPROACH, WITH CONCOMITANT COLOSTOMY
CLOSURE OF RECTOVAGINAL FISTULA; TRANSPERINEAL APPROACH, WITH PERINEAL BODY RECONSTRUCTION, W
CLOSURE OF URETHROVAGINAL FISTULA;
CLOSURE OF URETHROVAGINAL FISTULA; WITH BULBOCAVERNOSUS TRANSPLANT
CLOSURE OF VESICOVAGINAL FISTULA; VAGINAL APPROACH
CLOSURE OF VESICOVAGINAL FISTULA; TRANSVESICAL AND VAGINAL APPROACH
VAGINOPLASTY FOR INTERSEX STATE
DILATION OF VAGINA UNDER ANESTHESIA
PELVIC EXAMINATION UNDER ANESTHESIA
REMOVAL OF IMPACTED VAGINAL FOREIGN BODY (SEPARATE PROCEDURE) UNDER ANESTHESIA
COLPOSCOPY OF THE ENTIRE VAGINA, WITH CERVIX IF PRESENT;
COLPOSCOPY OF THE ENTIRE VAGINA, WITH CERVIX IF PRESENT; WITH BIOPSY(S)
COLPOSCOPY OF THE CERVIX INCLUDING UPPER/ADJACENT VAGINA;
COLPOSCOPY OF THE CERVIX INCLUDING UPPER/ADJACENT VAGINA; WITH BIOPSY(S) OF THE CERVIX AND ENDO
COLPOSCOPY OF THE CERVIX INCLUDING UPPER/ADJACENT VAGINA; WITH BIOPSY(S) OF THE CERVIX
COLPOSCOPY OF THE CERVIX INCLUDING UPPER/ADJACENT VAGINA; WITH ENDOCERVICAL CURETTAGE
COLPOSCOPY OF THE CERVIX INCLUDING UPPER/ADJACENT VAGINA; WITH LOOP ELECTRODE BIOPSY(S) OF THE
COLPOSCOPY OF THE CERVIX INCLUDING UPPER/ADJACENT VAGINA; WITH LOOP ELECTRODE CONIZATION OF TH
BIOPSY, SINGLE OR MULTIPLE, OR LOCAL EXCISION OF LESION, WITH OR WITHOUT FULGURATION (SEPARATE PR
ENDOCERVICAL CURETTAGE (NOT DONE AS PART OF A DILATION AND CURETTAGE)
CAUTERY OF CERVIX; ELECTRO OR THERMAL
CAUTERY OF CERVIX; CRYOCAUTERY, INITIAL OR REPEAT
CAUTERY OF CERVIX; LASER ABLATION
CONIZATION OF CERVIX, WITH OR WITHOUT FULGURATION, WITH OR WITHOUT DILATION AND CURETTAGE, WITH
CONIZATION OF CERVIX, WITH OR WITHOUT FULGURATION, WITH OR WITHOUT DILATION AND CURETTAGE, WITH
TRACHELECTOMY (CERVICECTOMY), AMPUTATION OF CERVIX (SEPARATE PROCEDURE)
RADICAL TRACHELECTOMY, WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PARA-AORTIC LYMPH NOD
EXCISION OF CERVICAL STUMP, ABDOMINAL APPROACH;
EXCISION OF CERVICAL STUMP, ABDOMINAL APPROACH; WITH PELVIC FLOOR REPAIR
EXCISION OF CERVICAL STUMP, VAGINAL APPROACH;
EXCISION OF CERVICAL STUMP, VAGINAL APPROACH; WITH ANTERIOR AND/OR POSTERIOR REPAIR
EXCISION OF CERVICAL STUMP, VAGINAL APPROACH; WITH REPAIR OF ENTEROCELE
CERCLAGE OF UTERINE CERVIX, NONOBSTETRICAL
TRACHELORRHAPHY, PLASTIC REPAIR OF UTERINE CERVIX, VAGINAL APPROACH
DILATION OF CERVICAL CANAL, INSTRUMENTAL (SEPARATE PROCEDURE)
DILATION AND CURETTAGE OF CERVICAL STUMP
ENDOMETRIAL SAMPLING (BIOPSY) WITH OR WITHOUT ENDOCERVICAL SAMPLING (BIOPSY), WITHOUT CERVICAL
DILATION AND CURETTAGE, DIAGNOSTIC AND/OR THERAPEUTIC (NONOBSTETRICAL)
MYOMECTOMY, EXCISION OF FIBROID TUMOR(S) OF UTERUS, 1 TO 4 INTRAMURAL MYOMA(S) WITH TOTAL WEIGH
MYOMECTOMY, EXCISION OF FIBROID TUMOR(S) OF UTERUS, 1 TO 4 INTRAMURAL MYOMA(S) WITH TOTAL WEIGH
MYOMECTOMY, EXCISION OF FIBROID TUMOR(S) OF UTERUS, 5 OR MORE INTRAMURAL MYOMAS AND/OR INTRAM
TOTAL ABDOMINAL HYSTERECTOMY (CORPUS AND CERVIX), WITH OR WITHOUT REMOVAL OF TUBE(S), WITH OR
TOTAL ABDOMINAL HYSTERECTOMY (CORPUS AND CERVIX), WITH OR WITHOUT REMOVAL OF TUBE(S), WITH OR
SUPRACERVICAL ABDOMINAL HYSTERECTOMY (SUBTOTAL HYSTERECTOMY), WITH OR WITHOUT REMOVAL OF TU
TOTAL ABDOMINAL HYSTERECTOMY, INCLUDING PARTIAL VAGINECTOMY, WITH PARA-AORTIC AND PELVIC LYMPH
RADICAL ABDOMINAL HYSTERECTOMY, WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PARA-AORTIC
PELVIC EXENTERATION FOR GYNECOLOGIC MALIGNANCY, WITH TOTAL ABDOMINAL HYSTERECTOMY OR CERVIC
VAGINAL HYSTERECTOMY, FOR UTERUS 250 GRAMS OR LESS;
VAGINAL HYSTERECTOMY, FOR UTERUS 250 GRAMS OR LESS; WITH REMOVAL OF TUBE(S), AND/OR OVARY(S)
VAGINAL HYSTERECTOMY, FOR UTERUS 250 GRAMS OR LESS; WITH REMOVAL OF TUBE(S), AND/OR OVARY(S), W
VAGINAL HYSTERECTOMY, FOR UTERUS 250 GRAMS OR LESS; WITH COLPO-URETHROCYSTOPEXY (MARSHALL-M
VAGINAL HYSTERECTOMY, FOR UTERUS 250 GRAMS OR LESS; WITH REPAIR OF ENTEROCELE
VAGINAL HYSTERECTOMY, WITH TOTAL OR PARTIAL VAGINECTOMY;
VAGINAL HYSTERECTOMY, WITH TOTAL OR PARTIAL VAGINECTOMY; WITH REPAIR OF ENTEROCELE
VAGINAL HYSTERECTOMY, RADICAL (SCHAUTA TYPE OPERATION)
VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS;
VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS; WITH REMOVAL OF TUBE(S) AND/OR OVARY
VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS; WITH REMOVAL OF TUBE(S) AND/OR OVARY
VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS; WITH COLPO-URETHROCYSTOPEXY (MARS
VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS; WITH REPAIR OF ENTEROCELE
INSERTION OF INTRAUTERINE DEVICE (IUD)
REMOVAL OF INTRAUTERINE DEVICE (IUD)
ARTIFICIAL INSEMINATION; INTRA-CERVICAL
ARTIFICIAL INSEMINATION; INTRA-UTERINE
SPERM WASHING FOR ARTIFICIAL INSEMINATION
INJECTION PROCEDURE FOR HYSTEROSALPINGOGRAPHY
TRANSCERVICAL INTRODUCTION OF FALLOPIAN TUBE CATHETER FOR DIAGNOSIS AND/OR RE-ESTABLISHING PAT
INSERTION OF HEYMAN CAPSULES FOR CLINICAL BRACHYTHERAPY
CHROMOTUBATION OF OVIDUCT, INCLUDING MATERIALS
ENDOMETRIAL ABLATION, THERMAL, WITHOUT HYSTEROSCOPIC GUIDANCE
UTERINE SUSPENSION, WITH OR WITHOUT SHORTENING OF ROUND LIGAMENTS, WITH OR WITHOUT SHORTENIN
UTERINE SUSPENSION, WITH OR WITHOUT SHORTENING OF ROUND LIGAMENTS, WITH OR WITHOUT SHORTENIN
HYSTERORRHAPHY, REPAIR OF RUPTURED UTERUS (NONOBSTETRICAL)
HYSTEROPLASTY, REPAIR OF UTERINE ANOMALY (STRASSMAN TYPE)
LAPAROSCOPY, SURGICAL, MYOMECTOMY, EXCISION; 1 TO 4 INTRAMURAL MYOMAS WITH TOTAL WEIGHT OF 250
LAPAROSCOPY, SURGICAL, MYOMECTOMY, EXCISION; 5 OR MORE INTRAMURAL MYOMAS AND/OR INTRAMURAL M
LAPAROSCOPY SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS 250 GRAMS OR LESS;
LAPAROSCOPY SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS 250 GRAMS OR LESS; WITH REMOVAL O
LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS;
LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS; WITH REM
HYSTEROSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE)
HYSTEROSCOPY, SURGICAL; WITH SAMPLING (BIOPSY) OF ENDOMETRIUM AND/OR POLYPECTOMY, WITH OR WIT
HYSTEROSCOPY, SURGICAL; WITH LYSIS OF INTRAUTERINE ADHESIONS (ANY METHOD)
HYSTEROSCOPY, SURGICAL; WITH DIVISION OR RESECTION OF INTRAUTERINE SEPTUM (ANY METHOD)
HYSTEROSCOPY, SURGICAL; WITH REMOVAL OF LEIOMYOMATA
HYSTEROSCOPY, SURGICAL; WITH REMOVAL OF IMPACTED FOREIGN BODY
HYSTEROSCOPY, SURGICAL; WITH ENDOMETRIAL ABLATION (EG, ENDOMETRIAL RESECTION, ELECTROSURGICAL
UNLISTED LAPAROSCOPY PROCEDURE, UTERUS
UNLISTED HYSTEROSCOPY PROCEDURE, UTERUS
LIGATION OR TRANSECTION OF FALLOPIAN TUBE(S), ABDOMINAL OR VAGINAL APPROACH, UNILATERAL OR BILAT
LIGATION OR TRANSECTION OF FALLOPIAN TUBE(S), ABDOMINAL OR VAGINAL APPROACH, POSTPARTUM, UNILAT
LIGATION OR TRANSECTION OF FALLOPIAN TUBE(S) WHEN DONE AT THE TIME OF CESAREAN DELIVERY OR INTRA
OCCLUSION OF FALLOPIAN TUBE(S) BY DEVICE (EG, BAND, CLIP, FALOPE RING) VAGINAL OR SUPRAPUBIC APPRO
LAPAROSCOPY, SURGICAL; WITH LYSIS OF ADHESIONS (SALPINGOLYSIS, OVARIOLYSIS) (SEPARATE PROCEDURE
LAPAROSCOPY, SURGICAL; WITH REMOVAL OF ADNEXAL STRUCTURES (PARTIAL OR TOTAL OOPHORECTOMY AN
LAPAROSCOPY, SURGICAL; WITH FULGURATION OR EXCISION OF LESIONS OF THE OVARY, PELVIC VISCERA, OR P
LAPAROSCOPY, SURGICAL; WITH FULGURATION OF OVIDUCTS (WITH OR WITHOUT TRANSECTION)
LAPAROSCOPY, SURGICAL; WITH OCCLUSION OF OVIDUCTS BY DEVICE (EG, BAND, CLIP, OR FALOPE RING)
LAPAROSCOPY, SURGICAL; WITH FIMBRIOPLASTY
LAPAROSCOPY, SURGICAL; WITH SALPINGOSTOMY (SALPINGONEOSTOMY)
UNLISTED LAPAROSCOPY PROCEDURE, OVIDUCT, OVARY
SALPINGECTOMY, COMPLETE OR PARTIAL, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE)
SALPINGO-OOPHORECTOMY, COMPLETE OR PARTIAL, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE)
LYSIS OF ADHESIONS (SALPINGOLYSIS, OVARIOLYSIS)
TUBOTUBAL ANASTOMOSIS
TUBOUTERINE IMPLANTATION
FIMBRIOPLASTY
SALPINGOSTOMY (SALPINGONEOSTOMY)
DRAINAGE OF OVARIAN CYST(S), UNILATERAL OR BILATERAL, (SEPARATE PROCEDURE); VAGINAL APPROACH
DRAINAGE OF OVARIAN CYST(S), UNILATERAL OR BILATERAL, (SEPARATE PROCEDURE); ABDOMINAL APPROACH
DRAINAGE OF OVARIAN ABSCESS; VAGINAL APPROACH
DRAINAGE OF OVARIAN ABSCESS; ABDOMINAL APPROACH
DRAINAGE OF PELVIC ABSCESS, TRANSVAGINAL OR TRANSRECTAL APPROACH, PERCUTANEOUS (EG, OVARIAN,
TRANSPOSITION, OVARY(S)
BIOPSY OF OVARY, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE)
WEDGE RESECTION OR BISECTION OF OVARY, UNILATERAL OR BILATERAL
OVARIAN CYSTECTOMY, UNILATERAL OR BILATERAL
OOPHORECTOMY, PARTIAL OR TOTAL, UNILATERAL OR BILATERAL;
OOPHORECT, PRTL OR TTL, UNILAT OR BIL; FOR OVAR, TUBAL OR PRIM PERITON MALIG, W PARA-AORT & PELV LY
RESECTION OF OVARIAN, TUBAL OR PRIMARY PERITONEAL MALIGNANCY WITH BILATERAL SALPINGO-OOPHOREC
RESECTION OF OVARIAN, TUBAL OR PRIMARY PERITONEAL MALIGNANCY WITH BILATERAL SALPINGO-OOPHOREC
RESECTION OF OVARIAN, TUBAL OR PRIMARY PERITONEAL MALIGNANCY WITH BSO AND OMENTECT; WITH RADIC
BILATERAL SALPINGO-OOPHORECTOMY WITH OMENTECTOMY, TOTAL ABDOMINAL HYSTERECTOMY AND RADICA
BILATERAL SALPINGO-OOPHORECTOMY WITH OMENTECTOMY, TOTAL ABDOMINAL HYSTERECTOMY AND RADICA
LAPAROT, FOR STAGING/RESTAG OF OVARIAN, TUBAL/PRIMARY PERITON MALIG (SECOND LOOK), W/W/O OMENTC
FOLLICLE PUNCTURE FOR OOCYTE RETRIEVAL, ANY METHOD
EMBRYO TRANSFER, INTRAUTERINE
GAMETE, ZYGOTE, OR EMBRYO INTRAFALLOPIAN TRANSFER, ANY METHOD
UNLISTED PROCEDURE, FEMALE GENITAL SYSTEM (NONOBSTETRICAL)
AMNIOCENTESIS; DIAGNOSTIC
AMNIOCENTESIS; THERAPEUTIC AMNIOTIC FLUID REDUCTION (INCLUDES ULTRASOUND GUIDANCE)
CORDOCENTESIS (INTRAUTERINE), ANY METHOD
CHORIONIC VILLUS SAMPLING, ANY METHOD
FETAL CONTRACTION STRESS TEST
FETAL NON-STRESS TEST
FETAL SCALP BLOOD SAMPLING
FETAL MONITORING DURING LABOR BY CONSULTING PHYSICIAN (IE, NON-ATTENDING PHYSICIAN) WITH WRITTEN
FETAL MONITORING DURING LABOR BY CONSULTING PHYSICIAN (IE, NON-ATTENDING PHYSICIAN) WITH WRITTEN
HYSTEROTOMY, ABDOMINAL (EG, FOR HYDATIDIFORM MOLE, ABORTION)
SURGICAL TREATMENT OF ECTOPIC PREGNANCY; TUBAL OR OVARIAN, REQUIRING SALPINGECTOMY AND/OR OO
SURGICAL TREATMENT OF ECTOPIC PREGNANCY; TUBAL OR OVARIAN, WITHOUT SALPINGECTOMY AND/OR OOPH
SURGICAL TREATMENT OF ECTOPIC PREGNANCY; ABDOMINAL PREGNANCY
SURGICAL TREATMENT OF ECTOPIC PREGNANCY; INTERSTITIAL, UTERINE PREGNANCY REQUIRING TOTAL HYSTE
SURGICAL TREATMENT OF ECTOPIC PREGNANCY; INTERSTITIAL, UTERINE PREGNANCY WITH PARTIAL RESECTIO
SURGICAL TREATMENT OF ECTOPIC PREGNANCY; CERVICAL, WITH EVACUATION
LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNANCY; WITHOUT SALPINGECTOMY AND/OR OOPHORECTOMY
LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNANCY; WITH SALPINGECTOMY AND/OR OOPHORECTOMY
CURRETTAGE, POSTPARTUM
INSERTION OF CERVICAL DILATOR (EG, LAMINARIA, PROSTAGLANDIN) (SEPARATE PROCEDURE)
EPISIOTOMY OR VAGINAL REPAIR, BY OTHER THAN ATTENDING PHYSICIAN
CERCLAGE OF CERVIX, DURING PREGNANCY; VAGINAL
CERCLAGE OF CERVIX, DURING PREGNANCY; ABDOMINAL
HYSTERORRHAPHY OF RUPTURED UTERUS
ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM CARE, VAGINAL DELIVERY (WITH OR WITHOUT EPISIOTOMY
VAGINAL DELIVERY ONLY (WITH OR WITHOUT EPISIOTOMY AND/OR FORCEPS);
VAGINAL DELIVERY ONLY (WITH OR WITHOUT EPISIOTOMY AND/OR FORCEPS); INCLUDING POSTPARTUM CARE
EXTERNAL CEPHALIC VERSION, WITH OR WITHOUT TOCOLYSIS
DELIVERY OF PLACENTA (SEPARATE PROCEDURE)
ANTEPARTUM CARE ONLY; 4-6 VISITS
ANTEPARTUM CARE ONLY; 7 OR MORE VISITS
POSTPARTUM CARE ONLY (SEPARATE PROCEDURE)
ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM CARE, CESAREAN DELIVERY, AND POSTPARTUM CARE
CESAREAN DELIVERY ONLY;
CESAREAN DELIVERY ONLY; INCLUDING POSTPARTUM CARE
SUBTOTAL OR TOTAL HYSTERECTOMY AFTER CESAREAN DELIVERY (LIST SEPARATELY IN ADDITION TO CODE FO
ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM CARE, VAGINAL DELIVERY (WITH OR WITHOUT EPISIOTOMY
VAGINAL DELIVERY ONLY, AFTER PREVIOUS CESAREAN DELIVERY (WITH OR WITHOUT EPISIOTOMY AND/OR FOR
VAGINAL DELIVERY ONLY, AFTER PREVIOUS CESAREAN DELIVERY (WITH OR WITHOUT EPISIOTOMY AND/OR FOR
ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM CARE, CESAREAN DELIVERY, AND POSTPARTUM CARE, FOL
CESAREAN DELIVERY ONLY, FOLLOWING ATTEMPTED VAGINAL DELIVERY AFTER PREVIOUS CESAREAN DELIVERY
CESAREAN DELIVERY ONLY, FOLLOWING ATTEMPTED VAGINAL DELIVERY AFTER PREVIOUS CESAREAN DELIVERY
TREATMENT OF INCOMPLETE ABORTION, ANY TRIMESTER, COMPLETED SURGICALLY
TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FIRST TRIMESTER
TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; SECOND TRIMESTER
TREATMENT OF SEPTIC ABORTION, COMPLETED SURGICALLY
INDUCED ABORTION, BY DILATION AND CURETTAGE
INDUCED ABORTION, BY DILATION AND EVACUATION
INDUCED ABORTION, BY ONE OR MORE INTRA-AMNIOTIC INJECTIONS (AMNIOCENTESIS-INJECTIONS), INC HOSP A
INDUCED ABORTION, BY ONE OR MORE INTRA-AMNIOTIC INJECTIONS (AMNIOCENTESIS-INJECTIONS), INC HOSP A
INDUCED ABORTION, BY ONE OR MORE INTRA-AMNIOTIC INJECTIONS (AMNIOCENTESIS-INJECTIONS), INC HOSP A
INDUCED ABORTION, BY ONE OR MORE VAGINAL SUPPOSITORIES (EG, PROSTAGLANDIN) W W/O CERVICAL DILAT
INDUCED ABORTION, BY ONE OR MORE VAGINAL SUPPOSITORIES (EG, PROSTAGLANDIN) W W/O CERVICAL DILAT
INDUCED ABORTION, BY ONE OR MORE VAGINAL SUPPOSITORIES (EG, PROSTAGLANDIN) W W/O CERVICAL DILAT
MULTIFETAL PREGNANCY REDUCTION(S) (MPR)
UTERINE EVACUATION AND CURETTAGE FOR HYDATIDIFORM MOLE
REMOVAL OF CERCLAGE SUTURE UNDER ANESTHESIA (OTHER THAN LOCAL)
UNLISTED LAPAROSCOPY PROCEDURE, MATERNITY CARE AND DELIVERY
UNLISTED PROCEDURE, MATERNITY CARE AND DELIVERY
INCISION AND DRAINAGE OF THYROGLOSSAL DUCT CYST, INFECTED
ASPIRATION AND/OR INJECTION, THYROID CYST
BIOPSY THYROID, PERCUTANEOUS CORE NEEDLE
EXCISION OF CYST OR ADENOMA OF THYROID, OR TRANSECTION OF ISTHMUS
PARTIAL THYROID LOBECTOMY, UNILATERAL; WITH OR WITHOUT ISTHMUSECTOMY
PARTIAL THYROID LOBECTOMY, UNILATERAL; WITH CONTRALATERAL SUBTOTAL LOBECTOMY, INCLUDING ISTHM
TOTAL THYROID LOBECTOMY, UNILATERAL; WITH OR WITHOUT ISTHMUSECTOMY
TOTAL THYROID LOBECTOMY, UNILATERAL; WITH CONTRALATERAL SUBTOTAL LOBECTOMY, INCLUDING ISTHMUS
THYROIDECTOMY, TOTAL OR COMPLETE
THYROIDECTOMY, TOTAL OR SUBTOTAL FOR MALIGNANCY; WITH LIMITED NECK DISSECTION
THYROIDECTOMY, TOTAL OR SUBTOTAL FOR MALIGNANCY; WITH RADICAL NECK DISSECTION
THYROIDECTOMY, REMOVAL OF ALL REMAINING THYROID TISSUE FOLLOWING PREVIOUS REMOVAL OF A PORTIO
THYROIDECTOMY, INCLUDING SUBSTERNAL THYROID; STERNAL SPLIT OR TRANSTHORACIC APPROACH
THYROIDECTOMY, INCLUDING SUBSTERNAL THYROID; CERVICAL APPROACH
EXCISION OF THYROGLOSSAL DUCT CYST OR SINUS;
EXCISION OF THYROGLOSSAL DUCT CYST OR SINUS; RECURRENT
PARATHYROIDECTOMY OR EXPLORATION OF PARATHYROID(S);
PARATHYROIDECTOMY OR EXPLORATION OF PARATHYROID(S); RE-EXPLORATION
PARATHYROIDECTOMY OR EXPLORATION OF PARATHYROID(S); WITH MEDIASTINAL EXPLORATION, STERNAL SPL
PARATHYROID AUTOTRANSPLANTATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
THYMECTOMY, PARTIAL OR TOTAL; TRANSCERVICAL APPROACH (SEPARATE PROCEDURE)
THYMECTOMY, PARTIAL OR TOTAL; STERNAL SPLIT OR TRANSTHORACIC APPROACH, WITHOUT RADICAL MEDIAS
THYMECTOMY, PARTIAL OR TOTAL; STERNAL SPLIT OR TRANSTHORACIC APPROACH, WITH RADICAL MEDIASTINA
ADRENALECTOMY, PARTIAL OR COMPLETE, OR EXPLORATION OF ADRENAL GLAND WITH OR WITHOUT BIOPSY, T
ADRENALECTOMY, PARTIAL OR COMPLETE, OR EXPLORATION OF ADRENAL GLAND WITH OR WITHOUT BIOPSY, T
EXCISION OF CAROTID BODY TUMOR; WITHOUT EXCISION OF CAROTID ARTERY
EXCISION OF CAROTID BODY TUMOR; WITH EXCISION OF CAROTID ARTERY
LAPAROSCOPY, SURGICAL, WITH ADRENALECTOMY, PARTIAL OR COMPLETE, OR EXPLORATION OF ADRENAL GLA
UNLISTED LAPAROSCOPY PROCEDURE, ENDOCRINE SYSTEM
UNLISTED PROCEDURE, ENDOCRINE SYSTEM
SUBDURAL TAP THROUGH FONTANELLE, OR SUTURE, INFANT, UNILATERAL OR BILATERAL; INITIAL
SUBDURAL TAP THROUGH FONTANELLE, OR SUTURE, INFANT, UNILATERAL OR BILATERAL; SUBSEQUENT TAPS
VENTRICULAR PUNCTURE THROUGH PREVIOUS BURR HOLE, FONTANELLE, SUTURE, OR IMPLANTED VENTRICULA
VENTRICULAR PUNCTURE THROUGH PREVIOUS BURR HOLE, FONTANELLE, SUTURE, OR IMPLANTED VENTRICULA
CISTERNAL OR LATERAL CERVICAL (C1-C2) PUNCTURE; WITHOUT INJECTION (SEPARATE PROCEDURE)
CISTERNAL OR LATERAL CERVICAL (C1-C2) PUNCTURE; WITH INJECTION OF MEDICATION OR OTHER SUBSTANCE
PUNCTURE OF SHUNT TUBING OR RESERVOIR FOR ASPIRATION OR INJECTION PROCEDURE
TWIST DRILL HOLE FOR SUBDURAL OR VENTRICULAR PUNCTURE
TWIST DRILL HOLE FOR SUBDURAL OR VENTRICULAR PUNCTURE; FOR IMPLANTING VENTRICULAR CATHETER OR
TWIST DRILL HOLE FOR SUBDURAL OR VENTRICULAR PUNCTURE; FOR EVACUATION AND/OR DRAINAGE OF SUBD
BURR HOLE(S) FOR VENTRICULAR PUNCTURE (INCLUDING INJECTION OF GAS, CONTRAST MEDIA, DYE, OR RADIO
BURR HOLE(S) OR TREPHINE; WITH BIOPSY OF BRAIN OR INTRACRANIAL LESION
BURR HOLE(S) OR TREPHINE; WITH DRAINAGE OF BRAIN ABSCESS OR CYST
BURR HOLE(S) OR TREPHINE; WITH SUBSEQUENT TAPPING (ASPIRATION) OF INTRACRANIAL ABSCESS OR CYST
BURR HOLE(S) WITH EVACUATION AND/OR DRAINAGE OF HEMATOMA, EXTRADURAL OR SUBDURAL
BURR HOLE(S); WITH ASPIRATION OF HEMATOMA OR CYST, INTRACEREBRAL
BURR HOLE(S); FOR IMPLANTING VENTRICULAR CATHETER, RESERVOIR, EEG ELECTRODE(S) OR PRESSURE REC
INSERTION OF SUBCUTANEOUS RESERVOIR, PUMP OR CONTINUOUS INFUSION SYSTEM FOR CONNECTION TO VE
BURR HOLE(S) OR TREPHINE, SUPRATENTORIAL, EXPLORATORY, NOT FOLLOWED BY OTHER SURGERY
BURR HOLE(S) OR TREPHINE, INFRATENTORIAL, UNILATERAL OR BILATERAL
CRANIECTOMY OR CRANIOTOMY, EXPLORATORY; SUPRATENTORIAL
CRANIECTOMY OR CRANIOTOMY, EXPLORATORY; INFRATENTORIAL (POSTERIOR FOSSA)
CRANIECTOMY OR CRANIOTOMY FOR EVACUATION OF HEMATOMA, SUPRATENTORIAL; EXTRADURAL OR SUBDUR
CRANIECTOMY OR CRANIOTOMY FOR EVACUATION OF HEMATOMA, SUPRATENTORIAL; INTRACEREBRAL
CRANIECTOMY OR CRANIOTOMY FOR EVACUATION OF HEMATOMA, INFRATENTORIAL; EXTRADURAL OR SUBDUR
CRANIECTOMY OR CRANIOTOMY FOR EVACUATION OF HEMATOMA, INFRATENTORIAL; INTRACEREBELLAR
INCISION AND SUBCUTANEOUS PLACEMENT OF CRANIAL BONE GRAFT (LIST SEPARATELY IN ADDITION TO CODE
CRANIECTOMY OR CRANIOTOMY, DRAINAGE OF INTRACRANIAL ABSCESS; SUPRATENTORIAL
CRANIECTOMY OR CRANIOTOMY, DRAINAGE OF INTRACRANIAL ABSCESS; INFRATENTORIAL
CRANIECTOMY/CRANIOTOMY, DECOMPRESSIVE, WITH/WITHOUT DURAPLASTY, FOR TREATMENT, INTRACRANIAL
CRANIECTOMY OR CRANIOTOMY, DECOMPRESSIVE, WITH OR WITHOUT DURAPLASTY, FOR TREATMENT OF INTR
DECOMPRESSION OF ORBIT ONLY, TRANSCRANIAL APPROACH
EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH); WITH BIOPSY
EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH); WITH REMOVAL OF LESION
EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH); WITH REMOVAL OF FOREIGN BODY
SUBTEMPORAL CRANIAL DECOMPRESSION (PSEUDOTUMOR CEREBRI, SLIT VENTRICLE SYNDROME)
CRANIECTOMY, SUBOCCIPITAL WITH CERVICAL LAMINECTOMY FOR DECOMPRESSION OF MEDULLA AND SPINAL C
OTHER CRANIAL DECOMPRESSION, POSTERIOR FOSSA
CRANIOTOMY FOR SECTION OF TENTORIUM CEREBELLI (SEPARATE PROCEDURE)
CRANIECTOMY, SUBTEMPORAL, FOR SECTION, COMPRESSION, OR DECOMPRESSION OF SENSORY ROOT OF GAS
CRANIECTOMY, SUBOCCIPITAL; FOR EXPLORATION OR DECOMPRESSION OF CRANIAL NERVES
CRANIECTOMY, SUBOCCIPITAL; FOR SECTION OF ONE OR MORE CRANIAL NERVES
CRANIECTOMY, SUBOCCIPITAL; FOR MEDULLARY TRACTOTOMY
CRANIECTOMY, SUBOCCIPITAL; FOR MESENCEPHALIC TRACTOTOMY OR PEDUNCULOTOMY
CRANIOTOMY FOR LOBOTOMY, INCLUDING CINGULOTOMY
CRANIECTOMY; WITH EXCISION OF TUMOR OR OTHER BONE LESION OF SKULL
CRANIECTOMY; FOR OSTEOMYELITIS
CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY; FOR EXCISION OF BRAIN TUMOR, SUPRATENTORIAL, E
CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY; FOR EXCISION OF MENINGIOMA, SUPRATENTORIAL
CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY; FOR EXCISION OF BRAIN ABSCESS, SUPRATENTORIAL
CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY; FOR EXCISION OR FENESTRATION OF CYST, SUPRATE
IMPLANTATION OF BRAIN INTRACAVITARY CHEMOTHERAPY AGENT (LIST SEPARATELY IN ADDITION TO CODE FOR
CRANIECTOMY FOR EXCISION OF BRAIN TUMOR, INFRATENTORIAL OR POSTERIOR FOSSA; EXCEPT MENINGIOMA
CRANIECTOMY FOR EXCISION OF BRAIN TUMOR, INFRATENTORIAL OR POSTERIOR FOSSA; MENINGIOMA
CRANIECTOMY FOR EXCISION OF BRAIN TUMOR, INFRATENTORIAL OR POSTERIOR FOSSA; CEREBELLOPONTINE
CRANIECTOMY FOR EXCISION OF BRAIN TUMOR, INFRATENTORIAL OR POSTERIOR FOSSA; MIDLINE TUMOR AT BA
CRANIECTOMY, INFRATENTORIAL OR POSTERIOR FOSSA; FOR EXCISION OF BRAIN ABSCESS
CRANIECTOMY, INFRATENTORIAL OR POSTERIOR FOSSA; FOR EXCISION OR FENESTRATION OF CYST
CRANIECTOMY, BONE FLAP CRANIOTOMY, TRANSTEMPORAL (MASTOID) FOR EXCISION OF CEREBELLOPONTINE A
CRANIECTOMY, BONE FLAP CRANIOTOMY, TRANSTEMPORAL (MASTOID) FOR EXCISION OF CEREBELLOPONTINE A
SUBDURAL IMPLANTATION OF STRIP ELECTRODES THROUGH ONE OR MORE BURR OR TREPHINE HOLE(S) FOR LO
CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR SUBDURAL IMPLANTATION OF AN ELECTRODE ARRAY, FOR L
CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR EXCISION OF EPILEPTOGENIC FOCUS WITHOUT ELECTROCO
CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR REMOVAL OF EPIDURAL OR SUBDURAL ELECTRODE ARRAY,
CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR EXCISION OF CEREBRAL EPILEPTOGENIC FOCUS, WITH ELEC
CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR LOBECTOMY WITH ELECTROCORTICOGRAPHY DURING SURG
CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR LOBECTOMY WITH ELECTROCORTICOGRAPHY DURING SURG
CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR TRANSECTION OF CORPUS CALLOSUM
CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR TOTAL HEMISPHERECTOMY
CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR PARTIAL OR SUBTOTAL HEMISPHERECTOMY
CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR EXCISION OR COAGULATION OF CHOROID PLEXUS
CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR EXCISION OF CRANIOPHARYNGIOMA
CRANIOTOMY FOR HYPOPHYSECTOMY OR EXCISION OF PITUITARY TUMOR, INTRACRANIAL APPROACH
HYPOPHYSECTOMY OR EXCISION OF PITUITARY TUMOR, TRANSNASAL OR TRANSSEPTAL APPROACH, NONSTERE
CRANIECTOMY FOR CRANIOSYNOSTOSIS; SINGLE CRANIAL SUTURE
CRANIECTOMY FOR CRANIOSYNOSTOSIS; MULTIPLE CRANIAL SUTURES
CRANIOTOMY FOR CRANIOSYNOSTOSIS; FRONTAL OR PARIETAL BONE FLAP
CRANIOTOMY FOR CRANIOSYNOSTOSIS; BIFRONTAL BONE FLAP
EXTENSIVE CRANIECTOMY FOR MULTIPLE CRANIAL SUTURE CRANIOSYNOSTOSIS (EG, CLOVERLEAF SKULL); NOT
EXTENSIVE CRANIECTOMY FOR MULTIPLE CRANIAL SUTURE CRANIOSYNOSTOSIS (EG, CLOVERLEAF SKULL); REC
EXCISION, INTRA AND EXTRACRANIAL, BENIGN TUMOR OF CRANIAL BONE (EG, FIBROUS DYSPLASIA); WITHOUT O
EXCISION, INTRA AND EXTRACRANIAL, BENIGN TUMOR OF CRANIAL BONE (EG, FIBROUS DYSPLASIA); WITH OPTIC
CRANIECTOMY OR CRANIOTOMY; WITH EXCISION OF FOREIGN BODY FROM BRAIN
CRANIECTOMY OR CRANIOTOMY; WITH TREATMENT OF PENETRATING WOUND OF BRAIN
TRANSORAL APPROACH TO SKULL BASE, BRAIN STEM OR UPPER SPINAL CORD FOR BIOPSY, DECOMPRESSION O
TRANSORAL APPROACH TO SKULL BASE, BRAIN STEM OR UPPER SPINAL CORD FOR BIOPSY, DECOMPRESSION O
CRANIOFACIAL APPROACH TO ANTERIOR CRANIAL FOSSA; EXTRADURAL, INCLUDING LATERAL RHINOTOMY, ETHM
CRANIOFACIAL APPROACH TO ANTERIOR CRANIAL FOSSA; EXTRADURAL, INCLUDING LATERAL RHINOTOMY, ORB
CRANIOFACIAL APPROACH TO ANTERIOR CRANIAL FOSSA; EXTRADURAL, INCLUDING UNILATERAL OR BIFRONTAL
CRANIOFACIAL APPROACH TO ANTERIOR CRANIAL FOSSA; INTRADURAL, INCLUDING UNILATERAL OR BIFRONTAL
ORBITOCRANIAL APPROACH TO ANTERIOR CRANIAL FOSSA, EXTRADURAL, INCLUDING SUPRAORBITAL RIDGE OS
ORBITOCRANIAL APPROACH TO ANTERIOR CRANIAL FOSSA, EXTRADURAL, INCLUDING SUPRAORBITAL RIDGE OS
BICORONAL, TRANSZYGOMATIC AND/OR LEFORT I OSTEOTOMY APPROACH TO ANTERIOR CRANIAL FOSSA WITH
INFRATEMPORAL PRE-AURICULAR APPROACH TO MID CRANIAL FOSSA (PARAPHARYNGEAL SPACE, INFRATEMPOR
INFRATEMPORAL POST-AURICULAR APPROACH TO MID CRANIAL FOSSA (INTERNAL AUDITORY MEATUS, PETROUS
ORBITOCRANIAL ZYGOMATIC APPROACH TO MIDDLE CRANIAL FOSSA (CAVERNOUS SINUS & CAROTID ARTERY, B
TRANSTEMPORAL APPROACH TO POSTERIOR CRANIAL FOSSA, JUGULAR FORAMEN OR MIDLINE SKULL BASE, INC
TRANSCOCHLEAR APPROACH TO POSTERIOR CRANIAL FOSSA, JUGULAR FORAMEN OR MIDLINE SKULL BASE, INC
TRANSCONDYLAR (FAR LATERAL) APPROACH TO POSTERIOR CRANIAL FOSSA, JUGULAR FORAMEN OR MIDLINE S
TRANSPETROSAL APPROACH TO POSTERIOR CRANIAL FOSSA, CLIVUS OR FORAMEN MAGNUM, INCLUDING LIGAT
RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF BASE OF ANTERIOR CRANIAL F
RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF BASE OF ANTERIOR CRANIAL F
RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF INFRATEMPORAL FOSSA, PARA
RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF INFRATEMPORAL FOSSA, PARA
RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF PARASELLAR AREA, CAVERNO
RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF PARASELLAR AREA, CAVERNO
TRANSECTION OR LIGATION, CAROTID ARTERY IN CAVERNOUS SINUS; WITHOUT REPAIR (LIST SEPARATELY IN AD
TRANSECTION OR LIGATION, CAROTID ARTERY IN CAVERNOUS SINUS; WITH REPAIR BY ANASTOMOSIS OR GRAFT
TRANSECTION OR LIGATION, CAROTID ARTERY IN PETROUS CANAL; WITHOUT REPAIR (LIST SEPARATELY IN ADD
TRANSECTION OR LIGATION, CAROTID ARTERY IN PETROUS CANAL; WITH REPAIR BY ANASTOMOSIS OR GRAFT (L
OBLITERATION OF CAROTID ANEURYSM, ARTERIOVENOUS MALFORMATION, OR CAROTID-CAVERNOUS FISTULA B
RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR/INFECTIOUS LESION BASE OF POSTERIOR CRANIAL FOSSA
RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR/INFECTIOUS LESION BASE OF POSTERIOR CRANIAL FOSSA
SECONDARY REPAIR,DURA,CEREBROSPINAL FLD LEAK,ANT,MIDDLE/POST CRANIAL FOSSA FOLL SURG,THE SKUL
SECONDARY REPR,A,CEREBROSPINAL FLD LEAK,ANT,MIDDLE/PST CRANIAL FOSSA FOLL SURG,THE SKULL BASE;L
ENDO TEMP BALOON ART OCLSIN,HED/NCK INCLUD SLCT CATH VESEL OCLDED,POSIT & INFLT OCLSIN,CNCMIT NE
TRANSCATHETER PERMANENT OCCLUSION OR EMBOLIZATION (EG, FOR TUMOR DESTRUCTION, TO ACHIEVE HEM
TRANSCATH PERM OCCLUSION/EMBOLIZATION (EG,, TUMR DESTRUCT, ACHIEVE HEMOSTA, OCCLUDEVASCMALFO
SURGERY OF INTRACRANIAL ARTERIOVENOUS MALFORMATION; SUPRATENTORIAL, SIMPLE
SURGERY OF INTRACRANIAL ARTERIOVENOUS MALFORMATION; SUPRATENTORIAL, COMPLEX
SURGERY OF INTRACRANIAL ARTERIOVENOUS MALFORMATION; INFRATENTORIAL, SIMPLE
SURGERY OF INTRACRANIAL ARTERIOVENOUS MALFORMATION; INFRATENTORIAL, COMPLEX
SURGERY OF INTRACRANIAL ARTERIOVENOUS MALFORMATION; DURAL, SIMPLE
SURGERY OF INTRACRANIAL ARTERIOVENOUS MALFORMATION; DURAL, COMPLEX
SURGERY OF COMPLEX INTRACRANIAL ANEURYSM, INTRACRANIAL APPROACH; CAROTID CIRCULATION
SURGERY OF COMPLEX INTRACRANIAL ANEURYSM, INTRACRANIAL APPROACH; VERTEBROBASILAR CIRCULATION
SURGERY OF SIMPLE INTRACRANIAL ANEURYSM, INTRACRANIAL APPROACH; CAROTID CIRCULATION
SURGERY OF SIMPLE INTRACRANIAL ANEURYSM, INTRACRANIAL APPROACH; VERTEBROBASILAR CIRCULATION
SURGERY OF INTRACRANIAL ANEURYSM, CERVICAL APPROACH BY APPLICATION OF OCCLUDING CLAMP TO CERV
SURGERY OF ANEURYSM, VASCULAR MALFORMATION OR CAROTID-CAVERNOUS FISTULA; BY INTRACRANIAL AND
SURGERY OF ANEURYSM, VASCULAR MALFORMATION OR CAROTID-CAVERNOUS FISTULA; BY INTRACRANIAL ELE
SURGERY OF ANEURYSM, VASCULAR MALFORMATION OR CAROTID-CAVERNOUS FISTULA; BY INTRA-ARTERIAL EM
ANASTOMOSIS, ARTERIAL, EXTRACRANIAL-INTRACRANIAL (EG, MIDDLE CEREBRAL/CORTICAL) ARTERIES
CREATION OF LESION BY STEREOTACTIC METHOD, INCLUDING BURR HOLE(S) AND LOCALIZING AND RECORDING
CREATION OF LESION BY STEREOTACTIC METHOD, INCLUDING BURR HOLE(S) AND LOCALIZING AND RECORDING
STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION, INCLUDING BURR HOLE(S), FOR INTRACRANIAL LESION;
STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION, INCLUDING BURR HOLE(S), FOR INTRACRANIAL LESION; WITH
STEREOTACTIC IMPLANTATION OF DEPTH ELECTRODES INTO THE CEREBRUM FOR LONG TERM SEIZURE MONITO
STEREOTACTIC LOCALIZATION, INCLUDING BURR HOLE(S), WITH INSERTION OF CATHETER(S) OR PROBE(S) FOR
CREATION OF LESION BY STEREOTACTIC METHOD, PERCUTANEOUS, BY NEUROLYTIC AGENT (EG, ALCOHOL, THE
CREATION OF LESION BY STEREOTACTIC METHOD, PERCUTANEOUS, BY NEUROLYTIC AGENT (EG, ALCOHOL, THE
STEREOTACTIC RADIOSURGERY (PARTICLE BEAM, GAMMA RAY OR LINEAR ACCELERATOR), ONE OR MORE SESS
STEREOTACTIC COMPUTER ASSISTED VOLUMETRIC (NAVIGATIONAL) PROCEDURE, INTRACRANIAL, EXTRACRANIA
TWIST DRILL OR BURR HOLE(S) FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CORTICAL
CRANIECTOMY OR CRANIOTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CEREBRAL, CORTICA
TWIST DRILL, BURR HOLE, CRANIOTOMY/CRANIECTOMY FOR STEREOTACTIC IMPLANTATION OF 1 NEUROSTIMUL
CRANIECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CEREBELLAR; CORTICAL
CRANIECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CEREBELLAR; SUBCORTICAL
REVISION OR REMOVAL OF INTRACRANIAL NEUROSTIMULATOR ELECTRODES
INCISION AND SUBCUTANEOUS PLACEMENT OF CRANIAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER
INCISION AND SUBCUTANEOUS PLACEMENT OF CRANIAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER
REVISION OR REMOVAL OF CRANIAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER
ELEVATION OF DEPRESSED SKULL FRACTURE; SIMPLE, EXTRADURAL
ELEVATION OF DEPRESSED SKULL FRACTURE; COMPOUND OR COMMINUTED, EXTRADURAL
ELEVATION OF DEPRESSED SKULL FRACTURE; WITH REPAIR OF DURA AND/OR DEBRIDEMENT OF BRAIN
CRANIOTOMY FOR REPAIR OF DURAL/CEREBROSPINAL FLUID LEAK, INCLUDING SURGERY FOR RHINORRHEA/OTO
REDUCTION OF CRANIOMEGALIC SKULL (EG, TREATED HYDROCEPHALUS); NOT REQUIRING BONE GRAFTS OR CR
REDUCTION OF CRANIOMEGALIC SKULL (EG, TREATED HYDROCEPHALUS); WITH SIMPLE CRANIOPLASTY
REDUCTION OF CRANIOMEGALIC SKULL (EG, TREATED HYDROCEPHALUS); REQUIRING CRANIOTOMY AND RECON
REPAIR OF ENCEPHALOCELE, SKULL VAULT, INCLUDING CRANIOPLASTY
CRANIOTOMY FOR REPAIR OF ENCEPHALOCELE, SKULL BASE
CRANIOPLASTY FOR SKULL DEFECT; UP TO 5 CM DIAMETER
CRANIOPLASTY FOR SKULL DEFECT; LARGER THAN 5 CM DIAMETER
REMOVAL OF BONE FLAP OR PROSTHETIC PLATE OF SKULL
REPLACEMENT OF BONE FLAP OR PROSTHETIC PLATE OF SKULL
CRANIOPLASTY FOR SKULL DEFECT WITH REPARATIVE BRAIN SURGERY
CRANIOPLASTY WITH AUTOGRAFT (INCLUDES OBTAINING BONE GRAFTS); UP TO 5 CM DIAMETER
CRANIOPLASTY WITH AUTOGRAFT (INCLUDES OBTAINING BONE GRAFTS); LARGER THAN 5 CM DIAMETER
INCISION AND RETRIEVAL OF SUBCUTANEOUS CRANIAL BONE GRAFT FOR CRANIOPLASTY (LIST SEPARATELY IN
NEUROENDOSCOPY, INTRACRANIAL, FOR PLACEMENT OR REPLACEMENT OF VENTRICULAR CATHETER AND ATTA
NEUROENDOSCOPY, INTRACRANIAL; WITH DISSECTION OF ADHESIONS, FENESTRATION OF SEPTUM PELLUCIDUM
NEUROENDOSCOPY, INTRACRANIAL; WITH FENESTRATION OR EXCISION OF COLLOID CYST, INCLUDING PLACEME
NEUROENDOSCOPY, INTRACRANIAL; WITH RETRIEVAL OF FOREIGN BODY
NEUROENDOSCOPY, INTRACRANIAL; WITH EXCISION OF BRAIN TUMOR, INCLUDING PLACEMENT OF EXTERNAL VE
NEUROENDOSCOPY, INTRACRANIAL; WITH EXCISION OF PITUITARY TUMOR,TRANSNASAL OR TRANS-SPHENOIDA
VENTRICULOCISTERNOSTOMY (TORKILDSEN TYPE OPERATION)
CREATION OF SHUNT; SUBARACHNOID/SUBDURAL-ATRIAL, -JUGULAR, -AURICULAR
CREATION OF SHUNT; SUBARACHNOID/SUBDURAL-PERITONEAL, -PLEURAL, OTHER TERMINUS
REPLACEMENT OR IRRIGATION, SUBARACHNOID/SUBDURAL CATHETER
VENTRICULOCISTERNOSTOMY, THIRD VENTRICLE;
VENTRICULOCISTERNOSTOMY, THIRD VENTRICLE; STEREOTACTIC, NEUROENDOSCOPIC METHOD
CREATION OF SHUNT; VENTRICULO-ATRIAL, -JUGULAR, -AURICULAR
CREATION OF SHUNT; VENTRICULO-PERITONEAL, -PLEURAL, OTHER TERMINUS
REPLACEMENT OR IRRIGATION, VENTRICULAR CATHETER
REPLACEMENT OR REVISION OF CEREBROSPINAL FLUID SHUNT, OBSTRUCTED VALVE, OR DISTAL CATHETER IN S
REPROGRAMMING OF PROGRAMMABLE CEREBROSPINAL SHUNT
REMOVAL OF COMPLETE CEREBROSPINAL FLUID SHUNT SYSTEM; WITHOUT REPLACEMENT
REMOVAL OF COMPLETE CEREBROSPINAL FLUID SHUNT SYSTEM; WITH REPLACEMENT BY SIMILAR OR OTHER SH
PERCUTANEOUS LYSIS, EPIDUR ADHES USING SOL INJECT (EG, HYPERTONIC SAL, ENZYME)/MECH MEANS (EG, CA
PERCUTANEOUS LYSIS OF EPIDURAL ADHESIONS USING SOLUTION INJECTION (EG, HYPERTONIC SALINE, ENZYM
PERCUTANEOUS ASPIRATION, SPINAL CORD CYST OR SYRINX
BIOPSY OF SPINAL CORD, PERCUTANEOUS NEEDLE
SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC
SPINAL PUNCTURE, THERAPEUTIC, FOR DRAINAGE OF CEREBROSPINAL FLUID (BY NEEDLE OR CATHETER)
INJECTION, EPIDURAL, OF BLOOD OR CLOT PATCH
INJECTION/INFUSION OF NEUROLYTIC SUBSTANCE (EG, ALCOHOL, PHENOL, ICED SALINE SOLUTIONS), WITH OR W
INJECTION OF NEUROLYTIC SUBSTANCE (EG, ALCOHOL, PHENOL, ICED SALINE SOLUTIONS); EPIDURAL, CERVICA
INJECTION/INFUSION OF NEUROLYTIC SUBSTANCE (EG, ALCOHOL, PHENOL, ICED SALINE SOLUTIONS), WITH OR W
INJECTION PROCEDURE FOR MYELOGRAPHY AND/OR COMPUTED TOMOGRAPHY, SPINAL (OTHER THAN C1-C2 AN
ASPIRATION OR DECOMPRESSION PROCEDURE, PERCUTANEOUS, OF NUCLEUS PULPOSUS OF INTERVERTEBRAL
INJECTION PROCEDURE FOR DISKOGRAPHY, EACH LEVEL; LUMBAR
INJECTION PROCEDURE FOR DISKOGRAPHY, EACH LEVEL; CERVICAL OR THORACIC
INJECTION PROCEDURE FOR CHEMONUCLEOLYSIS, INCLUDING DISKOGRAPHY, INTERVERTEBRAL DISK, SINGLE O
INJECTION PROCEDURE, ARTERIAL, FOR OCCLUSION OF ARTERIOVENOUS MALFORMATION, SPINAL
INJECTION, SING (NOT INDWELL CATH),NOT INCL NEUROLYT SUBST,WWO CONTRAST (FOR EITHER LOCAL/EPIDU
INJECTION, SING (NOT INDWELL CATH),NOT INCL NEUROLYT SUBST,WWO CONTRAST (FOR EITHER LOCAL/EPIDU
INJECT,INCL CATH PLACE,CONTIN INFUS/INTERMIT BOLUS,NOT INCL NEUROLYT SUB, WWO CONTRAST (EITHER L
INJECT,INCL CATH PLACE,CONTIN INFUS/INTERMIT BOLUS,NOT INCL NEUROLYT SUB, WWO CONTRAST (EITHER L
IMPLANTATION, REVISION OR REPOSITIONING OF TUNNELED INTRATHECAL/EPIDURAL CATHETER, FOR LONG-TER
IMPLANTATION, REVISION OR REPOSITIONING OF INTRATHECAL OR EPIDURAL CATHETER, FOR IMPLANTABLE RE
REMOVAL OF PREVIOUSLY IMPLANTED INTRATHECAL OR EPIDURAL CATHETER
IMPLANTATION OR REPLACEMENT OF DEVICE FOR INTRATHECAL OR EPIDURAL DRUG INFUSION; SUBCUTANEOU
IMPLANTATION OR REPLACEMENT OF DEVICE FOR INTRATHECAL OR EPIDURAL DRUG INFUSION; NON-PROGRAM
IMPLANTATION OR REPLACEMENT OF DEVICE FOR INTRATHECAL OR EPIDURAL DRUG INFUSION; PROGRAMMABL
REMOVAL OF SUBCUTANEOUS RESERVOIR OR PUMP, PREVIOUSLY IMPLANTED FOR INTRATHECAL OR EPIDURAL
ELECTRONIC ANALYSIS OF PROGRAMMABLE, IMPLANTED PUMP FOR INTRATHECAL OR EPIDURAL DRUG INFUSION
ELECTRONIC ANALYSIS OF PROGRAMMABLE, IMPLANTED PUMP FOR INTRATHECAL OR EPIDURAL DRUG INFUSION
LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOU
LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOU
LAMINECTOMY WITH EXPLORATION AND/OR DECOMP OF SPINAL CORD AND/OR CAUDA EQUINA, W/O FACETECTO
LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOU
LAMINECTOMY WITH REMOVAL OF ABNORMAL FACETS AND/OR PARS INTER-ARTICULARIS WITH DECOMPRESSIO
LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOU
LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOU
LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOU
LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECT
LAMINOTOMY (HEMILAMINECTOMY), W DECOMPRESSION OF NERVE ROOT(S), INCL PARTIAL FACETECTOMY, FOR
LAMINOTOMY (HEMILAMINECTOMY), W DECOMPRESS OF NERVE ROOT(S), INCL PART FACETECT, FORAMINOT &/ E
LAMINOTOMY (HEMILAMINECTOMY), W/DECOMPRESSION OF NERVE ROOT(S), INCLDG PARTIAL FACETECTOMY, F
LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECT
LAMINOTOMY (HEMILAMINECTOMY), W/ DECOMPRESS NERVE ROOT(S), INCL PART FACETECTOMY, FORAMINOTO
LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESS NERVE ROOT(S), INCL PART FACETECTOMY, FORAMINO
LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNI OR BILATERAL W DECOMP OF SPINAL CORD, CAUDA E
LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNI OR BILATERAL W DECOMP OF SPINAL CORD, CAUDA E
LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNI OR BILATERAL W DECOMP OF SPINAL CORD, CAUDA E
LAMINECT,FACETECT & FORAMINOT (UNI/BILAT W DECOMP OF SPINAL CORD,CAUDA EQUINA &/ NERVE ROOT(S),(
TRANSPEDICULAR APPROACH WITH DECOMPRESSION OF SPINAL CORD, EQUINA AND/OR NERVE ROOT(S) (EG, H
TRANSPEDICULAR APPR W DECOMPRESSION OF SPINAL CORD, EQUINA &/ NERVE ROOT(S) (EG,HERNIATED INTER
TRANSPEDICULAR APPROACH WITH DECOMPRESSION OF SPINAL CORD, EQUINA AND/OR NERVE ROOT(S) (EG, H
COSTOVERTEBRAL APPROACH WITH DECOMPRESSION OF SPINAL CORD OR NERVE ROOT(S), (EG, HERNIATED IN
COSTOVERTEBRAL APPROACH WITH DECOMPRESSION OF SPINAL CORD OR NERVE ROOT(S), (EG, HERNIATED IN
DISKECTOMY, ANTERIOR, WITH DECOMPRESSION OF SPINAL CORD AND/OR NERVE ROOT(S), INCLUDING OSTEOP
DISKECTOMY, ANTERIOR, WITH DECOMPRESSION OF SPINAL CORD AND/ OR NERVE ROOT(S), INCLUDING OSTEO
DISKECTOMY, ANTERIOR, WITH DECOMPRESSION OF SPINAL CORD AND/OR NERVE ROOT(S), INCLUDING OSTEOP
DISKECTOMY, ANTERIOR, WITH DECOMPRESSION OF SPINAL CORD AND/ OR NERVE ROOT(S), INCLUDING OSTEO
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, ANTERIOR APPROACH WITH
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, ANTERIOR APPROACH WITH
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, TRANSTHORACIC APPROAC
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, TRANSTHORACIC APPROAC
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, COMBINED THORACOLUMBA
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, COMBINED THORACOLUMBA
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, TRANS/RETROPERITONEAL
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PART/COMP, TRANSPERITONEAL/RETROPERITONEA
LAMINECTOMY WITH MYELOTOMY (EG, BISCHOF OR DREZ TYPE), CERVICAL, THORACIC OR THORACOLUMBAR
LAMINECTOMY WITH DRAINAGE OF INTRAMEDULLARY CYST/SYRINX; TO SUBARACHNOID SPACE
LAMINECTOMY WITH DRAINAGE OF INTRAMEDULLARY CYST/SYRINX; TO PERITONEAL SPACE
LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; ONE OR TW
LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, WITH OR WITHOUT DURAL GRAFT, CERVICAL; MORE THA
LAMINECTOMY WITH RHIZOTOMY; ONE OR TWO SEGMENTS
LAMINECTOMY WITH RHIZOTOMY; MORE THAN TWO SEGMENTS
LAMINECTOMY WITH SECTION OF SPINAL ACCESSORY NERVE
LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF ONE SPINOTHALAMIC TRACT, ONE STAGE; CERVICAL
LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF ONE SPINOTHALAMIC TRACT, ONE STAGE; THORACIC
LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, ONE STAGE; CERVICAL
LAMINECTOMY WITH CORDOTOMY, WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, ONE STAGE; THORACIC
LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, TWO STAGES WITHIN 14 D
LAMINECTOMY WITH CORDOTOMY WITH SECTION OF BOTH SPINOTHALAMIC TRACTS, TWO STAGES WITHIN 14 D
LAMINECTOMY WITH RELEASE OF TETHERED SPINAL CORD, LUMBAR
LAMINECTOMY FOR EXCISION OR OCCLUSION OF ARTERIOVENOUS MALFORMATION OF SPINAL CORD; CERVICAL
LAMINECTOMY FOR EXCISION OR OCCLUSION OF ARTERIOVENOUS MALFORMATION OF SPINAL CORD; THORACIC
LAMINECTOMY FOR EXCISION OR OCCLUSION OF ARTERIOVENOUS MALFORMATION OF SPINAL CORD; THORACO
LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM, EXTRADURAL;
LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM, EXTRADURAL;
LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM, EXTRADURAL;
LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM, EXTRADURAL;
LAMINECTOMY FOR EXCISION OF INTRASPINAL LESION OTHER THAN NEOPLASM, INTRADURAL; CERVICAL
LAMINECTOMY FOR EXCISION OF INTRASPINAL LESION OTHER THAN NEOPLASM, INTRADURAL; THORACIC
LAMINECTOMY FOR EXCISION OF INTRASPINAL LESION OTHER THAN NEOPLASM, INTRADURAL; LUMBAR
LAMINECTOMY FOR EXCISION OF INTRASPINAL LESION OTHER THAN NEOPLASM, INTRADURAL; SACRAL
LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL NEOPLASM; EXTRADURAL, CERVICAL
LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL NEOPLASM; EXTRADURAL, THORACIC
LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL NEOPLASM; EXTRADURAL, LUMBAR
LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL NEOPLASM; EXTRADURAL, SACRAL
LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL NEOPLASM; INTRADURAL, EXTRAMEDULLARY, CERVICAL
LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL NEOPLASM; INTRADURAL, EXTRAMEDULLARY, THORACIC
LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL NEOPLASM; INTRADURAL, EXTRAMEDULLARY, LUMBAR
LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL NEOPLASM; INTRADURAL, SACRAL
LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL NEOPLASM; INTRADURAL, INTRAMEDULLARY, CERVICAL
LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL NEOPLASM; INTRADURAL, INTRAMEDULLARY, THORACIC
LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL NEOPLASM; INTRADURAL, INTRAMEDULLARY, THORACOL
LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL NEOPLASM; COMBINED EXTRADURAL-INTRADURAL LESIO
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASP
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASP
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASP
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASP
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASP
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASP
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASP
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASP
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASP
CREATION OF LESION OF SPINAL CORD BY STEREOTACTIC METHOD, PERCUTANEOUS, ANY MODALITY (INCLUDIN
STEREOTACTIC STIMULATION OF SPINAL CORD, PERCUTANEOUS, SEPARATE PROCEDURE NOT FOLLOWED BY O
STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION OF LESION, SPINAL CORD
PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY, EPIDURAL
LAMINECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, PLATE/PADDLE, EPIDURAL
REVISION OR REMOVAL OF SPINAL NEUROSTIMULATOR ELECTRODE PERCUTANEOUS ARRAY(S) OR PLATE/PADD
INCISION AND SUBCUTANEOUS PLACEMENT OF SPINAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER, D
REVISION OR REMOVAL OF IMPLANTED SPINAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER
REPAIR OF MENINGOCELE; LESS THAN 5 CM DIAMETER
REPAIR OF MENINGOCELE; LARGER THAN 5 CM DIAMETER
REPAIR OF MYELOMENINGOCELE; LESS THAN 5 CM DIAMETER
REPAIR OF MYELOMENINGOCELE; LARGER THAN 5 CM DIAMETER
REPAIR OF DURAL/CEREBROSPINAL FLUID LEAK, NOT REQUIRING LAMINECTOMY
REPAIR OF DURAL/CEREBROSPINAL FLUID LEAK OR PSEUDOMENINGOCELE, WITH LAMINECTOMY
DURAL GRAFT, SPINAL
CREATION OF SHUNT, LUMBAR, SUBARACHNOID-PERITONEAL, -PLEURAL, OR OTHER; INCLUDING LAMINECTOMY
CREATION OF SHUNT, LUMBAR, SUBARACHNOID-PERITONEAL, -PLEURAL, OR OTHER; PERCUTANEOUS, NOT REQ
REPLACEMENT, IRRIGATION OR REVISION OF LUMBOSUBARACHNOID SHUNT
REMOVAL OF ENTIRE LUMBOSUBARACHNOID SHUNT SYSTEM WITHOUT REPLACEMENT
INJECTION, ANESTHETIC AGENT; TRIGEMINAL NERVE, ANY DIVISION OR BRANCH
INJECTION, ANESTHETIC AGENT; FACIAL NERVE
INJECTION, ANESTHETIC AGENT; GREATER OCCIPITAL NERVE
INJECTION, ANESTHETIC AGENT; VAGUS NERVE
INJECTION, ANESTHETIC AGENT; PHRENIC NERVE
INJECTION, ANESTHETIC AGENT; SPINAL ACCESSORY NERVE
INJECTION, ANESTHETIC AGENT; CERVICAL PLEXUS
INJECTION, ANESTHETIC AGENT; BRACHIAL PLEXUS, SINGLE
INJECTION, ANESTHETIC AGENT; BRACHIAL PLEXUS, CONTINUOUS INFUSION BY CATHETER (INCLUDING CATHETE
INJECTION, ANESTHETIC AGENT; AXILLARY NERVE
INJECTION, ANESTHETIC AGENT; SUPRASCAPULAR NERVE
INJECTION, ANESTHETIC AGENT; INTERCOSTAL NERVE, SINGLE
INJECTION, ANESTHETIC AGENT; INTERCOSTAL NERVES, MULTIPLE, REGIONAL BLOCK
INJECTION, ANESTHETIC AGENT; ILIOINGUINAL, ILIOHYPOGASTRIC NERVES
INJECTION, ANESTHETIC AGENT; PUDENDAL NERVE
INJECTION, ANESTHETIC AGENT; PARACERVICAL (UTERINE) NERVE
INJECTION, ANESTHETIC AGENT; SCIATIC NERVE, SINGLE
INJECTION, ANESTHETIC AGENT; SCIATIC NERVE, CONTINUOUS INFUSION BY CATHETER, (INCLUDING CATHETER
INJECTION, ANESTHETIC AGENT; FEMORAL NERVE, SINGLE
INJECTION, ANESTHETIC AGENT; FEMORAL NERVE, CONTINUOUS INFUSION BY CATHETER (INCLUDING CATHETER
INJECTION, ANESTHETIC AGENT; OTHER PERIPHERAL NERVE OR BRANCH
INJECTION, ANESTHETIC AGENT AND/OR STEROID, PARAVERTEBRAL FACET JOINT OR FACET JOINT NERVE; CERV
INJECTION, ANESTHETIC AGENT AND/OR STEROID, PARAVERTEBRAL FACET JOINT OR FACET JOINT NERVE; CERV
INJECTION, ANESTHETIC AGENT AND/OR STEROID, PARAVERTEBRAL FACET JOINT OR FACET JOINT NERVE; LUMB
INJECTION, ANESTHETIC AGENT AND/OR STEROID, PARAVERTEBRAL FACET JOINT OR FACET JOINT NERVE; LUMB
INJECTION, ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL; CERVICAL OR THORACIC, SINGL
INJECTION, ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL; CERVICAL OR THORACIC, EACH
INJECTION, ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL; LUMBAR OR SACRAL, SINGLE LE
INJECTION, ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL; LUMBAR OR SACRAL, EACH ADD
INJECTION, ANESTHETIC AGENT; SPHENOPALATINE GANGLION
INJECTION, ANESTHETIC AGENT; CAROTID SINUS (SEPARATE PROCEDURE)
INJECTION, ANESTHETIC AGENT; STELLATE GANGLION (CERVICAL SYMPATHETIC)
INJECTION, ANESTHETIC AGENT; LUMBAR OR THORACIC (PARAVERTEBRAL SYMPATHETIC)
INJECTION, ANESTHETIC AGENT; CELIAC PLEXUS, WITH OR WITHOUT RADIOLOGIC MONITORING
APPLICATION OF SURFACE (TRANSCUTANEOUS) NEUROSTIMULATOR
PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; CRANIAL NERVE
PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; PERIPHERAL NERVE (EXCLUDES SACRAL
PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; AUTONOMIC NERVE
PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; SACRAL NERVE (TRANSFORAMINAL PLAC
PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; NEUROMUSCULAR
INCISION FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; CRANIAL NERVE
INCISION FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; PERIPHERAL NERVE (EXCLUDES SACRAL NE
INCISION FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; AUTONOMIC NERVE
INCISION FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; NEUROMUSCULAR
INCISION FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; SACRAL NERVE (TRANSFORAMINAL PLACEM
REVISION OR REMOVAL OF PERIPHERAL NEUROSTIMULATOR ELECTRODES
INCISION AND SUBCUTANEOUS PLACEMENT OF PERIPHERAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIV
REVISION OR REMOVAL OF PERIPHERAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER
DESTRUCTION BY NEUROLYTIC AGENT, TRIGEMINAL NERVE; SUPRAORBITAL, INFRAORBITAL, MENTAL, OR INFERI
DESTRUCTION BY NEUROLYTIC AGENT, TRIGEMINAL NERVE; SECOND AND THIRD DIVISION BRANCHES AT FORAM
DESTRUCTION BY NEUROLYTIC AGENT, TRIGEMINAL NERVE; SECOND AND THIRD DIVISION BRANCHES AT FORAM
CHEMODENERVATION OF MUSCLE(S); MUSCLE(S) INNERVATED BY FACIAL NERVE (EG, FOR BLEPHAROSPASM, HE
CHEMODENERVATION OF MUSCLE(S); CERVICAL SPINAL MUSCLE(S) (EG, FOR SPASMODIC TORTICOLLIS)
CHEMODENERVATION OF MUSCLE(S); EXTREMITY(S) AND/OR TRUNK MUSCLE(S) (EG, FOR DYSTONIA, CEREBRAL
DESTRUCTION BY NEUROLYTIC AGENT, INTERCOSTAL NERVE
DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBRAL FACET JOINT NERVE; LUMBAR OR SACRAL, SINGLE LEV
DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBRAL FACET JOINT NERVE; LUMBAR OR SACRAL, EACH ADDIT
DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBRAL FACET JOINT NERVE; CERVICAL OR THORACIC, SINGLE
DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBRAL FACET JOINT NERVE; CERVICAL OR THORACIC, EACH A
DESTRUCTION BY NEUROLYTIC AGENT; PUDENDAL NERVE
DESTRUCTION BY NEUROLYTIC AGENT; OTHER PERIPHERAL NERVE OR BRANCH
DESTRUCTION BY NEUROLYTIC AGENT, CELIAC PLEXUS, WITH OR WITHOUT RADIOLOGIC MONITORING
NEUROPLASTY; DIGITAL, ONE OR BOTH, SAME DIGIT
NEUROPLASTY; NERVE OF HAND OR FOOT
NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG; OTHER THAN SPECIFIED
NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG; SCIATIC NERVE
NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG; BRACHIAL PLEXUS
NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG; LUMBAR PLEXUS
NEUROPLASTY AND/OR TRANSPOSITION; CRANIAL NERVE (SPECIFY)
NEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT ELBOW
NEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT WRIST
NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT CARPAL TUNNEL
DECOMPRESSION; UNSPECIFIED NERVE(S) (SPECIFY)
DECOMPRESSION; PLANTAR DIGITAL NERVE
INTERNAL NEUROLYSIS, REQUIRING USE OF OPERATING MICROSCOPE (LIST SEPARATELY IN ADDITION TO CODE
TRANSECTION OR AVULSION OF; SUPRAORBITAL NERVE
TRANSECTION OR AVULSION OF; INFRAORBITAL NERVE
TRANSECTION OR AVULSION OF; MENTAL NERVE
TRANSECTION OR AVULSION OF; INFERIOR ALVEOLAR NERVE BY OSTEOTOMY
TRANSECTION OR AVULSION OF; LINGUAL NERVE
TRANSECTION OR AVULSION OF; FACIAL NERVE, DIFFERENTIAL OR COMPLETE
TRANSECTION OR AVULSION OF; GREATER OCCIPITAL NERVE
TRANSECTION OR AVULSION OF; PHRENIC NERVE
TRANSECTION OR AVULSION OF; VAGUS NERVE (VAGOTOMY), TRANSTHORACIC
TRANSECTION OR AVULSION OF; VAGUS NERVES LIMITED TO PROXIMAL STOMACH (SELECTIVE PROXIMAL VAGOT
TRANSECTION OR AVULSION OF; VAGUS NERVE (VAGOTOMY), ABDOMINAL
TRANSECTION OR AVULSION OF; PUDENDAL NERVE
TRANSECTION OR AVULSION OF OBTURATOR NERVE, EXTRAPELVIC, WITH OR WITHOUT ADDUCTOR TENOTOMY
TRANSECTION OR AVULSION OF OBTURATOR NERVE, INTRAPELVIC, WITH OR WITHOUT ADDUCTOR TENOTOMY
TRANSECTION OR AVULSION OF OTHER CRANIAL NERVE, EXTRADURAL
TRANSECTION OR AVULSION OF OTHER SPINAL NERVE, EXTRADURAL
EXCISION OF NEUROMA; CUTANEOUS NERVE, SURGICALLY IDENTIFIABLE
EXCISION OF NEUROMA; DIGITAL NERVE, ONE OR BOTH, SAME DIGIT
EXCISION OF NEUROMA; DIGITAL NERVE, EACH ADDITIONAL DIGIT (LIST SEPARATELY IN ADDITION TO CODE FOR
EXCISION OF NEUROMA; HAND OR FOOT, EXCEPT DIGITAL NERVE
EXCISION OF NEUROMA; HAND OR FOOT, EACH ADDITIONAL NERVE, EXCEPT SAME DIGIT (LIST SEPARATELY IN A
EXCISION OF NEUROMA; MAJOR PERIPHERAL NERVE, EXCEPT SCIATIC
EXCISION OF NEUROMA; SCIATIC NERVE
IMPLANTATION OF NERVE END INTO BONE OR MUSCLE (LIST SEPARATELY IN ADDITION TO NEUROMA EXCISION)
EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; CUTANEOUS NERVE
EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; MAJOR PERIPHERAL NERVE
EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; EXTENSIVE (INCLUDING MALIGNANT TYPE)
BIOPSY OF NERVE
SYMPATHECTOMY, CERVICAL
SYMPATHECTOMY, CERVICOTHORACIC
SYMPATHECTOMY, THORACOLUMBAR
SYMPATHECTOMY, LUMBAR
SYMPATHECTOMY; DIGITAL ARTERIES, EACH DIGIT
SYMPATHECTOMY; RADIAL ARTERY
SYMPATHECTOMY; ULNAR ARTERY
SYMPATHECTOMY; SUPERFICIAL PALMAR ARCH
SUTURE OF DIGITAL NERVE, HAND OR FOOT; ONE NERVE
SUTURE OF DIGITAL NERVE, HAND OR FOOT; EACH ADDITIONAL DIGITAL NERVE (LIST SEPARATELY IN ADDITION T
SUTURE OF ONE NERVE, HAND OR FOOT; COMMON SENSORY NERVE
SUTURE OF ONE NERVE, HAND OR FOOT; MEDIAN MOTOR THENAR
SUTURE OF ONE NERVE, HAND OR FOOT; ULNAR MOTOR
SUTURE OF EACH ADDITIONAL NERVE, HAND OR FOOT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY P
SUTURE OF POSTERIOR TIBIAL NERVE
SUTURE OF MAJOR PERIPHERAL NERVE, ARM OR LEG, EXCEPT SCIATIC; INCLUDING TRANSPOSITION
SUTURE OF MAJOR PERIPHERAL NERVE, ARM OR LEG, EXCEPT SCIATIC; WITHOUT TRANSPOSITION
SUTURE OF SCIATIC NERVE
SUTURE OF EACH ADDITIONAL MAJOR PERIPHERAL NERVE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMA
SUTURE OF; BRACHIAL PLEXUS
SUTURE OF; LUMBAR PLEXUS
SUTURE OF FACIAL NERVE; EXTRACRANIAL
SUTURE OF FACIAL NERVE; INFRATEMPORAL, WITH OR WITHOUT GRAFTING
ANASTOMOSIS; FACIAL-SPINAL ACCESSORY
ANASTOMOSIS; FACIAL-HYPOGLOSSAL
ANASTOMOSIS; FACIAL-PHRENIC
SUTURE OF NERVE; REQUIRING SECONDARY OR DELAYED SUTURE (LIST SEPARATELY IN ADDITION TO CODE FO
SUTURE OF NERVE; REQUIRING EXTENSIVE MOBILIZATION, OR TRANSPOSITION OF NERVE (LIST SEPARATELY IN
SUTURE OF NERVE; REQUIRING SHORTENING OF BONE OF EXTREMITY (LIST SEPARATELY IN ADDITION TO CODE
NERVE GRAFT (INCLUDES OBTAINING GRAFT), HEAD OR NECK; UP TO 4 CM IN LENGTH
NERVE GRAFT (INCLUDES OBTAINING GRAFT), HEAD OR NECK; MORE THAN 4 CM IN LENGTH
NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND, HAND OR FOOT; UP TO 4 CM LENGTH
NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND, HAND OR FOOT; MORE THAN 4 CM LENGTH
NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND, ARM OR LEG; UP TO 4 CM LENGTH
NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND, ARM OR LEG; MORE THAN 4 CM LENGTH
NERVE GRAFT (INCLUDES OBTAINING GRAFT), MULTIPLE STRANDS (CABLE), HAND OR FOOT; UP TO 4 CM LENGTH
NERVE GRAFT (INCLUDES OBTAINING GRAFT), MULTIPLE STRANDS (CABLE), HAND OR FOOT; MORE THAN 4 CM LE
NERVE GRAFT (INCLUDES OBTAINING GRAFT), MULTIPLE STRANDS (CABLE), ARM OR LEG; UP TO 4 CM LENGTH
NERVE GRAFT (INCLUDES OBTAINING GRAFT), MULTIPLE STRANDS (CABLE), ARM OR LEG; MORE THAN 4 CM LENG
NERVE GRAFT, EACH ADDITIONAL NERVE; SINGLE STRAND (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMAR
NERVE GRAFT, EACH ADDITIONAL NERVE; MULTIPLE STRANDS (CABLE) (LIST SEPARATELY IN ADDITION TO CODE
NERVE PEDICLE TRANSFER; FIRST STAGE
NERVE PEDICLE TRANSFER; SECOND STAGE
UNLISTED PROCEDURE, NERVOUS SYSTEM
EVISCERATION OF OCULAR CONTENTS; WITHOUT IMPLANT
EVISCERATION OF OCULAR CONTENTS; WITH IMPLANT
ENUCLEATION OF EYE; WITHOUT IMPLANT
ENUCLEATION OF EYE; WITH IMPLANT, MUSCLES NOT ATTACHED TO IMPLANT
ENUCLEATION OF EYE; WITH IMPLANT, MUSCLES ATTACHED TO IMPLANT
EXENTERATION OF ORBIT (DOES NOT INCLUDE SKIN GRAFT), REMOVAL OF ORBITAL CONTENTS; ONLY
EXENTERATION OF ORBIT (DOES NOT INCLUDE SKIN GRAFT), REMOVAL OF ORBITAL CONTENTS; WITH THERAPEU
EXENTERATION OF ORBIT (DOES NOT INCLUDE SKIN GRAFT), REMOVAL OF ORBITAL CONTENTS; WITH MUSCLE O
MODIFICATION OF OCULAR IMPLANT WITH PLACEMENT OR REPLACEMENT OF PEGS (EG, DRILLING RECEPTACLE
INSERTION OF OCULAR IMPLANT SECONDARY; AFTER EVISCERATION, IN SCLERAL SHELL
INSERTION OF OCULAR IMPLANT SECONDARY; AFTER ENUCLEATION, MUSCLES NOT ATTACHED TO IMPLANT
INSERTION OF OCULAR IMPLANT SECONDARY; AFTER ENUCLEATION, MUSCLES ATTACHED TO IMPLANT
REINSERTION OF OCULAR IMPLANT; WITH OR WITHOUT CONJUNCTIVAL GRAFT
REINSERTION OF OCULAR IMPLANT; WITH USE OF FOREIGN MATERIAL FOR REINFORCEMENT AND/OR ATTACHME
REMOVAL OF OCULAR IMPLANT
REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CONJUNCTIVAL SUPERFICIAL
REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CONJUNCTIVAL EMBEDDED (INCLUDES CONCRETIONS), SUBCONJU
REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CORNEAL, WITHOUT SLIT LAMP
REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CORNEAL, WITH SLIT LAMP
REMOVAL OF FOREIGN BODY, INTRAOCULAR; FROM ANTERIOR CHAMBER OF EYE OR LENS
REMOVAL OF FOREIGN BODY, INTRAOCULAR; FROM POSTERIOR SEGMENT, MAGNETIC EXTRACTION, ANTERIOR O
REMOVAL OF FOREIGN BODY, INTRAOCULAR; FROM POSTERIOR SEGMENT, NONMAGNETIC EXTRACTION
REPAIR OF LACERATION; CONJUNCTIVA, WITH OR WITHOUT NONPERFORATING LACERATION SCLERA, DIRECT CL
REPAIR OF LACERATION; CONJUNCTIVA, BY MOBILIZATION AND REARRANGEMENT, WITHOUT HOSPITALIZATION
REPAIR OF LACERATION; CONJUNCTIVA, BY MOBILIZATION AND REARRANGEMENT, WITH HOSPITALIZATION
REPAIR OF LACERATION; CORNEA, NONPERFORATING, WITH OR WITHOUT REMOVAL FOREIGN BODY
REPAIR OF LACERATION; CORNEA AND/OR SCLERA, PERFORATING, NOT INVOLVING UVEAL TISSUE
REPAIR OF LACERATION; CORNEA AND/OR SCLERA, PERFORATING, WITH REPOSITION OR RESECTION OF UVEAL
REPAIR OF LACERATION; APPLICATION OF TISSUE GLUE, WOUNDS OF CORNEA AND/OR SCLERA
REPAIR OF WOUND, EXTRAOCULAR MUSCLE, TENDON AND/OR TENON'S CAPSULE
EXCISION OF LESION, CORNEA (KERATECTOMY, LAMELLAR, PARTIAL), EXCEPT PTERYGIUM
BIOPSY OF CORNEA
EXCISION OR TRANSPOSITION OF PTERYGIUM; WITHOUT GRAFT
EXCISION OR TRANSPOSITION OF PTERYGIUM; WITH GRAFT
SCRAPING OF CORNEA, DIAGNOSTIC, FOR SMEAR AND/OR CULTURE
REMOVAL OF CORNEAL EPITHELIUM; WITH OR WITHOUT CHEMOCAUTERIZATION (ABRASION, CURETTAGE)
REMOVAL OF CORNEAL EPITHELIUM; WITH APPLICATION OF CHELATING AGENT (EG, EDTA)
DESTRUCTION OF LESION OF CORNEA BY CRYOTHERAPY, PHOTOCOAGULATION OR THERMOCAUTERIZATION
MULTIPLE PUNCTURES OF ANTERIOR CORNEA (EG, FOR CORNEAL EROSION, TATTOO)
KERATOPLASTY (CORNEAL TRANSPLANT); LAMELLAR
KERATOPLASTY (CORNEAL TRANSPLANT); PENETRATING (EXCEPT IN APHAKIA)
KERATOPLASTY (CORNEAL TRANSPLANT); PENETRATING (IN APHAKIA)
KERATOPLASTY (CORNEAL TRANSPLANT); PENETRATING (IN PSEUDOPHAKIA)
KERATOMILEUSIS
KERATOPHAKIA
EPIKERATOPLASTY
KERATOPROSTHESIS
RADIAL KERATOTOMY
CORNEAL RELAXING INCISION FOR CORRECTION OF SURGICALLY INDUCED ASTIGMATISM
CORNEAL WEDGE RESECTION FOR CORRECTION OF SURGICALLY INDUCED ASTIGMATISM
PARACENTESIS OF ANTERIOR CHAMBER OF EYE (SEPARATE PROCEDURE); WITH DIAGNOSTIC ASPIRATION OF AQ
PARACENTESIS OF ANTERIOR CHAMBER OF EYE (SEPARATE PROCEDURE); WITH THERAPEUTIC RELEASE OF AQU
PARACENTESIS OF ANTERIOR CHAMBER OF EYE (SEPARATE PROCEDURE); WITH REMOVAL OF VITREOUS AND/O
PARACENTESIS OF ANTERIOR CHAMBER OF EYE (SEPARATE PROCEDURE); WITH REMOVAL OF BLOOD, WITH OR
GONIOTOMY
TRABECULOTOMY AB EXTERNO
TRABECULOPLASTY BY LASER SURGERY, ONE OR MORE SESSIONS (DEFINED TREATMENT SERIES)
SEVERING ADHESIONS OF ANTERIOR SEGMENT, LASER TECHNIQUE (SEPARATE PROCEDURE)
SEVERING ADHESIONS OF ANTERIOR SEGMENT OF EYE, INCISIONAL TECHNIQUE (WITH OR WITHOUT INJECTION
SEVERING ADHESIONS OF ANTERIOR SEGMENT OF EYE, INCISIONAL TECHNIQUE (WITH OR WITHOUT INJECTION
SEVERING ADHESIONS OF ANTERIOR SEGMENT OF EYE, INCISIONAL TECHNIQUE (WITH OR WITHOUT INJECTION
SEVERING ADHESIONS OF ANTERIOR SEGMENT OF EYE, INCISIONAL TECHNIQUE (WITH OR WITHOUT INJECTION
REMOVAL OF EPITHELIAL DOWNGROWTH, ANTERIOR CHAMBER OF EYE
REMOVAL OF IMPLANTED MATERIAL, ANTERIOR SEGMENT OF EYE
REMOVAL OF BLOOD CLOT, ANTERIOR SEGMENT OF EYE
INJECTION, ANTERIOR CHAMBER OF EYE (SEPARATE PROCEDURE); AIR OR LIQUID
INJECTION, ANTERIOR CHAMBER OF EYE (SEPARATE PROCEDURE); MEDICATION
EXCISION OF LESION, SCLERA
FISTULIZATION OF SCLERA FOR GLAUCOMA; TREPHINATION WITH IRIDECTOMY
FISTULIZATION OF SCLERA FOR GLAUCOMA; THERMOCAUTERIZATION WITH IRIDECTOMY
FISTULIZATION OF SCLERA FOR GLAUCOMA; SCLERECTOMY WITH PUNCH OR SCISSORS, WITH IRIDECTOMY
FISTULIZATION OF SCLERA FOR GLAUCOMA; IRIDENCLEISIS OR IRIDOTASIS
FISTULIZATION OF SCLERA FOR GLAUCOMA; TRABECULECTOMY AB EXTERNO IN ABSENCE OF PREVIOUS SURGE
FISTULIZATION OF SCLERA FOR GLAUCOMA; TRABECULECTOMY AB EXTERNO WITH SCARRING FROM PREVIOUS
AQUEOUS SHUNT TO EXTRAOCULAR RESERVOIR (EG, MOLTENO, SCHOCKET, DENVER-KRUPIN)
REVISION OF AQUEOUS SHUNT TO EXTRAOCULAR RESERVOIR
REPAIR OF SCLERAL STAPHYLOMA; WITHOUT GRAFT
REPAIR OF SCLERAL STAPHYLOMA; WITH GRAFT
REVISION OR REPAIR OF OPERATIVE WOUND OF ANTERIOR SEGMENT, ANY TYPE, EARLY OR LATE, MAJOR OR MI
IRIDOTOMY BY STAB INCISION (SEPARATE PROCEDURE); EXCEPT TRANSFIXION
IRIDOTOMY BY STAB INCISION (SEPARATE PROCEDURE); WITH TRANSFIXION AS FOR IRIS BOMBE
IRIDECTOMY, WITH CORNEOSCLERAL OR CORNEAL SECTION; FOR REMOVAL OF LESION
IRIDECTOMY, WITH CORNEOSCLERAL OR CORNEAL SECTION; WITH CYCLECTOMY
IRIDECTOMY, WITH CORNEOSCLERAL OR CORNEAL SECTION; PERIPHERAL FOR GLAUCOMA (SEPARATE PROCED
IRIDECTOMY, WITH CORNEOSCLERAL OR CORNEAL SECTION; SECTOR FOR GLAUCOMA (SEPARATE PROCEDURE
IRIDECTOMY, WITH CORNEOSCLERAL OR CORNEAL SECTION; "OPTICAL" (SEPARATE PROCEDURE)
REPAIR OF IRIS, CILIARY BODY (AS FOR IRIDODIALYSIS)
SUTURE OF IRIS, CILIARY BODY (SEPARATE PROCEDURE) WITH RETRIEVAL OF SUTURE THROUGH SMALL INCISIO
CILIARY BODY DESTRUCTION; DIATHERMY
CILIARY BODY DESTRUCTION; CYCLOPHOTOCOAGULATION
CILIARY BODY DESTRUCTION; CRYOTHERAPY
CILIARY BODY DESTRUCTION; CYCLODIALYSIS
IRIDOTOMY/IRIDECTOMY BY LASER SURGERY (EG, FOR GLAUCOMA) (ONE OR MORE SESSIONS)
IRIDOPLASTY BY PHOTOCOAGULATION (ONE OR MORE SESSIONS) (EG, FOR IMPROVEMENT OF VISION, FOR WIDE
DESTRUCTION OF CYST OR LESION IRIS OR CILIARY BODY (NONEXCISIONAL PROCEDURE)
DISCISSION OF SECONDARY MEMBRANOUS CATARACT (OPACIFIED POSTERIOR LENS CAPSULE AND/OR ANTERIO
DISCISSION OF SECONDARY MEMBRANOUS CATARACT (OPACIFIED POSTERIOR LENS CAPSULE AND/OR ANTERIO
REPOSITIONING OF INTRAOCULAR LENS PROSTHESIS, REQUIRING AN INCISION (SEPARATE PROCEDURE)
REMOVAL OF SECONDARY MEMBRANOUS CATARACT (OPACIFIED POSTERIOR LENS CAPSULE AND/OR ANTERIOR
REMOVAL OF LENS MATERIAL; ASPIRATION TECHNIQUE, ONE OR MORE STAGES
REMOVAL OF LENS MATERIAL; PHACOFRAGMENTATION TECHNIQUE (MECHANICAL OR ULTRASONIC) (EG, PHACO
REMOVAL OF LENS MATERIAL; PARS PLANA APPROACH, WITH OR WITHOUT VITRECTOMY
REMOVAL OF LENS MATERIAL; INTRACAPSULAR
REMOVAL OF LENS MATERIAL; INTRACAPSULAR, FOR DISLOCATED LENS
REMOVAL OF LENS MATERIAL; EXTRACAPSULAR (OTHER THAN 66840, 66850, 66852)
XCAPSULAR CTRCT REM W INS, IOL PRSTH,MAN/MECH TECHN,CMPLX,REQ S/TECHNS NO GENLY USED ROUTINE
INTRACAPSULAR CATARACT EXTRACTION WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (ONE STAGE PR
EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (ONE STAGE PRO
INSERTION OF INTRAOCULAR LENS PROSTHESIS (SECONDARY IMPLANT), NOT ASSOCIATED WITH CONCURRENT
EXCHANGE OF INTRAOCULAR LENS
USE OF OPHTHALMIC ENDOSCOPE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
UNLISTED PROCEDURE, ANTERIOR SEGMENT OF EYE
REMOVAL OF VITREOUS, ANTERIOR APPROACH (OPEN SKY TECHNIQUE OR LIMBAL INCISION); PARTIAL REMOVAL
REMOVAL OF VITREOUS, ANTERIOR APPROACH (OPEN SKY TECHNIQUE OR LIMBAL INCISION); SUBTOTAL REMOV
ASPIRATION OR RELEASE OF VITREOUS, SUBRETINAL OR CHOROIDAL FLUID, PARS PLANA APPROACH (POSTERIO
INJECTION OF VITREOUS SUBSTITUTE, PARS PLANA OR LIMBAL APPROACH, (FLUID-GAS EXCHANGE), WITH OR W
IMPLANTATION OF INTRAVITREAL DRUG DELIVERY SYSTEM (EG, GANCICLOVIR IMPLANT), INCLUDES CONCOMITA
INTRAVITREAL INJECTION OF A PHARMACOLOGIC AGENT (SEPARATE PROCEDURE)
DISCISSION OF VITREOUS STRANDS (WITHOUT REMOVAL), PARS PLANA APPROACH
SEVERING OF VITREOUS STRANDS, VITREOUS FACE ADHESIONS, SHEETS, MEMBRANES OR OPACITIES, LASER SU
VITRECTOMY, MECHANICAL, PARS PLANA APPROACH;
VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH EPIRETINAL MEMBRANE STRIPPING
VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH FOCAL ENDOLASER PHOTOCOAGULATION
VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH ENDOLASER PANRETINAL PHOTOCOAGULATION
REPAIR OF RETINAL DETACHMENT, ONE OR MORE SESSIONS; CRYOTHERAPY OR DIATHERMY, WITH OR WITHOUT
REPAIR OF RETINAL DETACHMENT, ONE OR MORE SESSIONS; PHOTOCOAGULATION (LASER OR XENON ARC, ONE
REPAIR RETINAL DETACHMENT; SCLERAL BUCKLING (SUCH AS LAMELLAR SCLERAL DISSECTION, IMBRICATION O
REPAIR RETINAL DETACHMENT; W/VITRECTOMY, ANY METHOD, W W/O AIR OR GAS TAMPONADE, FOCAL ENDOLA
REPAIR OF RETINAL DETACHMENT, ONE OR MORE SESSIONS; BY INJECTION OF AIR OR OTHER GAS (EG, PNEUMA
REPAIR OF RETINAL DETACHMENT; BY SCLERAL BUCKLING OR VITRECTOMY, ON PATIENT HAVING PREVIOUS IPS
RELEASE OF ENCIRCLING MATERIAL (POSTERIOR SEGMENT)
REMOVAL OF IMPLANTED MATERIAL, POSTERIOR SEGMENT; EXTRAOCULAR
REMOVAL OF IMPLANTED MATERIAL, POSTERIOR SEGMENT; INTRAOCULAR
PROPHYLAXIS OF RETINAL DETACHMENT (EG, RETINAL BREAK, LATTICE DEGENERATION) WITHOUT DRAINAGE, O
PROPHYLAXIS OF RETINAL DETACHMENT (EG, RETINAL BREAK, LATTICE DEGENERATION) WITHOUT DRAINAGE, O
DESTRUCTION OF LOCALIZED LESION OF RETINA (EG, MACULAR EDEMA, TUMORS), ONE OR MORE SESSIONS; CR
DESTRUCTION OF LOCALIZED LESION OF RETINA (EG, MACULAR EDEMA, TUMORS), ONE OR MORE SESSIONS; PH
DESTRUCTION OF LOCALIZED LESION OF RETINA (EG, MACULOPATHY, CHOROIDOPATHY, SMALL TUMORS), ONE O
DESTRUCTION OF LOCALIZED LESION OF CHOROID (EG, CHOROIDAL NEOVASCULARIZATION); PHOTOCOAGULATI
DESTRUCTION OF LOCALIZED LESION OF CHOROID (EG, CHOROIDAL NEOVASCULARIZATION); PHOTODYNAMIC TH
DESTRUCTION OF LOCALIZED LESION OF CHOROID (EG, CHOROIDAL NEOVASCULARIZATION); PHOTODYNAMIC TH
DESTRUCTION OF EXTENSIVE OR PROGRESSIVE RETINOPATHY (EG, DIABETIC RETINOPATHY), ONE OR MORE SE
DESTRUCTION OF EXTENSIVE OR PROGRESSIVE RETINOPATHY (EG, DIABETIC RETINOPATHY), ONE OR MORE SE
SCLERAL REINFORCEMENT (SEPARATE PROCEDURE); WITHOUT GRAFT
SCLERAL REINFORCEMENT (SEPARATE PROCEDURE); WITH GRAFT
UNLISTED PROCEDURE, POSTERIOR SEGMENT
STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE; ONE HORIZONTAL MUSCLE
STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE (PATIENT NOT PREVIOUSLY OPERATED ON); TW
STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE (PATIENT NOT PREVIOUSLY OPERATED ON); O
STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE (PATIENT NOT PREVIOUSLY OPERATED ON); TW
STRABISMUS SURGERY, ANY PROCEDURE, SUPERIOR OBLIQUE MUSCLE
TRANSPOSITION PROCEDURE (EG, FOR PARETIC EXTRAOCULAR MUSCLE), ANY EXTRAOCULAR MUSCLE (SPECIF
STRABISMUS SURGERY ON PATIENT WITH PREVIOUS EYE SURGERY OR INJURY THAT DID NOT INVOLVE THE EXT
STRABISMUS SURGERY ON PATIENT WITH SCARRING OF EXTRAOCULAR MUSCLES (EG, PRIOR OCULAR INJURY, S
STRABISMUS SURGERY BY POSTERIOR FIXATION SUTURE TECHNIQUE, WITH OR WITHOUT MUSCLE RECESSION
PLACEMENT OF ADJUSTABLE SUTURE(S) DURING STRABISMUS SURGERY, INCLUDING POSTOPERATIVE ADJUSTM
STRABISMUS SURGERY INVOLVING EXPLORATION AND/OR REPAIR OF DETACHED EXTRAOCULAR MUSCLE(S) (LIS
RELEASE OF EXTENSIVE SCAR TISSUE WITHOUT DETACHING EXTRAOCULAR MUSCLE (SEPARATE PROCEDURE)
CHEMODENERVATION OF EXTRAOCULAR MUSCLE
BIOPSY OF EXTRAOCULAR MUSCLE
UNLISTED PROCEDURE, OCULAR MUSCLE
ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL APPROACH); FOR EXPLORATION, WITH
ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL APPROACH); WITH DRAINAGE ONLY
ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL APPROACH); WITH REMOVAL OF LESION
ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL APPROACH); WITH REMOVAL OF FOREIG
ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL APPROACH); WITH REMOVAL OF BONE F
FINE NEEDLE ASPIRATION OF ORBITAL CONTENTS
ORBITOTOMY WITH BONE FLAP OR WINDOW, LATERAL APPROACH (EG, KROENLEIN); WITH REMOVAL OF LESION
ORBITOTOMY WITH BONE FLAP OR WINDOW, LATERAL APPROACH (EG, KROENLEIN); WITH REMOVAL OF FOREIG
ORBITOTOMY WITH BONE FLAP OR WINDOW, LATERAL APPROACH (EG, KROENLEIN); WITH DRAINAGE
ORBITOTOMY WITH BONE FLAP OR WINDOW, LATERAL APPROACH (EG, KROENLEIN); WITH REMOVAL OF BONE FO
ORBITOTOMY WITH BONE FLAP OR WINDOW, LATERAL APPROACH (EG, KROENLEIN); FOR EXPLORATION, WITH O
RETROBULBAR INJECTION; MEDICATION (SEPARATE PROCEDURE, DOES NOT INCLUDE SUPPLY OF MEDICATION)
RETROBULBAR INJECTION; ALCOHOL
INJECTION OF MEDICATION OR OTHER SUBSTANCE INTO TENON'S CAPSULE
ORBITAL IMPLANT (IMPLANT OUTSIDE MUSCLE CONE); INSERTION
ORBITAL IMPLANT (IMPLANT OUTSIDE MUSCLE CONE); REMOVAL OR REVISION
OPTIC NERVE DECOMPRESSION (EG, INCISION OR FENESTRATION OF OPTIC NERVE SHEATH)
UNLISTED PROCEDURE, ORBIT
BLEPHAROTOMY, DRAINAGE OF ABSCESS, EYELID
SEVERING OF TARSORRHAPHY
CANTHOTOMY (SEPARATE PROCEDURE)
EXCISION OF CHALAZION; SINGLE
EXCISION OF CHALAZION; MULTIPLE, SAME LID
EXCISION OF CHALAZION; MULTIPLE, DIFFERENT LIDS
EXCISION OF CHALAZION; UNDER GENERAL ANESTHESIA AND/OR REQUIRING HOSPITALIZATION, SINGLE OR MUL
BIOPSY OF EYELID
CORRECTION OF TRICHIASIS; EPILATION, BY FORCEPS ONLY
CORRECTION OF TRICHIASIS; EPILATION BY OTHER THAN FORCEPS (EG, BY ELECTROSURGERY, CRYOTHERAPY,
CORRECTION OF TRICHIASIS; INCISION OF LID MARGIN
CORRECTION OF TRICHIASIS; INCISION OF LID MARGIN, WITH FREE MUCOUS MEMBRANE GRAFT
EXCISION OF LESION OF EYELID (EXCEPT CHALAZION) WITHOUT CLOSURE OR WITH SIMPLE DIRECT CLOSURE
DESTRUCTION OF LESION OF LID MARGIN (UP TO 1 CM)
TEMPORARY CLOSURE OF EYELIDS BY SUTURE (EG, FROST SUTURE)
CONSTRUCTION OF INTERMARGINAL ADHESIONS, MEDIAN TARSORRHAPHY, OR CANTHORRHAPHY;
CONSTRUCTION OF INTERMARGINAL ADHESIONS, MEDIAN TARSORRHAPHY, OR CANTHORRHAPHY; WITH TRANSP
REPAIR OF BROW PTOSIS (SUPRACILIARY, MID-FOREHEAD OR CORONAL APPROACH)
REPAIR OF BLEPHAROPTOSIS; FRONTALIS MUSCLE TECHNIQUE WITH SUTURE OR OTHER MATERIAL
REPAIR OF BLEPHAROPTOSIS; FRONTALIS MUSCLE TECHNIQUE WITH FASCIAL SLING (INCLUDES OBTAINING FAS
REPAIR OF BLEPHAROPTOSIS; (TARSO)LEVATOR RESECTION OR ADVANCEMENT, INTERNAL APPROACH
REPAIR OF BLEPHAROPTOSIS; (TARSO)LEVATOR RESECTION OR ADVANCEMENT, EXTERNAL APPROACH
REPAIR OF BLEPHAROPTOSIS; SUPERIOR RECTUS TECHNIQUE WITH FASCIAL SLING (INCLUDES OBTAINING FASC
REPAIR OF BLEPHAROPTOSIS; CONJUNCTIVO-TARSO-MULLER'S MUSCLE-LEVATOR RESECTION (EG, FASANELLA-
REDUCTION OF OVERCORRECTION OF PTOSIS
CORRECTION OF LID RETRACTION
REPAIR OF ECTROPION; SUTURE
REPAIR OF ECTROPION; THERMOCAUTERIZATION
REPAIR OF ECTROPION; BLEPHAROPLASTY, EXCISION TARSAL WEDGE
REPAIR OF ECTROPION; BLEPHAROPLASTY, EXTENSIVE (EG, KUHNT-SZYMANOWSKI OR TARSAL STRIP OPERATIO
REPAIR OF ENTROPION; SUTURE
REPAIR OF ENTROPION; THERMOCAUTERIZATION
REPAIR OF ENTROPION; BLEPHAROPLASTY, EXCISION TARSAL WEDGE
REPAIR OF ENTROPION; BLEPHAROPLASTY, EXTENSIVE (EG, WHEELER OPERATION)
SUTURE OF RECENT WOUND, EYELID, INVOLVING LID MARGIN, TARSUS, AND/OR PALPEBRAL CONJUNCTIVA DIRE
SUTURE OF RECENT WOUND, EYELID, INVOLVING LID MARGIN, TARSUS, AND/OR PALPEBRAL CONJUNCTIVA DIRE
REMOVAL OF EMBEDDED FOREIGN BODY, EYELID
CANTHOPLASTY (RECONSTRUCTION OF CANTHUS)
EXCISION AND REPAIR OF EYELID, INVOLVING LID MARGIN, TARSUS, CONJUNCTIVA, CANTHUS, OR FULL THICKNE
EXCISION AND REPAIR OF EYELID, INVOLVING LID MARGIN, TARSUS, CONJUNCTIVA, CANTHUS, OR FULL THICKNE
RECONSTRUCTION OF EYELID, FULL THICKNESS BY TRANSFER OF TARSOCONJUNCTIVAL FLAP FROM OPPOSING
RECONSTRUCTION OF EYELID, FULL THICKNESS BY TRANSFER OF TARSOCONJUNCTIVAL FLAP FROM OPPOSING
RECONSTRUCTION OF EYELID, FULL THICKNESS BY TRANSFER OF TARSOCONJUNCTIVAL FLAP FROM OPPOSING
RECONSTRUCTION OF EYELID, FULL THICKNESS BY TRANSFER OF TARSOCONJUNCTIVAL FLAP FROM OPPOSING
UNLISTED PROCEDURE, EYELIDS
INCISION OF CONJUNCTIVA, DRAINAGE OF CYST
EXPRESSION OF CONJUNCTIVAL FOLLICLES, EG, FOR TRACHOMA
BIOPSY OF CONJUNCTIVA
EXCISION OF LESION, CONJUNCTIVA; UP TO 1 CM
EXCISION OF LESION, CONJUNCTIVA; OVER 1 CM
EXCISION OF LESION, CONJUNCTIVA; WITH ADJACENT SCLERA
DESTRUCTION OF LESION, CONJUNCTIVA
SUBCONJUNCTIVAL INJECTION
CONJUNCTIVOPLASTY; WITH CONJUNCTIVAL GRAFT OR EXTENSIVE REARRANGEMENT
CONJUNCTIVOPLASTY; WITH BUCCAL MUCOUS MEMBRANE GRAFT (INCLUDES OBTAINING GRAFT)
CONJUNCTIVOPLASTY, RECONSTRUCTION CUL-DE-SAC; WITH CONJUNCTIVAL GRAFT OR EXTENSIVE REARRANG
CONJUNCTIVOPLASTY, RECONSTRUCTION CUL-DE-SAC; WITH BUCCAL MUCOUS MEMBRANE GRAFT (INCLUDES O
REPAIR OF SYMBLEPHARON; CONJUNCTIVOPLASTY, WITHOUT GRAFT
REPAIR OF SYMBLEPHARON; WITH FREE GRAFT CONJUNCTIVA OR BUCCAL MUCOUS MEMBRANE (INCLUDES OBT
REPAIR OF SYMBLEPHARON; DIVISION OF SYMBLEPHARON, WITH OR WITHOUT INSERTION OF CONFORMER OR C
CONJUNCTIVAL FLAP; BRIDGE OR PARTIAL (SEPARATE PROCEDURE)
CONJUNCTIVAL FLAP; TOTAL (SUCH AS GUNDERSON THIN FLAP OR PURSE STRING FLAP)
UNLISTED PROCEDURE, CONJUNCTIVA
INCISION, DRAINAGE OF LACRIMAL GLAND
INCISION, DRAINAGE OF LACRIMAL SAC (DACRYOCYSTOTOMY OR DACRYOCYSTOSTOMY)
SNIP INCISION OF LACRIMAL PUNCTUM
EXCISION OF LACRIMAL GLAND (DACRYOADENECTOMY), EXCEPT FOR TUMOR; TOTAL
EXCISION OF LACRIMAL GLAND (DACRYOADENECTOMY), EXCEPT FOR TUMOR; PARTIAL
BIOPSY OF LACRIMAL GLAND
EXCISION OF LACRIMAL SAC (DACRYOCYSTECTOMY)
BIOPSY OF LACRIMAL SAC
REMOVAL OF FOREIGN BODY OR DACRYOLITH, LACRIMAL PASSAGES
EXCISION OF LACRIMAL GLAND TUMOR; FRONTAL APPROACH
EXCISION OF LACRIMAL GLAND TUMOR; INVOLVING OSTEOTOMY
PLASTIC REPAIR OF CANALICULI
CORRECTION OF EVERTED PUNCTUM, CAUTERY
DACRYOCYSTORHINOSTOMY (FISTULIZATION OF LACRIMAL SAC TO NASAL CAVITY)
CONJUNCTIVORHINOSTOMY (FISTULIZATION OF CONJUNCTIVA TO NASAL CAVITY); WITHOUT TUBE
CONJUNCTIVORHINOSTOMY (FISTULIZATION OF CONJUNCTIVA TO NASAL CAVITY); WITH INSERTION OF TUBE OR
CLOSURE OF THE LACRIMAL PUNCTUM; BY THERMOCAUTERIZATION, LIGATION, OR LASER SURGERY
CLOSURE OF THE LACRIMAL PUNCTUM; BY PLUG, EACH
CLOSURE OF LACRIMAL FISTULA (SEPARATE PROCEDURE)
DILATION OF LACRIMAL PUNCTUM, WITH OR WITHOUT IRRIGATION
PROBING OF NASOLACRIMAL DUCT, WITH OR WITHOUT IRRIGATION;
PROBING OF NASOLACRIMAL DUCT, WITH OR WITHOUT IRRIGATION; REQUIRING GENERAL ANESTHESIA
PROBING OF NASOLACRIMAL DUCT, WITH OR WITHOUT IRRIGATION; WITH INSERTION OF TUBE OR STENT
PROBING OF LACRIMAL CANALICULI, WITH OR WITHOUT IRRIGATION
INJECTION OF CONTRAST MEDIUM FOR DACRYOCYSTOGRAPHY
UNLISTED PROCEDURE, LACRIMAL SYSTEM
DRAINAGE EXTERNAL EAR, ABSCESS OR HEMATOMA; SIMPLE
DRAINAGE EXTERNAL EAR, ABSCESS OR HEMATOMA; COMPLICATED
DRAINAGE EXTERNAL AUDITORY CANAL, ABSCESS
EAR PIERCING
BIOPSY EXTERNAL EAR
BIOPSY EXTERNAL AUDITORY CANAL
EXCISION EXTERNAL EAR; PARTIAL, SIMPLE REPAIR
EXCISION EXTERNAL EAR; COMPLETE AMPUTATION
EXCISION EXOSTOSIS(ES), EXTERNAL AUDITORY CANAL
EXCISION SOFT TISSUE LESION, EXTERNAL AUDITORY CANAL
RADICAL EXCISION EXTERNAL AUDITORY CANAL LESION; WITHOUT NECK DISSECTION
RADICAL EXCISION EXTERNAL AUDITORY CANAL LESION; WITH NECK DISSECTION
REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL; WITHOUT GENERAL ANESTHESIA
REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL; WITH GENERAL ANESTHESIA
REMOVAL IMPACTED CERUMEN (SEPARATE PROCEDURE), ONE OR BOTH EARS
DEBRIDEMENT, MASTOIDECTOMY CAVITY, SIMPLE (EG, ROUTINE CLEANING)
DEBRIDEMENT, MASTOIDECTOMY CAVITY, COMPLEX (EG, WITH ANESTHESIA OR MORE THAN ROUTINE CLEANING
OTOPLASTY, PROTRUDING EAR, WITH OR WITHOUT SIZE REDUCTION
RECONSTRUCTION OF EXTERNAL AUDITORY CANAL (MEATOPLASTY) (EG, FOR STENOSIS DUE TO INJURY, INFECT
RECONSTRUCTION EXTERNAL AUDITORY CANAL FOR CONGENITAL ATRESIA, SINGLE STAGE
UNLISTED PROCEDURE, EXTERNAL EAR
EUSTACHIAN TUBE INFLATION, TRANSNASAL; WITH CATHETERIZATION
EUSTACHIAN TUBE INFLATION, TRANSNASAL; WITHOUT CATHETERIZATION
EUSTACHIAN TUBE CATHETERIZATION, TRANSTYMPANIC
FOCAL APPLICATION OF PHASE CONTROL SUBSTANCE, MIDDLE EAR (BAFFLE TECHNIQUE)
MYRINGOTOMY INCLUDING ASPIRATION AND/OR EUSTACHIAN TUBE INFLATION
MYRINGOTOMY INCLUDING ASPIRATION AND/OR EUSTACHIAN TUBE INFLATION REQUIRING GENERAL ANESTHES
VENTILATING TUBE REMOVAL REQUIRING GENERAL ANESTHESIA
TYMPANOSTOMY (REQUIRING INSERTION OF VENTILATING TUBE), LOCAL OR TOPICAL ANESTHESIA
TYMPANOSTOMY (REQUIRING INSERTION OF VENTILATING TUBE), GENERAL ANESTHESIA
MIDDLE EAR EXPLORATION THROUGH POSTAURICULAR OR EAR CANAL INCISION
TYMPANOLYSIS, TRANSCANAL
TRANSMASTOID ANTROTOMY ("SIMPLE" MASTOIDECTOMY)
MASTOIDECTOMY; COMPLETE
MASTOIDECTOMY; MODIFIED RADICAL
MASTOIDECTOMY; RADICAL
PETROUS APICECTOMY INCLUDING RADICAL MASTOIDECTOMY
RESECTION TEMPORAL BONE, EXTERNAL APPROACH
EXCISION AURAL POLYP
EXCISION AURAL GLOMUS TUMOR; TRANSCANAL
EXCISION AURAL GLOMUS TUMOR; TRANSMASTOID
EXCISION AURAL GLOMUS TUMOR; EXTENDED (EXTRATEMPORAL)
REVISION MASTOIDECTOMY; RESULTING IN COMPLETE MASTOIDECTOMY
REVISION MASTOIDECTOMY; RESULTING IN MODIFIED RADICAL MASTOIDECTOMY
REVISION MASTOIDECTOMY; RESULTING IN RADICAL MASTOIDECTOMY
REVISION MASTOIDECTOMY; RESULTING IN TYMPANOPLASTY
REVISION MASTOIDECTOMY; WITH APICECTOMY
TYMPANIC MEMBRANE REPAIR, WITH OR WITHOUT SITE PREPARATION OR PERFORATION FOR CLOSURE, WITH O
MYRINGOPLASTY (SURGERY CONFINED TO DRUMHEAD AND DONOR AREA)
TYMPANOPLASTY W/O MASTOIDECTOMY (INC CANALPLASTY, ATTICOTOMY AND/OR MIDDLE EAR SURGERY), INITI
TYMPANOPLASTY W/O MASTOIDECTOMY (INC CANALPLASTY, ATTICOTOMY AND/OR MIDDLE EAR SURGERY), INITI
TYMPANOPLASTY W/O MASTOIDECTOMY (INC CANALPLASTY, ATTICOTOMY AND/OR MIDDLE EAR SURGERY), INITI
TYMPANOPLASTY WITH ANTROTOMY OR MASTOIDOTOMY (INCLUDING CANALPLASTY, ATTICOTOMY, MIDDLE EAR
TYMPANOPLASTY WITH ANTROTOMY OR MASTOIDOTOMY (INCLUDING CANALPLASTY, ATTICOTOMY, MIDDLE EAR
TYMPANOPLASTY WITH ANTROTOMY OR MASTOIDOTOMY (INCLUDING CANALPLASTY, ATTICOTOMY, MIDDLE EAR
TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBR
TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBR
TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBR
TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBR
TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBR
TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBR
STAPES MOBILIZATION
STAPEDECTOMY OR STAPEDOTOMY WITH REESTABLISHMENT OF OSSICULAR CONTINUITY, WITH OR WITHOUT U
STAPEDECTOMY OR STAPEDOTOMY WITH REESTABLISHMENT OF OSSICULAR CONTINUITY, WITH OR WITHOUT U
REVISION OF STAPEDECTOMY OR STAPEDOTOMY
REPAIR OVAL WINDOW FISTULA
REPAIR ROUND WINDOW FISTULA
MASTOID OBLITERATION (SEPARATE PROCEDURE)
TYMPANIC NEURECTOMY
CLOSURE POSTAURICULAR FISTULA, MASTOID (SEPARATE PROCEDURE)
IMPLANTATION OR REPLACEMENT OF ELECTROMAGNETIC BONE CONDUCTION HEARING DEVICE IN TEMPORAL B
REMOVAL OR REPAIR OF ELECTROMAGNETIC BONE CONDUCTION HEARING DEVICE IN TEMPORAL BONE
IMPLANTATION, OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTER
IMPLANTATION, OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WITH PERCUTANEOUS ATTACHMENT TO EXTER
REPLACEMENT (INCLUDING REMOVAL OF EXISTING DEVICE), OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WI
REPLACEMENT (INCLUDING REMOVAL OF EXISTING DEVICE), OSSEOINTEGRATED IMPLANT, TEMPORAL BONE, WI
DECOMPRESSION FACIAL NERVE, INTRATEMPORAL; LATERAL TO GENICULATE GANGLION
DECOMPRESSION FACIAL NERVE, INTRATEMPORAL; INCLUDING MEDIAL TO GENICULATE GANGLION
SUTURE FACIAL NERVE, INTRATEMPORAL, WITH OR WITHOUT GRAFT OR DECOMPRESSION; LATERAL TO GENICU
SUTURE FACIAL NERVE, INTRATEMPORAL, WITH OR WITHOUT GRAFT OR DECOMPRESSION; INCLUDING MEDIAL T
UNLISTED PROCEDURE, MIDDLE EAR
LABYRINTHOTOMY, WITH OR WITHOUT CRYOSURGERY INCLUDING OTHER NONEXCISIONAL DESTRUCTIVE PROC
LABYRINTHOTOMY, WITH OR WITHOUT CRYOSURGERY OR OTHER NONEXCISIONAL DESTRUCTIVE PROCEDURES
ENDOLYMPHATIC SAC OPERATION; WITHOUT SHUNT
ENDOLYMPHATIC SAC OPERATION; WITH SHUNT
FENESTRATION SEMICIRCULAR CANAL
REVISION FENESTRATION OPERATION
LABYRINTHECTOMY; TRANSCANAL
LABYRINTHECTOMY; WITH MASTOIDECTOMY
VESTIBULAR NERVE SECTION, TRANSLABYRINTHINE APPROACH
COCHLEAR DEVICE IMPLANTATION, WITH OR WITHOUT MASTOIDECTOMY
UNLISTED PROCEDURE, INNER EAR
VESTIBULAR NERVE SECTION, TRANSCRANIAL APPROACH
TOTAL FACIAL NERVE DECOMPRESSION AND/OR REPAIR (MAY INCLUDE GRAFT)
DECOMPRESSION INTERNAL AUDITORY CANAL
REMOVAL OF TUMOR, TEMPORAL BONE
UNLISTED PROCEDURE, TEMPORAL BONE, MIDDLE FOSSA APPROACH
MICROSURGICAL TECHNIQUES, REQUIRING USE OF OPERATING MICROSCOPE (LIST SEPARATELY IN ADDITION TO
MYELOGRAPHY, POSTERIOR FOSSA, RADIOLOGICAL SUPERVISION AND INTERPRETATION
CISTERNOGRAPHY, POSITIVE CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION
RADIOLOGIC EXAMINATION, EYE, FOR DETECTION OF FOREIGN BODY
RADIOLOGIC EXAMINATION, MANDIBLE; PARTIAL, LESS THAN FOUR VIEWS
RADIOLOGIC EXAMINATION, MANDIBLE; COMPLETE, MINIMUM OF FOUR VIEWS
RADIOLOGIC EXAMINATION, MASTOIDS; LESS THAN THREE VIEWS PER SIDE
RADIOLOGIC EXAMINATION, MASTOIDS; COMPLETE, MINIMUM OF THREE VIEWS PER SIDE
RADIOLOGIC EXAMINATION, INTERNAL AUDITORY MEATI, COMPLETE
RADIOLOGIC EXAMINATION, FACIAL BONES; LESS THAN THREE VIEWS
RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE VIEWS
RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF THREE VIEWS
DACRYOCYSTOGRAPHY, NASOLACRIMAL DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION
RADIOLOGIC EXAMINATION; OPTIC FORAMINA
RADIOLOGIC EXAMINATION; ORBITS, COMPLETE, MINIMUM OF FOUR VIEWS
RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, LESS THAN THREE VIEWS
RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, COMPLETE, MINIMUM OF THREE VIEWS
RADIOLOGIC EXAMINATION, SELLA TURCICA
RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS, WITH OR WITHOUT STEREO
RADIOLOGIC EXAMINATION, SKULL; COMPLETE, MINIMUM OF FOUR VIEWS, WITH OR WITHOUT STEREO
RADIOLOGIC EXAMINATION, TEETH; SINGLE VIEW
RADIOLOGIC EXAMINATION, TEETH; PARTIAL EXAMINATION, LESS THAN FULL MOUTH
RADIOLOGIC EXAMINATION, TEETH; COMPLETE, FULL MOUTH
RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND CLOSED MOUTH; UNILATERAL
RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND CLOSED MOUTH; BILATERAL
TEMPOROMANDIBULAR JOINT ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
MAGNETIC RESONANCE (EG, PROTON) IMAGING, TEMPOROMANDIBULAR JOINT(S)
CEPHALOGRAM, ORTHODONTIC
ORTHOPANTOGRAM
RADIOLOGIC EXAMINATION; NECK, SOFT TISSUE
RADIOLOGIC EXAMINATION; PHARYNX OR LARYNX, INCLUDING FLUOROSCOPY AND/OR MAGNIFICATION TECHNIQ
COMPLEX DYNAMIC PHARYNGEAL AND SPEECH EVALUATION BY CINE OR VIDEO RECORDING
LARYNGOGRAPHY, CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION
RADIOLOGIC EXAMINATION, SALIVARY GLAND FOR CALCULUS
SIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL
COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITH CONTRAST MATERIAL(S)
COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIA
COMPUTED TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT C
COMPUTED TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITH CONT
COMPUTED TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT C
COMPUTED TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL
COMPUTED TOMOGRAPHY, MAXILLOFACIAL AREA; WITH CONTRAST MATERIAL(S)
COMPUTED TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL,FOLLOWED BY CONTRAST MA
COMPUTED TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL
COMPUTED TOMOGRAPHY, SOFT TISSUE NECK; WITH CONTRAST MATERIAL(S)
COMPUTED TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL FOLLOWED BY CONTRAST MATE
COMPUTED TOMOGRAPHIC ANGIOGRAPHY, HEAD, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST
COMPUTED TOMOGRAPHIC ANGIOGRAPHY, NECK, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST
MAGNETIC RESONANCE (EG, PROTON) IMAGING, ORBIT, FACE, AND NECK; WITHOUT CONTRAST MATERIAL(S)
MAGNETIC RESONANCE (EG, PROTON) IMAGING, ORBIT, FACE, AND NECK; WITH CONTRAST MATERIAL(S)
MAGNETIC RESONANCE (EG, PROTON) IMAGING, ORBIT, FACE, AND NECK; WITHOUT CONTRAST MATERIAL(S), FO
MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CONTRAST MATERIAL(S)
MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITH CONTRAST MATERIAL(S)
MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MA
MAGNETIC RESONANCE ANGIOGRAPHY, NECK; WITHOUT CONTRAST MATERIAL(S)
MAGNETIC RESONANCE ANGIOGRAPHY, NECK; WITH CONTRAST MATERIAL(S)
MAGNETIC RESONANCE ANGIOGRAPHY, NECK; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MA
MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIA
MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITH CONTRAST MATERIAL(S)
MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIA
RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTAL
RADIOLOGIC EXAMINATION, CHEST; STEREO, FRONTAL
RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;
RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; WITH APICAL LORDOTIC PROCEDURE
RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; WITH OBLIQUE PROJECTIONS
RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; WITH FLUOROSCOPY
RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS;
RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS; WITH FLUOROSCOPY
RADIOLOGIC EXAMINATION, CHEST, SPECIAL VIEWS (EG, LATERAL DECUBITUS, BUCKY STUDIES)
BRONCHOGRAPHY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
BRONCHOGRAPHY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
INSERTION PACEMAKER, FLUOROSCOPY AND RADIOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATIO
RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS
RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEW
RADIOLOGIC EXAMINATION, RIBS, BILATERAL; THREE VIEWS
RADIOLOGIC EXAMINATION, RIBS, BILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF FOUR VIEWS
RADIOLOGIC EXAMINATION; STERNUM, MINIMUM OF TWO VIEWS
RADIOLOGIC EXAMINATION; STERNOCLAVICULAR JOINT OR JOINTS, MINIMUM OF THREE VIEWS
COMPUTED TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL
COMPUTED TOMOGRAPHY, THORAX; WITH CONTRAST MATERIAL(S)
COMPUTED TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AN
COMPUTED TOMOGRAPHIC ANGIOGRAPHY, CHEST, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAS
MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR EVALUATION OF HILAR AND MEDIASTINAL LYMP
MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR EVALUATION OF HILAR AND MEDIASTINAL LYMP
MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR EVALUATION OF HILAR AND MEDIASTINAL LYMP
MAGNETIC RESONANCE ANGIOGRAPHY, CHEST (EXCLUDING MYOCARDIUM), WITH OR WITHOUT CONTRAST MATE
RADIOLOGIC EXAMINATION, SPINE, ENTIRE, SURVEY STUDY, ANTEROPOSTERIOR AND LATERAL
RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL
RADIOLOGIC EXAMINATION, SPINE, CERVICAL; TWO OR THREE VIEWS
RADIOLOGIC EXAMINATION, SPINE, CERVICAL; MINIMUM OF FOUR VIEWS
RADIOLOGIC EXAMINATION, SPINE, CERVICAL; COMPLETE, INCLUDING OBLIQUE AND FLEXION AND/OR EXTENSIO
RADIOLOGIC EXAMINATION, SPINE, THORACOLUMBAR, STANDING (SCOLIOSIS)
RADIOLOGIC EXAMINATION, SPINE; THORACIC, TWO VIEWS
RADIOLOGIC EXAMINATION, SPINE; THORACIC, THREE VIEWS
RADIOLOGIC EXAMINATION, SPINE; THORACIC, MINIMUM OF FOUR VIEWS
RADIOLOGIC EXAMINATION, SPINE; THORACOLUMBAR, TWO VIEWS
RADIOLOGIC EXAMINATION, SPINE; SCOLIOSIS STUDY, INCLUDING SUPINE AND ERECT STUDIES
RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; TWO OR THREE VIEWS
RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; MINIMUM OF FOUR VIEWS
RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, INCLUDING BENDING VIEWS
RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL, BENDING VIEWS ONLY, MINIMUM OF FOUR VIEWS
COMPUTED TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL
COMPUTED TOMOGRAPHY, CERVICAL SPINE; WITH CONTRAST MATERIAL
COMPUTED TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATER
COMPUTED TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL
COMPUTED TOMOGRAPHY, THORACIC SPINE; WITH CONTRAST MATERIAL
COMPUTED TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATER
COMPUTED TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL
COMPUTED TOMOGRAPHY, LUMBAR SPINE; WITH CONTRAST MATERIAL
COMPUTED TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIA
MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITHOUT CONTRAST
MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITH CONTRAST MA
MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITHOUT CONTRAS
MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITH CONTRAST MA
MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITHOUT CONTRAST M
MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITH CONTRAST MATE
MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL
MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL
MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL
MAGNETIC RESONANCE ANGIOGRAPHY, SPINAL CANAL AND CONTENTS, WITH OR WITHOUT CONTRAST MATERIA
RADIOLOGIC EXAMINATION, PELVIS; ONE OR TWO VIEWS
RADIOLOGIC EXAMINATION, PELVIS; COMPLETE, MINIMUM OF THREE VIEWS
COMPUTED TOMOGRAPHIC ANGIOGRAPHY, PELVIS, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAS
COMPUTED TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL
COMPUTED TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S)
COMPUTED TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND
MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS; WITHOUT CONTRAST MATERIAL(S)
MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS; WITH CONTRAST MATERIAL(S)
MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CON
MAGNETIC RESONANCE ANGIOGRAPHY, PELVIS, WITH OR WITHOUT CONTRAST MATERIAL(S)
RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; LESS THAN THREE VIEWS
RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; THREE OR MORE VIEWS
RADIOLOGIC EXAMINATION, SACRUM AND COCCYX, MINIMUM OF TWO VIEWS
MYELOGRAPHY, CERVICAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
MYELOGRAPHY, THORACIC, RADIOLOGICAL SUPERVISION AND INTERPRETATION
MYELOGRAPHY, LUMBOSACRAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
MYELOGRAPHY, ENTIRE SPINAL CANAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
EPIDUROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
DISKOGRAPHY, CERVICAL OR THORACIC, RADIOLOGICAL SUPERVISION AND INTERPRETATION
DISKOGRAPHY, LUMBAR, RADIOLOGICAL SUPERVISION AND INTERPRETATION
RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE
RADIOLOGIC EXAMINATION; SCAPULA, COMPLETE
RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW
RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS
RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
RADIOLOGIC EXAMINATION; ACROMIOCLAVICULAR JOINTS, BILATERAL, WITH OR WITHOUT WEIGHTED DISTRACT
RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS
RADIOLOGIC EXAMINATION, ELBOW; TWO VIEWS
RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWS
RADIOLOGIC EXAMINATION, ELBOW, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
RADIOLOGIC EXAMINATION; FOREARM, TWO VIEWS
RADIOLOGIC EXAMINATION; UPPER EXTREMITY, INFANT, MINIMUM OF TWO VIEWS
RADIOLOGIC EXAMINATION, WRIST; TWO VIEWS
RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS
RADIOLOGIC EXAMINATION, WRIST, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
RADIOLOGIC EXAMINATION, HAND; TWO VIEWS
RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS
RADIOLOGIC EXAMINATION, FINGER(S), MINIMUM OF TWO VIEWS
COMPUTED TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL
COMPUTED TOMOGRAPHY, UPPER EXTREMITY; WITH CONTRAST MATERIAL(S)
COMPUTED TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL,FOLLOWED BY CONTRAST MATE
COMPUTED TOMOGRAPHIC ANGIOGRAPHY, UPPER EXTREMITY, WITHOUT CONTRAST MATERIAL(S), FOLLOWED B
MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT; WITHOUT CONTRAST M
MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT; WITH CONTRAST MATE
MAGNETIC RESONANCE IMAGING, UPPER EXTREMITY, OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S), FO
MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY; WITHOUT CONTRAST MATER
MAGNETIC RESONANCE IMAGING, ANY JOINT OF UPPER EXTREMITY; WITH CONTRAST MATERIAL(S)
MAGNETIC RESONANCE IMAGING, ANY JOINT OF UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL(S), FOLLOW
MAGNETIC RESONANCE ANGIOGRAPHY, UPPER EXTREMITY, WITH OR WITHOUT CONTRAST MATERIAL(S)
RADIOLOGIC EXAMINATION, HIP UNILATERAL; ONE VIEW
RADIOLOGIC EXAMINATION, HIP UNILATERAL; COMPLETE, MINIMUM OF TWO VIEWS
RADIOLOGIC EXAMINATION, HIPS, BILATERAL, MINIMUM OF TWO VIEWS OF EACH HIP, INCLUDING ANTEROPOSTE
RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
RADIOLOGIC EXAMINATION, HIP, DURING OPERATIVE PROCEDURE
RADIOLOGIC EXAMINATION, PELVIS AND HIPS, INFANT OR CHILD, MINIMUM OF TWO VIEWS
RADIOLOGICAL EXAMINATION, SACROILIAC JOINT ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRE
RADIOLOGIC EXAMINATION, FEMUR, TWO VIEWS
RADIOLOGIC EXAMINATION, KNEE; ONE OR TWO VIEWS
RADIOLOGIC EXAMINATION, KNEE; THREE VIEWS
RADIOLOGIC EXAMINATION, KNEE; COMPLETE, FOUR OR MORE VIEWS
RADIOLOGIC EXAMINATION, KNEE; BOTH KNEES, STANDING, ANTEROPOSTERIOR
RADIOLOGIC EXAMINATION, KNEE, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, TWO VIEWS
RADIOLOGIC EXAMINATION; LOWER EXTREMITY, INFANT, MINIMUM OF TWO VIEWS
RADIOLOGIC EXAMINATION, ANKLE; TWO VIEWS
RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS
RADIOLOGIC EXAMINATION, ANKLE, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
RADIOLOGIC EXAMINATION, FOOT; TWO VIEWS
RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS
RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWS
RADIOLOGIC EXAMINATION; TOE(S), MINIMUM OF TWO VIEWS
COMPUTED TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL
COMPUTED TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST MATERIAL(S)
COMPUTED TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL,FOLLOWED BY CONTRAST MATE
COMPUTED TOMOGRAPHIC ANGIOGRAPHY, LOWER EXTREMITY, WITHOUT CONTRAST MATERIAL(S), FOLLOWED
MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER THAN JOINT; WITHOUT CONTRAST M
MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER THAN JOINT; WITH CONTRAST MATE
MAGNETIC RESONANCE IMAGING, LOWER EXTREMITY OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S), FO
MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATER
MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITH CONTRAST MATERIAL(
MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATER
MAGNETIC RESONANCE ANGIOGRAPHY, LOWER EXTREMITY, WITH OR WITHOUT CONTRAST MATERIAL(S)
RADIOLOGIC EXAMINATION, ABDOMEN; SINGLE ANTEROPOSTERIOR VIEW
RADIOLOGIC EXAMINATION, ABDOMEN; ANTEROPOSTERIOR AND ADDITIONAL OBLIQUE AND CONE VIEWS
RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE, INCLUDING DECUBITUS AND/OR ERECT VIEWS
RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE ACUTE ABDOMEN SERIES, INCLUDING SUPINE, ERECT, AND/OR
COMPUTED TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL
COMPUTED TOMOGRAPHY, ABDOMEN; WITH CONTRAST MATERIAL(S)
COMPUTED TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) A
COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMEN, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTR
MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIAL(S)
MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITH CONTRAST MATERIAL(S)
MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY W
MAGNETIC RESONANCE ANGIOGRAPHY, ABDOMEN, WITH OR WITHOUT CONTRAST MATERIAL(S)
PERITONEOGRAM (EG, AFTER INJECTION OF AIR OR CONTRAST), RADIOLOGICAL SUPERVISION AND INTERPRETA
RADIOLOGIC EXAMINATION; PHARYNX AND/OR CERVICAL ESOPHAGUS
RADIOLOGIC EXAMINATION; ESOPHAGUS
SWALLOWING FUNCTION, WITH CINERADIOGRAPHY/VIDEORADIOGRAPHY
REMOVAL OF FOREIGN BODY(S), ESOPHAGEAL, WITH USE OF BALLOON CATHETER, RADIOLOGICAL SUPERVISION
RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR WITHOUT DELAYED FILMS, WITHOUT K
RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR WITHOUT DELAYED FILMS, WITH KUB
RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH SMALL INTESTINE, INCLUDES MULTIPLE SE
RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH DENSITY
RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH DENSITY
RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH DENSITY
RADIOLOGIC EXAMINATION, SMALL INTESTINE, INCLUDES MULTIPLE SERIAL FILMS;
RADIOLOGIC EXAMINATION, SMALL INTESTINE, INCLUDES MULTIPLE SERIAL FILMS; VIA ENTEROCLYSIS TUBE
DUODENOGRAPHY, HYPOTONIC
RADIOLOGIC EXAMINATION, COLON; BARIUM ENEMA, WITH OR WITHOUT KUB
RADIOLOGIC EXAMINATION, COLON; AIR CONTRAST WITH SPECIFIC HIGH DENSITY BARIUM, WITH OR WITHOUT G
BARIUM ENEMA, THERAPEUTIC, FOR REDUCTION OF INTUSSUSCEPTION
CHOLECYSTOGRAPHY, ORAL CONTRAST;
CHOLECYSTOGRAPHY, ORAL CONTRAST; ADDITIONAL OR REPEAT EXAMINATION OR MULTIPLE DAY EXAMINATION
CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; INTRAOPERATIVE, RADIOLOGICAL SUPERVISION AND INTERP
CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; ADDITIONAL SET INTRAOPERATIVE, RADIOLOGICAL SUPERVIS
CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; THROUGH EXISTING CATHETER, RADIOLOGICAL SUPERVISIO
CHOLANGIOGRAPHY, PERCUTANEOUS, TRANSHEPATIC, RADIOLOGICAL SUPERVISION AND INTERPRETATION
POSTOPERATIVE BILIARY DUCT CALCULUS REMOVAL, PERCUTANEOUS VIA T-TUBE TRACT, BASKET, OR SNARE (E
ENDOSCOPIC CATHETERIZATION OF THE BILIARY DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND INTERPRE
ENDOSCOPIC CATHETERIZATION OF THE PANCREATIC DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND INTE
COMBINED ENDOSCOPIC CATHETERIZATION OF THE BILIARY AND PANCREATIC DUCTAL SYSTEMS, RADIOLOGICA
INTRODUCTION OF LONG GASTROINTESTINAL TUBE (EG, MILLER-ABBOTT), INCLUDING MULTIPLE FLUOROSCOPIE
PERCUTANEOUS PLACEMENT OF GASTROSTOMY TUBE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
PERCUTANEOUS PLACEMENT OF ENTEROCLYSIS TUBE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
INTRALUMINAL DILATION OF STRICTURES AND/OR OBSTRUCTIONS (EG, ESOPHAGUS), RADIOLOGICAL SUPERVISI
PERCUTANEOUS TRANSHEPATIC DILATION OF BILIARY DUCT STRICTURE WITH OR WITHOUT PLACEMENT OF STE
UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH OR WITHOUT TOMOGRAPHY;
UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE;
UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; WITH NEPHROTOMOGRAPHY
UROGRAPHY, RETROGRADE, WITH OR WITHOUT KUB
UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM, LOOPOGRAM), RADIOLOGICAL SUPERVISION A
CYSTOGRAPHY, MINIMUM OF THREE VIEWS, RADIOLOGICAL SUPERVISION AND INTERPRETATION
VASOGRAPHY, VESICULOGRAPHY, OR EPIDIDYMOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
CORPORA CAVERNOSOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
URETHROCYSTOGRAPHY, RETROGRADE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
URETHROCYSTOGRAPHY, VOIDING, RADIOLOGICAL SUPERVISION AND INTERPRETATION
RADIOLOGIC EXAMINATION, RENAL CYST STUDY, TRANSLUMBAR, CONTRAST VISUALIZATION, RADIOLOGICAL SUP
INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PER
INTRODUCTION OF URETERAL CATHETER OR STENT INTO URETER THROUGH RENAL PELVIS FOR DRAINAGE AND
DILATION OF NEPHROSTOMY, URETERS, OR URETHRA, RADIOLOGICAL SUPERVISION AND INTERPRETATION
PELVIMETRY, WITH OR WITHOUT PLACENTAL LOCALIZATION
HYSTEROSALPINGOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
TRANSCERVICAL CATHETERIZATION OF FALLOPIAN TUBE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
PERINEOGRAM (EG, VAGINOGRAM, FOR SEX DETERMINATION OR EXTENT OF ANOMALIES)
CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY; WITHOUT CONTRAST MATERIAL
CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY; WITH CONTRAST MATERIAL
CARDIAC MAGNETIC RESONANCE IMAGING FOR FUNCTION, WITH OR WITHOUT MORPHOLOGY; COMPLETE STUDY
CARDIAC MAGNETIC RESONANCE IMAGING FOR FUNCTION, WITH OR WITHOUT MORPHOLOGY;LIMITED STUDY
CARDIAC MAGNETIC RESONANCE IMAGING FOR VELOCITY FLOW MAPPING
AORTOGRAPHY, THORACIC, WITHOUT SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
AORTOGRAPHY, THORACIC, BY SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
AORTOGRAPHY, ABDOMINAL, BY SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
AORTOGRAPHY, ABDOMINAL PLUS BILATERAL ILIOFEMORAL LOWER EXTREMITY, CATHETER, BY SERIALOGRAPHY
COMPUTD TOMOGRAPH ANGIOGRAPHY,ABDOMIN AORTA & BILATRL ILIOFEMORAL LOW EXTREMITY RUNOFF,RAD
ANGIOGRAPHY, CERVICOCEREBRAL, CATHETER, INCLUDING VESSEL ORIGIN, RADIOLOGICAL SUPERVISION AND I
ANGIOGRAPHY, BRACHIAL, RETROGRADE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
ANGIOGRAPHY, EXTERNAL CAROTID, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATI
ANGIOGRAPHY, EXTERNAL CAROTID, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATIO
ANGIOGRAPHY, CAROTID, CEREBRAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
ANGIOGRAPHY, CAROTID, CEREBRAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
ANGIOGRAPHY, CAROTID, CERVICAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
ANGIOGRAPHY, CAROTID, CERVICAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
ANGIOGRAPHY, VERTEBRAL, CERVICAL, AND/OR INTRACRANIAL, RADIOLOGICAL SUPERVISION AND INTERPRETAT
ANGIOGRAPHY, SPINAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
ANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
ANGIOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
ANGIOGRAPHY, RENAL, UNILATERAL, SELECTIVE (INCLUDING FLUSH AORTOGRAM), RADIOLOGICAL SUPERVISION
ANGIOGRAPHY, RENAL, BILATERAL, SELECTIVE (INCLUDING FLUSH AORTOGRAM), RADIOLOGICAL SUPERVISION A
ANGIOGRAPHY, VISCERAL, SELECTIVE OR SUPRASELECTIVE, (WITH OR WITHOUT FLUSH AORTOGRAM), RADIOLO
ANGIOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
ANGIOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
ANGIOGRAPHY, PELVIC, SELECTIVE OR SUPRASELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
ANGIOGRAPHY, PULMONARY, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
ANGIOGRAPHY, PULMONARY, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
ANGIOGRAPHY, PULMONARY, BY NONSELECTIVE CATHETER OR VENOUS INJECTION, RADIOLOGICAL SUPERVISIO
ANGIOGRAPHY, INTERNAL MAMMARY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
ANGIOGRAPHY, SELECTIVE, EACH ADDITIONAL VESSEL STUDIED AFTER BASIC EXAMINATION, RADIOLOGICAL SUP
ANGIOGRAPHY, ARTERIOVENOUS SHUNT (EG, DIALYSIS PATIENT), RADIOLOGICAL SUPERVISION AND INTERPRET
LYMPHANGIOGRAPHY, EXTREMITY ONLY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
LYMPHANGIOGRAPHY, EXTREMITY ONLY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
SHUNTOGRAM FOR INVESTIGATION OF PREVIOUSLY PLACED INDWELLING NONVASCULAR SHUNT (EG, LEVEEN S
SPLENOPORTOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
VENOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
VENOGRAPHY, CAVAL, INFERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
VENOGRAPHY, CAVAL, SUPERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
VENOGRAPHY, RENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
VENOGRAPHY, RENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
VENOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
VENOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
VENOGRAPHY, SINUS OR JUGULAR, CATHETER, RADIOLOGICAL SUPERVISION AND INTERPRETATION
VENOGRAPHY, SUPERIOR SAGITTAL SINUS, RADIOLOGICAL SUPERVISION AND INTERPRETATION
VENOGRAPHY, EPIDURAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
VENOGRAPHY, ORBITAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITH HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISIO
PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITHOUT HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERV
HEPATIC VENOGRAPHY, WEDGED OR FREE, WITH HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AN
HEPATIC VENOGRAPHY, WEDGED OR FREE, WITHOUT HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION
VENOUS SAMPLING THROUGH CATHETER, WITH OR WITHOUT ANGIOGRAPHY (EG, FOR PARATHYROID HORMONE
TRANSCATHETER THERAPY, EMBOLIZATION, ANY METHOD, RADIOLOGICAL SUPERVISION AND INTERPRETATION
TRANSCATHETER THERAPY, INFUSION, ANY METHOD (EG, THROMBOLYSIS OTHER THAN CORONARY), RADIOLOG
ANGIOGRAPHY THROUGH EXISTING CATHETER FOR FOLLOW-UP STUDY FOR TRANSCATHETER THERAPY, EMBOL
EXCHANGE OF A PREVIOUSLY PLACED ARTERIAL CATHETER DURING THROMBOLYTIC THERAPY WITH CONTRAST
MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTIVE MATERIAL (EG, FIBRIN SHEATH) FROM CENTRAL VENO
MECHANICAL REMOVAL OF INTRALUMINAL (INTRACATHETER) OBSTRUCTIVE MATERIAL FROM CENTRAL VENOUS
PERCUTANEOUS PLACEMENT OF IVC FILTER, RADIOLOGICAL SUPERVISION AND INTERPRETATION
INTRAVASCULAR ULTRASOUND (NON-CORONARY VESSEL), RADIOLOGICAL SUPERVISION AND INTERPRETATION;
INTRAVASCULAR ULTRASOUND (NON-CORONARY VESSEL), RADIOLOGICAL SUPERVISION AND INTERPRETATION;
ENDOVASCULAR REPAIR OF INFRARENAL ABDOMINAL AORTIC ANEURYSM OR DISSECTION, RADIOLOGICAL SUPE
PLACEMENT OF PROXIMAL OR DISTAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAIR OF INFRARENAL AO
ENDOVASCULAR REPAIR OF ILIAC ARTERY ANEURYSM, PSEUDOANEURYSM, ARTERIOVENOUS MALFORMATION, O
TRANSCATHETER INTRODUCTION OF INTRAVASCULAR STENT(S), (NON-CORONARY VESSEL), PERCUTANEOUS AN
TRANSCATHETER RETRIEVAL, PERCUTANEOUS, OF INTRAVASCULAR FOREIGN BODY (EG, FRACTURED VENOUS O
TRANSLUMINAL BALLOON ANGIOPLASTY, PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETAT
TRANSLUMINAL BALLOON ANGIOPLASTY, EACH ADDITIONAL PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION
TRANSLUMINAL BALLOON ANGIOPLASTY, RENAL OR OTHER VISCERAL ARTERY, RADIOLOGICAL SUPERVISION AN
TRANSLUMINAL BALLOON ANGIOPLASTY, EACH ADDITIONAL VISCERAL ARTERY, RADIOLOGICAL SUPERVISION AN
TRANSCATHETER BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
TRANSLUMINAL BALLOON ANGIOPLASTY, VENOUS (EG, SUBCLAVIAN STENOSIS), RADIOLOGICAL SUPERVISION AN
PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE WITH CONTRAST MONITORING, RADIOLOGICAL SUPERVISIO
PERCUTANEOUS PLACEMENT OF DRAINAGE CATH FOR COMBINED INT/EXTERNAL BILIARY DRAINAGE FOR INTERN
CHANGE OF PERCUTANEOUS TUBE OR DRAINAGE CATHETER WITH CONTRAST MONITORING (EG, GASTROINTES
RADIOLOGICAL GUIDANCE (IE, FLUOROSCOPY, ULTRASOUND,/COMPUTED TOMOGRAPHY),, PERCUTANEOUS DRA
TRANSLUMINAL ATHERECTOMY, PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
TRANSLUMINAL ATHERECTOMY, EACH ADDITIONAL PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTE
TRANSLUMINAL ATHERECTOMY, RENAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
TRANSLUMINAL ATHERECTOMY, VISCERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
TRANSLUMINAL ATHERECTOMY, EACH ADDITIONAL VISCERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERP
FLUOROSCOPY (SEPARATE PROCEDURE), UP TO ONE HOUR PHYSICIAN TIME, OTHER THAN 71023 OR 71034 (EG,
FLUOROSCOPY, PHYSICIAN TIME MORE THAN ONE HOUR, ASSISTING A NON-RADIOLOGIC PHYSICIAN (EG, NEPHR
FLUOROSCOPIC GUIDANCE FOR NEEDLE PLACEMENT (EG, BIOPSY, ASPIRATION, INJECTION, LOCALIZATION DEVIC
FLUOROSCOPIC GUIDE & LOCAL OF NEEDLE/CATH TIP FOR SPINE/PARASPINOUS DIAG/THERAP INJ PROC (EPIDUR
MANUAL APPLICATION OF STRESS PERFORMED BY PHYSICIAN FOR JOINT RADIOGRAPHY, INCLUDING CONTRALA
RADIOLOGIC EXAMINATION FROM NOSE TO RECTUM FOR FOREIGN BODY, SINGLE VIEW, CHILD
RADIOLOGICAL SUPERVISION AND INTERPRETATION, PERCUTANEOUS VERTEBROPLASTY, PER VERTEBRAL BODY
RADIOLOGICAL SUPERVISION AND INTERPRETATION, PERCUTANEOUS VERTEBROPLASTY, PER VERTEBRAL BODY
BONE AGE STUDIES
BONE LENGTH STUDIES (ORTHOROENTGENOGRAM, SCANOGRAM)
RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; LIMITED (EG, FOR METASTASES)
RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; COMPLETE (AXIAL AND APPENDICULAR SKELETON)
RADIOLOGIC EXAMINATION, OSSEOUS SURVEY, INFANT
JOINT SURVEY, SINGLE VIEW, TWO OR MORE JOINTS (SPECIFY)
COMPUTED TOMOGRAPHY, BONE MINERAL DENSITY STUDY, ONE OR MORE SITES; AXIAL SKELETON (EG, HIPS, PE
COMPUTED TOMOGRAPHY, BONE MINERAL DENSITY STUDY, ONE OR MORE SITES; APPENDICULAR SKELETON (PE
DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA), BONE DENSITY STUDY
DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA), BONE DENSITY STUDY, ONE OR MORE SITES;APPENDICULAR SK
RADIOGRAPHIC ABSORPTIOMETRY (EG, PHOTODENSITOMETRY, RADIOGRAMMETRY), ONE OR MORE SITES
RADIOLOGIC EXAMINATION, FISTULA OR SINUS TRACT STUDY, RADIOLOGICAL SUPERVISION AND INTERPRETATIO
DIGITIZATION OF FILM RADIOGRAPHIC IMAGES WITH COMPUTER ANALYSIS FOR LESION DETECTION&FURTHER P
MAMMARY DUCTOGRAM OR GALACTOGRAM, SINGLE DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION
MAMMARY DUCTOGRAM OR GALACTOGRAM, MULTIPLE DUCTS, RADIOLOGICAL SUPERVISION AND INTERPRETAT
MAMMOGRAPHY; UNILATERAL
MAMMOGRAPHY; BILATERAL
SCREENING MAMMOGRAPHY, BILATERAL (TWO VIEW FILM STUDY OF EACH BREAST)
MAGNETIC RESONANCE IMAGING, BREAST, WITHOUT AND/OR WITH CONTRAST MATERIAL(S); UNILATERAL
MAGNETIC RESONANCE IMAGING, BREAST, WITHOUT AND/OR WITH CONTRAST MATERIAL(S); BILATERAL
STEREOTACTIC LOCALIZATION GUIDANCE FOR BREAST BIOPSY OR NEEDLE PLACEMENT (EG, FOR WIRE LOCALIZ
MAMMOGRAPHIC GUIDANCE FOR NEEDLE PLACEMENT, BREAST (EG, FOR WIRE LOCALIZATION OR FOR INJECTIO
RADIOLOGICAL EXAMINATION, SURGICAL SPECIMEN
RADIOLOGIC EXAMINATION, SINGLE PLANE BODY SECTION (EG, TOMOGRAPHY), OTHER THAN WITH UROGRAPHY
RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY SECTION (EG, MASTOID POLYTOMOG
RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY SECTION (EG, MASTOID POLYTOMOG
CINERADIOGRAPHY/VIDEORADIOGRAPHY, EXCEPT WHERE SPECIFICALLY INCLUDED
CINERADIOGRAPHY/VIDEORADIOGRAPHY TO COMPLEMENT ROUTINE EXAMINATION (LIST SEPARATELY IN ADDITI
CONSULTATION ON X-RAY EXAMINATION MADE ELSEWHERE, WRITTEN REPORT
XERORADIOGRAPHY
SUBTRACTION IN CONJUNCTION WITH CONTRAST STUDIES
COMPUTED TOMOGRAPHY GUIDANCE FOR STEREOTACTIC LOCALIZATION
COMPUTED TOMOGRAPHY GUIDANCE FOR NEEDLE PLACEMENT (EG, BIOPSY, ASPIRATION, INJECTION, LOCALIZA
COMPUTERIZED AXIAL TOMOGRAPHIC GUIDANCE FOR, AND MONITORING OF, TISSUE ABLATION
COMPUTED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS
CORONAL, SAGITTAL, MULTIPLANAR, OBLIQUE, 3-DIMENSIONAL AND/OR HOLOGRAPHIC RECONSTRUCTION OF CO
COMPUTED TOMOGRAPHY, LIMITED OR LOCALIZED FOLLOW-UP STUDY
MAGNETIC RESONANCE SPECTROSCOPY
MAGNETIC RESONANCE GUIDANCE FOR NEEDLE PLACEMENT (EG, FOR BIOPSY, NEEDLE ASPIRATION, INJECTION
MAGNETIC RESONANCE GUIDANCE FOR, AND MONITORING OF, TISSUE ABLATION
MAGNETIC RESONANCE (EG, PROTON) IMAGING, BONE MARROW BLOOD SUPPLY
ULTRASOUND GUIDANCE FOR, AND MONITORING OF, TISSUE ABLATION
UNLISTED FLUOROSCOPIC PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL)
UNLISTED COMPUTED TOMOGRAPHY PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL)
UNLISTED MAGNETIC RESONANCE PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL)
UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE
ECHOENCEPHALOGRAPHY, B-SCAN AND/OR REAL TIME W IMAGE DOC (GRAY SCALE) (FOR VENTRICULAR SIZE, DE
OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; A-SCAN ONLY, WITH AMPLITUDE QUANTIFICATION
OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CONTACT B-SCAN (WITH OR WITHOUT SIMULTANEOUS
OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; ANTERIOR SEGMENT ULTRASOUND, IMMERSION (WATE
OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN;
OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN; WITH INTRAOCULAR LENS POWER CALCULATI
OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION
ULTRASOUND, SOFT TISSUES OF HEAD AND NECK (EG, THYROID, PARATHYROID, PAROTID), B-SCAN AND/OR REA
ULTRASOUND, CHEST, B-SCAN (INCLUDES MEDIASTINUM) AND/OR REAL TIME WITH IMAGE DOCUMENTATION
ULTRASOUND, BREAST(S) (UNILATERAL OR BILATERAL), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATIO
ULTRASOUND, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE
ULTRASOUND, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (EG, SINGLE ORG
ULTRASOUND, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUM
ULTRASOUND, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUM
ULTRASOUND, TRANSPLANTED KIDNEY, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION, WITH OR WIT
ULTRASOUND, SPINAL CANAL AND CONTENTS
ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FETAL&MATERNAL EVALUATION, F
ULTRASOUND, PREGNANT UTERUS, REAL TIME W IMAGE DOCUMENTATION, FETAL&MATERNAL EVAL, 1ST TRIMES
ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FETAL AND MATERNAL EVALUATIO
ULTRASOUND, PREGNANT UTERUS, REAL TME W IMAGE DOCUMENT, FETAL&MATERNAL EVAL, AFTER 1ST TRIMES
ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FETAL AND MATERNAL EVALUATIO
ULTRASOUND, PREGNANT UTERUS, REAL TIME W IMAGE DOCUMENT, FETAL&MATERNAL EVAL+DETAILED FETAL
ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, LIMITED (EG, FETAL HEART BEAT,
US, PRGNANT UTERUS, REAL TME W IMG DOCUMENTATION, F/U (EG, RE-EVAL, ORGAN SYST(S) SUSPECTED/CONF
ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION,TRANSVAGINAL
FETAL BIOPHYSICAL PROFILE; WITH NON-STRESS TESTING
FETAL BIOPHYSICAL PROFILE; WITHOUT NON-STRESS TESTING
ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH IMAGE DOCUMENTATION (2D) WITH O
ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH IMAGE DOCUMENTATION (2D) WITH O
DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED WAVE AND/OR CONTINUOUS WAVE
DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED WAVE AND/OR CONTINUOUS WAVE
ULTRASOUND, TRANSVAGINAL
HYSTEROSONOGRAPHY, WITH OR WITHOUT COLOR FLOW DOPPLER
ULTRASOUND, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE
ULTRASOUND, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED OR
ULTRASOUND, SCROTUM AND CONTENTS
ECHOGRAPHY, TRANSRECTAL
ECHOGRAPHY, TRANSRECTAL; PROSTATE VOLUME STUDY FOR BRACHYTHERAPY TREATMENT PLANNING (SEPAR
ULTRASOUND, EXTREMITY, NON-VASCULAR, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION
ULTRASOUND, INFANT HIPS, REAL TIME WITH IMAGING DOCUMENTATION; DYNAMIC (REQUIRING PHYSICIAN MANI
ULTRASOUND, INFANT HIPS, REAL TIME WITH IMAGING DOCUMENTATION; LIMITED, STATIC (NOT REQUIRING PHY
ULTRASONIC GUIDANCE FOR PERICARDIOCENTESIS, IMAGING SUPERVISION AND INTERPRETATION
ULTRASONIC GUIDANCE FOR ENDOMYOCARDIAL BIOPSY, IMAGING SUPERVISION AND INTERPRETATION
ULTRASOUND GUIDED COMPRESSION REPAIR OF ARTERIAL PSEUDOANEURYSM OR ARTERIOVENOUS FISTULAE
ULTRASONIC GUIDANCE FOR INTRAUTERINE FETAL TRANSFUSION OR CORDOCENTESIS, IMAGING SUPERVISION
ULTRASONIC GUIDANCE FOR NEEDLE PLACEMENT (EG, BIOPSY, ASPIRATION, INJECTION, LOCALIZATION DEVICE)
ULTRASONIC GUIDANCE FOR CHORIONIC VILLUS SAMPLING, IMAGING SUPERVISION AND INTERPRETATION
ULTRASONIC GUIDANCE FOR AMNIOCENTESIS, IMAGING SUPERVISION AND INTERPRETATION
ULTRASONIC GUIDANCE FOR ASPIRATION OF OVA, IMAGING SUPERVISION AND INTERPRETATION
ULTRASONIC GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS
ULTRASONIC GUIDANCE FOR INTERSTITIAL RADIOELEMENT APPLICATION
ULTRASOUND STUDY FOLLOW-UP (SPECIFY)
GASTROINTESTINAL ENDOSCOPIC ULTRASOUND, SUPERVISION AND INTERPRETATION
ULTRASOUND BONE DENSITY MEASUREMENT AND INTERPRETATION, PERIPHERAL SITE(S), ANY METHOD
ULTRASONIC GUIDANCE, INTRAOPERATIVE
UNLISTED ULTRASOUND PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL)
THERAPEUTIC RADIOLOGY TREATMENT PLANNING; SIMPLE
THERAPEUTIC RADIOLOGY TREATMENT PLANNING; INTERMEDIATE
THERAPEUTIC RADIOLOGY TREATMENT PLANNING; COMPLEX
THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; SIMPLE
THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; INTERMEDIATE
THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; COMPLEX
THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; BY THREE-DIMENSIONAL RECONSTRUCTION OF T
UNLISTED PROCEDURE, THERAPEUTIC RADIOLOGY CLINICAL TREATMENT PLANNING
BASIC RAD DOSIMETRY CALC,CENTRL AXIS DPTH DOS CALC,TDF,NSD,GAP CALC,OFF AXIS FACTOR,TISS INHOMO
INTENSITY MODULATED RADIOTHERAPY PLAN, INCLUDING DOSE-VOLUME HISTOGRAMS FOR TARGET AND CRITIC
TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); SIMPLE (ONE OR TWO PARALLEL
TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); INTERMEDIATE (THREE OR MORE
TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); COMPLEX (MANTLE OR INVERTED
SPECIAL TELETHERAPY PORT PLAN, PARTICLES, HEMI-BODY, TOTAL BODY
BRACHYTHERAPY ISODOSE PLAN; SIMPLE (CALCULATION MADE FROM SINGLE PLANE, ONE TO FOUR SOURCES/R
BRACHYTHERAPY ISODOSE PLAN; INTERMEDIATE (MULTIPLANE DOSAGE CALCULATIONS, APPLICATION INVOLVIN
BRACHYTHERAPY ISODOSE PLAN; COMPLEX (MULTIPLANE ISODOSE PLAN, VOL IMPLANT CALCULATIONS, OVER 1
SPECIAL DOSIMETRY (EG, TLD, MICRODOSIMETRY) (SPECIFY), ONLY WHEN PRESCRIBED BY THE TREATING PHYS
TREATMENT DEVICES, DESIGN AND CONSTRUCTION; SIMPLE (SIMPLE BLOCK, SIMPLE BOLUS)
TREATMENT DEVICES, DESIGN AND CONSTRUCTION; INTERMEDIATE (MULTIPLE BLOCKS, STENTS, BITE BLOCKS,
TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR BLOCKS, SPECIAL SHIELDS, COMPEN
CONTINUING MEDICAL PHYSICS CONSULT, INCL ASSESSMENT OF TREAT PARAMETERS, QUALITY ASSURANCE OF
SPECIAL MEDICAL RADIATION PHYSICS CONSULTATION
UNLISTED PROCEDURE, MEDICAL RADIATION PHYSICS, DOSIMETRY AND TREATMENT DEVICES, AND SPECIAL SER
RADIATION TREATMENT DELIVERY, SUPERFICIAL AND/OR ORTHO VOLTAGE
RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS, SIM
RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS, SIM
RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS, SIM
RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS, SIM
RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE T
RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE T
RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE T
RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE T
RADIATION TREATMENT DELIVERY, >=3 SEPARATE TREATMENT AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS
RADIATION TREATMENT DELIVERY, >=3 SEPARATE TREATMENT AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS
RADIATION TREATMENT DELIVERY, >=3 SEPARATE TREATMENT AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS
RADIATION TREATMENT DELIVERY, >=3 SEPARATE TREATMENT AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS
THERAPEUTIC RADIOLOGY PORT FILM(S)
INTENSITY MODULATED TREATMENT DELIVERY, SINGLE OR MULTIPLE FIELDS/ARCS, VIA NARROW SPATIALLY AND
RADIATION TREATMENT MANAGEMENT, FIVE TREATMENTS
RADIATION THERAPY MANAGEMENT WITH COMPLETE COURSE OF THERAPY CONSISTING OF ONE OR TWO FRAC
STEREOTACTIC RADIATION TREATMENT MANAGEMENT OF CEREBRAL LESION(S) (COMPLETE COURSE OF TREAT
SPECIAL TREATMENT PROCEDURE (EG, TOTAL BODY IRRADIATION, HEMIBODY RADIATION, PER ORAL, ENDOCAVI
UNLISTED PROCEDURE, THERAPEUTIC RADIOLOGY TREATMENT MANAGEMENT
PROTON TREATMENT DELIVERY; SIMPLE, WITHOUT COMPENSATION
PROTON TREATMENT DELIVERY; SIMPLE, WITH COMPENSATION
PROTON TREATMENT DELIVERY; INTERMEDIATE
PROTON TREATMENT DELIVERY; COMPLEX
HYPERTHERMIA, EXTERNALLY GENERATED; SUPERFICIAL (IE, HEATING TO A DEPTH OF 4 CM OR LESS)
HYPERTHERMIA, EXTERNALLY GENERATED; DEEP (IE, HEATING TO DEPTHS GREATER THAN 4 CM)
HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); 5 OR FEWER INTERSTITIAL APPLICATORS
HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); MORE THAN 5 INTERSTITIAL APPLICATORS
HYPERTHERMIA GENERATED BY INTRACAVITARY PROBE(S)
INFUSION OR INSTILLATION OF RADIOELEMENT SOLUTION
INTRACAVITARY RADIATION SOURCE APPLICATION; SIMPLE
INTRACAVITARY RADIATION SOURCE APPLICATION; INTERMEDIATE
INTRACAVITARY RADIATION SOURCE APPLICATION; COMPLEX
INTERSTITIAL RADIATION SOURCE APPLICATION; SIMPLE
INTERSTITIAL RADIATION SOURCE APPLICATION; INTERMEDIATE
INTERSTITIAL RADIATION SOURCE APPLICATION; COMPLEX
REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 1-4 SOURCE POSITIONS OR CATHETERS
REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 5-8 SOURCE POSITIONS OR CATHETERS
REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 9-12 SOURCE POSITIONS OR CATHETERS
REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; OVER 12 SOURCE POSITIONS OR CATHETERS
SURFACE APPLICATION OF RADIATION SOURCE
SUPERVISION, HANDLING, LOADING OF RADIATION SOURCE
UNLISTED PROCEDURE, CLINICAL BRACHYTHERAPY
THYROID UPTAKE; SINGLE DETERMINATION
THYROID UPTAKE; MULTIPLE DETERMINATIONS
THYROID UPTAKE; STIMULATION, SUPPRESSION OR DISCHARGE (NOT INCLUDING INITIAL UPTAKE STUDIES)
THYROID IMAGING, WITH UPTAKE; SINGLE DETERMINATION
THYROID IMAGING, WITH UPTAKE; MULTIPLE DETERMINATIONS
THYROID IMAGING; ONLY
THYROID IMAGING; WITH VASCULAR FLOW
THYROID CARCINOMA METASTASES IMAGING; LIMITED AREA (EG, NECK AND CHEST ONLY)
THYROID CARCINOMA METASTASES IMAGING; WITH ADDITIONAL STUDIES (EG, URINARY RECOVERY)
THYROID CARCINOMA METASTASES IMAGING; WHOLE BODY
THYROID CARCINOMA METASTASES UPTAKE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDUR
PARATHYROID IMAGING
ADRENAL IMAGING, CORTEX AND/OR MEDULLA
UNLISTED ENDOCRINE PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
BONE MARROW IMAGING; LIMITED AREA
BONE MARROW IMAGING; MULTIPLE AREAS
BONE MARROW IMAGING; WHOLE BODY
PLASMA VOLUME, RADIOPHARMACEUTICAL VOLUME-DILUTION TECHNIQUE (SEPARATE PROCEDURE); SINGLE SA
PLASMA VOLUME, RADIOPHARMACEUTICAL VOLUME-DILUTION TECHNIQUE (SEPARATE PROCEDURE); MULTIPLE
RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); SINGLE SAMPLING
RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); MULTIPLE SAMPLINGS
WHOLE BLOOD VOLUME DETERMINATION, INCLUDING SEPARATE MEASUREMENT OF PLASMA VOLUME AND RED
RED CELL SURVIVAL STUDY;
RED CELL SURVIVAL STUDY; DIFFERENTIAL ORGAN/TISSUE KINETICS, (EG, SPLENIC AND/OR HEPATIC SEQUESTR
LABELED RED CELL SEQUESTRATION, DIFFERENTIAL ORGAN/TISSUE, (EG, SPLENIC AND/OR HEPATIC)
PLASMA RADIOIRON DISAPPEARANCE (TURNOVER) RATE
RADIOIRON ORAL ABSORPTION
RADIOIRON RED CELL UTILIZATION
CHELATABLE IRON FOR ESTIMATION OF TOTAL BODY IRON
SPLEEN IMAGING ONLY, WITH OR WITHOUT VASCULAR FLOW
KINETICS, STUDY OF PLATELET SURVIVAL, WITH OR WITHOUT DIFFERENTIAL ORGAN/TISSUE LOCALIZATION
PLATELET SURVIVAL STUDY
LYMPHATICS AND LYMPH NODES IMAGING
UNLISTED HEMATOPOIETIC, RETICULOENDOTHELIAL AND LYMPHATIC PROCEDURE, DIAGNOSTIC NUCLEAR MEDIC
LIVER IMAGING; STATIC ONLY
LIVER IMAGING; WITH VASCULAR FLOW
LIVER IMAGING (SPECT)
LIVER IMAGING (SPECT); WITH VASCULAR FLOW
LIVER AND SPLEEN IMAGING; STATIC ONLY
LIVER AND SPLEEN IMAGING; WITH VASCULAR FLOW
LIVER FUNCTION STUDY WITH HEPATOBILIARY AGENTS, WITH SERIAL IMAGES
HEPATOBILIARY DUCTAL SYSTEM IMAGING, INCLUDING GALLBLADDER, WITH OR WITHOUT PHARMACOLOGIC INT
SALIVARY GLAND IMAGING;
SALIVARY GLAND IMAGING; WITH SERIAL IMAGES
SALIVARY GLAND FUNCTION STUDY
ESOPHAGEAL MOTILITY
GASTRIC MUCOSA IMAGING
GASTROESOPHAGEAL REFLUX STUDY
GASTRIC EMPTYING STUDY
UREA BREATH TEST, C-14; ACQUISITION FOR ANALYSIS
UREA BREATH TEST, C-14; ANALYSIS
VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITHOUT INTRINSIC FACTOR
VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITH INTRINSIC FACTOR
VITAMIN B-12 ABSORPTION STUDIES COMBINED, WITH AND WITHOUT INTRINSIC FACTOR
ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING
GASTROINTESTINAL PROTEIN LOSS
INTESTINE IMAGING (EG, ECTOPIC GASTRIC MUCOSA, MECKELS LOCALIZATION, VOLVULUS)
PERITONEAL-VENOUS SHUNT PATENCY TEST (EG, FOR LEVEEN, DENVER SHUNT)
UNLISTED GASTROINTESTINAL PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
BONE AND/OR JOINT IMAGING; LIMITED AREA
BONE AND/OR JOINT IMAGING; MULTIPLE AREAS
BONE AND/OR JOINT IMAGING; WHOLE BODY
BONE AND/OR JOINT IMAGING; THREE PHASE STUDY
BONE AND/OR JOINT IMAGING; TOMOGRAPHIC (SPECT)
BONE DENSITY (BONE MINERAL CONTENT) STUDY; SINGLE PHOTON ABSORPTIOMETRY
BONE DENSITY (BONE MINERAL CONTENT) STUDY; DUAL PHOTON ABSORPTIOMETRY
UNLISTED MUSCULOSKELETAL PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
DETERMINATION OF CENTRAL C-V HEMODYNAMICS (NON-IMAGING) (EG, EJECTION FRACTION WITH PROBE TECH
CARDIAC SHUNT DETECTION
NON-CARDIAC VASCULAR FLOW IMAGING (IE, ANGIOGRAPHY, VENOGRAPHY)
VENOUS THROMBOSIS STUDY (EG, RADIOACTIVE FIBRINOGEN)
ACUTE VENOUS THROMBOSIS IMAGING, PEPTIDE
VENOUS THROMBOSIS IMAGING, VENOGRAM; UNILATERAL
VENOUS THROMBOSIS IMAGING (EG, VENOGRAM); BILATERAL
MYOCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET), METABOLIC EVALUATION
MYOCARDIAL PERFUSION IMAGING; (PLANAR) SINGLE STUDY, AT REST OR STRESS (EXERCISE AND/OR PHARMAC
MYOCARDIAL PERFUSION IMAGING; MULTIPLE STUDIES, (PLANAR) AT REST AND/OR STRESS (EXERCISE AND/OR P
MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), SINGLE STUDY AT REST OR STRESS (EXERCISE AND
MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), MULT. STUDIES AT REST AND/OR STRESS (EXERCIS
MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; QUALITATIVE OR QUANTITATIVE
MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; WITH EJECTION FRACTION BY FIRST PASS TECHNIQUE
MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; TOMOGRAPHIC SPECT WITH OR WITHOUT QUANTIFICATION
CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; PLANAR, SINGLE STUDY AT REST OR STRESS (EXERCISE A
CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; MULTIPLE STUDIES, WALL MOTION STUDY PLUS EJECTION
MYOCARDIAL PERFUSION STUDY WITH WALL MOTION, QUALITATIVE OR QUANTITATIVE STUDY (LIST SEPARATELY
MYOCARDIAL PERFUSION STUDY WITH EJECTION FRACTION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIM
CARDIAC BLOOD POOL IMAGING, (PLANAR), FIRST PASS TECHNIQUE; SINGLE STUDY, AT REST OR W/ STRESS (EX
CARDIAC BLOOD POOL IMAGING, (PLANAR), FIRST PASS TECH.; MULT. STUDIES, AT REST & W/ STRESS (EXERCISE
MYOCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET), PERFUSION;SINGLE STUDY AT REST OR STRE
MYOCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET), PERFUSION; MULTIPLE STUDIES AT REST AND
CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM, SPECT, AT REST, WALL MOTION STUDY PLUS EJECTION FR
CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM, SINGLE STUDY, AT REST, WITH RIGHT VENTRICULAR EJEC
UNLISTED CARDIOVASCULAR PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
PULMONARY PERFUSION IMAGING, PARTICULATE
PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION; SINGLE BREATH
PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION; REBREATHING AND WASHOUT, WITH OR W
PULMONARY VENTILATION IMAGING, AEROSOL; SINGLE PROJECTION
PULMONARY VENTILATION IMAGING, AEROSOL; MULTIPLE PROJECTIONS (EG, ANTERIOR, POSTERIOR, LATERAL V
PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION IMAGING, AEROSOL, ONE OR MULTIPLE PR
PULMONARY VENTILATION IMAGING, GASEOUS, SINGLE BREATH, SINGLE PROJECTION
PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND WASHOUT WITH OR WITHOUT SINGLE B
PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND WASHOUT WITH OR WITHOUT SINGLE B
PULMONARY QUANTITATIVE DIFFERENTIAL FUNCTION (VENTILATION/PERFUSION) STUDY
UNLISTED RESPIRATORY PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
BRAIN IMAGING, LIMITED PROCEDURE; STATIC
BRAIN IMAGING, LIMITED PROCEDURE; WITH VASCULAR FLOW
BRAIN IMAGING, COMPLETE STUDY; STATIC
BRAIN IMAGING, COMPLETE STUDY; WITH VASCULAR FLOW
BRAIN IMAGING, COMPLETE STUDY; TOMOGRAPHIC (SPECT)
BRAIN IMAGING, POSITRON EMISSION TOMOGRAPHY (PET); METABOLIC EVALUATION
BRAIN IMAGING, POSITRON EMISSION TOMOGRAPHY (PET); PERFUSION EVALUATION
BRAIN IMAGING, VASCULAR FLOW ONLY
CEREBRAL VASCULAR FLOW
CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); CISTERNOGRAPHY
CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); VENTRICULOGRAPHY
CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); SHUNT EVALUATION
CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); TOMOGRAPHIC (SPECT)
CEREBROSPINAL FLUID LEAKAGE DETECTION AND LOCALIZATION
RADIOPHARMACEUTICAL DACRYOCYSTOGRAPHY
UNLISTED NERVOUS SYSTEM PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
KIDNEY IMAGING; STATIC ONLY
KIDNEY IMAGING; WITH VASCULAR FLOW
KIDNEY IMAGING; WITH FUNCTION STUDY (IE, IMAGING RENOGRAM)
KIDNEY IMAGING; WITH VASCULAR FLOW AND FUNCTION STUDY
KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; SINGLE STUDY WITH PHARMACOLOGICAL INTERVENTIO
KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; MULTIPLE STUDIES, WITH AND WITHOUT PHARMACOLO
KIDNEY IMAGING; TOMOGRAPHIC (SPECT)
KIDNEY VASCULAR FLOW ONLY
KIDNEY FUNCTION STUDY, NON-IMAGING RADIOISOTOPIC STUDY
URINARY BLADDER RESIDUAL STUDY
URETERAL REFLUX STUDY (RADIOPHARMACEUTICAL VOIDING CYSTOGRAM)
TESTICULAR IMAGING;
TESTICULAR IMAGING; WITH VASCULAR FLOW
UNLISTED GENITOURINARY PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR; LIMITED AREA
RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR; MULTIPLE AREAS
RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR; WHOLE BODY
RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR; TOMOGRAPHIC (SPECT)
RADIOPHARMACEUTICAL LOCALIZATION OF INFLAMMATORY PROCESS; LIMITED AREA
RADIOPHARMACEUTICAL LOCALIZATION OF INFLAMMATORY PROCESS; WHOLE BODY
RADIOPHARMACEUTICAL LOCALIZATION OF INFLAMMATORY PROCESS; TOMOGRAPHIC (SPECT)
TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY (PET), METABOLIC EVALUATION
GENERATION OF AUTOMATED DATA: INTERACTIVE PROCESS INVOLVING NUCLEAR PHYSICIAN AND/OR ALLIED HE
GENERATION OF AUTOMATED DATA: INTERACTIVE PROCESS INVOLVING NUCLEAR PHYSICIAN AND/OR ALLIED HE
PROVISION OF DIAGNOSTIC RADIOPHARMACEUTICAL(S)
UNLISTED MISCELLANEOUS PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
RADIOPHARMACEUTICAL THERAPY, HYPERTHYROIDISM; INITIAL, INCLUDING EVALUATION OF PATIENT
RADIOPHARMACEUTICAL THERAPY, HYPERTHYROIDISM; SUBSEQUENT, EACH THERAPY
RADIOPHARMACEUTICAL THERAPY, THYROID SUPPRESSION (EUTHYROID CARDIAC DISEASE), INCLUDING EVALUA
RADIOPHARMACEUTICAL ABLATION OF GLAND FOR THYROID CARCINOMA
RADIOPHARMACEUTICAL THERAPY FOR METASTASES OF THYROID CARCINOMA
RADIOPHARMACEUTICAL THERAPY, POLYCYTHEMIA VERA, CHRONIC LEUKEMIA, EACH TREATMENT
INTRACAVITARY RADIOACTIVE COLLOID THERAPY
INTERSTITIAL RADIOACTIVE COLLOID THERAPY
RADIOPHARMACEUTICAL THERAPY, NONTHYROID, NONHEMATOLOGIC
INTRAVASCULAR RADIOPHARMACEUTICAL THERAPY, PARTICULATE
INTRA-ARTICULAR RADIOPHARMACEUTICAL THERAPY
PROVISION OF THERAPEUTIC RADIOPHARMACEUTICAL(S)
UNLISTED RADIOPHARMACEUTICAL THERAPEUTIC PROCEDURE
BASIC METABOLIC PANEL
GENERAL HEALTH PANEL
ELECTROLYTES PANEL
COMPREHENSIVE METABOLIC PANEL
OBSTETRIC PANEL
LIPID PANEL
RENAL FUNCTION PANEL
ACUTE HEPATITIS PANEL
HEPATIC FUNCTION PANEL
DRUG SCREEN, QUALITATIVE; MULTIPLE DRUG CLASSES CHROMATOGRAPHIC METHOD, EACH PROCEDURE
DRUG SCREEN, QUALITATIVE; SINGLE DRUG CLASS METHOD (EG, IMMUNOASSAY, ENZYME ASSAY), EACH DRUG C
DRUG, CONFIRMATION, EACH PROCEDURE
TISSUE PREPARATION FOR DRUG ANALYSIS
AMIKACIN
AMITRIPTYLINE
BENZODIAZEPINES
CARBAMAZEPINE; TOTAL
CARBAMAZEPINE; FREE
CYCLOSPORINE
DESIPRAMINE
DIGOXIN
DIPROPYLACETIC ACID (VALPROIC ACID)
DOXEPIN
ETHOSUXIMIDE
GENTAMICIN
GOLD
HALOPERIDOL
IMIPRAMINE
LIDOCAINE
LITHIUM
NORTRIPTYLINE
PHENOBARBITAL
PHENYTOIN; TOTAL
PHENYTOIN; FREE
PRIMIDONE
PROCAINAMIDE;
PROCAINAMIDE; WITH METABOLITES (EG, N-ACETYL PROCAINAMIDE)
QUINIDINE
SALICYLATE
QUANT DRUG TACROLIMUS
THEOPHYLLINE
TOBRAMYCIN
TOPIRAMATE
VANCOMYCIN
QUANTITATION OF DRUG, NOT ELSEWHERE SPECIFIED
ACTH STIMULATION PANEL; FOR ADRENAL INSUFFICIENCY THIS PANEL MUST INCLUDE THE FOLLOWING: CORTISO
ACTH STIMULATION PANEL; FOR 21 HYDROXYLASE DEFICIENCY THIS PANEL MUST INCLUDE THE FOLLOWING: CO
ACTH STIMULATION PANEL; FOR 3 BETA-HYDROXYDEHYDROGENASE DEFICIENCY THIS PANEL MUST INCLUDE TH
ALDOSTERONE SUPPRESSION EVALUATION PANEL (EG, SALINE INFUSION) THIS PANEL MUST INCLUDE THE FOLLO
CALCIUM-PENTAGASTRIN STIMULATION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CALCITONIN (82308
CORTICOTROPIC RELEASING HORMONE (CRH) STIMULATION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING
CHORIONIC GONADOTROPIN STIMULATION PANEL; TESTOSTERONE RESPONSE THIS PANEL MUST INCLUDE THE
CHORIONIC GONADOTROPIN STIMULATION PANEL; ESTRADIOL RESPONSE THIS PANEL MUST INCLUDE THE FOLL
RENAL VEIN RENIN STIMULATION PANEL (EG, CAPTOPRIL)
PERIPHERAL VEIN RENIN STIMULATION PANEL (EG, CAPTOPRIL)
COMBINED RAPID ANT PITUITARY EVAL PANEL MUST INCLUDE: (ACTH) (82024 X 4) (LH) (83002 X 4) (FSH) (83001 X 4
DEXAMETHASONE SUPPRESSION PANEL, 48 HOUR MUST INCLUDE: FREE CORTISOL, URINE (82530 X 2) CORTISOL
GLUCAGON TOLERANCE PANEL; FOR INSULINOMA MUST INCLUDE: GLUCOSE (82947 X 3) INSULIN (83525 X 3)
GLUCAGON TOLERANCE PANEL; FOR PHEOCHROMOCYTOMA MUST INCLUDE: CATECHOLAMINES, FRACTIONATED
GONADOTROPIN RELEASING HORMONE STIMULATION PANEL MUST INCLUDE: FOLLICLE STIMULATING HORMONE
GROWTH HORMONE STIMULATION PANEL (EG, ARGININE INFUSION, L-DOPA ADMINISTRATION) THIS PANEL MUST
GROWTH HORMONE SUPPRESSION PANEL (GLUCOSE ADMINISTRATION) THIS PANEL MUST INCLUDE THE FOLLOW
INSULIN-INDUCED C-PEPTIDE SUPPRESSION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: INSULIN (83525
INSULIN TOLERANCE PANEL; FOR ACTH INSUFFICIENCY THIS PANEL MUST INCLUDE THE FOLLOWING: CORTISOL
INSULIN TOLERANCE PANEL; FOR GROWTH HORMONE DEFICIENCY THIS PANEL MUST INCLUDE THE FOLLOWING
METYRAPONE PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CORTISOL (82533 X 2) 11 DEOXYCORTISOL (82
THYROTROPIN RELEASING HORMONE (TRH) STIMULATION PANEL; ONE HOUR THIS PANEL MUST INCLUDE THE FO
THYROTROPIN RELEASING HORMONE (TRH) STIMULATION PANEL; TWO HOUR THIS PANEL MUST INCLUDE THE FO
THYROTROPIN RELEASING HORMONE (TRH) STIMULATION PANEL; FOR HYPERPROLACTINEMIA THIS PANEL MUST
CLINICAL PATHOLOGY CONSULTATION; LIMITED, WITHOUT REVIEW OF PATIENT'S HISTORY AND MEDICAL RECOR
CLINICAL PATHOLOGY CONSULTATION; COMPREHENSIVE, FOR A COMPLEX DIAGNOSTIC PROBLEM, WITH REVIEW
URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTE
URINALYSIS, BY DIP STICK/TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, N
URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTE
URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTE
URINALYSIS; QUALITATIVE OR SEMIQUANTITATIVE, EXCEPT IMMUNOASSAYS
URINALYSIS; BACTERIURIA SCREEN, EXCEPT BY CULTURE OR DIPSTICK
URINALYSIS; MICROSCOPIC ONLY
URINALYSIS; TWO OR THREE GLASS TEST
URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS
VOLUME MEASUREMENT FOR TIMED COLLECTION, EACH
UNLISTED URINALYSIS PROCEDURE
ACETALDEHYDE, BLOOD
ACETAMINOPHEN
ACETONE OR OTHER KETONE BODIES, SERUM; QUALITATIVE
ACETONE OR OTHER KETONE BODIES, SERUM; QUANTITATIVE
ACETYLCHOLINESTERASE
ACYLCARNITINES; QUALITATIVE
ACYLCARNITINES; QUANTITATIVE, EACH SPECIMEN
ADRENOCORTICOTROPIC HORMONE (ACTH)
ADENOSINE, 5'-MONOPHOSPHATE, CYCLIC (CYCLIC AMP)
ALBUMIN; SERUM
ALBUMIN; URINE OR OTHER SOURCE, QUANTITATIVE, EACH SPECIMEN
ALBUMIN; URINE, MICROALBUMIN, QUANTITATIVE
ALBUMIN; URINE, MICROALBUMIN, SEMIQUANTITATIVE (EG, REAGENT STRIP ASSAY)
ALCOHOL (ETHANOL); ANY SPECIMEN EXCEPT BREATH
ALCOHOL (ETHANOL); BREATH
ALDOLASE
ALDOSTERONE
ALKALOIDS, URINE, QUANTITATIVE
ALPHA-1-ANTITRYPSIN; TOTAL
ALPHA-1-ANTITRYPSIN; PHENOTYPE
ALPHA-FETOPROTEIN; SERUM
ALPHA-FETOPROTEIN; AMNIOTIC FLUID
ALUMINUM
AMINES, VAGINAL FLUID, QUALITATIVE
AMINO ACIDS, SINGLE, QUALITATIVE
AMINO ACIDS, QUALITATIVE
AMINO ACIDS, QUANTITATION, EACH
AMINOLEVULINIC ACID, DELTA (ALA)
AMINO ACIDS, 2-5 AMINO ACIDS, QUANTITATIVE, EACH SPECIMEN
AMINO ACIDS, 6 OR MORE, QUANTITATIVE
AMMONIA
AMNIOTIC FLUID SCAN (SPECTROPHOTOMETRIC)
AMPHETAMINE OR METHAMPHETAMINE
AMYLASE
ANDROSTANEDIOL GLUCURONIDE
ANDROSTENEDIONE
ANDROSTERONE
ANGIOTENSIN II
ANGIOTENSIN I - CONVERTING ENZYME (ACE)
APOLIPOPROTEIN, EACH
ARSENIC
ASCORBIC ACID (VITAMIN C), BLOOD
ATOMIC ABSORPTION SPECTROSCOPY, EACH ANALYTE
BARBITURATES, NOT ELSEWHERE SPECIFIED
BETA-2 MICROGLOBULIN
BILE ACIDS; TOTAL
BILE ACIDS; CHOLYLGLYCINE
BILIRUBIN; TOTAL
BILIRUBIN;DIRECT
BILIRUBIN; FECES, QUALITATIVE
BIOTINIDASE
BLOOD, OCCULT, BY PEROXIDASE ACTIVITY (EG, GUAIAC), QUALITATIVE; FECES, 1-3 SIMULTANEOUS DETERMINAT
BLOOD, OCCULT, BY PEROXIDASE ACTIVITY (EG, GUAIAC), QUALITATIVE; OTHER SOURCES
BLOOD, OCCULT, BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOASSAY, QUALITATIVE, FECES, 1-3 SIMULTA
BRADYKININ
CADMIUM
CALCIFEDIOL (25-OH VITAMIN D-3)
CALCIFEROL (VITAMIN D)
CALCITONIN
CALCIUM; TOTAL
CALCIUM; IONIZED
CALCIUM; AFTER CALCIUM INFUSION TEST
CALCIUM; URINE QUANTITATIVE, TIMED SPECIMEN
CALCULUS; QUALITATIVE ANALYSIS
CALCULUS; QUANTITATIVE ANALYSIS, CHEMICAL
CALCULUS; INFRARED SPECTROSCOPY
CALCULUS; X-RAY DIFFRACTION
CARBOHYDRATE DEFICIENT TRANSFERRIN
CARBON DIOXIDE (BICARBONATE)
CARBON MONOXIDE, (CARBOXYHEMOGLOBIN); QUANTITATIVE
CARBON MONOXIDE, (CARBOXYHEMOGLOBIN); QUALITATIVE
CARCINOEMBRYONIC ANTIGEN (CEA)
CARNITINE (TOTAL & FREE), QUANTITATIVE
CAROTENE
CATECHOLAMINES; TOTAL URINE
CATECHOLAMINES; BLOOD
CATECHOLAMINES; FRACTIONATED
CATHEPSIN-D
CERULOPLASMIN
CHEMILUMINESCENT ASSAY
CHLORAMPHENICOL
CHLORIDE; BLOOD
CHLORIDE; URINE
OTHER SOURCE
CHLORINATED HYDROCARBONS, SCREEN
CHOLESTEROL, SERUM OR WHOLE BLOOD, TOTAL
CHOLINESTERASE; SERUM
CHOLINESTERASE; RBC
CHONDROITIN B SULFATE, QUANTITATIVE
CHROMATOGRAPHY, QUALITATIVE; COLUMN (EG, GAS LIQUID OR HIGH PERFORMANCE LIQUID CHROMATOGRAPH
CHROMATOGRAPHY, QUALITATIVE; PAPER, 1-DIMENSIONAL, ANALYTE NOT ELSEWHERE SPECIFIED
CHROMATOGRAPHY, QUALITATIVE; PAPER, 2-DIMENSIONAL, ANALYTE NOT ELSEWHERE SPECIFIED
CHROMATOGRAPHY, QUALITATIVE; THIN LAYER, ANALYTE NOT ELSEWHERE SPECIFIED
CHROMATOGRAPHY, QUANTITATIVE, COLUMN (EG, GAS LIQUID OR HIGH PERFORMANCE LIQUID CHROMATOGRAP
CHROMAT,QUANT,GLC/HPLC;MULTI,SINGLE,STATIONARY,MOBILE
CHROMIUM
CITRATE
COCAINE OR METABOLITE
COLLAGEN CROSS LINKS, ANY METHOD
COPPER
CORTICOSTERONE
CORTISOL; FREE
CORTISOL; TOTAL
CREATINE
COLUMN CHROMAT/MS,ANALYTE NOS;QUAL,SINGLE,STATIONARY,MOBILE
COLUMN CHROMAT/MS,ANALYTE NOS;QUANT,SINGLE,STATIONARY,MOBILE
COLUMN CHROMAT/MS,ANALYTE NOS;STABLE ISOTOPE,SINGLE,QUANT
COLUMN CHROMAT/MS,ANALYTE NOS;STABLE ISOTOPE,MULTI,QUANT
CREATINE KINASE (CK), (CPK); TOTAL
CREATINE KINASE (CK), (CPK); ISOENZYMES
CREATINE KINASE (CK), (CPK); MB FRACTION ONLY
CREATINE KINASE (CK), (CPK); ISOFORMS
CREATININE; BLOOD
CREATININE; OTHER SOURCE
CREATININE; CLEARANCE
CRYOFIBRINOGEN
CRYOGLOBULIN, QUALITATIVE OR SEMI-QUANTITATIVE (EG, CRYOCRIT)
CYANIDE
CYANOCOBALAMIN (VITAMIN B-12);
CYANOCOBALAMIN (VITAMIN B-12); UNSATURATED BINDING CAPACITY
CYSTINE AND HOMOCYSTINE, URINE, QUALITATIVE
DEHYDROEPIANDROSTERONE (DHEA)
DEHYDROEPIANDROSTERONE-SULFATE (DHEA-S)
DESOXYCORTICOSTERONE, 11-
DEOXYCORTISOL, 11-
DIBUCAINE NUMBER
DIHYDROCODEINONE
DIHYDROMORPHINONE
DIHYDROTESTOSTERONE (DHT)
DIHYDROXYVITAMIN D, 1,25-
DIMETHADIONE
ENZYME ACTIVITY,CULTURED CELLS OR TISSUE,NOS;NON-RADIOACTIVE
ENZYME ACTIVITY,CULTURED CELLS OR TISSUE,NOS;RADIOACTIVE
ELECTROPHORETIC TECHNIQUE, NOT ELSEWHERE SPECIFIED
EPIANDROSTERONE
ERYTHROPOIETIN
ESTRADIOL
ESTROGENS; FRACTIONATED
ESTROGENS; TOTAL
ESTRIOL
ESTRONE
ETHCHLORVYNOL
ETHYLENE GLYCOL
ETIOCHOLANOLONE
FAT OR LIPIDS, FECES; QUALITATIVE
FAT OR LIPIDS, FECES; QUANTITATIVE
FAT DIFFERENTIAL, FECES, QUANTITATIVE
FATTY ACIDS, NONESTERIFIED
VERY LONG CHAIN FATTY ACIDS
FERRITIN
FETAL FIBRONECTIN, CERVICO VAGINAL SECRETIONS, SEMI-QUANT
FLUORIDE
FLURAZEPAM
FOLIC ACID; SERUM
FOLIC ACID; RBC
FRUCTOSE, SEMEN
GALACTOKINASE, RBC
GALACTOSE
GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE; QUANTITATIVE
GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE; SCREEN
GAMMAGLOBULIN; IGA, IGD, IGG, IGM, EACH
GAMMAGLOBULIN; IGE
GAMMAGLOBULIN; IMMUNOGLOBULIN SUBCLASSES, (IGG1, 2, 3, OR 4), EACH
GASES, BLOOD, PH ONLY
GASES, BLOOD, ANY COMBINATION OF PH, PCO2, PO2, CO2, HCO2 (INCLUDING CALCULATED O2 SATURATION)
GASES, BLOOD, ANY COMBINATION OF PH, PCO2, PO2, CO2, HCO2 (INCLUDING CALCULATED O2 SATURATION); W
GASES, BLOOD, O2 SATURATION ONLY, BY DIRECT MEASUREMENT, EXCEPT PULSE OXIMETRY
HEMOGLOBIN-OXYGEN AFFINITY (PO2 FOR 50% HEMOGLOBIN SATURATION WITH OXYGEN)
GASTRIC ACID, FREE AND TOTAL, EACH SPECIMEN
GASTRIC ACID, FREE OR TOTAL; EACH SPECIMEN
GASTRIN AFTER SECRETIN STIMULATION
GASTRIN
GLUCAGON
GLUCOSE, BODY FLUID, OTHER THAN BLOOD
GLUCAGON TOLERANCE TEST
GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP)
GLUCOSE; BLOOD, REAGENT STRIP
GLUCOSE; POST GLUCOSE DOSE (INCLUDES GLUCOSE)
GLUCOSE; TOLERANCE TEST (GTT), THREE SPECIMENS (INCLUDES GLUCOSE)
GLUCOSE; TOLERANCE TEST, EACH ADDITIONAL BEYOND THREE SPECIMENS
GLUCOSE; TOLBUTAMIDE TOLERANCE TEST
GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD); QUANTITATIVE
GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD); SCREEN
GLUCOSE, BLOOD BY GLUCOSE MONITORING DEVICE(S) CLEARED BY THE FDA SPECIFICALLY FOR HOME USE
GLUCOSIDASE, BETA
GLUTAMATE DEHYDROGENASE
GLUTAMINE (GLUTAMIC ACID AMIDE)
GLUTAMYLTRANSFERASE, GAMMA (GGT)
GLUTATHIONE
GLUTATHIONE REDUCTASE, RBC
GLUTETHIMIDE
GLYCATED PROTEIN
GONADOTROPIN; FOLLICLE STIMULATING HORMONE (FSH)
GONADOTROPIN; LUTEINIZING HORMONE (LH)
GROWTH HORMONE, HUMAN (HGH) (SOMATOTROPIN)
GUANOSINE MONOPHOSPHATE (GMP), CYCLIC
HAPTOGLOBIN; QUANTITATIVE
HAPTOGLOBIN; PHENOTYPES
HELICOBACTER PYLORI; ANALYSIS FOR UREASE ACTIVITY, NON-RADIOACTIVE ISOTOPE
HELICOBACTER PYLORI; DRUG ADMINISTRATION AND SAMPLE COLLECTION
HEAVY METAL (ARSENIC, BARIUM, BERYLLIUM, BISMUTH, ANTIMONY, MERCURY); SCREEN
HEAVY METAL (ARSENIC, BARIUM, BERYLLIUM, BISMUTH, ANTIMONY, MERCURY); QUANTITATIVE, EACH
HEMOGLOBIN, ELECTROPHORESIS (EG, A2, S, C)
HEMOGLOBIN FRACTIONATION & QUANTITATION; CHROMATOGRAPHY
HEMOGLOBIN; BY COPPER SULFATE METHOD, NON-AUTOMATED
HEMOGLOBIN; F(FETAL), CHEMICAL
HEMOGLOBIN; F (FETAL), QUALITATIVE
HEMOGLOBIN; GLYCATED
HEMOGLOBIN; METHEMOGLOBIN, QUALITATIVE
HEMOGLOBIN; METHEMOGLOBIN, QUANTITATIVE
HEMOGLOBIN; PLASMA
HEMOGLOBIN; SULFHEMOGLOBIN, QUALITATIVE
HEMOGLOBIN; SULFHEMOGLOBIN, QUANTITATIVE
HEMOGLOBIN; THERMOLABILE
HEMOGLOBIN; UNSTABLE, SCREEN
HEMOGLOBIN; URINE
HEMOSIDERIN; QUALITATIVE
HEMOSIDERIN; QUANTITATIVE
B-HEXOSAMINIDASE, EACH ASSAY
HISTAMINE
HOMOCYSTINE
HOMOVANILLIC ACID (HVA)
HYDROXYCORTICOSTEROIDS, 17- (17-OHCS)
HYDROXYINDOLACETIC ACID, 5-(HIAA)
HYDROXYPROGESTERONE, 17-D
HYDROXYPROGESTERONE, 20-
HYDROXYPROLINE; FREE
HYDROXYPROLINE; TOTAL
IMMUNOASSAY FOR ANALYTE OTHER THAN ANTIBODY OR INFECTIOUS AGENT ANTIGEN, QUALITATIVE OR SEMIQ
IMMUNOASSAY FOR ANALYTE OTHER THAN ANTIBODY OR INFECTIOUS AGENT ANTIGEN, QUALITATIVE OR SEMIQ
IMMUNOASSAY, ANALYTE, QUANTITATIVE; BY RADIOPHARMACEUTICAL TECHNIQUE (EG, RIA)
IMMUNOASSAY, ANALYTE, QUANTITATIVE; NOT OTHERWISE SPECIFIED
INSULIN; TOTAL
INSULIN; FREE
INTRINSIC FACTOR
IRON
IRON BINDING CAPACITY
ISOCITRIC DEHYDROGENASE (IDH)
KETOGENIC STEROIDS, FRACTIONATION
KETOSTEROIDS, 17- (17-KS); TOTAL
KETOSTEROIDS, 17- (17-KS); FRACTIONATION
LACTATE (LACTIC ACID)
LACTATE DEHYDROGENASE (LD), (LDH);
LACTATE DEHYDROGENASE (LD), (LDH); ISOENZYMES, SEPARATION AND QUANTITATION
LACTOGEN, HUMAN PLACENTAL (HPL) HUMAN CHORIONIC SOMATOMAMMOTROPIN
LACTOSE, URINE; QUALITATIVE
LACTOSE, URINE; QUANTITATIVE
LEAD
FETAL LUNG MATURITY ASSESSMENT; LECITHIN SPHINGOMYELIN (L/S) RATIO
FETAL LUNG MATURITY ASSESSMENT; FOAM STABILITY TEST
FETAL LUNG MATURITY ASSESSMENT; FLUORESCENCE POLARIZATION
FETAL LUNG MATURITY ASSESSMENT; LAMELLAR BODY DENSITY
LEUCINE AMINOPEPTIDASE (LAP)
LIPASE
LIPOPROTEIN, BLOOD; ELECTROPHORETIC SEPARATION AND QUANTITATION
LIPOPROTEIN, BLOOD; HIGH RESOLUTION FRACTIONATION & QUANT
LIPOPROTEIN, DIRECT MEASUREMENT; HIGH DENSITY CHOLESTEROL (HDL CHOLESTEROL)
LIPOPROTEIN, DIRECT MEASUREMENT; VLDL CHOLESTEROL
LIPOPROTEIN, DIRECT MEASUREMENT; LDL CHOLESTEROL
LUTEINIZING RELEASING FACTOR (LRH)
MAGNESIUM
MALATE DEHYDROGENASE
MANGANESE
MASS SPEC & TANDEM MASS SPEC (MS,MS/MS), NOS, QUAL
MASS SPEC & TANDEM MASS SPEC (MS,MS/MS), NOS, QUANT
MEPROBAMATE
MERCURY, QUANTITATIVE
METANEPHRINES
METHADONE
METHEMALBUMIN
METHSUXIMIDE
MUCOPOLYSACCHARIDES, ACID; QUANTITATIVE
MUCOPOLYSACCHARIDES, ACID; SCREEN
MUCIN, SYNOVIAL FLUID (ROPES TEST)
MYELIN BASIC PROTEIN, CEREBROSPINAL FLUID
MYOGLOBIN
NATRIURETIC PEPTIDE
NEPHELOMETRY, EACH ANALYTE NOT ELSEWHERE SPECIFIED
NICKEL
NICOTINE
MOLECULAR DIAGNOSTICS; MOLECULAR ISOLATION OR EXTRACTION
MOLECULAR DIAGNOSTICS;ISOLATION/EXTRACTION HIGHLY PURIFIED
NUCLEAR MOLECULAR DIAGNOSTICS; ENZYMATIC DIGESTION
MOLECULAR DIAGNOSTICS;DOT/SLOT BLOT PRODUCTION
NUCLEAR MOLECULAR DIAGNOSTICS; SEPARATION (EG, DOT BLOT, ELECTROPHORESIS)
NUCLEAR MOLECULAR DIAGNOSTICS; NUCLEIC ACID PROBE, EACH
MOLECULAR DIAGNOSTICS; NUCLEIC ACID TRANSFER
MOLECULAR DIAGNOSTICS; AMPLIFICATION OF PATIENT NUCLEIC ACID (EG, PCR, LCR), SINGLE PRIMER PAIR, EAC
MOLECULAR DIAGNOSTICS;AMPLI NUCLEIC ACID,MULTIPLEX,EA
MOLECULAR DIAGNOSTICS; REVERSE TRANSCRIPTION
MOLECULAR DIAGNOSTICS;MUT SCANNING PHYSICAL PROPS,SINGLE,EA
MOLECULAR DIAGNOSTICS;MUTATION ID SEQUENCING,SINGLE SEG,EA
MOLECULAR DIAGNOSTICS;MUT ID ALLELE TRANSCR,SINGLE SEG,EA
MOLECULAR DIAGNOSTICS;MUT ID ALLELETRANSL,SINGLE SEG,EA
NUCLEAR MOLECULAR DIAGNOSTICS; INTERPRETATION AND REPORT
NUCLEOTIDASE 5'-
OLIGOCLONAL IMMUNE (OLIGOCLONAL BANDS)
ORGANIC ACIDS; TOTAL, QUANTITATIVE, EACH SPECIMEN
ORGANIC ACIDS, QUAL
ORGANIC ACID, SINGLE, QUANTITATIVE
OPIATES, (EG, MORPHINE, MEPERIDINE)
OSMOLALITY; BLOOD
OSMOLALITY; URINE
OSTEOCALCIN (BONE G1A PROTEIN)
OXALATE
ONCOPROTEIN, HER-2/NEU
PARATHORMONE (PARATHYROID HORMONE)
PH, BODY FLUID, EXCEPT BLOOD
PHENCYCLIDINE (PCP)
PHENOTHIAZINE
PHENYLALANINE (PKU), BLOOD
PHENYLKETONES, QUALITATIVE
PHOSPHATASE, ACID; TOTAL
PHOSPHATASE, ACID; FORENSIC EXAMINATION
PHOSPHATASE, ACID; PROSTATIC
PHOSPHATASE, ALKALINE;
PHOSPHATASE, ALKALINE; HEAT STABLE (TOTAL NOT INCLUDED)
PHOSPHATASE, ALKALINE; ISOENZYMES
PHOSPHATIDYLGLYCEROL
PHOSPHOGLUCONATE, 6-, DEHYDROGENASE, RBC
PHOSPHOHEXOSE ISOMERASE
PHOSPHORUS INORGANIC (PHOSPHATE);
PHOSPHORUS INORGANIC (PHOSPHATE); URINE
PORPHOBILINOGEN, URINE; QUALITATIVE
PORPHOBILINOGEN, URINE; QUANTITATIVE
PORPHYRINS, URINE; QUALITATIVE
PORPHYRINS, URINE; QUANTITATION AND FRACTIONATION
PORPHYRINS, FECES; QUANTITATIVE
PORPHYRINS, FECES; QUALITATIVE
POTASSIUM; SERUM
POTASSIUM; URINE
PREALBUMIN
PREGNANEDIOL
PREGNANETRIOL
PREGNENOLONE
17-HYDROXYPREGNENOLONE
PROGESTERONE
PROLACTIN
PROSTAGLANDIN, EACH
PROSTATE SPECIFIC ANTIGEN (PSA); COMPLEXED (DIRECT MEASUREMENT)
PROSTATE SPECIFIC ANTIGEN (PSA)
PROSTRATE SPECIFIC ANTIGEN (PSA); FREE
PROTEIN; TOTAL, EXCEPT REFRACTOMETRY
PROTEIN; REFRACTOMETRIC
PROTEIN; ELECTROPHORETIC FRACTIONATION AND QUANTITATION
PROTEIN; WESTERN BLOT, WITH INTERPRETATION AND REPORT, BLOOD OR OTHER BODY FLUID
PROTEIN; WESTERN BLOT, WITH INTERPRETATION AND REPORT, BLOOD OR OTHER BODY FLUID, IMMUNOLOGICA
PROTOPORPHYRIN, RBC; QUANTITATIVE
PROTOPORPHYRIN, RBC; SCREEN
PROINSULIN
PYRIDOXAL PHOSPHATE (VITAMIN B-6)
PYRUVATE
PYRUVATE KINASE
QUININE
RECEPTOR ASSAY; ESTROGEN
RECEPTOR ASSAY; PROGESTERONE
RECEPTOR ASSAY; ENDOCRINE, OTHER THAN ESTROGEN OR PROGESTERONE (SPECIFY HORMONE)
RECEPTOR ASSAY; NON-ENDOCRINE (EG, ACETYLCHOLINE) (SPECIFY RECEPTOR)
RENIN
RIBOFLAVIN (VITAMIN B-2)
SELENIUM
SEROTONIN
SEX HORMONE BINDING GLOBULIN (SHBG)
SIALIC ACID
SILICA
SODIUM; SERUM
SODIUM; URINE
SODIUM; OTHER SOURCE
SOMATOMEDIN
SOMATOSTATIN
SPECTROPHOTOMETRY, ANALYTE NOT ELSEWHERE SPECIFIED
SPECIFIC GRAVITY (EXCEPT URINE)
SUGARS, CHROMATOGRAPHIC, TLC OR PAPER CHROMATOGRAPHY
SUGARS; (MONO-,DI-,& OLIGOSACCHARIDES);SINGLE QUALITATIVE, EACH SPECIMEN
SUGARS; (MONO-,DI-,& OLIGOSACCHARIDES);MULTIPLE QUALITATIVE, EACH SPECIMEN
SUGARS; SINGLE QUANTITATIVE, EACH SPECIMEN
SUGARS; MULTIPLE QUANTITATIVE, EACH SPECIMEN
SULFATE, URINE
TESTOSTERONE; FREE
TESTOSTERONE; TOTAL
THIAMINE (VITAMIN B-1)
THIOCYANATE
THYROGLOBULIN
THYROXINE; TOTAL
THYROXINE; REQUIRING ELUTION (EG, NEONATAL)
THYROXINE; FREE
THYROXINE BINDING GLOBULIN (TBG)
THYROID STIMULATING HORMONE (TSH)
THYROID STIMULATING IMMUNE GLOBULINS (TSI)
TOCOPHEROL ALPHA (VITAMIN E)
TRANSCORTIN (CORTISOL BINDING GLOBULIN)
TRANSFERASE; ASPARTATE AMINO (AST) (SGOT)
TRANSFERASE; ALANINE AMINO (ALT) (SGPT)
TRANSFERRIN
TRIGLYCERIDES
THYROID HORMONE (T3 OR T4) UPTAKE OR THYROID HORMONE BINDING RATIO (THBR)
TRIIODOTHYRONINE T3; TOTAL (TT-3)
TRIIODOTHYRONINE (T-3); FREE
TRIIODOTHYRONINE (T-3); REVERSE
TROPONIN
TRYPSIN; DUODENAL FLUID
TRYPSIN; FECES, QUALITATIVE
TRYPSIN; FECES, QUANTITATIVE, 24-HOUR COLLECTION
TYROSINE
TROPONIN, QUALITATIVE
UREA NITROGEN; QUANTITATIVE
UREA NITROGEN; SEMIQUANTITATIVE (EG, REAGENT STRIP TEST)
UREA NITROGEN, URINE
UREA NITROGEN, CLEARANCE
URIC ACID; BLOOD
URIC ACID; OTHER SOURCE
UROBILINOGEN, FECES, QUANTITATIVE
UROBILINOGEN, URINE; QUALITATIVE
UROBILINOGEN, URINE; QUANTITATIVE, TIMED SPECIMEN
UROBILINOGEN, URINE; SEMIQUANTITATIVE
VANILLYLMANDELIC ACID (VMA), URINE
VASOACTIVE INTESTINAL PEPTIDE (VIP)
VASOPRESSIN (ANTIDIURETIC HORMONE, ADH)
VITAMIN A
VITAMIN, NOT OTHERWISE SPECIFIED
VITAMIN K
VOLATILES (EG, ACETIC ANHYDRIDE, CARBON TETRACHLORIDE, DICHLOROETHANE, DICHLOROMETHANE, DIETHY
XYLOSE ABSORPTION TEST, BLOOD AND/OR URINE
ZINC
C-PEPTIDE
GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE
GONADOTROPIN, CHORIONIC (HCG); QUALITATIVE
OVULATION TESTS, BY VISUAL COLOR COMPARISON METHODS FOR HUMAN LUTEINIZING HORMONE
UNLISTED CHEMISTRY PROCEDURE
BLEEDING TIME
BLOOD COUNT; AUTOMATED DIFFERENTIAL WBC COUNT
BLOOD COUNT; BLOOD SMEAR, MICROSCOPIC EXAMINATION WITH MANUAL DIFFERENTIAL WBC COUNT
BLOOD COUNT; BLOOD SMEAR, MICROSCOPIC EXAMINATION WITHOUT MANUAL DIFFERENTIAL WBC COUNT
BLOOD COUNT; MANUAL DIFFERENTIAL WBC COUNT, BUFFY COAT
BLOOD COUNT; SPUN MICROHEMATOCRIT
BLOOD COUNT; HEMATOCRIT (HCT)
BLOOD COUNT; HEMOGLOBIN (HGB)
BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT) AND AUTOMATED D
BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT)
BLOOD COUNT; MANUAL CELL COUNT (ERYTHROCYTE, LEUKOCYTE, OR PLATELET) EACH
BLOOD COUNT; RED BLOOD CELL (RBC), AUTOMATED
BLOOD COUNT; RETICULOCYTE, MANUAL
BLOOD COUNT; RETICULOCYTE, AUTOMATED
BLOOD COUNT; RETIC, HGB CONCENTRATION
BLOOD COUNT; LEUKOCYTE (WBC), AUTOMATED
BLOOD COUNT; PLATELET, AUTOMATED
BLOOD SMEAR, PERIPHERAL, INTERPRETATION BY PHYSICIAN WITH WRITTEN REPORT
BONE MARROW, SMEAR INTERPRETATION
CHROMOGENIC SUBSTRATE ASSAY
CLOT RETRACTION
CLOT LYSIS TIME, WHOLE BLOOD DILUTION
CLOTTING; FACTOR II, PROTHROMBIN, SPECIFIC
CLOTTING; FACTOR V (ACG OR PROACCELERIN), LABILE FACTOR
CLOTTING; FACTOR VII (PROCONVERTIN, STABLE FACTOR)
CLOTTING; FACTOR VIII (AHG), ONE STAGE
CLOTTING; FACTOR VIII RELATED ANTIGEN
CLOTTING; FACTOR VIII, VW FACTOR, RISTOCETIN COFACTOR
CLOTTING; FACTOR VIII, VW FACTOR ANTIGEN
CLOTTING; FACTOR VIII, VON WILLEBRAND'S FACTOR, MULTIMETRIC ANALYSIS
CLOTTING; FACTOR IX (PTC OR CHRISTMAS)
CLOTTING; FACTOR X (STUART-PROWER)
CLOTTING; FACTOR XI (PTA)
CLOTTING; FACTOR XII (HAGEMAN)
CLOTTING; FACTOR XIII (FIBRIN STABILIZING)
CLOTTING; FACTOR XIII (FIBRIN STABILIZING), SCREEN SOLUBILITY
CLOTTING; PREKALLIKREIN ASSAY (FLETCHER FACTOR ASSAY)
CLOTTING; HIGH MOLECULAR WEIGHT KININOGEN ASSAY (FITZGERALD FACTOR ASSAY)
CLOTTING INHIBITORS OR ANTICOAGULANTS; ANTITHROMBIN III, ACTIVITY
CLOTTING INHIBITORS OR ANTICOAGULANTS; ANTITHROMBIN III, ANTIGEN ASSAY
CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN C, ANTIGEN
CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN C, ACTIVITY
CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN S, TOTAL
CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN S, FREE
ACTIVATED PROTEIN C (APC) RESISTANCE ASSAY
FACTOR INHIBITOR TEST
THROMBOMODULIN
COAGULATION TIME; LEE AND WHITE
COAGULATION TIME; ACTIVATED
COAGULATION TIME; OTHER METHODS
EUGLOBULIN LYSIS
FIBRIN(OGEN) DEGRADATION (SPLIT) PRODUCTS (FDP)(FSP); AGGLUTINATION SLIDE, SEMIQUANTITATIVE
FIBRIN(OGEN) DEGRADATION (SPLIT) PRODUCTS (FDP)(FSP); PARACOAGULATION
FIBRIN(OGEN) DEGRADATION (SPLIT) PRODUCTS (FDP)(FSP); QUANTITATIVE
FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUALITATIVE OR SEMIQUANTITATIVE
FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE
FIBRIN DEGRADATION PRODUCTS, D-DIMER; ULTRASENSITIVE (EG, FOR EVALUATION FOR VENOUS THROMBOEM
FIBRINOGEN; ACTIVITY
FIBRINOGEN; ANTIGEN
FIBRINOLYSINS OR COAGULOPATHY SCREEN, INTERPRETATION AND REPORT
FIBRINOLYTIC FACTORS AND INHIBITORS; PLASMIN
FIBRINOLYTIC FACTORS AND INHIBITORS; ALPHA-2 ANTIPLASMIN
FIBRINOLYTIC FACTORS AND INHIBITORS; PLASMINOGEN ACTIVATOR
FIBRINOLYTIC FACTORS AND INHIBITORS; PLASMINOGEN, EXCEPT ANTIGENIC ASSAY
FIBRINOLYTIC FACTORS AND INHIBITORS; PLASMINOGEN, ANTIGENIC ASSAY
HEINZ BODIES; DIRECT
HEINZ BODIES; INDUCED, ACETYL PHENYLHYDRAZINE
HEMOGLOBIN OR RBCS, FETAL, FOR FETOMATERNAL HEMORRHAGE; DIFFERENTIAL LYSIS (KLEIHAUER-BETKE)
HEMOGLOBIN OR RBCS, FETAL, FOR FETOMATERNAL HEMORRHAGE; ROSETTE
HEMOLYSIN, ACID
HEPARIN ASSAY
HEPARIN NEUTRALIZATION
HEPARIN-PROTAMINE TOLERANCE TEST
IRON STAIN, PERIPHERAL BLOOD
LEUKOCYTE ALKALINE PHOSPHATASE WITH COUNT
MECHANICAL FRAGILITY, RBC
MURAMIDASE
OSMOTIC FRAGILITY, RBC; UNINCUBATED
OSMOTIC FRAGILITY, RBC; INCUBATED
PLATELET; AGGREGATION (IN VITRO), EACH AGENT
PLATELET NEUTRALIZATION
PROTHROMBIN TIME;
PROTHROMBIN TIME; SUBSTITUTION, PLASMA FRACTIONS, EACH
RUSSELL VIPER VENOM TIME (INCLUDES VENOM); UNDILUTED
RUSSELL VIPER VENOM TIME (INCLUDES VENOM); DILUTED
REPTILASE TEST
SEDIMENTATION RATE, ERYTHROCYTE, NON-AUTOMATED
SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED
SICKLING OF RBC, REDUCTION
THROMBIN TIME; PLASMA
THROMBIN TIME; TITER
THROMBOPLASTIN INHIBITION; TISSUE
THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD
THROMBOPLASTIN TIME, PARTIAL (PTT); SUBSTITUTION, PLASMA FRACTIONS, EACH
VISCOSITY
UNLISTED HEMATOLOGY AND COAGULATION PROCEDURE
AGGLUTININS, FEBRILE (EG, BRUCELLA, FRANCISELLA, MURINE TYPHUS, Q FEVER, ROCKY MOUNTAIN SPOTTED F
ALLERGEN SPECIFIC IGG QUANTITATIVE OR SEMIQUANTITATIVE, EACH ALLERGEN
ALLERGEN SPECIFIC IGE; QUANTITATIVE, EACH PANEL OF UP TO 12 ALLERGENS
ALLERGEN SPECIFIC IGE; QUALITATIVE, MULTIALLERGEN SCREEN (DIPSTICK OR DISK)
ANTIBODY IDENTIFICATION; LEUKOCYTE ANTIBODIES
ANTIBODY IDENTIFICATION; PLATELET ANTIBODIES
ANTIBODY IDENTIFICATION; PLATELET ASSOCIATED IMMUNOGLOBULIN ASSAY
ANTINUCLEAR ANTIBODIES (ANA);
ANTINUCLEAR ANTIBODIES (ANA); TITER
ANTISTREPTOLYSIN 0; TITER
ANTISTREPTOLYSIN 0; SCREEN
BLOOD BANK PHYSICIAN SERVICES; DIFFICULT CROSS MATCH AND/OR EVALUATION OF IRREGULAR ANTIBODY(S)
BLOOD BANK PHYSICIAN SERVICES; INVESTIGATION OF TRANSFUSION REACTION INCLUDING SUSPICION OF TRA
BLOOD BANK PHYSICIAN SERVICES; AUTHORIZATION FOR DEVIATION FROM STANDARD BLOOD BANKING PROCED
C-REACTIVE PROTEIN;
C-REACTIVE PROTEIN; HIGH SENSITIVITY (HSCRP)
BETA 2 GLYCOPROTEIN I ANTIBODY, EACH
CARDIOLIPIN (PHOSPHOLIPID) ANTIBODY, EACH IG CLASS
ANTI-PHOSPHATIDYLSERINE (PHOSPHOLIPID) ANTIBODY
CHEMOTAXIS ASSAY, SPECIFY METHOD
COLD AGGLUTININ; SCREEN
COLD AGGLUTININ; TITER
COMPLEMENT; ANTIGEN, EACH COMPONENT
COMPLEMENT; FUNCTIONAL ACTIVITY, EACH COMPONENT
COMPLEMENT; TOTAL HEMOLYTIC (CH50)
COMPLEMENT FIXATION TESTS, EACH ANTIGEN
COUNTERIMMUNOELECTROPHORESIS, EACH ANTIGEN
DEOXYRIBONUCLEASE, ANTIBODY
DEOXYRIBONUCLEIC ACID (DNA) ANTIBODY; NATIVE OR DOUBLE STRANDED
DEOXYRIBONUCLEIC ACID (DNA) ANTIBODY; SINGLE STRANDED
EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY TO, ANY METHOD (EG, NRNP, SS-A, SS-B, SM, RNP, SC170, J01), EAC
FC RECEPTOR
FLUORESCENT ANTIBODY; SCREEN, EACH ANTIBODY
FLUORESCENT ANTIBODY; TITER, EACH ANTIBODY
GROWTH HORMONE, HUMAN (HGH), ANTIBODY
HEMAGGLUTINATION INHIBITION TEST (HAI)
IMMUNOASSAY FOR TUMOR ANTIGEN, QUALITATIVE OR SEMIQUANTITATIVE (EG, BLADDER TUMOR ANTIGEN)
IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 15-3 (27.29)
IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 19-9
IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 125
HETEROPHILE ANTIBODIES; SCREENING
HETEROPHILE ANTIBODIES; TITER
HETEROPHILE ANTIBODIES; TITERS AFTER ABSORPTION WITH BEEF CELLS AND GUINEA PIG KIDNEY
IMMUNOASSAY FOR TUMOR ANTIGEN; OTHER ANTIGEN, QUANTITATIVE (EG, CA 50, 72-4, 549), EACH
IMMUNOASSAY FOR INFECTIOUS AGENT ANTIBODY, QUANTITATIVE, NOT ELSEWHERE SPECIFIED
IMMUNOASSAY FOR INFECTIOUS AGENT ANTIBODY, QUALITATIVE OR SEMIQUANTITATIVE, SINGLE STEP METHOD
IMMUNOELECTROPHORESIS; SERUM
IMMUNOELECTROPHORESIS; OTHER FLUIDS (EG, URINE, CEREBROSPINAL FLUID) WITH CONCENTRATION
IMMUNOELECTROPHORESIS; CROSSED (2-DIMENSIONAL ASSAY)
IMMUNODIFFUSION; NOT ELSEWHERE SPECIFIED
IMMUNODIFFUSION; GEL DIFFUSION, QUALITATIVE (OUCHTERLONY), EACH ANTIGEN OR ANTIBODY
IMMUNE COMPLEX ASSAY
IMMUNOFIXATION ELECTROPHORESIS
INHIBIN A
INSULIN ANTIBODIES
INTRINSIC FACTOR ANTIBODIES
ISLET CELL ANTIBODY
LEUKOCYTE HISTAMINE RELEASE TEST (LHR)
LEUKOCYTE PHAGOCYTOSIS
LYMPHOCYTE TRANSFORMATION, MITOGEN (PHYTOMITOGEN) OR ANTIGEN INDUCED BLASTOGENESIS
T CELLS; TOTAL COUNT
T CELLS; T4 AND T8, INCLUDING RATIO
T CELLS; CD4 ABSOLUTE COUNT
MICROSOMAL ANTIBODIES (EG, THYROID OR LIVER-KIDNEY), EACH
MIGRATION INHIBITORY FACTOR TEST (MIF)
NEUTRALIZATION TEST, VIRAL
NITROBLUE TETRAZOLIUM DYE TEST (NTD)
PARTICLE AGGLUTINATION; SCREEN, EACH ANTIBODY
PARTICLE AGGLUTINATION; TITER, EACH ANTIBODY
RHEUMATOID FACTOR; QUALITATIVE
RHEUMATOID FACTOR; QUANTITATIVE
SKIN TEST; CANDIDA
SKIN TEST; COCCIDIOIDOMYCOSIS
SKIN TEST; HISTOPLASMOSIS
SKIN TEST; TUBERCULOSIS, INTRADERMAL
SKIN TEST; TUBERCULOSIS, TINE TEST
SKIN TEST; UNLISTED ANTIGEN, EACH
STREPTOKINASE, ANTIBODY
SYPHILIS TEST; QUALITATIVE (EG, VDRL, RPR, ART)
SYPHILIS TEST; QUANTITATIVE
ANTIBODY; ACTINOMYCES
ANTIBODY; ADENOVIRUS
ANTIBODY; ASPERGILLUS
ANTIBODY; BACTERIUM, NOT ELSEWHERE SPECIFIED
ANTIBODY; BARTONELLA
ANTIBODY; BLASTOMYCES
ANTIBODY; BORDETELLA
ANTIBODY; BORRELIA BURGDORFERI (LYME DISEASE) CONFIRMATORY TEST (EG, WESTERN BLOT OR IMMUNOBL
ANTIBODY; BORRELIA BURGDORFERI (LYME DISEASE)
ANTIBODY; BORRELIA (RELAPSING FEVER)
ANTIBODY; BRUCELLA
ANTIBODY; CAMPYLOBACTER
ANTIBODY; CANDIDA
ANTIBODY; CHLAMYDIA
ANTIBODY; CHLAMYDIA, IGM
ANTIBODY; COCCIDIOIDES
ANTIBODY; COXIELLA BRUNETII (Q FEVER)
ANTIBODY; CRYPTOCOCCUS
ANTIBODY; CYTOMEGALOVIRUS (CMV)
ANTIBODY; CYTOMEGALOVIRUS (CMV), IGM
ANTIBODY; DIPHTHERIA
ANTIBODY; ENCEPHALITIS, CALIFORNIA (LA CROSSE)
ANTIBODY; ENCEPHALITIS, EASTERN EQUINE
ANTIBODY; ENCEPHALITIS, ST. LOUIS
ANTIBODY; ENCEPHALITIS, WESTERN EQUINE
ANTIBODY; ENTEROVIRUS (EG, COXSACKIE, ECHO, POLIO)
ANTIBODY; EPSTEIN-BARR (EB) VIRUS, EARLY ANTIGEN (EA)
ANTIBODY; EPSTEIN-BARR (EB) VIRUS, NUCLEAR ANTIGEN (EBNA)
ANTIBODY; EPSTEIN-BARR (EB) VIRUS, VIRAL CAPSID (VCA)
ANTIBODY; EHRLICHIA
ANTIBODY; FRANCISELLA TULARENSIS
ANTIBODY; FUNGUS, NOT ELSEWHERE SPECIFIED
ANTIBODY; GIARDIA LAMBLIA
ANTIBODY; HELICOBACTER PYLORI
ANTIBODY; HELMINTH, NOT ELSEWHERE SPECIFIED
ANTIBODY; HEMOPHILUS INFLUENZA
ANTIBODY; HTLV I
ANTIBODY; HTLV-II
ANTIBODY; HTLV OR HIV ANTIBODY, CONFIRMATORY TEST (EG, WESTERN BLOT)
ANTIBODY; HEPATITIS, DELTA AGENT
ANTIBODY; HERPES SIMPLEX, NON-SPECIFIC TYPE TEST
ANTIBODY; HERPES SIMPLEX, TYPE 1
ANTIBODY; HERPES SIMPLEX, TYPE 2
ANTIBODY; HISTOPLASMA
ANTIBODY; HIV-1
ANTIBODY; HIV-2
ANTIBODY; HIV-1 AND HIV-2, SINGLE ASSAY
HEPATITIS B CORE ANTIBODY (HBCAB), TOTAL
IGM ANTIBODY
HEPATITIS B SURFACE AB (HBSAB)
HEPATITIS BE ANTIBODY (HBEAB)
HEPATITIS A ANTIBODY (HAAB), TOTAL
HEPATITIS A ANTIBODY (HAAB), IGM ANTIBODY
ANTIBODY; INFLUENZA VIRUS
ANTIBODY; LEGIONELLA
ANTIBODY; LEISHMANIA
ANTIBODY; LEPTOSPIRA
ANTIBODY; LISTERIA MONOCYTOGENES
ANTIBODY; LYMPHOCYTIC CHORIOMENINGITIS
ANTIBODY; LYMPHOGRANULOMA VENEREUM
ANTIBODY; MUCORMYCOSIS
ANTIBODY; MUMPS
ANTIBODY; MYCOPLASMA
ANTIBODY; NEISSERIA MENINGITIDIS
ANTIBODY; NOCARDIA
ANTIBODY; PARVOVIRUS
ANTIBODY; PLASMODIUM (MALARIA)
ANTIBODY; PROTOZOA, NOT ELSEWHERE SPECIFIED
ANTIBODY; RESPIRATORY SYNCYTIAL VIRUS
ANTIBODY; RICKETTSIA
ANTIBODY; ROTAVIRUS
ANTIBODY; RUBELLA
ANTIBODY; RUBEOLA
ANTIBODY; SALMONELLA
ANTIBODY; SHIGELLA
ANTIBODY; TETANUS
ANTIBODY; TOXOPLASMA
ANTIBODY; TOXOPLASMA, IGM
ANTIBODY; TREPONEMA PALLIDUM, CONFIRMATORY TEST (EG, FTA-ABS)
ANTIBODY; TRICHINELLA
ANTIBODY; VARICELLA-ZOSTER
ANTIBODY; VIRUS, NOT ELSEWHERE SPECIFIED
ANTIBODY; YERSINIA
THYROGLOBULIN ANTIBODY
HEPATITIS C ANTIBODY
HEPATITIS C ANTIBODY, CONFIRM
LYMPHOCYTOTOXICITY ASSAY, VISUAL CROSSMATCH; WITH TITRATION
LYMPHOCYTOTOXICITY ASSAY, VISUAL CROSSMATCH; WITHOUT TITRATION
SERUM SCREENING FOR CYTOTOXIC PERCENT REACTIVE ANTIBODY (PRA); STANDARD METHOD
SERUM SCREENING FOR CYTOTOXIC PERCENT REACTIVE ANTIBODY (PRA); QUICK METHOD
HLA TYPING; A, B, OR C (EG, A10, B7, B27), SINGLE ANTIGEN
HLA TYPING; A, B, OR C, MULTIPLE ANTIGENS
HLA TYPING; DR/DQ, SINGLE ANTIGEN
HLA TYPING; DR/DQ, MULTIPLE ANTIGENS
HLA TYPING; LYMPHOCYTE CULTURE, MIXED (MLC)
HLA TYPING; LYMPHOCYTE CULTURE, PRIMED (PLC)
UNLISTED IMMUNOLOGY PROCEDURE
ANTIBODY SCREEN, RBC, EACH SERUM TECHNIQUE
ANTIBODY ELUTION (RBC), EACH ELUTION
ANTIBODY IDENTIFICATION, RBC ANTIBODIES, EACH PANEL FOR EACH SERUM TECHNIQUE
ANTIHUMAN GLOBULIN TEST (COOMBS TEST); DIRECT, EACH ANTISERUM
ANTIHUMAN GLOBULIN TEST (COOMBS TEST); INDIRECT, QUALITATIVE, EACH ANTISERUM
ANTIHUMAN GLOBULIN TEST (COOMBS TEST); INDIRECT, TITER, EACH ANTISERUM
AUTOLOGOUS BLOOD OR COMPONENT, COLLECTION PROCESSING AND STORAGE; PREDEPOSITED
AUTOLOGOUS BLOOD OR COMPONENT, COLLECTION PROCESSING AND STORAGE; INTRA- OR POSTOPERATIVE S
BLOOD TYPING; ABO
BLOOD TYPING; RH (D)
BLOOD TYPING; ANTIGEN SCREENING FOR COMPATIBLE BLOOD UNIT USING REAGENT SERUM, PER UNIT SCREEN
BLOOD TYPING; ANTIGEN SCREENING FOR COMPATIBLE UNIT USING PATIENT SERUM, PER UNIT SCREENED
BLOOD TYPING; RBC ANTIGENS, OTHER THAN ABO OR RH (D), EACH
BLOOD TYPING; RH PHENOTYPING, COMPLETE
BLOOD TYPING, FOR PATERNITY TESTING, PER INDIVIDUAL; ABO, RH AND MN
BLOOD TYPING, FOR PATERNITY TESTING, PER INDIVIDUAL, ABO, RH AND MN; EACH ADDITIONAL ANTIGEN SYSTE
COMPATIBILITY TEST EACH UNIT; IMMEDIATE SPIN TECHNIQUE
COMPATIBILITY TEST EACH UNIT; INCUBATION TECHNIQUE
COMPATIBILITY TEST EACH UNIT; ANTIGLOBULIN TECHNIQUE
FRESH FROZEN PLASMA, THAWING, EACH UNIT
FROZEN BLOOD, EACH UNIT; FREEZING (INCLUDES PREPARATION)
FROZEN BLOOD, EACH UNIT; THAWING
FROZEN BLOOD, EACH UNIT; FREEZING (INCLUDES PREPARATION) AND THAWING
HEMOLYSINS AND AGGLUTININS; AUTO, SCREEN, EACH
HEMOLYSINS AND AGGLUTININS, AUTO, SCREEN, EACH; INCUBATED
IRRADIATION OF BLOOD PRODUCT, EACH UNIT
LEUKOCYTE TRANSFUSION
POOLING OF PLATELETS OR OTHER BLOOD PRODUCTS
PRETREATMENT OF RBC'S FOR USE IN RBC ANTIBODY DETECTION, IDENTIFICATION, AND/OR COMPATIBILITY TES
PRETREATMENT OF RBC'S FOR USE IN RBC ANTIBODY DETECTION, IDENTIFICATION, AND/OR COMPATIBILITY TES
PRETREATMENT OF RBC'S FOR USE IN RBC ANTIBODY DETECTION, IDENTIFICATION, AND/OR COMPATIBILITY TES
PRETREATMENT OF SERUM FOR USE IN RBC ANTIBODY IDENTIFICATION; INCUBATION WITH DRUGS, EACH
PRETREATMENT OF SERUM FOR USE IN RBC ANTIBODY IDENTIFICATION; BY DILUTION
PRETREATMENT OF SERUM FOR USE IN RBC ANTIBODY IDENTIFICATION; INCUBATION WITH INHIBITORS, EACH
PRETREATMENT OF SERUM FOR USE IN RBC ANTIBODY IDENTIFICATION; BY DIFFERENTIAL RED CELL ABSORPTIO
SPLITTING OF BLOOD OR BLOOD PRODUCTS, EACH UNIT
UNLISTED TRANSFUSION MEDICINE PROCEDURE
ANIMAL INOCULATION, SMALL ANIMAL; WITH OBSERVATION
ANIMAL INOCULATION, SMALL ANIMAL; WITH OBSERVATION AND DISSECTION
CONCENTRATION (ANY TYPE), FOR INFECTIOUS AGENTS
CULTURE, BACTERIAL; BLOOD, WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES (INCLUDES AN
CULTURE, BACTERIAL; FECES, WITH ISOLATION AND PRELIMINARY EXAMINATION (EG, KIA, LIA), SALMONELLA AND
CULTURE, BACTERIAL; STOOL, ADDITIONAL PATHOGENS, ISOLATION AND PRELIMINARY EXAMINATION (EG, CAMP
CULTURE, BACTERIAL; ANY OTHER SOURCE EXCEPT URINE, BLOOD OR STOOL, WITH ISOLATION AND PRESUMPT
CULTURE, BACTERIAL; QUANTITATIVE, AEROBIC WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLAT
CULTURE, BACTERIAL; QUANTITATIVE, ANAEROBIC WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOL
CULTURE, BACTERIAL; ANY SOURCE, ANAEROBIC WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLA
CULTURE, BACTERIAL; ANAEROBIC ISOLATE, ADDITIONAL METHODS REQUIRED FOR DEFINITIVE IDENTIFICATION,
CULTURE, BACTERIAL; AEROBIC ISOLATE, ADDITIONAL METHODS REQUIRED FOR DEFINITIVE IDENTIFICATION, EA
CULTURE, PRESUMPTIVE, PATHOGENIC ORGANISMS, SCREENING ONLY
CULTURE, PRESUMPTIVE, PATHOGENIC ORGANISMS, SCREENING ONLY, BY COMMERCIAL KIT (SPECIFY TYPE); W
CULTURE, BACTERIAL; QUANTITATIVE COLONY COUNT, URINE
CULTURE, BACTERIAL; WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES, URINE
CULTURE, FUNGI (MOLD OR YEAST) ISOLATION, WITH PRESUMPTIVE IDENTIFICATION OF ISOLATES; SKIN, HAIR, O
CULTURE, FUNGI (MOLD OR YEAST) ISOLATION, WITH PRESUMPTIVE IDENTIFICATION OF ISOLATES; OTHER SOUR
CULTURE, FUNGI (MOLD OR YEAST) ISOLATION, WITH PRESUMPTIVE IDENTIFICATION OF ISOLATES; BLOOD
CULTURE, FUNGI, DEFINITIVE IDENTIFICATION, EACH ORGANISM; YEAST
CULTURE, FUNGI, DEFINITIVE IDENTIFICATION, EACH ORGANISM; MOLD
CULTURE, MYCOPLASMA, ANY SOURCE
CULTURE, CHLAMYDIA, ANY SOURCE
CULTURE, TUBERCLE OR OTHER ACID-FAST BACILLI (EG, TB, AFB, MYCOBACTERIA) ANY SOURCE, WITH ISOLATIO
CULTURE, MYCOBACTERIAL, DEFINITIVE IDENTIFICATION, EACH ISOLATE
CULTURE, TYPING; IMMUNOFLUORESCENT METHOD, EACH ANTISERUM
CULTURE, TYPING; GAS LIQUID CHROMATOGRAPHY (GLC) OR HIGH PRESSURE LIQUID CHROMATOGRAPHY (HPLC
CULTURE, TYPING; IMMUNOLOGIC METHOD, OTHER THAN IMMUNOFLUORESCENCE (EG, AGGLUTINATION GROUP
CULTURE, TYPING; IDENTIFICATION BY NUCLEIC ACID PROBE
CULTURE, TYPING; IDENTIFICATION BY PULSE FIELD GEL TYPING
CULTURE, TYPING; OTHER METHODS
DARK FIELD EXAMINATION, ANY SOURCE (EG, PENILE, VAGINAL, ORAL, SKIN); INCLUDES SPECIMEN COLLECTION
DARK FIELD EXAMINATION, ANY SOURCE (EG, PENILE, VAGINAL, ORAL, SKIN); WITHOUT COLLECTION
MACROSCOPIC EXAMINATION; ARTHROPOD
MACROSCOPIC EXAMINATION; PARASITE
PINWORM EXAM (EG, CELLOPHANE TAPE PREP)
HOMOGENIZATION, TISSUE, FOR CULTURE
OVA AND PARASITES, DIRECT SMEARS, CONCENTRATION AND IDENTIFICATION
SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; AGAR DILUTION METHOD, PER AGENT (EG, ANTIBIOTIC GRADIE
SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; DISK METHOD, PER PLATE (12 OR FEWER AGENTS)
SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; ENZYME DETECTION (EG, BETA LACTAMASE), PER ENZYME
SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; MICRODILUTION OR AGAR DILUTION (MINIMUM INHIBITORY CO
SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; MICRODILUTION OR AGAR DILUTION, MINIMUM LETHAL CONCE
SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; MACROBROTH DILUTION METHOD, EACH AGENT
SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; MYCOBACTERIA, PROPORTION METHOD, EACH AGENT
SERUM BACTERICIDAL TITER (SCHLICTER TEST)
SMEAR, PRIMARY SOURCE WITH INTERPRETATION; GRAM OR GIEMSA STAIN FOR BACTERIA, FUNGI, OR CELL TYP
SMEAR, PRIMARY SOURCE WITH INTERPRETATION; FLUORESCENT AND/OR ACID FAST STAIN FOR BACTERIA, FUN
SMEAR, PRIMARY SOURCE WITH INTERPRETATION; SPECIAL STAIN FOR INCLUSION BODIES OR PARASITES (EG, M
SMEAR, PRIMARY SOURCE WITH INTERPRETATION; WET MOUNT FOR INFECTIOUS AGENTS (EG, SALINE, INDIA INK
TISSUE EXAMINATION BY KOH SLIDE OF SAMPLES FROM SKIN, HAIR, OR NAILS FOR FUNGI OR ECTOPARASITE OV
TOXIN OR ANTITOXIN ASSAY, TISSUE CULTURE (EG, CLOSTRIDIUM DIFFICILE TOXIN)
VIRUS ISOLATION; INOCULATION OF EMBRYONATED EGGS, OR SMALL ANIMAL, INCLUDES OBSERVATION AND DIS
VIRUS ISOLATION; TISSUE CULTURE INOCULATION, OBSERVATION, AND PRESUMPTIVE IDENTIFICATION BY CYTOP
VIRUS ISOLATION; TISSUE CULTURE, ADDITIONAL STUDIES OR DEFINITIVE IDENTIFICATION (EG, HEMABSORPTION
VIRUS ISOLATION; CENTRIFUGE ENHANCED (SHELL VIAL) TECHNIQUE, INCLUDES IDENTIFICATION WITH IMMUNOF
VIRUS ISOLATION; INCLUDING IDENTIFICATION BY NON-IMMUNOLOGIC METHOD,OTHER THAN BY CYTOPATHIC EF
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; ADENOVIRUS
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; BORDETELLA PERTUSSIS/PARA
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE;ENTEROVIRUS, DIRECT FLUORE
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; CHLAMYDIA TRACHOMATIS
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; CYTOMEGALOVIRUS, DIRECT F
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; CRYPTOSPORIDIUM/GIARDIA
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; HERPES SIMPLEX VIRUS TYPE
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; HERPES SIMPLEX VIRUS TYPE
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; INFLUENZA B VIRUS
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; INFLUENZA A VIRUS
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; LEGIONELLA MICDADEI
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; LEGIONELLA PNEUMOPHILA
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; PARAINFLUENZA VIRUS, EACH
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; RESPIRATORY SYNCYTIAL VIRU
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; PNEUMOCYSTIS CARINII
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; RUBEOLA
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; TREPONEMA PALLIDUM
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; VARICELLA ZOSTER VIRUS
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; NOT OTHERWISE SPECIFIED, E
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE, POLYVALENT FOR MULTIPLE O
INFECTIOUS AGENT AG DETECT BY EI, MULTI;ADENOVIRUS TYPE 40/4
INFECTIOUS AGENT AG DETECT BY EI, MULTI;CHLAMYDIA
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTI
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTI
INFECTIOUS AGENT AG DETECT BY EI, MULTI;CRYPTOSPORIDUM
INFECTIOUS AGENT AG DETECT BY EI, MULTI;CYTOMEGALOVIRUS
INFECTIOUS AGENT AG DETECT BY EI, MULTI;ESCHERICHIA COLI
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTI
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTI
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTI
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTI
INFECTIOUS AGENT AG DETECT BY EI, MULTI; HBSAG
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTI
INFECTIOUS AGENT AG DETECT BY EI, MULTI; HBEAG
INFECTIOUS AGENT AG DETECT BY EI, MULTI;HEPATITIS, DELTA
INFECTIOUS AGENT AG DETECT BY EI, MULTI;HISTOPLASMA CAPSULAT
INFECTIOUS AGENT AG DETECT BY EI, MULTI; HIV-1
INFECTIOUS AGENT AG DETECT BY EI, MULTI; HIV-2
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTI
INFECTIOUS AGENT AG DETECT BY EI, MULTI; RSV
INFECTIOUS AGENT AG DETECT BY EI, MULTI; ROTAVIRUS
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTI
INFECTIOUS AGENT AG DETECT BY EI, MULTI;STREP, GRP A
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE QUALITATIVE OR SEMIQUANTIT
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE QUALITATIVE OR SEMIQUANTIT
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE QUALITATIVE OR SEMIQUANTIT
INFECTIOUS AGENT DETECT BY DNA/RNA; BARTONELLA, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; BARTONELLA, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; BARTONELLA, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; BORRELIA, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; BORRELIA AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; BORRELIA QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; CANDIDA, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; CANDIDA, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; CANDIDA, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; CHLAMYDIA P, DIRECT PROB
INFECTIOUS AGENT DETECT BY DNA/RNA; CHLAMYDIA P, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; CHLAMYDIA P, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; CHLAMYDIA T, DIRECT PROB
INFECTIOUS AGENT DETECT BY DNA/RNA; CHLAMYDIA T, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; CHLAMYDIA T, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; CYTOMEGALO, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; CYTOMEGALO, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; CYTOMEGALO, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA;GARDNERELLA, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA;GARDNERELLA, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA;GARDNERELLA, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; HEP B, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; HEP B, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; HEP B, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; HEP C, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; HEP C, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; HEP C, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; HEP G, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; HEP G, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; HEP G, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; HERPES SIMP, DIRECT PROB
INFECTIOUS AGENT DETECT BY DNA/RNA; HERPES SIMP, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; HERPES SIMP, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; HERPES -6, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; HERPES -6, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; HERPES -6, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; HIV-1, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; HIV-1, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; HIV-1, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; HIV-2, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; HIV-2, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; HIV-2, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; LEGIONELLA, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; LEGIONELLA, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; LEGIONELLA, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; MYCOBACT, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; MYCOBACT, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; MYCOBACT, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; MYCOBACA, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; MYCOBACA, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; MYCOBACA, QUANT
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA AVIUM-INTRACELLULARE, DIRE
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA AVIUM-INTRACELLULARE, AMP
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA AVIUM-INTRACELLULARE, QUA
INFECTIOUS AGENT DETECT BY DNA/RNA; MYCOPLASMA, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; MYCOPLASMA, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; MYCOPLASMA, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; NEISSERIA G, DIRECT PROB
INFECTIOUS AGENT DETECT BY DNA/RNA; NEISSERIA G, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; NEISSERIA G, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; PAPILLOMA, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; PAPILLOMA, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; PAPILLOMA, QUANT
INFECTIOUS AGENT DETECT BY DNA/RNA; STREP A, DIRECT PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; STREP A, AMP PROBE
INFECTIOUS AGENT DETECT BY DNA/RNA; STREP A, QUANT
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), NOT OTHERWISE SPECIFIED; DIRECT PROBE TE
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), NOT OTHERWISE SPECIFIED; AMPLIFIED PROBE
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), NOT OTHERWISE SPECIFIED; QUANTIFICATION,
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), MULTIPLE ORGANISMS; DIRECT PROBE(S) TECH
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), MULTIPLE ORGANISMS; AMPLIFIED PROBE(S) TE
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; STREPTOCOC
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; CLOSTRIDIUM
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; INFLUENZA
INFECTIOUS AGENT DETECT BY IMMUNOASSAY, DIRECT OPT, CHLAMYDI
INFECTIOUS AGENT DETECT BY IMMUNOASSAY, DIRECT OPT, NEISSERI
INFECTIOUS AGENT DETECT BY IMMUNOASSAY, DIRECT OPT, STREP A
INFECTIOUS AGENT DETECT BY IMMUNOASSAY, DIRECT OPT, NOS
INFECTIOUS AGENT GENOTYPE ANALYSIS BY NUCLEIC ACID (DNA OR RNA); HIV 1, REVERSE TRANSCRIPTASE AND
INFECTIOUS AGENT GENOTYPE ANALYSIS BY NUCLEIC ACID (DNA OR RNA); HEPATITIS C VIRUS
INFECTIOUS AGENT PHENOTYPE ANALYSIS BY NUCLEIC ACID (DNA OR RNA) WITH DRUG RESISTANCE TISSUE CU
INFECTIOUS AGENT PHENOTYPE ANALYSIS NUCLEIC ACID (DNA/RNA) WITH DRUG RESISTANCE TISSUE CULTURE
UNLISTED MICROBIOLOGY PROCEDURE
NECROPSY (AUTOPSY), GROSS EXAMINATION ONLY; WITHOUT CNS
NECROPSY (AUTOPSY), GROSS EXAMINATION ONLY; WITH BRAIN
NECROPSY (AUTOPSY), GROSS EXAMINATION ONLY; WITH BRAIN AND SPINAL CORD
NECROPSY (AUTOPSY), GROSS EXAMINATION ONLY; INFANT WITH BRAIN
NECROPSY (AUTOPSY), GROSS EXAMINATION ONLY; STILLBORN OR NEWBORN WITH BRAIN
NECROPSY (AUTOPSY), GROSS EXAMINATION ONLY; MACERATED STILLBORN
NECROPSY (AUTOPSY), GROSS AND MICROSCOPIC; WITHOUT CNS
NECROPSY (AUTOPSY), GROSS AND MICROSCOPIC; WITH BRAIN
NECROPSY (AUTOPSY), GROSS AND MICROSCOPIC; WITH BRAIN AND SPINAL CORD
NECROPSY (AUTOPSY), GROSS AND MICROSCOPIC; INFANT WITH BRAIN
NECROPSY (AUTOPSY), GROSS AND MICROSCOPIC; STILLBORN OR NEWBORN WITH BRAIN
NECROPSY (AUTOPSY), LIMITED, GROSS AND/OR MICROSCOPIC; REGIONAL
NECROPSY (AUTOPSY), LIMITED, GROSS AND/OR MICROSCOPIC; SINGLE ORGAN
NECROPSY (AUTOPSY); FORENSIC EXAMINATION
NECROPSY (AUTOPSY); CORONER'S CALL
UNLISTED NECROPSY (AUTOPSY) PROCEDURE
CYTOPATHOLOGY, FLUIDS, WASHINGS OR BRUSHINGS, EXCEPT CERVICAL OR VAGINAL; SMEARS WITH INTERPRE
CYTOPATHOLOGY, FLUIDS, WASHINGS OR BRUSHINGS, EXCEPT CERVICAL OR VAGINAL; FILTER METHOD ONLY W
CYTOPATHOLOGY, FLUIDS, WASHINGS OR BRUSHINGS, EXCEPT CERVICAL OR VAGINAL; SMEARS AND FILTER PR
CYTOPATHOLOGY, FLUIDS, WASHINGS OR BRUSHINGS, EXCEPT CERVICAL OR VAGINAL; CONCENTRATION TECHN
CYTOPATHOLOGY, FORENSIC (EG, SPERM)
SEX CHROMATIN IDENTIFICATION; BARR BODIES
SEX CHROMATIN IDENTIFICATION; PERIPHERAL BLOOD SMEAR, POLYMORPHONUCLEAR "DRUMSTICKS"
CYTOPATHOLOGY INTERPRETATION BY PHYSICIAN
CYTOPATHOLOGY; PAP SMEAR, PRESERVED, AUTO THIN LAYER, MAX 3
CYTPATH C/VAG T/LAYER REDO
CYTPATH C/VAG AUTOMATED
CYTOPATHOLOGY SMEARS, CERVICAL OR VAGINAL; SCREENING BY AUTOMATED SYSTEM WITH MANUAL RESCRE
CYTOPATHOLOGY, SMEARS, CERVICAL OR VAGINAL, UP TO THREE SMEARS; SCREENING BY TECHNICIAN UNDER
CYTOPATHOLOGY; PAP SMEAR, WITH PHYSICIAN RESCREEN
CYTPATH C/VAG REDO
CYTPATH C/VAG SELECT
CYTOPATHOLOGY, SMEARS, CERVICAL OR VAGINAL, UP TO THREE SMEARS; WITH DEFINITIVE HORMONAL EVALU
CYTOPATHOLOGY, SMEARS, ANY OTHER SOURCE; SCREENING AND INTERPRETATION
CYTOPATHOLOGY, SMEARS, ANY OTHER SOURCE; PREPARATION, SCREENING AND INTERPRETATION
CYTOPATHOLOGY, SMEARS, ANY OTHER SOURCE; EXTENDED STUDY INVOLVING OVER 5 SLIDES AND/OR MULTIP
CYTPATH TBS C/VAG MANUAL
CYTPATHOLOGY, SLIDES, CERVICAL OR VAGINAL (THE BETHESDA SYSTEM); WITH MANUAL SCREENING AND RES
CYTPATH TBS C/VAG AUTO REDO
CYTPATH TBS C/VAG SELECT
CYTOPATHOLOGY, EVALUATION OF FINE NEEDLE ASPIRATE; IMMEDIATE CYTOHISTOLOGIC STUDY TO DETERMIN
CYTOPATHOLOGY, EVALUATION OF FINE NEEDLE ASPIRATE; INTERPRETATION AND REPORT
CYTOPATHOLOGY, CERVICAL/VAGINAL (ANY RPTING SYSTEM), COLLECTED PRESERVATIVE FLUID, AUTOMATED T
CYTOPATHOLOGY, CERVICAL/VAGINAL (ANY REPORTING SYSTEM), COLLECTED PRESERVATIVE FLUID, AUTOMAT
FLOW CYTOMETRY; EACH CELL SURFACE, CYTOPLASMIC OR NUCLEAR MARKER
FLOW CYTOMETRY; CELL CYCLE OR DNA ANALYSIS
UNLISTED CYTOPATHOLOGY PROCEDURE
TISSUE CULTURE FOR CHROMOSOME ANALYSIS; LYMPHOCYTE
TISSUE CULTURE FOR CHROMOSOME ANALYSIS; SKIN OR OTHER SOLID TISSUE BIOPSY
TISSUE CULTURE FOR CHROMOSOME ANALYSIS; AMNIOTIC FLUID OR CHORIONIC VILLUS CELLS
TISSUE CULTURE FOR CHROMOSOME ANALYSIS; BONE MARROW (MYELOID) CELLS
TISSUE CULTURE FOR CHROMOSOME ANALYSIS; OTHER TISSUE
CRYOPRESERVATION,FREEZING,& STORAGE OF CELLS,EA CELL LINE
THAWING & EXPANSION OF FROZEN CELLS, EA ALIQUOT
CHROMOSOME ANALYSIS FOR BREAKAGE SYNDROMES; SCORE 25 CELLS (SCE STUDY), COUNT 5 CELLS, 1 KARYO
CHROMOSOME ANALYSIS FOR BREAKAGE SYNDROMES; SCORE 100 CELLS, COUNT 20 CELLS, 2 KARYOTYPES, WI
CHROMO ANALYSIS BREAKAGE SYNDS;100 CELLS,CLASTROGEN STRESS
CHROMOSOME ANALYSIS; COUNT 5 CELLS, 1 KARYOTYPE, WITH BANDING
CHROMOSOME ANALYSIS; COUNT 15-20 CELLS, 2 KARYOTYPES, WITH BANDING
CHROMOSOME ANALYSIS; COUNT 45 CELLS FOR MOSAICISM, 2 KARYOTYPES, WITH BANDING
CHROMOSOME ANALYSIS; ANALYZE 20-25 CELLS
CHROMOSOME ANALYSIS, AMNIOTIC FLUID OR CHORIONIC VILLUS, COUNT 15 CELLS, 1 KARYOTYPE, WITH BANDIN
CHROMOSOME ANALYSIS, IN SITU FOR AMNIOTIC FLUID CELLS, COUNT CELLS FROM 6-12 COLONIES, 1 KARYOTYP
CYTOGENETICS, DNA PROBE
CYTOGENETICS, 3-5
CYTOGENETICS, 10-30
CYTOGENETICS, 25-99
CYTOGENETICS, 100-300
CHROMOSOME ANALYSIS; ADDITIONAL KARYOTYPES, EACH STUDY
CHROMOSOME ANALYSIS; ADDITIONAL SPECIALIZED BANDING TECHNIQUE (EG, NOR, C-BANDING)
CHROMOSOME ANALYSIS; ADDITIONAL CELLS COUNTED, EACH STUDY
CHROMOSOME ANALYSIS; ADDITIONAL HIGH RESOLUTION STUDY
CYTOGENETICS & MOLECULAR CYTOGENETICS,INTERP & REPORT
UNLISTED CYTOGENETIC STUDY
LEVEL I - SURGICAL PATHOLOGY, GROSS EXAMINATION ONLY
LEVEL II - SURGICAL PATH, GROSS & MICRO EXAM APPENDIX, FALLOPIAN TUBE, STERILIZATION FINGERS/TOES, A
LVL III-SX PATHOLGY,GROSS&MICROSCOP X ABORT,IND ABSCESS ANRYM-ARTRL/VENTRIC ANUS,OTH THAN INCID
LVL IV-SX PATHOLOGY,GROSS&MICROSCOPIC X ABORT-SPON/MISSED ART,BX BN MARRW, BX BN XOSTOSIS BRA
LEVEL V - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION
LEVEL VI - SURGICAL PATH, GROSS & MICRO EXAM BONE RESECTION BREAST, MASTECTOMY - WITH REGIONAL L
DECALCIFICATION PROCEDURE (LIST SEPARATELY IN ADDITION TO CODE FOR SURGICAL PATHOLOGY EXAMINAT
SPECIAL STAINS (LIST SEPARATELY IN ADDITION TO CODE FOR SURGICAL PATHOLOGY EXAMINATION); GROUP I F
SPECIAL STAINS (LIST SEPARATELY IN ADDITION TO CODE FOR SURGICAL PATHOLOGY EXAMINATION); GROUP II,
SPECIAL STAINS (LIST SEPARATELY IN ADDITION TO CODE FOR SURGICAL PATHOLOGY EXAMINATION); HISTOCHE
DETERMINATIVE HISTOCHEMISTRY TO IDENTIFY CHEMICAL COMPONENTS (EG, COPPER, ZINC)
DETERMINATIVE HISTOCHEMISTRY OR CYTOCHEMISTRY TO IDENTIFY ENZYME CONSTITUENTS, EACH
CONSULTATION AND REPORT ON REFERRED SLIDES PREPARED ELSEWHERE
CONSULTATION AND REPORT ON REFERRED MATERIAL REQUIRING PREPARATION OF SLIDES
CONSULTATION, COMPREHENSIVE, WITH REVIEW OF RECORDS AND SPECIMENS, WITH REPORT ON REFERRED M
PATHOLOGY CONSULTATION DURING SURGERY;
PATHOLOGY CONSULTATION DURING SURGERY; FIRST TISSUE BLOCK, WITH FROZEN SECTION(S), SINGLE SPECI
PATHOLOGY CONSULTATION DURING SURGERY; EACH ADDITIONAL TISSUE BLOCK WITH FROZEN SECTION(S)
IMMUNOCYTOCHEMISTRY (INCLUDING TISSUE IMMUNOPEROXIDASE), EACH ANTIBODY
IMMUNOFLUORESCENT STUDY, EACH ANTIBODY; DIRECT METHOD
IMMUNOFLUORESCENT STUDY, EACH ANTIBODY; INDIRECT METHOD
ELECTRON MICROSCOPY; DIAGNOSTIC
ELECTRON MICROSCOPY; SCANNING
MORPHOMETRIC ANALYSIS; SKELETAL MUSCLE
MORPHOMETRIC ANALYSIS; NERVE
MORPHOMETRIC ANALYSIS; TUMOR
NERVE TEASING PREPARATIONS
TISSUE IN SITU HYBRIDIZATION, INTERPRETATION AND REPORT
PROTEIN ANALYSIS OF TISSUE BY WESTERN BLOT, WITH INTERPRETATION AND REPORT;
PROTEIN ANALYSIS OF TISSUE BY WESTERN BLOT, WITH INTERPRETATION AND REPORT; IMMUNOLOGICAL PROB
MICRODISSECTION (EG, MECHANICAL, LASER CAPTURE)
UNLISTED SURGICAL PATHOLOGY PROCEDURE
BILIRUBIN, TOTAL, TRANSCUTANEOUS
CELL COUNT, MISCELLANEOUS BODY FLUIDS (EG, CEREBROSPINAL FLUID, JOINT FLUID), EXCEPT BLOOD;
CELL COUNT, MISCELLANEOUS BODY FLUIDS (EG, CEREBROSPINAL FLUID, JOINT FLUID), EXCEPT BLOOD; WITH D
LEUKOCYTE COUNT, FECAL
CRYSTAL IDENTIFICATION BY LIGHT MICROSCOPY WITH OR WITHOUT POLARIZING LENS ANALYSIS, ANY BODY FL
DUODENAL INTUBATION AND ASPIRATION; SINGLE SPECIMEN (EG, SIMPLE BILE STUDY OR AFFERENT LOOP CULT
DUODENAL INTUBATION AND ASPIRATION; COLLECTION OF MULTIPLE FRACTIONAL SPECIMENS WITH PANCREAT
FAT STAIN, FECES, URINE, OR RESPIRATORY SECRETIONS
GASTRIC INTUBATION AND ASPIRATION, DIAGNOSTIC, EACH SPECIMEN, FOR CHEMICAL ANALYSES OR CYTOPATH
GASTRIC INTUBATION AND ASPIRATION, DIAGNOSTIC, EACH SPECIMEN, FOR CHEMICAL ANALYSES OR CYTOPATH
GASTRIC INTUBATION, ASPIRATION, AND FRACTIONAL COLLECTIONS (EG, GASTRIC SECRETORY STUDY); ONE HO
GASTRIC INTUBATION, ASPIRATION, AND FRACTIONAL COLLECTIONS (EG, GASTRIC SECRETORY STUDY); TWO HO
GASTRIC INTUBATION, ASPIRATION, AND FRACTIONAL COLLECTIONS (EG, GASTRIC SECRETORY STUDY); TWO HO
GASTRIC INTUBATION, ASPIRATION, AND FRACTIONAL COLLECTIONS (EG, GASTRIC SECRETORY STUDY); THREE
MEAT FIBERS, FECES
NASAL SMEAR FOR EOSINOPHILS
CULTURE AND FERTILIZATION OF OOCYTE(S)
CULTURE AND FERTILIZATION OF OOCYTE(S); WITH CO-CULTURE OF EMBRYOS
ASSISTED OOCYTE FERTILIZATION, MICROTECHNIQUE (ANY METHOD)
ASSISTED EMBRYO HATCHING, MICROTECHNIQUES (ANY METHOD)
OOCYTE IDENTIFICATION FROM FOLLICULAR FLUID
PREPARATION OF EMBRYO FOR TRANSFER (ANY METHOD)
PREPARATION OF CRYOPRESERVED EMBRYOS FOR TRANSFER (INCLUDES THAW)
SPERM IDENTIFICATION FROM ASPIRATION (OTHER THAN SEMINAL FLUID)
CRYOPRESERVATION; EMBRYO
CRYOPRESERVATION; SPERM
SPERM ISOLATION; SIMPLE PREP (EG, SPERM WASH AND SWIM-UP) FOR INSEMINATION OR DIAGNOSIS WITH SEM
SPERM ISOLATION; COMPLEX PREP (EG, PER COL GRADIENT, ALBUMIN GRADIENT) FOR INSEMINATION OR DIAGN
SPERM IDENTIFICATION FROM TESTIS TISSUE, FRESH OR CRYOPRESERVED
SEMEN ANALYSIS; PRESENCE AND/OR MOTILITY OF SPERM INCLUDING HUHNER TEST
SEMEN ANALYSIS; MOTILITY AND COUNT (NOT INCLUDING HUHNER TEST)
SEMEN ANALYSIS; COMPLETE (VOLUME, COUNT, MOTILITY AND DIFFERENTIAL)
SEMEN ANALYSIS, PRESENCE AND/OR MOTILITY OF SPERM
SPERM ANTIBODIES
SPERM EVALUATION; HAMSTER PENETRATION TEST
SPERM EVALUATION; CERVICAL MUCUS PENETRATION TEST, WITH OR WITHOUT SPINNBARKEIT TEST
SPUTUM, OBTAINING SPECIMEN, AEROSOL INDUCED TECHNIQUE (SEPARATE PROCEDURE)
STARCH GRANULES, FECES
SWEAT COLLECTION BY IONTOPHORESIS
WATER LOAD TEST
UNLISTED MISCELLANEOUS PATHOLOGY TEST
IMMUNE GLOBULIN (IG), HUMAN, FOR INTRAMUSCULAR USE
IMMUNE GLOBULIN (IGIV), HUMAN, FOR INTRAVENOUS USE
BOTULINUM ANTITOXIN, EQUINE, ANY ROUTE
BOTULISM IMMUNE GLOBULIN, HUMAN, FOR INTRAVENOUS USE
CYTOMEGALOVIRUS IMMUNE GLOBULIN (CMV-IGIV), HUMAN, FOR INTRAVENOUS USE
DIPHTHERIA ANTITOXIN, EQUINE, ANY ROUTE
HEPATITIS B IMMUNE GLOBULIN (HBIG), HUMAN, FOR INTRAMUSCULAR USE
RABIES IMMUNE GLOBULIN (RIG), HUMAN, FOR INTRAMUSCULAR AND/OR SUBCUTANEOUS USE
RABIES IMMUNE GLOBULIN, HEAT-TREATED (RIG-HT), HUMAN, FOR INTRAMUSCULAR AND/OR SUBCUTANEOUS US
RESPIRATORY SYNCYTIAL VIRUS IMMUNE GLOBULIN (RSV-IGIM), FOR INTRAMUSCULAR USE, 50 MG, EACH
RESPIRATORY SYNCYTIAL VIRUS IMMUNE GLOBULIN (RSV-IGIV), HUMAN, FOR INTRAVENOUS USE
RHO(D) IMMUNE GLOBULIN (RHIG), HUMAN, FULL-DOSE, FOR INTRAMUSCULAR USE
RHO(D) IMMUNE GLOBULIN (RHIG), HUMAN, MINI-DOSE, FOR INTRAMUSCULAR USE
RHO(D) IMMUNE GLOBULIN (RHIGIV), HUMAN, FOR INTRAVENOUS USE
TETANUS IMMUNE GLOBULIN (TIG), HUMAN, FOR INTRAMUSCULAR USE
VACCINIA IMMUNE GLOBULIN, HUMAN, FOR INTRAMUSCULAR USE
VARICELLA-ZOSTER IMMUNE GLOBULIN, HUMAN, FOR INTRAMUSCULAR USE
UNLISTED IMMUNE GLOBULIN
IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, INTRAMUSCULAR
IMMUNIZATION ADMINISTRATION (INCL PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, INTRAMUSCULAR&JET
IMMUNIZATION ADMINISTRATION BY INTRANASAL OR ORAL ROUTE; ONE VACCINE (SINGLE OR COMBINATION VAC
IMMUNIZATION ADMINISTRATION BY INTRANASAL OR ORAL ROUTE; EACH ADDITIONAL VACCINE (SINGLE OR COM
ADENOVIRUS VACCINE, TYPE 4, LIVE, FOR ORAL USE
ADENOVIRUS VACCINE, TYPE 7, LIVE, FOR ORAL USE
ANTHRAX VACCINE, FOR SUBCUTANEOUS USE
BACILLUS CALMETTE-GUERIN VACCINE (BCG) FOR TUBERCULOSIS, LIVE, FOR PERCUTANEOUS USE
BACILLUS CALMETTE-GUERIN VACCINE (BCG) FOR BLADDER CANCER, LIVE, FOR INTRAVESICAL USE
HEPATITIS A VACCINE, ADULT DOSAGE, FOR INTRAMUSCULAR USE
HEPATITIS A VACCINE, PEDIATRIC/ADOLESCENT DOSAGE-2 DOSE SCHEDULE, FOR INTRAMUSCULAR USE
HEPATITIS A VACCINE, PEDIATRIC/ADOLESCENT DOSAGE-3 DOSE SCHEDULE, FOR INTRAMUSCULAR USE
HEPATITIS A AND HEPATITIS B VACCINE (HEPA-HEPB), ADULT DOSAGE, FOR INTRAMUSCULAR USE
HEMOPHILUS INFLUENZA B VACCINE (HIB), HBOC CONJUGATE (4 DOSE SCHEDULE), FOR INTRAMUSCULAR USE
HEMOPHILUS INFLUENZA B VACCINE (HIB), PRP-D CONJUGATE, FOR BOOSTER USE ONLY, INTRAMUSCULAR USE
HEMOPHILUS INFLUENZA B VACCINE (HIB), PRP-OMP CONJUGATE (3 DOSE SCHEDULE), FOR INTRAMUSCULAR US
HEMOPHILUS INFLUENZA B VACCINE (HIB),PRP-T CONJUGATE (4 DOSE SCHEDULE), FOR INTRAMUSCULAR USE
INFLUENZA VIRUS VACCINE, SPLIT VIRUS, 6-35 MONTHS DOSAGE, FOR INTRAMUSCULAR OR JET INJECTION USE
INFLUENZA VIRUS VACCINE, SPLIT VIRUS, 3 YEARS AND ABOVE DOSAGE, FOR INTRAMUSCULAR OR JET INJECTIO
INFLUENZA VIRUS VACCINE, WHOLE VIRUS, FOR INTRAMUSCULAR OR JET INJECTION USE
INFLUENZA VIRUS VACCINE, LIVE, FOR INTRANASAL USE
LYME DISEASE VACCINE, ADULT DOSAGE, FOR INTRAMUSCULAR USE
PNEUMOCOCCAL CONJUGATE VACCINE, POLYVALENT, FOR CHILDREN UNDER FIVE YEARS, FOR INTRAMUSCULAR
RABIES VACCINE, FOR INTRAMUSCULAR USE
RABIES VACCINE, FOR INTRADERMAL USE
ROTAVIRUS VACCINE, TETRAVALENT, LIVE, FOR ORAL USE
TYPHOID VACCINE, LIVE, ORAL
TYPHOID VACCINE, VI CAPSULAR POLYSACCHARIDE (VICPS), FOR INTRAMUSCULAR USE
TYPHOID VACCINE, HEAT- AND PHENOL-INACTIVATED (H-P), FOR SUBCUTANEOUS OR INTRADERMAL USE
TYPHOID VACCINE, ACETONE-KILLED, DRIED (AKD), FOR SUBCUTANEOUS OR JET INJECTION USE (U.S. MILITARY)
DIPHTHERIA, TETANUS TOXOIDS, AND ACELLULAR PERTUSSIS VACCINE (DTAP), FOR INTRAMUSCULAR USE
DIPHTHERIA, TETANUS TOXOIDS, AND WHOLE CELL PERTUSSIS VACCINE (DTP), FOR INTRAMUSCULAR USE
DIPHTHERIA AND TETANUS TOXOIDS (DT) ADSORBED FOR USE IN INDIVIDUALS YOUNGER THAN SEVEN YEARS, FO
TETANUS TOXOID ADSORBED, FOR INTRAMUSCULAR OR JET INJECTION USE
MUMPS VIRUS VACCINE, LIVE, FOR SUBCUTANEOUS OR JET INJECTION USE
MEASLES VIRUS VACCINE, LIVE, FOR SUBCUTANEOUS OR JET INJECTION USE
RUBELLA VIRUS VACCINE, LIVE, FOR SUBCUTANEOUS OR JET INJECTION USE
MEASLES, MUMPS AND RUBELLA VIRUS VACCINE (MMR), LIVE, FOR SUBCUTANEOUS OR JET INJECTION USE
MEASLES AND RUBELLA VIRUS VACCINE, LIVE, FOR SUBCUTANEOUS OR JET INJECTION USE
MEASLES, MUMPS, RUBELLA, AND VARICELLA VACCINE (MMRV), LIVE, FOR SUBCUTANEOUS USE
POLIOVIRUS VACCINE, (ANY TYPE(S)) (OPV), LIVE, FOR ORAL USE
POLIOVIRUS VACCINE, INACTIVATED, (IPV), FOR SUBCUTANEOUS USE
VARICELLA VIRUS VACCINE, LIVE, FOR SUBCUTANEOUS USE
YELLOW FEVER VACCINE, LIVE, FOR SUBCUTANEOUS USE
TETANUS AND DIPHTHERIA TOXOIDS (TD) ADSORBED FOR USE IN INDIVIDUALS SEVEN YEARS OR OLDER, FOR INT
DIPHTHERIA TOXOID, FOR INTRAMUSCULAR USE
DIPHTHERIA, TETANUS TOXOIDS, AND WHOLE CELL PERTUSSIS VACCINE AND HEMOPHILUS INFLUENZA B VACCIN
DIPHTHERIA, TETANUS TOXOIDS, AND ACELLULAR PERTUSSIS VACCINE AND HEMOPHILUS INFLUENZA B VACCINE
DIPHTHERIA, TETANUS TOXOIDS, ACELLULAR PERTUSSIS VACCINE, HEPATITIS B, AND POLIOVIRUS VACCINE, INAC
CHOLERA VACCINE FOR INJECTABLE USE
PLAGUE VACCINE, FOR INTRAMUSCULAR OR JET INJECTION USE
PNEUMOCOCCAL POLYSACCHARIDE VACCINE, 23-VALENT, ADULT OR IMMUNOSUPPRESSED PATIENT DOSAGE, FO
MENINGOCOCOCCAL POLYSACCHARIDE VACCINE (ANY GROUP(S)), FOR SUBCUTANEOUS OR JET INJECTION USE
JAPANESE ENCEPHALITIS VIRUS VACCINE, FOR SUBCUTANEOUS USE
HEPATITIS B VACCINE, DIALYSIS OR IMMUNOSUPPRESSED PATIENT DOSAGE (3 DOSE SCHEDULE), FOR INTRAMU
HEPATITIS B VACCINE, ADOLESCENT (2 DOSE SCHEDULE), FOR INTRAMUSCULAR USE
HEPATITIS B VACCINE, PEDIATRIC/ADOLESCENT DOSAGE (3 DOSE SCHEDULE), FOR INTRAMUSCULAR USE
HEPATITIS B VACCINE, ADULT DOSAGE, FOR INTRAMUSCULAR USE
HEPATITIS B VACCINE, DIALYSIS OR IMMUNOSUPPRESSED PATIENT DOSAGE (4 DOSE SCHEDULE), FOR INTRAMU
HEPATITIS B AND HEMOPHILUS INFLUENZA B VACCINE (HEPB-HIB), FOR INTRAMUSCULAR USE
UNLISTED VACCINE/TOXOID
INTRAVENOUS INFUSION FOR THERAPY/DIAGNOSIS, ADMINISTERED BY PHYSICIAN OR UNDER DIRECT SUPERVISI
INTRAVENOUS INFUSION, THERAPY/DIAGNOSIS, ADMINISTERED PHYSICIAN/UNDER DIRECT SUPERVISION, PHYSIC
THERAPEUTIC, PROPHYLACTIC OR DIAGNOSTIC INJECTION (SPECIFY MATERIAL INJECTED); SUBCUTANEOUS OR
THERAPEUTIC OR DIAGNOSTIC INJECTION (SPECIFY MATERIAL INJECTED); INTRA-ARTERIAL
THERAPEUTIC OR DIAGNOSTIC INJECTION (SPECIFY MATERIAL INJECTED); INTRAVENOUS
INTRAMUSCULAR INJECTION OF ANTIBIOTIC (SPECIFY)
UNLISTED THERAPEUTIC, PROPHYLACTIC OR DIAGNOSTIC INJECTION
PSYCHIATRIC DIAGNOSTIC INTERVIEW EXAMINATION
INTERACTIVE PSYCHIATRIC DIAGNOSTIC INTERVIEW EXAMINATION USING PLAY EQUIPMENT, PHYSICAL DEVICES
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR SUPPORTIVE, IN AN OFFICE OR
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR SUPPORTIVE, IN AN OFFICE OR
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR SUPPORTIVE, IN AN OFFICE OR
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR SUPPORTIVE, IN AN OFFICE OR
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR SUPPORTIVE, IN AN OFFICE OR
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR SUPPORTIVE, IN AN OFFICE OR
INDIVIDUAL PSYCHOTHERAPY,INTERACTIVE,USING PLAY EQUIP, PHYSICAL DEVICES, LANG INTERPRETER/OTH ME
INDIVIDUAL PSYCHOTHER,INTERACT,PLAY EQUIP,PHYS DEVICES,LANG INTERPRETER/OTH MECHANISMS OF NON
INDIVIDUAL PSYCHOTHERAPY, INTERACTIVE, USING PLAY EQUIP, PHYSICAL DEVICES, LANG INTERPRETER/OTH M
INDIVIDUAL PSYCHOTHER,INTERACT,PLAY EQUIP,PHYS DEVICES,LANG INTERPRETER/OTH MECHANISMS OF NON
INDIVIDUAL PSYCHOTHERAPY,INTERACTIVE,USING PLAY EQUIP,PHYSICAL DEVICES, LANGUAGE INTERPRETER/OT
INDIVIDUAL PSYCHOTHER,INTERACT,PLAY EQUIP,PHYS DEVICES,LANG INTERPRETER/OTH MECHANISMS OF NON
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR SUPPORTIVE, IN AN INPATIENT
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAV MODIFY &/ SUPPORTIVE, IN AN INPATIENT HOSPITAL, P
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR SUPPORTIVE, IN AN INPATIENT
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAV MODIFY &/ SUPPORTIVE, IN AN INPATIENT HOSPITAL, P
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR SUPPORTIVE, IN AN INPATIENT
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAV MODIFY &/ SUPPORTIVE, IN AN INPATIENT HOSPITAL, P
INDIVIDUAL PSYCHOTHER,INTERACT,PLAY EQUIP,PHYS DEVICES,LANG INTERPRETER/OTH MECH OF NON-VERBA
INDIVIDUAL PSYCHOTHER, INTERACT, PLAY EQUIP, PHYS DEVICES, LANG INTERPRETER/OTH MECH OF NON-VERB
INDIVIDUAL PSYCHOTHER, INTERACTIVE, PLAY EQUIP, PHYS DEVICES, LANG INTERPRETER/OTH MECH OF NON-V
INDIVIDUAL PSYCHOTHER,INTERACT,PLAY EQUIP,PHYS DEVICE,LANG INTERPRETER/OTH MECH OF NON-VERBAL
INDIVIDUAL PSYCHOTHERAPY,INTERACTIVE, PLAY EQUIP,PHYS DEVICES,LANG INTERPRETER/OTH MECH OF NON
INDIVIDUAL PSYCHOTHER,INTERACT,PLAY EQUIP,PHYS DEVICE,LANG INTERPRETER/OTH MECH OF NON-VERBAL
PSYCHOANALYSIS
FAMILY PSYCHOTHERAPY (WITHOUT THE PATIENT PRESENT)
FAMILY PSYCHOTHERAPY (CONJOINT PSYCHOTHERAPY) (WITH PATIENT PRESENT)
MULTIPLE-FAMILY GROUP PSYCHOTHERAPY
GROUP PSYCHOTHERAPY (OTHER THAN OF A MULTIPLE-FAMILY GROUP)
INTERACTIVE GROUP PSYCHOTHERAPY
PHARMACOLOGIC MANAGEMENT, INCLUDING PRESCRIPTION, USE, AND REVIEW OF MEDICATION WITH NO MORE
NARCOSYNTHESIS FOR PSYCHIATRIC DIAGNOSTIC AND THERAPEUTIC PURPOSES (EG, SODIUM AMOBARBITAL (A
ELECTROCONVULSIVE THERAPY (INCLUDES NECESSARY MONITORING); SINGLE SEIZURE
ELECTROCONVULSIVE THERAPY (INCLUDES NECESSARY MONITORING); MULTIPLE SEIZURES, PER DAY
INDIV. PSYCHOPHYSIOLOGICAL THRPY INCORP. BIOFEEDBACK TRNG BY ANY MODALITY FACE/FACE W/ PT.(EG, IN
INDIV. PSYCHOPHYSIOLOGICAL THRPY INCORP. BIOFEEDBACK TRNG BY ANY MODALITY FACE/FACE W/ PT.(EG, IN
HYPNOTHERAPY
ENVIRONMENTAL INTERVENTION FOR MEDICAL MGMT PURPOSES ON A PSYCHIATRIC PATIENT'S BEHALF WITH AG
PSYCHIATRIC EVALUATION OF HOSPITAL RECORDS, OTHER PSYCHIATRIC REPORTS, PSYCHOMETRIC AND/OR PR
INTERPRETATION OR EXPLANATION OF RESULTS OF PSYCHIATRIC, OTH MEDICAL EXAMS/PROCEDURES, OR OTH
PREPARATION OF REPORT OF PATIENT'S PSYCHIATRIC STATUS, HISTORY, TREATMENT, OR PROGRESS (OTHER T
UNLISTED PSYCHIATRIC SERVICE OR PROCEDURE
BIOFEEDBACK TRAINING BY ANY MODALITY
BIOFEEDBACK TRAINING, PERINEAL MUSCLES, ANORECTAL OR URETHRAL SPHINCTER, INCLUDING EMG AND/OR
END STAGE RENAL DISEASE (ESRD) RELATED SERVICES PER FULL MONTH; <2 YEARS OF AGE TO INC MONITORIN
END STAGE RENAL DISEASE (ESRD) RELATED SERVICES PER FULL MONTH; FOR PATIENTS 2-11 YEARS OLD TO IN
END STAGE RENAL DISEASE (ESRD) RELATED SERVICES PER FULL MONTH; FOR PATIENTS 12-19 YEARS OLD TO I
END STAGE RENAL DISEASE (ESRD) RELATED SERVICES PER FULL MONTH; 20 YEARS OF AGE AND OVER
END STAGE RENAL DISEASE (ESRD) RELATED SERVICES (LESS THAN FULL MONTH), PER DAY; FOR PATIENTS UND
END STAGE RENAL DISEASE (ESRD) RELATED SERVICES (LESS THAN FULL MONTH), PER DAY; FOR PATIENTS BET
END STAGE RENAL DISEASE (ESRD) RELATED SERVICES (LESS THAN FULL MONTH), PER DAY; FOR PATIENTS BET
END STAGE RENAL DISEASE (ESRD) RELATED SERVICES (LESS THAN FULL MONTH), PER DAY; FOR PATIENTS TWE
HEMODIALYSIS PROCEDURE WITH SINGLE PHYSICIAN EVALUATION
HEMODIALYSIS PROCEDURE REQUIRING REPEATED EVALUATION(S) WITH OR WITHOUT SUBSTANTIAL REVISION
HEMODIALYSIS ACCESS FLOW STUDY TO DETERMINE BLOOD FLOW IN GRAFTS AND ARTERIOVENOUS FISTULAE
HEMODIALYSIS ACCESS FLOW STUDY TO DETERMINE BLOOD FLOW IN GRAFTS AND ARTERIOVENOUS FISTULAE
DIALYSIS PROCEDURE OTHER THAN HEMODIALYSIS (EG, PERITONEAL DIALYSIS, HEMOFILTRATION, OR OTHER CO
DIALYSIS PROC OTHER THAN HEMODIALY (EG, PERITONEAL DIALYSIS, HEMOFILTRATION,/OTHER CONT RENAL RE
DIALYSIS TRAINING, PATIENT, INCLUDING HELPER WHERE APPLICABLE, ANY MODE, COMPLETED COURSE
DIALYSIS TRAINING, PATIENT, INCLUDING HELPER WHERE APPLICABLE, ANY MODE, COURSE NOT COMPLETED, P
HEMOPERFUSION (EG, WITH ACTIVATED CHARCOAL OR RESIN)
UNLISTED DIALYSIS PROCEDURE, INPATIENT OR OUTPATIENT
ESOPHAGEAL INTUBATION AND COLLECTION OF WASHINGS FOR CYTOLOGY, INCLUDING PREPARATION OF SPEC
ESOPHAGEAL MOTILITY (MANOMETRIC STUDY OF THE ESOPHAGUS AND/OR GASTROESOPHAGEAL JUNCTION) ST
ESOPHAGEAL MOTILITY STUDY; WITH MECHOLYL OR SIMILAR STIMULANT
ESOPHAGEAL MOTILITY STUDY; WITH ACID PERFUSION STUDIES
GASTRIC MOTILITY (MANOMETRIC) STUDIES
ESOPHAGUS, ACID PERFUSION (BERNSTEIN) TEST FOR ESOPHAGITIS
ESOPHAGUS, ACID REFLUX TEST, WITH INTRALUMINAL PH ELECTRODE FOR DETECTION OF GASTROESOPHAGEA
ESOPHAGUS, ACID REFLUX TEST, WITH INTRALUMINAL PH ELECTRODE FOR DETECTION OF GASTROESOPHAGEA
GASTRIC ANALYSIS TEST WITH INJECTION OF STIMULANT OF GASTRIC SECRETION (EG, HISTAMINE, INSULIN, PEN
GASTRIC INTUBATION, WASHINGS, AND PREPARING SLIDES FOR CYTOLOGY (SEPARATE PROCEDURE)
GASTRIC SALINE LOAD TEST
BREATH HYDROGEN TEST (EG, FOR DETECTION OF LACTASE DEFICIENCY)
INTESTINAL BLEEDING TUBE, PASSAGE, POSITIONING AND MONITORING
GASTRIC INTUBATION, AND ASPIRATION OR LAVAGE FOR TREATMENT (EG, FOR INGESTED POISONS)
ANORECTAL MANOMETRY
PULSED IRRIGATION OF FECAL IMPACTION
ELECTROGASTROGRAPHY, DIAGNOSTIC, TRANSCUTANEOUS
ELECTROGASTROGRAPHY, DIAGNOSTIC, TRANSCUTANEOUS; WITH PROVOCATIVE TESTING
UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE
OPHTHALMOLOGICAL SERVICES: MEDICAL EXAMINATION AND EVALUATION WITH INITIATION OF DIAGNOSTIC AND
OPHTHALMOLOGICAL SERVICES: MEDICAL EXAMINATION AND EVALUATION WITH INITIATION OF DIAGNOSTIC AND
OPHTHALMOLOGICAL SERVICES: MEDICAL EXAMINATION AND EVALUATION, WITH INITIATION OR CONTINUATION
OPHTHALMOLOGICAL SERVICES: MEDICAL EXAMINATION AND EVALUATION, WITH INITIATION OR CONTINUATION
DETERMINATION OF REFRACTIVE STATE
OPHTHALMOLOGICAL EXAMINATION AND EVALUATION, UNDER GENERAL ANESTHESIA, WITH OR WITHOUT MANIP
OPHTHALMOLOGICAL EXAMINATION AND EVALUATION, UNDER GENERAL ANESTHESIA, WITH OR WITHOUT MANIP
GONIOSCOPY (SEPARATE PROCEDURE)
SENSORIMOTOR EXAMINATION WITH MULTIPLE MEASUREMENTS OF OCULAR DEVIATION (EG, RESTRICTIVE OR P
ORTHOPTIC AND/OR PLEOPTIC TRAINING, WITH CONTINUING MEDICAL DIRECTION AND EVALUATION
FITTING OF CONTACT LENS FOR TREATMENT OF DISEASE, INCLUDING SUPPLY OF LENS
VISUAL FIELD EXAMINATION, UNI OR BILATERAL, WITH MEDICAL DIAGNOSTIC EVAL; LIMITED EXAM (EG, TANGENT
VISUAL FIELD EXAMINATION, UNI OR BILATERAL, WITH MEDICAL DIAGNOSTIC EVAL; INTERMEDIATE EXAM (EG, AT
VISUAL FIELD EXAMINATION, UNI OR BILATERAL, WITH MEDICAL DIAGNOSTIC EVAL; EXTENDED EXAM (EG, GOLDM
SERIAL TONOMETRY (SEP PROC) WITH MULT MEAS OF INTRAOCULAR PRESSURE OVER EXTENDED TIME PERIOD
TONOGRAPHY WITH INTERPRETATION AND REPORT, RECORDING INDENTATION TONOMETER METHOD OR PERIL
TONOGRAPHY WITH WATER PROVOCATION
SCANNING COMPUTERIZED OPHTHALMIC DIAGNOSTIC IMAGING (EG, SCANNING LASER) WITH INTERPRETATION A
OPHTHALMIC BIOMETRY BY PARTIAL COHERENCE INTERFEROMETRY WITH INTRAOCULAR LENS POWER CALCUL
PROVOCATIVE TESTS FOR GLAUCOMA, WITH INTERPRETATION AND REPORT, WITHOUT TONOGRAPHY
OPHTHALMOSCOPY, EXTENDED, WITH RETINAL DRAWING (EG, FOR RETINAL DETACHMENT, MELANOMA), WITH IN
OPHTHALMOSCOPY, EXTENDED, WITH RETINAL DRAWING (EG, FOR RETINAL DETACHMENT, MELANOMA), WITH M
FLUORESCEIN ANGIOSCOPY WITH INTERPRETATION AND REPORT
FLUORESCEIN ANGIOGRAPHY (INCLUDES MULTIFRAME IMAGING) WITH INTERPRETATION AND REPORT
INDOCYANINE-GREEN ANGIOGRAPHY (INCLUDES MULTIFRAME IMAGING) WITH INTERPRETATION AND REPORT
FUNDUS PHOTOGRAPHY WITH INTERPRETATION AND REPORT
OPHTHALMODYNAMOMETRY
NEEDLE OCULOELECTROMYOGRAPHY, ONE OR MORE EXTRAOCULAR MUSCLES, ONE OR BOTH EYES, WITH MED
ELECTRO-OCULOGRAPHY, WITH MEDICAL DIAGNOSTIC EVALUATION
ELECTRORETINOGRAPHY, WITH MEDICAL DIAGNOSTIC EVALUATION
COLOR VISION EXAMINATION, EXTENDED, EG, ANOMALOSCOPE OR EQUIVALENT
DARK ADAPTATION EXAMINATION, WITH MEDICAL DIAGNOSTIC EVALUATION
EXTERNAL OCULAR PHOTOGRAPHY WITH INTERPRETATION AND REPORT FOR DOCUMENTATION OF MEDICAL PR
SPECIAL ANTERIOR SEGMENT PHOTOGRAPHY WITH INTERPRETATION AND REPORT; WITH SPECULAR ENDOTHEL
SPECIAL ANTERIOR SEGMENT PHOTOGRAPHY WITH MEDICAL DIAGNOSTIC EVALUATION; WITH FLUORESCEIN AN
PRESCRIPTION OF OPTICAL AND PHYSICAL CHARACTERISTICS OF AND FITTING OF CONTACT LENS, WITH MEDICA
PRESCRIPTION OF OPTICAL AND PHYSICAL CHARACTERISTICS OF AND FITTING OF CONTACT LENS, WITH MEDICA
PRESCRIPTION OF OPTICAL AND PHYSICAL CHARACTERISTICS OF AND FITTING OF CONTACT LENS, WITH MEDICA
PRESCRIPTION OF OPTICAL AND PHYSICAL CHARACTERISTICS OF AND FITTING OF CONTACT LENS, WITH MEDICA
PRESCRIPTION OF OPTICAL AND PHYSICAL CHARACTERISTICS OF CONTACT LENS, WITH MEDICAL SUPERVISION
PRESCRIPTION OF OPTICAL AND PHYSICAL CHARACTERISTICS OF CONTACT LENS, WITH MEDICAL SUPERVISION
PRESCRIPTION OF OPTICAL AND PHYSICAL CHARACTERISTICS OF CONTACT LENS, WITH MEDICAL SUPERVISION
PRESCRIPTION OF OPTICAL AND PHYSICAL CHARACTERISTICS OF CONTACT LENS, WITH MEDICAL SUPERVISION
MODIFICATION OF CONTACT LENS (SEPARATE PROCEDURE), WITH MEDICAL SUPERVISION OF ADAPTATION
REPLACEMENT OF CONTACT LENS
PRESCRIPTION, FITTING, AND SUPPLY OF OCULAR PROSTHESIS (ARTIFICIAL EYE), WITH MEDICAL SUPERVISION O
PRESCRIPTION OF OCULAR PROSTHESIS (ARTIFICIAL EYE) AND DIRECTION OF FITTING AND SUPPLY BY INDEPEN
FITTING OF SPECTACLES, EXCEPT FOR APHAKIA; MONOFOCAL
FITTING OF SPECTACLES, EXCEPT FOR APHAKIA; BIFOCAL
FITTING OF SPECTACLES, EXCEPT FOR APHAKIA; MULTIFOCAL, OTHER THAN BIFOCAL
FITTING OF SPECTACLE PROSTHESIS FOR APHAKIA; MONOFOCAL
FITTING OF SPECTACLE PROSTHESIS FOR APHAKIA; MULTIFOCAL
FITTING OF SPECTACLE MOUNTED LOW VISION AID; SINGLE ELEMENT SYSTEM
FITTING OF SPECTACLE MOUNTED LOW VISION AID; TELESCOPIC OR OTHER COMPOUND LENS SYSTEM
PROSTHESIS SERVICE FOR APHAKIA, TEMPORARY (DISPOSABLE OR LOAN, INCLUDING MATERIALS)
REPAIR AND REFITTING SPECTACLES; EXCEPT FOR APHAKIA
REPAIR AND REFITTING SPECTACLES; SPECTACLE PROSTHESIS FOR APHAKIA
SUPPLY OF SPECTACLES, EXCEPT PROSTHESIS FOR APHAKIA AND LOW VISION AIDS
SUPPLY OF CONTACT LENSES, EXCEPT PROSTHESIS FOR APHAKIA
SUPPLY OF LOW VISION AIDS (ANY LENS OR DEVICE USED TO AID OR IMPROVE VISUAL FUNCTION IN PERSON WH
SUPPLY OF OCULAR PROSTHESIS (ARTIFICIAL EYE)
SUPPLY OF PERMANENT PROSTHESIS FOR APHAKIA; SPECTACLES
SUPPLY OF PERMANENT PROSTHESIS FOR APHAKIA; CONTACT LENSES
UNLISTED OPHTHALMOLOGICAL SERVICE OR PROCEDURE
OTOLARYNGOLOGIC EXAMINATION UNDER GENERAL ANESTHESIA
BINOCULAR MICROSCOPY (SEPARATE DIAGNOSTIC PROCEDURE)
EVALUATION OF SPEECH, LANGUAGE, VOICE, COMMUNICATION, AUDITORY PROCESSING, AND/OR AURAL REHAB
TREATMENT OF SPEECH, LANGUAGE, VOICE, COMMUNICATION, AND/OR AUDITORY PROCESSING DISORDER (INC
TREATMENT OF SPEECH, LANGUAGE, VOICE, COMMUNICATION, AND/OR AUDITORY PROCESSING DISORDER (INC
AURAL REHABILITATION FOLLOWING COCHLEAR IMPLANT (INCLUDES EVALUATION OF AURAL REHABILITATION ST
NASOPHARYNGOSCOPY WITH ENDOSCOPE (SEPARATE PROCEDURE)
NASAL FUNCTION STUDIES (EG, RHINOMANOMETRY)
FACIAL NERVE FUNCTION STUDIES (EG, ELECTRONEURONOGRAPHY)
LARYNGEAL FUNCTION STUDIES
TREATMENT OF SWALLOWING DYSFUNCTION AND/OR ORAL FUNCTION FOR FEEDING
SPONTANEOUS NYSTAGMUS, INCLUDING GAZE
POSITIONAL NYSTAGMUS TEST
CALORIC VESTIBULAR TEST, EACH IRRIGATION (BINAURAL, BITHERMAL STIMULATION CONSTITUTES FOUR TESTS
OPTOKINETIC NYSTAGMUS TEST
SPONTANEOUS NYSTAGMUS TEST, INCLUDING GAZE AND FIXATION NYSTAGMUS, WITH RECORDING
POSITIONAL NYSTAGMUS TEST, MINIMUM OF 4 POSITIONS, WITH RECORDING
CALORIC VESTIBULAR TEST, EACH IRRIGATION (BINAURAL, BITHERMAL STIMULATION CONSTITUTES FOUR TESTS
OPTOKINETIC NYSTAGMUS TEST, BIDIRECTIONAL, FOVEAL OR PERIPHERAL STIMULATION, WITH RECORDING
OSCILLATING TRACKING TEST, WITH RECORDING
SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING
USE OF VERTICAL ELECTRODES (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
COMPUTERIZED DYNAMIC POSTUROGRAPHY
SCREENING TEST, PURE TONE, AIR ONLY
PURE TONE AUDIOMETRY (THRESHOLD); AIR ONLY
PURE TONE AUDIOMETRY (THRESHOLD); AIR AND BONE
SPEECH AUDIOMETRY THRESHOLD;
SPEECH AUDIOMETRY THRESHOLD; WITH SPEECH RECOGNITION
COMPREHENSIVE AUDIOMETRY THRESHOLD EVALUATION AND SPEECH RECOGNITION (92553 AND 92556 COMBIN
AUDIOMETRIC TESTING OF GROUPS
BEKESY AUDIOMETRY; SCREENING
BEKESY AUDIOMETRY; DIAGNOSTIC
LOUDNESS BALANCE TEST, ALTERNATE BINAURAL OR MONAURAL
TONE DECAY TEST
SHORT INCREMENT SENSITIVITY INDEX (SISI)
STENGER TEST, PURE TONE
TYMPANOMETRY (IMPEDANCE TESTING)
ACOUSTIC REFLEX TESTING
ACOUSTIC REFLEX DECAY TEST
FILTERED SPEECH TEST
STAGGERED SPONDAIC WORD TEST
LOMBARD TEST
SENSORINEURAL ACUITY LEVEL TEST
SYNTHETIC SENTENCE IDENTIFICATION TEST
STENGER TEST, SPEECH
VISUAL REINFORCEMENT AUDIOMETRY (VRA)
CONDITIONING PLAY AUDIOMETRY
SELECT PICTURE AUDIOMETRY
ELECTROCOCHLEOGRAPHY
AUDITORY EVOKED POTENTIALS FOR EVOKED RESPONSE AUDIOMETRY AND/OR TESTING OF THE CENTRAL NER
AUDITORY EVOKED POTENTIALS FOR EVOKED RESPONSE AUDIOMETRY AND/OR TESTING OF THE CENTRAL NER
EVOKED OTOACOUSTIC EMISSIONS; LIMITED (SINGLE STIMULUS LEVEL, EITHER TRANSIENT OR DISTORTION PRO
EVOKED OTOACOUSTIC EMISSIONS; COMPREHENSIVE OR DIAGNOSTIC EVALUATION (COMPARISON OF TRANSIEN
CENTRAL AUDITORY FUNCTION TEST(S) (SPECIFY)
HEARING AID EXAMINATION AND SELECTION; MONAURAL
HEARING AID EXAMINATION AND SELECTION; BINAURAL
HEARING AID CHECK; MONAURAL
HEARING AID CHECK; BINAURAL
ELECTROACOUSTIC EVALUATION FOR HEARING AID; MONAURAL
ELECTROACOUSTIC EVALUATION FOR HEARING AID; BINAURAL
EAR PROTECTOR ATTENUATION MEASUREMENTS
EVALUATION FOR USE AND/OR FITTING OF VOICE PROSTHETIC DEVICE TO SUPPLEMENT ORAL SPEECH
DIAGNOSTIC ANALYSIS OF COCHLEAR IMPLANT, PATIENT UNDER 7 YEARS OF AGE; WITH PROGRAMMING
DIAGNOSTIC ANALYSIS OF COCHLEAR IMPLANT, PATIENT UNDER 7 YEARS OF AGE; SUBSEQUENT REPROGRAMMI
DIAGNOSTIC ANALYSIS OF COCHLEAR IMPLANT, AGE 7 YEARS OR OLDER; WITH PROGRAMMING
DIAGNOSTIC ANALYSIS OF COCHLEAR IMPLANT, AGE 7 YEARS OR OLDER; SUBSEQUENT REPROGRAMMING
EVALUATION FOR PRESCRIPTION OF NON-SPEECH-GENERATING AUGMENTATIVE AND ALTERNATIVE COMMUNICA
THERAPEUTIC SERVICE(S) FOR THE USE OF NON-SPEECH-GENERATING DEVICE, INCLUDING PROGRAMMING AND
EVALUATION FOR PRESCRIPTION FOR SPEECH-GENERATING AUGMENTATIVE AND ALTERNATIVE COMMUNICATIO
EVAL, RX, SPEECH-GENERATING AUGMENTATIVE&ALTERNATIVE COMM, FCE-TO-FCE W THE PT; EA ADD 30 MIN
THERAPEUTIC SERVICES FOR THE USE OF SPEECH-GENERATING DEVICE, INCLUDING PROGRAMMING AND MODI
EVALUATION OF ORAL AND PHARYNGEAL SWALLOWING FUNCTION
MOTION FLUOROSCOPIC EVALUATION OF SWALLOWING FUNCTION BY CINE OR VIDEO RECORDING
FLEXIBLE FIBEROPTIC ENDOSCOPIC EVALUATION OF SWALLOWING BY CINE OR VIDEO RECORDING
FLEXIBLE FIBEROPTIC ENDOSCOPIC EVALUATION OF SWALLOWING BY CINE OR VIDEO RECORDING; PHYSICIAN I
FLEXIBLE FIBEROPTIC ENDOSCOPIC EVALUATION, LARYNGEAL SENSORY TESTING BY CINE OR VIDEO RECORDIN
FLEXIBLE FIBEROPTIC ENDOSCOPIC EVALUATION, LARYNGEAL SENSORY TESTING BY CINE OR VIDEO RECORDIN
FLEX FIBEROPTIC ENDOSCOPIC EVAL, SWALLOW&LARYNGEAL SENSRY TSTING CINE/VIDEO REC;
FLEXIBLE FIBEROPTIC ENDOSCOPIC EVALUATION OF SWALLOWING AND LARYNGEAL SENSORY TESTING BY CINE
UNLISTED OTORHINOLARYNGOLOGICAL SERVICE OR PROCEDURE
CARDIOPULMONARY RESUSCITATION (EG, IN CARDIAC ARREST)
TEMPORARY TRANSCUTANEOUS PACING
CARDIOVERSION, ELECTIVE, ELECTRICAL CONVERSION OF ARRHYTHMIA; EXTERNAL
CARDIOVERSION, ELECTIVE, ELECTRICAL CONVERSION OF ARRHYTHMIA; INTERNAL (SEPARATE PROCEDURE)
CARDIOASSIST-METHOD OF CIRCULATORY ASSIST; INTERNAL
CARDIOASSIST-METHOD OF CIRCULATORY ASSIST; EXTERNAL
PERCUTANEOUS TRANSLUMINAL CORONARY THROMBECTOMY (LIST SEPARATELY IN ADDITION TO CODE FOR PR
TRANSCATHETER PLACEMENT OF RADIATION DELIVERY DEVICE FOR SUBSEQUENT CORONARY INTRAVASCULAR
THROMBOLYSIS, CORONARY; BY INTRACORONARY INFUSION, INCLUDING SELECTIVE CORONARY ANGIOGRAPHY
THROMBOLYSIS, CORONARY; BY INTRAVENOUS INFUSION
INTRAVASCULAR ULTRASOUND (CORONARY VESSEL/GRAFT) DURING DIAG EVALUATION &/ THERAPEUTIC INTERV
INTRAVASCULAR ULTRASOUND (CORONARY VESSEL OR GRAFT) DURING THERAPEUTIC INTERVENTION INCLUDIN
TRANSCATHETER PLACEMENT OF AN INTRACORONARY STENT(S), PERCUTANEOUS, WITH OR WITHOUT OTHER T
TRANSCATHETER PLACEMENT OF AN INTRACORONARY STENT(S), PERCUTANEOUS, WITH OR WITHOUT OTHER T
PERCUTANEOUS TRANSLUMINAL CORONARY BALLOON ANGIOPLASTY; SINGLE VESSEL
PERCUTANEOUS TRANSLUMINAL CORONARY BALLOON ANGIOPLASTY; EACH ADDITIONAL VESSEL (LIST SEPARAT
PERCUTANEOUS BALLOON VALVULOPLASTY; AORTIC VALVE
PERCUTANEOUS BALLOON VALVULOPLASTY; MITRAL VALVE
PERCUTANEOUS BALLOON VALVULOPLASTY; PULMONARY VALVE
ATRIAL SEPTECTOMY OR SEPTOSTOMY; TRANSVENOUS METHOD, BALLOON (EG, RASHKIND TYPE) (INCLUDES CA
ATRIAL SEPTECTOMY OR SEPTOSTOMY; BLADE METHOD (PARK SEPTOSTOMY) (INCLUDES CARDIAC CATHETERIZ
PERCUTANEOUS TRANSLUMINAL CORONARY ATHERECTOMY, BY MECHANICAL OR OTHER METHOD, WITH OR WIT
PERCUTANEOUS TRANSLUMINAL CORONARY ATHERECTOMY, BY MECHANICAL OR OTHER METHOD, WITH OR WIT
PERCUTANEOUS TRANSLUMINAL PULMONARY ARTERY BALLOON ANGIOPLASTY; SINGLE VESSEL
PERCUTANEOUS TRANSLUMINAL PULMONARY ARTERY BALLOON ANGIOPLASTY; EACH ADDITIONAL VESSEL (LIST
ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND REPORT
ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; TRACING ONLY, WITHOUT INTERPRETATION AN
ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; INTERPRETATION AND REPORT ONLY
TELEPHONIC TRANSMISSION OF POST-SYMPTOM ELECTROCARDIOGRAM RHYTHM STRIP(S), 24-HOUR ATTENDED
TELEPHONIC TRANSMISSION OF POST-SYMPTOM ELECTROCARDIOGRAM RHYTHM STRIP(S), 24-HOUR ATTENDED
CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMAL TREADMILL OR BICYCLE EXERCISE, CONTINO
CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMAL TREADMILL OR BICYCLE EXERCISE, CONTINO
CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMAL TREADMILL OR BICYCLE EXERCISE, CONTINO
CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMAL TREADMILL OR BICYCLE EXERCISE, CONTINO
ERGONOVINE PROVOCATION TEST
MICROVOLT T-WAVE ALTERNANS FOR ASSESSMENT OF VENTRICULAR ARRHYTHMIAS
RHYTHM ECG, ONE TO THREE LEADS; WITH INTERPRETATION AND REPORT
RHYTHM ECG, ONE TO THREE LEADS; TRACING ONLY WITHOUT INTERPRETATION AND REPORT
RHYTHM ECG, ONE TO THREE LEADS; INTERPRETATION AND REPORT ONLY
ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS ORIGINAL ECG WAVEFORM RECORD &
ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS ORIGINAL ECG WAVEFORM RECORD &
ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS ORIGINAL ECG WAVEFORM RECORD &
ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS ORIGINAL ECG WAVEFORM RECORD &
ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS ORIGINAL ECG WAVEFORM RECORD &
ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS ORIGINAL ECG WAVEFORM RECORD &
ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS ORIGINAL ECG WAVEFORM RECORD &
ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS ORIGINAL ECG WAVEFORM RECORD &
ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS COMPUTER MONITOR & NON-CONTINUO
ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS COMPUTER MONITOR & NON-CONTINUO
ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS COMPUTER MONITOR & NON-CONTINUO
PATIENT DEMAND SINGLE OR MULTIPLE EVENT RECORDING WITH PRESYMPTOM MEMORY LOOP, 24-HOUR ATTEN
PATIENT DEMAND SINGLE OR MULTIPLE EVENT RECORDING WITH PRESYMPTOM MEMORY LOOP, 24-HOUR ATTEN
PATIENT DEMAND SINGLE OR MULTIPLE EVENT RECORDING WITH PRESYMPTOM MEMORY LOOP, 24-HOUR ATTEN
PATIENT DEMAND SINGLE OR MULTIPLE EVENT RECORDING WITH PRESYMPTOM MEMORY LOOP, 24-HOUR ATTEN
SIGNAL-AVERAGED ELECTROCARDIOGRAPHY (SAECG), WITH OR WITHOUT ECG
TRANSTHORACIC ECHOCARDIOGRAPHY FOR CONGENTIAL CARDIAC ANOMALIES; COMPLETE
TRANSTHORACIC ECHOCARDIOGRAPHY FOR CONGENTIAL CARDIAC ANOMALIES; FOLLOW-UP OR LIMITED STUDY
ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-M
ECHOCARDIOGRAPHY, REAL-TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE RECORDING; F
ECHOCARDIOGRAPHY, TRANSESOPHAGEAL, REAL TIME WITH IMAGE DOCUMENTATION (2D) (WITH OR WITHOUT M
ECHOCARDIOGRAPHY, REAL TIME WITH IMAGE DOCUMENTATION (2D) (WITH OR WITHOUT M-MODE RECORDING)
ECHOCARDIOGRAPHY, REAL TIME WITH IMAGE DOCUMENTATION (2D) (WITH OR WITHOUT M-MODE RECORDING)
TRANSESOPHAGEAL ECHOCARDIOGRAPHY FOR CONGENTIAL CARDIAC ANOMALIES; INCLUDING PROBE PLACEME
TRANSESOPHAGEAL ECHOCARDIOGRAPHY FOR CONGENTIAL CARDIAC ANOMALIES; PLACEMENT OF TRANSESOP
TRANSESOPHAGEAL ECHOCARDIOGRAPHY FOR CONGENTIAL CARDIAC ANOMALIES; IMAGE ACQUISITION, INTERP
ECHOCARDIOGRAPHY,TRANSESOPHAGEAL MONITOR PRPOSES,INCL PROBE PLCEMNT,REAL TIME 2 DIMENZIONA
DOPPLER ECHOCARDIOGRAPHY, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPLAY (LIST SEP
DOPPLER ECHOCARDIOGRAPHY, PULSED WAVE &/ CONTINUOUS WAVE W SPEC DISP (LIST SEP IN ADD TO CODES
DOPPLER ECHOCARDIOGRAPHY COLOR FLOW VELOCITY MAPPING (LIST SEPARATELY IN ADDITION TO CODES FO
ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME W IMAGE DOC (2D, WWO M-MODE RCRDNG), DURING REST &
RIGHT HEART CATHETERIZATION
INSERTION AND PLACEMENT OF FLOW DIRECTED CATHETER (EG, SWAN-GANZ) FOR MONITORING PURPOSES
ENDOMYOCARDIAL BIOPSY
CATHETER PLACEMENT IN CORONARY ARTERY(S), ARTERIAL CORONARY CONDUIT(S), AND/OR VENOUS CORONA
LEFT HEART CATHETERIZATION, RETROGRADE, FROM THE BRACHIAL ARTERY, AXILLARY ARTERY OR FEMORAL A
LEFT HEART CATHETERIZATION, RETROGRADE, FROM THE BRACHIAL ARTERY, AXILLARY ARTERY OR FEMORAL A
LEFT HEART CATHETERIZATION BY LEFT VENTRICULAR PUNCTURE
COMBINED TRANSSEPTAL AND RETROGRADE LEFT HEART CATHETERIZATION
COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE LEFT HEART CATHETERIZATION
COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH INTA
COMBINED RIGHT HEART CATHETERIZATION WITH LEFT VENTRICULAR PUNCTURE (WITH OR WITHOUT RETROGR
COMBINED RIGHT HEART CATHETERIZATION AND LEFT HEART CATHETERIZATION THROUGH EXISTING SEPTAL O
RIGHT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES
COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENIT
COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH INTA
COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH EXIS
INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION; FOR SELECTIVE OPACIFICATION OF ARTERIAL CON
INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION; FOR SELECTIVE OPACIFICATION OF AORTOCORON
INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION; FOR PULMONARY ANGIOGRAPHY
INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION; FOR SELECTIVE RIGHT VENTRICULAR OR RIGHT A
INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION; FOR SELECTIVE LEFT VENTRICULAR OR LEFT ATR
INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION; FOR AORTOGRAPHY
INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION; FOR SELECTIVE CORONARY ANGIOGRAPHY (INJEC
IMAGING SUPERVISION, INTERPRETATION AND REPORT FOR INJECTION PROCEDURE(S) DURING CARDIAC CATHE
IMAGING SUPERVISION, INTERPRETATION AND REPORT FOR INJECTION PROCEDURE(S) DURING CARDIAC CATH;
INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMAL DILUTION, INCLUDING ARTERIAL AND/OR VENOUS CAT
INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMAL DILUTION, INCLUDING ARTERIAL AND/OR VENOUS CAT
INTRAVASCULAR DOPPLER VELOCITY AND/OR PRESSURE DERIVED CORONARY FLOW RESERVE MEASUREMENT
INTRAVASCULAR DOPPLER VELOCITY AND/OR PRESSURE DERIVED CORONARY FLOW RESERVE MEASUREMENT
PERCUTANEOUS TRANSCATHETER CLOSURE OF CONGENITAL INTERATRIAL COMMUNICATION (IE, FONTAN FENE
PERCUTANEOUS TRANSCATHETER CLOSURE OF A CONGENITAL VENTRICULAR SEPTAL DEFECT WITH IMPLANT
BUNDLE OF HIS RECORDING
INTRA-ATRIAL RECORDING
RIGHT VENTRICULAR RECORDING
INTRAVENTRICULAR &/ INTRA-ATRIAL MAPPING, TACHYCARDIA SITE(S) WITH CATHETER MANIPULATION TO RECO
INTRA-ATRIAL PACING
INTRAVENTRICULAR PACING
INTRACARDIAC ELECTROPHYSIOLOGIC 3-DIMENSIONAL MAPPING (LIST SEPARATELY IN ADDITION TO CODE FOR P
ESOPHAGEAL RECORDING OF ATRIAL ELECTROGRAM WITH OR WITHOUT VENTRICULAR ELECTROGRAM(S);
ESOPHAGEAL RECORDING OF ATRIAL ELECTROGRAM WITH OR WITHOUT VENTRICULAR ELECTROGRAM(S); WITH
INDUCTION OF ARRHYTHMIA BY ELECTRICAL PACING
COMPR ELECTROPHYSIOLOGIC EVAL W RIGHT ATRIAL PACING&REC, RIGHT VENTRICULAR PACING&REC, HIS BUN
COMPR ELECTROPHYSIOLOGIC EVAL INCL INSERTION&REPOSITION, MULTI ELECTRODE CATHETERS W INDUCTIO
COMPREHENSIVE ELECTROPHYSIOLOGIC EVAL INCLUD INSERTION & REPOS OF MULT ELECTRODE CATH W INDU
COMPREHENSIVE ELECTROPHYSIOLOGIC EVAL INCLUDING INSERTION & REPOSITIONING OF MULTIPLE ELECTRO
PROGRAMMED STIMULATION AND PACING AFTER INTRAVENOUS DRUG INFUSION (LIST SEPARATELY IN ADDITION
ELECTROPHYSIOLOGIC FOLLOW-UP STUDY WITH PACING AND RECORDING TO TEST EFFECTIVENESS OF THERAP
INTRA-OPERATIVE EPICARDIAL AND ENDOCARDIAL PACING AND MAPPING TO LOCALIZE THE SITE OF TACHYCARD
ELECTROPHYSIOLOGIC EVAL,1/2 CHAMB PAC CARDIOVERT-DEFIBRILL LEADS INCL DEFIBRILL THRESH EVAL (INDU
ELECTROPHYSIOLOGIC EVAL,1/2 CHAMB PAC CARDIOVERT-DEFIBRILL LEADS INCL DEFIBRILL THRESH EVAL (INDU
ELECTROPHYSIOLOGIC EVAL, 1/2 CHAMB PAC CARDIOVERT-DEFIBRILL (INCL DEFIBRILL THRESH EVAL, INDUCT OF
INTRACARDIAC CATHETER ABLATION OF ATRIOVENTRICULAR NODE FUNCTION, ATRIOVENTRICULAR CONDUCTIO
INTRACARDIAC CATHETER ABLATION OF ARRHYTHMOGENIC FOCUS; FOR TX OF SUPRAVENTRICULAR TACHYCAR
INTRACARDIAC CATHETER ABLATION OF ARRHYTHMOGENIC FOCUS; FOR TREATMENT OF VENTRICULAR TACHYC
EVALUATION OF CARDIOVASCULAR FUNCTION WITH TILT TABLE EVALUATION, WITH CONTINUOUS ECG MONITOR
INTRACARDIAC ECHOCARDIOGRAPHY DURING THERAPEUTIC/DIAGNOSTIC INTERVENTION, INCLUDING IMAGING S
PERIPHERAL ARTERIAL DISEASE (PAD) REHABILITATION, PER SESSION
BIOIMPEDANCE, THORACIC, ELECTRICAL
PLETHYSMOGRAPHY, TOTAL BODY; WITH INTERPRETATION AND REPORT
PLETHYSMOGRAPHY, TOTAL BODY; TRACING ONLY, WITHOUT INTERPRETATION AND REPORT
PLETHYSMOGRAPHY, TOTAL BODY; INTERPRETATION AND REPORT ONLY
ELECTRONIC ANALYSIS OF ANTITACHYCARDIA PACEMAKER (INC ELECTROCARDIOGRAPHIC RECORDING, PROGR
ELECTRONIC ANALYSIS OF IMPLANTABLE LOOP RECORDER (ILR) SYSTEM (INCLUDES RETRIEVAL OF RECORDED
ELECTRONIC ANALYSIS OF DUAL-CHAMBER PACEMAKER, RECORDING AND INTERPRETATION AT REST AND EXER
ELECTRONIC ANALYSIS OF DUAL-CHAMBER PACEMAKER, RECORDING & INTERPRET AT REST AND DURING EXERC
ELECTRONIC ANALYSIS OF DUAL-CHAMBER INTERNAL PACEMAKE (MAY INCLUDE RATE, PULSE AMPLITUDE AND D
ELECTRONIC ANALYSIS OF SINGLE CHAMBER PACEMAKER SYSTEM (INC EVAL OF PROGRAMMABLE PARAMETERS
ELECTRONIC ANALYSIS OF SINGLE CHAMBER PACEMAKER SYSTEM (INC EVAL OF PROGRAMMABLE PARAMETERS
ELECTRONIC ANALYSIS OF SINGLE CHAMBER INTERNAL PACEMAKER (RATE, PULSE AMPLITUDE & DURATION, CO
TEMPERATURE GRADIENT STUDIES
ELECTRONIC ANALYSIS OF PACING CARDIOVERTER-DEFIBRILLATOR (INTERROG,EVAL PULSE GENERATOR,PROG
ELECTRONIC ANALYSIS OF PACING CARDIOVERTER-DEFIBRILLATOR (INTERROG,EVAL PULSE GENERATOR,PROG
ELECTRONIC ANALYSIS OF PACING CARDIOVERTER-DEFIBRILLATOR (INTERROG,EVAL PULSE GENERATOR,PROG
ELECTRONIC ANALYSIS OF PACING CARDIOVERTER-DEFIBRILLATOR (INTERROG,EVAL PULSE GENERATOR,PROG
THERMOGRAM; CEPHALIC
THERMOGRAM; PERIPHERAL
DETERMINATION OF VENOUS PRESSURE
AMBULATORY BLOOD PRESSURE MONITORING, UTILIZING A SYSTEM SUCH AS MAGNETIC TAPE AND/OR COMPUT
AMBULATORY BLOOD PRESSURE MONITORING, UTILIZING A SYSTEM SUCH AS MAGNETIC TAPE AND/OR COMPUT
AMBULATORY BLOOD PRESSURE MONITORING, UTILIZING A SYSTEM SUCH AS MAGNETIC TAPE AND/OR COMPUT
AMBULATORY BLOOD PRESSURE MONITORING, UTILIZING A SYSTEM SUCH AS MAGNETIC TAPE AND/OR COMPUT
PHYSICIAN SERVICES FOR OUTPATIENT CARDIAC REHABILITATION; WITHOUT CONTINUOUS ECG MONITORING (P
PHYSICIAN SERVICES FOR OUTPATIENT CARDIAC REHABILITATION; WITH CONTINUOUS ECG MONITORING (PER S
UNLISTED CARDIOVASCULAR SERVICE OR PROCEDURE
NONINVASIVE PHYSIOLOGIC STUDIES OF EXTRACRANIAL ARTERIES, COMPLETE BILATERAL STUDY (EG, PERIORB
DUPLEX SCAN OF EXTRACRANIAL ARTERIES; COMPLETE BILATERAL STUDY
DUPLEX SCAN OF EXTRACRANIAL ARTERIES; UNILATERAL OR LIMITED STUDY
TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES; COMPLETE STUDY
TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES; LIMITED STUDY
NONINVASIVE PHYSIOLOGIC STUDIES OF UPPER/LOWER EXTREMITY ARTERIES, SINGLE LEVEL, BILATERAL (EG, A
NONINVASIVE PHYSIOLOGIC STUDIES OF UPPER/LOWER EXTREMITY ARTERIES, MULT LEVEL OR W/ PROVOCATIV
NONINVASIVE PHYSIOLOGIC STUDIES OF LOWER EXTREMITY ARTERIES, AT REST AND FOLLOWING TREADMILL S
DUPLEX SCAN OF LOWER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; COMPLETE BILATERAL STUDY
DUPLEX SCAN OF LOWER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; UNILATERAL OR LIMITED STUDY
DUPLEX SCAN OF UPPER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; COMPLETE BILATERAL STUDY
DUPLEX SCAN OF UPPER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; UNILATERAL OR LIMITED STUDY
NONINVASIVE PHYSIOLOGIC STUDIES OF EXTREMITY VEINS, COMPLETE BILATERAL STUDY (EG, DOPPLER WAVEF
DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS; COMP
DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS; UNILA
DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF ABDOMINAL, PELVIC, SCROTAL CONTENTS AND/
DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF ABDOMINAL, PELVIC, AND/OR RETROPERITONEA
DUPLEX SCAN OF AORTA, INFERIOR VENA CAVA, ILIAC VASCULATURE, OR BYPASS GRAFTS; COMPLETE STUDY
DUPLEX SCAN OF AORTA, INFERIOR VENA CAVA, ILIAC VASCULATURE, OR BYPASS GRAFTS; UNILATERAL OR LIMI
DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF PENILE VESSELS; COMPLETE STUDY
DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF PENILE VESSELS; FOLLOW-UP OR LIMITED STUD
DUPLEX SCAN OF HEMODIALYSIS ACCESS (INCLUDING ARTERIAL INFLOW, BODY OF ACCESS AND VENOUS OUTFL
SPIROMETRY, INCLUDING GRAPHIC RECORD, TOTAL AND TIMED VITAL CAPACITY, EXPIRATORY FLOW RATE MEAS
PATIENT-INITIATED SPIROMETRIC RECORDING PER 30-DAY PERIOD OF TIME; INCL REINFORCED EDUC, TRANSMIS
PATIENT INITIATED SPIROMETRIC RECORDING PER 30-DAY PERIOD OF TIME; RECORDING (INCLUDES HOOK-UP, R
PATIENT INITIATED SPIROMETRIC RECORDING PER 30-DAY PERIOD OF TIME; PHYSICIAN REVIEW AND INTERPRET
BRONCHOSPASM EVALUATION: SPIROMETRY AS IN 94010, BEFORE AND AFTER BRONCHODILATOR (AEROSOL OR
PROLONGED POSTEXPOSURE EVALUATION OF BRONCHOSPASM WITH MULTIPLE SPIROMETRIC DETERMINATION
VITAL CAPACITY, TOTAL (SEPARATE PROCEDURE)
MAXIMUM BREATHING CAPACITY, MAXIMAL VOLUNTARY VENTILATION
FUNCTIONAL RESIDUAL CAPACITY OR RESIDUAL VOLUME: HELIUM METHOD, NITROGEN OPEN CIRCUIT METHOD,
EXPIRED GAS COLLECTION, QUANTITATIVE, SINGLE PROCEDURE (SEPARATE PROCEDURE)
THORACIC GAS VOLUME
DETERMINATION OF MALDISTRIBUTION OF INSPIRED GAS: MULTIPLE BREATH NITROGEN WASHOUT CURVE INCLU
DETERMINATION OF RESISTANCE TO AIRFLOW, OSCILLATORY OR PLETHYSMOGRAPHIC METHODS
DETERMINATION OF AIRWAY CLOSING VOLUME, SINGLE BREATH TESTS
RESPIRATORY FLOW VOLUME LOOP
BREATHING RESPONSE TO CO2 (CO2 RESPONSE CURVE)
BREATHING RESPONSE TO HYPOXIA (HYPOXIA RESPONSE CURVE)
PULMONARY STRESS TESTING; SIMPLE (EG, PROLONGED EXERCISE TEST FOR BRONCHOSPASM WITH PRE- AND
PULMONARY STRESS TESTING; COMPLEX (INCLUDING MEASUREMENTS OF CO2 PRODUCTION, O2 UPTAKE, AND E
PRESSURIZED/NONPRESSURIZED INHAL TREATMENT, ACT AIRWAY OBSTRUC/FOR SPUTUM INDUCTION, DIAG PUR
AEROSOL INHALATION OF PENTAMIDINE FOR PNEUMOCYSTIS CARINII PNEUMONIA TREATMENT OR PROPHYLAXIS
VENTILATION ASSIST AND MANAGEMENT, INITIATION OF PRESSURE OR VOLUME PRESET VENTILATORS FOR ASS
VENTILATION ASSIST AND MANAGEMENT, INITIATION OF PRESSURE OR VOLUME PRESET VENTILATORS FOR ASS
CONTINUOUS POSITIVE AIRWAY PRESSURE VENTILATION (CPAP), INITIATION AND MANAGEMENT
CONTINUOUS NEGATIVE PRESSURE VENTILATION (CNP), INITIATION AND MANAGEMENT
DEMONSTRATION AND/OR EVALUATION OF PATIENT UTILIZATION OF AN AEROSOL GENERATOR, NEBULIZER, MET
MANIPULATION CHEST WALL, SUCH AS CUPPING, PERCUSSING, AND VIBRATION TO FACILITATE LUNG FUNCTION;
MANIPULATION CHEST WALL, SUCH AS CUPPING, PERCUSSING, AND VIBRATION TO FACILITATE LUNG FUNCTION;
OXYGEN UPTAKE, EXPIRED GAS ANALYSIS; REST AND EXERCISE, DIRECT, SIMPLE
OXYGEN UPTAKE, EXPIRED GAS ANALYSIS; INCLUDING CO2 OUTPUT, PERCENTAGE OXYGEN EXTRACTED
OXYGEN UPTAKE, EXPIRED GAS ANALYSIS; REST, INDIRECT (SEPARATE PROCEDURE)
CARBON MONOXIDE DIFFUSING CAPACITY (EG, SINGLE BREATH, STEADY STATE)
MEMBRANE DIFFUSION CAPACITY
PULMONARY COMPLIANCE STUDY (EG, PLETHYSMOGRAPHY, VOLUME AND PRESSURE MEASUREMENTS)
NONINVASIVE EAR OR PULSE OXIMETRY FOR OXYGEN SATURATION; SINGLE DETERMINATION
NONINVASIVE EAR OR PULSE OXIMETRY FOR OXYGEN SATURATION; MULTIPLE DETERMINATIONS (EG, DURING E
NONINVASIVE EAR OR PULSE OXIMETRY FOR OXYGEN SATURATION; BY CONTINUOUS OVERNIGHT MONITORING
CARBON DIOXIDE, EXPIRED GAS DETERMINATION BY INFRARED ANALYZER
CIRCADIAN RESPIRATORY PATTERN RECORDING (PEDIATRIC PNEUMOGRAM), 12 TO 24 HOUR CONTINUOUS RECO
UNLISTED PULMONARY SERVICE OR PROCEDURE
PERCUTANEOUS TESTS (SCRATCH, PUNCTURE, PRICK) WITH ALLERGENIC EXTRACTS, IMMEDIATE TYPE REACTIO
PERCUTANEOUS TESTS (SCRATCH, PUNCTURE, PRICK) SEQUENTIAL AND INCREMENTAL, WITH DRUGS, BIOLOGIC
INTRACUTANEOUS (INTRADERMAL) TESTS, SEQUENTIAL AND INCREMENTAL, WITH DRUGS, BIOLOGICALS, OR VEN
INTRACUTANEOUS (INTRADERMAL) TESTS WITH ALLERGENIC EXTRACTS, IMMEDIATE TYPE REACTION, SPECIFY N
INTRACUTANEOUS (INTRADERMAL) TESTS, SEQUENTIAL AND INCREMENTAL, WITH ALLERGENIC EXTRACTS FOR
INTRACUTANEOUS (INTRADERMAL) TESTS WITH ALLERGENIC EXTRACTS, DELAYED TYPE REACTION, INCLUDING
PATCH OR APPLICATION TEST(S) (SPECIFY NUMBER OF TESTS)
PHOTO PATCH TEST(S) (SPECIFY NUMBER OF TESTS)
PHOTO TESTS
OPHTHALMIC MUCOUS MEMBRANE TESTS
DIRECT NASAL MUCOUS MEMBRANE TEST
INHALATION BRONCHIAL CHALLENGE TESTING (NOT INCLUDING NECESSARY PULMONARY FUNCTION TESTS); WIT
INHALATION BRONCHIAL CHALLENGE TESTING (NOT INCLUDING NECESSARY PULMONARY FUNCTION TESTS); WIT
INGESTION CHALLENGE TEST (SEQUENTIAL AND INCREMENTAL INGESTION OF TEST ITEMS, EG, FOOD, DRUG OR
PROVOCATIVE TESTING (EG, RINKEL TEST)
PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY NOT INCLUDING PROVISION OF ALLERGENIC EXTRA
PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY NOT INCLUDING PROVISION OF ALLERGENIC EXTRA
PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY IN PRESCRIBING PHYSICIAN'S OFFICE OR INSTITUTI
PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY IN PRESCRIBING PHYSICIAN'S OFFICE OR INSTITUTI
PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY IN PRESCRIBING PHYSICIAN'S OFFICE OR INSTITUTI
PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY IN PRESCRIBING PHYSICIAN'S OFFICE OR INSTITUTI
PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY IN PRESCRIBING PHYSICIAN'S OFFICE OR INSTITUTI
PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY IN PRESCRIBING PHYSICIAN'S OFFICE OR INSTITUTI
PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY IN PRESCRIBING PHYSICIAN'S OFFICE OR INSTITUTI
PROFESSIONAL SERVICES FOR THE SUPERVISION OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERG
PROFESSIONAL SERVICES FOR THE SUPERVISION OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERG
PROFESSIONAL SERVICES FOR THE SUPERVISION OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERG
PROFESSIONAL SERVICES FOR THE SUPERVISION OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERG
PROFESSIONAL SERVICES FOR THE SUPERVISION OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERG
PROFESSIONAL SERVICES FOR THE SUPERVISION OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERG
PROFESSIONAL SERVICES FOR THE SUPERVISION OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERG
PROFESSIONAL SERVICES FOR THE SUPERVISION OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERG
RAPID DESENSITIZATION PROCEDURE, EACH HOUR (EG, INSULIN, PENICILLIN, EQUINE SERUM)
UNLISTED ALLERGY/CLINICAL IMMUNOLOGIC SERVICE OR PROCEDURE
GLUC MON, UP 72 HRS CONT REC&STORAGE, GLUC VALUES,INTERSTITIAL TISSUE FLUID VIA SUBCUTANEOUS SE
MULTIPLE SLEEP LATENCY OR MAINTENANCE OF WAKEFULNESS TESTING, RECORDING, ANALYSIS AND INTERPR
SLEEP STUDY, SIMULTANEOUS RECORDING OF VENTILATION, RESPIRATORY EFFORT, ECG OR HEART RATE, AND
SLEEP STUDY, SIMULTANEOUS RECORDING OF VENTILATION, RESPIRATORY EFFORT, ECG OR HEART RATE, AND
POLYSOMNOGRAPHY; SLEEP STAGING WITH 1-3 ADDITIONAL PARAMETERS OF SLEEP, ATTENDED BY A TECHNOL
POLYSOMNOGRAPHY; SLEEP STAGING WITH 4 OR MORE ADDITIONAL PARAMETERS OF SLEEP, ATTENDED BY A T
POLYSOMNOGRAPHY; OF SLEEP,ATTEND BY A TECHNOLOGIST SLEEP STAGING W 4/+ ADD PARAMETERS OF SLEE
ELECTROENCEPHALOGRAM (EEG) EXTENDED MONITORING; 41-60 MINUTES
ELECTROENCEPHALOGRAM (EEG) EXTENDED MONITORING; GREATER THAN ONE HOUR
ELECTROENCEPHALOGRAM (EEG); INCLUDING RECORDING AWAKE AND DROWSY
ELECTROENCEPHALOGRAM (EEG); INCLUDING RECORDING AWAKE AND ASLEEP
ELECTROENCEPHALOGRAM (EEG); RECORDING IN COMA OR SLEEP ONLY
ELECTROENCEPHALOGRAM (EEG); CEREBRAL DEATH EVALUATION ONLY
ELECTROENCEPHALOGRAM (EEG); ALL NIGHT RECORDING
ELECTROCORTICOGRAM AT SURGERY (SEPARATE PROCEDURE)
INSERTION BY PHYSICIAN OF SPHENOIDAL ELECTRODES FOR ELECTROENCEPHALOGRAPHIC (EEG) RECORDING
MUSCLE TESTING, MANUAL (SEPARATE PROCEDURE) WITH REPORT; EXTREMITY (EXCLUDING HAND) OR TRUNK
MUSCLE TESTING, MANUAL (SEPARATE PROCEDURE); HAND (WITH OR WITHOUT COMPARISON WITH NORMAL SID
MUSCLE TESTING, MANUAL (SEPARATE PROCEDURE); TOTAL EVALUATION OF BODY, EXCLUDING HANDS
MUSCLE TESTING, MANUAL (SEPARATE PROCEDURE); TOTAL EVALUATION OF BODY, INCLUDING HANDS
RANGE OF MOTION MEASUREMENTS AND REPORT (SEPARATE PROCEDURE); EACH EXTREMITY (EXCLUDING HAN
RANGE OF MOTION MEASUREMENTS AND REPORT (SEPARATE PROCEDURE); HAND, WITH OR WITHOUT COMPAR
TENSILON TEST FOR MYASTHENIA GRAVIS;
TENSILON TEST FOR MYASTHENIA GRAVIS; WITH ELECTROMYOGRAPHIC RECORDING
NEEDLE ELECTROMYOGRAPHY, ONE EXTREMITY WITH OR WITHOUT RELATED PARASPINAL AREAS
NEEDLE ELECTROMYOGRAPHY, TWO EXTREMITIES WITH OR WITHOUT RELATED PARASPINAL AREAS
NEEDLE ELECTROMYOGRAPHY, THREE EXTREMITIES WITH OR WITHOUT RELATED PARASPINAL AREAS
NEEDLE ELECTROMYOGRAPHY, FOUR EXTREMITIES WITH OR WITHOUT RELATED PARASPINAL AREAS
NEEDLE ELECTROMYOGRAPHY; CRANIAL NERVE SUPPLIED MUSCLE(S), UNILATERAL
NEEDLE ELECTROMYOGRAPHY, CRANIAL NERVE SUPPLIED MUSCLES, BILATERAL
NEEDLE ELECTROMYOGRAPHY; THORACIC PARASPINAL MUSCLES (EXCLUDING T1 OR T12)
NEEDLE ELECTROMYOGRAPHY; LIMITED STUDY OF MUSCLES IN ONE EXTREMITY OR NON-LIMB (AXIAL) MUSCLES
NEEDLE ELECTROMYOGRAPHY USING SINGLE FIBER ELECTRODE, WITH QUANTITATIVE MEASUREMENT OF JITTE
ISCHEMIC LIMB EXERCISE TEST WITH SERIAL SPECIMEN(S) ACQUISITION FOR MUSCLE(S) METABOLITE(S)
NERVE CONDUCTION, AMPLITUDE AND LATENCY/VELOCTIY STUDY, EACH NERVE; MOTOR, WITHOUT F-WAVE STU
NERVE CONDUCTION, AMPLITUDE AND LATENCY/VELOCITY STUDY, EACH NERVE, ANY/ALL SITE(S) ALONG THE NE
NERVE CONDUCTION, AMPLITUDE AND LATENCY/VELOCITY STUDY, EACH NERVE; SENSORY
INTRAOPERATIVE NEUROPHYSIOLOGY TESTING, PER HOUR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMA
TSTNG AUTONOMIC NRVOUS SYST. FNCTN; CARDIOVAGAL INNERVATION (PARASYMPATHETIC FNCTN), INCL. 2+ O
TSTNG AUTONOMIC NRVOUS SYST. FUNCT.; VASOMOTOR ADRENERGIC (AD.) INNERVATION (SYMP. AD. FUNCT.), I
TSTNG AUTONOMIC NRVOUS SYST. FUNCT.;SUDOMOTOR, INCL. 1+ OF FOLLOWING: QUANT. SUDOMOTOR AXON R
SHORT-LATENCY SOMATOSENSORY EVOKED POTENTIAL STUDY, STIMULATION OF ANY/ALL PERIPHERAL NERVES
SHORT-LATENCY SOMATOSENSORY EVOKED POTENTIAL STUDY, STIMULATION OF ANY/ALL PERIPHERAL NERVES
SHORT-LATENCY SOMATOSENSORY EVOKED POTENTIAL STUDY, STIMULATION OF ANY/ALL PERIPHERAL NERVES
VISUAL EVOKED POTENTIAL (VEP) TESTING CENTRAL NERVOUS SYSTEM, CHECKERBOARD OR FLASH
ORBICULARIS OCULI (BLINK) REFLEX, BY ELECTRODIAGNOSTIC TESTING
H-REFLEX, AMPLITUDE AND LATENCY STUDY; RECORD GASTROCNEMIUS/SOLEUS MUSCLE
H-REFLEX, AMPLITUDE AND LATENCY STUDY; RECORD MUSCLE OTHER THAN GASTROCNEMIUS/SOLEUS MUSCLE
NEUROMUSCULAR JUNCTION TESTING (REPETITIVE STIMULATION, PAIRED STIMULI), EACH NERVE, ANY ONE MET
MONITORING FOR IDENTIFICATION AND LATERALIZATION OF CEREBRAL SEIZURE FOCUS, ELECTROENCEPHALOG
MONITORING FOR LOCALIZATION OF CEREBRAL SEIZURE FOCUS BY CABLE OR RADIO, 16 OR MORE CHANNEL TE
MONITORING FOR LOCALIZATION OF CEREBRAL SEIZURE FOCUS BY COMPUTERIZED PORTABLE 16 OR MORE CH
PHARMACOLOGICAL OR PHYSICAL ACTIVATION REQUIRING PHYSICIAN ATTENDANCE DURING EEG RECORDING O
ELECTROENCEPHALOGRAM (EEG) DURING NONINTRACRANIAL SURGERY (EG, CAROTID SURGERY)
MONITORING FOR LOCALIZATION OF CEREBRAL SEIZURE FOCUS BY CABLE OR RADIO, 16 OR MORE CHANNEL TE
DIGITAL ANALYSIS OF ELECTROENCEPHALOGRAM (EEG) (EG, FOR EPILEPTIC SPIKE ANALYSIS)
WADA ACTIVATION TEST FOR HEMISPHERIC FUNCTION, INCLUDING ELECTROENCEPHALOGRAPHIC (EEG) MONITO
FUNCTIONAL CORTICAL AND SUBCORTICAL MAPPING BY STIMULATION &/ RECORDING OF ELECTRODES ON BRAIN
FUNCTIONAL CORTICAL MAPPING BY STIMULATION OF ELECTRODES ON BRAIN SURFACE, OR OF DEPTH ELECTRO
MAGNETOENCEPHALOGRAPHY (MEG), RECORDING AND ANALYSIS; FOR SPONTANEOUS BRAIN MAGNETIC ACTIVI
MAGNETOENCEPHALOGRAPHY (MEG), RECORDING AND ANALYSIS; FOR EVOKED MAGNETIC FIELDS, SINGLE MOD
MAGNETOENCEPHALOGRAPHY (MEG), RECORDING&ANALYSIS;EVOKED MAGNETIC FIELDS, EA ADDITION MODALIT
ELECTRONIC ANAL OF IMPLANT NEUROSTIM PULSE GEN SYS; SIMPLE/COMPLEX BRAIN, SPINAL CORD/PERIPHERA
ELECTRONIC ANAL OF IMPLANT NEUROSTIM PULSE GEN SYS; SIMPLE BRAIN, SPINAL CORD, OR PERIPHERAL (IE, P
ELECTRONIC ANAL OF IMPLANT NEUROSTIM PULSE GEN SYS; COMPLEX BRAIN, SPINAL CORD, OR PERIPHERAL (E
ELECTRONIC ANAL OF IMPLANT NEUROSTIM PULSE GEN SYS;COMPLEX BRAIN,SPINAL CORD/PERIPHERAL (EXCEP
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR SYSTEM (EG, RATE, PULSE AMPL
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR SYSTEM (EG, RATE, PULSE AMPL
REFILLING AND MAINTENANCE OF IMPLANTABLE PUMP OR RESERVOIR FOR DRUG DELIVERY, SPINAL (INTRATHEC
UNLISTED NEUROLOGICAL OR NEUROMUSCULAR DIAGNOSTIC PROCEDURE
COMPREHENSIVE COMPUTER-BASED MOTION ANALYSIS BY VIDEO-TAPING AND 3-D KINEMATICS;
COMPREHENSIVE COMPUTER-BASED MOTION ANALYSIS BY VIDEO-TAPING AND 3-D KINEMATICS; WITH DYNAMIC
DYNAMIC SURFACE ELECTROMYOGRAPHY, DURING WALKING OR OTHER FUNCTIONAL ACTIVITIES, 1-12 MUSCLES
DYNAMIC FINE WIRE ELECTROMYOGRAPHY, DURING WALKING OR OTHER FUNCTIONAL ACTIVITIES, 1 MUSCLE
PHYSICIAN REV&INTERPRET, COMPR COMPUTER BASED MOTION ANAL, DYNAM PLANTAR PRESS MEASURES, DYN
PSYCHOLOGICAL TESTING (INCLUDES PSYCHODIAGNOSTIC ASSESSMENT OF PERSONALITY PSYCHOPATHOLOGY
ASSESSMENT OF APHASIA (INCLUDES ASSESS EXPRESS & RECEPT SPEECH & LANG FNC, LANG COMPR, SPEECH
DEVELOPMENTAL TESTING; LIMITED (EG, DEVELOPMENTAL SCREENING TEST II, EARLY LANGUAGE MILESTONE S
DEVELOPMENTAL TESTING; EXTENDED (INCLUDES ASSESSMENT OF MOTOR, LANGUAGE, SOCIAL, ADAPTIVE &/OR
NEUROBEHAVIORAL STATUS EXAM (CLINICAL ASSESS OF THINKING, REASON & JUDGMENT, EG, ACQUIRED KNOW
NEUROPSYCHOLOGICAL TESTING BATTERY (EG, HALSTEAD-REITAN, LURIA, WAIS-R) WITH INTERPRETATION AND
HEALTH&BEHAV ASSESSMENT (EG, HEALTH-FOC CLINICAL INTERVIEW, BEHAVIORAL OBSERVATIONS, PSYCHOPH
HEALTH AND BEHAVIOR ASSESS (EG, HEALTH-FOC CLIN INTERVIEW, BEHAVIORAL OBSERVATIONS, PSYCHOPHYS
HEALTH AND BEHAVIOR INTERVENTION, EACH 15 MINUTES, FACE-TO-FACE; INDIVIDUAL
HEALTH AND BEHAVIOR INTERVENTION, EACH 15 MINUTES, FACE-TO-FACE; GROUP (2 OR MORE PATIENTS)
HEALTH AND BEHAVIOR INTERVENTION, EACH 15 MINUTES, FACE-TO-FACE; FAMILY (WITH THE PATIENT PRESENT
HEALTH AND BEHAVIOR INTERVENTION, EACH 15 MINUTES, FACE-TO-FACE; FAMILY (WITHOUT THE PATIENT PRES
CHEMOTHERAPY ADMINISTRATION, SUBCUTANEOUS OR INTRAMUSCULAR, WITH OR WITHOUT LOCAL ANESTHES
CHEMOTHERAPY ADMINISTRATION, INTRALESIONAL; UP TO AND INCLUDING 7 LESIONS
CHEMOTHERAPY ADMINISTRATION, INTRALESIONAL; MORE THAN 7 LESIONS
CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS; PUSH TECHNIQUE
CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS; INFUSION TECHNIQUE, UP TO ONE HOUR
CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS; INFUSION TECHNIQUE, ONE TO 8 HOURS, EACH ADDITIONAL H
CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS; INFUSION TECHNIQUE, INITIATION OF PROLONGED INFUSION
CHEMOTHERAPY ADMINISTRATION, INTRA-ARTERIAL; PUSH TECHNIQUE
CHEMOTHERAPY ADMINISTRATION, INTRA-ARTERIAL; INFUSION TECHNIQUE, UP TO ONE HOUR
CHEMOTHERAPY ADMINISTRATION, INTRA-ARTERIAL; INFUSION TECHNIQUE, ONE TO 8 HOURS, EACH ADDITIONA
CHEMOTHERAPY ADMINISTRATION, INTRA-ARTERIAL; INFUSION TECHNIQUE, INITIATION OF PROLONGED INFUSIO
CHEMOTHERAPY ADMINISTRATION INTO PLEURAL CAVITY, REQUIRING AND INCLUDING THORACENTESIS
CHEMOTHERAPY ADMINISTRATION INTO PERITONEAL CAVITY, REQUIRING AND INCLUDING PERITONEOCENTESIS
CHEMOTHERAPY ADMINISTRATION, INTO CNS (EG, INTRATHECAL), REQUIRING AND INCLUDING SPINAL PUNCTUR
REFILLING AND MAINTENANCE OF PORTABLE PUMP
REFILLING AND MAINTENANCE OF IMPLANTABLE PUMP OR RESERVOIR FOR DRUG DELIVERY, SYSTEMIC (EG, INTR
CHEMOTHERAPY INJECTION, SUBARACHNOID OR INTRAVENTRICULAR VIA SUBCUTANEOUS RESERVOIR, SINGLE
PROVISION OF CHEMOTHERAPY AGENT
UNLISTED CHEMOTHERAPY PROCEDURE
PHOTODYNAMIC THERAPY EXTERNAL APPLICATION, LIGHT TO DESTROY PREMALIGNANT &/ MALIGNANT LESIONS
PHOTODYNAMIC THERAPY BY ENDOSCOPIC APPL OF LIGHT TO ABLATE ABNORMAL TISS VIA ACTIVAT OF PHOTOS
PHOTODYNAMIC THERAPY BY ENDOSCOPIC APPL OF LIGHT TO ABLATE ABNORMAL TISS VIA ACTIVAT OF PHOTOS
ACTINOTHERAPY (ULTRAVIOLET LIGHT)
MICROSCOPIC EXAMINATION OF HAIRS PLUCKED OR CLIPPED BY THE EXAMINER (EXCLUDING HAIR COLLECTED B
PHOTOCHEMOTHERAPY; TAR AND ULTRAVIOLET B (GOECKERMAN TREATMENT) OR PETROLATUM AND ULTRAVIO
PHOTOCHEMOTHERAPY; PSORALENS AND ULTRAVIOLET A (PUVA)
PHOTOCHEMOTHERAPY (GOECKERMAN AND/OR PUVA) FOR SEVERE PHOTORESPONSIVE DERMATOSES REQUIR
LASER TREATMENT FOR INFLAMMATORY SKIN DISEASE (PSORIASIS); TOTAL AREA LESS THAN 250 SQ CM
LASER TREATMENT FOR INFLAMMATORY SKIN DISEASE (PSORIASIS); 250 SQ CM TO 500 SQ CM
LASER TREATMENT FOR INFLAMMATORY SKIN DISEASE (PSORIASIS); OVER 500 SQ CM
UNLISTED SPECIAL DERMATOLOGICAL SERVICE OR PROCEDURE
PHYSICAL THERAPY EVALUATION
PHYSICAL THERAPY RE-EVALUATION
OCCUPATIONAL THERAPY EVALUATION
OCCUPATIONAL THERAPY RE-EVALUATION
ATHLETIC TRAINING EVALUATION
ATHLETIC TRAINING RE-EVALUATION
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; HOT OR COLD PACKS
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; TRACTION, MECHANICAL
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; ELECTRICAL STIMULATION (UNATTENDED)
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; VASOPNEUMATIC DEVICES
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; PARAFFIN BATH
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; MICROWAVE
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; WHIRLPOOL
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; DIATHERMY
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; INFRARED
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; ULTRAVIOLET
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; ELECTRICAL STIMULATION (MANUAL), EACH 15 MINUTES
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; IONTOPHORESIS, EACH 15 MINUTES
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; CONTRAST BATHS, EACH 15 MINUTES
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; ULTRASOUND, EACH 15 MINUTES
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; HUBBARD TANK, EACH 15 MINUTES
UNLISTED MODALITY (SPECIFY TYPE AND TIME IF CONSTANT ATTENDANCE)
THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EACH 15 MINUTES; THERAPEUTIC EXERCISES TO DEVELOP S
THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EA 15 MINUTES; NEUROMUSCULAR REEDUCATION OF MOVEM
THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EACH 15 MINUTES; AQUATIC THERAPY WITH THERAPEUTIC E
THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EACH 15 MINUTES; GAIT TRAINING (INCLUDES STAIR CLIMBIN
THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EACH 15 MINUTES; MASSAGE, INCLUDING EFFLEURAGE, PETR
UNLISTED THERAPEUTIC PROCEDURE (SPECIFY)
MANUAL THERAPY TECHNIQUES (EG, MOBILIZATION/MANIPULATION, MANUAL LYMPHATIC DRAINAGE, MANUAL TR
THERAPEUTIC PROCEDURE(S), GROUP (2 OR MORE INDIVIDUALS)
ORTHOTIC(S) FITTING AND TRAINING, UPPER EXTREMITY(IES), LOWER EXTREMITY(IES), AND/OR TRUNK, EACH 15
PROSTHETIC TRAINING, UPPER AND/OR LOWER EXTREMITIES, EACH 15 MINUTES
THERAPEUTIC ACTIVITIES, DIRECT (ONE ON ONE) PATIENT CONTACT BY THE PROVIDER (USE OF DYNAMIC ACTIV
DEVELOPMENT OF COGNITIVE SKILLS TO IMPROVE ATTENTION, MEMORY, PROBLEM SOLVING, (INCLUDES COMPE
SENSORY INTEGRATIVE TECHNIQUES TO ENHANCE SENSORY PROCESSING AND PROMOTE ADAPTIVE RESPONSE
SELF-CARE/HOME MGT TRAIN (EG, ACTIVITIES, DAILY LIVNG (ADL)&COMPENSAT TRAIN, MEAL PREP, SAFETY PROC
COMMUNITY/WORK REINTEGRATION TRAIN (EG, SHOP, TRANSPORT, MONEY MGMT, AVOCATIONAL ACTIVITIES &/
WHEELCHAIR MANAGEMENT/PROPULSION TRAINING, EACH 15 MINUTES
WORK HARDENING/CONDITIONING; INITIAL 2 HOURS
WORK HARDENING/CONDITIONING; EACH ADDITIONAL HOUR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIM
REM,DEVITAL TISS,WND(S);SEL DEBRIDE,WO ANES(EG,HI PRESS WATER JET,SHRP SEL DEBRIDE W SCISSORS, SC
REM, DEVITAL TISSUE,WOUND(S); NON-SELECT DEBRIDEMENT, WO ANES (EG, WET-TO-MOIST DRESSINGS, ENZY
CHECKOUT FOR ORTHOTIC/PROSTHETIC USE, ESTABLISHED PATIENT, EACH 15 MINUTES
PHYSICAL PERFORMANCE TEST OR MEASUREMENT (EG, MUSCULOSKELETAL, FUNCTIONAL CAPACITY), WITH WR
ACUPUNCTURE, ONE OR MORE NEEDLES; WITHOUT ELECTRICAL STIMULATION
ACUPUNCTURE, ONE OR MORE NEEDLES; WITH ELECTRICAL STIMULATION
UNLISTED PHYSICAL MEDICINE/REHABILITATION SERVICE OR PROCEDURE
MEDICAL NUTRITION THERAPY; INITIAL ASSESSMENT AND INTERVENTION, INDIVIDUAL, FACE-TO-FACE WITH THE
MEDICAL NUTRITION THERAPY; RE-ASSESSMENT AND INTERVENTION, INDIVIDUAL, FACE-TO-FACE WITH THE PAT
MEDICAL NUTRITION THERAPY; GROUP (2 OR MORE INDIVIDUAL(S)), EACH 30 MINUTES
OSTEOPATHIC MANIPULATIVE TREATMENT (OMT); ONE TO TWO BODY REGIONS INVOLVED
OSTEOPATHIC MANIPULATIVE TREATMENT (OMT); THREE TO FOUR BODY REGIONS INVOLVED
OSTEOPATHIC MANIPULATIVE TREATMENT (OMT); FIVE TO SIX BODY REGIONS INVOLVED
OSTEOPATHIC MANIPULATIVE TREATMENT (OMT); SEVEN TO EIGHT BODY REGIONS INVOLVED
OSTEOPATHIC MANIPULATIVE TREATMENT (OMT); NINE TO TEN BODY REGIONS INVOLVED
CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, ONE TO TWO REGIONS
CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, THREE TO FOUR REGIONS
CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, FIVE REGIONS
CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); EXTRASPINAL, ONE OR MORE REGIONS
HANDLING AND/OR CONVEYANCE OF SPECIMEN FOR TRANSFER FROM THE PHYSICIAN'S OFFICE TO A LABORATO
HANDLING AND/OR CONVEYANCE OF SPECIMEN FOR TRANSFER FROM THE PATIENT IN OTHER THAN A PHYSICIA
HANDLING, CONVEYANCE, ANY OTHER SERVICE IN CONNECTION WITH DEVICES (EG, DESIGNING, FITTING, PACKA
POSTOPERATIVE FOLLOW-UP VISIT, INCLUDED IN GLOBAL SERVICE
INITIAL (NEW PATIENT) VISIT WHEN STARRED ( ) SURGICAL PROCEDURE CONSTITUTES MAJOR SERVICE AT THAT
HOSPITAL MANDATED ON CALL SERVICE; IN-HOSPITAL, EACH HOUR
HOSPITAL MANDATED ON CALL SERVICE; OUT-OF-HOSPITAL, EACH HOUR
SERVICES REQUESTED AFTER OFFICE HOURS IN ADDITION TO BASIC SERVICE
SERVICES REQUESTED BETWEEN 10:00 PM AND 8:00 AM IN ADDITION TO BASIC SERVICE
SERVICES REQUESTED ON SUNDAYS AND HOLIDAYS IN ADDITION TO BASIC SERVICE
SERVICES PROVIDED AT REQUEST OF PATIENT IN A LOCATION OTHER THAN PHYSICIAN'S OFFICE WHICH ARE NO
OFFICE SERVICES PROVIDED ON AN EMERGENCY BASIS
SUPPLIES & MATERIALS (EXCEPT SPECTACLES), PROVIDED BY PHYSICIAN OVER AND ABOVE THOSE USUALLY INC
EDUCATIONAL SUPPLIES, SUCH AS BOOKS, TAPES, AND PAMPHLETS, PROVIDED BY THE PHYSICIAN FOR THE PAT
MEDICAL TESTIMONY
PHYSICIAN EDUCATIONAL SERVICES RENDERED TO PATIENTS IN A GROUP SETTING (EG, PRENATAL, OBESITY, OR
SPECIAL REPORTS SUCH AS INSURANCE FORMS, MORE THAN THE INFORMATION CONVEYED IN THE USUAL MEDI
UNUSUAL TRAVEL (EG, TRANSPORTATION AND ESCORT OF PATIENT)
ANALYSIS OF CLINICAL DATA STORED IN COMPUTERS (EG, ECGS, BLOOD PRESSURES, HEMATOLOGIC DATA)
COLLECT&INTERPRET, PHYSIOLOGIC DATA (EG, ECG, BLOOD PRESS, GLUC MON) DIGITALLY STORED &/ TRANSMI
ANESTHESIA FOR PATIENT OF EXTREME AGE, UNDER ONE YEAR AND OVER SEVENTY (LIST SEPARATELY IN ADDI
ANESTHESIA COMPLICATED BY UTILIZATION OF TOTAL BODY HYPOTHERMIA (LIST SEPARATELY IN ADDITION TO C
ANESTHESIA COMPLICATED BY UTILIZATION OF CONTROLLED HYPOTENSION (LIST SEPARATELY IN ADDITION TO
ANESTHESIA COMPLICATED BY EMERGENCY CONDITIONS (SPECIFY) (LIST SEPARATELY IN ADDITION TO CODE FO
SEDATION WITH OR WITHOUT ANALGESIA (CONSCIOUS SEDATION); INTRAVENOUS, INTRAMUSCULAR OR INHALAT
SEDATION WITH OR WITHOUT ANALGESIA (CONSCIOUS SEDATION); ORAL, RECTAL AND/OR INTRANASAL
ANOGENITAL EXAMINATION WITH COLPOSCOPIC MAGNIFICATION IN CHILDHOOD FOR SUSPECTED TRAUMA
VISUAL FUNCTION SCREENING, AUTOMATED OR SEMI-AUTOMATED BILATERAL QUANTITATIVE DETERMINATION O
SCREENING TEST OF VISUAL ACUITY, QUANTITATIVE, BILATERAL
IPECAC OR SIMILAR ADMINISTRATION FOR INDIVIDUAL EMESIS AND CONTINUED OBSERVATION UNTIL STOMACH
PHYSICIAN ATTENDANCE AND SUPERVISION OF HYPERBARIC OXYGEN THERAPY, PER SESSION
HYPOTHERMIA; REGIONAL
HYPOTHERMIA; TOTAL BODY
ASSEMBLY AND OPERATION OF PUMP WITH OXYGENATOR OR HEAT EXCHANGER (WITH OR WITHOUT ECG AND/O
ASSEMBLY AND OPERATION OF PUMP WITH OXYGENATOR OR HEAT EXCHANGER (WITH OR WITHOUT ECG AND/O
ASSEMBLY AND OPERATION OF PUMP WITH OXYGENATOR OR HEAT EXCHANGER (WITH OR WITHOUT ECG AND/O
PHLEBOTOMY, THERAPEUTIC (SEPARATE PROCEDURE)
UNLISTED SPECIAL SERVICE, PROCEDURE OR REPORT
OFFICE OR OTHER OUTPATIENT VISIT FOR EVAL & MGMT OF NEW PATIENT, REQUIRES: PROBLEM FOCUSED HIST
OFFICE OR OTHER OUTPATIENT VISIT FOR EVAL & MGMT OF NEW PATIENT, REQUIRES: EXPANDED PROBLEM FOC
OFFICE OR OTHER OUTPATIENT VISIT FOR EVAL & MGMT OF NEW PATIENT, REQUIRES: DETAILED HISTORY; EXAM
OFFICE OR OTHER OUTPATIENT VISIT FOR EVAL & MGMT OF NEW PATIENT, REQUIRES: COMPREHENSIVE HISTOR
OFFICE OR OTHER OUTPATIENT VISIT FOR EVAL & MGMT OF NEW PATIENT, REQUIRES: COMPREHENSIVE HISTOR
OFFICE OR OTHER OUTPATIENT VISIT FOR EVAL & MGMT OF ESTABLISHED PATIENT, MAY NOT REQUIRE PHYSICIA
OFFICE OR OTHER OUTPATIENT VISIT FOR EVAL & MGMT OF ESTABLISHED PATIENT, REQUIRES 2 OF 3: PROBLEM
OFFICE OR OTHER OUTPATIENT VISIT FOR EVAL & MGMT OF ESTABLISHED PATIENT, REQUIRES 2 OF 3: EXPANDE
OFFICE OR OTHER OUTPATIENT VISIT FOR EVAL & MGMT OF ESTABLISHED PATIENT, REQUIRES 2 OF 3: DETAILED
OFFICE OR OTHER OUTPATIENT VISIT FOR EVAL & MGMT OF ESTABLISHED PATIENT, REQUIRES 2 OF 3: COMPREH
OBSERVATION CARE DISCHARGE DAY MANAGEMENT
INITIAL OBSERVATION CARE, PER DAY FOR EVAL & MGMT OF PATIENT, REQUIRES: COMPREHENSIVE HISTORY; EX
INITIAL OBSERVATION CARE, PER DAY FOR EVAL & MGMT OF PATIENT, REQUIRES: COMPREHENSIVE HISTORY; EX
INITIAL OBSERVATION CARE, PER DAY FOR EVAL & MGMT OF PATIENT, REQUIRES: COMPREHENSIVE HISTORY; EX
INITIAL HOSPITAL CARE, PER DAY, FOR EVAL & MGMT OF PATIENT REQUIRES: COMPREHENSIVE HISTORY; EXAM;
INITIAL HOSPITAL CARE, PER DAY, FOR EVAL & MGMT OF PATIENT, REQUIRES: COMPREHENSIVE HISTORY; EXAM;
INITIAL HOSPITAL CARE, PER DAY, FOR EVAL & MGMT OF PATIENT, REQUIRES: COMPREHENSIVE HISTORY; EXAM;
SUBSEQUENT HOSPITAL CARE, PER DAY, FOR EVAL & MGMT, REQUIRES 2 OF: PROBLEM FOCUSED INTERVAL HIS
SUBSEQUENT HOSPITAL CARE, PER DAY, FOR EVAL & MGMT, REQUIRES 2 OF: EXPANDED INTERVAL HISTORY; EX
SUBSEQUENT HOSPITAL CARE, PER DAY, FOR EVAL & MGMT, REQUIRES 2 OF: DETAILED INTERVAL HISTORY; EXA
OBSER/INPAT HOSP CARE,INC ADMIS & DISCH ON SAME DATE,REQ:DETAIL/COMP HX,EXAM;MED DEC MAKING THA
OBSER/INPAT HOSP CARE,INC ADMIS & DISCH ON SAME DATE,REQ:COMP HX,EXAM;MED DEC MAKING OF MOD CO
OBSER/INPAT HOSP CARE,INC ADMIS & DISCH ON SAME DATE,REQ:COMP HX,EXAM;MED DEC MAKING OF HIGH CO
HOSPITAL DISCHARGE DAY MANAGEMENT; 30 MINUTES OR LESS
HOSPITAL DISCHARGE DAY MANAGEMENT; MORE THAN 30 MINUTES
OFFICE CONSULTATION FOR NEW OR ESTABLISHED PATIENT, REQUIRES: PROBLEM FOCUSED HISTORY; EXAM; S
OFFICE CONSULTATION FOR A NEW/EST PATIENT,REQUIRES THESE 3 KEY COMP:AN EXPAND PROB FOC HX;AN E
OFFICE CONSULTATION FOR NEW OR ESTABLISHED PATIENT, REQUIRES: DETAILED HISTORY; DETAILED EXAM; M
OFFICE CONSULTATION FOR NEW OR ESTABLISHED PATIENT, REQUIRES: COMPREHENSIVE HISTORY; EXAM; MED
OFFICE CONSULTATION FOR NEW OR ESTABLISHED PATIENT, REQUIRES: COMPREHENSIVE HISTORY; EXAM; MED
INITIAL INPATIENT CONSULT FOR NEW OR ESTABLISHED PATIENT, REQUIRES: PROBLEM FOCUSED HISTORY; EXA
INITIAL INPATIENT CONSULT FOR NEW OR ESTABLISHED PATIENT, REQUIRES: EXPANDED PROBLEM FOCUSED HI
INITIAL INPATIENT CONSULT FOR NEW OR ESTABLISHED PATIENT, REQUIRES: DETAILED HISTORY; EXAM; MEDICA
INITIAL INPATIENT CONSULT FOR NEW OR ESTABLISHED PATIENT, REQUIRES: COMPREHENSIVE HISTORY; EXAM;
INITIAL INPATIENT CONSULT FOR NEW OR ESTABLISHED PATIENT, REQUIRES: A COMPREHENSIVE HISTORY; A CO
FOLLOW-UP INPATIENT CONSULT FOR ESTABLISHED PATIENT REQUIRES 2 OF: PROBLEM FOCUSED INTERVAL HIS
FOLLOW-UP INPATIENT CONSULT FOR ESTABLISHED PATIENT REQUIRES 2 OF: EXPANDED PROBLEM FOCUSED H
FOLLOW-UP INPATIENT CONSULT FOR ESTABLISHED PATIENT REQUIRES 2 OF: DETAILED INTERVAL HISTORY; EX
CONFIRMATORY CONSULT, REQUIRES: PROBLEM FOCUSED HISTORY; EXAM; STRAIGHTFORWARD MEDICAL DECI
CONFIRMATORY CONSULT, REQUIRES: EXPANDED PROBLEM FOCUSED HISTORY; AN EXPANDED PROBLEM FOCU
CONFIRMATORY CONSULT, REQUIRES: DETAILED HISTORY; EXAM; MEDICAL DECISION MAKING OF LOW COMPLEX
CONFIRMATORY CONSULT, REQUIRES: COMPREHENSIVE HISTORY; COMPREHENSIVE EXAM; MEDICAL DECISION
CONFIRMATORY CONSULT, REQUIRES: COMPREHENSIVE HISTORY; COMPREHENSIVE EXAM; MEDICAL DECISION
EMERGENCY DEPARTMENT VISIT FOR EVAL & MGMT, REQUIRES: PROBLEM FOCUSED HISTORY; EXAM; AND STRA
EMERGENCY DEPARTMENT VISIT FOR EVAL & MGMT, REQUIRES: EXPANDED PROBLEM FOCUSED HISTORY; EXAM
EMERGENCY DEPARTMENT VISIT FOR EVAL & MGMT, REQUIRES: EXPANDED PROBLEM FOCUSED HISTORY; EXAM
EMERGENCY DEPARTMENT VISIT FOR EVAL & MGMT, REQUIRES: DETAILED HISTORY; EXAM; MEDICAL DECISION M
EMERGENCY DEPART VISIT FOR THE EVAL & MGT OF A PATIENT,REQUIRES THESE 3 KEY COMP:COMP HX; COMP
PHYSICIAN DIRECTION OF EMERGENCY MEDICAL SYSTEMS (EMS) EMERGENCY CARE, ADVANCED LIFE SUPPORT
CRITICAL CARE SVCS DELIVERED PHYSICIAN, FACE-TO-FACE, DUR AN INTERFACIL TRANSPORT, CRITICALLY ILL/C
CRITICAL CARE SVCS DELIVER PHYSICIAN, FCE-TO-FCE, DUR ANINTERFACIL TRNSPORT, CRITICALLY ILL/CRITICAL
CRITICAL CARE, EVALUATION AND MANAGEMENT OF THE CRITICALLY ILL OR CRITICALLY INJURED PATIENT; FIRS
CRITICAL CARE, EVALUATION AND MANAGEMENT OF THE UNSTABLE CRITICALLY ILL OR UNSTABLE CRITICALLY IN
INITIAL PEDIATRIC CRITICAL CARE, 31 DAYS UP THROUGH 24 MONTHS OF AGE, PER DAY, FOR THE EVALUATION A
SUBSEQUENT PEDIATRIC CRITICAL CARE, 31 DAYS UP THROUGH 24 MONTHS OF AGE,PER DAY, FOR THE EVALUA
INIT NEO CRIT CARE,PER DAY,EVAL & MANAG CRIT ILL NEO,30 DAYS OLD/<THIS CDE IS RSRD DATE ADMIS NEO CR
SUBSEQUENT NEO CRITICAL CARE,PER DAY, FOR THE EVALU &MANAGEMENT CRITI ILL NEONATE,30 DAYS OLD\<
SUBSEQUENT INTENSIVE CARE, PER DAY, EVALUATION & MANAGEMENT RECOVERING VERY LOW BIRTH WT INFA
SUBSEQUENT INTENSIVE CARE,PER DAY,FOR EVAL&MANAGEMENT OF RECOVR LOW BIRTH WT;INFNT W BODY W
EVAL&MGT,NEW/EST PT AN ANNUAL NURSE FAC ASSESS,REQS 3 COMPTS:DET INTRVL HX;COMPR X;&MED DECIS
EVALUATION & MGMT OF NEW/ESTABLISHED PATIENT INVOLVING NURSING FACILITY ASSESSMENT; MODERATE T
EVALUATION & MGMT OF NEW/ESTABLISHED PATIENT INVOLVING NURSING FACILITY ASSESSMENT; INITIAL ADMIS
SUBSQNT NURSE FAC CARE,EVAL&MGT,NEW/EST PT,REQS AT LST TWO,3 KEY COMPTS:PROB FOC INTERVAL HX;
SUBSEQUENT NURSING FACILITY CARE, PER DAY, EVAL & MGMT OF NEW/ESTABLISHED PATIENT, REQUIRES 2 OF
SUBSEQUENT NURSING FACILITY CARE, PER DAY, EVAL & MGMT OF NEW/ESTABLISHED PATIENT, REQUIRES 2 OF
NURSING FACILITY DISCHARGE DAY MANAGEMENT; 30 MINUTES OR LESS
NURSING FACILITY DISCHARGE DAY MANAGEMENT; MORE THAN 30 MINUTES
DOMICILIARY OR REST HOME VISIT FOR EVAL & MGMT OF NEW PATIENT REQUIRES: PROBLEM FOCUSED HISTOR
DOMICILIARY OR REST HOME VISIT FOR EVAL & MGMT OF NEW PATIENT REQUIRES: EXPANDED PROBLEM FOCUS
DOMICILIARY OR REST HOME VISIT FOR EVAL & MGMT OF NEW PATIENT REQUIRES: DETAILED HISTORY; EXAM; M
DOMICILIARY OR REST HOME VISIT FOR EVAL & MGMT OF ESTABLISHED PATIENT REQUIRES 2 OF: PROBLEM FOC
DOMICILIARY OR REST HOME VISIT FOR EVAL & MGMT OF ESTABLISHED PATIENT REQUIRES 2 OF: EXPANDED PR
DOMICILIARY OR REST HOME VISIT FOR EVAL & MGMT OF ESTABLISHED PATIENT REQUIRES 2 OF: DETAILED HIST
HOME VISIT FOR E&M OF NEW PAT,REQ 3: PROB FOCUSED HX,EXAM;STRAIGHTFORWARD MED DEC MAKING;CAR
HOME VISIT FOR E&M OF NEW PAT,REQ 3:EXPAND PROB FOC HX,EXAM;MED DEC MAKING OF LOW COMPLX;CARE
HOME VISIT FOR E&M OF NEW PAT,REQ 3:DETAILED HX,EXAM;MED DEC MAKING OF MOD COMPLX;CARE CONSIST
HOME VISIT FOR E&M OF NEW PAT,REQ: COMP HX,EXAM;MED DEC MAKING OF MOD COMPLX;CARE CONSIST W P
HME VIS FOR E&M OF NEW PAT,REQ:COMP HX,EXAM;MED DEC MAKING OF HIGH COMPLX;CARE CONSIST W PROB
HME VIS FOR E&M OF ESTAB PAT,REQ AT LEAST 2:PROB FOCUSED INTERVAL HX,EXAM;STRAIGHTFOR MEDICAL D
HME VIS FOR E&M OF ESTAB PAT,REQ AT LEAST 2:EXPAND PROB FOC INTERVAL HX,EXAM;LOW COMPLX MED DE
HME VIS FOR E&M OF ESTAB PAT,REQ AT LEAST 2:DETAIL INTERVAL HX,EXAM; MED DEC MAKING OF MOD COMPL
HM VIS FOR E&M OF ESTAB PAT,REQ AT LEAST 2:COMP INTER HX,EXAM;MED DEC MAKING MOD-HIGH COMPLX;CA
PROLONGED PHYSICIAN SERVICE IN THE OFFICE OR OTHER OUTPATIENT SETTING REQUIRING DIRECT (FACE-TO
PROLONGED PHYSICIAN SERVICE IN THE OFFICE OR OTHER OUTPATIENT SETTING REQUIRING DIRECT (FACE-TO
PROLONGED PHYSICIAN SERVICE IN THE INPATIENT SETTING, REQUIRING DIRECT (FACE-TO-FACE) PATIENT CON
PROLONGED PHYSICIAN SERVICE IN THE INPATIENT SETTING, REQUIRING DIRECT (FACE-TO-FACE) PATIENT CON
PROLONGED EVALUATION AND MANAGEMENT SERVICE BEFORE AND/OR AFTER DIRECT (FACE-TO-FACE) PATIEN
PROLONGED EVALUATION AND MANAGEMENT SERVICE BEFORE AND/OR AFTER DIRECT (FACE-TO-FACE) PATIEN
PHYSICIAN STANDBY SERVICE, REQUIRING PROLONGED PHYSICIAN ATTENDANCE, EACH 30 MINUTES (EG, OPERA
MEDICAL CONFERENCE BY PHYSICIAN WITH INTERDISCIPLINARY TEAM OF HEALTH PROFESSIONALS OR REPRES
MEDICAL CONFERENCE BY PHYSICIAN WITH INTERDISCIPLINARY TEAM OF HEALTH PROFESSIONALS OR REPRES
TELEPHONE CALL BY PHYSICIAN TO PATIENT OR CONSULT OR MEDICAL MGMT OR FOR COORDINATING W/ OTH H
TELEPHONE CALL BY PHYSICIAN TO PATIENT OR CONSULT OR MEDICAL MGMT OR FOR COORDINATING W/ OTH H
TELEPHONE CALL BY PHYSICIAN TO PATIENT OR CONSULT OR MEDICAL MGMT OR FOR COORDINATING W/ OTH H
PHYS SUPRVSN,PT UNDER CARE,HHA HM,DOMICIL/EQUIV ENV REQ CMPLX&MULTDISC CARE MODAL DR DEV &/CA
PHYS SUPRVSN,PT UNDER CARE,HHA HOME,CARE PLANS, REV, SUBSQNT RPTS, PT STATUS, REV, RELATED LAB&
PHYS SUPRVSN,HOSPICE PT REQ CMPLX&MULTDISC CARE MODAL &/CARE PLANS,SUBSQNT RPTS,PT STATUS,RE
PHYS SUPRVSN,HOSPICE PT REQ CMPLX&MULTDISCIPL CARE MODAL&/CARE PLANS,PT STATUS,REV,RELATED LA
PHYS SUPRVSN,NURSE FAC PT REQ CMPLX&MULTDIS CARE MODAL&/CARE PLANS,REV,SUBSQNT RPTS,PT STATU
PHYS SUPRVSN,NURSE FAC PT REQ CMPLX&MULTDISCIPL CARE MODAL&/CARE PLANSPT STATUS,REV,RELATED
INT COMPR PREVENTIVE MEDICINE EVAL&MGT, AN INDIV AN AGE&GENDER HX, EX, COUNS/ANTICIPATORY/RSK FA
INT COMPR PREVENTIVE MEDICINE EVAL&MGT, AN INDIV AN AGE&GENDER HX, X, COUNS/ANTICIPATORY/RSK FAC
INT COMPR PREVENTIVE MEDICINE EVAL&MGT, AN INDIV AN AGE&GENDER HX, X, COUNS/ANTICIPATORY/RSK FAC
INT COMPR PREVENTIVE MEDICINE EVAL&MGT, AN INDIV AN AGE&GENDER HX, X, COUNS/ANTICIPATORY/RSK FAC
INIT COMPR PREVENTIVE MEDICINE EVAL&MGT, AN INDIV AN AGE&GENDER APPROP HX, EX,COUNS/ANTICIPATOR
INIT COMPR PREVENTIVE MEDICINE EVAL&MGT, AN INDIV AN AGE&GENDER APPROP HX, EX,COUNS/ANTICIPATOR
INIT COMPR PREVENTIVE MEDICINE EVAL&MGT, AN INDIV AN AGE&GENDER APPROP HX, EX,COUNS/ANTICIPATOR
PDIC COMPR PREVENTIVE MEDICINE REEVAL&MGT, AN INDIV AN AGE&GENDER HX, X, COUNS/ANTICIPATORY/RSK
PDIC COMPR PREVENTIVE MEDICINE REEVAL&MGT, AN INDIV AN AGE&GENDER HX, X, COUNS/ANTICIPATORY/RSK
PDIC COMPR PREVENTIVE MEDICINE REEVAL&MGT, AN INDIV AN AGE&GENDER HX, X, COUNS/ANTICIPATORY/RSK
PDIC COMPR PREVENTIVE MEDICINE REEVAL&MGT, AN INDIV AN AGE&GENDER HX, X, COUNS/ANTICIPATORY/RSK
PDIC COMPR PREVENTIVE MEDICINE REEVAL&MGT, AN INDIV AN AGE&GENDER HX, EX, COUNS/ANTICIPATORY/RS
PDIC COMPR PREVENTIVE MEDICINE REEVAL&MGT, AN INDIV AN AGE&GENDER HX, EX, COUNS/ANTICIPATORY/RS
PDIC COMPR PREVENTIVE MEDICINE REEVAL&MGT, AN INDIV AN AGE&GENDER HX, EX, COUNS/ANTICIPATORY/RS
PREVENTIVE MEDICINE COUNSELING AND/OR RISK FACTOR REDUCTION INTERVENTION(S) PROVIDED TO AN INDI
PREVENTIVE MEDICINE COUNSELING AND/OR RISK FACTOR REDUCTION INTERVENTION(S) PROVIDED TO AN INDI
PREVENTIVE MEDICINE COUNSELING AND/OR RISK FACTOR REDUCTION INTERVENTION(S) PROVIDED TO AN INDI
PREVENTIVE MEDICINE COUNSELING AND/OR RISK FACTOR REDUCTION INTERVENTION(S) PROVIDED TO AN INDI
PREVENTIVE MEDICINE COUNSELING AND/OR RISK FACTOR REDUCTION INTERVENTION(S) PROVIDED TO INDIVID
PREVENTIVE MEDICINE COUNSELING AND/OR RISK FACTOR REDUCTION INTERVENTION(S) PROVIDED TO INDIVID
ADMINISTRATION AND INTERPRETATION OF HEALTH RISK ASSESSMENT INSTRUMENT (EG, HEALTH HAZARD APPR
UNLISTED PREVENTIVE MEDICINE SERVICE
HISTORY AND EXAM OF THE NORMAL NEWBORN INFANT, INITIATION OF DIAGNOSTIC AND TREATMENT PROGRAM
NORMAL NEWBORN CARE IN OTHER THAN HOSPITAL OR BIRTHING ROOM SETTING, INCLUDING PHYSICAL EXAM O
SUBSEQUENT HOSPITAL CARE, FOR EVAL & MGMT OF A NORMAL NEWBORN, PER DAY
HISTORY AND EXAM OF NORMAL NEWBORN INFANT, INCLUDING PREP OF MEDICAL RECORDS (THIS CODE SHOUL
ATTENDANCE AT DELIVERY (WHEN REQUESTED BY DELIVERING PHYSICIAN) AND INITIAL STABILIZATION OF NEWB
NEWBORN RESUSCITATION: PROVISION OF POSITIVE PRESSURE VENTILATION AND/OR CHEST COMPRESSIONS I
BASIC LIFE AND/OR DISABILITY EXAM THAT INCLUDES: HEIGHT, WEIGHT & BLOOD PRESSURE; COMPLETION OF M
WORK RELATED OR MEDICAL DISABILITY EXAM BY TREATING PHYSICIAN INC: MEDICAL HISTORY; EXAM; DIAGNOS
WORK RELATED OR MEDICAL DISABILITY EXAM BY OTHER THAN TREATING PHYSICIAN INC: MEDICAL HX; EXAM; D
UNLISTED EVALUATION & MANAGEMENT SERVICE
HOME VISIT FOR PRENATAL MONITORING AND ASSESSMENT TO INCLUDE FETAL HEART RATE, NON-STRESS TEST
HOME VISIT FOR POSTNATAL ASSESSMENT AND FOLLOW-UP CARE
HOME VISIT FOR NEWBORN CARE AND ASSESSMENT
HOME VISIT FOR RESPIRATORY THERAPY CARE (EG, BRONCHODILATOR, OXYGEN THERAPY, RESPIRATORY ASSE
HOME VISIT FOR MECHANICAL VENTILATION CARE
HOME VISIT FOR STOMA CARE AND MAINTENANCE INCLUDING COLOSTOMY AND CYSTOSTOMY
HOME VISIT FOR INTRAMUSCULAR INJECTIONS
HOME VISIT FOR CARE AND MAINTENANCE OF CATHETER(S) (EG, URINARY, DRAINAGE, AND ENTERAL)
HOME VISIT FOR ASSISTANCE WITH ACTIVITIES OF DAILY LIVING AND PERSONAL CARE
HOME VISIT FOR INDIVIDUAL, FAMILY, OR MARRIAGE COUNSELING
HOME VISIT FOR FECAL IMPACTION MANAGEMENT AND ENEMA ADMINISTRATION
HOME VISIT FOR HEMODIALYSIS
HOME INFUSION FOR PAIN MANAGEMENT (INTRAVENOUS OR SUBCUTANEOUS), PER VISIT
HOME INFUSION FOR PAIN MANAGEMENT (EPIDURAL OR INTRATHECAL), PER VISIT
HOME INFUSION FOR TOCOLYTIC THERAPY, PER VISIT
HOME INFUSION FOR HEMATOPOIETIC HORMONES (EG, ERYTHROPOIETIN, G-CSF, CM-CSF) OR PLATELETS, PER V
HOME INFUSION FOR CHEMOTHERAPY, PER VISIT
HOME INFUSION FOR ANTIBIOTICS/ANTIFUNGALS/ANTIVIRALS, PER VISIT
HOME INFUSION OF CONTINUOUS ANTICOAGULANT THERAPY (EG, HEPARIN), PER VISIT
HOME INFUSION OF IMMUNOTHERAPY, PER VISIT
HOME INFUSION OF PERITONEAL DIALYSIS, PER VISIT
HOME INFUSION OF ENTERAL NUTRITION, PER VISIT
HOME INFUSION OF HYDRATION THERAPY, PER VISIT
HOME INFUSION OF TOTAL PARENTERAL NUTRITION, PER VISIT
HOME ADMINISTRATION OF AEROSOLIZED PENTAMIDINE, PER VISIT
HOME INFUSION FOR ANTI-HEMOPHILIC AGENTS (EG, FACTOR VIII), PER VISIT
HOME INFUSION OF ALPHA-1-PROTEINASE INHIBITOR (EG, PROLASTIN), PER VISIT
HOME INFUSION FOR UNINTERRUPTED, LONG-TERM INTRAVENOUS TREATMENT (EG,EPOPROSTENOL), PER VISIT
HOME INFUSION OF SYMPATHOMIMETIC AGENTS (EG, DOBUTAMINE), PER VISIT
HOME INFUSION OF MISCELLANEOUS DRUGS, PER VISIT
HOME INFUSION, EACH ADDITIONAL THERAPY GIVEN ON SAME DAY (LIST SEPARATELY IN ADDITION TO CODE FOR
UNLISTED HOME VISIT SERVICE OR PROCEDURE
ENDOVASCULAR REPAIR OF INFRARENAL ABDOMINAL AORTIC ANEURYSM OR DISSECTION; MODULAR BIFURCATE
ENDOVASCULAR REPAIR OF INFRARENAL ABDOMINAL AORTIC ANEURYSM OR DISSECTION; AORTO-UNI-ILIAC OR
CERVICOGRAPHY
TRANSCATHETER PLACEMENT OF EXTRACRANIAL CEREBROVASCULAR ARTERY STENT(S), PERCUTANEOUS; INIT
TRANSCATHETER PLACEMENT OF EXTRACRANIAL CEREBROVASCULAR ARTERY STENT(S), PERCUTANEOUS; EAC
TRANSCATHETER PLACEMENT OF EXTRACRANIAL CEREBROVASCULAR ARTERY STENT(S), PERCUTANEOUS, RAD
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND
ENDOMETRIAL CRYOABLATION WITH ULTRASONIC GUIDANCE
ANESTHESIA FOR PROCEDURES ON SALIVARY GLANDS, INCLUDING BIOPSY
ANESTHESIA FOR PROCEDURES ON PLASTIC REPAIR OF CLEFT LIP
ANESTHESIA FOR RECONSTRUCTIVE PROCEDURES OF EYELID (EG, BLEPHAROPLASTY, PTOSIS SURGERY)
ANESTHESIA FOR ELECTROCONVULSIVE THERAPY
TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY MEASUREMENT OF GAMMA INTERFERON ANTIGEN RESPONSE
ANESTHESIA FOR PROCEDURES ON EXTERNAL, MIDDLE, AND INNER EAR INCLUDING BIOPSY; NOT OTHERWISE S
ANESTHESIA FOR PROCEDURES ON EXTERNAL, MIDDLE, AND INNER EAR INCLUDING BIOPSY; OTOSCOPY
ANESTHESIA FOR PROCEDURES ON EXTERNAL, MIDDLE, AND INNER EAR INCLUDING BIOPSY; TYMPANOTOMY
ARTHROSCOPY, KNEE, SURGICAL, IMPLANTATION OF OSTEOCHONDRAL GRAFT(S) FOR TREATMENT OF ARTICULA
ARTHROSCOPY, KNEE, SURGICAL, IMPLANTATION OF OSTEOCHONDRAL GRAFT(S) FOR TREATMENT OF ARTICULA
ANESTHESIA FOR PROCEDURES ON EYE; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON EYE; LENS SURGERY
ANESTHESIA FOR PROCEDURES ON EYE; CORNEAL TRANSPLANT
ANESTHESIA FOR PROCEDURES ON EYE; VITREORETINAL SURGERY
ANESTHESIA FOR PROCEDURES ON EYE; IRIDECTOMY
ANESTHESIA FOR PROCEDURES ON EYE; OPHTHALMOSCOPY
MENISCAL TRANSPLANTATION, MEDIAL OR LATERAL, KNEE (ANY METHOD)
ANESTHESIA FOR PROCEDURES ON NOSE AND ACCESSORY SINUSES; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON NOSE AND ACCESSORY SINUSES; RADICAL SURGERY
ANESTHESIA FOR PROCEDURES ON NOSE AND ACCESSORY SINUSES; BIOPSY, SOFT TISSUE
DESTRUCTION OF LOCALIZED LESION OF CHOROID (EG, CHOROIDAL NEOVASCULARIZATION), TRANSPUPILLARY T
ANESTHESIA FOR INTRAORAL PROCEDURES, INCLUDING BIOPSY; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR INTRAORAL PROCEDURES, INCLUDING BIOPSY; REPAIR OF CLEFT PALATE
ANESTHESIA FOR INTRAORAL PROCEDURES, INCLUDING BIOPSY; EXCISION OF RETROPHARYNGEAL TUMOR
ANESTHESIA FOR INTRAORAL PROCEDURES, INCLUDING BIOPSY; RADICAL SURGERY
DESTRUCTION OF MACULAR DRUSEN, PHOTOCOAGULATION
DELIVERY OF HIGH POWER, FOCAL MAGNETIC PULSES FOR DIRECT STIMULATION TO CORTICAL NEURONS
ANESTHESIA FOR PROCEDURES ON FACIAL BONES OR SKULL; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON FACIAL BONES OR SKULL; RADICAL SURGERY (INCLUDING PROGNATHISM)
EXTRACORPOREAL SHOCK WAVE THERAPY; INVOLVING MUSCULOSKELETAL SYSTEM
EXTRACORPOREAL SHOCK WAVE THERAPY; INVOLVING PLANTAR FASCIA
ANESTHESIA FOR INTRACRANIAL PROCEDURES; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR INTRACRANIAL PROCEDURES; SUBDURAL TAPS
ANESTHESIA FOR INTRACRANIAL PROCEDURES; BURR HOLES, INCLUDING VENTRICULOGRAPHY
ANESTHESIA FOR INTRACRANIAL PROCEDURES; CRANIOPLASTY OR ELEVATION OF DEPRESSED SKULL FRACTUR
ANESTHESIA FOR INTRACRANIAL PROCEDURES; VASCULAR PROCEDURES
ANESTHESIA FOR INTRACRANIAL PROCEDURES; PROCEDURES IN SITTING POSITION
INSERTION OF TRANSCERVICAL OR TRANSVAGINAL FETAL OXIMETRY SENSOR
ANESTHESIA FOR INTRACRANIAL PROCEDURES; CEREBROSPINAL FLUID SHUNTING PROCEDURES
ANESTHESIA FOR INTRACRANIAL PROCEDURES; ELECTROCOAGULATION OF INTRACRANIAL NERVE
INFECTIOUS AGENT DRUG SUSCEPTIBILITY PHENOTYPE PREDICTION USING GENOTYPIC COMPARISON TO KNOW
NON-SURGICAL SEPTAL REDUCTION THERAPY (EG, ALCOHOL ABLATION), FOR HYPERTROPHIC OBSTRUCTIVE CA
DETERMINATION OF CORNEAL THICKNESS (EG, PACHYMETRY) WITH INTERPRETATIONAND REPORT, BILATERAL
LIPOPROTEIN, DIRECT MEASUREMENT, INTERMEDIATE DENSITY LIPOPROTEINS (IDL)(REMNANT LIPOPROTEINS)
ENDOSCOPIC LYSIS OF EPIDURAL ADHESIONS W DIRECT VISUALIZATION USING MECHANICAL MEANS (EG, SPINAL
DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA) BODY COMPOSITION STUDY, ONE OR MORE SITES
TREATMENT(S) FOR INCONTINENCE, PULSED MAGNETIC NEUROMODULATION, PER DAY
ANESTHESIA FOR ALL PROCEDURES ON THE INTEGUMENTARY SYSTEM, MUSCLES AND NERVES OF HEAD, NECK,
ANTIPROTHROMBIN (PHOSPHOLIPID COFACTOR) ANTIBODY, EACH IG CLASS
SPECULOSCOPY
ANESTHESIA FOR ALL PROCEDURES ON ESOPHAGUS, THYROID, LARYNX, TRACHEA AND LYMPHATIC SYSTEM OF
ANESTHESIA FOR ALL PROCEDURES ON ESOPHAGUS, THYROID, LARYNX, TRACHEA AND LYMPHATIC SYSTEM OF
ANESTHESIA FOR ALL PROCEDURES ON THE LARYNX AND TRACHEA IN CHILDREN LESS THAN 1 YEAR OF AGE
SPECULOSCOPY; WITH DIRECTED SAMPLING
ENDOVASCULAR REPAIR OF DESCENDING THORACIC AORTIC ANEURYSM, PSEUDOANEURYSM OR DISSECTION; I
ENDOVASCULAR REPAIR OF DESCENDING THORACIC AORTIC ANEURYSM, PSEUDOANEURYSM OR DISSECTION; N
ANESTHESIA FOR PROCEDURES ON MAJOR VESSELS OF NECK; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON MAJOR VESSELS OF NECK; SIMPLE LIGATION
PLACEMENT OF PROXIMAL OR DISTAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAIR OF DESCENDING T
PLACEMENT OF PROXIMAL/ DISTAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAIR OF DESCENDING THO
OPEN SUBCLAVIAN TO CAROTID ARTERY TRANSPOSITION PERFORMED IN CONJUNCTION WITH ENDOVASCULAR
ENDOVASCULAR REPAIR, DESCENDING THORACIC AORTIC ANEURYSM, PSEUDOANEURYSM/DISSECTION INVOLVI
ENDOVASCULAR REPAIR, DESCENDING THORACIC AORTIC ANEURYSM, PSEUDOANEURYSM/DISSECTION NO INVO
ANESTHESIA FOR PROCEDURES ON THE INTEGUMENTARY SYSTEM ON THE EXTREMITIES, ANTERIOR TRUNK AND
ANESTHESIA FOR PROCEDURES ON ANTERIOR INTEGUMENTARY SYSTEM OF CHEST, INCLUDING SUBCUTANEOU
ANESTHESIA FOR PROCEDURES ON ANTERIOR INTEGUMENTARY SYSTEM OF CHEST, INCLUDING SUBCUTANEOU
ANESTHESIA FOR PROCEDURES ON ANTERIOR INTEGUMENTARY SYSTEM OF CHEST, INCLUDING SUBCUTANEOU
PLACEMENT, PROXIMAL OR DISTAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAIR, DESCENDING THORA
ANESTHESIA FOR PROCEDURES ON ANTERIOR INTEGUMENTARY SYSTEM OF CHEST, INCLUDING SUBCUTANEOU
URINALYSIS INFECTIOUS AGENT DETECTION, SEMI-QUANTITATIVE ANALYSIS OF VOLATILE COMPOUNDS
CEREBRAL PERFUSION ANAL USING COMPUTED TOMOGRAPHY W CONTRAST ADMIN, INCLUDING POST-PROCESS
CARBON MONOXIDE, EXPIRED GAS ANALYSIS (EG, ETCOC/HEMOLYSIS BREATH TEST)
WHOLE BODY INTEGUMENTARY PHOTOGRAPHY, AT REQUEST OF A PHYSICIAN, FOR MONITORING OF HIGH-RISK
ANESTHESIA FOR PROCEDURES ON CLAVICLE AND SCAPULA; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON CLAVICLE AND SCAPULA; RADICAL SURGERY
ANESTHESIA FOR PROCEDURES ON CLAVICLE AND SCAPULA; BIOPSY OF CLAVICLE
ANESTHESIA FOR PARTIAL RIB RESECTION; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PARTIAL RIB RESECTION; THORACOPLASTY (ANY TYPE)
ANESTHESIA FOR PARTIAL RIB RESECTION; RADICAL PROCEDURES (EG, PECTUS EXCAVATUM)
ANESTHESIA FOR ALL PROCEDURES ON ESOPHAGUS
ANESTHESIA FOR CLOSED CHEST PROCEDURES; (INCLUDING BRONCHOSCOPY) NOT OTHERWISE SPECIFIED
ANESTHESIA FOR CLOSED CHEST PROCEDURES (INCLUDING ESOPHAGOSCOPY, BRONCHOSCOPY, THORACOSC
ANESTHESIA FOR CLOSED CHEST PROCEDURES (INCLUDING ESOPHAGOSCOPY, BRONCHOSCOPY, THORACOSC
ANESTHESIA FOR CLOSED CHEST PROCEDURES; MEDIASTINOSCOPY AND DIAGNOSTIC THORACOSCOPY
ANESTHESIA FOR PERMANENT TRANSVENOUS PACEMAKER INSERTION
ANESTHESIA FOR ACCESS TO CENTRAL VENOUS CIRCULATION
ANESTHESIA FOR TRANSVENOUS INSERTION OR REPLACEMENT OF PACING CARDIOVERTER-DEFIBRILLATOR
ANESTHESIA FOR CARDIAC ELECTROPHYSIOLOGIC PROCEDURES INCLUDING RADIOFREQUENCY ABLATION
ANESTHESIA FOR TRACHEOBRONCHIAL RECONSTRUCTION
ANESTHESIA FOR THORACOTOMY PROCEDURES INVOLVING LUNGS, PLEURA, DIAPHRAGM, AND MEDIASTINUM (IN
ANESTHESIA FOR THORACOTOMY PROCEDURES INVOLVING LUNGS, PLEURA, DIAPHRAGM, AND MEDIASTINUM (IN
ANESTHESIA FOR THORACOTOMY PROCEDURES INVOLVING LUNGS, PLEURA, DIAPHRAGM, AND MEDIASTINUM; D
ANESTHESIA FOR THORACOTOMY PROCEDURES INVOLVING LUNGS, PLEURA, DIAPHRAGM, AND MEDIASTINUM; P
ANESTHESIA FOR THORACOTOMY PROCEDURES INVOLVING LUNGS, PLEURA, DIAPHRAGM, AND MEDIASTINUM; P
ANESTHESIA FOR THORACOTOMY PROCEDURES INVOLVING LUNGS, PLEURA, DIAPHRAGM, AND MEDIASTINUM (IN
ANESTHESIA FOR STERNAL DEBRIDEMENT
ANESTHESIA FOR PROCEDURES ON HEART, PERICARDIAL SAC, AND GREAT VESSELS OF CHEST; WITHOUT PUMP
ANESTHESIA FOR PROCEDURES ON HEART, PERICARDIAL SAC, AND GREAT VESSELS OF CHEST; WITH PUMP OXY
ANESTHESIA FOR PROCEDURES ON HEART, PERICARDIAL SAC, AND GREAT VESSELS OF CHEST; WITH PUMP OXY
ANESTHESIA FOR DIRECT CORONARY ARTERY BYPASS GRAFTING WITHOUT PUMP OXYGENATOR
ANESTHESIA FOR HEART TRANSPLANT OR HEART/LUNG TRANSPLANT
ANESTHESIA FOR PROCEDURES ON CERVICAL SPINE AND CORD; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON CERVICAL SPINE AND CORD; PROCEDURES WITH PATIENT IN THE SITTING PO
ANESTHESIA FOR PROCEDURES ON THORACIC SPINE AND CORD; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON THORACIC SPINE AND CORD; THORACOLUMBAR SYMPATHECTOMY
ANESTHESIA FOR PROCEDURES IN LUMBAR REGION; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES IN LUMBAR REGION; LUMBAR SYMPATHECTOMY
ANESTHESIA FOR PROCEDURES IN LUMBAR REGION; CHEMONUCLEOLYSIS
ANESTHESIA FOR PROCEDURES IN LUMBAR REGION; DIAGNOSTIC OR THERAPEUTIC LUMBAR PUNCTURE
ANESTHESIA FOR MANIPULATION OF THE SPINE OR FOR CLOSED PROCEDURES ON THE CERVICAL, THORACIC O
ANESTHESIA FOR EXTENSIVE SPINE AND SPINAL CORD PROCEDURES (EG, SPINAL INSTRUMENTATION OR VASCU
ANESTHESIA FOR PROCEDURES ON UPPER ANTERIOR ABDOMINAL WALL; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON UPPER ANTERIOR ABDOMINAL WALL; PERCUTANEOUS LIVER BIOPSY
ANESTHESIA FOR PROCEDURES ON UPPER POSTERIOR ABDOMINAL WALL
ANESTHESIA FOR UPPER GASTROINTESTINAL ENDOSCOPIC PROCEDURES, ENDOSCOPE INTRODUCED PROXIMA
ANESTHESIA FOR HERNIA REPAIRS IN UPPER ABDOMEN; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR HERNIA REPAIRS IN UPPER ABDOMEN; LUMBAR AND VENTRAL (INCISIONAL) HERNIAS AND/OR W
ANESTHESIA FOR HERNIA REPAIRS IN UPPER ABDOMEN; OMPHALOCELE
ANESTHESIA FOR HERNIA REPAIRS IN UPPER ABDOMEN; TRANSABDOMINAL REPAIR OF DIAPHRAGMATIC HERNIA
ANESTHESIA FOR ALL PROCEDURES ON MAJOR ABDOMINAL BLOOD VESSELS
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN UPPER ABDOMEN INCLUDING LAPAROSCOPY; NOT OTHER
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN UPPER ABDOMEN INCLUDING LAPAROSCOPY; PARTIAL HE
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN UPPER ABDOMEN INCLUDING LAPAROSCOPY; PANCREATE
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN UPPER ABDOMEN INCLUDING LAPAROSCOPY; LIVER TRAN
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN UPPER ABDOMEN INCLUDING LAPAROSCOPY; GASTRIC RE
ANESTHESIA FOR PROCEDURES ON LOWER ANTERIOR ABDOMINAL WALL; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON LOWER ANTERIOR ABDOMINAL WALL; PANNICULECTOMY
ANESTHESIA FOR LOWER INTESTINAL ENDOSCOPIC PROCEDURES, ENDOSCOPE INTRODUCED DISTAL TO DUODE
ANESTHESIA FOR PROCEDURES ON LOWER POSTERIOR ABDOMINAL WALL
ANESTHESIA FOR HERNIA REPAIRS IN LOWER ABDOMEN; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR HERNIA REPAIRS IN LOWER ABDOMEN; VENTRAL AND INCISIONAL HERNIAS
ANESTHESIA FOR HERNIA REPAIRS IN THE LOWER ABDOMEN NOT OTHERWISE SPECIFIED, UNDER 1 YEAR OF AG
ANESTHESIA FOR HERNIA REPAIRS IN THE LOWER ABDOMEN NOT OTHERWISE SPECIFIED, INFANTS LESS THAN 3
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN INCLUDING LAPAROSCOPY; NOT OTHER
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN INCLUDING LAPAROSCOPY; AMNIOCEN
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN INCLUDING LAPAROSCOPY; ABDOMINO
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN INCLUDING LAPAROSCOPY; RADICAL HY
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN INCLUDING LAPAROSCOPY; PELVIC EXE
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN INCLUDING LAPAROSCOPY; TUBAL LIGA
ANESTHESIA FOR EXTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN, INCLUDING URINARY TRACT; NOT OTH
ANESTHESIA FOR EXTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN, INCLUDING URINARY TRACT; RENAL P
ANESTHESIA FOR EXTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN, INCLUDING URINARY TRACT; TOTAL C
ANESTHESIA FOR EXTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN, INCLUDING URINARY TRACT; RADICAL
ANESTHESIA FOR EXTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN, INCLUDING URINARY TRACT; ADRENAL
ANESTHESIA FOR EXTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN, INCLUDING URINARY TRACT; RENAL T
ANESTHESIA FOR EXTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN, INCLUDING URINARY TRACT; CYSTOLI
ANESTHESIA FOR LITHOTRIPSY, EXTRACORPOREAL SHOCK WAVE; WITH WATER BATH
ANESTHESIA FOR LITHOTRIPSY, EXTRACORPOREAL SHOCK WAVE; WITHOUT WATER BATH
ANESTHESIA FOR PROCEDURES ON MAJOR LOWER ABDOMINAL VESSELS; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON MAJOR LOWER ABDOMINAL VESSELS; INFERIOR VENA CAVA LIGATION
ANESTHESIA FOR; ANORECTAL PROCEDURE
ANESTHESIA FOR; RADICAL PERINEAL PROCEDURE
ANESTHESIA FOR; VULVECTOMY
ANESTHESIA FOR; PERINEAL PROSTATECTOMY
ANESTHESIA FOR TRANSURETHRAL PROCEDURES (INCLUDING URETHROCYSTOSCOPY); NOT OTHERWISE SPEC
ANESTHESIA FOR TRANSURETHRAL PROCEDURES (INCLUDING URETHROCYSTOSCOPY); TRANSURETHRAL RESE
ANESTHESIA FOR TRANSURETHRAL PROCEDURES (INCLUDING URETHROCYSTOSCOPY); TRANSURETHRAL RESE
ANESTHESIA FOR TRANSURETHRAL PROCEDURES (INCLUDING URETHROCYSTOSCOPY); POST-TRANSURETHRAL
ANESTHESIA FOR TRANSURETHRAL PROCEDURES (INCLUDING URETHROCYSTOSCOPY); WITH FRAGMENTATION
ANESTHESIA FOR PROCEDURES ON MALE GENITALIA (INCLUDING OPEN URETHRAL PROCEDURES); NOT OTHERW
ANESTHESIA FOR PROCEDURES ON MALE GENITALIA (INCLUDING OPEN URETHRAL PROCEDURES); VASECTOMY,
ANESTHESIA FOR PROCEDURES ON MALE GENITALIA (INCLUDING OPEN URETHRAL PROCEDURES); SEMINAL VES
ANESTHESIA FOR PROCEDURES ON MALE GENITALIA (INCLUDING OPEN URETHRAL PROCEDURES); UNDESCENDE
ANESTHESIA FOR PROCEDURES ON MALE GENITALIA (INCLUDING OPEN URETHRAL PROCEDURES); RADICAL ORC
ANESTHESIA FOR PROCEDURES ON MALE GENITALIA (INCLUDING OPEN URETHRAL PROCEDURES); RADICAL ORC
ANESTHESIA FOR PROCEDURES ON MALE GENITALIA (INCLUDING OPEN URETHRAL PROCEDURES); ORCHIOPEXY
ANESTHESIA FOR PROCEDURES ON MALE GENITALIA (INCLUDING OPEN URETHRAL PROCEDURES); COMPLETE A
ANESTHESIA FOR PROCEDURES ON MALE GENITALIA (INCLUDING OPEN URETHRAL PROCEDURES); RADICAL AMP
ANESTHESIA FOR PROCEDURES ON MALE GENITALIA (INCLUDING OPEN URETHRAL PROCEDURES); RADICAL AMP
ANESTHESIA FOR PROCEDURES ON MALE GENITALIA (INCLUDING OPEN URETHRAL PROCEDURES); INSERTION O
ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF LABIA, VAGINA, CERVIX OR ENDOMETRIUM); NO
ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF LABIA, VAGINA, CERVIX OR ENDOMETRIUM); CO
ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF LABIA, VAGINA, CERVIX OR ENDOMETRIUM); VA
ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF LABIA, VAGINA, CERVIX OR ENDOMETRIUM); CE
ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF LABIA, VAGINA, CERVIX OR ENDOMETRIUM); CU
ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF LABIA, VAGINA, CERVIX OR ENDOMETRIUM); HY
ANESTHESIA FOR BONE MARROW ASPIRATION AND/OR BIOPSY, ANTERIOR OR POSTERIOR ILIAC CREST
ANESTHESIA FOR PROCEDURES ON BONY PELVIS
ANESTHESIA FOR BODY CAST APPLICATION OR REVISION
ANESTHESIA FOR INTERPELVIABDOMINAL (HINDQUARTER) AMPUTATION
ANESTHESIA FOR RADICAL PROCEDURES FOR TUMOR OF PELVIS, EXCEPT HINDQUARTER AMPUTATION
ANESTHESIA FOR CLOSED PROCEDURES INVOLVING SYMPHYSIS PUBIS OR SACROILIAC JOINT
ANESTHESIA FOR OPEN PROCEDURES INVOLVING SYMPHYSIS PUBIS OR SACROILIAC JOINT
ANESTHESIA FOR OBTURATOR NEURECTOMY; EXTRAPELVIC
ANESTHESIA FOR OBTURATOR NEURECTOMY; INTRAPELVIC
ANESTHESIA FOR ALL CLOSED PROCEDURES INVOLVING HIP JOINT
ANESTHESIA FOR ARTHROSCOPIC PROCEDURES OF HIP JOINT
ANESTHESIA FOR OPEN PROCEDURES INVOLVING HIP JOINT; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR OPEN PROCEDURES INVOLVING HIP JOINT; HIP DISARTICULATION
ANESTHESIA FOR OPEN PROCEDURES INVOLVING HIP JOINT; TOTAL HIP ARTHROPLASTY
ANESTHESIA FOR OPEN PROCEDURES INVOLVING HIP JOINT; REVISION OF TOTAL HIP ARTHROPLASTY
ANESTHESIA FOR ALL CLOSED PROCEDURES INVOLVING UPPER 2/3 OF FEMUR
ANESTHESIA FOR OPEN PROCEDURES INVOLVING UPPER 2/3 OF FEMUR; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR OPEN PROCEDURES INVOLVING UPPER 2/3 OF FEMUR; AMPUTATION
ANESTHESIA FOR OPEN PROCEDURES INVOLVING UPPER 2/3 OF FEMUR; RADICAL RESECTION
ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSA OF UPPER LEG
ANESTHESIA FOR ALL PROCEDURES INVOLVING VEINS OF UPPER LEG, INCLUDING EXPLORATION
ANESTHESIA FOR PROCEDURES INVOLVING ARTERIES OF UPPER LEG, INCLUDING BYPASS GRAFT; NOT OTHERW
ANESTHESIA FOR PROCEDURES INVOLVING ARTERIES OF UPPER LEG, INCLUDING BYPASS GRAFT; FEMORAL ART
ANESTHESIA FOR PROCEDURES INVOLVING ARTERIES OF UPPER LEG, INCLUDING BYPASS GRAFT; FEMORAL ART
ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSA OF KNEE AND/OR PO
ANESTHESIA FOR ALL CLOSED PROCEDURES ON LOWER 1/3 OF FEMUR
ANESTHESIA FOR ALL OPEN PROCEDURES ON LOWER 1/3 OF FEMUR
ANESTHESIA FOR ALL CLOSED PROCEDURES ON KNEE JOINT
ANESTHESIA FOR DIAGNOSTIC ARTHROSCOPIC PROCEDURES OF KNEE JOINT
ANESTHESIA FOR ALL CLOSED PROCEDURES ON UPPER ENDS OF TIBIA, FIBULA, AND/OR PATELLA
ANESTHESIA FOR ALL OPEN PROCEDURES ON UPPER ENDS OF TIBIA, FIBULA, AND/OR PATELLA
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON KNEE JOINT;NOT OTHERWISE SPECIFIE
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON KNEE JOINT;TOTAL KNEE ARTHROPLAS
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON KNEE JOINT;DISARTICULATION AT KNE
ANESTHESIA FOR ALL CAST APPLICATIONS, REMOVAL, OR REPAIR INVOLVING KNEE JOINT
ANESTHESIA FOR PROCEDURES ON VEINS OF KNEE AND POPLITEAL AREA; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON VEINS OF KNEE AND POPLITEAL AREA; ARTERIOVENOUS FISTULA
ANESTHESIA FOR PROCEDURES ON ARTERIES OF KNEE AND POPLITEAL AREA; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON ARTERIES OF KNEE AND POPLITEAL AREA; POPLITEAL THROMBOENDARTERE
ANESTHESIA FOR PROCEDURES ON ARTERIES OF KNEE AND POPLITEAL AREA; POPLITEAL EXCISION AND GRAFT
ANESTHESIA FOR ALL CLOSED PROCEDURES ON LOWER LEG, ANKLE, AND FOOT
ANESTHESIA FOR ARTHROSCOPIC PROCEDURES OF ANKLE AND/OR FOOT
ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, AND FASCIA OF LOWER LEG, ANKLE, AND FOO
ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, AND FASCIA OF LOWER LEG, ANKLE, AND FOO
ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, AND FASCIA OF LOWER LEG, ANKLE, AND FOO
ANESTHESIA FOR OPEN PROCEDURES ON BONES OF LOWER LEG, ANKLE, AND FOOT; NOT OTHERWISE SPECIFIE
ANESTHESIA FOR OPEN PROCEDURES ON BONES OF LOWER LEG, ANKLE, AND FOOT; RADICAL RESECTION (INCL
ANESTHESIA FOR OPEN PROCEDURES ON BONES OF LOWER LEG, ANKLE, AND FOOT; OSTEOTOMY OR OSTEOPL
ANESTHESIA FOR OPEN PROCEDURES ON BONES OF LOWER LEG, ANKLE, AND FOOT; TOTAL ANKLE REPLACEME
ANESTHESIA FOR LOWER LEG CAST APPLICATION, REMOVAL, OR REPAIR
ANESTHESIA FOR PROCEDURES ON ARTERIES OF LOWER LEG, INCLUDING BYPASS GRAFT; NOT OTHERWISE SPE
ANESTHESIA FOR PROCEDURES ON ARTERIES OF LOWER LEG, INCLUDING BYPASS GRAFT; EMBOLECTOMY, DIRE
ANESTHESIA FOR PROCEDURES ON VEINS OF LOWER LEG; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON VEINS OF LOWER LEG; VENOUS THROMBECTOMY, DIRECT OR CATHETER
ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSA OF SHOULDER AND A
ANESTHESIA FOR ALL CLOSED PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCLAVICULAR JOINT, ACROM
ANESTHESIA FOR DIAGNOSTIC ARTHROSCOPIC PROCEDURES OF SHOULDER JOINT
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCL
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCL
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCL
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCL
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCL
ANESTHESIA FOR PROCEDURES ON ARTERIES OF SHOULDER AND AXILLA; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON ARTERIES OF SHOULDER AND AXILLA; AXILLARY-BRACHIAL ANEURYSM
ANESTHESIA FOR PROCEDURES ON ARTERIES OF SHOULDER AND AXILLA; BYPASS GRAFT
ANESTHESIA FOR PROCEDURES ON ARTERIES OF SHOULDER AND AXILLA; AXILLARY-FEMORAL BYPASS GRAFT
ANESTHESIA FOR ALL PROCEDURES ON VEINS OF SHOULDER AND AXILLA
ANESTHESIA FOR SHOULDER CAST APPLICATION, REMOVAL OR REPAIR; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR SHOULDER CAST APPLICATION, REMOVAL OR REPAIR; SHOULDER SPICA
ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSA OF UPPER ARM AND ELB
ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSA OF UPPER ARM AND ELB
ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSA OF UPPER ARM AND ELB
ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSA OF UPPER ARM AND ELB
ANESTHESIA FOR ALL CLOSED PROCEDURES ON HUMERUS AND ELBOW
ANESTHESIA FOR DIAGNOSTIC ARTHROSCOPIC PROCEDURES OF ELBOW JOINT
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES OF THE ELBOW;NOT OTHERWISE SPECIFIE
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES OF THE ELBOW;OSTEOTOMY OF HUMERUS
ANESTHESIA FOR OPEN/SURGICAL ARTHROSCOPIC PROCEDURES, THE ELBOW;REPAIR, NONUNION/MALUNION, H
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES OF THE ELBOW;RADICAL PROCEDURES
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES OF THE ELBOW;EXCISION OF CYST OR TUM
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES OF THE ELBOW;TOTAL ELBOW REPLACEM
ANESTHESIA FOR PROCEDURES ON ARTERIES OF UPPER ARM AND ELBOW; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON ARTERIES OF UPPER ARM AND ELBOW; EMBOLECTOMY
ANESTHESIA FOR PROCEDURES ON VEINS OF UPPER ARM AND ELBOW; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON VEINS OF UPPER ARM AND ELBOW; PHLEBORRHAPHY
ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSA OF FOREARM, WRIST
ANESTHESIA FOR ALL CLOSED PROCEDURES ON RADIUS, ULNA, WRIST, OR HAND BONES
ANESTHESIA FOR DIAGNOSTIC ARTHROSCOPIC PROCEDURES ON THE WRIST
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC/ENDOSCOPIC PROCEDURES ON DISTAL RADIUS, DISTAL U
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC/ENDOSCOPIC PROCEDURES ON DISTAL RADIUS, DISTAL U
ANESTHESIA FOR PROCEDURES ON ARTERIES OF FOREARM, WRIST, AND HAND; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON ARTERIES OF FOREARM, WRIST, AND HAND; EMBOLECTOMY
ANESTHESIA FOR VASCULAR SHUNT, OR SHUNT REVISION, ANY TYPE (EG, DIALYSIS)
ANESTHESIA FOR PROCEDURES ON VEINS OF FOREARM, WRIST, AND HAND; NOT OTHERWISE SPECIFIED
ANESTHESIA FOR PROCEDURES ON VEINS OF FOREARM, WRIST, AND HAND; PHLEBORRHAPHY
ANESTHESIA FOR FOREARM, WRIST, OR HAND CAST APPLICATION, REMOVAL, OR REPAIR
ANESTHESIA FOR MYELOGRAPHY, DISKOGRAPHY, VERTEBROPLASTY
ANESTHESIA FOR DIAGNOSTIC ARTERIOGRAPHY/VENOGRAPHY
ANESTHESIA FOR CARDIAC CATHETERIZATION INCLUDING CORONARY ANGIOGRAPHY AND VENTRICULOGRAPHY
ANESTHESIA FOR NON-INVASIVE IMAGING OR RADIATION THERAPY
ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL RADIOLOGIC PROCEDURES INVOLVING THE ARTERIAL SYSTEM
ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL RADIOLOGIC PROCEDURES INVOLVING THE ARTERIAL SYSTEM
ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL RADIOLOGIC PROCEDURES INVOLVING THE ARTERIAL SYSTEM
ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL RADIOLOGIC PROCEDURES INVOLVING THE VENOUS/LYMPHA
ANES, THERAPEUTIC INTERVENEAL RADIOLOGIC PROCS INVOLV THE VENOUS/LYMPHATIC SYST (NOT INCL ACCS
ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL RADIOLOGIC PROCEDURES INVOLVING THE VENOUS/LYMPHA
ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL RADIOLOGIC PROCEDURES INVOLVING THE VENOUS/LYMPHA
ANESTHESIA, SECOND&THIRD DEGREE BURN EXCISION/DEBRIDEMENT WWO SKIN GRAFTING, ANY SITE,TOTAL B
ANESTHESIA, SECOND&THIRD DEGREE BURN EXCISION/DEBRIDEMENT WWO SKIN GRAFTING, ANY SITE,TOTAL B
ANESTHESIA, 2ND&3RD DEGREE BURN EXCISION/DEBRIDEMENT WWO SKIN GRAFTING, ANY SITE,TOTAL BODY SU
ANESTHESIA FOR; VAGINAL DELIVERY ONLY
ANESTHESIA FOR CESAREAN DELIVERY ONLY
ANESTHESIA FOR URGENT HYSTERECTOMY FOLLOWING DELIVERY
ANESTHESIA FOR CESAREAN HYSTERECTOMY WITHOUT ANY LABOR ANALGESIA/ANESTHESIA CARE
ANESTHESIA FOR ABORTION PROCEDURES
NEURAXIAL LABOR ANALGESIA/ANESTHESIA FOR PLANNED VAGINAL DELIVERY (THIS INCLUDES ANY REPEAT SUB
ANESTHESIA FOR CESAREAN DELIVERY FOLLOWING NEURAXIAL LABOR ANALGESIA/ANESTHESIA (LIST SEPARAT
ANESTHESIA FOR CESAREAN HYSTERECTOMY FOLLOWING NEURAXIAL LABOR ANALGESIA/ANESTHESIA (LIST SE
PHYSIOLOGICAL SUPPORT FOR HARVESTING OF ORGAN(S) FROM BRAIN-DEAD PATIENT
ANESTHESIA FOR DIAGNOSTIC OR THERAPEUTIC NERVE BLOCKS AND INJECTIONS (WHEN BLOCK OR INJECTION
ANESTHESIA FOR DIAGNOSTIC OR THERAPEUTIC NERVE BLOCKS AND INJECTIONS (WHEN BLOCK OR INJECTION
REGIONAL INTRAVENOUS ADMINISTRATION OF LOCAL ANESTHETIC AGENT OR OTHER MEDICATION
DAILY HOSPITAL MANAGEMENT OF EPIDURAL OR SUBARACHNOID CONTINUOUS DRUG ADMINISTRATION
UNLISTED ANESTHESIA PROCEDURE(S)
AMBULANCE SERVICE, OUTSIDE STATE PER MILE, TRANSPORT (MEDICAID ONLY)
NON-EMERGENCY TRANSPORTATION, PER MILE - VEHICLE PROVIDED BY VOLUNTEER (INDIVIDUAL OR ORGANIZA
NON-EMERGENCY TRANSPORTATION, PER MILE - VEHICLE PROVIDED BY INDIVIDUAL (FAMILY MEMBER, SELF, NEI
NON-EMERGENCY TRANSPORTATION; TAXI
NONEMERGENCY TRANSPORTATION AND BUS, INTRA- OR INTER STATE CARRIER
NON-EMERGENCY TRANSPORTATION: MINI-BUS, MOUNTAIN AREA TRANSPORTS, OR OTHER TRANSPORTATION S
NONEMERGENCY TRANSPORTATION: WHEELCHAIR VAN
NONEMERGENCY TRANSPORTATION AND AIR TRAVEL (PRIVATE OR COMMERCIAL) INTRA OR INTER STATE
NONEMERGENCY TRANSPORTATION: PER MILE - CASE WORKER OR SOCIAL WORKER
TRANSPORTATION ANCILLARY: PARKING FEES, TOLLS, OTHER
NONEMERGENCY TRANSPORTATION: ANCILLARY: LODGING-RECIPIENT
NONEMERGENCY TRANSPORTATION: ANCILLARY: MEALS-RECIPIENT
NONEMERGENCY TRANSPORTATION: ANCILLARY: LODGING ESCORT
NONEMERGENCY TRANSPORTATION: ANCILLARY: MEALS-ESCORT
AMBULANCE SERVICE, NEONATAL TRANSPORT, BASE RATE, EMERGENCY TRANSPORT, ONE WAY
BLS MILEAGE (PER MILE)
BLS ROUTINE DISPOSABLE SUPPLIES
BLS SPECIALIZED SERVICE DISPOSABLE SUPPLIES; DEFIBRILLATION (USED BY ALS AMBULANCES AND BLS AMBUL
ALS MILEAGE (PER MILE)
ALS SPECIALIZED SERVICE DISPOSABLE SUPPLIES; DEFIBRILLATION (TO BE USED ONLY IN JURISDICTIONS WHER
ALS SPECIALIZED SERVICE DISPOSABLE SUPPLIES; IV DRUG THERAPY
ALS SPECIALIZED SERVICE DISPOSABLE SUPPLIES; ESOPHAGEAL INTUBATION
ALS ROUTINE DISPOSABLE SUPPLIES
AMBULANCE WAITING TIME (ALS OR BLS), ONE HALF (1/2) HOUR INCREMENTS
AMBULANCE (ALS OR BLS) OXYGEN AND OXYGEN SUPPLIES, LIFE SUSTAINING SITUATION
EXTRA AMBULANCE ATTENDANT, GROUND (ALS OR BLS) OR AIR (FIXED OR ROTARY WINGED); (REQUIRES MEDIC
GROUND MILEAGE, PER STATUTE MILE
AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, NON-EMERGENCY TRANSPORT, LEVEL 1 (ALS 1)
AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, EMERGENCY TRANSPORT, LEVEL 1 (ALS1-EMERGENCY)
AMBULANCE SERVICE, BASIC LIFE SUPPORT, NON-EMERGENCY TRANSPORT (BLS)
AMBULANCE SERVICE, BASIC LIFE SUPPORT, EMERGENCY TRANSPORT (BLS-EMERGENCY)
AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (FIXED WING)
AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (ROTARY WING)
PARAMEDIC INTERCEPT (PI), RURAL AREA, TRANSPORT FURNISHED BY A VOLUNTEER AMBULANCE COMPANY WH
ADVANCED LIFE SUPPORT, LEVEL 2 (ALS 2)
SPECIALTY CARE TRANSPORT (SCT)
FIXED WING AIR MILEAGE, PER STATUTE MILE
ROTARY WING AIR MILEAGE, PER STATUTE MILE
NONCOVERED AMBULANCE MILEAGE, PER MILE (E.G., FOR MILES TRAVELED BEYOND CLOSEST APPROPRIATE FA
UNLISTED AMBULANCE SERVICE
SYRINGE WITH NEEDLE, STERILE 1CC, EACH
SYRINGE WITH NEEDLE, STERILE 2CC, EACH
SYRINGE WITH NEEDLE, STERILE 3CC, EACH
SYRINGE WITH NEEDLE, STERILE 5CC OR GREATER, EACH
NEEDLE-FREE INJECTION DEVICE, EACH
SUPPLIES FOR SELF-ADMINISTERED INJECTIONS
NON CORING NEEDLE OR STYLET WITH OR WITHOUT CATHETER
SYRINGE, STERILE, 20 CC OR GREATER, EACH
STERILE SALINE OR WATER, 30 CC VIAL
NEEDLES ONLY, STERILE, ANY SIZE, EACH
REFILL KIT FOR IMPLANTABLE INFUSION PUMP
SUPPLIES FOR MAINTENANCE OF DRUG INFUSION CATHETER, PER WEEK (LIST DRUG SEPARATELY)
SUPPLIES FOR EXTERNAL DRUG INFUSION PUMP, PER CASSETTE OR BAG (LIST DRUG SEPARATELY)
INFUSION SET FOR EXTERNAL INSULIN PUMP, NON NEEDLE CANNULA TYPE
INFUSION SET FOR EXTERNAL INSULIN PUMP, NEEDLE TYPE
SYRINGE WITH NEEDLE FOR EXTERNAL INSULIN PUMP, STERILE, 3CC
ALCOHOL OR PEROXIDE, PER PINT
ALCOHOL WIPES, PER BOX
BETADINE OR PHISOHEX SOLUTION, PER PINT
BETADINE OR IODINE SWABS/WIPES, PER BOX
URINE TEST OR REAGENT STRIPS OR TABLETS (100 TABLETS OR STRIPS)
BLOOD GLUCOSE TEST OR REAGENT STRIPS FOR HOME BLOOD GLUCOSE MONITOR, PER 50 STRIPS
REPLACEMENT BATTERY, ANY TYPE, FOR USE WITH MEDICALLY NECESSARY HOME BLOOD GLUCOSE MONITOR O
PLATFORMS FOR HOME BLOOD GLUCOSE MONITOR, 50 PER BOX
NORMAL, LOW AND HIGH CALIBRATOR SOLUTION/CHIPS
REPLACEMENT LENS SHIELD CARTRIDGE FOR USE WITH LASER SKIN PIERCING DEVICE, EACH
SPRING-POWERED DEVICE FOR LANCET, EACH
LANCETS, PER BOX OF 100
LEVONORGESTREL (CONTRACEPTIVE) IMPLANTS SYSTEM, INCLUDING IMPLANTS AND SUPPLIES
CERVICAL CAP FOR CONTRACEPTIVE USE
TEMPORARY, ABSORBABLE LACRIMAL DUCT IMPLANT, EACH
PERMANENT, LONG-TERM, NONDISSOLVABLE LACRIMAL DUCT IMPLANT, EACH
PARAFFIN, PER POUND
DIAPHRAGM FOR CONTRACEPTIVE USE
CONTRACEPTIVE SUPPLY, CONDOM, MALE, EACH
CONTRACEPTIVE SUPPLY, CONDOM, FEMALE, EACH
CONTRACEPTIVE SUPPLY, SPERMICIDE (E.G., FOAM, GEL), EACH
DISPOSABLE ENDOSCOPE SHEATH, EACH
ADHESIVE SKIN SUPPORT ATTACHMENT FOR USE WITH EXTERNAL BREAST PROSTHESIS, EACH
TUBING FOR BREAST PUMP, REPLACEMENT
ADAPTER FOR BREAST PUMP, REPLACEMENT
CAP FOR BREAST PUMP BOTTLE, REPLACEMENT
BREAST SHIELD AND SPLASH PROTECTOR FOR USE WITH BREAST PUMP, REPLACEMENT
POLYCARBONATE BOTTLE FOR USE WITH BREAST PUMP, REPLACEMENT
LOCKING RING FOR BREAST PUMP, REPLACEMENT
SACRAL NERVE STIMULATION TEST LEAD, EACH
IMPLANTABLE ACCESS CATHETER,(E.G., VENOUS, ARTERIAL, EPIDURAL SUBARACHNOID, OR PERITONEAL, ETC.) E
IMPLANTABLE ACCESS TOTAL CATHETER, PORT/RESERVOIR (E.G., VENOUS, ARTERIAL, EPIDURAL, SUBARACHNO
DISPOSABLE DRUG DELIVERY SYSTEM, FLOW RATE OF 50 ML OR GREATER PER HOUR
DISPOSABLE DRUG DELIVERY SYSTEM, FLOW RATE OF 5 ML OR LESS PER HOUR
INSERTION TRAY WITHOUT DRAINAGE BAG AND WITHOUT CATHETER (ACCESSORIES ONLY)
INSERTION TRAY WITHOUT DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, TWO-WAY LATEX WITH C
INSERTION TRAY WITHOUT DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, TWO-WAY, ALL SILICONE
INSERTION TRAY WITHOUT DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, THREE-WAY, FOR CONTI
INSERTION TRAY WITH DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, TWO-WAY LATEX WITH COAT
INSERTION TRAY WITH DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, TWO-WAY, ALL SILICONE
INSERTION TRAY WITH DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, THREE-WAY, FOR CONTINUO
STERILE WATER IRRIGATION SOLUTION, 1000 ML
IRRIGATION TRAY WITH BULB OR PISTON SYRINGE, ANY PURPOSE
THERAPEUTIC AGENT FOR URINARY CATHETER IRRIGATION
IRRIGATION SYRINGE, BULB OR PISTON, EACH
STERILE SALINE IRRIGATION SOLUTION, 1000 ML
MALE EXTERNAL CATHETER, WITH ADHESIVE COATING, EACH
MALE EXTERNAL CATHETER, WITH ADHESIVE STRIP, EACH
MALE EXTERNAL CATHETER SPECIALTY TYPE (E.G., INFLATABLE, FACEPLATE, ETC.), EACH
FEMALE EXTERNAL URINARY COLLECTION DEVICE; METAL CUP, EACH
FEMALE EXTERNAL URINARY COLLECTION DEVICE; POUCH, EACH
PERIANAL FECAL COLLECTION POUCH WITH ADHESIVE, EACH
EXTENSION DRAINAGE TUBING, ANY TYPE, ANY LENGTH, WITH CONNECTOR/ADAPTOR, FOR USE WITH URINARY L
LUBRICANT, INDIVIDUAL STERILE PACKET, FOR INSERTION OF URINARY CATHETER, EACH
URINARY CATHETER ANCHORING DEVICE, ADHESIVE SKIN ATTACHMENT, EACH
URINARY CATHETER ANCHORING DEVICE, LEG STRAP, EACH
INCONTINENCE SUPPLY; MISCELLANEOUS
INDWELLING CATHETER; FOLEY TYPE, TWO-WAY LATEX WITH COATING (TEFLON, SILICONE, SILICONE ELASTOME
INDWELLING CATHETER; SPECIALTY TYPE, (E.G., COUDE, MUSHROOM, WING, ETC.), EACH
INDWELLING CATHETER, FOLEY TYPE, TWO-WAY, ALL SILICONE, EACH
INDWELLING CATHETER; FOLEY TYPE, THREE WAY FOR CONTINUOUS IRRIGATION, EACH
MALE EXTERNAL CATHETER WITH OR WITHOUT ADHESIVE, WITH OR WITHOUT ANTI-REFLUX DEVICE; PER DOZEN
MALE EXTERNAL CATHETER WITH INTEGRAL COLLECTION COMPARTMENT, EXTENDED WEAR, EACH (E.G., 2 PER
INTERMITTENT URINARY CATHETER; STRAIGHT TIP, WITH OR WITHOUT COATING(TEFLON, SILICONE, SILICONE E
INTERMITTENT URINARY CATHETER; COUDE (CURVED) TIP, WITH OR WITHOUT COATING(TEFLON, SILICONE. SILIC
INTERMITTENT URINARY CATHETER, WITH INSERTION SUPPLIES
INSERTION TRAY WITH DRAINAGE BAG BUT WITHOUT CATHETER
IRRIGATION TUBING SET FOR CONTINUOUS BLADDER IRRIGATION THROUGH A THREE-WAY INDWELLING FOLEY C
EXTERNAL URETHRAL CLAMP OR COMPRESSION DEVICE (NOT TO BE USED FOR CATHETER CLAMP), EACH
BEDSIDE DRAINAGE BAG, DAY OR NIGHT, WITH OR WITHOUT ANTI-REFLUX DEVICE, WITH OR WITHOUT TUBE, EAC
URINARY DRAINAGE BAG, LEG OR ABDOMEN, VINYL, WITH OR WITHOUT TUBE, WITH STRAPS, EACH
URINARY SUSPENSORY WITHOUT LEG BAG, EACH
OSTOMY FACEPLATE, EACH
SKIN BARRIER; SOLID, FOUR BY FOUR OR EQUIVALENT; EACH
ADHESIVE, LIQUID OR EQUAL, ANY TYPE
ADHESIVE REMOVER WIPES, ANY TYPE, PER 50
OSTOMY BELT, EACH
OSTOMY FILTER, ANY TYPE, EACH
OSTOMY SKIN BARRIER, LIQUID (SPRAY, BRUSH, ETC), PER OZ
OSTOMY SKIN BARRIER, POWDER, PER OZ
OSTOMY SKIN BARRIER, SOLID 4X4 OR EQUIVALENT, WITH BUILT-IN CONVEXITY, EACH
OSTOMY SKIN BARRIER, WITH FLANGE (SOLID, FLEXIBLE OR ACCORDIAN), WITH BUILT-IN CONVEXITY, ANY SIZE,
OSTOMY POUCH, DRAINABLE, WITH FACEPLATE ATTACHED, PLASTIC, EACH
OSTOMY POUCH, DRAINABLE, WITH FACEPLATE ATTACHED, RUBBER, EACH
OSTOMY POUCH, DRAINABLE, FOR USE ON FACEPLATE, PLASTIC, EACH
OSTOMY POUCH, DRAINABLE, FOR USE ON FACEPLATE, RUBBER, EACH
OSTOMY POUCH, URINARY, WITH FACEPLATE ATTACHED, PLASTIC, EACH
OSTOMY POUCH, URINARY, WITH FACEPLATE ATTACHED, RUBBER, EACH
OSTOMY POUCH, URINARY, FOR USE ON FACEPLATE, PLASTIC, EACH
OSTOMY POUCH, URINARY, FOR USE ON FACEPLATE, HEAVY PLASTIC, EACH
OSTOMY POUCH, URINARY, FOR USE ON FACEPLATE, RUBBER, EACH
OSTOMY FACEPLATE EQUIVALENT, SILICONE RING, EACH
OSTOMY SKIN BARRIER, SOLID 4X4 OR EQUIVALENT, EXTENDED WEAR, WITHOUT BUILT-IN CONVEXITY, EACH
OSTOMY POUCH, CLOSED, WITH BARRIER ATTACHED, WITH BUILT-IN CONVEXITY (1 PIECE), EACH
OSTOMY POUCH, DRAINABLE, WITH EXTENDED WEAR BARRIER ATTACHED, (1 PIECE), EACH
OSTOMY POUCH, DRAINABLE, WITH BARRIER ATTACHED, WITH BUILT-IN CONVEXITY (1 PIECE), EACH
OSTOMY POUCH, DRAINABLE, WITH EXTENDED WEAR BARRIER ATTACHED, WITH BUILT-IN CONVEXITY (1 PIECE),
OSTOMY POUCH, URINARY, WITH EXTENDED WEAR BARRIER ATTACHED (1 PIECE), EACH
OSTOMY POUCH, URINARY, WITH STANDARD WEAR BARRIER ATTACHED, WITH BUILT-IN CONVEXITY (1 PIECE), EA
OSTOMY POUCH, URINARY, WITH EXTENDED WEAR BARRIER ATTACHED, WITH BUILT-IN CONVEXITY (1 PIECE), EA
OSTOMY DEODORANT FOR USE IN OSTOMY POUCH, LIQUID, PER FLUID OUNCE
OSTOMY DEODORANT FOR USE IN OSTOMY POUCH, SOLID, PER TABLET
OSTOMY BELT WITH PERISTOMAL HERNIA SUPPORT
IRRIGATION SUPPLY; SLEEVE, EACH
OSTOMY IRRIGATION SUPPLY; BAG, EACH
OSTOMY IRRIGATION SUPPLY; CONE/CATHETER, INCLUDING BRUSH
OSTOMY IRRIGATION SET
LUBRICANT, PER OUNCE
OSTOMY RING, EACH
OSTOMY SKIN BARRIER, NON-PECTIN BASED, PASTE, PER OUNCE
OSTOMY SKIN BARRIER, PECTIN-BASED, PASTE, PER OUNCE
OSTOMY SKIN BARRIER, WITH FLANGE (SOLID, FLEXIBLE, OR ACCORDION), EXTENDED WEAR, WITH BUILT-IN CON
OSTOMY SKIN BARRIER, WITH FLANGE (SOLID, FLEXIBLE OR ACCORDION), EXTENDED WEAR, WITH BUILT-IN CON
OSTOMY SKIN BARRIER, WITH FLANGE (SOLID, FLEXIBLE OR ACCORDION), EXTENDED WEAR, WITHOUT BUILT-IN
OSTOMY SKIN BARRIER, WITH FLANGE (SOLID, FLEXIBLE OR ACCORDION), EXTENDED WEAR, WITHOUT BUILT-IN
OSTOMY POUCH, DRAINABLE, HIGH OUTPUT, FOR USE ON A BARRIER WITH FLANGE (2 PIECE SYSTEM), WITH FILT
OSTOMY SKIN BARRIER, WITH FLANGE (SOLID, FLEXIBLE OR ACCORDION), WITHOUT BUILT-IN CONVEXITY, 4 X 4 IN
OSTOMY SKIN BARRIER, WITH FLANGE (SOLID, FLEXIBLE OR ACCORDION), WITHOUT BUILT-IN CONVEXITY, LARGE
OSTOMY SUPPLY; MISCELLANEOUS
OSTOMY ABSORBENT MATERIAL (SHEET/PAD/CRYSTAL PACKET) FOR USE IN OSTOMY POUCH TO THICKEN LIQUID
TAPE, NON-WATERPROOF, PER 18 SQUARE INCHES
TAPE, WATERPROOF, PER 18 SQUARE INCHES
ADHESIVE REMOVER OR SOLVENT (FOR TAPE, CEMENT OR OTHER ADHESIVE), PER OUNCE
ENEMA BAG WITH TUBING, REUSABLE
ABDOMINAL DRESSING HOLDER, EACH
NONELASTIC BINDER FOR EXTREMITY
GRAVLEE JET WASHER
VABRA ASPIRATOR
TRACHEOSTOMA FILTER, ANY TYPE, ANY SIZE, EACH
MOISTURE EXCHANGER, DISPOSABLE, FOR USE WITH INVASIVE MECHANICAL VENTILATION
SURGICAL STOCKINGS ABOVE KNEE LENGTH, EACH
SURGICAL STOCKINGS THIGH LENGTH, EACH
SURGICAL STOCKINGS BELOW KNEE LENGTH, EACH
SURGICAL STOCKINGS FULL-LENGTH, EACH
ADULT-SIZED INCONTINENCE PRODUCT, DIAPER, SMALL SIZE, EACH
ADULT-SIZED INCONTINENCE PRODUCT, DIAPER, MEDIUM SIZE, EACH
ADULT-SIZED INCONTINENCE PRODUCT, DIAPER, LARGE SIZE, EACH
ADULT-SIZED INCONTINENCE PRODUCT, DIAPER, EXTRA LARGE SIZE, EACH
ADULT-SIZED INCONTINENCE PRODUCT, BRIEF, SMALL SIZE, EACH
ADULT-SIZED INCONTINENCE PRODUCT, BRIEF, MEDIUM SIZE, EACH
ADULT-SIZED INCONTINENCE PRODUCT, BRIEF, LARGE SIZE, EACH
ADULT-SIZED INCONTINENCE PRODUCT, BRIEF, EXTRA-LARGE SIZE, EACH
CHILD-SIZED INCONTINENCE PRODUCT, DIAPER, SMALL/MEDIUM SIZE, EACH
CHILD-SIZED INCONTINENCE PRODUCT, DIAPER, LARGE SIZE, EACH
CHILD-SIZED INCONTINENCE PRODUCT, BRIEF, SMALL/MEDIUM SIZE, EACH
CHILD-SIZED INCONTINENCE PRODUCT, BRIEF, LARGE SIZE, EACH
YOUTH-SIZED INCONTINENCE PRODUCT, DIAPER, EACH
YOUTH-SIZED INCONTINENCE PRODUCT, BRIEF, EACH
DISPOSABLE LINER/SHIELD FOR INCONTINENCE, EACH
PROTECTIVE UNDERWEAR, WASHABLE, ANY SIZE, EACH
UNDER PAD, REUSABLE/WASHABLE, ANY SIZE, EACH
DIAPER SERVICE, REUSABLE DIAPER, EACH DIAPER
SURGICAL TRAYS
DISPOSABLE UNDERPADS, ALL SIZES, (E.G., CHUX'S)
ELECTRODES (E.G., APNEA MONITOR), PER PAIR
LEAD WIRES (E.G., APNEA MONITOR), PER PAIR
CONDUCTIVE PASTE OR GEL
PESSARY, RUBBER, ANY TYPE
PESSARY, NON RUBBER, ANY TYPE
SLINGS
SPLINT
TOPICAL HYPERBARIC OXYGEN CHAMBER, DISPOSABLE
CAST SUPPLIES (E.G. PLASTER)
SPECIAL CASTING MATERIAL (E.G. FIBERGLASS)
ELECTRICAL STIMULATOR SUPPLIES, 2 LEAD, PER MONTH, (E.G. TENS, NMES)
OXYGEN PROBE FOR USE WITH OXIMETER DEVICE, REPLACEMENT
TRANSTRACHEAL OXYGEN CATHETER, EACH
TRACHEAL SUCTION CATHETER, CLOSED SYSTEM, FOR LESS THAN 72 HOURS OF USE, EACH
TRACHEAL SUCTION CATHETER, CLOSED SYSTEM, FOR 72 OR MORE HOURS OF USE, EACH
BATTERY, HEAVY DUTY; REPLACEMENT FOR PATIENT OWNED VENTILATOR
BATTERY CABLES; REPLACEMENT FOR PATIENT-OWNED VENTILATOR
BATTERY CHARGER; REPLACEMENT FOR PATIENT-OWNED VENTILATOR
PEAK EXPIRATORY FLOW RATE METER, HAND HELD
CANNULA, NASAL
TUBING (OXYGEN), PER FOOT
MOUTH PIECE
BREATHING CIRCUITS
FACE TENT
VARIABLE CONCENTRATION MASK
TRACHEOSTOMY MASK OR COLLAR
TRACHEOSTOMY OR LARYNGECTOMY TUBE
TRACHEOSTOMY, INNER CANNULA (REPLACEMENT ONLY)
TRACHEAL SUCTION CATHETER, ANY TYPE OTHER THAN CLOSED SYSTEM, EACH
TRACHEOSTOMY CARE KIT FOR NEW TRACHEOSTOMY
TRACHEOSTOMY CLEANING BRUSH, EACH
SPACER, BAG OR RESERVOIR, WITH OR WITHOUT MASK, FOR USE WITH METERED DOSE INHALER
OROPHARYNGEAL SUCTION CATHETER, EACH
TRACHEOSTOMY CARE KIT FOR ESTABLISHED TRACHEOSTOMY
REPLACEMENT BATTERIES FOR MEDICALLY NECESSARY TRANSCUTANEOUS ELECTRICAL NERVE STIMULATOR (T
REPLACEMENT BATTERIES FOR MEDICALLY NECESSARY ELECTRONIC WHEEL CHAIR OWNED BY PATIENT
REPLACEMENT BATTERY FOR EXTERNAL INFUSION PUMP, ANY TYPE, EACH
REPLACEMENT BULB/LAMP FOR ULTRAVIOLET LIGHT THERAPY SYSTEM, EACH
REPLACEMENT BULB FOR THERAPEUTIC LIGHT BOX, TABLETOP MODEL
UNDERARM PAD, CRUTCH, REPLACEMENT, EACH
REPLACEMENT, HANDGRIP, CANE, CRUTCH, OR WALKER, EACH
REPLACEMENT, TIP, CANE, CRUTCH, WALKER, EACH
REPLACEMENT PAD FOR INFRARED HEATING PAD SYSTEM, EACH
REPLACEMENT PAD FOR USE WITH MEDICALLY NECESSARY ALTERNATING PRESSURE PAD OWNED BY PATIENT
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, NOT OTHERWISE CLASSIFIED
SUPPLY OF SATUMOMAB PENDETIDE, RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, PER DOSE
SUPPLY OF ADDITIONAL HIGH DOSE CONTRAST MATERIAL(S) DURING MAGNETIC RESONANCE IMAGING, E.G., GAD
SUPPLY OF LOW OSMOLAR CONTRAST MATERIAL (100-199 MG OF IODINE)
SUPPLY OF LOW OSMOLAR CONTRAST MATERIAL (200-299 MG OF IODINE)
SUPPLY OF LOW OSMOLAR CONTRAST MATERIAL (300-399 MG OF IODINE)
SUPPLY OF PARAMAGNETIC CONTRAST MATERIAL (E.G., GADOLINIUM)
SURGICAL SUPPLY; MISCELLANEOUS
CALIBRATED MICROCAPILLARY TUBE, EACH
MICROCAPILLARY TUBE SEALANT
PERITONEAL DIALYSIS CATHETER ANCHORING DEVICE, BELT, EACH
NEEDLE, ANY SIZE, EACH
SYRINGE, WITH OR WITHOUT NEEDLE, EACH
SPHYGMOMANOMETER/BLOOD PRESSURE APPARATUS WITH CUFF AND STETHOSCOPE
BLOOD PRESSURE CUFF ONLY
AUTOMATIC BLOOD PRESSURE MONITOR
ACTIVATED CARBON FILTER FOR HEMODIALYSIS, EACH
DIALYZER (ARTIFICIAL KIDNEYS), ALL TYPES, ALL SIZES, FOR HEMODIALYSIS, EACH
BICARBONATE CONCENTRATE, SOLUTION, FOR HEMODIALYSIS, PER GALLON
BICARBONATE CONCENTRATE, POWDER, FOR HEMODIALYSIS, PER PACKET
ACETATE CONCENTRATE SOLUTION, FOR HEMODIALYSIS, PER GALLON
ACID CONCENTRATE, SOLUTION, FOR HEMODIALYSIS, PER GALLON
WATER, STERILE, FOR INJECTION, PER 10 ML
TREATED WATER (DEIONIZED, DISTILLED, OR REVERSE OSMOSIS) FOR PERITONEALDIALYSIS, PER GALLON
Y SET TUBING FOR PERITONEAL DIALYSIS
DIALYSATE SOLUTION, ANY CONCENTRATION OF DEXTROSE, FLUID VOLUME GREATER THAN 249CC, BUT LESS TH
DIALYSATE SOLUTION, ANY CONCENTRATION OF DEXTROSE, FLUID VOLUME GREATER THAN 999CC, BUT LESS TH
DIALYSATE SOLUTION, ANY CONCENTRATION OF DEXTROSE, FLUID VOLUME GREATER THAN 1999CC, BUT LESS T
DIALYSATE SOLUTION, ANY CONCENTRATION OF DEXTROSE, FLUID VOLUME GREATER THAN 2999CC, BUT LESS T
DIALYSATE SOLUTION, ANY CONCENTRATION OF DEXTROSE, FLUID VOLUME GREATER THAN 3999CC, BUT LESS T
DIALYSATE SOLUTION, ANY CONCENTRATION OF DEXTROSE, FLUID VOLUME GREATER THAN 4999CC, BUT LESS T
DIALYSATE SOLUTION, ANY CONCENTRATION OF DEXTROSE, FLUID VOLUME GREATER THAN 5999CC, FOR PERIT
FISTULA CANNULATION SET FOR HEMODIALYSIS, EACH
TOPICAL ANESTHETIC, FOR DIALYSIS, PER GRAM
INJECTABLE ANESTHETIC, FOR DIALYSIS, PER 10 ML
SHUNT ACCESSORY, FOR HEMODIALYSIS, ANY TYPE, EACH
BLOOD TUBING, ARTERIAL OR VENOUS, FOR HEMODIALYSIS, EACH
BLOOD TUBING, ARTERIAL AND VENOUS COMBINED, FOR HEMODIALYSIS, EACH
DIALYSATE SOLUTION TEST KIT, FOR PERITONEAL DIALYSIS, ANY TYPE, EACH
DIALYSATE CONCENTRATE, POWDER, ADDITIVE FOR PERITONEAL DIALYSIS, PER PACKET
DIALYSATE CONCENTRATE, SOLUTION, ADDITIVE FOR PERITONEAL DIALYSIS, PER 10 ML
BLOOD COLLECTION TUBE, VACUUM, FOR DIALYSIS, PER 50
SERUM CLOTTING TIME TUBE, FOR DIALYSIS, PER 50
BLOOD GLUCOSE TEST STRIPS, FOR DIALYSIS, PER 50
OCCULT BLOOD TEST STRIPS, FOR DIALYSIS, PER 50
AMMONIA TEST STRIPS, FOR DIALYSIS, PER 50
PROTAMINE SULFATE, FOR HEMODIALYSIS, PER 50 MG
DISPOSABLE CATHETER TIPS FOR PERITONEAL DIALYSIS, PER 10
PLUMBING AND/OR ELECTRICAL WORK FOR HOME HEMODIALYSIS EQUIPMENT
CONTRACTS, REPAIR AND MAINTENANCE, FOR HEMODIALYSIS EQUIPMENT
DRAIN BAG/BOTTLE, FOR DIALYSIS, EACH
MISCELLANEOUS DIALYSIS SUPPLIES, NOT OTHERWISE SPECIFIED
VENOUS PRESSURE CLAMP, FOR HEMODIALYSIS, EACH
GLOVES, NON-STERILE, PER 100
SURGICAL MASK, PER 20
TOURNIQUET FOR DIALYSIS, EACH
GLOVES, STERILE, PER PAIR
ORAL THERMOMETER, REUSABLE, ANY TYPE, EACH
RECTAL THERMOMETER, REUSABLE, ANY TYPE, EACH
OSTOMY POUCH, CLOSED; WITH BARRIER ATTACHED (1 PIECE), EACH
OSTOMY POUCH, CLOSED; WITHOUT BARRIER ATTACHED (1 PIECE), EACH
OSTOMY POUCH, CLOSED; FOR USE ON FACEPLATE, EACH
OSTOMY POUCH, CLOSED; FOR USE ON BARRIER WITH FLANGE (2 PIECE), EACH
STOMA CAP
OSTOMY POUCH, DRAINABLE; WITH BARRIER ATTACHED, (1 PIECE), EACH
OSTOMY POUCH, DRAINABLE; WITHOUT BARRIER ATTACHED (1 PIECE), EACH
OSTOMY POUCH, DRAINABLE; FOR USE ON BARRIER WITH FLANGE (2 PIECE SYSTEM), EACH
OSTOMY POUCH, URINARY; WITH BARRIER ATTACHED (1 PIECE), EACH
OSTOMY POUCH, URINARY; WITHOUT BARRIER ATTACHED (1 PIECE), EACH
OSTOMY POUCH, URINARY; FOR USE ON BARRIER WITH FLANGE (2 PIECE), EACH
CONTINENT DEVICE; PLUG FOR CONTINENT STOMA
CONTINENT DEVICE; CATHETER FOR CONTINENT STOMA
OSTOMY ACCESSORY; CONVEX INSERT
BEDSIDE DRAINAGE BOTTLE WITH OR WITHOUT TUBING, RIGID OR EXPANDABLE, EACH
URINARY SUSPENSORY; WITH LEG BAG, WITH OR WITHOUT TUBE
URINARY LEG BAG; LATEX
LEG STRAP; LATEX, REPLACEMENT ONLY, PER SET
LEG STRAP; FOAM OR FABRIC, REPLACEMENT ONLY, PER SET
SKIN BARRIER; WIPES, BOX PER 50
SKIN BARRIER; SOLID, 6 X 6 OR EQUIVALENT, EACH
SKIN BARRIER; SOLID, 8 X 8 OR EQUIVALENT, EACH
ADHESIVE OR NON-ADHESIVE; DISK OR FOAM PAD
APPLIANCE CLEANER, INCONTINENCE AND OSTOMY APPLIANCES, PER 16 OZ.
PERCUTANEOUS CATHETER/TUBE ANCHORING DEVICE, ADHESIVE SKIN ATTACHMENT
FOR DIABETICS ONLY, FITTING (INCLUDING FOLLOW-UP), CUSTOM PREPARATION AND SUPPLY OF OFF-THE-SHEL
FOR DIABETICS ONLY, FITTING (INCLUDING FOLLOW-UP), CUSTOM PREPARATION AND SUPPLY OF SHOE MOLDED
FOR DIABETICS ONLY, MODIFICATION (INCLUDING FITTING) OF OFF-THE-SHELF DEPTH-INLAY SHOE OR CUSTOM M
FOR DIABETICS ONLY, MODIFICATION (INCLUDING FITTING) OF OFF-THE-SHELF DEPTH-INLAY SHOE OR CUSTOM M
FOR DIABETICS ONLY, MODIFICATION (INCLUDING FITTING) OF OFF-THE-SHELF DEPTH-INLAY SHOE OR CUSTOM M
FOR DIABETICS ONLY, MODIFICATION (INCLUDING FITTING) OF OFF-THE-SHELF DEPTH-INLAY SHOE OR CUSTOM M
FOR DIABETICS ONLY, NOT OTHERWISE SPECIFIED MODIFICATION (INCLUDING FITTING) OF OFF-THE-SHELF DEPT
FOR DIABETICS ONLY, DELUXE FEATURE OF OFF-THE-SHELF DEPTH-INLAY SHOE OR CUSTOM MOLDED SHOE, PE
FOR DIABETICS ONLY, DIRECT FORMED, MOLDED TO FOOT WITH EXTERNAL HEAT SOURCE (I.E. HEAT GUN) MULT
FOR DIABETICS ONLY, DIRECT FORMED, COMPRESSION MOLDED TO PATIENT'S FOOT WITHOUT EXTERNAL HEAT
FOR DIABETICS ONLY, CUSTOM-MOLDED FROM MODEL OF PATIENT'S FOOT, MULTIPLE DENSITY INSERT(S), CUST
NON-CONTACT WOUND WARMING WOUND COVER FOR USE WITH THE NON-CONTACT WOUND WARMING DEVICE
COLLAGEN BASED WOUND FILLER, DRY FORM, PER GRAM OF COLLAGEN
COLLAGEN BASED WOUND FILLER, GEL/PASTE, PER GRAM OF COLLAGEN
COLLAGEN DRESSING, PAD SIZE 16 SQ. IN. OR LESS, EACH
COLLAGEN DRESSING, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACH
COLLAGEN DRESSING, PAD SIZE MORE THAN 48 SQ. IN., EACH
COLLAGEN DRESSING WOUND FILLER, PER 6 INCHES
SILICONE GEL SHEET, EACH
WOUND POUCH, EACH
ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, EACH DRESSING
ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THA
ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., EACH DRESSI
ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND FILLER, PER 6 INCHES
COMPOSITE DRESSING, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING
COMPOSITE DRESSING, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., WITHOUT ADHE
COMPOSITE DRESSING, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING
COMPOSITE DRESSING, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING
COMPOSITE DRESSING, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., WITH ANY SIZE
COMPOSITE DRESSING, PAD SIZE MORE THAN 48 SQ. IN., WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING
CONTACT LAYER, 16 SQ. IN. OR LESS, EACH DRESSING
CONTACT LAYER, MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACH DRESSING
CONTACT LAYER, MORE THAN 48 SQ. IN., EACH DRESSING
FOAM DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING
FOAM DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., WITH
FOAM DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSIN
FOAM DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BORDER, EACH DRESS
FOAM DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., WITH
FOAM DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., WITH ANY SIZE ADHESIVE BORDER, EACH DR
FOAM DRESSING, WOUND FILLER, PER GRAM
GAUZE, NON-IMPREGNATED, NON-STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DR
GAUZE, NON-IMPREGNATED, NON-STERILE, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ
GAUZE, NON-IMPREGNATED, NON-STERILE, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH
GAUZE, NON-IMPREGNATED, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING
GAUZE, NON-IMPREGNATED, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., WITH ANY
GAUZE, NON-IMPREGNATED, PAD SIZE MORE THAN 48 SQ. IN., WITH ANY SIZE ADHESIVE BORDER, EACH DRESSIN
GAUZE, IMPREGNATED WITH OTHER THAN WATER, NORMAL SALINE, OR HYDROGEL, PAD SIZE 16 SQ. IN. OR LESS
GAUZE, IMPREGNATED WITH OTHER THAN WATER, NORMAL SALINE, OR HYDROGEL, PAD SIZE MORE THAN 16 SQ
GAUZE, IMPREGNATED WITH OTHER THAN WATER, NORMAL SALINE, OR HYDROGEL, PAD SIZE MORE THAN 48 SQ
GAUZE, IMPREGNATED, WATER OR NORMAL SALINE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER,
GAUZE, IMPREGNATED, WATER OR NORMAL SALINE, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL
GAUZE, IMPREGNATED, WATER OR NORMAL SALINE, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORD
GAUZE, IMPREGNATED, HYDROGEL, FOR DIRECT WOUND CONTACT, PAD SIZE 16 SQ. IN. OR LESS, EACH DRESSIN
GAUZE, IMPREGNATED, HYDROGEL, FOR DIRECT WOUND CONTACT, PAD SIZE GREATER THAN 16 SQ. IN., BUT LES
GAUZE, IMPREGNATED, HYDROGEL FOR DIRECT WOUND CONTACT, PAD SIZE MORE THAN 48 SQ. IN., EACH DRES
HYDROCOLLOID DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH D
HYDROCOLLOID DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ
HYDROCOLLOID DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EAC
HYDROCOLLOID DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BORDER, EA
HYDROCOLLOID DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ
HYDROCOLLOID DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., WITH ANY SIZE ADHESIVE BORDER
HYDROCOLLOID DRESSING, WOUND FILLER, PASTE, PER FLUID OUNCE
HYDROCOLLOID DRESSING, WOUND FILLER, DRY FORM, PER GRAM
HYDROGEL DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESS
HYDROGEL DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN.
HYDROGEL DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DR
HYDROGEL DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BORDER, EACH D
HYDROGEL DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN.
HYDROGEL DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., WITH ANY SIZE ADHESIVE BORDER, EAC
HYDROGEL DRESSING, WOUND FILLER, GEL, PER FLUID OUNCE
SKIN SEALANTS, PROTECTANTS, MOISTURIZERS, OINTMENTS, ANY TYPE, ANY SIZE
SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER
SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL
SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORD
SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BOR
SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL
SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, PAD SIZE MORE THAN 48 SQ. IN., WITH ANY SIZE ADHESIVE
TRANSPARENT FILM, 16 SQ. IN. OR LESS, EACH DRESSING
TRANSPARENT FILM, MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACH DRESSING
TRANSPARENT FILM, MORE THAN 48 SQ. IN., EACH DRESSING
WOUND CLEANSERS, ANY TYPE, ANY SIZE
WOUND FILLER, GEL/PASTE, PER FLUID OUNCE, NOT ELSEWHERE CLASSIFIED
WOUND FILLER, DRY FORM, PER GRAM, NOT ELSEWHERE CLASSIFIED
GAUZE, IMPREGNATED, OTHER THAN WATER, NORMAL SALINE, OR ZINC PASTE, ANY WIDTH, PER LINEAR YARD
GAUZE, NON-IMPREGNATED, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSIN
GAUZE, NON-IMPREGNATED, STERILE, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., W
GAUZE, NON-IMPREGNATED, STERILE, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRE
EYE PAD, STERILE, EACH
EYE PAD, NON-STERILE, EACH
EYE PATCH, OCCLUSIVE, EACH
PADDING BANDAGE, NON-ELASTIC, NON-WOVEN/NON-KNITTED, WIDTH GREATER THAN OR EQUAL TO 3 INCHES A
CONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, NON-STERILE, WIDTH GREATER THAN OR EQUAL TO 3
ONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, NON-STERILE, WIDTH GREATER THAN OR EQUAL TO 5 IN
CONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, STERILE WIDTH GREATER THAN OR EQUAL TO 3 INCHE
CONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, STERILE, WIDTH GREATER THAN OR EQUAL TO 5 INCH
LIGHT COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, LOAD RESISTANCE < 1.25 FOOT POUNDS AT 50% MA
LIGHT COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, LOAD RESISTANCE < 1.25 FT LBS AT 50% MAX STRET
MODERATE COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, LOAD RESISTANCE OF 1.25 - 1.34 FOOT POUND
HIGH COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, LOAD RESISTANCE >/= 1.35 FOOT POUNDS AT 50% MA
SELF-ADHERENT BANDAGE, ELASTIC, NON-KNITTED/NON-WOVEN, LOAD RESISTANCE >/= 0.55 FOOT POUNDS AT 5
ZINC PASTE IMPREGNATED BANDAGE, NON-ELASTIC, KNITTED/WOVEN, WIDTH GREATER THAN OR EQUAL TO 3 IN
COMPRESSION BURN GARMENT, BODYSUIT (HEAD TO FOOT), CUSTOM FABRICATED
COMPRESSION BURN GARMENT, CHIN STRAP, CUSTOM FABRICATED
COMPRESSION BURN GARMENT, FACIAL HOOD, CUSTOM FABRICATED
COMPRESSION BURN GARMENT, GLOVE TO WRIST, CUSTOM FABRICATED
COMPRESSION BURN GARMENT, GLOVE TO ELBOW, CUSTOM FABRICATED
COMPRESSION BURN GARMENT, GLOVE TO AXILLA, CUSTOM FABRICATED
COMPRESSION BURN GARMENT, FOOT TO KNEE LENGTH, CUSTOM FABRICATED
COMPRESSION BURN GARMENT, FOOT TO THIGH LENGTH, CUSTOM FABRICATED
COMPRESSION BURN GARMENT, UPPER TRUNK TO WAIST INCLUDING ARM OPENINGS (VEST), CUSTOM FABRICAT
COMPRESSION BURN GARMENT, TRUNK, INCLUDING ARMS DOWN TO LEG OPENINGS (LEOTARD), CUSTOM FABRI
COMPRESSION BURN GARMENT, LOWER TRUNK INCLUDING LEG OPENINGS (PANTY), CUSTOM FABRICATED
COMPRESSION BURN GARMENT, NOT OTHERWISE CLASSIFIED
CANISTER, DISPOSABLE, USED WITH SUCTION PUMP, EACH
CANISTER, NON-DISPOSABLE, USED WITH SUCTION PUMP, EACH
TUBING, USED WITH SUCTION PUMP, EACH
ADMINISTRATION SET, WITH SMALL VOLUME NONFILTERED PNEUMATIC NEBULIZER, DISPOSABLE
SMALL VOLUME NONFILTERED PNEUMATIC NEBULIZER, DISPOSABLE
ADMINISTRATION SET, WITH SMALL VOLUME NONFILTERED PNEUMATIC NEBULIZER, NON-DISPOSABLE
ADMINISTRATION SET, WITH SMALL VOLUME FILTERED PNEUMATIC NEBULIZER
LARGE VOLUME NEBULIZER, DISPOSABLE, UNFILLED, USED WITH AEROSOL COMPRESSOR
LARGE VOLUME NEBULIZER, DISPOSABLE, PREFILLED, USED WITH AEROSOL COMPRESSOR
RESERVOIR BOTTLE, NON-DISPOSABLE, USED WITH LARGE VOLUME ULTRASONIC NEBULIZER
CORRUGATED TUBING, DISPOSABLE, USED WITH LARGE VOLUME NEBULIZER, 100 FEET
CORRUGATED TUBING, NON-DISPOSABLE, USED WITH LARGE VOLUME NEBULIZER, 10 FEET
WATER COLLECTION DEVICE, USED WITH LARGE VOLUME NEBULIZER
FILTER, DISPOSABLE, USED WITH AEROSOL COMPRESSOR
FILTER, NONDISPOSABLE, USED WITH AEROSOL COMPRESSOR OR ULTRASONIC GENERATOR
AEROSOL MASK, USED WITH DME NEBULIZER
DOME AND MOUTHPIECE, USED WITH SMALL VOLUME ULTRASONIC NEBULIZER
NEBULIZER, DURABLE, GLASS OR AUTOCLAVABLE PLASTIC, BOTTLE TYPE, NOT USED WITH OXYGEN
WATER, DISTILLED, USED WITH LARGE VOLUME NEBULIZER, 1000 ML
SALINE SOLUTION, PER 10 ML, METERED DOSE DISPENSER, FOR USE WITH INHALATION DRUGS
STERILE WATER OR STERILE SALINE, 1000 ML, USED WITH LARGE VOLUME NEBULIZER
HIGH FREQUENCY CHEST WALL OSCILLATION SYSTEM VEST, REPLACEMENT FOR USE WITH PATIENT OWNED EQ
HIGH FREQUENCY CHEST WALL OSCILLATION SYSTEM HOSE, REPLACEMENT FOR USE WITH PATIENT OWNED EQ
FULL FACE MASK USED WITH POSITIVE AIRWAY PRESSURE DEVICE, EACH
FACE MASK INTERFACE, REPLACEMENT FOR FULL FACE MASK, EACH
REPLACEMENT CUSHION FOR NASAL APPLICATION DEVICE, EACH
REPLACEMENT PILLOWS FOR NASAL APPLICATION DEVICE, PAIR
NASAL INTERFACE (MASK OR CANNULA TYPE) USED WITH POSITIVE AIRWAY PRESSURE DEVICE, WITH OR WITHO
HEADGEAR USED WITH POSITIVE AIRWAY PRESSURE DEVICE
CHINSTRAP USED WITH POSITIVE AIRWAY PRESSURE DEVICE
TUBING USED WITH POSITIVE AIRWAY PRESSURE DEVICE
FILTER, DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE
FILTER, NON DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE
IMPLANTED PLEURAL CATHETER, EACH
VACUUM DRAINAGE BOTTLE AND TUBING FOR USE WITH IMPLANTED CATHETER
ORAL INTERFACE USED WITH POSITIVE AIRWAY PRESSURE DEVICE, EACH
TRACHEOSTOMA VALVE, INCLUDING DIAPHRAGM, EACH
REPLACEMENT DIAPHRAGM/FACEPLATE FOR TRACHEOSTOMA VALVE, EACH
FILTER HOLDER OR FILTER CAP, REUSABLE, FOR USE IN A TRACHEOSTOMA HEAT AND MOISTURE EXCHANGE SY
FILTER FOR USE IN A TRACHEOSTOMA HEAT AND MOISTURE EXCHANGE SYSTEM, EACH
HOUSING, REUSABLE WITHOUT ADHESIVE, FOR USE IN A HEAT AND MOISTURE EXCHANGE SYSTEM AND/OR WITH
ADHESIVE DISC FOR USE IN A HEAT AND MOISTURE EXCHANGE SYSTEM AND/OR WITH TRACHEOSTOMA VALVE, A
FILTER HOLDER AND INTEGRATED FILTER WITHOUT ADHESIVE, FOR USE IN A TRACHEOSTOMA HEAT AND MOIST
HOUSING AND INTEGRATED ADHESIVE, FOR USE IN A TRACHEOSTOMA HEAT AND MOISTURE EXCHANGE SYSTEM
FILTER HOLDER AND INTEGRATED FILTER HOUSING, AND ADHESIVE, FOR USE AS A TRACHEOSTOMA HEAT AND M
NONPRESCRIPTION DRUG
NONCOVERED ITEM OR SERVICE
EXERCISE EQUIPMENT
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M SESTAMIBI, PER DOSE
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M TETROFOSMIN, PER UN
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M, MEDRONATE, UP TO 30
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M APCITIDE
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, THALLOUS CHLORIDE TL-201, PER MILLICURIE
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, INDIUM IN 111 CAPROMAB PENDETIDE, PER D
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, IOBENGUANE SULFATE I-131, PER 0.5 MCI
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC99M DISOFENIN, PER VIAL
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M, DEPREOTIDE, PER MCI
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC-99M PERTECHNETATE, PER
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC-99M MEBROFENIN, PER MCI
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC-99M PYROPHOSPHATE, PER
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC-99M PENTETATE, PER MCI
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, I-123 SODIUM IODIDE CAPSULE, PER 100 UCI
SUPPLY OF RADIOPHARMACEUTICAL THERAPEUTIC IMAGING AGENT, I-131 SODIUM IODIDE CAPSULE, PER MCI
SUPPLY OF RADIOPHARMACEUTICAL THERAPEUTIC IMAGING AGENT, I-131 SODIUM IODIDE SOLUTION, PER UCI
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC-99M MACROAGGREGATED A
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC-99M SULFUR COLLOID, PER
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC-99M EXAMETAZINE, PER DO
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, INDIUM-111 IBRITUMOMAB TIUXETAN, PER MC
SUPPLY OF RADIOPHARMACEUTICAL THERAPEUTIC IMAGING AGENT, YTTRIUM 90 IBRITUMOMAB TIUXETAN, PER
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, IODINATED I-131 SERUM ALBUMIN, 5 MICROCU
SUPPLY OF THERAPEUTIC RADIOPHARMACEUTICAL, STRONTIUM-89 CHLORIDE, PER MCI
SUPPLY OF THERAPEUTIC RADIOPHARMACEUTICAL, I-131 SODIUM IODIDE CAPSULE, PER MCI
SUPPLY OF THERAPEUTIC RADIOPHARMACEUTICAL, SAMARIUM SM 153 LEXIDRONAMM, 50 MCI
SUPPLY OF RADIOPHARMACEUTICAL THERAPEUTIC IMAGING AGENT, NOT OTHERWISE CLASSIFIED
SUPPLY OF INJECTABLE CONTRAST MATERIAL FOR USE IN ECHOCARDIOGRAPHY, PER STUDY
MISCELLANEOUS DME SUPPLY, ACCESSORY, AND/OR SERVICE COMPONENT OF ANOTHER HCPCS CODE
DME DELIVERY, SET UP, AND/OR DISPENSING SERVICE COMPONENT OF ANOTHER HCPCS CODE
ENTERAL FEEDING SUPPLY KIT; SYRINGE, PER DAY
ENTERAL FEEDING SUPPLY KIT; PUMP FED, PER DAY
ENTERAL FEEDING SUPPLY KIT; GRAVITY FED, PER DAY
NASOGASTRIC TUBING WITH STYLET
NASOGASTRIC TUBING WITHOUT STYLET
STOMACH TUBE - LEVINE TYPE
GASTROSTOMY/JEJUNOSTOMY TUBE, ANY MATERIAL, ANY TYPE, (STANDARD OR LOW PROFILE), EACH
FOOD THICKENER, ADMINISTERED ORALLY, PER OUNCE
ENTERAL FORMULAE; CATEGORY I; SEMI-SYNTHETIC INTACT PROTEIN/PROTEIN ISOLATES, ADMINISTERED THRO
ENTERAL FORMULAE; CATEGORY I: NATURAL INTACT PROTEIN/PROTEIN ISOLATES, ADMINISTERED THROUGH AN
ENTERAL FORMULAE; CATEGORY II: INTACT PROTEIN/PROTEIN ISOLATES (CALORICALLY DENSE), ADMINISTERED
ENTERAL FORMULAE; CATEGORY III: HYDROLIZED PROTEIN/AMINO ACIDS, ADMINISTERED THROUGH AN ENTERA
ENTERAL FORMULAE; CATEGORY IV: DEFINED FORMULA FOR SPECIAL METABOLIC NEED, ADMINISTERED THROU
ENTERAL FORMULAE; CATEGORY V: MODULAR COMPONENTS, ADMINISTERED THROUGH AN ENTERAL FEEDING T
ENTERAL FORMULAE; CATEGORY VI: STANDARDIZED NUTRIENTS, ADMINISTERED THROUGH AN ENTERAL FEEDIN
PARENTERAL NUTRITION SOLUTION; CARBOHYDRATES (DEXTROSE), 50% OR LESS (500 ML = 1 UNIT) - HOMEMIX
PARENTERAL NUTRITION SOLUTION; AMINO ACID, 3.5%, (500 ML = 1 UNIT) - HOMEMIX
PARENTERAL NUTRITION SOLUTION; AMINO ACID, 5.5% THROUGH 7%, (500 ML = 1 UNIT) - HOMEMIX
PARENTERAL NUTRITION SOLUTION; AMINO ACID, 7% THROUGH 8.5%, (500 ML = 1 UNIT) - HOMEMIX
PARENTERAL NUTRITION SOLUTION; AMINO ACID, GREATER THAN 8.5% (500 ML = 1 UNIT) - HOMEMIX
PARENTERAL NUTRITION SOLUTION; CARBOHYDRATES (DEXTROSE), GREATER THAN 50% (500 ML=1 UNIT) - HOME
PARENTERAL NUTRITION SOLUTION; LIPIDS, 10% WITH ADMINISTRATION SET (500 ML = 1 UNIT)
PARENTERAL NUTRITION SOLUTION, LIPIDS, 20% WITH ADMINISTRATION SET (500 ML = 1 UNIT)
PARENTERAL NUTRITION SOLUTION; COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, T
PARENTERAL NUTRITION SOLUTION; COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, T
PARENTERAL NUTRITION SOLUTION; COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, T
PARENTERAL NUTRITION SOLUTION; COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, T
PARENTERAL NUTRITION; ADDITIVES (VITAMINS, TRACE ELEMENTS, HEPARIN, ELECTROLYTES) HOMEMIX PER DA
PARENTERAL NUTRITION SUPPLY KIT; PREMIX, PER DAY
PARENTERAL NUTRITION SUPPLY KIT; HOME MIX, PER DAY
PARENTERAL NUTRITION ADMINISTRATION KIT, PER DAY
PARENTERAL NUTRITION SOLUTION; COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES,TR
PARENTERAL NUTRITION SOLUTION; COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES,TR
PARENTERAL NUTRITION SOLUTION; COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, T
ENTERAL NUTRITION INFUSION PUMP - WITHOUT ALARM
ENTERAL NUTRITION INFUSION PUMP - WITH ALARM
PARENTERAL NUTRITION INFUSION PUMP, PORTABLE
PARENTERAL NUTRITION INFUSION PUMP, STATIONARY
NOC FOR ENTERAL SUPPLIES
NOC FOR PARENTERAL SUPPLIES
WHOLE BLOOD OR RED BLOOD CELLS, LEUKOREDUCED, CMV NEGATIVE, EACH UNIT
PLATELET, HLA-MATCHED LEUKOREDUCED, APHERESIS/PHERESIS, EACH UNIT
PLATELETS, PHERESIS, LEUKOCYTE-REDUCED, CMV NEGATIVE, IRRADIATED, EACH UNIT
WHOLE BLOOD OR RED BLOOD CELLS, LEUKOREDUCED, FROZEN, DEGLYCEROL, WASHED, EACH UNIT
PLATELET, LEUKOREDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT
WHOLE BLOOD, LEUKOREDUCED, IRRADIATED, EACH UNIT
RED BLOOD CELLS, FROZEN/DEGLYCEROLIZED/WASHED, LEUKOCYTE-REDUCED, IRRADIATED, EACH UNIT
RED BLOOD CELLS, LEUKOCYTE-REDUCED, CMV NEGATIVE, IRRADIATED, EACH UNIT
PLASMA, FROZEN WITHIN 24 HOURS OF COLLECTION, EACH UNIT
ELECTRODE, NEEDLE, ABLATION, MR COMPATIBLE LEVEEN, MODIFIED LEVEEN NEEDLE ELECTRODE
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, CYANOCOBALAMIN CO 57/58, PER 0.5 MICROC
LASER OPTIC TREATMENT SYSTEM, INDIGO LASEROPTIC TREATMENT SYSTEM
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, INDIUM 111 OXYQUINOLINE, PER 0.5 MILLICUR
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, INDIUM 111 PENTETATE, PER 0.5 MILLICURIE
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M ARCITUMOMAB, PER VIA
ENDOTRACHEAL TUBE, VETT TRACHEOBRONCHIAL TUBE
INJECTION, CYTARABINE LIPOSOME, PER 10 MG
INJECTION, EPIRUBICIN HYDROCHLORIDE, 2 MG
BIOPSY DEVICE, BREAST, ABBI DEVICE
BIOPSY DEVICE, 11-GAUGE MAMMOTOME PROBE WITH VACUUM CANNISTER
INJECTION, BUSULFAN, PER 6 MG
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M SODIUM GLUCOHEPTON
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M SUCCIMER, PER VIAL
HYPERBARIC OXYGEN UNDER PRESSURE, FULL BODY CHAMBER, PER 30 MINUTE INTERVAL
APLIGRAF, PER 44 SQ CM
ELECTRODE, DISPOSABLE, PALATE SOMNOPLASTY COAGULATING ELECTRODE, BASE OF TONGUE SOMNOPLAST
ELECTRODE, DISPOSABLE, TURBINATE SOMNOPLASTY COAGULATING ELECTRODE
ELECTRODE, DISPOSABLE, VAPR ELECTRODE, VAPR T THERMAL ELECTRODE
ELECTRODE, DISPOSABLE, LIGASURE DISPOSABLE ELECTRODE
ELECTRODE, DISPOSABLE, GYNECARE VERSAPOINT RESECTOSCOPIC SYSTEM BIPOLAR ELECTRODE
INFUSION SYSTEM, ON-Q PAIN MANAGEMENT SYSTEM, ON-Q SOAKER PAIN MANAGEMENT SYSTEM, AND PAINBUS
ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (INPLANTABLE)
BRACHYTHERAPY SEED, GOLD 198
BRACHYTHERAPY SEED, IODINE 125
BRACHYTHERAPY SEED, NON-HIGH DOSE RATE IRIDIUM 192
BRACHYTHERAPY SEED, PALLADIUM 103
ADHESION BARRIER
INJECTION, DARBEPOETIN ALFA (FOR NON ESRD USE), PER 1 MCG
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, FLUORODEOXYGLUCOSE F18 (2-DEOXY-2-[18
OCULAR IMPLANT, AQUEOUS DRAINAGE ASSIST DEVICE
CATHETER, ABLATION, NON-CARDIAC, ENDOVASCULAR (IMPLANTABLE)
LEAD, LEFT VENTRICULAR CORONARY VENOUS SYSTEM
CATHETER, GOLD PROBE SINGLE-USE ELECTROHEMOSTASIS CATHETER
PROBE, PERCUTANEOUS LUMBAR DISCECTOMY
BRACHYTHERAPY SEED, YTTRIUM-90
PROBE, CRYOABLATION
BRACHYTHERAPY SOLUTION, IODINE-125, PER MCI
MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, ABDOMEN
MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, ABDOMEN
MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, ABDOMEN
MAGNETIC RESONANCE IMAGING WITH CONTRAST, BREAST; UNILATERAL
MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST, BREAST; UNILATERAL
MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; UNILATERAL
MAGNETIC RESONANCE IMAGING WITH CONTRAST, BREAST; BILATERAL
MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST, BREAST; BILATERAL
MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; BILATERAL
MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, CHEST (EXCLUDING MYOCARDIUM)
MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, CHEST (EXCLUDING MYOCARDIUM)
MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, CHEST (EXCLUDIN
MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, LOWER EXTREMITY
MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, LOWER EXTREMITY
MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, LOWER EXTREMIT
INJECTION, SODIUM CHROMATE CR51, PER 0.25 MCI
PALIVIZUMAB-RSV-IGM, PER 50 MG
BACLOFEN INTRATHECAL SCREENING KIT (1 AMP)
BACLOFEN INTRATHECAL REFILL KIT, PER 500 MCG
BACLOFEN REFILL KIT, PER 2000 MCG
BACLOFEN INTRATHECAL REFILL KIT, PER 4000 MCG
SUPPLY OF CO 57 COBALTOUS CHLORIDE, RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, 51 SODIUM CHROMATE, PER 50 MCI
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, SODIUM IOTHALAMATE I-125 INJECTION, PER
INJECTION, HEPATITIS B IMMUNE GLOBULIN, PER 1 ML
INJECTION, TIROFIBAN HYDROCHLORIDE, 6.25 MG
INJECTION, BIVALIRUDIN, 250 MG PER VIAL
INJECTION, PERFLUTREN LIPID MICROSPHERE, PER 2 ML VIAL
INJECTION, PANTOPRAZOLE SODIUM, PER VIAL
INJECTION, ERTAPENEM SODIUM, PER 1 GRAM VIAL
INJECTION, PEGFILGRASTIM, PER 6 MG SINGLE DOSE VIAL
INJECTION, FULVESTRANT, PER 50 MG
INJECTION, ARGATROBAN, PER 5 MG
ORCEL, PER 36 SQUARE CENTIMETERS
DERMAGRAFT, PER 37.5 SQUARE CENTIMETERS
FRESH FROZEN PLASMA, DONOR RETESTED, EACH UNIT
STRETTA SYSTEM
BARD ENDOSCOPIC SUTURING SYSTEM
H.E.L.P. APHERESIS SYSTEM
PERIODIC ORAL EVALUATION
LIMIT ORAL EVAL PROBLM FOCUS
COMPREHENSIVE ORAL EVALUATION - NEW OR ESTABLISHED PATIENT
EXTENSV ORAL EVAL PROB FOCUS
RE-EVALUATION-LIMITED, PROBLEM FOCUSED (ESTABLISHED PATIENT; NOT POST-OPERATIVE VISIT)
COMPREHENSIVE PERIODONTAL EVALUATION - NEW OR ESTABLISHED PATIENT
INTRAOR COMPLETE FILM SERIES
INTRAORAL PERIAPICAL FIRST F
INTRAORAL PERIAPICAL EA ADD
INTRAORAL OCCLUSAL FILM
EXTRAORAL FIRST FILM
EXTRAORAL EA ADDITIONAL FILM
DENTAL BITEWING SINGLE FILM
DENTAL BITEWINGS TWO FILMS
DENTAL BITEWINGS FOUR FILMS
VERTICAL BITEWINGS - 7 TO 8 FILMS
DENTAL FILM SKULL/ FACIAL BON
DENTAL SALIOGRAPHY
DENTAL TMJ ARTHROGRAM INCL I
DENTAL OTHER TMJ FILMS
DENTAL TOMOGRAPHIC SURVEY
DENTAL PANORAMIC FILM
DENTAL CEPHALOMETRIC FILM
ORAL/FACIAL IMAGES (INCLUDES INTRA AND EXTRAORAL IMAGES)
BACTERIOLOGIC STUDY
CARIES SUSCEPTIBILITY TEST
PULP VITALITY TEST
DIAGNOSTIC CASTS
ACCESSION OF TISSUE, GROSS EXAMINATION, PREPARATION AND TRANSMISSION OF WRITTEN REPORT
ACCESSION OF TISSUE, GROSS AND MICROSCOPIC EXAMINATION, PREPARATION AND TRANSMISSION OF WRITT
ACCESSION OF TISSUE, GROSS AND MICROSCOPIC EXAMINATION, INCLUDING ASSESSMENT OF SURGICAL MARG
PROCESSING AND INTERPRETATION OF CYTOLOGIC SMEARS, INCLUDING THE PREPARATION AND TRANSMISSION
OTHER ORAL PATHOLOGY PROCEDU
UNSPECIFIED DIAGNOSTIC PROCE
DENTAL PROPHYLAXIS ADULT
DENTAL PROPHYLAXIS CHILD
TOPICAL FLUOR W/ PROPHY CHILD
TOPICAL FLUOR W/O PROPHY CHI
TOPICAL FLUOR W/O PROPHY ADU
TOPICAL FLUORIDE W/ PROPHY A
NUTRI COUNSEL-CONTROL CARIES
TOBACCO COUNSELING
ORAL HYGIENE INSTRUCTION
DENTAL SEALANT PER TOOTH
SPACE MAINTAINER FXD UNILAT
FIXED BILAT SPACE MAINTAINER
REMOVE UNILAT SPACE MAINTAIN
REMOVE BILAT SPACE MAINTAIN
RECEMENT SPACE MAINTAINER
AMALGAM-ONE SURFACE, PRIMARY OR PERMANENT
AMALGAM-TWO SURFACES, PRIMARY OR PERMANENT
AMALGAM-THREE SURFACES, PRIMARY OR PERMANENT
AMALGAM-FOUR OR MORE SURFACES, PRIMARY OR PERMANENT
RESIN ONE SURFACE- ANTERIOR
RESIN TWO SURFACES- ANTERIOR
RESIN THREE SURFACES- ANTERIO
RESIN 4/> SURF OR W/ INCIS AN
RESIN-BASED COMPOSITE CROWN, ANTERIOR
RESIN-BASED COMPOSITE - ONE SURFACE, POSTERIOR
RESIN-BASED COMPOSITE - TWO SURFACES, POSTERIOR
RESIN-BASED COMPOSITE - THREE SURFACES, POSTERIOR
RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES, POSTERIOR
DENTAL GOLD FOIL ONE SURFACE
DENTAL GOLD FOIL TWO SURFACE
DENTAL GOLD FOIL THREE SURFA
DENTAL INLAY METALIC 1 SURF
DENTAL INLAY METALLIC 2 SURF
DENTAL INLAY METL 3/ MORE SUR
ONLAY-METALLIC-TWO SURFACES
DENTAL ONLAY METALLIC 3 SURF
DENTAL ONLAY METL 4/ MORE SUR
INLAY PORCELAIN/CERAMIC 1 SU
INLAY PORCELAIN/CERAMIC 2 SU
DENTAL ONLAY PORC 3/ MORE SUR
DENTAL ONLAY PORCELIN 2 SURF
DENTAL ONLAY PORCELIN 3 SURF
DENTAL ONLAY PORC 4/ MORE SUR
INLAY - RESIN-BASED COMPOSITE - ONE SURFACE
INLAY - RESIN-BASED COMPOSITE - TWO SURFACES
INLAY - RESIN-BASED COMPOSITE - THREE OR MORE SURFACES
ONLAY - RESIN-BASED COMPOSITE - TWO SURFACES
ONLAY - RESIN-BASED COMPOSITE - THREE SURFACES
ONLAY - RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES
CROWN - RESIN (INDIRECT)
CROWN RESIN W/ HIGH NOBLE ME
CROWN RESIN W/ BASE METAL
CROWN RESIN W/ NOBLE METAL
CROWN PORCELAIN/CERAMIC SUBS
CROWN PORCELAIN W/ H NOBLE M
CROWN PORCELAIN FUSED BASE M
CROWN PORCELAIN W/ NOBLE MET
CROWN - 3/4 CAST HIGH NOBLE METAL
CROWN - 3/4 CAST PREDOMINANTLY BASE METAL
CROWN - 3/4 CAST NOBLE METAL (SINGLE RESTORATION ONLY)
CROWN - 3/4 PORCELAIN/CERAMIC (SINGLE RESTORATION ONLY)
CROWN FULL CAST HIGH NOBLE M
CROWN FULL CAST BASE METAL
CROWN FULL CAST NOBLE METAL
PROVISIONAL CROWN
DENTAL RECEMENT INLAY
DENTAL RECEMENT CROWN
PREFAB STNLSS STEEL CRWN PRI
PREFAB STNLSS STEEL CROWN PE
PREFABRICATED RESIN CROWN
PREFAB STAINLESS STEEL CROWN
DENTAL SEDATIVE FILLING
CORE BUILD-UP INCL ANY PINS
TOOTH PIN RETENTION
POST AND CORE CAST + CROWN
EACH ADDITIONAL CAST POST - SAME TOOTH (OTHER RESTORATIVE SERVICES)
PREFAB POST/CORE + CROWN
POST REMOVAL
EACH ADDITIONAL PREFABRICATED POST - SAME TOOTH (OTHER RESTORATIVE SERVICES)
LAMINATE LABIAL VENEER
LAB LABIAL VENEER RESIN
LAB LABIAL VENEER PORCELAIN
TEMPORARY- FRACTURED TOOTH
CROWN REPAIR
DENTAL UNSPEC RESTORATIVE PR
PULP CAP DIRECT
PULP CAP INDIRECT
THERAPEUTIC PULPOTOMY (EXCLUDING FINAL RESTORATION) REMOVAL OF PULP CORONAL TO THE DENTINOCE
PULPAL DEBRIDEMENT, PRIMARY AND PERMANENT TEETH
PULPAL THERAPY ANTERIOR PRIM
PULPAL THERAPY POSTERIOR PRI
ANTERIOR
ROOT CANAL THERAPY 2 CANALS
ROOT CANAL THERAPY 3 CANALS
TREATMENT OF ROOT CANAL OBSTRUCTION; NON-SURGICAL ACCESS
INCOMPLETE ENDODONTIC THERAPY; INOPERABLE OR FRACTURED TOOTH
INTERNAL ROOT REPAIR OF PERFORATION DEFECTS
RETREAT ROOT CANAL ANTERIOR
RETREAT ROOT CANAL BICUSPID
RETREAT ROOT CANAL MOLAR
APEXIFICATION/RECALC INITIAL
APEXIFICATION/RECALC INTERIM
APEXIFICATION/RECALC FINAL
APICOECT/PERIRAD SURG ANTER
ROOT SURGERY BICUSPID
ROOT SURGERY MOLAR
ROOT SURGERY EA ADD ROOT
RETROGRADE FILLING
ROOT AMPUTATION
ENDODONTIC ENDOSSEOUS IMPLAN
INTENTIONAL REPLANTATION
ISOLATION-TOOTH W RUBB DAM
TOOTH SPLITTING
CANAL PREP/FITTING OF DOWEL
ENDODONTIC PROCEDURE
GINGIVECTOMY OR GINGIVOPLASTY - FOUR OR MORE CONTIGUOUS TEETH OR BOUNDED TEETH SPACES, PER Q
GINGIVECTOMY OR GINGIVOPLASTY - ONE TO THREE TEETH, PER QUADRANT
GINGIVAL FLAP PROCEDURE, INCLUDING ROOT PLANING - FOUR OR MORE CONTIGUOUS TEETH OR BOUNDED TE
GINGIVAL FLAP PROCEDURE, INCLUDING ROOT PLANING - ONE TO THREE TEETH, PER QUADRANT
APICALLY POSITIONED FLAP
CROWN LENGTHEN HARD TISSUE
OSSEOUS SURGERY (INCLUDING FLAP ENTRY AND CLOSURE) - FOUR OR MORE CONTIGUOUS TEETH OR BOUNDE
OSSEOUS SURGERY (INCLUDING FLAP ENTRY AND CLOSURE) - ONE TO THREE TEETH, PER QUADRANT
BONE REPLCE GRAFT FIRST SITE
BONE REPLCE GRAFT EACH ADD
BIOLOGIC MATERIALS TO AID IN SOFT AND OSSEOUS TISSUE REGENERATION
GUIDED TISSUE REGENERATION - RESORBABLE BARRIER, PER SITE
GUIDED TISSUE REGENERATION - NONRESORBABLE BARRIER, PER SITE, (INCLUDES MEMBRANE REMOVAL)
SURGICAL REVISION PROCEDURE, PER TOOTH
PEDICLE SOFT TISSUE GRAFT PR
FREE SOFT TISSUE GRAFT PROC
SUBEPITHELIAL CONNECTIVE TISSUE GRAFT PROCEDURES
DISTAL/PROXIMAL WEDGE PROC
SOFT TISSUE ALLOGRAFT
COMBINED CONNECTIVE TISSUE AND DOUBLE PEDICLE GRAFT
PROVISION SPLNT INTRACORONAL
PROVISIONAL SPLINT EXTRACORO
PERIODONTAL SCALING AND ROOT PLANING - FOUR OR MORE CONTIGUOUS TEETH OR BOUNDED TEETH SPACE
PERIODONTAL SCALING AND ROOT PLANING - ONE TO THREE TEETH, PER QUADRANT
FULL MOUTH DEBRIDEMENT TO ENABLE COMPREHENSIVE EVALUATION AND DIAGNOSIS
LOCALIZED CHEMO DELIVERY
PERIODONTAL MAINTENANCE
UNSCHEDULED DRESSING CHANGE
UNSPECIFIED PERIODONTAL PROC
DENTURES COMPLETE MAXILLARY
DENTURES COMPLETE MANDIBLE
DENTURES IMMEDIAT MAXILLARY
DENTURES IMMEDIAT MANDIBLE
DENTURES MAXILL PART RESIN
DENTURES MAND PART RESIN
DENTURES MAXILL PART METAL
DENTURES MANDIBL PART METAL
REMOVABLE PARTIAL DENTURE
DENTURES ADJUST CMPLT MAXIL
DENTURES ADJUST CMPLT MAND
DENTURES ADJUST PART MAXILL
DENTURES ADJUST PART MANDBL
DENTUR REPR BROKEN COMPL BAS
REPLACE DENTURE TEETH COMPLT
DENTURES REPAIR RESIN BASE
REP PART DENTURE CAST FRAME
REP PARTIAL DENTURE CLASP
REPLACE PART DENTURE TEETH
ADD TOOTH TO PARTIAL DENTURE
ADD CLASP TO PARTIAL DENTURE
REPLACE ALL TEETH AND ACRYLIC ON CAST METAL FRAMEWORK (MAXILLARY)
REPLACE ALL TEETH AND ACRYLIC ON CAST METAL FRAMEWORK (MANDIBULAR)
DENTURES REBASE CMPLT MAXIL
DENTURES REBASE CMPLT MAND
DENTURES REBASE PART MAXILL
DENTURES REBASE PART MANDBL
DENTURE RELN CMPLT MAXIL CH
DENTURE RELN CMPLT MAND CHR
DENTURE RELN PART MAXIL CHR
DENTURE RELN PART MAND CHR
DENTURE RELN CMPLT MAX LAB
DENTURE RELN CMPLT MAND LAB
DENTURE RELN PART MAXIL LAB
DENTURE RELN PART MAND LAB
DENTURE INTERM CMPLT MAXILL
DENTURE INTERM CMPLT MANDBL
DENTURE INTERM PART MAXILL
DENTURE INTERM PART MANDBL
DENTURE TISS CONDITN MAXILL
DENTURE TISS CONDTIN MANDBL
OVERDENTURE COMPLETE
OVERDENTURE PARTIAL
PRECISION ATTACHMENT BY REPORT
REPLACEMENT OF REPLACEABLE PART OF SEMI-PRECISION OR PRECISION ATTACHMENT (MALE OR FEMALE COM
MODIFICATION OF REMOVABLE PROSTHESIS FOLLOWING IMPLANT SURGERY
REMOVABLE PROSTHODONTIC PROC
FACIAL MOULAGE SECTIONAL
FACIAL MOULAGE COMPLETE
NASAL PROSTHESIS
AURICULAR PROSTHESIS
ORBITAL PROSTHESIS
OCULAR PROSTHESIS
FACIAL PROSTHESIS
NASAL SEPTAL PROSTHESIS
OCULAR PROSTHESIS INTERIM
CRANIAL PROSTHESIS
FACIAL AUGMENTATION IMPLANT
REPLACEMENT NASAL PROSTHESIS
AURICULAR REPLACEMENT
ORBITAL REPLACEMENT
FACIAL REPLACEMENT
SURGICAL OBTURATOR
POSTSURGICAL OBTURATOR
REFITTING OF OBTURATOR
MANDIBULAR FLANGE PROSTHESIS
MANDIBULAR DENTURE PROSTH
TEMP OBTURATOR PROSTHESIS
TRISMUS APPLIANCE
FEEDING AID
PEDIATRIC SPEECH AID
ADULT SPEECH AID
SUPERIMPOSED PROSTHESIS
PALATAL LIFT PROSTHESIS
INTRAORAL CON DEF INTER PLT
INTRAORAL CON DEF MOD PALAT
MODIFY SPEECH AID PROSTHESIS
SURGICAL STENT
RADIATION APPLICATOR
RADIATION SHIELD
RADIATION CONE LOCATOR
FLUORIDE APPLICATOR
COMMISSURE SPLINT
SURGICAL SPLINT
MAXILLOFACIAL PROSTHESIS
ODONTICS ENDOSTEAL IMPLANT
ODONTICS ABUTMENT PLACEMENT
ODONTICS EPOSTEAL IMPLANT
ODONTICS TRANSOSTEAL IMPLNT
IMPLANT/ABUTMENT SUPPORTED REMOVABLE DENTURE FOR COMPLETELY EDENTULOUS ARCH
IMPLANT/ABUTMENT SUPPORTED REMOVABLE DENTURE FOR PARTIALLY EDENTULOUS ARCH
IMPLANT CONNECTING BAR
PREFABRICATED ABUTMENT
CUSTOM ABUTMENT
ABUTMENT SUPPORTED PORCELAIN/CERAMIC CROWN
ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (HIGH NOBLE METAL)
ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (PREDOMINANTLY BASE METAL)
ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (NOBLE METAL)
ABUTMENT SUPPORTED CAST METAL CROWN (HIGH NOBLE METAL)
ABUTMENT SUPPORTED CAST METAL CROWN (PREDOMINANTLY BASE METAL)
ABUTMENT SUPPORTED CAST METAL CROWN (NOBLE METAL)
IMPLANT SUPPORTED PORCELAIN/CERAMIC CROWN
IMPLANT SUPPORTED PORCELAIN FUSED TO METAL CROWN (TITANIUM, TITANIUM ALLOY, HIGH NOBLE METAL)
IMPLANT SUPPORTED METAL CROWN (TITANIUM, TITANIUM ALLOY, HIGH NOBLE METAL)
ABUTMENT SUPPORTED RETAINER FOR PORCELAIN/CERAMIC FPD
ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (HIGH NOBLE METAL)
ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (PREDOMINANTLY BASE METAL)
ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (NOBLE METAL)
ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (HIGH NOBLE METAL)
ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (PREDOMINANTLY BASE METAL)
ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (NOBLE METAL)
IMPLANT SUPPORTED RETAINER FOR CERAMIC FPD
IMPLANT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (TITANIUM, TITANIUM ALLOY, OR HIGH N
IMPLANT SUPPORTED RETAINER FOR CAST METAL FPD (TITANIUM, TITANIUM ALLOY, OR HIGH NOBLE METAL)
IMPLANT/ABUTMENT SUPPORTED FIXED DENTURE FOR COMPLETELY EDENTULOUS ARCH
IMPLANT/ABUTMENT SUPPORTED FIXED DENTURE FOR PARTIALLY EDENTULOUS ARCH
IMPLANT MAINTENANCE
REPAIR IMPLANT
ODONTICS REPR ABUTMENT
REMOVAL OF IMPLANT
IMPLANT PROCEDURE
PROSTHODONT HIGH NOBLE METAL
BRIDGE BASE METAL CAST
BRIDGE NOBLE METAL CAST
BRIDGE PORCELAIN HIGH NOBLE
BRIDGE PORCELAIN BASE METAL
BRIDGE PORCELAIN NOBEL METAL
PONTIC - PORCELAIN/CERAMIC
BRIDGE RESIN W/HIGH NOBLE
BRIDGE RESIN BASE METAL
BRIDGE RESIN W/NOBLE METAL
PROVISIONAL PONTIC
DENTAL RETAINR CAST METL
RETAINER - PORCELAIN/CERAMIC FOR RESIN BONDED FIXED PROSTHESIS
INLAY-PORCELAIN/CERAMIC, TWO SURFACES
INLAY - PORCELAIN/CERAMIC, THREE OR MORE SURFACES
INLAY - CAST HIGH NOBLE METAL, TWO SURFACES
INLAY - CAST HIGH NOBLE METAL, THREE OR MORE SURFACES
INLAY - CAST PREDOMINANTLY BASE METAL, TWO SURFACES
INLAY - CAST PREDOMINANTLY BASE METAL, THREE OR MORE SURFACES
INLAY - CAST NOBLE METAL, TWO SURFACES
INLAY - CAST NOBLE METAL, THREE OR MORE SURFACES
ONLAY - PORCELAIN/CERAMIC, TWO SURFACES
ONLAY - PORCELAIN/CERAMIC, THREE OR MORE SURFACES
ONLAY - CAST HIGH NOBLE METAL, TWO SURFACES
ONLAY - CAST HIGH NOBLE METAL, THREE OR MORE SURFACES
ONLAY - CAST PREDOMINANTLY BASE METAL, TWO SURFACES
ONLAY - CAST PREDOMINANTLY BASE METAL, THREE OR MORE SURFACES
ONLAY - CAST NOBLE METAL, TWO SURFACES
ONLAY - CAST NOBLE METAL, THREE OR MORE SURFACES
RETAIN CROWN RESIN W HI NBLE
CROWN RESIN W/BASE METAL
CROWN RESIN W/NOBLE METAL
CROWN - PORCELAIN/CERAMIC
CROWN PORCELAIN HIGH NOBLE
CROWN PORCELAIN BASE METAL
CROWN PORCELAIN NOBLE METAL
CROWN \3/4\ HIGH NOBLE METAL
CROWN - 3/4 CAST PREDOMINANTLY BASED METAL
CRWN - 3/4 CAST NOBLE METAL (FIXED PARTIAL DENTURE RETAINERS)
CROWN - 3/4 PORCELAIN/CERAMIC (FIXED PARTIAL DENTURE RETAINERS-CROWNS)
CROWN FULL HIGH NOBLE METAL
CROWN FULL BASE METAL CAST
CROWN FULL NOBLE METAL CAST
PROVISIONAL RETAINER CROWN
DENTAL CONNECTOR BAR
DENTAL RECEMENT BRIDGE
STRESS BREAKER
PRECISION ATTACH
POST & CORE PLUS RETAINER
CAST POST BRIDGE RETAINER
PREFAB POST & CORE PLUS RETA
CORE BUILD UP FOR RETAINER
COPING METAL
EACH ADDITIONAL CAST POST - SAME TOOTH (OTHER FIXED PARTIAL DENTURE SERVICES)
EA ADDITIONAL PREFABRICATED POST - SAME TOOTH (OTHER FIXED PARTIAL DENTURE SERVICES)
BRIDGE REPAIR
PEDIATRIC PARTIAL DENTURE, FIXED
FIXED PROSTHODONTIC PROC
CORONAL REMNANTS - DECIDUOUS TOOTH
EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT (ELEVATION AND/OR FORCEPS REMOVAL)
REM IMP TOOTH W MUCOPER FLP
IMPACT TOOTH REMOV SOFT TISS
IMPACT TOOTH REMOV PART BONY
IMPACT TOOTH REMOV COMP BONY
IMPACT TOOTH REM BONY W/ COMP
SURG REMOV TOOTH ROOTS (CUT PROC)
ORAL ANTRAL FISTULA CLOSURE
PRIMARY CLOSURE OF A SINUS PERFORATION
TOOTH REIMPLANTATION AND/OR STABILIZATION OF ACCIDENTALLY EVULSED OR DISPLACED TOOTH
TOOTH TRANSPLANTATION
SURGICAL ACCESS OF AN UNERUPTED TOOTH
EXPOSURE TOOTH AID ERUPTION
MOBILIZATION OF ERUPTED OR MALPOSITIONED TOOTH TO AID ERUPTION
BIOPSY OF ORAL TISSUE - HARD (BONE, TOOTH)
BIOPSY OF ORAL TISSUE - SOFT (ALL OTHERS)
CYTOLOGY SAMPLE COLLECTION
REPOSITIONING OF TEETH
TRANSSEPTAL FIBEROTOMY/SUPRA CRESTAL FIBEROTOMY, BY REPORT
ALVEOPLASTY W/ EXTRACTION
ALVEOPLASTY W/O EXTRACTION
VESTIBULOPLASTY RIDGE EXTENS
VESTIBULOPLASTY EXTEN GRAFT
EXCISION OF BENIGN LESION UP TO 1.25 CM
EXCISION OF BENIGN LESION GREATER THAN 1.25 CM
EXCISION OF BENIGN LESION, COMPLICATED
EXCISION OF MALIGNANT LESION UP TO 1.25 CM
EXCISION OF MALIGNANT LESION GREATER THAN 1.25 CM
EXCISION OF MALIGNANT LESION, COMPLICATED
MALIG TUMOR EXC TO 125 CM
MALIG TUMOR > 125 CM
REMOVAL OF BENIGN ODONTOGENIC CYST OR TUMOR-LESION DIAMETER UP T0 1.25 CM
REMOVAL OF BENIGN ODONTOGENIC CYST OR TUMOR-LESION DIAMETER GREATER THAN 1.25 CM
REMOVAL OF BENIGN NONODONTOGENIC CYST OR TUMOR-LESION DIAMETER UP TO 1.25 CM
REMOVAL OF BENIGN NONODONTOGENIC CYST OR TUMOR-LESION DIAMETER GREATER THAN 1.25 CM
LESION DESTRUCTION
REMOVAL OF LATERAL EXOSTOSIS (MAXILLA OR MANDIBLE)
REMOVAL OF TORUS PALATINUS
REMOVAL OF TORUS MANDIBULARIS
SURGICAL REDUCTION OF OSSEOUS TUBEROSITY
MANDIBLE RESECTION
I&D ABSC INTRAORAL SOFT TISS
I&D ABSCESS EXTRAORAL
REMOVAL OF FOREIGN BODY FROM MUCOSA, SKIN, OR SUBCUTANEOUS ALVEOLAR TISSUE
REMOVAL OF FB REACTION
PARTIAL OSTECTOMY/SEQUESTRECTOMY FOR REMOVAL OF NON-VITAL BONE
MAXILLARY SINUSOTOMY
MAXILLA OPEN REDUCT SIMPLE
CLSD REDUCT SIMPL MAXILLA FX
OPEN RED SIMPL MANDIBLE FX
CLSD RED SIMPL MANDIBLE FX
OPEN RED SIMP MALAR/ ZYGOM FX
CLSD RED SIMP MALAR/ ZYGOM FX
ALVEOLUS - CLOSED REDUCTION, MAY INCLUDE STABILIZATION OF TEETH
ALVEOLUS - OPEN REDUCTION, MAY INCLUDE STABILIZATION OF TEETH
REDUCT SIMPLE FACIAL BONE FX
MAXILLA OPEN REDUCT COMPOUND
CLSD REDUCT COMPD MAXILLA FX
OPEN REDUCT COMPD MANDBLE FX
CLSD REDUCT COMPD MANDBLE FX
OPEN RED COMP MALAR/ ZYGMA FX
CLSD RED COMP MALAR/ ZYGMA FX
ALVEOLUS - OPEN REDUCTION STABILIZATION OF TEETH
ALVEOLUS, CLOSED REDUCTION STABILIZATION OF TEETH
REDUCT COMPND FACIAL BONE FX
TMJ OPEN REDUCT- DISLOCATION
CLOSED TMP MANIPULATION
TMJ MANIPULATION UNDER ANEST
REMOVAL OF TMJ CONDYLE
TMJ MENISCECTOMY
TMJ REPAIR OF JOINT DISC
TMJ EXCISN OF JOINT MEMBRANE
TMJ CUTTING OF A MUSCLE
TMJ RECONSTRUCTION
TMJ CUTTING INTO JOINT
TMJ RESHAPING COMPONENTS
TMJ ASPIRATION JOINT FLUID
NON-ARTHROSCOPIC LYSIS AND LAVAGE
TMJ DIAGNOSTIC ARTHROSCOPY
TMJ ARTHROSCOPY LYSIS ADHESN
TMJ ARTHROSCOPY DISC REPOSIT
TMJ ARTHROSCOPY SYNOVECTOMY
TMJ ARTHROSCOPY DISCECTOMY
TMJ ARTHROSCOPY DEBRIDEMENT
OCCLUSAL ORTHOTIC APPLIANCE
TMJ UNSPECIFIED THERAPY
DENT SUTURE RECENT WOUND TO 5 CM
DENTAL SUTURE WOUND TO 5 CM
SUTURE COMPLICATE WND > 5 CM
DENTAL SKIN GRAFT
RESHAPING BONE ORTHOGNATHIC
OSTEOTOMY- MANDIBULAR RAMI
OSTEOTOMY - MANDIBULAR RAMI WITH BONE GRAFT; INCLUDES OBTAINING THE GRAFT
BONE CUTTING SEGMENTED
BONE CUTTING BODY MANDIBLE
RECONSTRUCTION MAXILLA TOTAL
RECONSTRUCT MAXILLA SEGMENT
RECONSTRUCT MIDFACE NO GRAFT
RECONSTRUCT MIDFACE W/ GRAFT
MANDIBLE GRAFT
REPAIR MAXILLOFACIAL DEFECTS
FRENULECTOMY/ FRENULOTOMY
EXCISION HYPERPLASTIC TISSUE
EXCISION PERICORONAL GINGIVA
SURGICAL REDUCTION OF FIBROUS TUBEROSITY
SIALOLITHOTOMY
EXCISION OF SALIVARY GLAND
SIALODOCHOPLASTY
CLOSURE OF SALIVARY FISTULA
EMERGENCY TRACHEOTOMY
DENTAL CORONOIDECTOMY
SYNTHETIC GRAFT FACIAL BONES
IMPLANT MANDIBLE FOR AUGMENT
APPLIANCE REMOVAL (NOT BY DENTIST WHO PLACED APPLIANCE), INCLUDES REMOVAL OF ARCHBAR
ORAL SURGERY PROCEDURE
LIMITED DENTAL TX PRIMARY
LIMITED DENTAL TX TRANSITION
LIMITED DENTAL TX ADOLESCENT
LIMITED DENTAL TX ADULT
NTERCEP DENTAL TX PRIMARY
INTERCEP DENTAL TX TRANSITION
COMPRE DENTAL TX TRANSITION
COMPRE DENTAL TX ADOLESCENT
COMPRE DENTAL TX ADULT
ORTHODONTIC REM APPLIANCE TX
FIXED APPLIANCE THERAPY HABT
PREORTHODONTIC TX VISIT
PERIODIC ORTHODONTIC TX VISIT
ORTHODONTIC RETENTION
ORTHODONTIC TREATMENT
REPAIR OF ORTHODONTIC APPLIANCE
REPLACEMENT OF LOST OR BROKEN RETAINER
ORTHODONTIC PROCEDURE
TX DENTAL PAIN MINOR PROC
DENT ANESTHESIA W/O SURGERY
REGIONAL BLOCK ANESTHESIA
TRIGEMINAL BLOCK ANESTHESIA
LOCAL ANESTHESIA
DEEP SEDATION/GENERAL ANESTHESIA-FIRST 30 MINUTES
DEEP SEDATION/GENERAL ANESTHESIA-EACH ADDITIONAL 15 MINUTES
ANALGESIA, ANXIOLYSIS, INHALATION OF NITROUS OXIDE
INTRAVENOUS CONSCIOUS SEDATION/ANALGESIA - FIRST 30 MINUTES
INTRAVENOUS CONSCIOUS SEDATION/ANALGESIA - EACH ADDITIONAL 15 MINUTES
NON-INTRAVENOUS CONSCIOUS SEDATION
DENTAL CONSULTATION
HOUSE/EXTENDED CARE FACILITY CALL
HOSPITAL CALL
OFFICE VISIT DURING HOURS
OFFICE VISIT AFTER HOURS
CASE PRESENTATION, DETAILED AND EXTENSIVE TREATMENT PLANNING
DENT THERAPEUTIC DRUG INJECT
OTHER DRUGS/MEDICAMENTS
DENT APPL DESENSITIZING MED
APPLICATION OF DESENSITIZING RESIN FOR CERVICAL AND/OR ROOT SURFACE, PER TOOTH
BEHAVIOR MANAGEMENT
TREATMENT OF COMPLICATIONS
DENTAL OCCLUSAL GUARD
FABRICATION ATHLETIC GUARD
OCCLUSION ANALYSIS
LIMITED OCCLUSAL ADJUSTMENT
COMPLETE OCCLUSAL ADJUSTMENT
ENAMEL MICROABRASION
ODONTOPLASTY 1 - 2 TEETH; INCLUDES REMOVAL OF ENAMEL PROJECTIONS
EXTERNAL BLEACHING - PER ARCH
EXTERNAL BLEACHING - PER TOOTH
INTERNAL BLEACHING - PER TOOTH
ADJUNCTIVE PROCEDURE
CANE, INCLUDES CANES OF ALL MATERIALS, ADJUSTABLE OR FIXED, WITH TIP
CANE, QUAD OR THREE PRONG, INCLUDES CANES OF ALL MATERIALS, ADJUSTABLE OR FIXED, WITH TIPS
CRUTCHES, FOREARM, INCLUDES CRUTCHES OF VARIOUS MATERIALS, ADJUSTABLE OR FIXED, PAIR, COMPLETE
CRUTCH FOREARM, INCLUDES CRUTCHES OF VARIOUS MATERIALS, ADJUSTABLE OR FIXED, EACH, WITH TIP AND
CRUTCHES UNDERARM, WOOD, ADJUSTABLE OR FIXED, PAIR, WITH PADS, TIPS AND HANDGRIPS
CRUTCH UNDERARM, WOOD, ADJUSTABLE OR FIXED, EACH, WITH PAD, TIP AND HANDGRIP
CRUTCHES UNDERARM, OTHER THAN WOOD, ADJUSTABLE OR FIXED, PAIR, WITH PADS, TIPS AND HANDGRIPS
CRUTCH UNDERARM, OTHER THAN WOOD, ADJUSTABLE OR FIXED, EACH, WITH PAD, TIP AND HANDGRIP
CRUTCH, UNDERARM, ARTICULATING, SPRING ASSISTED, EACH
WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT
WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT
RIGID WALKER, WHEELED, WITHOUT SEAT
RIGID WALKER, WHEELED, WITH SEAT
FOLDING WALKER, WHEELED, WITHOUT SEAT
ENCLOSED, FRAMED FOLDING WALKER, WHEELED, WITH POSTERIOR SEAT
WALKER, WHEELED, WITH SEAT AND CRUTCH ATTACHMENTS
FOLDING WALKER, WHEELED, WITH SEAT
HEAVY DUTY, MULTIPLE BREAKING SYSTEM, VARIABLE WHEEL RESISTANCE WALKER
WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH
WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE, EACH
PLATFORM ATTACHMENT, FOREARM CRUTCH, EACH
PLATFORM ATTACHMENT, WALKER, EACH
WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR
SEAT ATTACHMENT, WALKER
CRUTCH ATTACHMENT, WALKER, EACH
LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4)
BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH
SITZ TYPE BATH OR EQUIPMENT, PORTABLE, USED WITH OR WITHOUT COMMODE
SITZ TYPE BATH OR EQUIPMENT, PORTABLE, USED WITH OR WITHOUT COMMODE, WITH FAUCET ATTACHMENT/S
SITZ BATH CHAIR
COMMODE CHAIR, STATIONARY, WITH FIXED ARMS
COMMODE CHAIR, MOBILE, WITH FIXED ARMS
COMMODE CHAIR, STATIONARY, WITH DETACHABLE ARMS
COMMODE CHAIR, MOBILE, WITH DETACHABLE ARMS
PAIL OR PAN FOR USE WITH COMMODE CHAIR
COMMODE CHAIR, EXTRA WIDE AND/OR HEAVY DUTY, STATIONARY OR MOBILE, WITH OR WITHOUT ARMS, ANY T
COMMODE CHAIR WITH SEAT LIFT MECHANISM
FOOT REST, FOR USE WITH COMMODE CHAIR, EACH
AIR PRESSURE PAD OR CUSHION, NONPOSITIONING
WATER PRESSURE PAD OR CUSHION, NONPOSITIONING
GEL OR GEL-LIKE PRESSURE PAD OR CUSHION, NONPOSITIONING
DRY PRESSURE PAD OR CUSHION, NONPOSITIONING
PRESSURE PAD, ALTERNATING WITH PUMP
PRESSURE PAD, ALTERNATING WITH PUMP, HEAVY DUTY
PUMP FOR ALTERNATING PRESSURE PAD
DRY PRESSURE MATTRESS
GEL OR GEL-LIKE PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH
AIR PRESSURE MATTRESS
WATER PRESSURE MATTRESS
SYNTHETIC SHEEPSKIN PAD
LAMBSWOOL SHEEPSKIN PAD, ANY SIZE
HEEL OR ELBOW PROTECTOR, EACH
LOW PRESSURE AND POSITIONING EQUALIZATION PAD, FOR WHEELCHAIR
POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY)
AIR FLUIDIZED BED
GEL PRESSURE MATTRESS
AIR PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH
WATER PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH
DRY PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH
HEAT LAMP, WITHOUT STAND (TABLE MODEL), INCLUDES BULB, OR INFRARED ELEMENT
PHOTOTHERAPY (BILIRUBIN) LIGHT WITH PHOTOMETER
THERAPEUTIC LIGHTBOX, MINIMUM 10,000 LUX, TABLE TOP MODEL
HEAT LAMP, WITH STAND, INCLUDES BULB, OR INFRARED ELEMENT
ELECTRIC HEAT PAD, STANDARD
ELECTRIC HEAT PAD, MOIST
WATER CIRCULATING HEAT PAD WITH PUMP
WATER CIRCULATING COLD PAD WITH PUMP
HOT WATER BOTTLE
INFRARED HEATING PAD SYSTEM
HYDROCOLLATOR UNIT, INCLUDES PADS
ICE CAP OR COLLAR
NON-CONTACT WOUND WARMING DEVICE (TEMPERATURE CONTROL UNIT, AC ADAPTER AND POWER CORD) FOR
WARMING CARD FOR USE WITH THE NON CONTACT WOUND WARMING DEVICE AND NON CONTACT WOUND WAR
PARAFFIN BATH UNIT, PORTABLE (SEE MEDICAL SUPPLY CODE A4265 FOR PARAFFIN)
PUMP FOR WATER CIRCULATING PAD
NON-ELECTRIC HEAT PAD, MOIST
HYDROCOLLATOR UNIT, PORTABLE
BATH TUB WALL RAIL, EACH
BATH TUB RAIL, FLOOR BASE
TOILET RAIL, EACH
RAISED TOILET SEAT
TUB STOOL OR BENCH
TRANSFER TUB RAIL ATTACHMENT
PAD FOR WATER CIRCULATING HEAT UNIT
HOSPITAL BED, FIXED HEIGHT, WITH ANY TYPE SIDE RAILS, WITH MATTRESS
HOSPITAL BED, FIXED HEIGHT, WITH ANY TYPE SIDE RAILS, WITHOUT MATTRESS
HOSPITAL BED, VARIABLE HEIGHT, HI-LO, WITH ANY TYPE SIDE RAILS, WITH MATTRESS
HOSPITAL BED, VARIABLE HEIGHT, HI-LO, WITH ANY TYPE SIDE RAILS, WITHOUT MATTRESS
HOSPITAL BED, SEMI-ELECTRIC (HEAD AND FOOT ADJUSTMENT), WITH ANY TYPE SIDE RAILS, WITH MATTRESS
HOSPITAL BED, SEMI-ELECTRIC (HEAD AND FOOT ADJUSTMENT), WITH ANY TYPE SIDE RAILS, WITHOUT MATTRES
HOSPITAL BED, TOTAL ELECTRIC (HEAD, FOOT AND HEIGHT ADJUSTMENTS), WITH ANY TYPE SIDE RAILS, WITH M
HOSPITAL BED, TOTAL ELECTRIC (HEAD, FOOT AND HEIGHT ADJUSTMENTS), WITH ANY TYPE SIDE RAILS, WITHOU
HOSPITAL BED, INSTITUTIONAL TYPE INCLUDES: OSCILLATING, CIRCULATING AND STRYKER FRAME, WITH MATTR
MATTRESS, INNERSPRING
MATTRESS, FOAM RUBBER
BED BOARD
OVER-BED TABLE
BED PAN, STANDARD, METAL OR PLASTIC
BED PAN, FRACTURE, METAL OR PLASTIC
POWERED PRESSURE-REDUCING AIR MATTRESS
BED CRADLE, ANY TYPE
HOSPITAL BED, FIXED HEIGHT, WITHOUT SIDE RAILS, WITH MATTRESS
HOSPITAL BED, FIXED HEIGHT, WITHOUT SIDE RAILS, WITHOUT MATTRESS
HOSPITAL BED, VARIABLE HEIGHT, HI-LO, WITHOUT SIDE RAILS, WITH MATTRESS
HOSPITAL BED, VARIABLE HEIGHT, HI-LO, WITHOUT SIDE RAILS, WITHOUT MATTRESS
HOSPITAL BED, SEMI-ELECTRIC (HEAD AND FOOT ADJUSTMENT), WITHOUT SIDE RAILS, WITH MATTRESS
HOSPITAL BED, SEMI-ELECTRIC (HEAD AND FOOT ADJUSTMENT), WITHOUT SIDE RAILS, WITHOUT MATTRESS
HOSPITAL BED, TOTAL ELECTRIC (HEAD, FOOT AND HEIGHT ADJUSTMENTS), WITHOUT SIDE RAILS, WITH MATTRE
HOSPITAL BED, TOTAL ELECTRIC (HEAD, FOOT AND HEIGHT ADJUSTMENTS), WITHOUT SIDE RAILS, WITHOUT MAT
BED SIDE RAILS, HALF-LENGTH
BED SIDE RAILS, FULL-LENGTH
BED ACCESSORY: BOARD, TABLE, OR SUPPORT DEVICE, ANY TYPE
SAFETY ENCLOSURE FRAME/CANOPY FOR USE WITH HOSPITAL BED, ANY TYPE
URINAL; MALE, JUG-TYPE, ANY MATERIAL
URINAL; FEMALE, JUG-TYPE, ANY MATERIAL
CONTROL UNIT FOR ELECTRONIC BOWEL IRRIGATION/EVACUATION SYSTEM
DISPOSABLE PACK (WATER RESERVOIR BAG, SPECULUM, VALVING MECHANISM AND COLLECTION BAG/BOX) FOR
AIR PRESSURE ELEVATOR FOR HEEL
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND
POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH
NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS
STATIONARY COMPRESSED GASEOUS OXYGEN SYSTEM, RENTAL; INCLUDES CONTAINER, CONTENTS, REGULATO
STATIONARY COMPRESSED GAS SYSTEM, PURCHASE; INCLUDES REGULATOR, FLOWMETER, HUMIDIFIER, NEBUL
PORTABLE GASEOUS OXYGEN SYSTEM, PURCHASE; INCLUDES REGULATOR, FLOWMETER, HUMIDIFIER, CANNULA
PORTABLE GASEOUS OXYGEN SYSTEM, RENTAL; INCLUDES PORTABLE CONTAINER, REGULATOR, FLOWMETER, H
PORTABLE LIQUID OXYGEN SYSTEM, RENTAL; INCLUDES PORTABLE CONTAINER, SUPPLY RESERVOIR, HUMIDIFIE
PORTABLE LIQUID OXYGEN SYSTEM, PURCHASE; INCLUDES PORTABLE CONTAINER, SUPPLY RESERVOIR, FLOWM
STATIONARY LIQUID OXYGEN SYSTEM, RENTAL; INCLUDES CONTAINER, CONTENTS, REGULATOR, FLOWMETER, H
STATIONARY LIQUID OXYGEN SYSTEM, PURCHASE; INCLUDES USE OF RESERVOIR, CONTENTS INDICATOR, REGU
OXYGEN CONTENTS, GASEOUS (FOR USE WITH OWNED GASEOUS STATIONARY SYSTEMS OR WHEN BOTH A STA
OXYGEN CONTENTS, LIQUID (FOR USE WITH OWNED LIQUID STATIONARY SYSTEMS OR WHEN BOTH A STATIONA
PORTABLE OXYGEN CONTENTS, GASEOUS (FOR USE ONLY WITH PORTABLE GASEOUS SYSTEMS WHEN NO STAT
PORTABLE OXYGEN CONTENTS, LIQUID (FOR USE ONLY WITH PORTABLE LIQUID SYSTEMS WHEN NO STATIONAR
OXIMETER DEVICE FOR MEASURING BLOOD OXYGEN LEVELS NON-INVASIVELY
VOLUME VENTILATOR, STATIONARY OR PORTABLE, WITH BACKUP RATE FEATURE, USED WITH INVASIVE INTERFA
PRESSURE VENTILATOR WITH PRESSURE CONTROL, PRESSURE SUPPORT AND FLOW TRIGGERING FEATURES
OXYGEN TENT, EXCLUDING CROUP OR PEDIATRIC TENTS
CHEST SHELL (CUIRASS)
CHEST WRAP
NEGATIVE PRESSURE VENTILATOR; PORTABLE OR STATIONARY
VOLUME VENTILATOR, STATIONARY OR PORTABLE, WITH BACKUP RATE FEATURE, USED WITH NON-INVASIVE INT
ROCKING BED WITH OR WITHOUT SIDE RAILS
PERCUSSOR, ELECTRIC OR PNEUMATIC, HOME MODEL
INTRAPULMONARY PERCUSSIVE VENTILATION SYSTEM AND RELATED ACCESSORIES
COUGH STIMULATING DEVICE, ALTERNATING POSITIVE AND NEGATIVE AIRWAY PRESSURE
HIGH FREQUENCY CHEST WALL OSCILLATION AIR-PULSE GENERATOR SYSTEM, (INCLUDES HOSES AND VEST), EA
OSCILLATORY POSITIVE EXPIRATORY PRESSURE DEVICE, NON-ELECTRIC, ANY TYPE, EACH
IPPB MACHINE, ALL TYPES, WITH BUILT-IN NEBULIZATION; MANUAL OR AUTOMATIC VALVES; INTERNAL OR EXTER
HUMIDIFIER, DURABLE FOR EXTENSIVE SUPPLEMENTAL HUMIDIFICATION DURING IPPB TREATMENTS OR OXYGEN
HUMIDIFIER, DURABLE, GLASS OR AUTOCLAVABLE PLASTIC BOTTLE TYPE, FOR USE WITH REGULATOR OR FLOW
HUMIDIFIER, DURABLE FOR SUPPLEMENTAL HUMIDIFICATION DURING IPPB TREATMENT OR OXYGEN DELIVERY
COMPRESSOR, AIR POWER SOURCE FOR EQUIPMENT WHICH IS NOT SELF- CONTAINED OR CYLINDER DRIVEN
NEBULIZER, WITH COMPRESSOR
AEROSOL COMPRESSOR, BATTERY POWERED, FOR USE WITH SMALL VOLUME NEBULIZER
AEROSOL COMPRESSOR, ADJUSTABLE PRESSURE, LIGHT DUTY FOR INTERMITTENT USE
ULTRASONIC/ELECTRONIC AEROSOL GENERATOR WITH SMALL VOLUME NEBULIZER
NEBULIZER, ULTRASONIC, LARGE VOLUME
NEBULIZER, DURABLE, GLASS OR AUTOCLAVABLE PLASTIC, BOTTLE TYPE, FOR USE WITH REGULATOR OR FLOW
NEBULIZER, WITH COMPRESSOR AND HEATER
DISPENSING FEE COVERED DRUG ADMINISTERED THROUGH DME NEBULIZER
RESPIRATORY SUCTION PUMP, HOME MODEL, PORTABLE OR STATIONARY, ELECTRIC
CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE
BREAST PUMP, MANUAL, ANY TYPE
BREAST PUMP, ELECTRIC (AC AND/OR DC), ANY TYPE
BREAST PUMP, HEAVY DUTY,HOSPITAL GRADE,PISTON OPERATED,PULSATILE VACUUM SUCTION/RELEASE CYCL
VAPORIZER, ROOM TYPE
POSTURAL DRAINAGE BOARD
HOME BLOOD GLUCOSE MONITOR
PACEMAKER MONITOR, SELF-CONTAINED, CHECKS BATTERY DEPLETION, INCLUDES AUDIBLE AND VISIBLE CHEC
PACEMAKER MONITOR, SELF-CONTAINED, CHECKS BATTERY DEPLETION AND OTHER PACEMAKER COMPONENTS
IMPLANTABLE CARDIAC EVENT RECORDER WITH MEMORY, ACTIVATOR AND PROGRAMMER
EXTERNAL DEFIBRILLATOR WITH INTEGRATED ELECTROCARDIOGRAM ANALYSIS
APNEA MONITOR, WITHOUT RECORDING FEATURE
APNEA MONITOR, WITH RECORDING FEATURE
SKIN PIERCING DEVICE FOR COLLECTION OF CAPILLARY BLOOD, LASER, EACH
SLING OR SEAT, PATIENT LIFT, CANVAS OR NYLON
PATIENT LIFT, KARTOP, BATHROOM OR TOILET
SEAT LIFT MECHANISM INCORPORATED INTO A COMBINATION LIFT-CHAIR MECHANISM
SEPARATE SEAT LIFT MECHANISM FOR USE WITH PATIENT OWNED FURNITURE-ELECTRIC
SEPARATE SEAT LIFT MECHANISM FOR USE WITH PATIENT OWNED FURNITURE-NON-ELECTRIC
PATIENT LIFT, HYDRAULIC, WITH SEAT OR SLING
PATIENT LIFT, ELECTRIC WITH SEAT OR SLING
MULTIPOSITIONAL PATIENT SUPPORT SYSTEM, WITH INTEGRATED LIFT, PATIENT ACCESSIBLE CONTROLS
PNEUMATIC COMPRESSOR, NONSEGMENTAL HOME MODEL
PNEUMATIC COMPRESSOR, SEGMENTAL HOME MODEL WITHOUT CALIBRATED GRADIENT PRESSURE
PNEUMATIC COMPRESSOR, SEGMENTAL HOME MODEL WITH CALIBRATED GRADIENT PRESSURE
NONSEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF ARM
NONSEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL LEG
NONSEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL ARM
NONSEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF LEG
SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL LEG
SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL ARM
SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF LEG
SEGMENTAL GRADIENT PRESSURE PNEUMATIC APPLIANCE, FULL LEG
SEGMENTAL GRADIENT PRESSURE PNEUMATIC APPLIANCE, FULL ARM
SEGMENTAL GRADIENT PRESSURE PNEUMATIC APPLIANCE, HALF LEG
ULTRAVIOLET LIGHT THERAPY SYSTEM PANEL, INCLUDES BULBS/LAMPS, TIMER AND EYE PROTECTION; TREATME
ULTRAVIOLET LIGHT THERAPY SYSTEM PANEL, INCLUDES BULBS/LAMPS, TIMER AND EYE PROTECTION, 4 FOOT P
ULTRAVIOLET LIGHT THERAPY SYSTEM PANEL, INCLUDES BULBS/LAMPS, TIMER AND EYE PROTECTION, 6 FOOT P
ULTRAVIOLET MULTIDIRECTIONAL LIGHT THERAPY SYSTEM IN 6 FOOT CABINET, INCLUDES BULBS/LAMPS, TIMER
SAFETY EQUIPMENT (E.G., BELT, HARNESS OR VEST)
HELMET WITH FACE GUARD AND SOFT INTERFACE MATERIAL, PREFABRICATED
RESTRAINT, ANY TYPE (BODY, CHEST, WRIST OR ANKLE)
TENS, TWO LEAD, LOCALIZED STIMULATION
TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION DEVICE, FOUR OR MORE LEADS, FOR MULTIPLE NERVE ST
FORM-FITTING CONDUCTIVE GARMENT FOR DELIVERY OF TENS OR NMES (WITH CONDUCTIVE FIBERS SEPARATE
INCONTINENCE TREATMENT SYSTEM, PELVIC FLOOR STIMULATOR, MONITOR, SENSOR AND/OR TRAINER
NEUROMUSCULAR STIMULATOR FOR SCOLIOSIS
NEUROMUSCULAR STIMULATOR, ELECTRONIC SHOCK UNIT
ELECTROMYOGRAPHY (EMG), BIOFEEDBACK DEVICE
OSTEOGENESIS STIMULATOR, ELECTRICAL, NONINVASIVE, OTHER THAN SPINAL APPLICATIONS
OSTEOGENESIS STIMULATOR, ELECTRICAL, NONINVASIVE, SPINAL APPLICATIONS
OSTEOGENESIS STIMULATOR, ELECTRICAL, SURGICALLY IMPLANTED
IMPLANTABLE NEUROSTIMULATOR ELECTRODE, EACH
PATIENT PROGRAMMER (EXTERNAL) FOR USE WITH IMPLANTABLE PROGRAMMABLE NEUROSTIMULATOR PULSE
ELECTRONIC SALIVARY REFLEX STIMULATOR (INTRAORAL/NONINVASIVE)
IMPLANTABLE NEUROSTIMULATOR PULSE GENERATOR
IMPLANTABLE NEUROSTIMULATOR RADIOFREQUENCY RECEIVER
RADIOFREQUENCY TRANSMITTER (EXTERNAL) FOR USE WITH IMPLANTABLE NEUROSTIMULATOR RADIOFREQUE
RADIOFREQUENCY TRANSMITTER (EXTERNAL) FOR USE WITH IMPLANTABLE SACRAL ROOT NEUROSTIMULATOR
OSTEOGENESIS STIMULATOR, LOW INTENSITY ULTRASOUND, NON-INVASIVE
NON-THERMAL PULSED HIGH FREQUENCY RADIOWAVES, HIGH PEAK POWER ELECTROMAGNETIC ENERGY TREA
FDA APPROVED NERVE STIMULATOR, WITH REPLACEABLE BATTERIES, FOR TREATMENT OF NAUSEA AND VOMITI
IV POLE
AMBULATORY INFUSION PUMP, MECHANICAL, REUSABLE, FOR INFUSION 8 HOURS OR GREATER
AMBULATORY INFUSION PUMP, MECHANICAL, REUSABLE, FOR INFUSION LESS THAN 8 HOURS
AMBULATORY INFUSION PUMP, SINGLE OR MULTIPLE CHANNELS, ELECTRIC OR BATTERY OPERATED, WITH ADMI
INFUSION PUMP, IMPLANTABLE, NON-PROGRAMMABLE (INCLUDES ALL COMPONENTS, E.G., PUMP, CATHETER, CO
INFUSION PUMP SYSTEM, IMPLANTABLE, PROGRAMMABLE (INCLUDES ALL COMPONENTS, E.G., PUMP, CATHETER
EXTERNAL AMBULATORY INFUSION PUMP, INSULIN
IMPLANTABLE INTRASPINAL (EPIDURAL/INTRATHECAL) CATHETER USED WITH IMPLANTABLE INFUSION PUMP, RE
IMPLANTABLE PROGRAMMABLE INFUSION PUMP, REPLACEMENT (EXCLUDES IMPLANTABLE INTRASPINAL CATHET
PARENTERAL INFUSION PUMP, STATIONARY, SINGLE OR MULTI-CHANNEL
AMBULATORY TRACTION DEVICE, ALL TYPES, EACH
TRACTION FRAME, ATTACHED TO HEADBOARD, CERVICAL TRACTION
TRACTION STAND, FREE STANDING, CERVICAL TRACTION
CERVICAL TRACTION EQUIPMENT NOT REQUIRING ADDITIONAL STAND OR FRAME
TRACTION EQUIPMENT, OVERDOOR, CERVICAL
TRACTION FRAME, ATTACHED TO FOOTBOARD, EXTREMITY TRACTION, (E.G., BUCK'S)
TRACTION STAND, FREE STANDING, EXTREMITY TRACTION, (E.G., BUCK'S)
TRACTION FRAME, ATTACHED TO FOOTBOARD, PELVIC TRACTION
TRACTION STAND, FREE STANDING, PELVIC TRACTION, (E.G., BUCK'S)
TRAPEZE BARS, ALSO KNOWN AS PATIENT HELPER, ATTACHED TO BED, WITH GRAB BAR
FRACTURE FRAME, ATTACHED TO BED, INCLUDES WEIGHTS
FRACTURE FRAME, FREE STANDING, INCLUDES WEIGHTS
PASSIVE MOTION EXERCISE DEVICE
TRAPEZE BAR, FREE STANDING, COMPLETE WITH GRAB BAR
GRAVITY ASSISTED TRACTION DEVICE, ANY TYPE
CERVICAL HEAD HARNESS/HALTER
CERVICAL PILLOW
PELVIC BELT/HARNESS/BOOT
EXTREMITY BELT/HARNESS
FRACTURE, FRAME, DUAL WITH CROSS BARS, ATTACHED TO BED, (E.G. BALKEN, 4 POSTER)
FRACTURE FRAME, ATTACHMENTS FOR COMPLEX PELVIC TRACTION
FRACTURE FRAME, ATTACHMENTS FOR COMPLEX CERVICAL TRACTION
TRAY
LOOP HEEL, EACH
LOOP TOE, EACH
PNEUMATIC TIRE, EACH
SEMI-PNEUMATIC CASTER, EACH
WHEELCHAIR ATTACHMENT TO CONVERT ANY WHEELCHAIR TO ONE ARM DRIVE
AMPUTEE ADAPTER (DEVICE USED TO COMPENSATE FOR TRANSFER OF WEIGHT DUE TO LOST LIMBS TO MAINTA
BRAKE EXTENSION, FOR WHEELCHAIR
ONE-INCH CUSHION, FOR WHEELCHAIR
TWO-INCH CUSHION, FOR WHEELCHAIR
THREE-INCH CUSHION, FOR WHEELCHAIR
FOUR-INCH CUSHION, FOR WHEELCHAIR
HOOK ON HEAD REST EXTENSION
WHEELCHAIR HAND RIMS WITH EIGHT VERTICAL RUBBER TIPPED PROJECTIONS, PAIR
COMMODE SEAT, WHEELCHAIR
NARROWING DEVICE, WHEELCHAIR
NO.2 FOOTPLATES, EXCEPT FOR ELEVATING LEG REST
ANTI-TIPPING DEVICE WHEELCHAIR
TRANSFER BOARD OR DEVICE
ADJUSTABLE HEIGHT DETACHABLE ARMS, DESK OR FULL-LENGTH, WHEELCHAIR
"GRADE-AID" (DEVICE TO PREVENT ROLLING BACK ON AN INCLINE) FOR WHEELCHAIR
REINFORCED SEAT UPHOLSTERY, WHEELCHAIR
REINFORCED BACK, WHEELCHAIR, UPHOLSTERY OR OTHER MATERIAL
WEDGE CUSHION, WHEELCHAIR
BELT, SAFETY WITH AIRPLANE BUCKLE, WHEELCHAIR
BELT, SAFETY WITH VELCRO CLOSURE, WHEELCHAIR
SAFETY VEST, WHEELCHAIR
ELEVATING LEG REST, EACH
UPHOLSTERY SEAT
SOLID SEAT INSERT
BACK, UPHOLSTERY
ARM REST, EACH
CALF REST, EACH
TIRE, SOLID, EACH
CASTER WITH FORK
CASTER WITHOUT FORK
PNEUMATIC TIRE WITH WHEEL
TIRE, PNEUMATIC CASTER
WHEEL, SINGLE
MODIFICATION TO PEDIATRIC WHEELCHAIR, WIDTH ADJUSTMENT PACKAGE (NOT TO BE DISPENSED WITH INITIAL
INTEGRATED SEATING SYSTEM, PLANAR, FOR PEDIATRIC WHEELCHAIR
INTEGRATED SEATING SYSTEM, CONTOURED, FOR PEDIATRIC WHEELCHAIR
RECLINING BACK, ADDITION TO PEDIATRIC WHEELCHAIR
SHOCK ABSORBER FOR MANUAL WHEELCHAIR, EACH
SHOCK ABSORBER FOR POWER WHEELCHAIR, EACH
HEAVY DUTY SHOCK ABSORBER FOR HEAVY DUTY OR EXTRA HEAVY DUTY MANUAL WHEELCHAIR, EACH
HEAVY DUTY SHOCK ABSORBER FOR HEAVY DUTY OR EXTRA HEAVY DUTY POWER WHEELCHAIR, EACH
RESIDUAL LIMB SUPPORT SYSTEM FOR WHEELCHAIR
LATERAL THORACIC SUPPORT, NON-CONTOURED, FOR PEDIATRIC WHEELCHAIR, EACH (INCLUDES HARDWARE)
LATERAL THORACIC SUPPORT, CONTOURED, FOR PEDIATRIC WHEELCHAIR, EACH (INCLUDES HARDWARE)
LATERAL/ANTERIOR SUPPORT, FOR PEDIATRIC WHEELCHAIR, EACH (INCLUDES HARDWARE)
ROLLABOUT CHAIR, ANY AND ALL TYPES WITH CASTERS FIVE INCHES OR GREATER
MULTI-POSITIONAL PATIENT TRANSFER SYSTEM, WITH INTEGRATED SEAT, OPERATED BY CARE GIVER
TRANSPORT CHAIR, PEDIATRIC SIZE
TRANSPORT CHAIR, ADULT SIZE
FULLY RECLINING WHEELCHAIR; FIXED FULL-LENGTH ARMS, SWING-AWAY, DETACHABLE, ELEVATING LEGRESTS
FULLY RECLINING WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETACHABLE, ELEV
POWER ATTACHMENT (TO CONVERT ANY WHEELCHAIR TO MOTORIZED WHEELCHAIR, E.G., SOLO)
BATTERY CHARGER
DEEP CYCLE BATTERY
FULLY RECLINING WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETACHABLE FOOT
HEMI-WHEELCHAIR; FIXED FULL-LENGTH ARMS, SWING-AWAY, DETACHABLE, ELEVATING LEGRESTS
HEMI-WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETACHABLE, ELEVATING LEGR
HEMI-WHEELCHAIR; FIXED FULL-LENGTH ARMS, SWING-AWAY, DETACHABLE FOOTRESTS
HEMI-WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETACHABLE FOOTRESTS
HIGH-STRENGTH LIGHTWEIGHT WHEELCHAIR; FIXED FULL-LENGTH ARMS, SWING-AWAY, DETACHABLE, ELEVATIN
HIGH-STRENGTH LIGHTWEIGHT WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETAC
HIGH-STRENGTH LIGHTWEIGHT WHEELCHAIR; FIXED-LENGTH ARMS, SWING-AWAY, DETACHABLE FOOTRESTS
HIGH-STRENGTH LIGHTWEIGHT WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETAC
WIDE HEAVY-DUTY WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETACHABLE, ELE
WIDE HEAVY-DUTY WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH ARMS, SWING-AWAY, DETACHABL
SEMI-RECLINING WHEELCHAIR; FIXED FULL-LENGTH ARMS, SWING-AWAY, DETACHABLE, ELEVATING LEGRESTS
SEMI-RECLINING WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, ELEVATING LEG REST
STANDARD WHEELCHAIR; FIXED FULL-LENGTH ARMS, FIXED OR SWING-AWAY, DETACHABLE FOOTRESTS
WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETACHABLE FOOTRESTS
WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETACHABLE, ELEVATING LEGRESTS
WHEELCHAIR; FIXED FULL-LENGTH ARMS, SWING-AWAY, DETACHABLE, ELEVATING LEGRESTS
MANUAL ADULT SIZE WHEELCHAIR, INCLUDES TILT IN SPACE
AMPUTEE WHEELCHAIR; FIXED FULL-LENGTH ARMS, SWING-AWAY, DETACHABLE, ELEVATING LEGRESTS
AMPUTEE WHEELCHAIR; FIXED FULL-LENGTH ARMS, WITHOUT FOOTRESTS OR LEGRESTS
AMPUTEE WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, WITHOUT FOOTRESTS OR LEGRESTS
AMPUTEE WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETACHABLE FOOTRESTS
AMPUTEE WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETACHABLE, ELEVATING L
HEAVY DUTY WHEELCHAIR; FIXED FULL-LENGTH ARMS, SWING-AWAY, DETACHABLE, ELEVATING LEGRESTS
AMPUTEE WHEELCHAIR; FIXED FULL-LENGTH ARMS, SWING-AWAY, DETACHABLE FOOTREST
MOTORIZED WHEELCHAIR; FIXED FULL-LENGTH ARMS, SWING-AWAY, DETACHABLE, ELEVATING LEGRESTS
MOTORIZED WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETACHABLE, ELEVATING
MOTORIZED WHEELCHAIR; FIXED FULL-LENGTH ARMS, SWING-AWAY, DETACHABLE FOOTRESTS
MOTORIZED WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETACHABLE FOOTREST
WHEELCHAIR; SPECIALLY SIZED OR CONSTRUCTED, (INDICATE BRAND NAME, MODEL NUMBER, IF ANY, AND JUST
WHEELCHAIR WITH FIXED ARM, FOOTRESTS
WHEELCHAIR WITH FIXED ARM, ELEVATING LEGRESTS
WHEELCHAIR WITH DETACHABLE ARMS, FOOTRESTS
WHEELCHAIR WITH DETACHABLE ARMS, ELEVATING LEGRESTS
SEMI-RECLINING BACK FOR CUSTOMIZED WHEEL CHAIR
FULL RECLINING BACK FOR CUSTOMIZED WHEELCHAIR
SPECIAL HEIGHT ARMS FOR WHEELCHAIR
SPECIAL BACK HEIGHT FOR WHEELCHAIR
POWER OPERATED VEHICLE (THREE- OR FOUR-WHEEL NONHIGHWAY), SPECIFY BRAND NAME AND MODEL NUMB
WHEELCHAIR, PEDIATRIC SIZE, TILT-IN-SPACE, RIGID, ADJUSTABLE, WITH SEATING SYSTEM
WHEELCHAIR, PEDIATRIC SIZE, TILT-IN-SPACE, FOLDING, ADJUSTABLE, WITH SEATING SYSTEM
WHEELCHAIR, PEDIATRIC SIZE, TILT-IN-SPACE, RIGID, ADJUSTABLE, WITHOUT SEATING SYSTEM
WHEELCHAIR, PEDIATRIC SIZE, TILT-IN-SPACE, FOLDING, ADJUSTABLE, WITHOUT SEATING SYSTEM
WHEELCHAIR, PEDIATRIC SIZE, RIGID, ADJUSTABLE, WITH SEATING SYSTEM
WHEELCHAIR, PEDIATRIC SIZE, FOLDING, ADJUSTABLE, WITH SEATING SYSTEM
WHEELCHAIR, PEDIATRIC SIZE, RIGID, ADJUSTABLE, WITHOUT SEATING SYSTEM
WHEELCHAIR, PEDIATRIC SIZE, FOLDING, ADJUSTABLE, WITHOUT SEATING SYSTEM
LIGHTWEIGHT WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETACHABLE, ELEVATIN
LIGHTWEIGHT WHEELCHAIR; FIXED FULL-LENGTH ARMS, SWING-AWAY, DETACHABLE FOOTRESTS
LIGHTWEIGHT WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETACHABLE FOOTRES
LIGHTWEIGHT WHEELCHAIR; FIXED FULL-LENGTH ARMS, SWING-AWAY, DETACHABLE, ELEVATING LEGRESTS
HEAVY DUTY WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, ELEVATING LEGRESTS
HEAVY DUTY WHEELCHAIR; FIXED FULL-LENGTH ARMS, SWING-AWAY, DETACHABLE FOOTREST
HEAVY DUTY WHEELCHAIR; DETACHABLE ARMS, DESK OR FULL-LENGTH, SWING-AWAY, DETACHABLE FOOTREST
HEAVY DUTY WHEELCHAIR; FIXED FULL-LENGTH ARMS, ELEVATING LEGREST
SPECIAL WHEELCHAIR SEAT HEIGHT FROM FLOOR
SPECIAL WHEELCHAIR SEAT DEPTH, BY UPHOLSTERY
SPECIAL WHEELCHAIR SEAT DEPTH AND/OR WIDTH, BY CONSTRUCTION
WHIRLPOOL, PORTABLE (OVERTUB TYPE)
WHIRLPOOL, NONPORTABLE (BUILT-IN TYPE)
REPAIR OR NONROUTINE SERVICE FOR DURABLE MEDICAL EQUIPMENT REQUIRING THE SKILL OF A TECHNICIAN,
REGULATOR
STAND/RACK
IMMERSION EXTERNAL HEATER FOR NEBULIZER
OXYGEN CONCENTRATOR, CAPABLE OF DELIVERING 85 PERCENT OR GREATER OXYGEN CONCENTRATION AT TH
DURABLE MEDICAL EQUIPMENT, MISCELLANEOUS
OXYGEN AND WATER VAPOR ENRICHING SYSTEM WITH HEATED DELIVERY
OXYGEN AND WATER VAPOR ENRICHING SYSTEM WITHOUT HEATED DELIVERY
CENTRIFUGE, FOR DIALYSIS
KIDNEY, DIALYSATE DELIVERY SYSTEM KIDNEY MACHINE, PUMP RECIRCULATING, AIR REMOVAL SYSTEM, FLOWR
HEPARIN INFUSION PUMP FOR HEMODIALYSIS
AIR BUBBLE DETECTOR FOR HEMODIALYSIS, EACH, REPLACEMENT
PRESSURE ALARM FOR HEMODIALYSIS, EACH, REPLACEMENT
BATH CONDUCTIVITY METER FOR HEMODIALYSIS, EACH
BLOOD LEAK DETECTOR FOR HEMODIALYSIS, EACH, REPLACEMENT
ADJUSTABLE CHAIR, FOR ESRD PATIENTS
TRANSDUCER PROTECTORS/FLUID BARRIERS, FOR HEMODIALYSIS, ANY SIZE, PER 10
UNIPUNCTURE CONTROL SYSTEM FOR HEMODIALYSIS
HEMODIALYSIS MACHINE
AUTOMATIC INTERMITTENT PERITONEAL DIALYSIS SYSTEM
CYCLER DIALYSIS MACHINE FOR PERITONEAL DIALYSIS
DELIVERY AND/OR INSTALLATION CHARGES FOR HEMODIALYSIS EQUIPMENT
REVERSE OSMOSIS WATER PURIFICATION SYSTEM, FOR HEMODIALYSIS
DEIONIZER WATER PURIFICATION SYSTEM, FOR HEMODIALYSIS
BLOOD PUMP FOR HEMODIALYSIS, REPLACEMENT
WATER SOFTENING SYSTEM, FOR HEMODIALYSIS
RECIPROCATING PERITONEAL DIALYSIS SYSTEM
WEARABLE ARTIFICIAL KIDNEY, EACH
COMPACT (PORTABLE) TRAVEL HEMODIALYZER SYSTEM
SORBENT CARTRIDGES, FOR HEMODIALYSIS, PER 10
HEMOSTATS, EACH
SCALE, EACH
DIALYSIS EQUIPMENT, NOT OTHERWISE SPECIFIED
JAW MOTION REHABILITATION SYSTEM
REPLACEMENT CUSHIONS FOR JAW MOTION REHABILITATION SYSTEM, PACKAGE OF SIX
REPLACEMENT MEASURING SCALES FOR JAW MOTION REHABILITATION SYSTEM, PACKAGE OF 200
DYNAMIC ADJUSTABLE ELBOW EXTENSION/FLEXION DEVICE, INCLUDES SOFT INTERFACE MATERIAL
BI-DIRECTIONAL STATIC PROGRESSIVE STRETCH ELBOW DEVICE WITH RANGE OF MOTION ADJUSTMENT, INCLUD
DYNAMIC ADJUSTABLE FOREARM PRONATION/SUPINATION DEVICE, INCLUDES SOFT INTERFACE MATERIAL
DYNAMIC ADJUSTABLE WRIST EXTENSION/FLEXION DEVICE, INCLUDES SOFT INTERFACE MATERIAL
BI-DIRECTIONAL STATIC PROGRESSIVE STRETCH WRIST DEVICE WITH RANGE OF MOTION ADJUSTMENT, INCLUD
DYNAMIC ADJUSTABLE KNEE EXTENSION/FLEXION DEVICE, INCLUDES SOFT INTERFACE MATERIAL
BI-DIRECTIONAL STATIC PROGRESSIVE STRETCH KNEE DEVICE WITH RANGE OF MOTION ADJUSTMENT, INCLUDE
DYNAMIC ADJUSTABLE ANKLE EXTENSION/FLEXION DEVICE, INCLUDES SOFT INTERFACE MATERIAL
BI-DIRECTIONAL STATIC PROGRESSIVE STRETCH ANKLE DEVICE WITH RANGE OF MOTION ADJUSTMENT, INCLUD
BI-DIRECTIONAL STATIC PROGRESSIVE STRETCH FOREARM PRONATION/SUPINATION DEVICE WITH RANGE OF M
REPLACEMENT SOFT INTERFACE MATERIAL, DYNAMIC ADJUSTABLE EXTENSION/FLEXION DEVICE
REPLACEMENT SOFT INTERFACE MATERIAL/CUFFS FOR BI-DIRECTIONAL STATIC PROGRESSIVE STRETCH DEVICE
DYNAMIC ADJUSTABLE FINGER EXTENSION/FLEXION DEVICE, INCLUDES SOFT INTERFACE MATERIAL
DYNAMIC ADJUSTABLE TOE EXTENSION/FLEXION DEVICE, INCLUDES SOFT INTERFACE MATERIAL
DYNAMIC ADJUSTABLE SHOULDER FLEXION/ABDUCTION/ROTATION DEVICE, INCLUDES SOFT INTERFACE MATERI
COMMUNICATION BOARD, NON-ELECTRONIC AUGMENTATIVE OR ALTERNATIVE COMMUNICATION DEVICE
GASTRIC SUCTION PUMP, HOME MODEL, PORTABLE OR STATIONARY, ELECTRIC
BLOOD GLUCOSE MONITOR WITH INTEGRATED VOICE SYNTHESIZER
BLOOD GLUCOSE MONITOR WITH INTEGRATED LANCING/BLOOD SAMPLE
ROUTINE VENIPUNCTURE FOR COLLECTION OF SPECIMEN(S)
ADMINISTRATION OF INFLUENZA VIRUS VACCINE WHEN NO PHYSICIAN FEE SCHEDULE SERVICE ON THE SAME DA
ADMINISTRATION OF PNEUMOCOCCAL VACCINE WHEN NO PHYSICIAN FEE SCHEDULE SERVICE ON THE SAME DA
ADMINISTRATION OF HEPATITIS B VACCINE WHEN NO PHYSICIAN FEE SCHEDULE SERVICE ON THE SAME DAY
COLLAGEN SKIN TEST KIT
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING PREVIOUS PET, G0030-G0047); SINGLE STUDY, REST OR ST
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING PREVIOUS PET, G0030-G0047); MULTIPLE STUDIES, REST OR
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING REST SPECT, 78464); SINGLE STUDY, REST OR STRESS (EX
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING REST SPECT, 78464); MULTIPLE STUDIES, REST OR STRESS
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS SPECT, 78465); SINGLE STUDY, REST OR STRESS (
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS SPECT, 78465); MULTIPLE STUDIES, REST OR STRE
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING CORONARY ANGIOGRAPHY, 93510-93529); SINGLE STUDY, R
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING CORONARY ANGIOGRAPHY, 93510-93529); MULTIPLE STUDIE
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS PLANAR MYOCARDIAL PERFUSION, 78460); SINGLE
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS PLANAR MYOCARDIAL PERFUSION, 78460); MULTIP
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS ECHOCARDIOGRAM, 93350); SINGLE STUDY, REST
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS ECHOCARDIOGRAM, 93350); MULTIPLE STUDIES, R
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS NUCLEAR VENTRICULOGRAM, 78481 OR 78483); SIN
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS NUCLEAR VENTRICULOGRAM, 78481 OR 78483); MU
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING REST ECG, 93000); SINGLE STUDY, REST OR STRESS (EXER
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING REST ECG, 93000); MULTIPLE STUDIES, REST OR STRESS (E
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS ECG, 93015); SINGLE STUDY, REST OR STRESS (EX
PET MYOCARDIAL PERFUSION IMAGING, (FOLLOWING STRESS ECG, 93015); MULTIPLE STUDIES, REST OR STRESS
CERVICAL OR VAGINAL CANCER SCREENING; PELVIC AND CLINICAL BREAST EXAMINATION
PROSTATE CANCER SCREENING; DIGITAL RECTAL EXAMINATION
PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA), TOTAL
COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY
COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK
COLORECTAL CANCER SCREENING; ALTERNATIVE TO G0104, SCREENING SIGMOIDOSCOPY, BARIUM ENEMA
COLORECTAL CANCER SCREENING; FECAL-OCCULT BLOOD TEST, 1-3 SIMULTANEOUS DETERMINATIONS
DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES
DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION (2 OR MORE), PER 30 MINUTE
NETT PULMONARY REHABILITATION; EDUCATION/SKILLS TRAINING, INDIVIDUAL
NETT PULMONARY REHABILITATION; EDUCATION/SKILLS TRAINING, GROUP
NETT PULMONARY REHABILITATION; NUTRITIONAL GUIDANCE, INITIAL
NETT PULMONARY REHABILITATION; NUTRITIONAL GUIDANCE, SUBSEQUENT
NETT PULMONARY REHABILITATION; PSYCHOSOCIAL CONSULTATION
NETT PULMONARY REHABILITATION; PSYCHOLOGICAL TESTING
NETT PULMONARY REHABILITATION; PSYCHOSOCIAL COUNSELLING
GLAUCOMA SCREENING FOR HIGH RISK PATIENTS FURNISHED BY AN OPTOMETRIST OR OPHTHALMOLOGIST
GLAUCOMA SCREENING FOR HIGH RISK PATIENT FURNISHED UNDER THE DIRECT SUPERVISION OF AN OPTOMET
COLORECTAL CANCER SCREENING; ALTERNATIVE TO G0105, SCREENING COLONOSCOPY, BARIUM ENEMA
COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK
COLORECTAL CANCER SCREENING; BARIUM ENEMA
SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIV
SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIV
PET IMAGING REGIONAL OR WHOLE BODY; SINGLE PULMONARY NODULE
TRIMMING OF DYSTROPHIC NAILS, ANY NUMBER
DIRECT (FACE-TO-FACE WITH PATIENT) SKILLED NURSING SERVICES OF A REGISTERED NURSE PROVIDED IN A C
OCCUPATIONAL THERAPY REQUIRING THE SKILLS OF A QUALIFIED OCCUPATIONAL THERAPIST, FURNISHED AS A
SINGLE ENERGY X-RAY ABSORPTIOMETRY (SEXA) BONE DENSITY STUDY, ONE OR MORE SITES; APPENDICULAR S
SCREENING CYTOPATHOLOGY SMEARS, CERVICAL OR VAGINAL, PERFORMED BY AUTOMATED SYSTEM, WITH MA
SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIV
SCREENING CYTOPATHOLOGY, CERVICAL/VAGINAL, COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAY
SCREENING CYTOPATHOLOGY, CERVICAL/VAGINAL (ANY RPTING SYSTEM), COLLECTED PRESERVATIVE FLUID, AU
SCREENING CYTOPATHOLOGY SMEARS, CERVICAL OR VAGINAL, PERFORMED BY AUTOMATED SYSTEM UNDER P
SCREENING CYTOPATHOLOGY SMEARS, CERVICAL OR VAGINAL, PERFORMED BY AUTOMATED SYSTEM WITH MA
SERVICES OF PHYSICAL THERAPIST IN HOME HEALTH SETTING, EACH 15 MINUTES
SERVICES OF OCCUPATIONAL THERAPIST IN HOME HEALTH SETTING, EACH 15 MINUTES
SERVICES OF SPEECH AND LANGUAGE PATHOLOGIST IN HOME HEALTH SETTING, EACH 15 MINUTES
SERVICES OF SKILLED NURSE IN HOME HEALTH SETTING, EACH 15 MINUTES
SERVICES OF CLINICAL SOCIAL WORKER IN HOME HEALTH SETTING, EACH 15 MINUTES
SERVICES OF HOME HEALTH AIDE IN HOME HEALTH SETTING, EACH 15 MINUTES
EXTERNAL COUNTERPULSATION, PER TREATMENT SESSION
HYPERBARIC OXYGEN TREATMENT NOT REQUIRING PHYSICIAN ATTENDANCE, PER TREATMENT SESSION
WOUND CLOSURE UTILIZING TISSUE ADHESIVE(S) ONLY
STEREOTACTIC RADIOSURGERY, COMPLETE COURSE OF THERAPY IN ONE SESSION
SCHEDULED INTERDISCIPLINARY TEAM CONFERENCE (MINIMUM OF THREE EXCLUSIVE OF PATIENT CARE NURSIN
ACTIVITY THERAPY, SUCH AS MUSIC, DANCE, ART OR PLAY THERAPIES NOT FOR RECREATION, RELATED TO THE
TRAINING AND EDUCATIONAL SERVICES RELATED TO THE CARE AND TREATMENT OF PATIENT'S DISABLING MENT
PHYSICIAN RE-CERTIFICATION MEDICARE-COVERED HOME HEALTH SERVICES,CONTACTS W AGENCY & REVIEW R
PHYS CERT, MEDICARE-CVR HOME HEALTH SVCS UNDER HOME HEALTH PLAN, CARE (PT NO PRES), CONTS W H
PHYS SUPERVSN,PAT RECEIV MEDICARE-COVERD SRV PROV BY PART HHA REQ COMPLX&MULTIDISC CARE MOD
PHYS SUPERVSN,PAT UNDR MEDICARE-APPROVED HOSPICE REQ COMPLX&MULTIDISC CARE MODALITIES INVLV
DESTRUCTION OF LOCALIZED LESION OF CHOROID (FOR EXAMPLE, CHOROIDAL NEOVASCULARIZATION); PHOTO
SCREENING MAMMOGRAPHY, PRODUCING DIRECT DIGITAL IMAGE, BILATERAL, ALL VIEWS
DIAGNOSTIC MAMMOGRAPHY, PRODUCING DIRECT DIGITAL IMAGE, BILATERAL, ALL VIEWS
DIAGNOSTIC MAMMOGRAPHY, PRODUCING DIRECT DIGITAL IMAGE, UNILATERAL, ALL VIEWS
PET IMAGING WHOLE BODY; DIAGNOSIS; LUNG CANCER, NON-SMALL CELL
PET IMAGING WHOLE BODY; INITIAL STAGING; LUNG CANCER; NON-SMALL CELL (REPLACES G0126)
PET IMAGING WHOLE BODY; RESTAGING; LUNG CANCER; NON-SMALL
PET IMAGING WHOLE BODY; DIAGNOSIS; COLORECTAL
PET IMAGING WHOLE BODY; INITIAL STAGING; COLORECTAL
PET IMAGING WHOLE BODY; RESTAGING; COLORECTAL CANCER (REPLACES G0163)
PET IMAGING WHOLE BODY; DIAGNOSIS; MELANOMA
PET IMAGING WHOLE BODY; INITIAL STAGING; MELANOMA
PET IMAGING WHOLE BODY; RESTAGING; MELANOMA (REPLACES G0165)
PET IMAGING WHOLE BODY; MELANOMA FOR NON-COVERED INDICATIONS
PET IMAGING WHOLE BODY; DIAGNOSIS; LYMPHOMA
PET IMAGING WHOLE BODY; INITIAL STAGING; LYMPHOMA (REPLACES G0164)
PET IMAGING WHOLE BODY; RESTAGING; LYMPHOMA (REPLACES G0164)
PET IMAGING WHOLE BODY OR REGIONAL; DIAGNOSIS; HEAD AND NECK CANCER; EXCLUDING THYROID AND CNS
PET IMAGING WHOLE BODY OR REGIONAL; INITIAL STAGING; HEAD AND NECK CANCER; EXCLUDING THYROID AND
PET IMAGING WHOLE BODY OR REGIONAL; RESTAGING; HEAD AND NECK CANCER, EXCLUDING THYROID AND CN
PET IMAGING WHOLE BODY; DIAGNOSIS; ESOPHAGEAL CANCER
PET IMAGING WHOLE BODY; INITIAL STAGING; ESOPHAGEAL CANCER
PET IMAGING WHOLE BODY; RESTAGING; ESOPHAGEAL CANCER
PET IMAGING; METABOLIC BRAIN IMAGING FOR PRE-SURGICAL EVALUATION OF REFRACTORY SEIZURES
PET IMAGING; METABOLIC ASSESSMENT FOR MYOCARDIAL VIABILITY FOLLOWING INCONCLUSIVE SPECT STUDY
PET, WHOLE BODY, FOR RECURRENCE OF COLORECTAL OR COLORECTAL METASTATIC CANCER; GAMMA CAMER
PET, WHOLE BODY, FOR STAGING AND CHARACTERIZATION OF LYMPHOMA; GAMMA CAMERAS ONLY
PET, WHOLE BODY, FOR RECURRENCE OF MELANOMA OR MELANOMA METASTATIC CANCER; GAMMA CAMERAS O
PET, REGAL/WHOLE BDY, SOLITARY PULMONARY NODULE FOLL CT/FOR INT STGNG, PATHOLOGICALLY DIAGNOSE
DIGITIZATION, FILM RADIOGRAPHIC IMAG W COMPUTER ANAL, LES DETECT,/COMP ANAL DIG MAMMO &FURTHER
THERAPEUTIC PROCEDURES TO INCREASE STRENGTH OR ENDURANCE OF RESPIRATORY MUSCLES, FACE TO FA
THERAPEUTIC PROCEDURES TO IMPROVE RESPIRATORY FUNCTION, OTHER THAN DESCRIBED BY G0237, ONE ON
THERAPEUTIC PROCEDURES TO IMPROVE RESPIRATORY FUNCTION / INCREASE STRENGTH / ENDURANCE OF RE
MULT-SRC PHOTON STEREOTAC RADSRG PLAN,DOS HISTOGMS,TARGT&CRITICL STRUCTUR TOLERANCES,PLAN
MULTI-SOURCE PHOTON STEREOTACTIC RADIOSURGERY, DELIVERY INCLUDING COLLIMATOR CHANGES AND CU
OBSERVATION CARE PROVIDED BY A FACILITY TO A PATIENT WITH CHF, CHEST PAIN, OR ASTHMA, MINIMUM EIGH
INITIAL PHYSICIAN EVALUATION & MANAGEMENT DIABETIC W SENSORY NEUROPATHY LOSS OF PROTECTIVE SEN
FOLLOW-UP PHYSICIAN EVALUATION & MANAGEMENT DIABETIC W SENSORY NEUROPATHY LOSS OF PROTECTIV
ROUTINE FOOT CARE BY A PHYSICIAN OF A DIABETIC W SENSORY NEUROPATHY LOSS OF PROTECTIVE SENSATI
DEMONSTRATION,INITIAL USE,HOME INR MONITORING PATIENT W MECHANICAL HEART VALVE MEDICARE COVER
PROVISION OF TEST MATERIALS & EQUIPMENT HOME INR MONITORING TO PATIENT W MECHANICAL HEART VALV
PHYSICIAN REVIEW, INTERPRETATION AND PATIENT MANAGEMENT OF HOME INR TESTING FOR A PATIENT WITH
LINEAR ACCELERATOR BASED STEREOTACTIC RADIOSURGERY, DELIVERY INCLUDING COLLIMATOR CHANGES &
PET IMAGING, FULL AND PARTIAL-RING PET SCANNERS ONLY, FOR INITIAL DIAGNOSIS OF BREAST CANCER AND/O
PET IMAGING FOR BREAST CANCER, FULL & PARTIAL-RING PET SCANNERS ONLY, STAGING/RESTAGING OF LOCA
PET IMAGING FOR BREAST CANCER, FULL AND PARTIAL-RING PET SCANNERS ONLY, EVALUATION OF RESPONSE
CURRENT PERCEPTION THRESHOLD/SENSORY NERVE CONDUCTION TEST, (SNCT) PER LIMB, ANY NERVE
PROSTATE BRACHYTHERAPY USING PERMANENTLY IMPLANTED PALLADIUM SEEDS, TRANSPERITONEAL PLACEM
UNSCHEDULED OR EMERGENCY DIALYSIS TREATMENT FOR AN ESRD PATIENT IN A HOSPITAL OUTPATIENT DEPA
INTRAVENOUS INFUSION DURING SEPARATELY PAYABLE OBSERVATION STAY, PER OBSERVATION STAY (MUST B
INJECTION PROCEDURE FOR SACROILIAC JOINT; ARTHROGRAPY
INJECTION PROCEDURE FOR SACROILIAC JOINT; PROVISION OF ANESTHETIC, STEROID AND/OR OTHER THERAPE
PROSTATE BRACHYTHERAPY PERMANENTLY IMPLANTED IODINE SEEDS, INCLUDING TRANSPERINEAL PLACEMEN
SMALL INTESTINAL IMAGING; INTRALUMINAL, FROM LIGAMENT OF TREITZ TO THE ILEO CECAL VALVE, INCLUDES P
DIRECT ADMISSION OF PATIENT WITH DIAGNOSIS OF CONGESTIVE HEART FAILURE, CHEST PAIN OR ASTHMA FOR
INITIAL NURSING ASSESSMENT OF PATIENT DIRECTLY ADMITTED TO OBSERVATION WITH DIAGNOSIS OTHER THA
CRYOPRESERVATION, FREEZING AND STORAGE OF CELLS FOR THERAPEUTIC USE, EACH CELL LINE
THAWING AND EXPANSION OF FROZEN CELLS FOR THERAPEUTIC USE, EACH ALIQUOT
BONE MARROW OR PERIPHERAL STEM CELL HARVEST, MODIFICATION OR TREATMENT TO ELIMINATE CELL TYPE
REMOVAL OF IMPACTED CERUMEN (ONE OR BOTH EARS) BY PHYSICIAN ON SAME DATE OF SERVICE AS AUDIOLO
PLACEMENT OF OCCLUSIVE DEVICE INTO EITHER A VENOUS OR ARTERIAL ACCESS SITE, POST SURGICAL OR INT
MEDICAL NUTRITION THERAPY; REASSESSMENT & SUBSEQUENT INTERVENTION FOLLOWING 2ND REFERRL SAM
MEDICAL NUTRITION THERAPY, REASSESSMENT & SUBSEQUENT INTERVENTION FOLLOWING 2ND REFERRL SAM
NASO/ORO GASTRIC TUBE PLACEMENT, REQUIRING PHYSICIAN'S SKILL AND FLUOROSCOPIC GUIDANCE (INCLUDE
RADIOPHARMACEUTICAL BIODISTRIBUTION, SINGLE/MULTIPLE SCANS 1 /+ DAYS, PRE-TREATMENT PLANNING RAD
RADIOPHARMACEUTICAL THERAPY, NON-HODGKIN'S LYMPHOMA, INCLUDES ADMINISTRATION OF RADIOPHARMA
RENAL ARTERY ANGIOGRAPHY PERFORMED TIME OF CARDIAC CATHETERIZATION, INCLUDES CATHETER PLACEM
ILIAC ARTERY ANGIOGRAPHY PERFORMED AT THE SAME TIME OF CARDIAC CATHETERIZATION, INCLUDES CATHE
EXTRACORPOREAL SHOCK WAVE THERAPY; INVOLVING ELBOW EPICONDYLITIS
EXTRACORPOREAL SHOCK WAVE THERAPY; INVOLVING OTHER THAN ELBOW EPICONDYLITIS OR PLANTAR FASC
ELECTRICAL STIMULATION,TO 1/+ AREAS,FOR CHRONIC STAGE III & STAGE IV PRESSURE ULCERS,ARTERIAL ULCE
ELECTRICAL STIMULATION, (UNATTENDED), TO ONE OR MORE AREAS, FOR WOUND CARE OTHER THAN DESCRIB
ELECTRICAL STIMULATION (UNATTENDED), TO ONE OR MORE AREAS FOR INDICATION(S) OTHER THAN WOUND C
RECONSTRUCTION, COMPUTED TOMOGRAPHIC ANGIOGRAPHY OF AORTA FOR SURGICAL PLANNING FOR VASCU
ARTHROSCOPY, KNEE, SURGICAL, FOR REMOVAL OF LOOSE BODY, FOREIGN BODY, DEBRIDEMENT/SHAVING OF A
TRANSCATHETER PLACEMENT OF A DRUG ELUTING INTRACORONARY STENT(S), PERCUTANEOUS, W/ WO OTHER
TRANSCATHETER PLACEMENT OF A DRUG ELUTING INTRACORONARY STENT(S), PERCUTANEOUS,W/WO OTHER
ADMINISTRATION EXPERIMENTAL DRUG ONLY MEDICARE QUALIFYING CLINICAL TRIAL (INCLUDES ADMINISTRATIO
NONCOVERED SURGICAL PROCEDURE(S) USING CONSCIOUS SEDATION, REGIONAL, GENERAL OR SPINAL ANEST
NONCOVERED PROCEDURE(S) USING EITHER NO ANESTHESIA OR LOCAL ANESTHESIA ONLY, IN A MEDICARE QUA
ELECTROMAGNETIC STIMULATION, TO ONE OR MORE AREAS
COORDINATED CARE FEE, INITIAL RATE
COORDINATED CARE FEE, MAINTENANCE RATE
COORDINATED CARE FEE, RISK ADJUSTED HIGH, INITIAL
COORDINATED CARE FEE, RISK ADJUSTED LOW, INITIAL
COORDINATED CARE FEE, RISK ADJUSTED MAINTENANCE
COORDINATED CARE FEE, HOME MONITORING
COORDINATED CARE FEE, SCHEDULE TEAM CONFERENCE
COORDINATED CARE FEE, PHYSICIAN COORDINATED CARE OVERSIGHT SERVICES
COORDINATED CARE FEE, RISK ADJUSTED MAINTENANCE, LEVEL 3
COORDINATED CARE FEE, RISK ADJUSTED MAINTENANCE, LEVEL 4
COORDINATED CARE FEE, RISK ADJUSTED MAINTENANCE, LEVEL 5
OTHER SPECIFIED CASE MANAGEMENT SERVICE NOT ELSEWHERE CLASSIFIED
SMOKING CESSATION COUNSELING, INDIVIDUAL, IN THE ABSENCE OF OR IN ADDITION TO ANY OTHER EVALUATIO
ALCOHOL AND/OR DRUG ASSESSMENT
BEHAVIORAL HEALTH SCREENING TO DETERMINE ELIGIBILITY FOR ADMISSION TO TREATMENT PROGRAM
ALCOHOL AND/OR DRUG SCREENING; LABORATORY ANALYSIS OF SPECIMENS FOR PRESENCE OF ALCOHOL AND
BEHAVIORAL HEALTH COUNSELING AND THERAPY, PER 15 MINUTES
ALCOHOL AND/OR DRUG SERVICES; GROUP COUNSELING BY A CLINICIAN
ALCOHOL AND/OR DRUG SERVICES; CASE MANAGEMENT
ALCOHOL AND/OR DRUG SERVICES; CRISIS INTERVENTION (OUTPATIENT)
ALCOHOL AND/OR DRUG SERVICES; SUB-ACUTE DETOXIFICATION (HOSPITAL INPATIENT)
ALCOHOL AND/OR DRUG SERVICES; ACUTE DETOXIFICATION (HOSPITAL INPATIENT)
ALCOHOL AND/OR DRUG SERVICES; SUB-ACUTE DETOXIFICATION (RESIDENTIAL ADDICTION PROGRAM INPATIEN
ALCOHOL AND/OR DRUG SERVICES; ACUTE DETOXIFICATION (RESIDENTIAL ADDICTION PROGRAM INPATIENT)
ALCOHOL AND/OR DRUG SERVICES; SUB-ACUTE DETOXIFICATION (RESIDENTIAL ADDICTION PROGRAM OUTPATIE
ALCOHOL AND/OR DRUG SERVICES; ACUTE DETOXIFICATION (RESIDENTIAL ADDICTION PROGRAM OUTPATIENT)
ALCOHOL AND/OR DRUG SERVICES; AMBULATORY DETOXIFICATION
ALCOHOL AND/OR DRUG SERVICES; INTENSIVE OUTPATIENT (TX PRGM OPERATES >= 3 HRS/DAY & >= 3 DAYS/WK
ALCOHOL AND/OR DRUG SERVICES; MEDICAL/SOMATIC (MEDICAL INTERVENTION IN AMBULATORY SETTING)
BEHAVIORAL HEALTH; RESIDENTIAL (HOSPITAL RESIDENTIAL TREATMENT PROGRAM), WITHOUT ROOM AND BOA
BEHAVIORAL HEALTH; SHORT-TERM RESIDENTIAL (NON-HOSPITAL RESIDENTIAL TREATMENT PROGRAM), WITHO
BEHAVIORAL HEALTH; LONG-TERM RESIDENTIAL (NON-MEDIAL, NON-ACUTE CARE IN A RESIDENTIAL TREATMENT
ALCOHOL AND/OR DRUG SERVICES; METHADONE ADMINISTRATION AND/OR SERVICE (PROVISION OF THE DRUG B
ALCOHOL AND/OR DRUG TRAINING SERVICE (FOR STAFF AND PERSONNEL NOT EMPLOYED BY PROVIDERS)
ALCOHOL AND/OR DRUG INTERVENTION SERVICE (PLANNED FACILITATION)
BEHAVIORAL HEALTH OUTREACH SERVICE (PLANNED APPROACH TO REACH A TARGETED POPULATION)
BEHAVIORAL HEALTH PREVENTION INFORMATION DISSEMINATION SERVICE (ONE-WAY DIRECT OR NON-DIRECT C
BEHAVIORAL HEALTH PREVENTION EDUCATION SERVICE (DELIVERY OF SERVICES WITH TARGET POPULATION TO
ALCOHOL AND/OR DRUG PREVENTION PROCESS SERVICE, COMMUNITY-BASED (DELIVERY OF SERVICES TO DEVE
ALCOHOL AND/OR DRUG PREVENTION ENVIRONMENTAL SERVICE (BROAD RANGE OF EXTERNAL ACTIVITIES GEA
ALCOHOL AND/OR DRUG PREVENTION PROBLEM IDENTIFICATION AND REFERRAL SERVICE (E.G., STUDENT ASSIS
ALCOHOL AND/OR DRUG PREVENTION ALTERNATIVES SERVICE (SERVICES FOR POPULATIONS THAT EXCLUDE AL
BEHAVIORAL HEALTH HOTLINE SERVICE
MENTAL HEALTH ASSESSMENT, BY NON-PHYSICIAN
MENTAL HEALTH SERVICE PLAN DEVELOPMENT BY NON-PHYSICIAN
ORAL MEDICATION ADMINISTRATION, DIRECT OBSERVATION
MEDICATION TRAINING AND SUPPORT, PER 15 MINUTES
MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS
COMMUNITY PSYCHIATRIC SUPPORTIVE TREATMENT, FACE-TO-FACE, PER 15 MINUTES
COMMUNITY PSYCHIATRIC SUPPORTIVE TREATMENT PROGRAM, PER DIEM
SELF-HELP/PEER SERVICES, PER 15 MINUTES
ASSERTIVE COMMUNITY TREATMENT, FACE-TO-FACE, PER 15 MINUTES
ASSERTIVE COMMUNITY TREATMENT PROGRAM, PER DIEM
FOSTER CARE, CHILD, NON-THERAPEUTIC, PER DIEM
FOSTER CARE, CHILD, NON-THERAPEUTIC, PER MONTH
SUPPORTED HOUSING, PER DIEM
SUPPORTED HOUSING, PER MONTH
RESPITE CARE SERVICES, NOT IN THE HOME, PER DIEM
MENTAL HEALTH SERVICES, NOT OTHERWISE SPECIFIED
ALCOHOL AND/OR OTHER DRUG ABUSE SERVICES, NOT OTHERWISE SPECIFIED
ALCOHOL AND/OR OTHER DRUG TESTING: COLLECTION AND HANDLING ONLY, SPECIMENS OTHER THAN BLOOD
PRENATAL CARE, AT-RISK ASSESSMENT
PRENATAL CARE, AT-RISK ENHANCED SERVICE; ANTEPARTUM MANAGEMENT
PRENATAL CARE, AT RISK ENHANCED SERVICE; CARE COORDINATION
PRENATAL CARE, AT-RISK ENHANCED SERVICE; EDUCATION
PRENATAL CARE, AT-RISK ENHANCED SERVICE; FOLLOW-UP HOME VISIT
PRENATAL CARE, AT-RISK ENHANCED SERVICE PACKAGE (INCLUDES H1001-H1004)
NON-MEDICAL FAMILY PLANNING EDUCATION, PER SESSION
FAMILY ASSESSMENT BY LICENSED BEHAVIORAL HEALTH PROFESSIONAL FOR STATE DEFINED PURPOSES
COMPREHENSIVE MULTIDISCIPLINARY EVALUATION
REHABILITATION PROGRAM, PER 1/2 DAY
INJECTION, TETRACYCLINE, UP TO 250 MG
INJECTION ABCIXIMAB, 10 MG
INJECTION, ADENOSINE, 6 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS, INSTEA
INJECTION, ADENOSINE, 90 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS, INSTE
INJECTION, ADRENALIN, EPINEPHRINE, UP TO 1 ML AMPULE
INJECTION, BIPERIDEN LACTATE, PER 5 MG
INJECTION, ALATROFLOXACIN MESYLATE, 100 MG
INJECTION, ALGLUCERASE, PER 10 UNITS
INJECTION, AMIFOSTINE, 500 MG
INJECTION, METHYLDOPATE HCL, UP TO 250 MG
INJECTION, ALPHA 1 - PROTEINASE INHIBITOR - HUMAN, 10 MG
INJECTION, ALPROSTADIL, 1.25 MCG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER TH
ALPROSTADIL URETHRAL SUPPOSITORY (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDE
INJECTION, AMINOPHYLLIN, UP TO 250 MG
INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG
INJECTION, AMPHOTERICIN B, 50 MG
INJECTION, AMPHOTERICIN B LIPID COMPLEX, 10 MG
INJECTION, AMPHOTERICIN B CHOLESTERYL SULFATE COMPLEX, 10 MG
INJECTION, AMPHOTERICIN B LIPOSOME, 10 MG
INJECTION, AMPICILLIN SODIUM, 500 MG
INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 G
INJECTION, AMOBARBITAL, UP TO 125 MG
INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG
INJECTION, ANISTREPLASE, PER 30 UNITS
INJECTION, HYDRALAZINE HCL, UP TO 20 MG
INJECTION, METARAMINOL BITARTRATE, PER 10 MG
INJECTION, CHLOROQUINE HCL, UP TO 250 MG
INJECTION, ARBUTAMINE HCL, 1 MG
INJECTION, AZITHROMYCIN, 500 MG
INJECTION, ATROPINE SULFATE, UP TO 0.3 MG
INJECTION, DIMERCAPROL, PER 100 MG
INJECTION, BACLOFEN, 10 MG
INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL
INJECTION, DICYCLOMINE HCL, UP TO 20 MG
INJECTION, BENZTROPINE MESYLATE, PER 1 MG
INJECTION, BETHANECHOL CHLORIDE, MYOTONACHOL OR URECHOLINE, UP TO 5 MG
INJECTION, PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE, UP TO 600,000 UNITS
INJECTION, PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE, UP TO 1,200,000 UNITS
INJECTION, PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE, UP TO 2,400,000 UNITS
INJECTION, PENICILLIN G BENZATHINE, UP TO 600,000 UNITS
INJECTION, PENICILLIN G BENZATHINE, UP TO 1,200,000 UNITS
INJECTION, PENICILLIN G BENZATHINE, UP TO 2,400,000 UNITS
BOTULINUM TOXIN TYPE A, PER UNIT
BOTULINUM TOXIN TYPE B, PER 100 UNITS
INJECTION, BUPRENORPHINE HYDROCHLORIDE, 0.1 MG
INJECTION, EDETATE CALCIUM DISODIUM, UP TO 1000 MG
INJECTION, CALCIUM GLUCONATE, PER 10 ML
INJECTION, CALCIUM GLYCEROPHOSPHATE AND CALCIUM LACTATE, PER 10 ML
INJECTION, CALCITONIN-SALMON, UP TO 400 UNITS
INJECTION, CALCITRIOL, 0.1 MCG
INJECTION, CASPOFUNGIN ACETATE, 5 MG
INJECTION, LEUCOVORIN CALCIUM, PER 50 MG
INJECTION, MEPIVACAINE HCL, PER 10 ML
INJECTION, CEFAZOLIN SODIUM, 500 MG
INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG
INJECTION, CEFOXITIN SODIUM, 1 G
INJECTION, CEFTRIAXONE SODIUM, PER 250 MG
INJECTION, STERILE CEFUROXIME SODIUM, PER 750 MG
CEFOTAXIME SODIUM, PER G
INJECTION, BETAMETHASONE ACETATE AND BETAMETHASONE SODIUM PHOSPHATE, PER 3 MG
INJECTION, BETAMETHASONE SODIUM PHOSPHATE, PER 4 MG
INJECTION, CAFFEINE CITRATE, 5MG
INJECTION, CEPHAPIRIN SODIUM, UP TO 1 G
INJECTION, CEFTAZIDIME, PER 500 MG
INJECTION, CEFTIZOXIME SODIUM, PER 500 MG
INJECTION, CHLORAMPHENICOL SODIUM SUCCINATE, UP TO 1 G
INJECTION, CHORIONIC GONADOTROPIN, PER 1,000 USP UNITS
INJECTION, CLONIDINE HYDROCHLORIDE, 1 MG
INJECTION, CIDOFOVIR, 375 MG
INJECTION, CILASTATIN SODIUM; IMIPENEM, PER 250 MG
INJECTION, CIPROFLOXACIN FOR INTRAVENOUS INFUSION, 200 MG
INJECTION, CODEINE PHOSPHATE, PER 30 MG
INJECTION, COLCHICINE, PER 1MG
INJECTION, COLISTIMETHATE SODIUM, UP TO 150 MG
INJECTION, PROCHLORPERAZINE, UP TO 10 MG
INJECTION, CORTICOTROPIN, UP TO 40 UNITS
INJECTION, COSYNTROPIN, PER 0.25 MG
INJECTION, CYTOMEGALOVIRUS IMMUNE GLOBULIN INTRAVENOUS (HUMAN), PER VIAL
INJECTION, DARBEPOETIN ALFA, 5 MCG
INJECTION, DEFEROXAMINE MESYLATE, 500 MG
INJECTION, TESTOSTERONE ENANTHATE AND ESTRADIOL VALERATE, UP TO 1 CC
INJECTION, BROMPHENIRAMINE MALEATE, PER 10 MG
INJECTION, ESTRADIOL VALERATE, UP TO 40 MG
INJECTION, DEPO-ESTRADIOL CYPIONATE, UP TO 5 MG
INJECTION, METHYLPREDNISOLONE ACETATE, 20 MG
INJECTION, METHYLPREDNISOLONE ACETATE, 40 MG
INJECTION, METHYLPREDNISOLONE ACETATE, 80 MG
INJECTION, MEDROXYPROGESTERONE ACETATE, 50 MG
INJECTION, MEDROXYPROGESTERONE ACETATE FOR CONTRACEPTIVE USE, 150 MG
INJECTION, MEDROXYPROGESTERONE ACETATE/ESTRADIOL CYPIONATE, 5MG/25MG
INJECTION, TESTOSTERONE CYPIONATE AND ESTRADIOL CYPIONATE, UP TO 1 ML
INJECTION, TESTOSTERONE CYPIONATE, UP TO 100 MG
INJECTION, TESTOSTERONE CYPIONATE, 1 CC, 200 MG
INJECTION, DEXAMETHASONE ACETATE, 1 MG
INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1MG
INJECTION, DIHYDROERGOTAMINE MESYLATE, PER 1 MG
INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG
INJECTION, DIGOXIN, UP TO 0.5 MG
INJECTION, PHENYTOIN SODIUM, PER 50 MG
INJECTION, HYDROMORPHONE, UP TO 4 MG
INJECTION, DYPHYLLINE, UP TO 500 MG
INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG
INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG
INJECTION, CHLOROTHIAZIDE SODIUM, PER 500 MG
INJECTION, DMSO, DIMETHYL SULFOXIDE, 50%, 50 ML
INJECTION, METHADONE HCL, UP TO 10 MG
INJECTION, DIMENHYDRINATE, UP TO 50 MG
INJECTION, DIPYRIDAMOLE, PER 10 MG
INJECTION, DOBUTAMINE HCL, PER 250 MG
INJECTION, DOLASETRON MESYLATE, 10 MG
INJECTION, DOXERCALCIFEROL, 1 MCG
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
INJECTION, EPOPROSTENOL, 0.5 MG
INJECTION, EPTIFIBATIDE, 5 MG
INJECTION, ERGONOVINE MALEATE, UP TO 0.2 MG
INJECTION, ERYTHROMYCIN LACTOBIONATE, PER 500 MG
INJECTION, ESTRADIOL VALERATE, UP TO 10 MG
INJECTION, ESTRADIOL VALERATE, UP TO 20 MG
INJECTION, ESTROGEN CONJUGATED, PER 25 MG
INJECTION, ESTRONE, PER 1 MG
INJECTION, ETIDRONATE DISODIUM, PER 300 MG
INJECTION, ETANERCEPT, 25 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE D
INJECTION, FILGRASTIM (G-CSF), 300 MCG
INJECTION, FILGRASTIM (G-CSF), 480 MCG
INJECTION FLUCONAZOLE, 200 MG
INJECTION, FOMIVIRSEN SODIUM, INTRAOCULAR, 1.65 MG
INJECTION, FOSCARNET SODIUM, PER 1000 MG
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 1 CC
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 2 CC
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 3 CC
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 4 CC
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 5 CC
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 6 CC
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 7 CC
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 8 CC
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 9 CC
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, 10 CC
INJECTION, GAMMA GLOBULIN, INTRAMUSCULAR, OVER 10 CC
INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, 1G
INJECTION, IMMUNE GLOBULIN, 10 MG
INJECTION, RESPIRATORY SYNCYTIAL VIRUS IMMUNE GLOBULIN, INTRAVENOUS, 50 MG
INJECTION, GANCICLOVIR SODIUM, 500 MG
INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG
INJECTION, GATIFLOXACIN, 10MG
INJECTION, GOLD SODIUM THIOMALATE, UP TO 50 MG
INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG
INJECTION, GONADORELIN HYDROCHLORIDE, PER 100 MCG
INJECTION, GRANISETRON HYDROCHLORIDE, 100 MCG
INJECTION, HALOPERIDOL, UP TO 5 MG
INJECTION, HALOPERIDOL DECANOATE, PER 50 MG
INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS
INJECTION, HEPARIN SODIUM, PER 1000 UNITS
INJECTION, DALTEPARIN SODIUM, PER 2500 IU
INJECTION, ENOXAPARIN SODIUM, 10 MG
INJECTION, FONDAPARINUX SODIUM, 0.5 MG
INJECTION, TINZAPARIN SODIUM, 1000 IU
INJECTION, TETANUS IMMUNE GLOBULIN, HUMAN, UP TO 250 UNITS
INJECTION, HYDROCORTISONE ACETATE, UP TO 25 MG
INJECTION, HYDROCORTISONE SODIUM PHOSPHATE, UP TO 50 MG
INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG
INJECTION, DIAZOXIDE, UP TO 300 MG
INJECTION, IBUTILIDE FUMARATE, 1 MG
INJECTION INFLIXIMAB, 10 MG
INJECTION, IRON DEXTRAN, 50 MG
INJECTION, IRON SUCROSE, 1 MG
INJECTION, IMIGLUCERASE, PER UNIT
INJECTION, DROPERIDOL, UP TO 5 MG
INJECTION, PROPRANOLOL HCL, UP TO 1 MG
INJECTION, DROPERIDOL AND FENTANYL CITRATE, UP TO 2 ML AMPULE
INJECTION, INSULIN, PER 5 UNITS
INSULIN FOR ADMINISTRATION THROUGH DME (I.E., INSULIN PUMP) PER 50 UNITS
INJECTION, INTERFERON BETA-1A, 33 MCG
INJECTION INTERFERON BETA-1B, 0.25 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UND
INJECTION, ITRACONAZOLE, 50 MG
INJECTION, KANAMYCIN SULFATE, UP TO 500 MG
INJECTION, KANAMYCIN SULFATE, UP TO 75 MG
INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG
INJECTION, CEPHALOTHIN SODIUM, UP TO 1 G
INJECTION, KUTAPRESSIN, UP TO 2 ML
INJECTION, FUROSEMIDE, UP TO 20 MG
INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG
INJECTION, LEVOCARNITINE, PER 1 G
INJECTION, LEVOFLOXACIN, 250 MG
INJECTION, LEVORPHANOL TARTRATE, UP TO 2 MG
INJECTION, CHLORDIAZEPOXIDE HCL, UP TO 100 MG
INJECTION, LIDOCAINE HCL, 50 CC
INJECTION, LINCOMYCIN HCL, UP TO 300 MG
INJECTION, LINEZOLID, 200MG
INJECTION, LORAZEPAM, 2 MG
INJECTION, MANNITOL, 25% IN 50 ML
INJECTION, MEPERIDINE HCL, PER 100 MG
INJECTION, MEPERIDINE AND PROMETHAZINE HCL, UP TO 50 MG
INJECTION, METHYLERGONOVINE MALEATE, UP TO 0.2 MG
INJECTION, MIDAZOLAM HCL, PER 1 MG
INJECTION, MILRINON LACTATE, 5MG
INJECTION, MORPHINE SULFATE, UP TO 10 MG
INJECTION, MORPHINE SULFATE, 100MG
INJECTION, MORPHINE SULFATE (PRESERVATIVE-FREE STERILE SOLUTION), PER 10 MG
INJECTION, NALBUPHINE HCL, PER 10 MG
INJECTION, NALOXONE HCL, PER 1 MG
INJECTION, NANDROLONE DECANOATE, UP TO 50 MG
INJECTION, NANDROLONE DECANOATE, UP TO 100 MG
INJECTION, NANDROLONE DECANOATE, UP TO 200 MG
INJECTION, NESIRITIDE, 0.5 MG
INJECTION, OCTREOTIDE ACETATE, 1 MG
INJECTION, OPRELVEKIN, 5 MG
INJECTION, ORPHENADRINE CITRATE, UP TO 60 MG
INJECTION, PHENYLEPHRINE HCL, UP TO 1 ML
INJECTION, CHLOROPROCAINE HCL, PER 30 ML
INJECTION, ONDANSETRON HCL, PER 1 MG
INJECTION, OXYMORPHONE HCL, UP TO 1 MG
INJECTION, PAMIDRONATE DISODIUM, PER 30 MG
INJECTION, PAPAVERINE HCL, UP TO 60 MG
INJECTION, OXYTETRACYCLINE HCL, UP TO 50 MG
INJECTION, PARICALCITOL, 1 MCG
INJECTION, PENICILLIN G PROCAINE, AQUEOUS, UP TO 600,000 UNITS
INJECTION, PENTOBARBITAL SODIUM, PER 50 MG
INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS
INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)
PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, PER 300 MG, ADMINISTERED THROUGH A DME
INJECTION, PROMETHAZINE HCL, UP TO 50 MG
INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG
INJECTION, OXYTOCIN, UP TO 10 UNITS
INJECTION, DESMOPRESSIN ACETATE, PER 1 MCG
INJECTION, PREDNISOLONE ACETATE, UP TO 1 ML
INJECTION, TOLAZOLINE HCL, UP TO 25 MG
INJECTION, PROGESTERONE, PER 50 MG
INJECTION, FLUPHENAZINE DECANOATE, UP TO 25 MG
INJECTION, PROCAINAMIDE HCL, UP TO 1 G
INJECTION, OXACILLIN SODIUM, UP TO 250 MG
INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG
INJECTION, PROTAMINE SULFATE, PER 10 MG
INJECTION, PROTIRELIN, PER 250 MCG
INJECTION, PRALIDOXIME CHLORIDE, UP TO 1 G
INJECTION, PHENTOLAMINE MESYLATE, UP TO 5 MG
INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG
INJECTION, QUINUPRISTIN/DALFOPRISTIN, 500 MG (150/350)
INJECTION, RANITIDINE HYDROCHLORIDE, 25 MG
INJECTION, RHO D IMMUNE GLOBULIN, HUMAN, MINIDOSE, 50 MCG
INJECTION, RHO D IMMUNE GLOBULIN, HUMAN, FULL DOSE, 300 MCG
INJECTION, RHO D IMMUNE GLOBULIN, INTRAVENOUS, HUMAN, SOLVENT DETERGENT, 100 IU
INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG
INJECTION, METHOCARBAMOL, UP TO 10 ML
INJECTION, THEOPHYLLINE, PER 40 MG
INJECTION, SARGRAMOSTIM (GM-CSF), 50 MCG
INJECTION, AUROTHIOGLUCOSE, UP TO 50 MG
INJECTION, SODIUM CHLORIDE, 0.9%, PER 2 ML
INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MG
INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 40 MG
INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 125 MG
INJECTION, SOMATREM, 1 MG
INJECTION, SOMATROPIN, 1 MG
INJECTION, PROMAZINE HCL, UP TO 25 MG
INJECTION, RETEPLASE, 18.1 MG
INJECTION, STREPTOKINASE, PER 250,000 IU
INJECTION, ALTEPLASE RECOMBINANT, 1 MG
INJECTION, STREPTOMYCIN, UP TO 1 G
INJECTION, FENTANYL CITRATE, 0.1 MG
INJECTION, SUMATRIPTAN SUCCINATE, 6 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED U
INJECTION, PENTAZOCINE, 30 MG
INJECTION, TENECTEPLASE, 50MG
INJECTION, TERBUTALINE SULFATE, UP TO 1 MG
INJECTION, TESTOSTERONE ENANTHATE, UP TO 100 MG
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
INJECTION, TESTOSTERONE SUSPENSION, UP TO 50 MG
INJECTION, TESTOSTERONE PROPIONATE, UP TO 100 MG
INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG
INJECTION, THYROTROPIN ALPHA, 0.9 MG, PROVIDED IN 1.1 MG VIAL
INJECTION, TIROFIBAN HYDROCHLORIDE, 12.5 MG
INJECTION, TRIMETHOBENZAMIDE HCL, UP TO 200 MG
INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG
INJECTION, TORSEMIDE, 10 MG/ML
INJECTION, THIETHYLPERAZINE MALEATE, UP TO 10 MG
INJECTION, TRIAMCINOLONE ACETONIDE, PER 10MG
INJECTION, TRIAMCINOLONE DIACETATE, PER 5MG
INJECTION, TRIAMCINOLONE HEXACETONIDE, PER 5MG
INJECTION, TRIMETREXATE GLUCORONATE, PER 25 MG
INJECTION, PERPHENAZINE, UP TO 5 MG
INJECTION, TRIPTORELIN PAMOATE, 3.75 MG
INJECTION, SPECTINOMYCIN DIHYDROCHLORIDE, UP TO 2 G
INJECTION, UREA, UP TO 40 G
INJECTION, DIAZEPAM, UP TO 5 MG
INJECTION, UROKINASE, 5000 IU VIAL
INJECTION, IV, UROKINASE, 250,000 IU VIAL
INJECTION, VANCOMYCIN HCL, 500 MG
INJECTION, VERTEPORFIN, 15MG
INJECTION, TRIFLUPROMAZINE HCL, UP TO 20 MG
INJECTION, HYDROXYZINE HCL, UP TO 25 MG
INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG
INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG
INJECTION, HYALURONIDASE, UP TO 150 UNITS
INJECTION, MAGNESIUM SULPHATE, PER 500 MG
INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ
INJECTION, ZIDOVUDINE, 10 MG
INJECTION, ZOLEDRONIC ACID, 1 MG
UNCLASSIFIED DRUGS
EDETATE DISODIUM, PER 150 MG
NASAL VACCINE INHALATION
DRUG ADMINISTERED THROUGH A METERED DOSE INHALER
LAETRILE, AMYGDALIN, VITAMIN B-17
UNCLASSIFIED BIOLOGICS
INFUSION, NORMAL SALINE SOLUTION , 1000 CC
INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML=1 UNIT)
5% DEXTROSE/NORMAL SALINE (500 ML = 1 UNIT)
INFUSION, NORMAL SALINE SOLUTION , 250 CC
STERILE SALINE OR WATER, UP TO 5 CC
5% DEXTROSE/WATER (500 ML = 1 UNIT)
INFUSION, D5W, 1000 CC
INFUSION, DEXTRAN 40, 500 ML
INFUSION, DEXTRAN 75, 500 ML
RINGERS LACTATE INFUSION, UP TO 1000 CC
HYPERTONIC SALINE SOLUTION, 50 OR 100 MEQ, 20 CC VIAL
FACTOR VIII (ANTIHEMOPHILIC FACTOR, HUMAN) PER IU
FACTOR VIII (ANTIHEMOPHILIC FACTOR (PORCINE)), PER IU
FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER IU
FACTOR IX (ANTIHEMOPHILIC FACTOR, PURIFIED, NON-RECOMBINANT) PER I.U.
FACTOR IX, COMPLEX, PER IU
FACTOR IX (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U.
ANTITHROMBIN III (HUMAN), PER IU
ANTI-INHIBITOR, PER IU
HEMOPHILIA CLOTTING FACTOR, NOT OTHERWISE CLASSIFIED
INTRAUTERINE COPPER CONTRACEPTIVE
LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM, 52 MG
AMINOLEVULINIC ACID HCL FOR TOPICAL ADMINISTRATION, 20%, SINGLE UNIT DOSAGE FORM (354 MG)
GANCICLOVIR, 4.5 MG, LONG-ACTING IMPLANT
SODIUM HYALURONATE, PER 20 TO 25 MG DOSE FOR INTRA-ARTICULAR INJECTION
HYLAN G-F 20, 16 MG, FOR INTRA-ARTICULAR INJECTION
AUTOLOGOUS CULTURED CHONDROCYTES, IMPLANT
DERMAL AND EPIDERMAL TISSUE OF HUMAN ORIGIN, WITH OR WITHOUT BIOENGINEERED OR PROCESSED ELEM
DERMAL TISSUE, OF HUMAN ORIGIN, WITH OR WITHOUT OTHER BIOENGINEERED OR PROCESSED ELEMENTS, WI
DERMAL TISSUE OF HUMAN ORIGIN, INJECTABLE, WITH OR WITHOUT OTHER BIOENGINEERED OR PROCESSED EL
AZATHIOPRINE, ORAL, 50 MG
AZATHIOPRINE, PARENTERAL, 100 MG
CYCLOSPORINE, ORAL, 100 MG
LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, EQUINE, PARENTERAL, 250 MG
MUROMONAB-CD3, PARENTERAL, 5 MG
PREDNISONE, ORAL, PER 5MG
TACROLIMUS, ORAL, PER 1 MG
TACROLIMUS, ORAL, PER 5 MG
METHYLPREDNISOLONE ORAL, PER 4 MG
PREDNISOLONE ORAL, PER 5 MG
LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, RABBIT, PARENTERAL, 25MG
DACLIZUMAB, PARENTERAL, 25 MG
CYCLOSPORINE, ORAL, 25 MG
CYCLOSPORINE, PARENTERAL, 250 MG
MYCOPHENOLATE MOFETIL, ORAL, 250 MG
SIROLIMUS, ORAL, 1 MG
TACROLIMUS, PARENTERAL, 5 MG
IMMUNOSUPPRESSIVE DRUG, NOT OTHERWISE CLASSIFIED
ACETYLCYSTEINE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM
ALBUTEROL,ALL FORMULATIONS SEPARATED ISOMERS,INHALATION SOLUTION ADMINISTERED THRU DME,CONCE
ALBUTEROL,ALL FORMULATIONS SEPARATED ISOMERS,INHALATION SOLUTION ADMINISTERED THRU DME,UNIT D
BECLOMETHASONE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM
BETAMETHASONE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM
BUDESONIDE INHALATION SOLUTION, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 0.25 TO 0.50 MG
BITOLTEROL MESYLATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, PER MIL
BITOLTEROL MESYLATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRA
CROMOLYN SODIUM, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 10 MILLIGRA
BUDESONIDE, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, PER 0.25 MILLIGRA
ATROPINE, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, PER MILLIGRAM
ATROPINE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM
DEXAMETHASONE, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, PER MILLIGRA
DEXAMETHASONE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM
DORNASE ALPHA, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM
FLUNISOLIDE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE, PER MILLIGRAM
GLYCOPYRROLATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, PER MILLIGR
GLYCOPYRROLATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM
IPRATROPIUM BROMIDE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRA
ISOETHARINE HCL, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, PER MILLIGRA
ISOETHARINE HCL, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM
ISOPROTERENOL HCL, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, PER MILL
ISOPROTERENOL HCL, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM
METAPROTERENOL SULFATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, PE
METAPROTERENOL SULFATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 10 M
TERBUTALINE SULFATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, PER MIL
TERBUTALINE SULFATE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRA
TOBRAMYCIN, UNIT DOSE FORM, 300 MG, INHALATION SOLUTION, ADMINISTERED THROUGH DME
TRIAMCINOLONE, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, PER MILLIGRAM
TRIAMCINOLONE, INHALATION SOLUTION ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM
NOC DRUGS, INHALATION SOLUTION ADMINISTERED THROUGH DME
NOC DRUGS, OTHER THAN INHALATION DRUGS, ADMINISTERED THROUGH DME
PRESCRIPTION DRUG, ORAL, NONCHEMOTHERAPEUTIC, NOT OTHERWISE SPECIFIED
BUSULFAN; ORAL, 2 MG
CAPECITABINE, ORAL, 150 MG
CAPECITABINE, ORAL, 500 MG
CYCLOPHOSPHAMIDE; ORAL, 25 MG
ETOPOSIDE; ORAL, 50 MG
MELPHALAN; ORAL, 2 MG
METHOTREXATE; ORAL, 2.5 MG
TEMOZOLOMIDE, ORAL, 5 MG
PRESCRIPTION DRUG, ORAL, CHEMOTHERAPEUTIC, NOS
DOXORUBICIN HCL, 10 MG
DOXORUBICIN HYDROCHLORIDE, ALL LIPID FORMULATIONS, 10 MG
ALEMTUZUMAB, 10 MG
ALDESLEUKIN, PER SINGLE USE VIAL
ARSENIC TRIOXIDE, 1MG
ASPARAGINASE, 10,000 UNITS
BCG LIVE (INTRAVESICAL) PER INSTALLATION
BLEOMYCIN SULFATE, 15 UNITS
CARBOPLATIN, 50 MG
CARMUSTINE, 100 MG
CISPLATIN, POWDER OR SOLUTION, PER 10 MG
CISPLATIN, 50 MG
INJECTION, CLADRIBINE, PER 1 MG
CYCLOPHOSPHAMIDE, 100 MG
CYCLOPHOSPHAMIDE, 200 MG
CYCLOPHOSPHAMIDE, 500 MG
CYCLOPHOSPHAMIDE, 1.0 G
CYCLOPHOSPHAMIDE, 2.0 G
CYCLOPHOSPHAMIDE, LYOPHILIZED, 100 MG
CYCLOPHOSPHAMIDE, LYOPHILIZED, 200 MG
CYCLOPHOSPHAMIDE, LYOPHILIZED, 500 MG
CYCLOPHOSPHAMIDE, LYOPHILIZED, 1.0 GRAM
CYCLOPHOSPHAMIDE, LYOPHILIZED, 2.0 GRAM
CYTARABINE, 100 MG
CYTARABINE, 500 MG
DACTINOMYCIN, 0.5 MG
DACARBAZINE, 100 MG
DACARBAZINE, 200 MG
DAUNORUBICIN, 10 MG
DAUNORUBICIN CITRATE, LIPOSOMAL FORMULATION, 10 MG
DENILEUKIN DIFTITOX, 300 MCG
DIETHYLSTILBESTROL DIPHOSPHATE, 250 MG
DOCETAXEL, 20 MG
EPIRUBICIN HYDROCHLORIDE, 50 MG
ETOPOSIDE, 10 MG
ETOPOSIDE, 100 MG
FLUDARABINE PHOSPHATE, 50 MG
FLUOROURACIL, 500 MG
FLOXURIDINE, 500 MG
GEMCITABINE HCL, 200 MG
GOSERELIN ACETATE IMPLANT, PER 3.6 MG
IRINOTECAN, 20 MG
IFOSFAMIDE, 1 G
MESNA, 200 MG
IDARUBICIN HCL, 5 MG
INJECTION, INTERFERON ALFACON-1, RECOMBINANT, 1 MCG
INTERFERON, ALFA-2A, RECOMBINANT, 3 MILLION UNITS
INTERFERON, ALFA-2B, RECOMBINANT, 1 MILLION UNITS
INTERFERON, ALFA-N3, (HUMAN LEUKOCYTE DERIVED), 250,000 IU
INTERFERON, GAMMA 1-B, 3 MILLION UNITS
LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG
LEUPROLIDE ACETATE, PER 1 MG
LEUPROLIDE ACETATE IMPLANT, 65 MG
MECHLORETHAMINE HCL, (NITROGEN MUSTARD), 10 MG
INJECTION, MELPHALAN HCL, 50 MG
METHOTREXATE SODIUM, 5 MG
METHOTREXATE SODIUM, 50 MG
PACLITAXEL, 30 MG
PEGASPARGASE, PER SINGLE DOSE VIAL
PENTOSTATIN, PER 10 MG
PLICAMYCIN, 2.5 MG
MITOMYCIN, 5 MG
MITOMYCIN, 20 MG
MITOMYCIN, 40 MG
INJECTION, MITOXANTRONE HYDROCHLORIDE, PER 5 MG
GEMTUZUMAB OZOGAMICIN, 5MG
RITUXIMAB, 100 MG
STREPTOZOCIN, 1 G
THIOTEPA, 15 MG
TOPOTECAN, 4 MG
TRASTUZUMAB, 10 MG
VALRUBICIN, INTRAVESICAL, 200 MG
VINBLASTINE SULFATE, 1 MG
VINCRISTINE SULFATE, 1 MG
VINCRISTINE SULFATE, 2 MG
VINCRISTINE SULFATE, 5 MG
VINORELBINE TARTRATE, PER 10 MG
PORFIMER SODIUM, 75 MG
NOT OTHERWISE CLASSIFIED, ANTINEOPLASTIC DRUG
STANDARD WHEELCHAIR
STANDARD HEMI (LOW SEAT) WHEELCHAIR
LIGHTWEIGHT WHEELCHAIR
HIGH STRENGTH, LIGHTWEIGHT WHEELCHAIR
ULTRALIGHTWEIGHT WHEELCHAIR
HEAVY DUTY WHEELCHAIR
EXTRA HEAVY DUTY WHEELCHAIR
OTHER MANUAL WHEELCHAIR/BASE
STANDARD - WEIGHT FRAME MOTORIZED/POWER WHEELCHAIR
STANDARD - WEIGHT FRAME MOTORIZED/POWER WHEELCHAIR WITH PROGRAMMABLE CONTROL PARAMETERS
LIGHTWEIGHT PORTABLE MOTORIZED/POWER WHEELCHAIR
OTHER MOTORIZED/POWER WHEELCHAIR BASE
DETACHABLE, NONADJUSTABLE HEIGHT ARMREST, EACH
DETACHABLE, ADJUSTABLE HEIGHT ARMREST, COMPLETE ASSEMBLY, EACH
DETACHABLE, ADJUSTABLE HEIGHT ARMREST, BASE, EACH
DETACHABLE, ADJUSTABLE HEIGHT ARMREST, UPPER PORTION, EACH
ARM PAD, EACH
FIXED, ADJUSTABLE HEIGHT ARMREST, PAIR
REINFORCED BACK UPHOLSTERY
SOLID BACK INSERT, PLANAR BACK, SINGLE DENSITY FOAM, ATTACHED WITH STRAPS
SOLID BACK INSERT, PLANAR BACK, SINGLE DENSITY FOAM, WITH ADJUSTABLE HOOK-ON HARDWARE
HOOK-ON HEADREST EXTENSION
BACK UPHOLSTERY FOR ULTRALIGHTWEIGHT OR HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR
BACK UPHOLSTERY FOR WHEELCHAIR TYPE OTHER THAN ULTRALIGHTWEIGHT OR HIGH STRENGTH LIGHTWEIGH
MANUAL, FULLY RECLINING BACK
REINFORCED SEAT UPHOLSTERY
SOLID SEAT INSERT, PLANAR SEAT, SINGLE DENSITY FOAM
SAFETY BELT/PELVIC STRAP, EACH
SEAT UPHOLSTERY FOR ULTRALIGHTWEIGHT OR HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR
SEAT UPHOLSTERY FOR WHEELCHAIR TYPE OTHER THAN ULTRALIGHTWEIGHT OR HIGH STRENGTH LIGHTWEIGH
HEEL LOOP WITH ANKLE STRAP, EACH
TOE LOOP, EACH
HIGH MOUNT FLIP-UP FOOTREST, EACH
LEG STRAP, EACH
LEG STRAP, H STYLE, EACH
ADJUSTABLE ANGLE FOOTPLATE, EACH
LARGE SIZE FOOTPLATE, EACH
STANDARD SIZE FOOTPLATE, EACH
FOOTREST, LOWER EXTENSION TUBE, EACH
FOOTREST, UPPER HANGER BRACKET, EACH
FOOTREST, COMPLETE ASSEMBLY
ELEVATING LEGREST, LOWER EXTENSION TUBE, EACH
ELEVATING LEGREST, UPPER HANGER BRACKET, EACH
ELEVATING LEGREST, COMPLETE ASSEMBLY
CALF PAD, EACH
RATCHET ASSEMBLY
CAM RELEASE ASSEMBLY, FOOTREST OR LEGREST, EACH
SWINGAWAY, DETACHABLE FOOTRESTS, EACH
ELEVATING FOOTRESTS, ARTICULATING (TELESCOPING), EACH
SEAT WIDTH OF 10, 11, 12, 15, 17, OR 20 INCHES FOR A HIGH STRENGTH, LIGHTWEIGHT OR ULTRALIGHTWEIGHT W
SEAT DEPTH OF 15, 17, OR 18 INCHES FOR A HIGH STRENGTH, LIGHTWEIGHT OR ULTRALIGHTWEIGHT WHEELCHA
SEAT HEIGHT LESS THAN 17 INCHES OR EQUAL TO OR GREATER THAN 21 INCHES FOR A HIGH STRENGTH, LIGHT
SEAT WIDTH 19 OR 20 INCHES FOR HEAVY DUTY OR EXTRA HEAVY DUTY CHAIR
SEAT DEPTH 17 OR 18 INCHES FOR MOTORIZED/POWER WHEELCHAIR
PLASTIC COATED HANDRIM, EACH
STEEL HANDRIM, EACH
ALUMINUM HANDRIM, EACH
HANDRIM WITH 8 TO 10 VERTICAL OR OBLIQUE PROJECTIONS, EACH
HANDRIM WITH 12 TO 16 VERTICAL OR OBLIQUE PROJECTIONS, EACH
ZERO PRESSURE TUBE (FLAT FREE INSERT), ANY SIZE, EACH
SPOKE PROTECTORS, EACH
SOLID TIRE, ANY SIZE, EACH
PNEUMATIC TIRE, ANY SIZE, EACH
PNEUMATIC TIRE TUBE, EACH
REAR WHEEL ASSEMBLY, COMPLETE, WITH SOLID TIRE, SPOKES OR MOLDED, EACH
REAR WHEEL ASSEMBLY, COMPLETE, WITH PNEUMATIC TIRE, SPOKES OR MOLDED, EACH
FRONT CASTER ASSEMBLY, COMPLETE, WITH PNEUMATIC TIRE, EACH
FRONT CASTER ASSEMBLY, COMPLETE, WITH SEMI-PNEUMATIC TIRE, EACH
CASTER PIN LOCK,EACH
PNEUMATIC CASTER TIRE, ANY SIZE, EACH
SEMIPNEUMATIC CASTER TIRE, ANY SIZE, EACH
SOLID CASTER TIRE, ANY SIZE, EACH
FRONT CASTER ASSEMBLY, COMPLETE, WITH SOLID TIRE, EACH
PNEUMATIC CASTER TIRE TUBE, EACH
WHEEL LOCK EXTENSION, PAIR
ANTIROLLBACK DEVICE, PAIR
WHEEL LOCK ASSEMBLY, COMPLETE, EACH
22 NF NON-SEALED LEAD ACID BATTERY, EACH
22 NF SEALED LEAD ACID BATTERY, EACH (E.G., GEL CELL, ABSORBED GLASS MAT)
GROUP 24 NON-SEALED LEAD ACID BATTERY, EACH
GROUP 24 SEALED LEAD ACID BATTERY, EACH (E.G., GEL CELL, ABSORBED GLASS MAT)
U-1 NON-SEALED LEAD ACID BATTERY, EACH
U-1 SEALED LEAD ACID BATTERY, EACH (E.G., GEL CELL, ABSORBED GLASS MAT)
BATTERY CHARGER, SINGLE MODE, FOR USE WITH ONLY ONE BATTERY TYPE, SEALED OR NON-SEALED
BATTERY CHARGER, DUAL MODE, FOR USE WITH EITHER BATTERY TYPE, SEALED OR NON-SEALED
REAR WHEEL TIRE FOR POWER WHEELCHAIR, ANY SIZE, EACH
REAR WHEEL TIRE TUBE OTHER THAN ZERO PRESSURE FOR POWER WHEELCHAIR, ANY SIZE, EACH
REAR WHEEL ASSEMBLY FOR POWER WHEELCHAIR, COMPLETE, EACH
REAR WHEEL ZERO PRESSURE TIRE TUBE (FLAT FREE INSERT) FOR POWER WHEELCHAIR, ANY SIZE, EACH
WHEEL TIRE FOR POWER BASE, ANY SIZE, EACH
WHEEL TIRE TUBE OTHER THAN ZERO PRESSURE FOR EACH BASE, ANY SIZE, EACH
WHEEL ASSEMBLY FOR POWER BASE, COMPLETE, EACH
WHEEL ZERO PRESSURE TIRE TUBE (FLAT FREE INSERT) FOR POWER BASE, ANY SIZE, EACH
DRIVE BELT FOR POWER WHEELCHAIR
FRONT CASTER FOR POWER WHEELCHAIR
WHEELCHAIR ADAPTER FOR AMPUTEE, PAIR
CRUTCH AND CANE HOLDER, EACH
TRANSFER BOARD, LESS THAN 25 INCHES
CYLINDER TANK CARRIER, EACH
IV HANGER, EACH
ARM TROUGH, EACH
WHEELCHAIR TRAY
OTHER ACCESSORIES
TRUNK SUPPORT DEVICE, VEST TYPE, WITH INNER FRAME, PREFABRICATED
TRUNK SUPPORT DEVICE, VEST TYPE, WITHOUT INNER FRAME, PREFABRICATED
BACK SUPPORT SYSTEM FOR USE WITH A WHEELCHAIR, WITH INNER FRAME, PREFABRICATED
SEATING SYSTEM, BACK MODULE, POSTERIORLATERAL CONTROL, WITH OR WITHOUT LATERAL SUPPORTS, CUS
SEATING SYSTEM, COMBINED BACK AND SEAT MODULE, CUSTOM FABRICATED FOR ATTACHMENT TO WHEELCHA
ELEVATING LEGRESTS, PAIR (FOR USE WITH CAPPED RENTAL WHEELCHAIR BASE)
HUMIDIFIER, NONHEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE
PRESCRIPTION ANTIEMETIC DRUG, ORAL, PER 1 MG, FOR USE IN CONJUNCTION WITH ORAL ANTI-CANCER DRUG
PRESCRIPTION ANTIEMETIC DRUG, RECTAL, PER 1 MG, FOR USE IN CONJUNCTION WITH ORAL ANTI-CANCER DRU
WHEELCHAIR BEARINGS, ANY TYPE
INFUSION PUMP USED FOR UNINTERRUPTED ADMINISTRATION OF EPOPROSTENOL
POWER ADD-ON, TO CONVERT MANUAL WHEELCHAIR TO MOTORIZED WHEELCHAIR, JOYSTICK CONTROL
POWER ADD-ON, TO CONVERT MANUAL WHEELCHAIR TO POWER OPERATED VEHICLE, TILLER CONTROL
TEMPORARY REPLACEMENT FOR PATIENT OWNED EQUIPMENT BEING REPAIRED, ANY TYPE
HUMIDIFIER, HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE
RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPABILITY, WITHOUT BACKUP RATE FEATURE, USED WITH
RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPABILITY, WITH BACKUP RATE FEATURE, USED WITH NON
RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPACITY, WITH BACK UP RATE FEATURE, USED WITH INVAS
NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STATIONARY OR PORTABLE
DRESSING SET FOR NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STATIONARY OR PORTABLE, EA
CANISTER SET FOR NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STATIONARY OR PORTABLE, EA
SPEECH GENERATING DEVICE, DIGITIZED SPEECH, USING PRE-RECORDED MESSAGES, LESS THAN OR EQUAL TO
SPEECH GENERATING DEVICE, DIGITIZED SPEECH, USING PRE-RECORDED MESSAGES, GREATER THAN 8 MINUTE
SPEECH GENERATING DEVICE, SYNTHESIZED SPEECH, REQUIRING MESSAGE FORMULATION BY SPELLING AND A
SPEECH GENERATING DEVICE, SYNTHESIZED SPEECH, PERMITTING MULTIPLE METHODS OF MESSAGE FORMULA
SPEECH GENERATING SOFTWARE PROGRAM, FOR PERSONAL COMPUTER OR PERSONAL DIGITAL ASSISTANT
ACCESSORY FOR SPEECH GENERATING DEVICE, MOUNTING SYSTEM
ACCESSORY FOR SPEECH GENERATING DEVICE, NOT OTHERWISE CLASSIFIED
HOSPITAL BED, HEAVY DUTY, EXTRA WIDE, WITH WEIGHT CAPACITY GREATER THAN 350 POUNDS, BUT LESS THA
HOSPITAL BED, EXTRA HEAVY DUTY, EXTRA WIDE, WITH WEIGHT CAPACITY GREATER THAN 600 POUNDS, WITH A
ADDITION TO LOWER EXTREMITY, BELOW KNEE/ABOVE KNEE, CUSTOM FABRICATED FROM EXISTING MOLD OR P
ADDITION TO LOWER EXTREMITY, BELOW KNEE/ABOVE KNEE, CUSTOM FABRICATED FROM EXISTING MOLD OR P
ADDITION LOWER EXTREMITY,BELOW KNEE/ABOVE KNEE,CUSTOM FABRICATED SOCKET INSERT FOR CONGENIT
ADDITION LOWER EXTREMITY,BELOW KNEE/ABOVE KNEE,CUSTOM FABRICATED SOCKET INSERT NOT CONGENIT
OSTOMY POUCH, CLOSED, WITH BARRIER ATTACHED, WITH FILTER (1 PIECE), EACH
OSTOMY POUCH, CLOSED, WITH BARRIER ATTACHED, WITH BUILT-IN CONVEXITY, WITH FILTER (1 PIECE), EACH
OSTOMY POUCH, CLOSED; WITHOUT BARRIER ATTACHED, WITH FILTER (1 PIECE), EACH
OSTOMY POUCH, CLOSED; FOR USE ON BARRIER WITH FLANGE, WITH FILTER (2 PIECE), EACH
OSTOMY POUCH, CLOSED; FOR USE ON BARRIER WITH LOCKING FLANGE (2 PIECE), EACH
OSTOMY POUCH, CLOSED; FOR USE ON BARRIER WITH LOCKING FLANGE, WITH FILTER (2 PIECE), EACH
OSTOMY POUCH, DRAINABLE, WITH BARRIER ATTACHED, WITH FILTER (1 PIECE), EACH
OSTOMY POUCH, DRAINABLE; FOR USE ON BARRIER WITH FLANGE, WITH FILTER (2 PIECE SYSTEM), EACH
OSTOMY POUCH, DRAINABLE; FOR USE ON BARRIER WITH LOCKING FLANGE (2 PIECE SYSTEM), EACH
OSTOMY POUCH, DRAINABLE; FOR USE ON BARRIER WITH LOCKING FLANGE, WITH FILTER (2 PIECE SYSTEM), EA
OSTOMY POUCH, URINARY, WITH EXTENDED WEAR BARRIER ATTACHED, WITH FAUCET-TYPE TAP WITH VALVE (1
OSTOMY POUCH, URINARY, WITH BARRIER ATTACHED, WITH BUILT-IN CONVEXITY, WITH FAUCET-TYPE TAP WITH
OSTOMY POUCH, URINARY, WITH EXTENDED WEAR BARRIER ATTACHED, WITH BUILT-IN CONVEXITY, WITH FAUCE
OSTOMY POUCH, URINARY; WITH BARRIER ATTACHED, WITH FAUCET-TYPE TAP WITH VALVE (1 PIECE), EACH
OSTOMY POUCH, URINARY; FOR USE ON BARRIER WITH FLANGE, WITH FAUCET-TYPE TAP WITH VALVE (2 PIECE),
OSTOMY POUCH, URINARY; FOR USE ON BARRIER WITH LOCKING FLANGE (2 PIECE), EACH
OSTOMY POUCH, URINARY; FOR USE ON BARRIER WITH LOCKING FLANGE, WITH FAUCET-TYPE TAP WITH VALVE
CRANIAL ORTHOSIS (HELMET), WITH OR WITHOUT SOFT INTERFACE, MOLDED TO PATIENT MODEL
CRANIAL ORTHOSIS (HELMET), WITH OR WITHOUT SOFT-INTERFACE, NON-MOLDED
CERVICAL, FLEXIBLE, NONADJUSTABLE (FOAM COLLAR)
CERVICAL, FLEXIBLE, THERMOPLASTIC COLLAR, MOLDED TO PATIENT
CERVICAL, SEMI-RIGID, ADJUSTABLE (PLASTIC COLLAR)
CERVICAL, SEMI-RIGID, ADJUSTABLE MOLDED CHIN CUP (PLASTIC COLLAR WITH MANDIBULAR/OCCIPITAL PIECE)
CERVICAL, SEMI-RIGID, WIRE FRAME OCCIPITAL/MANDIBULAR SUPPORT
CERVICAL, COLLAR, MOLDED TO PATIENT MODEL
CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE
CERVICAL, COLLAR, SEMI-RIGID, THERMOPLASTIC FOAM, TWO PIECE WITH THORACIC EXTENSION
CERVICAL, MULTIPLE POST COLLAR, OCCIPITAL/MANDIBULAR SUPPORTS, ADJUSTABLE
CERVICAL, MULTIPLE POST COLLAR, OCCIPITAL/MANDIBULAR SUPPORTS, ADJUSTABLE CERVICAL BARS (SOMI, G
CERVICAL, MULTIPLE POST COLLAR, OCCIPITAL/MANDIBULAR SUPPORTS, ADJUSTABLE CERVICAL BARS, AND THO
THORACIC, RIB BELT
THORACIC, RIB BELT, CUSTOM FABRICATED
TLSO,FLEXIBLE,PROVIDES TRUNK SUPPORT,UPPER THORACIC REGION,PRODUCES INTRACAVITARY PRESSURE R
TLSO,FLEXIBLE,PROVIDES TRUNK SUPPORT,UPPER THORACIC REGION,PRODUCES INTRACAVITARY PRESSURE R
TLSO FLEXIBLE,TRUNK SUPPORT,SACROCOCCYGEAL JUNCTION ABOVE T-9 VERTEBRA,RESTRICTS GROSS TRUN
TLSO,FLEXIBLE,TRUNK SUPPORT,THORACIC REGION,RIGID POSTERIOR PANEL & SOFT ANTERIOR APRON,EXTEND
TLSO,TRIPLANAR CONTROL,MODULAR SEGMENTED SPINAL SYSTEM,2 RIGID PLASTIC SHELLS,POSTERIOR EXTEN
TLSO,TRIPLANAR CONTROL,MODULAR SEGMENTED SPINAL SYSTEM,2 RIGID PLASTIC SHELLS,POSTERIOR EXTEN
TLSO,TRIPLANAR CONTROL,MODULAR SEGMENTED SPINAL SYSTEM,3 RIGID PLASTIC SHELLS,POSTERIOR EXTEN
TLSO,TRIPLANAR CONTROL,MODULAR SEGMENTED SPINAL SYSTEM,4 RIGID PLASTIC SHELLS,POSTERIOR EXTEN
TLSO,SAGITTAL CONTROL,RIGID POSTERIOR FRAME & FLEX SOFT ANTERIOR APRON W STRAPS,CLOSURES & PA
TLSO,SAGITTAL-CORONAL CONTROL,RIGID POSTERIOR FRAME & FLEXIBLE SOFT ANTERIOR APRON W STRAPS,C
TLSO,TRIPLANAR CONTROL,RIGID POSTERIOR FRAME & FLEXIBLE SOFT ANTERIOR APRON W STRAPS, CLOSURES
TLSO,TRIPLANAR CONTROL,HYPEREXTENSION,RIGID ANTERIOR & LATERAL FRAME EXTENDS SYMPHYSIS PUBIS T
TLSO,TRIPLANAR CONTROL,RIGID POSTERIOR FRAME W FLEXIBLE SOFT APRON ANTERIOR W MULTIPLE STRAPS
TLSO,SAGITTAL-CORONAL CONTROL,FLEXION COMPRESS JACKET,2 RIGID PLASTIC SHELLS W SOFT LINER,POST
TLSO,SAGITTAL-CORONAL CONTROL,FLEXION COMPRESSION JACKET,2 RIGID PLASTIC SHELLS W SOFT LINER,PO
TLSO,TRIPLANAR CONTROL,1 PIECE RIGID PLASTIC SHELL WO INTERFACE LINER,W MULTIPLE STRAPS & CLOSUR
TLSO,TRIPLANAR CONTROL,1 PIECE RIGID PLASTIC SHELL W INTERFACE LINER,MULTIPLE STRAPS & CLOSURES,P
TLSO,TRIPLANAR CONTROL,2 PIECE RIGID PLASTIC SHELL WO INTERFACE LINER,W MULTIPLE STRAPS & CLOSUR
TLSO,TRIPLANAR CONTROL,2 PIECE RIGID PLASTIC SHELL W INTERFACE LINER,MULTIPLE STRAPS & CLOSURES,P
TLSO,TRIPLANAR CONTROL,1 PIECE RIGID PLASTIC SHELL W INTERFACE LINER,MULTIPLE STRAPS & CLOSURES,P
TLSO,SAGITTAL-CORONAL CONTROL,1 PIECE RIGID PLASTIC SHELL,W OVERLAPPING REINFORCED ANTERIOR,W
LUMBAR-SACRAL-ORTHOSIS (LSO), FLEXIBLE, (LUMBO-SACRAL SUPPORT)
LSO, FLEXIBLE (LUMBO-SACRAL SUPPORT), CUSTOM FABRICATED
LSO, ANTERIOR-POSTERIOR CONTROL, WITH RIGID OR SEMI-RIGID POSTERIOR PANEL, PREFABRICATED
LUMBAR-SACRAL ORTHOSIS (LSO), ANTERIOR-POSTERIOR-LATERAL CONTROL (KNIGHT, WILCOX TYPES), WITH A
LUMBAR-SACRAL ORTHOSIS (LSO), ANTERIOR-POSTERIOR CONTROL (MACAUSLAND TYPE), WITH APRON FRONT
LUMBAR-SACRAL ORTHOSIS (LSO), LUMBAR FLEXION (WILLIAMS FLEXION TYPE)
LUMBAR-SACRAL ORTHOSIS (LSO), ANTERIOR-POSTERIOR-LATERAL CONTROL, MOLDED TO PATIENT MODEL
LUMBAR-SACRAL ORTHOSIS (LSO), ANTERIOR-POSTERIOR-LATERAL CONTROL, MOLDED TO PATIENT MODEL, WIT
LSO, ANTERIOR-POSTERIOR-LATERAL CONTROL, WITH RIGID OR SEMI-RIGID POSTERIOR PANEL, PREFABRICATED
LUMBAR-SACRAL ORTHOSIS (LSO), ANTERIOR-POSTERIOR-LATERAL CONTROL, CUSTOM FITTED
SACROILIAC, FLEXIBLE (SACROILIAC SURGICAL SUPPORT)
SACROILIAC, FLEXIBLE (SACROILIAC SURGICAL SUPPORT), CUSTOM FABRICATED
SACROILIAC, SEMI-RIGID (GOLDTHWAITE, OSGOOD TYPES), WITH APRON FRONT
CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO), ANTERIOR-POSTERIOR-LATERAL CONTROL, MOLDED
CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO), ANTERIOR-POSTERIOR-LATERAL-CONTROL, MOLDED
HALO PROCEDURE, CERVICAL HALO INCORPORATED INTO JACKET VEST
HALO PROCEDURE, CERVICAL HALO INCORPORATED INTO PLASTER BODY JACKET
HALO PROCEDURE, CERVICAL HALO INCORPORATED INTO MILWAUKEE TYPE ORTHOSIS
ADDITION TO HALO PROCEDURES, MAGNETIC RESONANCE IMAGE COMPATIBLE SYSTEM
TORSO SUPPORT, POST SURGICAL SUPPORT, PADS FOR POST SURGICAL SUPPORT
THORACIC-LUMBAR-SACRAL ORTHOSIS (TLSO), CORSET FRONT
LUMBAR-SACRAL ORTHOSIS (LSO), CORSET FRONT
THORACIC-LUMBAR-SACRAL ORTHOSIS (TLSO), FULL CORSET
LUMBAR-SACRAL ORTHOSIS (LSO), FULL CORSET
AXILLARY CRUTCH EXTENSION
PERONEAL STRAPS, PAIR
STOCKING SUPPORTER GRIPS, SET OF FOUR (4)
PROTECTIVE BODY SOCK, EACH
ADDITION TO SPINAL ORTHOSIS, NOT OTHERWISE SPECIFIED
CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) (MILWAUKEE), INCLUSIVE OF FURNISHING INITIAL ORT
TENSION BASED SCOLIOSIS ORTHOSIS AND ACCESSORY PADS, INCLUDES FITTING AND ADJUSTMENT
ADDITION TO CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) OR SCOLIOSIS ORTHOSIS, AXILLA SLING
ADDITION TO CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) OR SCOLIOSIS ORTHOSIS, KYPHOSIS PA
ADDITION TO CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) OR SCOLIOSIS ORTHOSIS, KYPHOSIS PA
ADDITION TO CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) OR SCOLIOSIS ORTHOSIS, LUMBAR BOL
ADDITION TO CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) OR SCOLIOSIS ORTHOSIS, LUMBAR OR L
ADDITION TO CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) OR SCOLIOSIS ORTHOSIS, STERNAL PAD
ADDITION TO CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) OR SCOLIOSIS ORTHOSIS, THORACIC PA
ADDITION TO CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) OR SCOLIOSIS ORTHOSIS, TRAPEZIUS S
ADDITION TO CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) OR SCOLIOSIS ORTHOSIS, OUTRIGGER
ADDITION TO CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) OR SCOLIOSIS ORTHOSIS, OUTRIGGER,
ADDITION TO CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) OR SCOLIOSIS ORTHOSIS, LUMBAR SLIN
ADDITION TO CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) OR SCOLIOSIS ORTHOSIS, RING FLANGE
ADDITION TO CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO) OR SCOLIOSIS ORTHOSIS, RING FLANGE
ADDITION TO CERVICAL-THORACIC-LUMBAR-SACRAL ORTHOSIS (CTLSO), SCOLIOSIS ORTHOSIS, COVER FOR UPR
THORACIC-LUMBAR-SACRAL ORTHOSIS (TLSO), INCLUSIVE OF FURNISHING INITIAL ORTHOSIS ONLY
ADDITION TO THORACIC-LUMBAR-SACRAL ORTHOSIS (TLSO), (LOW PROFILE), LATERAL THORACIC EXTENSION
ADDITION TO THORACIC-LUMBAR-SACRAL ORTHOSIS (TLSO), (LOW PROFILE), ANTERIOR THORACIC EXTENSION
ADDITION TO THORACIC-LUMBAR-SACRAL ORTHOSIS (TLSO), (LOW PROFILE), MILWAUKEE TYPE SUPERSTRUCTU
ADDITION TO THORACIC-LUMBAR-SACRAL ORTHOSIS (TLSO), (LOW PROFILE), LUMBAR DEROTATION PAD
ADDITION TO THORACIC-LUMBAR-SACRAL ORTHOSIS (TLSO), (LOW PROFILE), ANTERIOR ASIS PAD
ADDITION TO THORACIC-LUMBAR-SACRAL ORTHOSIS (TLSO), (LOW PROFILE), ANTERIOR THORACIC DEROTATION
ADDITION TO THORACIC-LUMBAR-SACRAL ORTHOSIS (TLSO), (LOW PROFILE), ABDOMINAL PAD
ADDITION TO THORACIC-LUMBAR-SACRAL ORTHOSIS (TLSO), (LOW PROFILE), RIB GUSSET (ELASTIC), EACH
ADDITION TO THORACIC-LUMBAR-SACRAL ORTHOSIS (TLSO), (LOW PROFILE), LATERAL TROCHANTERIC PAD
OTHER SCOLIOSIS PROCEDURE, BODY JACKET MOLDED TO PATIENT MODEL
OTHER SCOLIOSIS PROCEDURE, POSTOPERATIVE BODY JACKET
SPINAL ORTHOSIS, NOT OTHERWISE SPECIFIED
THORACIC-HIP-KNEE-ANKLE ORTHOSIS (THKAO), MOBILITY FRAME (NEWINGTON, PARAPODIUM TYPES)
THKAO, STANDING FRAME, WITH OR WITHOUT TRAY AND ACCESSORIES
THORACIC-HIP-KNEE-ANKLE ORTHOSIS (THKAO), SWIVEL WALKER
HIP ORTHOSIS (HO), ABDUCTION CONTROL OF HIP JOINTS, FLEXIBLE, FREJKA TYPE WITH COVER, PREFABRICATE
HIP ORTHOSIS (HO), ABDUCTION CONTROL OF HIP JOINTS, FLEXIBLE, (FREJKA COVER ONLY), PREFABRICATED, IN
HIP ORTHOSIS (HO), ABDUCTION CONTROL OF HIP JOINTS, FLEXIBLE, (PAVLIK HARNESS), PREFABRICATED, INCLU
HIP ORTHOSIS (HO), ABDUCTION CONTROL OF HIP JOINTS, SEMI-FLEXIBLE (VON ROSEN TYPE), CUSTOM FABRICA
HIP ORTHOSIS (HO), ABDUCTION CONTROL OF HIP JOINTS, STATIC, PELVIC BAND OR SPREADER BAR, THIGH CUF
HIP ORTHOSIS (HO), ABDUCTION CONTROL OF HIP JOINTS, STATIC, ADJUSTABLE, (ILFLED TYPE), PREFABRICATED
HIP ORTHOSIS, BILATERAL THIGH CUFFS WITH ADJUSTABLE ABDUCTOR SPREADER BAR, ADULT SIZE, PREFABRIC
HIP ORTHOSIS (HO), ABDUCTION CONTROL OF HIP JOINTS, STATIC, PLASTIC, PREFABRICATED, INCLUDES FITTING
HIP ORTHOSIS (HO), ABDUCTION CONTROL OF HIP JOINTS, DYNAMIC, PELVIC CONTROL, ADJUSTABLE HIP MOTION
HIP ORTHOSIS (HO), ABDUCTION CONTROL OF HIP JOINT, POSTOPERATIVE HIP ABDUCTION TYPE, CUSTOM FABR
HIP ORTHOSIS (HO), ABDUCTION CONTROL OF HIP JOINT, POSTOPERATIVE HIP ABDUCTION TYPE, PREFABRICATE
COMBINATION, BILATERAL, LUMBO-SACRAL, HIP, FEMUR ORTHOSIS PROVIDING ADDUCTION AND INTERNAL ROTA
LEGG PERTHES ORTHOSIS, (TORONTO TYPE), CUSTOM FABRICATED
LEGG PERTHES ORTHOSIS, (NEWINGTON TYPE), CUSTOM FABRICATED
LEGG PERTHES ORTHOSIS, TRILATERAL, (TACHDIJAN TYPE), CUSTOM FABRICATED
LEGG PERTHES ORTHOSIS, (SCOTTISH RITE TYPE), CUSTOM FABRICATED
LEGG PERTHES ORTHOSIS, LEGG PERTHES SLING (SAM BROWN TYPE), PREFABRICATED, INCLUDES FITTING AND
LEGG PERTHES ORTHOSIS, (PATTEN BOTTOM TYPE), CUSTOM FABRICATED
KNEE ORTHOSIS (KO), ELASTIC WITH STAYS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
KNEE ORTHOSIS (KO), ELASTIC WITH JOINTS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
KNEE ORTHOSIS (KO), ELASTIC OR OTHER ELASTIC TYPE MATERIAL WITH CONDYLAR PAD(S), PREFABRICATED, IN
KNEE ORTHOSIS (KO), ELASTIC WITH CONDYLAR PADS AND JOINTS, PREFABRICATED, INCLUDES FITTING AND AD
KNEE ORTHOSIS (KO), ELASTIC KNEE CAP, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
KNEE ORTHOSIS (KO), IMMOBILIZER, CANVAS LONGITUDINAL, PREFABRICATED, INCLUDES FITTING AND ADJUSTM
KNEE ORTHOSIS (KO), ADJUSTABLE KNEE JOINTS, POSITIONAL ORTHOSIS, RIGID SUPPORT, PREFABRICATED, INC
KNEE ORTHOSIS (KO), WITHOUT KNEE JOINT, RIGID, CUSTOM FABRICATED
KNEE ORTHOSIS, RIGID, WITHOUT JOINT(S), INCLUDES SOFT INTERFACE MATERIAL, PREFABRICATED, INCLUDES
KNEE ORTHOSIS (KO), DEROTATION, MEDIAL-LATERAL, ANTERIOR CRUCIATE LIGAMENT, CUSTOM FABRICATED
KNEE ORTHOSIS, SINGLE UPRIGHT, THIGH&CALF, WITH ADJUSTABLE FLEXION&EXTENSION JOINT, MEDIAL-LATER
KNEE ORTHOSIS, SINGLE UPRIGHT, THIGH AND CALF, WITH ADJUSTABLE FLEXION AND EXTENSION JOINT, MEDIA
KNEE ORTHOSIS (KO), DOUBLE UPRIGHT, THIGH AND CALF, WITH ADJUSTABLE FLEXION AND EXTENSION JOINT, M
KNEE ORTHOSIS (KO), DOUBLE UPRIGHT, THIGH AND CALF, WITH ADJUSTABLE FLEXION AND EXTENSION JOINT, M
KNEE ORTHOSIS (KO), DOUBLE UPRIGHT WITH ADJUSTABLE JOINT, WITH INFLATABLE AIR SUPPORT CHAMBER(S)
KNEE ORTHOSIS (KO), SWEDISH TYPE, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
KNEE ORTHOSIS (KO), MOLDED PLASTIC, THIGH AND CALF SECTIONS, WITH DOUBLE UPRIGHT KNEE JOINTS, CUS
KNEE ORTHOSIS (KO), MOLDED PLASTIC, POLYCENTRIC KNEE JOINTS, PNEUMATIC KNEE PADS (CTI), CUSTOM FA
KNEE ORTHOSIS (KO), MODIFICATION OF SUPRACONDYLAR PROSTHETIC SOCKET, CUSTOM FABRICATED (SK)
KNEE ORTHOSIS (KO), DOUBLE UPRIGHT, THIGH AND CALF LACERS, WITH KNEE JOINTS, CUSTOM FABRICATED
KNEE ORTHOSIS (KO), DOUBLE UPRIGHT, NON-MOLDED THIGH AND CALF CUFFS/LACERS WITH KNEE JOINTS, CUS
KNEE ORTHOSIS (KO), SINGLE OR DOUBLE UPRIGHT, THIGH AND CALF, WITH FUNCTIONAL ACTIVE RESISTANCE C
ANKLE-FOOT ORTHOSIS (AFO), SPRING WIRE, DORSIFLEXION ASSIST CALF BAND, CUSTOM FABRICATED
ANKLE ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT (E.G. NEOPRENE, LYCRA)
ANKLE-FOOT ORTHOSIS (AFO), ANKLE GAUNTLET, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
ANKLE-FOOT ORTHOSIS (AFO), MOLDED ANKLE GAUNTLET, CUSTOM FABRICATED
ANKLE-FOOT ORTHOSIS (AFO), MULTILIGAMENTUS ANKLE SUPPORT, PREFABRICATED, INCLUDES FITTING AND AD
ANKLE-FOOT ORTHOSIS (AFO), POSTERIOR, SINGLE BAR, CLASP ATTACHMENT TO SHOE COUNTER, PREFABRICA
ANKLE-FOOT ORTHOSIS (AFO), SINGLE UPRIGHT WITH STATIC OR ADJUSTABLE STOP (PHELPS OR PERLSTEIN TY
ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, CUSTOM-FABRICATED
ANKLE-FOOT ORTHOSIS (AFO), MOLDED TO PATIENT MODEL, PLASTIC, RIGID ANTERIOR TIBIAL SECTION (FLOOR R
ANKLE-FOOT ORTHOSIS (AFO), SPIRAL, (IRM TYPE), PLASTIC, CUSTOM FABRICATED
ANKLE-FOOT ORTHOSIS (AFO), POSTERIOR SOLID ANKLE, PLASTIC, CUSTOM FABRICATED
ANKLE-FOOT ORTHOSIS (AFO), PLASTIC, WITH ANKLE JOINT, CUSTOM FABRICATED
ANKLE-FOOT ORTHOSIS (AFO), SINGLE UPRIGHT FREE PLANTAR DORSIFLEXION, SOLID STIRRUP, CALF BAND/CUF
ANKLE-FOOT ORTHOSIS (AFO), DOUBLE UPRIGHT FREE PLANTAR DORSIFLEXION, SOLID STIRRUP, CALF BAND/CU
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), SINGLE UPRIGHT, FREE KNEE, FREE ANKLE, SOLID STIRRUP, THIGH AND C
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), SINGLE UPRIGHT, FREE ANKLE, SOLID STIRRUP, THIGH AND CALF BANDS/C
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), DOUBLE UPRIGHT, FREE KNEE, FREE ANKLE, SOLID STIRRUP, THIGH AND C
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), DOUBLE UPRIGHT, FREE ANKLE, SOLID STIRRUP, THIGH AND CALF BANDS/
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), FULL PLASTIC, STATIC, (PEDIATRIC SIZE), PREFABRICATED, INCLUDES FITT
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), FULL PLASTIC, DOUBLE UPRIGHT, FREE KNEE, CUSTOM FABRICATED
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), FULL PLASTIC, SINGLE UPRIGHT, FREE KNEE, CUSTOM FABRICATED
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), FULL PLASTIC, WITHOUT KNEE JOINT, MULTI-AXIS ANKLE, (LIVELY ORTHOS
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), FULL PLASTIC, SINGLE UPRIGHT, POLY-AXIAL HINGE, MEDIAL LATERAL ROT
HIP-KNEE-ANKLE-FOOT ORTHOSIS (HKAFO), TORSION CONTROL, BILATERAL ROTATION STRAPS, PELVIC BAND/BE
HIP-KNEE-ANKLE-FOOT ORTHOSIS (HKAFO), TORSION CONTROL, BILATERAL TORSION CABLES, HIP JOINT, PELVIC
HIP-KNEE-ANKLE-FOOT ORTHOSIS (HKAFO), TORSION CONTROL, BILATERAL TORSION CABLES, BALL BEARING HIP
HIP-KNEE-ANKLE-FOOT ORTHOSIS (HKAFO), TORSION CONTROL, UNILATERAL ROTATION STRAPS, PELVIC BAND/B
HIP-KNEE-ANKLE-FOOT ORTHOSIS (HKAFO), TORSION CONTROL, UNILATERAL TORSION CABLE, HIP JOINT, PELVIC
HIP-KNEE-ANKLE-FOOT ORTHOSIS (HKAFO), TORSION CONTROL, UNILATERAL TORSION CABLE, BALL BEARING HI
ANKLE-FOOT ORTHOSIS (AFO), FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, PLASTER TYPE CASTIN
ANKLE-FOOT ORTHOSIS (AFO), FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, SYNTHETIC TYPE CAST
ANKLE-FOOT ORTHOSIS (AFO), FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, THERMOPLASTIC TYPE
ANKLE-FOOT ORTHOSIS (AFO), FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, CUSTOM FABRICATED
ANKLE-FOOT ORTHOSIS (AFO), FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, SOFT, PREFABRICATED, INCL
ANKLE-FOOT ORTHOSIS (AFO), FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, SEMI-RIGID, PREFABRICATED
ANKLE-FOOT ORTHOSIS (AFO), FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, PREFABRICATED, INC
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), FRACTURE ORTHOSIS, FEMORAL FRACTURE CAST ORTHOSIS, PLASTER TY
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), FRACTURE ORTHOSIS, FEMORAL FRACTURE CAST ORTHOSIS, SYNTHETIC
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), FRACTURE ORTHOSIS, FEMORAL FRACTURE CAST ORTHOSIS, THERMOPL
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), FRACTURE ORTHOSIS, FEMORAL FRACTURE CAST ORTHOSIS, CUSTOM FA
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), FRACTURE ORTHOSIS, FEMORAL FRACTURE CAST ORTHOSIS, SOFT, PREF
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), FRACTURE ORTHOSIS, FEMORAL FRACTURE CAST ORTHOSIS, SEMI-RIGID
KNEE-ANKLE-FOOT ORTHOSIS (KAFO), FRACTURE ORTHOSIS, FEMORAL FRACTURE CAST ORTHOSIS, RIGID, PREF
ADDITION TO LOWER EXTREMITY FRACTURE ORTHOSIS, PLASTIC SHOE INSERT WITH ANKLE JOINTS
ADDITION TO LOWER EXTREMITY FRACTURE ORTHOSIS, DROP LOCK KNEE JOINT
ADDITION TO LOWER EXTREMITY FRACTURE ORTHOSIS, LIMITED MOTION KNEE JOINT
ADDITION TO LOWER EXTREMITY FRACTURE ORTHOSIS, ADJUSTABLE MOTION KNEE JOINT, LERMAN TYPE
ADDITION TO LOWER EXTREMITY FRACTURE ORTHOSIS, QUADRILATERAL BRIM
ADDITION TO LOWER EXTREMITY FRACTURE ORTHOSIS, WAIST BELT
ADDITION TO LOWER EXTREMITY FRACTURE ORTHOSIS, HIP JOINT, PELVIC BAND, THIGH FLANGE, AND PELVIC BE
ADDITION TO LOWER EXTREMITY, LIMITED ANKLE MOTION, EACH JOINT
ADDITION TO LOWER EXTREMITY, DORSIFLEXION ASSIST (PLANTAR FLEXION RESIST), EACH JOINT
ADDITION TO LOWER EXTREMITY, DORSIFLEXION AND PLANTAR FLEXION ASSIST/RESIST, EACH JOINT
ADDITION TO LOWER EXTREMITY, SPLIT FLAT CALIPER STIRRUPS AND PLATE ATTACHMENT
ADDITION TO LOWER EXTREMITY, ROUND CALIPER AND PLATE ATTACHMENT
ADDITION TO LOWER EXTREMITY, FOOT PLATE, MOLDED TO PATIENT MODEL, STIRRUP ATTACHMENT
ADDITION TO LOWER EXTREMITY, REINFORCED SOLID STIRRUP (SCOTT-CRAIG TYPE)
ADDITION TO LOWER EXTREMITY, LONG TONGUE STIRRUP
ADDITION TO LOWER EXTREMITY, VARUS/VALGUS CORRECTION ("T") STRAP, PADDED/LINED OR MALLEOLUS PAD
ADDITION TO LOWER EXTREMITY, VARUS/VALGUS CORRECTION, PLASTIC MODIFICATION, PADDED/LINED
ADDITION TO LOWER EXTREMITY, MOLDED INNER BOOT
ADDITION TO LOWER EXTREMITY, ABDUCTION BAR (BILATERAL HIP INVOLVEMENT), JOINTED, ADJUSTABLE
ADDITION TO LOWER EXTREMITY, ABDUCTION BAR-STRAIGHT
ADDITION TO LOWER EXTREMITY, NON-MOLDED LACER
ADDITION TO LOWER EXTREMITY, LACER MOLDED TO PATIENT MODEL
ADDITION TO LOWER EXTREMITY, ANTERIOR SWING BAND
ADDITION TO LOWER EXTREMITY, PRE-TIBIAL SHELL, MOLDED TO PATIENT MODEL
ADDITION TO LOWER EXTREMITY, PROSTHETIC TYPE, (BK) SOCKET, MOLDED TO PATIENT MODEL, (USED FOR 'PT
ADDITION TO LOWER EXTREMITY, EXTENDED STEEL SHANK
ADDITION TO LOWER EXTREMITY, PATTEN BOTTOM
ADDITION TO LOWER EXTREMITY, TORSION CONTROL, ANKLE JOINT AND HALF SOLID STIRRUP
ADDITION TO LOWER EXTREMITY, TORSION CONTROL, STRAIGHT KNEE JOINT, EACH JOINT
ADDITION TO LOWER EXTREMITY, STRAIGHT KNEE JOINT, HEAVY DUTY, EACH JOINT
ADDITION TO LOWER EXTREMITY, OFFSET KNEE JOINT, EACH JOINT
ADDITION TO LOWER EXTREMITY, OFFSET KNEE JOINT, HEAVY DUTY, EACH JOINT
ADDITION TO LOWER EXTREMITY ORTHOSIS, SUSPENSION SLEEVE
ADDITION TO KNEE JOINT, DROP LOCK, EACH JOINT
ADDITION TO KNEE LOCK WITH INTEGRATED RELEASE MECHANISM (BAIL, CABLE, OR EQUAL), ANY MATERIAL, EAC
ADDITION TO KNEE JOINT, DISC OR DIAL LOCK FOR ADJUSTABLE KNEE FLEXION, EACH JOINT
ADDITION TO KNEE JOINT, RATCHET LOCK FOR ACTIVE AND PROGRESSIVE KNEE EXTENSION, EACH JOINT
ADDITION TO KNEE JOINT, POLYCENTRIC JOINT, EACH JOINT
ADDITION TO KNEE JOINT, LIFT LOOP FOR DROP LOCK RING
ADDITION TO LOWER EXTREMITY, THIGH/WEIGHT BEARING, GLUTEAL/ ISCHIAL WEIGHT BEARING, RING
ADDITION TO LOWER EXTREMITY, THIGH/WEIGHT BEARING, QUADRI- LATERAL BRIM, MOLDED TO PATIENT MODE
ADDITION TO LOWER EXTREMITY, THIGH/WEIGHT BEARING, QUADRI- LATERAL BRIM, CUSTOM FITTED
ADDITION TO LOWER EXTREMITY, THIGH/WEIGHT BEARING, ISCHIAL CONTAINMENT/NARROW M-L BRIM MOLDED
ADDITION TO LOWER EXTREMITY, THIGH/WEIGHT BEARING, ISCHIAL CONTAINMENT/NARROW M-L BRIM, CUSTOM
ADDITION TO LOWER EXTREMITY, THIGH-WEIGHT BEARING, LACER, NON-MOLDED
ADDITION TO LOWER EXTREMITY, THIGH/WEIGHT BEARING, LACER, MOLDED TO PATIENT MODEL
ADDITION TO LOWER EXTREMITY, THIGH/WEIGHT BEARING, HIGH ROLL CUFF
ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, HIP JOINT, CLEVIS TYPE TWO POSITION JOINT, EACH
ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, PELVIC SLING
ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, HIP JOINT, CLEVIS TYPE, OR THRUST BEARING, FREE, EACH
ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, HIP JOINT, CLEVIS OR THRUST BEARING, LOCK, EACH
ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, HIP JOINT, HEAVY DUTY, EACH
ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, HIP JOINT, ADJUSTABLE FLEXION, EACH
ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, HIP JOINT, ADJUSTABLE FLEXION, EXTENSION, ABDUCTION
ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, PLASTIC, MOLDED TO PATIENT MODEL, RECIPROCATING HIP
ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, METAL FRAME, RECIPROCATING HIP JOINT AND CABLES
ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, BAND AND BELT, UNILATERAL
ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, BAND AND BELT, BILATERAL
ADDITION TO LOWER EXTREMITY, PELVIC AND THORACIC CONTROL, GLUTEAL PAD, EACH
ADDITION TO LOWER EXTREMITY, THORACIC CONTROL, THORACIC BAND
ADDITION TO LOWER EXTREMITY, THORACIC CONTROL, PARASPINAL UPRIGHTS
ADDITION TO LOWER EXTREMITY, THORACIC CONTROL, LATERAL SUPPORT UPRIGHTS
ADDITION TO LOWER EXTREMITY ORTHOSIS, PLATING CHROME OR NICKEL, PER BAR
ADDITION TO LOWER EXTREMITY ORTHOSIS, HIGH STRENGTH, LIGHTWEIGHT MATERIAL, ALL HYBRID LAMINATION
ADDITION TO LOWER EXTREMITY ORTHOSIS, EXTENSION, PER EXTENSION, PER BAR (FOR LINEAL ADJUSTMENT F
ORTHOTIC SIDE BAR DISCONNECT DEVICE, PER BAR
ADDITION TO LOWER EXTREMITY ORTHOSIS, ANY MATERIAL - PER BAR OR JOINT
ADDITION TO LOWER EXTREMITY ORTHOSIS, NON-CORROSIVE FINISH, PER BAR
ADDITION TO LOWER EXTREMITY ORTHOSIS, DROP LOCK RETAINER, EACH
ADDITION TO LOWER EXTREMITY ORTHOSIS, KNEE CONTROL, FULL KNEECAP
ADDITION TO LOWER EXTREMITY ORTHOSIS, KNEE CONTROL, KNEE CAP, MEDIAL OR LATERAL PULL
ADDITION TO LOWER EXTREMITY ORTHOSIS, KNEE CONTROL, CONDYLAR PAD
ADDITION TO LOWER EXTREMITY ORTHOSIS, SOFT INTERFACE FOR MOLDED PLASTIC, BELOW KNEE SECTION
ADDITION TO LOWER EXTREMITY ORTHOSIS, SOFT INTERFACE FOR MOLDED PLASTIC, ABOVE KNEE SECTION
ADDITION TO LOWER EXTREMITY ORTHOSIS, TIBIAL LENGTH SOCK, FRACTURE OR EQUAL, EACH
ADDITION TO LOWER EXTREMITY ORTHOSIS, FEMORAL LENGTH SOCK, FRACTURE OR EQUAL, EACH
ADDITION TO LOWER EXTREMITY JOINT, KNEE OR ANKLE, CONCENTRIC ADJUSTABLE TORSION STYLE MECHANIS
LOWER EXTREMITY ORTHOSES, NOT OTHERWISE SPECIFIED
FOOT INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, "UCB" TYPE, BERKELEY SHELL, EACH
FOOT INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, SPENCO, EACH
FOOT INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, PLASTAZOTE OR EQUAL, EACH
FOOT INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, SILICONE GEL, EACH
FOOT INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, LONGITUDINAL ARCH SUPPORT, EACH
FOOT INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, LONGITUDINAL/ METATARSAL SUPPORT, EACH
FOOT INSERT, REMOVABLE, FORMED TO PATIENT FOOT, EACH
FOOT, ARCH SUPPORT, REMOVABLE, PREMOLDED, LONGITUDINAL, EACH
FOOT, ARCH SUPPORT, REMOVABLE, PREMOLDED, METATARSAL, EACH
FOOT, ARCH SUPPORT, REMOVABLE, PREMOLDED, LONGITUDINAL/ METATARSAL, EACH
FOOT, ARCH SUPPORT, NONREMOVABLE ATTACHED TO SHOE, LONGITUDINAL, EACH
FOOT, ARCH SUPPORT, NONREMOVABLE ATTACHED TO SHOE, METATARSAL, EACH
FOOT, ARCH SUPPORT, NONREMOVABLE ATTACHED TO SHOE, LONGITUDINAL/METATARSAL, EACH
HALLUS-VALGUS NIGHT DYNAMIC SPLINT
FOOT, ABDUCTION ROTATION BAR, INCLUDING SHOES
FOOT, ABDUCTION ROTATION BAR, WITHOUT SHOES
FOOT, ADJUSTABLE SHOE-STYLED POSITIONING DEVICE
FOOT, PLASTIC HEEL STABILIZER
ORTHOPEDIC SHOE, OXFORD WITH SUPINATOR OR PRONATOR, INFANT
ORTHOPEDIC SHOE, OXFORD WITH SUPINATOR OR PRONATOR, CHILD
ORTHOPEDIC SHOE, OXFORD WITH SUPINATOR OR PRONATOR, JUNIOR
ORTHOPEDIC SHOE, HIGHTOP WITH SUPINATOR OR PRONATOR, INFANT
ORTHOPEDIC SHOE, HIGHTOP WITH SUPINATOR OR PRONATOR, CHILD
ORTHOPEDIC SHOE, HIGHTOP WITH SUPINATOR OR PRONATOR, JUNIOR
SURGICAL BOOT, EACH, INFANT
SURGICAL BOOT, EACH, CHILD
SURGICAL BOOT, EACH, JUNIOR
BENESCH BOOT, PAIR, INFANT
BENESCH BOOT, PAIR, CHILD
BENESCH BOOT, PAIR, JUNIOR
ORTHOPEDIC FOOTWEAR, WOMAN'S SHOES, OXFORD
ORTHOPEDIC FOOTWEAR, WOMAN'S SHOES, DEPTH INLAY
ORTHOPEDIC FOOTWEAR, WOMAN'S SHOES, HIGHTOP, DEPTH INLAY
ORTHOPEDIC FOOTWEAR, MAN'S SHOES, OXFORD
ORTHOPEDIC FOOTWEAR, MAN'S SHOES, DEPTH INLAY
ORTHOPEDIC FOOTWEAR, MAN'S SHOES, HIGHTOP, DEPTH INLAY
ORTHOPEDIC FOOTWEAR, WOMAN'S SHOE, OXFORD, USED AS AN INTEGRAL PART OF A BRACE (ORTHOSIS)
ORTHOPEDIC FOOTWEAR, MAN'S SHOE, OXFORD, USED AS AN INTEGRAL PART OF A BRACE (ORTHOSIS)
ORTHOPEDIC FOOTWEAR, CUSTOM SHOES, DEPTH INLAY
ORTHOPEDIC FOOTWEAR, CUSTOM MOLDED SHOE, REMOVABLE INNER MOLD, PROSTHETIC SHOE, EACH
FOOT, SHOE MOLDED TO PATIENT MODEL, SILICONE SHOE, EACH
FOOT, SHOE MOLDED TO PATIENT MODEL, PLASTAZOTE (OR SIMILAR), CUSTOM FABRICATED, EACH
FOOT, MOLDED SHOE PLASTAZOTE (OR SIMILAR), CUSTOM FITTED, EACH
NONSTANDARD SIZE OR WIDTH
NONSTANDARD SIZE OR LENGTH
ORTHOPEDIC FOOTWEAR, ADDITIONAL CHARGE FOR SPLIT SIZE
SURGICAL BOOT/SHOE, EACH
PLASTAZOTE SANDAL, EACH
LIFT, ELEVATION, HEEL, TAPERED TO METATARSALS, PER INCH
LIFT, ELEVATION, HEEL AND SOLE, NEOPRENE, PER INCH
LIFT, ELEVATION, HEEL AND SOLE, CORK, PER INCH
LIFT, ELEVATION, METAL EXTENSION (SKATE)
LIFT, ELEVATION, INSIDE SHOE, TAPERED, UP TO ONE-HALF INCH
LIFT, ELEVATION, HEEL, PER INCH
HEEL WEDGE, SACH
HEEL WEDGE
SOLE WEDGE, OUTSIDE SOLE
SOLE WEDGE, BETWEEN SOLE
CLUBFOOT WEDGE
OUTFLARE WEDGE
METATARSAL BAR WEDGE, ROCKER
METATARSAL BAR WEDGE, BETWEEN SOLE
FULL SOLE AND HEEL WEDGE, BETWEEN SOLE
HEEL, COUNTER, PLASTIC REINFORCED
HEEL, COUNTER, LEATHER REINFORCED
HEEL, SACH CUSHION TYPE
HEEL, NEW LEATHER, STANDARD
HEEL, NEW RUBBER, STANDARD
HEEL, THOMAS WITH WEDGE
HEEL, THOMAS EXTENDED TO BALL
HEEL, PAD AND DEPRESSION FOR SPUR
HEEL, PAD, REMOVABLE FOR SPUR
ORTHOPEDIC SHOE ADDITION, INSOLE, LEATHER
ORTHOPEDIC SHOE ADDITION, INSOLE, RUBBER
ORTHOPEDIC SHOE ADDITION, INSOLE, FELT COVERED WITH LEATHER
ORTHOPEDIC SHOE ADDITION, SOLE, HALF
ORTHOPEDIC SHOE ADDITION, SOLE, FULL
ORTHOPEDIC SHOE ADDITION, TOE TAP STANDARD
ORTHOPEDIC SHOE ADDITION, TOE TAP, HORSESHOE
ORTHOPEDIC SHOE ADDITION, SPECIAL EXTENSION TO INSTEP (LEATHER WITH EYELETS)
ORTHOPEDIC SHOE ADDITION, CONVERT INSTEP TO VELCRO CLOSURE
ORTHOPEDIC SHOE ADDITION, CONVERT FIRM SHOE COUNTER TO SOFT COUNTER
ORTHOPEDIC SHOE ADDITION, MARCH BAR
TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, CALIPER PLATE, EXISTING
TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, CALIPER PLATE, NEW
TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, SOLID STIRRUP, EXISTING
TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, SOLID STIRRUP, NEW
TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, DENNIS BROWNE SPLINT (RIVETON), BOTH SHOES
ORTHOPEDIC SHOE, MODIFICATION, ADDITION OR TRANSFER, NOT OTHERWISE SPECIFIED
SHOULDER ORTHOSIS (SO), FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FIT
SHOULDER ORTHOSIS, SINGLE SHOULDER, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT (E.G
SHOULDER ORTHOSIS, DOUBLE SHOULDER, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT (E.
SHOULDER ORTHOSIS (SO), FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND WEBBING, PREFA
SHOULDER ORTHOSIS (SO), ACROMIO/CLAVICULAR, CANVAS AND WEBBING TYPE, PREFABRICATED, INCLUDES FI
SHOULDER ORTHOSIS (SO), VEST TYPE ABDUCTION RESTRAINER, CANVAS WEBBING TYPE, OR EQUAL, PREFABR
SHOULDER ORTHOSIS, HARD PLASTIC, SHOULDER STABILIZER, PRE-FABRICATED, INCLUDES FITTING AND ADJUS
ELBOW ORTHOSIS (EO), ELASTIC WITH STAYS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
ELBOW ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT (E.G. NEOPRENE, LYCRA)
ELBOW ORTHOSIS (EO), ELASTIC WITH METAL JOINTS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
ELBOW ORTHOSIS (EO), DOUBLE UPRIGHT WITH FOREARM/ARM CUFFS, FREE MOTION, CUSTOM FABRICATED
ELBOW ORTHOSIS (EO), DOUBLE UPRIGHT WITH FOREARM/ARM CUFFS, EXTENSION/ FLEXION ASSIST, CUSTOM F
ELBOW ORTHOSIS (EO), DOUBLE UPRIGHT WITH FOREARM/ARM CUFFS, ADJUSTABLE POSITION LOCK WITH ACTI
ELBOW ORTHOSIS (EO), WITH ADJUSTABLE POSITION LOCKING JOINT(S), PREFABRICATED, INCLUDES FITTING AN
ELBOW ORTHOSIS, RIGID, WITHOUT JOINTS, INCLUDES SOFT INTERFACE MATERIAL, PREFABRICATED, INCLUDES
WRIST-HAND-FINGER ORTHOSIS (WHFO), SHORT OPPONENS, NO ATTACHMENTS, CUSTOM FABRICATED
WRIST-HAND-FINGER ORTHOSIS (WHFO), LONG OPPONENS, NO ATTACHMENT, CUSTOM FABRICATED
WRIST-HAND-FINGER ORTHOSIS (WHFO), WITHOUT JOINT(S), PREFABRICATED, INCLUDES FITTING AND ADJUSTM
WRIST-HAND-FINGER ORTHOSIS (WHFO), ADDITION TO SHORT AND LONG OPPONENS, THUMB ABDUCTION ("C") B
WRIST-HAND-FINGER ORTHOSIS (WHFO), ADDITION TO SHORT AND LONG OPPONENS, SECOND M.P. ABDUCTION
WRIST-HAND-FINGER ORTHOSIS (WHFO), ADDITION TO SHORT AND LONG OPPONENS, I.P. EXTENSION ASSIST, W
WRIST-HAND-FINGER ORTHOSIS (WHFO), ADDITION TO SHORT AND LONG OPPONENS, M.P. EXTENSION STOP
WRIST-HAND-FINGER ORTHOSIS (WHFO), ADDITION TO SHORT AND LONG OPPONENS, M.P. EXTENSION ASSIST
WRIST-HAND-FINGER ORTHOSIS (WHFO), ADDITION TO SHORT AND LONG OPPONENS, M.P. SPRING EXTENSION A
WRIST-HAND-FINGER ORTHOSIS (WHFO), ADDITION TO SHORT AND LONG OPPONENS, SPRING SWIVEL THUMB
WRIST-HAND-FINGER ORTHOSIS (WHFO), ADDITION TO SHORT AND LONG OPPONENS, THUMB I.P. EXTENSION AS
WRIST-HAND ORTHOSIS (WHO), ADDITION TO SHORT AND LONG OPPONENS, ACTION WRIST, WITH DORSIFLEXIO
WRIST-HAND-FINGER ORTHOSIS (WHFO), ADDITION TO SHORT AND LONG OPPONENS, ADJUSTABLE M.P. FLEXION
WRIST-HAND-FINGER ORTHOSIS (WHFO), ADDITION TO SHORT AND LONG OPPONENS, ADJUSTABLE M.P. FLEXION
ADDITION TO UPPER EXTREMITY JOINT, WRIST OR ELBOW, CONCENTRIC ADJUSTABLE TORSION STYLE MECHAN
WRIST-HAND-FINGER ORTHOSIS (WHFO), DYNAMIC FLEXOR HINGE, RECIPROCAL WRIST EXTENSION/ FLEXION, FI
WRIST-HAND-FINGER ORTHOSIS (WHFO), DYNAMIC FLEXOR HINGE, RECIPROCAL WRIST EXTENSION/ FLEXION, FI
WRIST-HAND-FINGER ORTHOSIS (WHFO), EXTERNAL POWERED, COMPRESSED GAS, CUSTOM FABRICATED
WRIST-HAND-FINGER ORTHOSIS (WHFO), EXTERNAL POWERED, ELECTRIC, CUSTOM FABRICATED
WRIST-HAND ORTHOSIS (WHO), WRIST GAUNTLET, MOLDED TO PATIENT MODEL, CUSTOM FABRICATED
WRIST-HAND-FINGER ORTHOSIS (WHFO), WRIST GAUNTLET WITH THUMB SPICA, MOLDED TO PATIENT MODEL, CU
WRIST-HAND ORTHOSIS (WHO), WRIST EXTENSION CONTROL COCK-UP, NON MOLDED, PREFABRICATED, INCLUD
WRIST ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT (E.G. NEOPRENE, LYCRA)
WRIST-HAND-FINGER ORTHOSIS (WHFO), SWANSON DESIGN, PREFABRICATED, INCLUDES FITTING AND ADJUSTM
WRIST HAND FINGER ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT (E.G. NEOPRE
HAND-FINGER ORTHOSIS (HFO), FLEXION GLOVE WITH ELASTIC FINGER CONTROL, PREFABRICATED, INCLUDES F
WRIST-HAND ORTHOSIS (WHO), WRIST EXTENSION COCK-UP, PREFABRICATED, INCLUDES FITTING AND ADJUSTM
WRIST-HAND-FINGER ORTHOSIS (WHFO), WRIST EXTENSION COCK-UP, WITH OUTRIGGER, PREFABRICATED, INCL
HAND-FINGER ORTHOSIS (HFO), KNUCKLE BENDER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
HAND-FINGER ORTHOSIS (HFO), KNUCKLE BENDER, WITH OUTRIGGER, PREFABRICATED, INCLUDES FITTING AND
HAND-FINGER ORTHOSIS (HFO), KNUCKLE BENDER, TWO SEGMENT TO FLEX JOINTS, PREFABRICATED, INCLUDES
HAND-FINGER ORTHOSIS (HFO), WITHOUT JOINT(S), PREFABRICATED, INCLUDES FITTING AND ADJUSTMENTS, AN
WRIST-HAND-FINGER ORTHOSIS (WHFO), OPPENHEIMER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
WRIST-HAND-FINGER ORTHOSIS (WHFO), THOMAS SUSPENSION, PREFABRICATED, INCLUDES FITTING AND ADJU
HAND-FINGER ORTHOSIS (HFO), FINGER EXTENSION, WITH CLOCK SPRING, PREFABRICATED, INCLUDES FITTING
WRIST-HAND-FINGER ORTHOSIS (WHFO), FINGER EXTENSION, WITH WRIST SUPPORT, PREFABRICATED, INCLUDE
FINGER ORTHOSIS (FO), SAFETY PIN, SPRING WIRE, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
FINGER ORTHOSIS (FO), SAFETY PIN, MODIFIED, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
WRIST-HAND-FINGER ORTHOSIS (WHFO), PALMER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
WRIST-HAND-FINGER ORTHOSIS (WHFO), DORSAL WRIST, PREFABRICATED, INCLUDES FITTING AND ADJUSTMEN
WRIST-HAND-FINGER ORTHOSIS (WHFO), DORSAL WRIST, WITH OUTRIGGER ATTACHMENT, PREFABRICATED, INC
HAND-FINGER ORTHOSIS (HFO), REVERSE KNUCKLE BENDER, PREFABRICATED, INCLUDES FITTING AND ADJUSTM
HAND-FINGER ORTHOSIS (HFO), REVERSE KNUCKLE BENDER, WITH OUTRIGGER, PREFABRICATED, INCLUDES FIT
HAND-FINGER ORTHOSIS (HFO), COMPOSITE ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
FINGER ORTHOSIS (FO), FINGER KNUCKLE BENDER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
WRIST-HAND-FINGER ORTHOSIS (WHFO), COMBINATION OPPENHEIMER, WITH KNUCKLE BENDER AND TWO ATTA
WRIST-HAND-FINGER ORTHOSIS (WHFO), COMBINATION OPPENHEIMER, WITH REVERSE KNUCKLE AND TWO ATT
HAND-FINGER ORTHOSIS (HFO), SPREADING HAND, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
ADDITION OF JOINT TO UPPER EXTREMITY ORTHOSIS, ANY MATERIAL; PER JOINT
SHOULDER-ELBOW-WRIST-HAND ORTHOSIS (SEWHO), ABDUCTION POSITIONING, AIRPLANE DESIGN, PREFABRIC
SHOULDER-ELBOW-WRIST-HAND ORTHOSIS (SEWHO), ABDUCTION POSITIONING, ERB'S PALSEY DESIGN, PREFAB
SHOULDER-ELBOW-WRIST-HAND ORTHOSIS (SEWHO), MOLDED SHOULDER, ARM, FOREARM, AND WRIST, WITH A
SHOULDER-ELBOW ORTHOSIS (SEO), MOBILE ARM SUPPORT ATTACHED TO WHEELCHAIR, BALANCED, ADJUSTAB
SHOULDER-ELBOW ORTHOSIS (SEO), MOBILE ARM SUPPORT ATTACHED TO WHEELCHAIR, BALANCED, ADJUSTAB
SHOULDER-ELBOW ORTHOSIS (SEO), MOBILE ARM SUPPORT ATTACHED TO WHEELCHAIR, BALANCED, RECLINING
SHOULDER-ELBOW ORTHOSIS (SEO), MOBILE ARM SUPPORT ATTACHED TO WHEELCHAIR, BALANCED, FRICTION
SHOULDER-ELBOW ORTHOSIS (SEO), MOBILE ARM SUPPORT, MONOSUSPENSION ARM AND HAND SUPPORT, OVE
SHOULDER-ELBOW ORTHOSIS (SEO), ADDITION TO MOBILE ARM SUPPORT, ELEVATING PROXIMAL ARM
SHOULDER-ELBOW ORTHOSIS (SEO), ADDITION TO MOBILE ARM SUPPORT, OFFSET OR LATERAL ROCKER ARM W
SHOULDER-ELBOW ORTHOSIS (SEO), ADDITION TO MOBILE ARM SUPPORT, SUPINATOR
UPPER EXTREMITY FRACTURE ORTHOSIS, HUMERAL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
UPPER EXTREMITY FRACTURE ORTHOSIS, RADIUS/ULNAR, PREFABRICATED, INCLUDES FITTING AND ADJUSTMEN
UPPER EXTREMITY FRACTURE ORTHOSIS, WRIST, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
UPPER EXTREMITY FRACTURE ORTHOSIS, FOREARM, HAND WITH WRIST HINGE, CUSTOM FABRICATED
UPPER EXTREMITY FRACTURE ORTHOSIS, COMBINATION OF HUMERAL, RADIUS/ULNAR, WRIST (EXAMPLE: COLLE
ADDITION TO UPPER EXTREMITY ORTHOSIS, SOCK, FRACTURE OR EQUAL, EACH
UPPER LIMB ORTHOSIS, NOT OTHERWISE SPECIFIED
REPLACE GIRDLE FOR SPINAL ORTHOSIS
REPLACE TRILATERAL SOCKET BRIM
REPLACE QUADRILATERAL SOCKET BRIM, MOLDED TO PATIENT MODEL
REPLACE QUADRILATERAL SOCKET BRIM, CUSTOM FITTED
REPLACE MOLDED THIGH LACER
REPLACE NONMOLDED THIGH LACER
REPLACE MOLDED CALF LACER
REPLACE NONMOLDED CALF LACER
REPLACE HIGH ROLL CUFF
REPLACE PROXIMAL AND DISTAL UPRIGHT FOR KNEE-ANKLE-FOOT ORTHOSIS (KAFO)
REPLACE METAL BANDS KNEE-ANKLE-FOOT ORTHOSIS (KAFO), PROXIMAL THIGH
REPLACE METAL BANDS KAFO-AFO, CALF OR DISTAL THIGH
REPLACE LEATHER CUFF KNEE-ANKLE-FOOT ORTHOSIS (KAFO), PROXIMAL THIGH
REPLACE LEATHER CUFF KAFO-AFO, CALF OR DISTAL THIGH
REPLACE PRETIBIAL SHELL
REPAIR OF ORTHOTIC DEVICE, LABOR COMPONENT, PER 15 MINUTES
REPAIR OF ORTHOTIC DEVICE, REPAIR OR REPLACE MINOR PARTS
PNEUMATIC ANKLE CONTROL SPLINT, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
PNEUMATIC ANKLE FOOT ORTHOSIS, WITH OR WITHOUT JOINTS, PREFABRICATED, INCLUDES FITTING AND ADJU
PNEUMATIC FULL LEG SPLINT, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
PNEUMATIC KNEE SPLINT, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
NON-PNEUMATIC WALKING SPLINT, WITH OR WITHOUT JOINTS, PREFABRICATED, INCLUDES FITTING AND ADJUST
REPLACEMENT SOFT INTERFACE MATERIAL, STATIC ANKLE-FOOT ORTHOSIS (AFO)
REPLACE SOFT INTERFACE MATERIAL, FOOT DROP SPLINT
STATIC ANKLE FOOT ORTHOSIS, INCL SFT INTERFACE MATL,ADJUST, FIT, POSITIONING, PRESSURE REDUCTION,
FOOT DROP SPLINT, RECUMBENT POSITIONING DEVICE, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
PARTIAL FOOT, SHOE INSERT WITH LONGITUDINAL ARCH, TOE FILLER
PARTIAL FOOT, MOLDED SOCKET, ANKLE HEIGHT, WITH TOE FILLER
PARTIAL FOOT, MOLDED SOCKET, TIBIAL TUBERCLE HEIGHT, WITH TOE FILLER
ANKLE, SYMES, MOLDED SOCKET, SACH FOOT
ANKLE, SYMES, METAL FRAME, MOLDED LEATHER SOCKET, ARTICULATED ANKLE/FOOT
BELOW KNEE, MOLDED SOCKET, SHIN, SACH FOOT
BELOW KNEE, PLASTIC SOCKET, JOINTS AND THIGH LACER, SACH FOOT
KNEE DISARTICULATION (OR THROUGH KNEE), MOLDED SOCKET, EXTERNAL KNEE JOINTS, SHIN, SACH FOOT
KNEE DISARTICULATION (OR THROUGH KNEE), MOLDED SOCKET, BENT KNEE CONFIGURATION, EXTERNAL KNEE
ABOVE KNEE, MOLDED SOCKET, SINGLE AXIS CONSTANT FRICTION KNEE, SHIN, SACH FOOT
ABOVE KNEE, SHORT PROSTHESIS, NO KNEE JOINT ("STUBBIES"), WITH FOOT BLOCKS, NO ANKLE JOINTS, EACH
ABOVE KNEE, SHORT PROSTHESIS, NO KNEE JOINT ("STUBBIES"), WITH ARTICULATED ANKLE/FOOT, DYNAMICALL
ABOVE KNEE, FOR PROXIMAL FEMORAL FOCAL DEFICIENCY, CONSTANT FRICTION KNEE, SHIN, SACH FOOT
HIP DISARTICULATION, CANADIAN TYPE; MOLDED SOCKET, HIP JOINT, SINGLE AXIS CONSTANT FRICTION KNEE, S
HIP DISARTICULATION, TILT TABLE TYPE; MOLDED SOCKET, LOCKING HIP JOINT, SINGLE AXIS CONSTANT FRICTIO
HEMIPELVECTOMY, CANADIAN TYPE; MOLDED SOCKET, HIP JOINT, SINGLE AXIS CONSTANT FRICTION KNEE, SHIN
BELOW KNEE, MOLDED SOCKET, SHIN, SACH FOOT, ENDOSKELETAL SYSTEM
KNEE DISARTICULATION (OR THROUGH KNEE), MOLDED SOCKET, EXTERNAL KNEE JOINTS, SHIN, SACH FOOT, EN
ABOVE KNEE, MOLDED SOCKET, OPEN END, SACH FOOT, ENDOSKELETAL SYSTEM, SINGLE AXIS KNEE
HIP DISARTICULATION, CANADIAN TYPE, MOLDED SOCKET, ENDOSKELETAL SYSTEM, HIP JOINT, SINGLE AXIS KNE
HEMIPELVECTOMY, CANADIAN TYPE, MOLDED SOCKET, ENDOSKELETAL SYSTEM, HIP JOINT, SINGLE AXIS KNEE, S
IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF INITIAL RIGID DRESSING, INCLUDING FITTING, A
IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF INITIAL RIGID DRESSING, INCLUDING FITTING, A
IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF INITIAL RIGID DRESSING, INCLUDING FITTING, A
IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF INITIAL RIGID DRESSING, INCLUDING FITTING, A
IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF NONWEIGHT BEARING RIGID DRESSING, BELOW
IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF NONWEIGHT BEARING RIGID DRESSING, ABOVE
INITIAL, BELOW KNEE "PTB" TYPE SOCKET, NON-ALIGNABLE SYSTEM, PYLON, NO COVER, SACH FOOT, PLASTER S
INITIAL, ABOVE KNEE - KNEE DISARTICULATION, ISCHIAL LEVEL SOCKET, NON-ALIGNABLE SYSTEM, PYLON, NO CO
PREPARATORY, BELOW KNEE "PTB" TYPE SOCKET, NON-ALIGNABLE SYSTEM, PYLON, NO COVER, SACH FOOT, PL
PREPARATORY, BELOW KNEE "PTB" TYPE SOCKET, NON-ALIGNABLE SYSTEM, PYLON, NO COVER, SACH FOOT, TH
PREPARATORY, BELOW KNEE "PTB" TYPE SOCKET, NON-ALIGNABLE SYSTEM, PYLON, NO COVER, SACH FOOT, TH
PREPARATORY, BELOW KNEE "PTB" TYPE SOCKET, NON-ALIGNABLE SYSTEM, PYLON, NO COVER, SACH FOOT, PR
PREPARATORY, BELOW KNEE "PTB" TYPE SOCKET, NON-ALIGNABLE SYSTEM, PYLON, NO COVER, SACH FOOT, LA
PREPARATORY, ABOVE KNEE- KNEE DISARTICULATION, ISCHIAL LEVEL SOCKET, NON-ALIGNABLE SYSTEM, PYLON
PREPARATORY, ABOVE KNEE - KNEE DISARTICULATION, ISCHIAL LEVEL SOCKET, NON-ALIGNABLE SYSTEM, PYLO
PREPARATORY, ABOVE KNEE - KNEE DISARTICULATION ISCHIAL LEVEL SOCKET, NON-ALIGNABLE SYSTEM, PYLON
PREPARATORY, ABOVE KNEE - KNEE DISARTICULATION, ISCHIAL LEVEL SOCKET, NON-ALIGNABLE SYSTEM, PYLO
PREPARATORY, ABOVE KNEE - KNEE DISARTICULATION ISCHIAL LEVEL SOCKET, NON-ALIGNABLE SYSTEM, PYLON
PREPARATORY, HIP DISARTICULATION-HEMIPELVECTOMY, PYLON, NO COVER, SACH FOOT, THERMOPLASTIC OR
PREPARATORY, HIP DISARTICULATION-HEMIPELVECTOMY, PYLON, NO COVER, SACH FOOT, LAMINATED SOCKET,
ADDITION TO LOWER EXTREMITY, ENDOSKELETAL SYSTEM, ABOVE KNEE, HYDRACADENCE SYSTEM
ADDITION TO LOWER EXTREMITY, ENDOSKELETAL SYSTEM, ABOVE KNEE - KNEE DISARTICULATION, 4-BAR LINKA
ADDITION TO LOWER EXTREMITY, ENDOSKELETAL SYSTEM, ABOVE KNEE-KNEE DISARTICULATION, 4-BAR LINKAG
ADDITION TO LOWER EXTREMITY, ENDOSKELETAL SYSTEM, ABOVE KNEE-KNEE DISARTICULATION, 4-BAR LINKAG
ADDITION TO LOWER EXTREMITY, ENDOSKELETAL SYSTEM, ABOVE KNEE, UNIVERSAL MULTIPLEX SYSTEM, FRICT
ADDITION TO LOWER EXTREMITY, QUICK CHANGE SELF-ALIGNING UNIT, ABOVE KNEE OR BELOW KNEE, EACH
ADDITION TO LOWER EXTREMITY, TEST SOCKET, SYMES
ADDITION TO LOWER EXTREMITY, TEST SOCKET, BELOW KNEE
ADDITION TO LOWER EXTREMITY, TEST SOCKET, KNEE DISARTICULATION
ADDITION TO LOWER EXTREMITY, TEST SOCKET, ABOVE KNEE
ADDITION TO LOWER EXTREMITY, TEST SOCKET, HIP DISARTICULATION
ADDITION TO LOWER EXTREMITY, TEST SOCKET, HEMIPELVECTOMY
ADDITION TO LOWER EXTREMITY, BELOW KNEE, ACRYLIC SOCKET
ADDITION TO LOWER EXTREMITY, SYMES TYPE, EXPANDABLE WALL SOCKET
ADDITION TO LOWER EXTREMITY, ABOVE KNEE OR KNEE DISARTICULATION, ACRYLIC SOCKET
ADDITION TO LOWER EXTREMITY, SYMES TYPE, "PTB" BRIM DESIGN SOCKET
ADDITION TO LOWER EXTREMITY, SYMES TYPE, POSTERIOR OPENING (CANADIAN) SOCKET
ADDITION TO LOWER EXTREMITY, SYMES TYPE, MEDIAL OPENING SOCKET
ADDITION TO LOWER EXTREMITY, BELOW KNEE, TOTAL CONTACT
ADDITION TO LOWER EXTREMITY, BELOW KNEE, LEATHER SOCKET
ADDITION TO LOWER EXTREMITY, BELOW KNEE, WOOD SOCKET
ADDITION TO LOWER EXTREMITY, KNEE DISARTICULATION, LEATHER SOCKET
ADDITION TO LOWER EXTREMITY, ABOVE KNEE, LEATHER SOCKET
ADDITION TO LOWER EXTREMITY, HIP DISARTICULATION, FLEXIBLE INNER SOCKET, EXTERNAL FRAME
ADDITION TO LOWER EXTREMITY, ABOVE KNEE, WOOD SOCKET
ADDITION TO LOWER EXTREMITY, BELOW KNEE, FLEXIBLE INNER SOCKET, EXTERNAL FRAME
ADDITION TO LOWER EXTREMITY, BELOW KNEE, AIR CUSHION SOCKET
ADDITION TO LOWER EXTREMITY, BELOW KNEE SUCTION SOCKET
ADDITION TO LOWER EXTREMITY, ABOVE KNEE, AIR CUSHION SOCKET
ADDITION TO LOWER EXTREMITY, ISCHIAL CONTAINMENT/NARROW M-L SOCKET
ADDITION TO LOWER EXTREMITY, TOTAL CONTACT, ABOVE KNEE OR KNEE DISARTICULATION SOCKET
ADDITION TO LOWER EXTREMITY, ABOVE KNEE, FLEXIBLE INNER SOCKET, EXTERNAL FRAME
ADDITION TO LOWER EXTREMITY, SUCTION SUSPENSION, ABOVE KNEE OR KNEE DISARTICULATION SOCKET
ADDITION TO LOWER EXTREMITY, KNEE DISARTICULATION, EXPANDABLE WALL SOCKET
ADDITION TO LOWER EXTREMITY, SOCKET INSERT, SYMES, (KEMBLO, PELITE, ALIPLAST, PLASTAZOTE OR EQUAL
ADDITION TO LOWER EXTREMITY, SOCKET INSERT, BELOW KNEE (KEMBLO, PELITE, ALIPLAST, PLASTAZOTE OR E
ADDITION TO LOWER EXTREMITY, SOCKET INSERT, KNEE DISARTICULATION (KEMBLO, PELITE, ALIPLAST, PLASTA
ADDITION TO LOWER EXTREMITY, SOCKET INSERT, ABOVE KNEE (KEMBLO, PELITE, ALIPLAST, PLASTAZOTE OR E
ADDITION TO LOWER EXTREMITY, SOCKET INSERT, MULTI-DUROMETER SYMES
ADDITION TO LOWER EXTREMITY, SOCKET INSERT, MULTI-DUROMETER, BELOW KNEE
ADDITION TO LOWER EXTREMITY, BELOW KNEE, CUFF SUSPENSION
ADDITION TO LOWER EXTREMITY, BELOW KNEE, MOLDED DISTAL CUSHION
ADDITION TO LOWER EXTREMITY, BELOW KNEE, MOLDED SUPRACONDYLAR SUSPENSION ("PTS" OR SIMILAR)
ADDITION TO LOWER EXTREMITY, BELOW KNEE/ABOVE KNEE SUSPENSION LOCKING MECHANISM (SHUTTLE, LAN
ADDITION TO LOWER EXTREMITY, BELOW KNEE, REMOVABLE MEDIAL BRIM SUSPENSION
ADDITION TO LOWER EXTREMITY, BELOW KNEE, SUSPENSION SLEEVE, ANY MATERIAL, EACH
ADDITION TO LOWER EXTREMITY, BELOW KNEE, SUSPENSION SLEEVE, HEAVY DUTY, ANY MATERIAL, EACH
ADDITION TO LOWER EXTREMITY, BELOW KNEE, KNEE JOINTS, SINGLE AXIS, PAIR
ADDITION TO LOWER EXTREMITY, BELOW KNEE, KNEE JOINTS, POLYCENTRIC, PAIR
ADDITION TO LOWER EXTREMITY, BELOW KNEE, JOINT COVERS, PAIR
ADDITION TO LOWER EXTREMITY, BELOW KNEE, THIGH LACER, NONMOLDED
ADDITION TO LOWER EXTREMITY, BELOW KNEE, THIGH LACER, GLUTEAL/ISCHIAL, MOLDED
ADDITION TO LOWER EXTREMITY, BELOW KNEE, FORK STRAP
ADDITION TO LOWER EXTREMITY, BELOW KNEE, BACK CHECK (EXTENSION CONTROL)
ADDITION TO LOWER EXTREMITY, BELOW KNEE, WAIST BELT, WEBBING
ADDITION TO LOWER EXTREMITY, BELOW KNEE, WAIST BELT, PADDED AND LINED
ADDITION TO LOWER EXTREMITY, ABOVE KNEE, PELVIC CONTROL BELT, LIGHT
ADDITION TO LOWER EXTREMITY, ABOVE KNEE, PELVIC CONTROL BELT, PADDED AND LINED
ADDITION TO LOWER EXTREMITY, ABOVE KNEE, PELVIC CONTROL, SLEEVE SUSPENSION, NEOPRENE OR EQUAL,
ADDITION TO LOWER EXTREMITY, ABOVE KNEE OR KNEE DISARTICULATION, PELVIC JOINT
ADDITION TO LOWER EXTREMITY, ABOVE KNEE OR KNEE DISARTICULATION, PELVIC BAND
ADDITION TO LOWER EXTREMITY, ABOVE KNEE OR KNEE DISARTICULATION, SILESIAN BANDAGE
ALL LOWER EXTREMITY PROSTHESES, SHOULDER HARNESS
REPLACEMENT, SOCKET, BELOW KNEE, MOLDED TO PATIENT MODEL
REPLACEMENT, SOCKET, ABOVE KNEE/KNEE DISARTICULATION, INCLUDING ATTACHMENT PLATE, MOLDED TO PA
REPLACEMENT, SOCKET, HIP DISARTICULATION, INCLUDING HIP JOINT, MOLDED TO PATIENT MODEL
CUSTOM SHAPED PROTECTIVE COVER, BELOW KNEE
CUSTOM SHAPED PROTECTIVE COVER, ABOVE KNEE
CUSTOM SHAPED PROTECTIVE COVER, KNEE DISARTICULATION
CUSTOM SHAPED PROTECTIVE COVER, HIP DISARTICULATION
ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, MANUAL LOCK
ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, MANUAL LOCK, ULTRA-LIGHT MATERIAL
ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, FRICTION SWING AND STANCE PHASE CONTROL (SA
ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, VARIABLE FRICTION SWING PHASE CONTROL
ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, POLYCENTRIC, MECHANICAL STANCE PHASE LOCK
ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, POLYCENTRIC, FRICTION SWING AND STANCE PHASE CONTROL
ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, PNEUMATIC SWING, FRICTION STANCE PHASE CONT
ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, FLUID SWING PHASE CONTROL
ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, EXTERNAL JOINTS FLUID SWING PHASE CONTROL
ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, FLUID SWING AND STANCE PHASE CONTROL
ADDITION, EXOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, PNEUMATIC/HYDRA PNEUMATIC SWING PHASE CONT
ADDITION TO LOWER LIMB PROSTHESIS, VACUUM PUMP, RESIDUAL LIMB VOLUME MANAGEMENT AND MOISTURE
ADDITION TO LOWER LIMB PROSTHESIS, VACUUM PUMP, RESIDUAL LIMB VOLUME MANAGEMENT AND MOISTURE
ADDITION, EXOSKELETAL SYSTEM, BELOW KNEE, ULTRA-LIGHT MATERIAL (TITANIUM, CARBON FIBER OR EQUAL)
ADDITION, EXOSKELETAL SYSTEM, ABOVE KNEE, ULTRA-LIGHT MATERIAL (TITANIUM, CARBON FIBER OR EQUAL)
ADDITION, EXOSKELETAL SYSTEM, HIP DISARTICULATION, ULTRA-LIGHT MATERIAL (TITANIUM, CARBON FIBER OR
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, MANUAL LOCK
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, MANUAL LOCK, ULTRA-LIGHT MATERIAL
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, FRICTION SWING AND STANCE PHASE CONTROL (S
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, POLYCENTRIC, HYDRAULIC SWING PHASE CONTROL, MECHANIC
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, POLYCENTRIC, MECHANICAL STANCE PHASE LOCK
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, POLYCENTRIC, FRICTION SWING, AND STANCE PHASE CONTROL
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, PNEUMATIC SWING, FRICTION STANCE PHASE CON
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, FLUID SWING PHASE CONTROL
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, HYDRAULIC SWING PHASE CONTROL, WITH MINIAT
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, FLUID SWING AND STANCE PHASE CONTROL
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, PNEUMATIC/ SWING PHASE CONTROL
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, 4-BAR LINKAGE OR MULTIAXIAL, PNEUMATIC SWING PHASE CONT
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, STANCE FLEXION FEATURE, ADJUSTABLE
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, MICROPROCESSOR CONTROL FEATURE, SWING PHASE ONLY
ADDITION, ENDOSKELETAL KNEE-SHIN SYSTEM, MICROPROCESSOR CONTROL FEATURE, STANCE PHASE
ADDITION TO ENDOSKELETAL, KNEE-SHIN SYSTEM, HYDRAULIC STANCE EXTENSION, DAMPENING FEATURE, ADJU
ADDITION, ENDOSKELETAL SYSTEM, ABOVE KNEE OR HIP DISARTICULATION, KNEE EXTENSION ASSIST
ADDITION, ENDOSKELETAL SYSTEM, HIP DISARTICULATION, MECHANICAL HIP EXTENSION ASSIST
ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ALIGNABLE SYSTEM
ADDITION, ENDOSKELETAL SYSTEM, ABOVE KNEE OR HIP DISARTICULATION, ALIGNABLE SYSTEM
ADDITION, ENDOSKELETAL SYSTEM, ABOVE KNEE, KNEE DISARTICULATION OR HIP DISARTICULATION, MANUAL LO
ADDITION, ENDOSKELETAL SYSTEM, HIGH ACTIVITY KNEE CONTROL FRAME
ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ULTRA-LIGHT MATERIAL (TITANIUM, CARBON FIBER OR EQUAL
ADDITION, ENDOSKELETAL SYSTEM, ABOVE KNEE, ULTRA-LIGHT MATERIAL (TITANIUM, CARBON FIBER OR EQUAL
ADDITION, ENDOSKELETAL SYSTEM, HIP DISARTICULATION, ULTRA-LIGHT MATERIAL (TITANIUM, CARBON FIBER O
ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, FLEXIBLE PROTECTIVE OUTER SURFACE COVERING SYSTEM
ADDITION, ENDOSKELETAL SYSTEM, ABOVE KNEE, FLEXIBLE PROTECTIVE OUTER SURFACE COVERING SYSTEM
ADDITION, ENDOSKELETAL SYSTEM, HIP DISARTICULATION, FLEXIBLE PROTECTIVE OUTER SURFACE COVERING
ADDITION TO LOWER LIMB PROSTHESIS, MULTIAXIAL ANKLE WITH SWING PHASE ACTIVE DORSIFLEXION FEATUR
ALL LOWER EXTREMITY PROSTHESES, FOOT, EXTERNAL KEEL, SACH FOOT
ALL LOWER EXTREMITY PROSTHESES, FLEXIBLE KEEL FOOT (SAFE, STEN, BOCK DYNAMIC OR EQUAL)
ALL LOWER EXTREMITY PROSTHESES, FOOT, SINGLE AXIS ANKLE/FOOT
ALL LOWER EXTREMITY PROSTHESIS, COMBINATION SINGLE AXIS ANKLE AND FLEXIBLE KEEL FOOT
ALL LOWER EXTREMITY PROSTHESES, ENERGY STORING FOOT (SEATTLE CARBON COPY II OR EQUAL)
ALL LOWER EXTREMITY PROSTHESES, FOOT, MULTIAXIAL ANKLE/FOOT
ALL LOWER EXTREMITY PROSTHESES, MULTI-AXIAL ANKLE, DYNAMIC RESPONSE FOOT, ONE PIECE SYSTEM
ALL LOWER EXTREMITY PROSTHESES, FLEX FOOT SYSTEM
ALL LOWER EXTREMITY PROSTHESES, FLEX-WALK SYSTEM OR EQUAL
ALL EXOSKELETAL LOWER EXTREMITY PROSTHESES, AXIAL ROTATION UNIT
ALL ENDOSKELETAL LOWER EXTREMITY PROSTHESES, AXIAL ROTATION UNIT
ALL ENDOSKELETAL LOWER EXTREMITY PROTHESES, DYNAMIC PROSTHETIC PYLON
ALL LOWER EXTREMITY PROSTHESES, MULTI-AXIAL ROTATION UNIT ("MCP" OR EQUAL)
ALL LOWER EXTREMITY PROSTHESIS, SHANK FOOT SYSTEM WITH VERTICAL LOADING PYLON
ADDITION TO LOWER LIMB PROSTHESIS, VERTICAL SHOCK REDUCING PYLON FEATURE
ADDITION TO LOWER EXTREMITY PROSTHESIS, ENDOSKELETAL SYSTEM, PYLON WITH INTEGRATED ELECTRONIC
ADDITION TO LOWER EXTREMITY PROSTHESIS, USER ADJUSTABLE HEEL HEIGHT
ADDITION TO LOWER EXTREMITY PROSTHESIS, HEAVY DUTY FEATURE (FOR PATIENT WEIGHT > 300 LBS)
LOWER EXTREMITY PROSTHESIS, NOT OTHERWISE SPECIFIED
PARTIAL HAND, ROBIN-AIDS, THUMB REMAINING (OR EQUAL)
PARTIAL HAND, ROBIN-AIDS, LITTLE AND/OR RING FINGER REMAINING (OR EQUAL)
PARTIAL HAND, ROBIN-AIDS, NO FINGER REMAINING (OR EQUAL)
TRANSCARPAL/METACARPAL/PARTIAL HAND DISARTICULATION PROSTHESIS, EXTERN POWER,SELF-SUSPENDED
WRIST DISARTICULATION, MOLDED SOCKET, FLEXIBLE ELBOW HINGES, TRICEPS PAD
WRIST DISARTICULATION, MOLDED SOCKET WITH EXPANDABLE INTERFACE, FLEXIBLE ELBOW HINGES, TRICEPS
BELOW ELBOW, MOLDED SOCKET, FLEXIBLE ELBOW HINGE, TRICEPS PAD
BELOW ELBOW, MOLDED SOCKET, (MUENSTER OR NORTHWESTERN SUSPENSION TYPES)
BELOW ELBOW, MOLDED DOUBLE WALL SPLIT SOCKET, STEP-UP HINGES, HALF CUFF
BELOW ELBOW, MOLDED DOUBLE WALL SPLIT SOCKET, STUMP ACTIVATED LOCKING HINGE, HALF CUFF
ELBOW DISARTICULATION, MOLDED SOCKET, OUTSIDE LOCKING HINGE, FOREARM
ELBOW DISARTICULATION, MOLDED SOCKET WITH EXPANDABLE INTERFACE, OUTSIDE LOCKING HINGES, FOREA
ABOVE ELBOW, MOLDED DOUBLE WALL SOCKET, INTERNAL LOCKING ELBOW, FOREARM
SHOULDER DISARTICULATION, MOLDED SOCKET, SHOULDER BULKHEAD, HUMERAL SECTION, INTERNAL LOCKING
SHOULDER DISARTICULATION, PASSIVE RESTORATION (COMPLETE PROSTHESIS)
SHOULDER DISARTICULATION, PASSIVE RESTORATION (SHOULDER CAP ONLY)
INTERSCAPULAR THORACIC, MOLDED SOCKET, SHOULDER BULKHEAD, HUMERAL SECTION, INTERNAL LOCKING E
INTERSCAPULAR THORACIC, PASSIVE RESTORATION (COMPLETE PROSTHESIS)
INTERSCAPULAR THORACIC, PASSIVE RESTORATION (SHOULDER CAP ONLY)
IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF INITIAL RIGID DRESSING, INCLUDING FITTING AL
IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF INITIAL RIGID DRESSING INCLUDING FITTING AL
IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF INITIAL RIGID DRESSING INCLUDING FITTING AL
IMMEDIATE POST SURGICAL OR EARLY FITTING, EACH ADDITIONAL CAST CHANGE AND REALIGNMENT
IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF RIGID DRESSING ONLY
BELOW ELBOW, MOLDED SOCKET, ENDOSKELETAL SYSTEM, INCLUDING SOFT PROSTHETIC TISSUE SHAPING
ELBOW DISARTICULATION, MOLDED SOCKET, ENDOSKELETAL SYSTEM, INCLUDING SOFT PROSTHETIC TISSUE SH
ABOVE ELBOW, MOLDED SOCKET, ENDOSKELETAL SYSTEM, INCLUDING SOFT PROSTHETIC TISSUE SHAPING
SHOULDER DISARTICULATION, MOLDED SOCKET, ENDOSKELETAL SYSTEM, INCLUDING SOFT PROSTHETIC TISSU
INTERSCAPULAR THORACIC, MOLDED SOCKET, ENDOSKELETAL SYSTEM, INCLUDING SOFT PROSTHETIC TISSUE
PREPARATORY,WRIST DISARTICULATN/BELOW ELBOW,1 WALL PLASTIC SOCKET, FRICTION WRIST, FLEXIBLE ELB
PREPARATORY, WRIST DISARTICULATION OR BELOW ELBOW, SINGLE WALL SOCKET, FRICTION WRIST, FLEXIBLE
PREPARATORY, ELBOW DISARTICULATION OR ABOVE ELBOW, SINGLE WALL PLASTIC SOCKET, FRICTION WRIST,
PREPARATORY, ELBOW DISARTICULATION OR ABOVE ELBOW, SINGLE WALL SOCKET, FRICTION WRIST, LOCKING
PREPARATORY, SHOULDER DISARTICULATION OR INTERSCAPULAR THORACIC, SINGLE WALL PLASTIC SOCKET,S
PREPARATORY, SHOULDER DISARTICULATION OR INTERSCAPULAR THORACIC, SINGLE WALL SOCKET, SHOULDE
UPPER EXTREMITY ADDITIONS, POLYCENTRIC HINGE, PAIR
UPPER EXTREMITY ADDITIONS, SINGLE PIVOT HINGE, PAIR
UPPER EXTREMITY ADDITIONS, FLEXIBLE METAL HINGE, PAIR
UPPER EXTREMITY ADDITION, DISCONNECT LOCKING WRIST UNIT
UPPER EXTREMITY ADDITION, ADDITIONAL DISCONNECT INSERT FOR LOCKING WRIST UNIT, EACH
UPPER EXTREMITY ADDITION, FLEXION-FRICTION WRIST UNIT
UPPER EXTREMITY ADDITION, SPRING ASSISTED ROTATIONAL WRIST UNIT WITH LATCH RELEASE
UPPER EXTREMITY ADDITION, ROTATION WRIST UNIT WITH CABLE LOCK
UPPER EXTREMITY ADDITION, QUICK DISCONNECT HOOK ADAPTER, OTTO BOCK OR EQUAL
UPPER EXTREMITY ADDITION, QUICK DISCONNECT LAMINATION COLLAR WITH COUPLING PIECE, OTTO BOCK OR
UPPER EXTREMITY ADDITION, STAINLESS STEEL, ANY WRIST
UPPER EXTREMITY ADDITION, LATEX SUSPENSION SLEEVE, EACH
UPPER EXTREMITY ADDITION, LIFT ASSIST FOR ELBOW
UPPER EXTREMITY ADDITION, NUDGE CONTROL ELBOW LOCK
UPPER EXTREMITY ADDITION TO PROSTHESIS, ELECTRIC LOCKING FEATURE, ONLY FOR USE WITH MANUALLY PO
UPPER EXTREMITY ADDITIONS, SHOULDER ABDUCTION JOINT, PAIR
UPPER EXTREMITY ADDITION, EXCURSION AMPLIFIER, PULLEY TYPE
UPPER EXTREMITY ADDITION, EXCURSION AMPLIFIER, LEVER TYPE
UPPER EXTREMITY ADDITION, SHOULDER FLEXION-ABDUCTION JOINT, EACH
UPPER EXTREMITY ADDITION, SHOULDER JOINT, MULTIPOSITIONAL LOCKING, FLEXION, ADJUSTABLE ABDUCTION
UPPER EXTREMITY ADDITION, SHOULDER LOCK MECHANISM, BODY POWERED ACTUATOR
UPPER EXTREMITY ADDITION, SHOULDER LOCK MECHANISM, EXTERNAL POWERED ACTUATOR
UPPER EXTREMITY ADDITION, SHOULDER UNIVERSAL JOINT, EACH
UPPER EXTREMITY ADDITION, STANDARD CONTROL CABLE, EXTRA
UPPER EXTREMITY ADDITION, HEAVY DUTY CONTROL CABLE
UPPER EXTREMITY ADDITION, TEFLON, OR EQUAL, CABLE LINING
UPPER EXTREMITY ADDITION, HOOK TO HAND, CABLE ADAPTER
UPPER EXTREMITY ADDITION, HARNESS, CHEST OR SHOULDER, SADDLE TYPE
UPPER EXTREMITY ADDITION, HARNESS, FIGURE OF EIGHT TYPE, FOR SINGLE CONTROL
UPPER EXTREMITY ADDITION, HARNESS, FIGURE OF EIGHT TYPE, FOR DUAL CONTROL
UPPER EXTREMITY ADDITION, TEST SOCKET, WRIST DISARTICULATION OR BELOW ELBOW
UPPER EXTREMITY ADDITION, TEST SOCKET, ELBOW DISARTICULATION OR ABOVE ELBOW
UPPER EXTREMITY ADDITION, TEST SOCKET, SHOULDER DISARTICULATION OR INTERSCAPULAR THORACIC
UPPER EXTREMITY ADDITION, SUCTION SOCKET
UPPER EXTREMITY ADDITION, FRAME TYPE SOCKET, BELOW ELBOW OR WRIST DISARTICULATION
UPPER EXTREMITY ADDITION, FRAME TYPE SOCKET, ABOVE ELBOW OR ELBOW DISARTICULATION
UPPER EXTREMITY ADDITION, FRAME TYPE SOCKET, SHOULDER DISARTICULATION
UPPER EXTREMITY ADDITION, FRAME TYPE SOCKET, INTERSCAPULAR-THORACIC
UPPER EXTREMITY ADDITION, REMOVABLE INSERT, EACH
UPPER EXTREMITY ADDITION, SILICONE GEL INSERT OR EQUAL, EACH
UPPER EXTREMITY ADDITION, LOCKING ELBOW, FOREARM COUNTERBALANCE
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #3
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #5
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #5X
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #5XA
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #6
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #7
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #7LO
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #8
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #8X
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #88X
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #10P
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #10X
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #12P
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #99X
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #555
TERMINAL DEVICE, HOOK, DORRANCE, OR EQUAL, MODEL #SS555
TERMINAL DEVICE, HOOK, ACCU HOOK, OR EQUAL
TERMINAL DEVICE, HOOK, 2 LOAD, OR EQUAL
TERMINAL DEVICE, HOOK, APRL VC, OR EQUAL
TERMINAL DEVICE, MODIFIER WRIST FLEXION UNIT
TERMINAL DEVICE, HOOK, TRS GRIP, GRIP III, VC, OR EQUAL
TERMINAL DEVICE, HOOK, GRIP I, GRIP II, VC, OR EQUAL
TERMINAL DEVICE, HOOK, TRS ADEPT, INFANT OR CHILD, VC, OR EQUAL
TERMINAL DEVICE, HOOK, TRS SUPER SPORT, PASSIVE
TERMINAL DEVICE, PINCHER TOOL, OTTO BOCK OR EQUAL
TERMINAL DEVICE, HAND, DORRANCE, VO
TERMINAL DEVICE, HAND, APRL, VC
TERMINAL DEVICE, HAND, SIERRA, VO
TERMINAL DEVICE, HAND, BECKER IMPERIAL
TERMINAL DEVICE, HAND, BECKER LOCK GRIP
TERMINAL DEVICE, HAND, BECKER PLYLITE
TERMINAL DEVICE, HAND, ROBIN-AIDS, VO
TERMINAL DEVICE, HAND, ROBIN-AIDS, VO SOFT
TERMINAL DEVICE, HAND, PASSIVE HAND
TERMINAL DEVICE, HAND, DETROIT INFANT HAND (MECHANICAL)
TERMINAL DEVICE, HAND, PASSIVE INFANT HAND, (STEEPER, HOSMER OR EQUAL)
TERMINAL DEVICE, HAND, CHILD MITT
TERMINAL DEVICE, HAND, NYU CHILD HAND
TERMINAL DEVICE, HAND, MECHANICAL INFANT HAND, STEEPER OR EQUAL
TERMINAL DEVICE, HAND, BOCK, VC
TERMINAL DEVICE, HAND, BOCK, VO
AUTOMATIC GRASP FEATURE, ADDITION TO UPPER LIMB PROSTHETIC TERMINAL DEVICE
MICROPROCESSOR CONTROL FEATURE, ADDITION TO UPPER LIMB PROSTHETIC TERMINAL DEVICE
TERMINAL DEVICE, GLOVE FOR ABOVE HANDS, PRODUCTION GLOVE
TERMINAL DEVICE, GLOVE FOR ABOVE HANDS, CUSTOM GLOVE
HAND RESTORATION (CASTS, SHADING AND MEASUREMENTS INCLUDED), PARTIAL HAND, WITH GLOVE, THUMB O
HAND RESTORATION (CASTS, SHADING AND MEASUREMENTS INCLUDED), PARTIAL HAND, WITH GLOVE, MULTIPLE
HAND RESTORATION (CASTS, SHADING AND MEASUREMENTS INCLUDED), PARTIAL HAND, WITH GLOVE, NO FINGE
HAND RESTORATION (SHADING, AND MEASUREMENTS INCLUDED), REPLACEMENT GLOVE FOR ABOVE
WRIST DISARTICULATION, EXTERNAL POWER, SELF-SUSPENDED INNER SOCKET, REMOVABLE FOREARM SHELL,
WRIST DISARTICULATION, EXTERNAL POWER, SELF-SUSPENDED INNER SOCKET, REMOVABLE FOREARM SHELL,
BELOW ELBOW, EXTERNAL POWER, SELF-SUSPENDED INNER SOCKET, REMOVABLE FOREARM SHELL, OTTO BOC
BELOW ELBOW, EXTERNAL POWER, SELF-SUSPENDED INNER SOCKET, REMOVABLE FOREARM SHELL, OTTO BOC
ELBOW DISARTICULATION, EXTERNAL POWER, MOLDED INNER SOCKET, REMOVABLE HUMERAL SHELL, OUTSIDE
ELBOW DISARTICULATION, EXTERNAL POWER, MOLDED INNER SOCKET, REMOV HUMERAL SHELL, OUTSIDE LOCK
ABOVE ELBOW, EXTERNAL POWER, MOLDED INNER SOCKET, REMOVABLE HUMERAL SHELL, INTERNAL LOCKING
ABOVE ELBOW, EXTERNAL POWER, MOLDED INNER SOCKET, REMOVABLE HUMERAL SHELL, INTERNAL LOCKING
SHLDR DISARTICULTN,EXTERNL POWR,MOLDED INNER SOCKET,REMOV SHLDR SHELL,SHLDR BULKHEAD,HUMRA
SHLDR DISARTICULTN,EXTERN POWR,MOLDED INNER SOCKET,REMOV SHLDR SHELL,SHLDR BULKHEAD,HMERAL
INTERSCAPULAR-THORAC,EXTERN POWR,MOLDED INNR SOCKET,REMOV SHLDR SHELL,SHLDR BULKHEAD,HUME
INTERSCAPULAR-THORACIC, EXTERNAL POWER,MOLDED INNER SOCKET,REMOV SHLDR SHELL,SHLDR BULKHEA
ELECTRONIC HAND, OTTO BOCK, STEEPER OR EQUAL, SWITCH CONTROLLED
ELECTRONIC HAND, SYSTEM TEKNIK, VARIETY VILLAGE OR EQUAL, SWITCH CONTROLLED
ELECTRONIC GREIFER, OTTO BOCK OR EQUAL, SWITCH CONTROLLED
ELECTRONIC HAND, OTTO BOCK OR EQUAL, MYOELECTRONICALLY CONTROLLED
ELECTRONIC HAND, SYSTEM TEKNIK, VARIETY VILLAGE OR EQUAL, MYOELECTRONICALLY CONTROLLED
ELECTRONIC GREIFER, OTTO BOCK OR EQUAL, MYOELECTRONICALLY CONTROLLED
PREHENSILE ACTUATOR, HOSMER OR EQUAL, SWITCH CONTROLLED
ELECTRONIC HOOK, CHILD, MICHIGAN OR EQUAL, SWITCH CONTROLLED
ELECTRONIC ELBOW, HOSMER OR EQUAL, SWITCH CONTROLLED
ELECTRONIC ELBOW, BOSTON, UTAH OR EQUAL, MYOELECTRONICALLY CONTROLLED
ELECTRONIC ELBOW, ADOLESCENT, VARIETY VILLAGE OR EQUAL, SWITCH CONTROLLED
ELECTRONIC ELBOW, CHILD, VARIETY VILLAGE OR EQUAL, SWITCH CONTROLLED
ELECTRONIC ELBOW, ADOLESCENT, VARIETY VILLAGE OR EQUAL, MYOELECTRONICALLY CONTROLLED
ELECTRONIC ELBOW, CHILD, VARIETY VILLAGE OR EQUAL, MYOELECTRONICALLY CONTROLLED
ELECTRONIC WRIST ROTATOR, OTTO BOCK OR EQUAL
ELECTRONIC WRIST ROTATOR, FOR UTAH ARM
SERVO CONTROL, STEEPER OR EQUAL
ANALOGUE CONTROL, UNB OR EQUAL
PROPORTIONAL CONTROL, 6-12 VOLT, LIBERTY, UTAH OR EQUAL
SIX VOLT BATTERY, OTTO BOCK OR EQUAL, EACH
BATTERY CHARGER, SIX VOLT, OTTO BOCK OR EQUAL
TWELVE VOLT BATTERY, UTAH OR EQUAL, EACH
BATTERY CHARGER, TWELVE VOLT, UTAH OR EQUAL
LITHIUM ION BATTERY, REPLACEMENT
LITHIUM ION BATTERY CHARGER
UPPER EXTREMITY PROSTHESIS, NOT OTHERWISE SPECIFIED
REPAIR OF PROSTHETIC DEVICE, HOURLY RATE (EXCLUDES V5335 REPAIR OF ORAL OR LARYNGEAL PROSTHESIS
REPAIR OF PROSTHETIC DEVICE, REPAIR OR REPLACE MINOR PARTS
REPAIR PROSTHETIC DEVICE, LABOR COMPONENT, PER 15 MINUTES
VACUUM ERECTION SYSTEM
BREAST PROSTHESIS, MASTECTOMY BRA
BREAST PROSTHESIS, MASTECTOMY BRA, WITH INTEGRATED BREAST PROSTHESIS FORM, UNILATERAL
BREAST PROSTHESIS, MASTECTOMY BRA, WITH INTEGRATED BREAST PROSTHESIS FORM, BILATERAL
BREAST PROSTHESIS, MASTECTOMY SLEEVE
EXTERNAL BREAST PROSTHESIS GARMENT, WITH MASTECTOMY FORM, POST MASTECTOMY
BREAST PROSTHESIS, MASTECTOMY FORM
BREAST PROSTHESIS, SILICONE OR EQUAL
CUSTOM BREAST PROSTHESIS, POST MASTECTOMY, MOLDED TO PATIENT MODEL
BREAST PROSTHESIS, NOT OTHERWISE SPECIFIED
NASAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN
MIDFACIAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN
ORBITAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN
UPPER FACIAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN
HEMI-FACIAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN
AURICULAR PROSTHESIS, PROVIDED BY A NON-PHYSICIAN
PARTIAL FACIAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN
NASAL SEPTAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN
UNSPECIFIED MAXILLOFACIAL PROSTHESIS, BY REPORT, PROVIDED BY A NON-PHYSICIAN
REPAIR OR MODIFICATION OF MAXILLOFACIAL PROSTHESIS, LABOR COMPONENT, 15 MINUTE INCREMENTS, PROV
GRADIENT COMPRESSION STOCKING, BELOW KNEE, 18-30 MMHG, EACH
GRADIENT COMPRESSION STOCKING, BELOW KNEE, 30-40 MMHG, EACH
GRADIENT COMPRESSION STOCKING, BELOW KNEE, 40-50 MMHG, EACH
GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 18-30 MMHG, EACH
GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 30-40 MMHG, EACH
GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 40-50 MMHG, EACH
GRADIENT COMPRESSION STOCKING, FULL-LENGTH/CHAP STYLE, 18-30 MMHG, EACH
GRADIENT COMPRESSION STOCKING, FULL-LENGTH/CHAP STYLE, 30-40 MMHG, EACH
GRADIENT COMPRESSION STOCKING, FULL-LENGTH/CHAP STYLE, 40-50 MMHG, EACH
GRADIENT COMPRESSION STOCKING, WAIST LENGTH, 18-30 MMHG, EACH
GRADIENT COMPRESSION STOCKING, WAIST LENGTH, 30-40 MMHG, EACH
GRADIENT COMPRESSION STOCKING, WAIST LENGTH, 40-50 MMHG, EACH
GRADIENT COMPRESSION STOCKING, CUSTOM MADE
GRADIENT COMPRESSION STOCKING, LYMPHEDEMA
GRADIENT COMPRESSION STOCKING, GARTER BELT
GRADIENT COMPRESSION STOCKING, NOT OTHERWISE SPECIFIED
TRUSS, SINGLE WITH STANDARD PAD
TRUSS, DOUBLE WITH STANDARD PADS
TRUSS, ADDITION TO STANDARD PAD, WATER PAD
TRUSS, ADDITION TO STANDARD PAD, SCROTAL PAD
PROSTHETIC SHEATH, BELOW KNEE, EACH
PROSTHETIC SHEATH, ABOVE KNEE, EACH
PROSTHETIC SHEATH, UPPER LIMB, EACH
PROSTHETIC SHEATH/SOCK, INCLUDING A GEL CUSHION LAYER, BELOW KNEE OR ABOVE KNEE, EACH
PROSTHETIC SOCK, MULTIPLE PLY, BELOW KNEE, EACH
PROSTHETIC SOCK, MULTIPLE PLY, ABOVE KNEE, EACH
PROSTHETIC SOCK, MULTIPLE PLY, UPPER LIMB, EACH
PROSTHETIC SHRINKER, BELOW KNEE, EACH
PROSTHETIC SHRINKER, ABOVE KNEE, EACH
PROSTHETIC SHRINKER, UPPER LIMB, EACH
PROSTHETIC SOCK, SINGLE PLY, FITTING, BELOW KNEE, EACH
PROSTHETIC SOCK, SINGLE PLY, FITTING, ABOVE KNEE, EACH
PROSTHETIC SOCK, SINGLE PLY, FITTING, UPPER LIMB, EACH
ADDITION TO PROSTHETIC SHEATH/SOCK, AIR SEAL SUCTION RETENTION SYSTEM
UNLISTED PROCEDURE FOR MISCELLANEOUS PROSTHETIC SERVICES
ARTIFICIAL LARYNX, ANY TYPE
TRACHEOSTOMY SPEAKING VALVE
ARTIFICIAL LARYNX REPLACEMENT BATTERY/ACCESSORY, ANY TYPE
TRACHEO-ESOPHAGEAL VOICE PROSTHESIS, PATIENT INSERTED, ANY TYPE, EACH
TRACHEO-ESOPHAGEAL VOICE PROSTHESIS, INSERTED BY A LICENSED HEALTH CARE PROVIDER, ANY TYPE
VOICE AMPLIFIER
IMPLANTABLE BREAST PROSTHESIS, SILICONE OR EQUAL
INJECTABLE BULKING AGENT, COLLAGEN IMPLANT, URINARY TRACT, 2.5 ML SYRINGE, INCLUDES SHIPPING AND N
INJECTABLE BULKING AGENT, SYNTHETIC IMPLANT, URINARY TRACT, 1 ML SYRINGE, INCLUDES SHIPPING AND NE
OCULAR IMPLANT
AQUEOUS SHUNT
OSSICULA IMPLANT
COCHLEAR DEVICE/SYSTEM
COCHLEAR IMPLANT EXTERNAL SPEECH PROCESSOR, REPLACEMENT
METACARPOPHALANGEAL JOINT IMPLANT
METATARSAL JOINT IMPLANT
HALLUX IMPLANT
INTERPHALANGEAL JOINT IMPLANT
VASCULAR GRAFT MATERIAL, SYNTHETIC, IMPLANT
PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED
ORTHOTIC AND PROSTHETIC SUPPLY, ACCESSORY, AND/OR SERVICE COMPONENT OF ANOTHER HCPCS L CODE
BRIEF OFFICE VISIT FOR THE SOLE PURPOSE OF MONITORING OR CHANGING DRUG PRESCRIPTIONS USED IN TH
CELLULAR THERAPY
PROLOTHERAPY
INTRAGASTRIC HYPOTHERMIA USING GASTRIC FREEZING (MNP)
IV CHELATION THERAPY (CHEMICAL ENDARTERECTOMY)
FABRIC WRAPPING OF ABDOMINAL ANEURYSM (MNP)
CEPHALIN FLOCULATION, BLOOD
CONGO RED, BLOOD
HAIR ANALYSIS (EXCLUDING ARSENIC)
THYMOL TURBIDITY, BLOOD
MUCOPROTEIN, BLOOD (SEROMUCOID) (MEDICAL NECESSITY PROCEDURE)
SCREENING PAPANICOLAOU SMEAR, CERVICAL OR VAGINAL, UP TO THREE SMEARS, BY TECHNICIAN UNDER PHY
SCREENING PAPANICOLAOU SMEAR, CERVICAL OR VAGINAL, UP TO THREE SMEARS, REQUIRING INTERPRETATIO
CULTURE, BACTERIAL, URINE; QUANTITATIVE, SENSITIVITY STUDY
BLOOD (WHOLE), FOR TRANSFUSION, PER UNIT
BLOOD (SPLIT UNIT), SPECIFY AMOUNT
CRYOPRECIPITATE, EACH UNIT
RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT
FRESH FROZEN PLASMA (SINGLE DONOR), EACH UNIT
PLATELETS, EACH UNIT
PLATELET RICH PLASMA, EACH UNIT
RED BLOOD CELLS, EACH UNIT
RED BLOOD CELLS, WASHED, EACH UNIT
PLASMA, POOLED MULTIPLE DONOR, SOLVENT/DETERGENT TREATED, FROZEN, EACH UNIT
PLATELETS, LEUKOCYTES REDUCED, EACH UNIT
PLATELETS, IRRADIATED, EACH UNIT
PLATELETS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT
PLATELETS, PHERESIS, EACH UNIT
PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT
PLATELETS, PHERESIS, IRRADIATED, EACH UNIT
PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT
RED BLOOD CELLS, IRRADIATED, EACH UNIT
RED BLOOD CELLS, DEGLYCEROLIZED, EACH UNIT
RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT
INFUSION, ALBUMIN (HUMAN), 5%, 50 ML
INFUSION, PLASMA PROTEIN FRACTION (HUMAN), 5%, 50 ML
PLASMA, CRYOPRECIPITATE REDUCED, EACH UNIT
INFUSION, ALBUMIN (HUMAN), 5%, 250 ML
INFUSION, ALBUMIN (HUMAN), 25%, 20 ML
INFUSION, ALBUMIN (HUMAN), 25%, 50 ML
INFUSION, PLASMA PROTEIN FRACTION (HUMAN), 5%, 250ML
GRANULOCYTES, PHERESIS, EACH UNIT
TRAVEL ALLOWANCE ONE WAY IN CONNECTION WITH MEDICALLY NECESSARY LABORATORY SPECIMEN COLLEC
TRAVEL ALLOWANCE ONE WAY IN CONNECTION WITH MEDICALLY NECESSARY LABORATORY SPECIMEN COLLEC
CATHETERIZATION FOR COLLECTION OF SPECIMEN, SINGLE PATIENT, ALL PLACES OF SERVICE
CATHETERIZATION FOR COLLECTION OF SPECIMEN (S) (MULTIPLE PATIENTS)
CARDIOKYMOGRAPHY
INFUSION THERAPY, USING OTHER THAN CHEMOTHERAPEUTIC DRUGS, PER VISIT
CHEMOTHERAPY ADMINISTRATION BY OTHER THAN INFUSION TECHNIQUE ONLY (E.G., SUBCUTANEOUS, INTRAM
CHEMOTHERAPY ADMINISTRATION BY INFUSION TECHNIQUE ONLY, PER VISIT
CHEMOTHERAPY ADMINISTRATION BY BOTH INFUSION TECHNIQUE AND OTHER TECHNIQUE(S) (E.G., SUBCUTANE
PHYSICAL THERAPY EVALUATION/TREATMENT, PER VISIT
SCREENING PAPANICOLAOU SMEAR; OBTAINING, PREPARING AND CONVEYANCE OF CERVICAL OR VAGINAL SME
SET-UP PORTABLE X-RAY EQUIPMENT
WET MOUNTS, INCLUDING PREPARATIONS OF VAGINAL, CERVICAL OR SKIN SPECIMENS
ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS
PINWORM EXAMINATION
FERN TEST
POST-COITAL DIRECT, QUALITATIVE EXAMINATIONS OF VAGINAL OR CERVICAL MUCOUS
INJECTION, EPOETIN ALPHA, (FOR NON ESRD USE), PER 1000 UNITS
AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM
DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A
PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPL
PROCHLORPERAZINE MALEATE, 10 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMP
GRANISETRON HYDROCHLORIDE, 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMP
DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUT
DRONABINOL, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC
PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A C
PROMETHAZINE HYDROCHLORIDE, 25 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A CO
CHLORPROMAZINE HYDROCHLORIDE, 10 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A
CHLORPROMAZINE HYDROCHLORIDE, 25 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A
TRIMETHOBENZAMIDE HYDROCHLORIDE, 250 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE A
THIETHYLPERAZINE MALEATE, 10 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPL
PERPHENZAINE, 4 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEU
PERPHENZAINE, 8 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEU
HYDROXYZINE PAMOATE, 25 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE T
HYDROXYZINE PAMOATE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE T
ONDANSETRON HYDROCHLORIDE 8 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COM
DOLASETRON MESYLATE, 100 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE
UNSPECIFIED ORAL DOSAGE FORM, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THE
DERMAL TISSUE, OF HUMAN ORIGIN, WITH AND WITHOUT OTHER BIOENGINEERED OR PROCESSED ELEMENTS, B
DERMAL TISSUE, OF HUMAN ORIGIN, WITH OR WITHOUT OTHER BIOENGINEERED OR PROCESSED ELEMENTS, WI
FACTOR VIIA (COAGULATION FACTOR, RECOMBINANT) PER 1.2 MG
NEW TECHNOLOGY INTRAOCULAR LENS CATEGORY 1 AS DEFINED IN FEDERAL REGISTER NOTICE, VOL. 65, DATE
NEW TECHNOLOGY INTRAOCULAR LENS CATEGORY 2 AS DEFINED IN FEDERAL REGISTER NOTICE, VOL. 65, DATE
NEW TECHNOLOGY INTRAOCULAR LENS CATEGORY 3 AS DEFINED IN FEDERAL REGISTER NOTICE
NEW TECHNOLOGY INTRAOCULAR LENS CATEGORY 4 AS DEFINED IN FEDERAL REGISTER NOTICE
NEW TECHNOLOGY INTRAOCULAR LENS CATEGORY 5 AS DEFINED IN FEDERAL REGISTER NOTICE
ORAL, CABERGOLINE, 0.5 MG
INJECTION, ELLIOTTS B SOLUTION, PER ML
INJECTION, APROTININ, 10,000 KIU
IRRIGATION SOLUTION FOR TREATMENT OF BLADDER CALCULI, FOR EXAMPLE RENACIDIN, PER 500 ML
INJECTION, CORTICORELIN OVINE TRIFLUTATE, PER DOSE
INJECTION, DIGOXIN IMMUNE FAB (OVINE), PER VIAL
INJECTION, ETHANOLAMINE OLEATE, 100 MG
INJECTION, FOMEPIZOLE, 15 MG
INJECTION, FOSPHENYTOIN, 50 MG
INJECTION, GLATIRAMER ACETATE, PER DOSE
INJECTION, HEMIN, PER 1 MG
INJECTION, PEGADEMASE BOVINE, 25 IU
INJECTION, PENTASTARCH, 10% SOLUTION, PER 100 ML
INJECTION, SERMORELIN ACETATE, 0.5 MG
INJECTION, TENIPOSIDE, 50 MG
INJECTION, UROFOLLITROPIN, 75 IU
INJECTION, BASILIXIMAB, 20 MG
INJECTION, HISTRELIN ACETATE, 10 MG
INJECTION, LEPIRUDIN, 50 MG
VON WILLEBRAND FACTOR COMPLEX, HUMAN, PER IU
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, RUBIDIUM RB-82, PER DOSE
RADIOELEMENTS FOR BRACHYTHERAPY, ANY TYPE, EACH
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, GALLIUM GA 67, PER MCI
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC99M BICISATE, PER UNIT DOS
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, XENON XE 133, PER 10 MCI
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M MERTIATIDE, PER MCI
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC 99M GLUCEPATATE, PER 5 M
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, SODIUM PHOSPHATE P32, PER MCI
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, INDIUM 111-IN PENTETREOTIDE, PER 3 MCI
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC99M OXIDRONATE, PER MCI
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, TECHNETIUM TC99M - LABELED RED BLOOD C
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, CHROMIC PHOSPHATE P32 SUSPENSION, PER
SUPPLY OF ORAL RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, CYANOCOBALAMIN COBALT CO57, PER
TELEHEALTH ORIGINATING SITE FACILITY FEE
ALS VEHICLE USED, EMERGENCY TRANSPORT, NO ALS LEVEL SERVICES FURNISHED
ALS VEHICLE USED, NON-EMERGENCY TRANSPORT, NO ALS LEVEL SERVICE FURNISHED
INJECTION, HEPATITIS B VACCINE, PEDIATRIC OR ADOLESCENT, PER DOSE
INJECTION, HEPATITIS B VACCINE, ADULT, PER DOSE
INJECTION, HEPATITIS B VACCINE, IMMUNOSUPPRESSED PATIENTS (INCLUDING RENAL DIALYSIS PATIENTS), PER
INJECTION, INTERFERON BETA-1A, 11 MCG FOR INTRAMUSCULAR USE
INJECTION, INTERFERON BETA-1A, 11 MCG FOR SUBCUTANEOUS USE
CASTING SUPPLIES, BODY CAST ADULT, WITH OR WITHOUT HEAD, PLASTER
CAST SUPPLIES, BODY CAST ADULT, WITH OR WITHOUT HEAD, FIBERGLASS
CAST SUPPLIES, SHOULDER CAST, ADULT (11 YEARS +), PLASTER
CAST SUPPLIES, SHOULDER CAST, ADULT (11 YEARS +), FIBERGLASS
CAST SUPPLIES, LONG ARM CAST, ADULT (11 YEARS +), PLASTER
CAST SUPPLIES, LONG ARM CAST, ADULT (11 YEARS +), FIBERGLASS
CAST SUPPLIES, LONG ARM CAST, PEDIATRIC (0-10 YEARS), PLASTER
CAST SUPPLIES, LONG ARM CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS
CAST SUPPLIES, SHORT ARM CAST, ADULT (11 YEARS +), PLASTER
CAST SUPPLIES, SHORT ARM CAST, ADULT (11 YEARS +), FIBERGLASS
CAST SUPPLIES, SHORT ARM CAST, PEDIATRIC (0-10 YEARS), PLASTER
CAST SUPPLIES, SHORT ARM CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS
CAST SUPPLIES, GAUNTLET CAST (INCLUDES LOWER FOREARM AND HAND), ADULT (11 YEARS +), PLASTER
CAST SUPPLIES, GAUNTLET CAST (INCLUDES LOWER FOREARM AND HAND), ADULT (11 YEARS +), FIBERGLASS
CAST SUPPLIES, GAUNTLET CAST (INCLUDES LOWER FOREARM AND HAND), PEDIATRIC (0-10 YEARS), PLASTER
CAST SUPPLIES, GAUNTLET CAST (INCLUDES LOWER FOREARM AND HAND), PEDIATRIC (0-10 YEARS), FIBERGLAS
CAST SUPPLIES, LONG ARM SPLINT, ADULT (11 YEARS +), PLASTER
CAST SUPPLIES, LONG ARM SPLINT, ADULT (11 YEARS +), FIBERGLASS
CAST SUPPLIES, LONG ARM SPLINT, PEDIATRIC (0-10 YEARS), PLASTER
CAST SUPPLIES, LONG ARM SPLINT, PEDIATRIC (0-10 YEARS), FIBERGLASS
CAST SUPPLIES, SHORT ARM SPLINT, ADULT (11 YEARS +), PLASTER
CAST SUPPLIES, SHORT ARM SPLINT, ADULT (11 YEARS +), FIBERGLASS
CAST SUPPLIES, SHORT ARM SPLINT, PEDIATRIC (0-10 YEARS), PLASTER
CAST SUPPLIES, SHORT ARM SPLINT, PEDIATRIC (0-10 YEARS), FIBERGLASS
CAST SUPPLIES, HIP SPICA (ONE OR BOTH LEGS), ADULT (11 YEARS +), PLASTER
CAST SUPPLIES, HIP SPICA (ONE OR BOTH LEGS), ADULT (11 YEARS +), FIBERGLASS
CAST SUPPLIES, HIP SPICA (ONE OR BOTH LEGS), PEDIATRIC (0-10 YEARS), PLASTER
CAST SUPPLIES, HIP SPICA (ONE OR BOTH LEGS), PEDIATRIC (0-10 YEARS), FIBERGLASS
CAST SUPPLIES, LONG LEG CAST, ADULT (11 YEARS +), PLASTER
CAST SUPPLIES, LONG LEG CAST, ADULT (11 YEARS +), FIBERGLASS
CAST SUPPLIES, LONG LEG CAST, PEDIATRIC (0-10 YEARS), PLASTER
CAST SUPPLIES, LONG LEG CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS
CAST SUPPLIES, LONG LEG CYLINDER CAST, ADULT (11 YEARS +), PLASTER
CAST SUPPLIES, LONG LEG CYLINDER CAST, ADULT (11 YEARS +), FIBERGLASS
CAST SUPPLIES, LONG LEG CYLINDER CAST, PEDIATRIC (0-10 YEARS), PLASTER
CAST SUPPLIES, LONG LEG CYLINDER CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS
CAST SUPPLIES, SHORT LEG CAST, ADULT (11 YEARS +), PLASTER
CAST SUPPLIES, SHORT LEG CAST, ADULT (11 YEARS +), FIBERGLASS
CAST SUPPLIES, SHORT LEG CAST, PEDIATRIC (0-10 YEARS), PLASTER
CAST SUPPLIES, SHORT LEG CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS
CAST SUPPLIES, LONG LEG SPLINT, ADULT (11 YEARS +), PLASTER
CAST SUPPLIES, LONG LEG SPLINT, ADULT (11 YEARS +), FIBERGLASS
CAST SUPPLIES, LONG LEG SPLINT, PEDIATRIC (0-10 YEARS), PLASTER
CAST SUPPLIES, LONG LEG SPLINT, PEDIATRIC (0-10 YEARS), FIBERGLASS
CAST SUPPLIES, SHORT LEG SPLINT, ADULT (11 YEARS +), PLASTER
CAST SUPPLIES, SHORT LEG SPLINT, ADULT (11 YEARS +), FIBERGLASS
CAST SUPPLIES, SHORT LEG SPLINT, PEDIATRIC (0-10 YEARS), PLASTER
CAST SUPPLIES, SHORT LEG SPLINT, PEDIATRIC (0-10 YEARS), FIBERGLASS
FINGER SPLINT, STATIC
CAST SUPPLIES, FOR UNLISTED TYPES AND MATERIALS OF CASTS
SPLINT SUPPLIES, MISCELLANEOUS (INCLUDES THERMOPLASTICS, STRAPPING, FASTENERS, PADDING AND OTHE
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 20 OR LESS
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 21
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 22
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 23
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 24
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 25
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 26
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 27
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 28
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 29
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 30
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 31
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 32
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 33
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 34
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 35
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 36
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 37
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 38
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 39
INJECTION OF EPO, PER 1000 UNITS, AT PATIENT HCT OF 40 OR ABOVE
TRANSPORTATION OF PORTABLE X-RAY EQUIPMENT AND PERSONNEL TO HOME OR NURSING HOME, PER TRIP T
TRANSPORTATION OF PORTABLE X-RAY EQUIPMENT AND PERSONNEL TO HOME OR NURSING HOME, PER TRIP T
TRANSPORTATION OF PORTABLE EKG TO FACILITY OR LOCATION, PER PATIENT
INJECTION, BUTORPHANOL TARTRATE, 1 MG
BUTORPHANOL TARTRATE, NASAL SPRAY, 25 MG
TACRINE HYDROCHLORIDE, 10 MG
INJECTION, AMIKACIN SULFATE, 500 MG
INJECTION, AMINOCAPROIC ACID, 5 GRAMS
INJECTION, BUPIVICAINE HYDROCHLORIDE, 30 ML
INJECTION, CEFTOPERAZONE SODIUM, 1 GRAM
INJECTION, CIMETIDINE HYDROCHLORIDE, 300 MG
INJECTION, FAMOTIDINE, 20 MG
INJECTION, METRONIDAZOLE, 500 MG
INJECTION, NAFCILLIN SODIUM, 2 GRAMS
INJECTION, OFLOXACIN, 400 MG
INJECTION, SULFAMETHOXAZOLE AND TRIMETHOPRIM, 10 ML
INJECTION, TICARCILLIN DISODIUM AND CLAVULANATE POTASSIUM, 3.1 GRAMS
INJECTION, ACYCLOVIR SODIUM, 50 MG
INJECTION, AMIKACIN SULFATE, 100 MG
INJECTION, AZTREONAM, 500 MG
INJECTION, CEFOTETAN DISODIUM, 500 MG
INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG
INJECTION, FOSPHENYTOIN SODIUM, 750 MG
INJECTION, OCTREOTIDE ACETATE, 100 MCG (FOR DOSES OVER 1 MG USE J2352 OR C1207)
INJECTION, PENTAMIDINE ISETHIONATE, 300 MG
INJECTION, PIPERACILLIN SODIUM, 500 MG
ALEMTUZUMAB INJECTION, 30 MG
SILDENAFIL CITRATE, 25 MG
GRAINSETRON HYDROCHLORIDE, 1MG (FOR CIRCUMSTANCES FALLING UNDER THE MEDICARE STATUE, USE Q01
INJECTION, HYROMORPHONE HYDROCHLORIDE, 250MG (LOADING DOSE FOR INFUSION PUMP)
INJECTION, MORPHINE SULFATE, 500MG (LOADING DOSE FOR INFUSION PUMP)
ZIDOVUDINE, ORAL, 100MG
BUPROPION HCL SUSTAINED RELEASE TABLET, 150 MG, PER BOTTLE OF 60 TABLETS
MERCAPTOPURINE, ORAL, 50 MG
INJECTION, TREPROSTINIL SODIUM, 0.5 MG
INJECTION, MENOTROPINS, 75 IU
INJECTION, UROFOLLITROPIN, PURIFIED, 75 IU
INJECTION, FOLLITROPIN ALFA, 75 IU
INJECTION, FOLLITROPIN BETA, 75 IU
INJECTION, CHORIONIC GONADOTROPIN, 5000 UNITS
INJECTION, GANIRELIX ACETATE, 250 MCG
INJECTION, PEGFILGRASTIM, 6MG
STERILE DILUTANT FOR EPOPROSTENOL, 50ML
EXEMESTANE, 25 MG
BECAPLERMIN GEL 0.01%, 0.5 G
ANASTROZOLE, ORAL, 1MG
INJECTION, BUMETANIDE, 0.5MG
CHLORAMBUCIL, ORAL, 2MG
DEXAMETHASONE, ORAL, 4MG
DOLASETRON MESYLATE, ORAL 50MG (FOR CIRCUMSTANCES FALLING UNDER THE MEDICARE STATUTE, USE Q01
FLUTAMIDE, ORAL, 125MG
HYDROXYUREA, ORAL, 500MG
LEVAMISOLE HYDROCHLORIDE, ORAL, 50MG
LOMUSTINE, ORAL, 10MG
MEGESTROL ACETATE, ORAL, 20MG
ONDANSETRON HYDROCHLORIDE, ORAL, 4MG (FOR CIRCUMSTANCES FALLING UNDER THE MEDICARE STATUTE,
PROCARBAZINE HYDROCHLORIDE, ORAL, 50MG
PROCHLORPERAZINE MALEATE, ORAL, 5MG (FOR CIRCUMSTANCES FALLING UNDER THE MEDICARE STATUTE, US
TAMOXIFEN CITRATE, ORAL, 10MG
TESTOSTERONE PELLET, 75MG
MIFEPRISTONE, ORAL, 200 MG
MISOPROSTOL, ORAL, 200 MCG
PNEUMOCOCCAL CONJUGATE VACCINE, POLYVALENT, INTRAMUSCULAR, FOR CHILDREN FROM FIVE YEARS TO N
MEDICALLY INDUCED ABORTION BY ORAL INGESTION OF MEDICATION INCLUDING ALL ASSOCIATED SERVICES AN
PARTIAL HOSPITALIZATION SERVICES, LESS THAN 24 HOURS, PER DIEM
PARAMEDIC INTERCEPT, NON-HOSPITAL BASED ALS SERVICE (NON-VOLUNTARY), NON-TRANSPORT
PARAMEDIC INTERCEPT, HOSPITAL-BASED ALS SERVICE (NON-VOLUNTARY), NON-TRANSPORT
WHEELCHAIR VAN, MILEAGE, PER MILE
NON-EMERGENCY TRANSPORTATION; MILEAGE, PER MILE
MEDICAL CONFERENCE BY A PHYSICIAN WITH INTERDISCIPLINARY TEAM OF HEALTH PROFESSIONALS OR REPRE
MEDICAL CONFERENCE BY A PHYSICIAN WITH INTERDISCIPLINARY TEAM OF HEALTH PROFESSIONALS OR REPRE
COMPREHENSIVE GERIATRIC ASSESSMENT AND TREATMENT PLANNING PERFORMED BY ASSESSMENT TEAM
HOSPICE REFERRAL VISIT (ADVISING PATIENT AND FAMILY OF CARE OPTIONS) PERFORMED BY NURSE, SOCIAL W
HISTORY&PHYSICAL (OUTPATIENT/OFFICE) RELATED SURGICAL PROCEDURE (LIST SEPARATELY ADDITION CD, A
COMPLETED EARLY PERIODIC SCREENING DIAGNOSIS AND TREATMENT (EPSDT) SERVICE (LIST IN ADDITION TO C
HOSPITALIST SERVICES (LIST SEPARATELY IN ADDITION TO CODE FOR APPROPRIATE EVALUATION AND MANAGE
DISEASE MANAGEMENT PROGRAM; INITIAL ASSESSMENT AND INITIATION OF THE PROGRAM
FOLLOW-UP/REASSESSMENT
TELEPHONE CALLS BY A REGISTERED NURSE TO A DISEASE MANAGEMENT PROGRAM MEMBER FOR MONITORING
LIFESTYLE MODIFICATION PROGRAM FOR MANAGEMENT OF CORONARY ARTERY DISEASE, INCLUDING ALL SUPP
LIFESTYLE MODIFICATION PROGRAM FOR MANAGEMENT OF CORONARY ARTERY DISEASE, INCLUDING ALL SUPP
LIFESTYLE MODIFICATION PROGRAM FOR MANAGEMENT OF CORONARY ARTERY DISEASE, INCLUDING ALL SUPP
ROUTINE FOOT CARE; REMOVAL AND/OR TRIMMING OF CORNS, CALLUSES AND/OR NAILS AND PREVENTIVE MAIN
IMPRESSION CASTING OF A FOOT PERFORMED BY A PRACTITIONER OTHER THAN THE MANUFACTURER OF THE O
GLOBAL FEE FOR EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY TREATMENT OF KIDNEY STONE(S)
DISPOSABLE CONTACT LENS, PER LENS
SINGLE VISION PRESCRIPTION LENS (SAFETY, ATHLETIC, OR SUNGLASS), PER LENS
BIFOCAL VISION PRESCRIPTION LENS (SAFETY, ATHLETIC, OR SUNGLASS), PER LENS
TRIFOCAL VISION PRESCRIPTION LENS (SAFETY, ATHLETIC, OR SUNGLASS), PER LENS
NON-PRESCRIPTION LENS (SAFETY, ATHLETIC, OR SUNGLASS), PER LENS
DAILY WEAR SPECIALTY CONTACT LENS, PER LENS
COLOR CONTACT LENS, PER LENS
SAFETY EYEGLASS FRAMES
SUNGLASSES FRAMES
POLYCARBONATE LENS (LIST THIS CODE IN ADDITION TO THE BASIC CODE FOR THE LENS)
NONSTANDARD LENS (LIST THIS CODE IN ADDITION TO THE BASIC CODE FOR THE LENS)
INTEGRAL LENS SERVICE, MISCELLANEOUS SERVICES REPORTED SEPARATELY
COMPREHENSIVE CONTACT LENS EVALUATION
SCREENING PROCTOSCOPY
DIGITAL RECTAL EXAMINATION, ANNUAL
ANNUAL GYNECOLOGICAL EXAMINATION, NEW PATIENT
ANNUAL GYNECOLOGICAL EXAMINATION, ESTABLISHED PATIENT
ROUTINE OPHTHALMOLOGICAL EXAMINATION INCLUDING REFRACTION; NEW PATIENT
ROUTINE OPHTHALMOLOGICAL EXAMINATION INCLUDING REFRACTION; ESTABLISHED PATIENT
PHYSICAL EXAM FOR COLLEGE, NEW OR ESTABLISHED PATIENT (LIST SEPARATELY IN ADDITION TO APPROPRIAT
REMOVAL OF SUTURES; BY A PHYSICIAN OTHER THAN THE PHYSICIAN WHO ORIGINALLY CLOSED THE WOUND
LASER IN SITU KERATOMILEUSIS (LASIK)
PHOTOREFRACTIVE KERATECTOMY (PRK)
PHOTOTHERAPEUTIC KERATECTOMY (PTK)
COMPUTERIZED CORNEAL TOPOGRAPHY, UNILATERAL
ULTRASOUND PACHYMETRY TO DETERMINE CORNEAL THICKNESS, WITH INTERPRETATION AND REPORT, UNILAT
DELUXE ITEM, PATIENT AWARE (LIST IN ADDITION TO CODE FOR BASIC ITEM)
CUSTOMIZED ITEM (LIST IN ADDITION TO CODE FOR BASIC ITEM)
IV TUBING EXTENSION SET
NON-PVC (POLYVINYL CHLORIDE) INTRAVENOUS ADMINISTRATION SET, FOR USE WITH DRUGS THAT ARE NOT ST
INHALED NITRIC OXIDE FOR THE TREATMENT OF HYPOXIC RESPIRATORY FAILURE IN THE NEONATE; PER DIEM
CONTINUOUS NONINVASIVE GLUCOSE MONITORING DEVICE, PURCHASE (FOR PHYSICIAN INTERPRETATION OF D
CONT NONINVASIVE GLUCOSE MONITOR DEVICE, RENTAL, INCL SENSR, SENSR REPLCMNT,&DOWNLOAD MONITO
CRAINAL REMOLDING ORTHOSIS, RIGID, WITH SOFT INTERFACE MATERIAL, CUSTOM FABRICATED, INCLUDES FIT
TRANSPLANTATION OF SMALL INTESTINE AND LIVER ALLOGRAFTS
TRANSPLANTATION OF MULTIVISCERAL ORGANS
HARVESTING OF DONOR MULTIVISCERAL ORGANS, WITH PREPARATION AND MAINTENANCE OF ALLOGRAFTS; FR
LOBAR LUNG TRANSPLANTATION
DONOR LOBECTOMY (LUNG) FOR TRANSPLANTATION, LIVING DONOR
SIMULTANEOUS PANCREAS KIDNEY TRANSPLANTATION
LASER-ASSISTED UVULOPALATOPLASTY (LAUP)
ISLET CELL TISSUE TRANSPLANT FROM PANCREAS; ALLOGENEIC
ADRENAL TISSUE TRANSPLANT TO BRAIN
ADOPTIVE IMMUNOTHERAPY I.E. DEVELOPMENT OF SPECIFIC ANTI-TUMOR REACTIVITY (E.G. TUMOR-INFILTRATIN
ARTHROSCOPY, KNEE, SURGICAL FOR HARVESTING OF CARTILAGE (CHONDROCYTE CELLS)
OSTEOTOMY, PERIACETABULAR, WITH INTERNAL FIXATION
LOW DENSITY LIPOPROTEIN (LDL) APHERESIS USING HEPARIN-INDUCED EXTRACORPOREAL LDL PRECIPITATION
ENDOLUMINAL RADIOFREQUENCY ABLATION OF REFLUXING SAPHENOUS VEIN
CORD BLOOD HARVESTING FOR TRANSPLANTATION, ALLOGENEIC
CORD BLOOD-DERIVED STEM-CELL TRANSPLANTATION, ALLOGENEIC
BN MARRW/BLOOD-DERIVED PERIPH STEM CELL HARV&TRANSPLANT, ALLO/AUTOLOGOUS, INCL PHERES, HI-DOS
ECHOSCLEROTHERAPY
MINIMALLY INVASIVE DIRECT CORONARY ARTERY BYPASS SURGERY INVOLVING MINI-THORACOTOMY OR MINI-ST
MINIMALLY INVASIVE DIRECT CORONARY ARTERY BYPASS SURGERY INVOLVING MINI-THORACOTOMY OR MINI-ST
MINIMALLY INVASIVE DIRECT CORONARY ARTERY BYPASS SURGERY INVOLVING MINI-THORACOTOMY OR MINI-ST
MINIMALLY INVASIVE DIRECT CORONARY ARTERY BYPASS SURGERY INVOLVING MINI-THORACOTOMY OR MINI-ST
MINIMALLY INVASIVE DIRECT CORONARY ARTERY BYPASS SURGERY INVOLVING MINI-THORACOTOMY OR MINI-ST
TRANSCATHETER PLACEMENT OF INTRAVASCULAR STENT(S), CAROTID ARTERY, PERCUTANEOUS, UNILATERAL (
UTERINE ARTERY EMBOLIZATION FOR UTERINE FIBROIDS
INDUCED ABORTION, 17 TO 24 WEEKS, ANY SURGICAL METHOD
ABORTION FOR MATERNAL INDICATION, 25 WEEKS OR GREATER
ABORTION FOR FETAL INDICATION, 25-28 WEEKS
ABORTION FOR FETAL INDICATION, 29-31 WEEKS
ABORTION FOR FETAL INDICATION, 32 WEEKS OR GREATER
ARTHROSCOPY, SHOULDER, SURGICAL; WITH THERMALLY-INDUCED CAPSULORRHAPHY
CHEMODENERVATION OF ABDUCTOR MUSCLE(S) OF VOCAL CORD
CHEMODENERVATION OF ADDUCTOR MUSCLE(S) OF VOCAL CORD
NASAL ENDOSCOPY FOR POST-OPERATIVE DEBRIDEMENT FOLLOWING FUNCTIONAL ENDOSCOPIC SINUS SURGE
DISKECTOMY, ANTERIOR, WITH DECOMPRESSION OF SPINAL CORD AND/OR NERVE ROOT(S), INCLUDING OSTEOP
DISKECTOMY, ANTERIOR, WITH DECOMPRESSION OF SPINAL CORD AND/OR NERVE ROOT(S), INCLUDING OSTEOP
PERCUTANEOUS VERTEBROPLASTY, ONE VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION; CERVICAL
EACH ADDITIONAL CERVICAL VERTEBRAL BODY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCED
INTRADISCAL ELECTROTHERMAL THERAPY, SINGLE INTERSPACE
EACH ADDITIONAL INTERSPACE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
REPAIR, CONGENITAL DIAPHRAGMATIC HERNIA IN THE FETUS USING TEMPORARY TRACHEAL OCCLUSION, PROC
REPAIR, URINARY TRACT OBSTRUCTION IN THE FETUS, PROCEDURE PERFORMED IN UTERO
REPAIR, CONGENITAL CYSTIC ADENOMATOID MALFORMATION IN THE FETUS, PROCEDURE PERFORMED IN UTER
REPAIR, EXTRALOBAR PULMONARY SEQUESTRATION IN THE FETUS, PROCEDURE PERFORMED IN UTERO
REPAIR, MYELOMENINGOCELE IN THE FETUS, PROCEDURE PERFORMED IN UTERO
REPAIR OF SACROCOCCYGEAL TERATOMA IN THE FETUS, PROCEDURE PERFORMED IN UTERO
REPAIR, CONGENITAL MALFORMATION OF FETUS, PROCEDURE PERFORMED IN UTERO, NOT OTHERWISE CLASSI
FETOSCOPIC LASER THERAPY FOR TREATMENT OF TWIN-TO-TWIN TRANSFUSION SYNDROME
STAT LABORATORY REQUEST (SITUATIONS OTHER THAN S3601)
EMERGENCY STAT LABORATORY CHARGE FOR PATIENT WHO IS HOMEBOUND OR RESIDING IN A NURSING FACIL
NEWBORN METABOLIC SCREENING PANEL, INCLUDES TEST KIT, POSTAGE AND THE LABORATORY TESTS SPECIF
EOSINOPHIL COUNT, BLOOD, DIRECT
HIV-1 ANTIBODY TESTING OF ORAL MUCOSAL TRANSUDATE
SALIVA TEST, HORMONE LEVEL; DURING MENOPAUSE
SALIVA TEST, HORMONE LEVEL; TO ASSESS PRETERM LABOR RISK
ANTISPERM ANTIBODIES TEST (IMMUNOBEAD)
IMMUNOASSAY FOR NUCLEAR MATRIX PROTEIN 22 (NMP-22), QUANTITATIVE
GASTROINTESTINAL FAT ABSORPTION STUDY
COMPLETE GENE SEQUENCE ANALYSIS; BRCA1 GENE
COMPLETE GENE SEQUENCE ANALYSIS; BRCA2 GENE
COMPLETE MLH1 AND MLH2 GENE SEQUENCE ANALYSIS FOR HEREDITARY NONPOLYPOSIS COLORECTAL CANCE
1-MUTATION ANAL (IN INDIV W KNOWN MLH1&MLH2 MUTATION THE FAMILY), HEREDITARY NONPOLYPOSIS COLOR
COMPLETE GENE SEQUENCE ANALYSIS FOR CYSTIC FIBROSIS GENETIC TESTING
COMPLETE GENE SEQUENCE ANALYSIS FOR HEMOCHROMATOSIS GENETIC TESTING
SURFACE ELECTROMYOGRAPHY (EMG)
BALLISTOCARDIOGRAM
MASTERS TWO STEP
INTERIM LABOR FACILITY GLOBAL (LABOR OCCURRING BUT NOT RESULTING IN DELIVERY)
IN VITRO FERTILIZATION; INCLUDING BUT NO LIMITED IDENTIFICATION&INCUBATION, MATURE OOCYTES, FERTILIZ
COMPLETE CYCLE, GAMETE INTRAFALLOPIAN TRANSFER (GIFT), CASE RATE
COMPLETE CYCLE, ZYGOTE INTRAFALLOPIAN TRANSFER (ZIFT), CASE RATE
COMPLETE IN VITRO FERTILIZATION CYCLE, NOT OTHERWISE SPECIFIED, CASE RATE
FROZEN IN VITRO FERTILIZATION CYCLE, CASE RATE
INCOMPLETE CYCLE, TREATMENT CANCELLED PRIOR TO STIMULATION, CASE RATE
FROZEN EMBRYO TRANSFER PROCEDURE CANCELLED BEFORE TRANSFER, CASE RATE
IN VITRO FERTILIZATION PROCEDURE CANCELLED BEFORE ASPIRATION, CASE RATE
IN VITRO FERTILIZATION PROCEDURE CANCELLED AFTER ASPIRATION, CASE RATE
ASSISTED OOCYTE FERTILIZATION, CASE RATE
DONOR EGG CYCLE, INCOMPLETE, CASE RATE
DONOR SERVICES FOR IN VITRO FERTILIZATION (SPERM OR EMBRYO), CASE RATE
PROCUREMENT OF DONOR SPERM FROM SPERM BANK
STORAGE OF PREVIOUSLY FROZEN EMBRYOS
MICROSURGICAL EPIDIDYMAL SPERM ASPIRATION (MESA)
SPERM PROCUREMENT AND CRYOPRESERVATION SERVICES; INITIAL VISIT
SPERM PROCUREMENT AND CRYOPRESERVATION SERVICES; SUBSEQUENT VISIT
STIMULATED INTRAUTERINE INSEMINATION (IUI), CASE RATE
INTRAVAGINAL CULTURE (IVC), CASE RATE
CRYOPRESERVED EMBRYO TRANSFER, CASE RATE
MONITORING AND STORAGE OF CRYOPRESERVED EMBRYOS, PER 30 DAYS
INSERTION OF LEVONORGESTREL-RELEASING INTRAUTERINE SYSTEM
CONTRACEPTIVE INTRAUTERINE DEVICE (E.G. PROGESTACERT IUD), INCLUDING IMPLANTS AND SUPPLIES
NICOTINE PATCHES, LEGEND
NICOTINE PATCHES, NON-LEGEND
CONTRACEPTIVE PILLS FOR BIRTH CONTROL
SMOKING CESSATION GUM
PRESCRIPTION DRUG, GENERIC
PRESCRIPTION DRUG, BRAND NAME
5% DEXTROSE AND 45% NORMAL SALINE, 1000 ML
5% DEXTROSE IN LACTATED RINGER'S, 1000 ML
5% DEXTROSE WITH POTASSIUM CHLORIDE, 1000 ML
5% DEXTROSE/45% NORMAL SALINE WITH POTASSIUM CHLORIDE AND MAGNESIUM SULFATE, 1000 ML
5% DEXTROSE/0.45% NORMAL SALINE WITH POTASSIUM CHLORIDE AND MAGNESIUM SULFATE, 1500 ML
HOME INFUSION THERAPY, ROUTINE SERVICE OF INFUSION DEVICE (E.G. PUMP MAINTENANCE)
HOME INFUSION THERAPY, REPAIR OF INFUSION DEVICE (E.G. PUMP REPAIR)
DAY CARE SERVICES, ADULT;PER 15 MINUTES
DAY CARE SERVICES, ADULT;PER HALF DAY
DAY CARE SERVICES, ADULT;PER DIEM
DAY CARE SERVICES, CENTER-BASED;SERVICES NOT INCLUDED IN PROGRAM FEE, PER DIEM
HOME CARE TRAINING, FAMILY;PER 15 MINUTES
HOME CARE TRAINING, FAMILY;PER SESSION
HOME CARE TRAINING, NON-FAMILY; PER 15 MINUTES
HOME CARE TRAINING, NON-FAMILY; PER SESSION
CHORE SERVICES; PER 15 MINUTES
CHORE SERVICES; PER DIEM
ATTENDANT CARE SERVICES; PER 15 MINUTES
ATTENDANT CARE SERVICES; PER DIEM
HOMEMAKER SERVICES, NOS; PER 15 MINUTES
HOMEMAKER SERVICES, NOS; PER DIEM
COMPAINION CARE, ADULT(E.G. IADL/ADL);PER 15 MINUTES
COMPAINION CARE, ADULT(E.G. IADL/ADL);PER DIEM
FOSTER CARE, ADULT; PER DIEM
FOSTER CARE, ADULT;PER MONTH
FOSTER CARE, THERAPEUTIC, CHILD; PER DIEM
FOSTER CARE, THERAPEUTIC, CHILD; PER MONTH
UNSKILLED RESPITE CARE, NOT HOSPICE; PER 15 MINUTES
UNSKILLED RESPITE CARE, NOT HOSPICE; PER DIEM
EMERGENCY RESPONSE SYSTEM; INSTALLATION AND TESTING
EMERGENCY RESPONSE SYSTEM; SERVICE FEE, PER MONTH(EXCLUDES INSTALLATION AND TESTING)
EMERGENCY RESPONSE SYSTEM; PURCHASE ONLY
HOME MODIFICATIONS; PER SERVICE
HOME DELIVERED MEALS, INCLUDING PREPARATION; PER MEAL
LAUNDRY SERBICE, EXTERNAL,PROFESSIONAL; PER ORDER
HOME HEALTH RESPIRATORY THERAPY, INITIAL EVALUATION
HOME HEALTH RESPIRATORY THERAPY, NOS, PER DIEM
MEDICATION REMINDER SERVICE, NON-FACE-TO-FACE; PER MONTH
WELLNESS ASSESSMENT, PERFORMED BY NON-PHYSICIAN
PERSONAL CARE ITEM, NOS, EACH
HOME INFUS TX, CATH CARE/MAINT, NOT OTHRWISE CLASSFD; ADMINISTRATIVE SVCS, PROFSIONAL PHARMACY
HOME INFUS TX, CATH CARE/MAINT, SIMP (1 LMN), ADMINISTRATIVE SVCS, PROFSIONAL PHARMACY SVCS, CARE
HOME INFUS TX, CATH CARE/MAINT, CMPLX (> 1 LMN), ADMINISTRATIVE SVCS, PROFSIONAL PHARMACY SVCS, CA
HOME INFUS TX, CATH CARE/MAINT, IMPLED ACCSS, ADMIN SVCS, PROFSIONAL PHARMACY SVCS, CARE COORDN
HOME INFUSION THERAPY, ALL SUPPLIES NECESSARY FOR RESTORATION OF CATHETER PATENCY OR DECLOTT
HOME INFUSION THERAPY, ALL SUPPLIES NECESSARY FOR CATHETER REPAIR
HOME INFUSION THERAPY, ALL SUPPLIES (INCLUDING CATHETER) NECESSARY FOR A PERIPHERALLY INSERTED
HOME INFUSION THERAPY, ALL SUPPLIES (INCLUDING CATHETER) NECESSARY FOR A MIDLINE CATHETER INSERT
HOME INFUSION THERAPY, INSERTION OF PERIPHERALLY INSERTED CENTRAL VENOUS CATHETER (PICC), NURSI
HOME INFUSION THERAPY, INSERTION OF MIDLINE CENTRAL VENOUS CATHETER, NURSING SERVICES ONLY (NO
RADIOIMMUNOPHARMACEUTICAL LOCALIZATION OF TARGETED CELLS; WHOLE BODY
SCLERAL APPLICATION OF TANTALUM RING(S) FOR LOCALIZATION OF LESIONS FOR PROTON BEAM THERAPY
MAGNETIC SOURCE IMAGING
MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY (MRCP)
TOPOGRAPHIC BRAIN MAPPING
MAGNETIC RESONANCE IMAGING (MRI), LOW-FIELD
INTRAOPERATIVE RADIATION THERAPY (SINGLE ADMINISTRATION)
US, MULTFET PRG REDUCTION(S), TECHNICAL COMPONENT (BE USED WHEN THEDRDOING THE REDUCTN PROC
SCINTIMAMMOGRAPHY (RADIOIMMUNOSCINTIGRAPHY OF THE BREAST), UNILATERAL, INCLUDING SUPPLY OF RAD
FLUORINE-18 FLUORODEOXYGLUCOSE (F-18 FDG) IMAGING USING DUAL-HEAD COINCIDENCE DETECTION SYSTEM
ELECTRON BEAM COMPUTED TOMOGRAPHY (ALSO KNOWN AS ULTRAFAST CT, CINE CT)
WIG (FOR MEDICALLY-INDUCED OR CONGENITAL HAIR LOSS)
PORTABLE PEAK FLOW METER
ASTHMA KIT (INCLUDING BUT NOT LIMITED TO PORTABLE PEAK EXPIRATORY FLOW METER, INSTRUCTIONAL VIDE
HOLDING CHAMBER OR SPACER FOR USE WITH AN INHALER OR NEBULIZER; WITHOUT MASK
HOLDING CHAMBER OR SPACER FOR USE WITH AN INHALER OR NEBULIZER; WITH MASK
PEAK EXPIRATORY FLOW RATE (PHYSICIAN SERVICES)
TRACHEOSTOMY SHOWER PROTECTOR
TRACHEOSTOMY TUBE HOLDER
HUMIDIFIER, HEATED, USED WITH VENTILATOR, NON-SERVO-CONTROLLED
HUMIDIFIER, HEATED, USED WITH VENTILATOR, DUAL SERVO-CONTROLLED WITH TEMPERATURE MONITORING
FLUTTER DEVICE
SWIVEL ADAPTOR
TRACHEOSTOMY SUPPLY, NOT OTHERWISE CLASSIFIED
ELECTRONIC SPIROMETER (OR MICROSPIROMETER)
MUCUS TRAP
ORAL ORTHOTIC FOR TREATMENT OF SLEEP APNEA, INCLUDES FITTING, FABRICATION, AND MATERIALS
MANDIBULAR ORTHOPEDIC REPOSITIONING DEVICE, EACH
HABERMAN FEEDER FOR CLEFT LIP/PALATE
SUPPLIES FOR HOME DELIVERY OF INFANT
GRADIENT PRESSURE AID (SLEEVE AND GLOVE COMBINATION), CUSTOM MADE
GRADIENT PRESSURE AID (SLEEVE AND GLOVE COMBINATION), READY MADE
GRADIENT PRESSURE AID (SLEEVE), CUSTOM MADE, MEDIUM WEIGHT
GRADIENT PRESSURE AID (SLEEVE), CUSTOM MADE, HEAVY WEIGHT
GRADIENT PRESSURE AID (SLEEVE), READY MADE
GRADIENT PRESSURE AID (GLOVE), CUSTOM MADE, MEDIUM WEIGHT
GRADIENT PRESSURE AID (GLOVE), CUSTOM MADE, HEAVY WEIGHT
GRADIENT PRESSURE AID (GLOVE), READY MADE
GRADIENT PRESSURE AID (GAUNTLET), READY MADE
GRADIENT PRESSURE EXTERIOR WRAP
PADDING FOR COMPRESSION BANDAGE, ROLL
COMPRESSION BANDAGE, ROLL
SPLINT, PREFABRICATED, DIGIT (SPECIFY DIGIT BY USE OF MODIFIER)
SPLINT, PREFABRICATED, WRIST OR ANKLE
SPLINT, PREFABRICATED, ELBOW
INSULIN SYRINGES (100 SYRINGES, ANY SIZE)
PHYSICAL MEDICINE TREATMENT (CONSTANT ATTENDANCE BY PROVIDER) TO ONE AREA, INITIAL 30 MINUTES, EA
COMPLEX LYMPHEDEMA THERAPY, EACH 15 MINUTES
RESUSCITATION BAG (FOR USE BY PATIENT ON ARTIFICIAL RESPIRATION DURING POWER FAILURE OR OTHER CA
HOME UTERINE MONITOR WITH OR WITHOUT ASSOCIATED NURSING SERVICES
ULTRAFILTRATION MONITOR
AUTOMATED EEG MONITORING
DIGITAL SUBTRACTION ANGIOGRAPHY (USE IN ADDITION TO CPT CODE FOR THE PROCEDURE FOR FURTHER IDE
PARANASAL SINUS ULTRASOUND
OMNICARDIOGRAM/CARDIOINTEGRAM
EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY FOR GALL STONES (IF PERFORMED WITH ERCP, USE 43265)
PROCUREN OR OTHER GROWTH FACTOR PREPARATION TO PROMOTE WOUND HEALING
COMA STIMULATION PER DIEM
HOME ADMINISTRATION, AEROSOLIZED DRUG THERAPY (E.G., PENTAMIDINE); ADMINISTRATIVE SERVICES, PROFE
SMOKING CESSATION TREATMENT
GLOBAL FEE URGENT CARE CENTERS
SERVICES PROVIDED IN AN URGENT CARE CENTER (LIST IN ADDITION TO CODE FOR SERVICE)
VERTEBRAL AXIAL DECOMPRESSION, PER SESSION
CANOLITH REPOSITIONING, PER VISIT
HOME VISIT, PHOTOTHERAPY SERVICES (E.G. BILI-LITE), INCLUDING EQUIPMENT RENTAL, NURSING SERVICES, BL
CONGESTIVE HEART FAILURE TELEMONITORING, EQUIPMENT RENTAL, INCLUDING TELESCALE, COMPUTER SYST
BACK SCHOOL, PER VISIT
HOME HEALTH AIDE OR CERTIFIED NURSE ASSISTANT, PROVIDING CARE IN THE HOME; PER HOUR
NURSING CARE, IN THE HOME; BY REGISTERED NURSE, PER HOUR (USE FOR GENERAL NURSING CARE ONLY, NO
NURSING CARE, IN THE HOME; BY LICENSED PRACTICAL NURSE, PER HOUR
RESPITE CARE, IN THE HOME, PER DIEM
HOSPICE CARE, IN THE HOME, PER DIEM
SOCIAL WORK VISIT, IN THE HOME, PER DIEM
SPEECH THERAPY, IN THE HOME, PER DIEM
OCCUPATIONAL THERAPY, IN THE HOME, PER DIEM
PHYSICAL THERAPY; IN THE HOME, PER DIEM
DIABETIC MANAGEMENT PROGRAM, FOLLOW-UP VISIT TO NON-MD PROVIDER
DIABETIC MANAGEMENT PROGRAM, FOLLOW-UP VISIT TO MD PROVIDER
INSULIN PUMP INITIATION, INSTRUCTION IN INITIAL USE OF PUMP (PUMP NOT INCLUDED)
EVALUATION BY OCULARIST
HOME MGT, PRETERM LABOR, ADMINISTRATIVE SVCS, PROFSIONAL PHARMACY SVCS, CARE COORDINATION, AN
HOME MGT, PRETERM PREMATURE RUPTURE, MEMBRANES (PPROM), ADMINISTRATIVE SVCS, PROFSIONAL PHAR
HOME MGT, GESTATIONAL HTN, ADMINISTRATIVE SVCS, PROFSIONAL PHARMACY SVCS, CARE COORDINATION, A
HOME MGT, PSTPT HTN, ADMINISTRATIVE SVCS, PROFSIONAL PHARMACY SVCS, CARE COORDINATION, AND SUP
HOME MGT, PREECLAMPSIA, ADMINISTRATIVE SVCS, PROFSIONAL PHARMACY SVCS, CARE COORDINATION,SUP&
HOME MGT, GESTATIONAL DIABETES, ADMINISTRATIVE SVCS, PROFSIONAL PHARMACY SVCS, CARE COORDINATI
HOME INFUS TX, PAIN MGT INFUS; ADMINISTRATIVE SVCS, PROFSIONAL PHARMACY SVCS, CARE COORD,SUP&EQ
HOME INFUSION THERAPY, CONTINUOUS PAIN MGT INFUSION; ADMINISTRATIVE SVCS, PROFESSIONAL PHARMAC
HOME INFUSION THERAPY, INTERMITTENT PAIN MGT INFUSION; ADMINISTRATIVE SVCS, PROFESSIONAL PHARMA
HOME INFUSION THERAPY, IMPLANTED PUMP PAIN MGT INFUSION; ADMINISTRATIVE SVCS, PROFESSIONAL PHAR
HOME INFUS TX, CHEMOTX INFUS; ADMINISTRATIVE SVCS, PROFSIONAL PHARMACY SVCS, CARE COORDINATION
HOME INFUSION THERAPY, CONTINUOUS CHEMOTHERAPY INFUSION; ADMINISTRATIVE SVCS, PROFESSIONAL PH
HOME INFUSION THERAPY, INTERMITTENT CHEMOTHERAPY INFUSION; ADMINISTRATIVE SVCS, PROFESSIONAL P
HOME INFUS TX, CONT ANTICOAGULANT INFUS TX (E.G. HEPARIN), ADMINISTRATIVE SVCS, PROFSIONAL PHARMA
HOME INFUSION THERAPY, IMMUNOTHERAPY THERAPY; ADMINISTRATIVE SVCS, PROFESSIONAL PHARMACY SVC
HOME THERAPY; PERITONEAL DIALYSIS, ADMINISTRATIVE SVCS, PROFESSIONAL PHARMACY SVCS, CARE COORD
HOME THERAPY; ENTERAL NUTRITION; ADMINISTRATIVE SVCS, PROFESSIONAL PHARMACY SVCS, CARE COORDIN
HOME THERAPY; ENTERAL NUTRITION VIA GRAVITY; ADMINISTRATIVE SVCS, PROFESSIONAL PHARMACY SVCS, C
HOME THERAPY; ENTERAL NUTRITION VIA PUMP; ADMINISTRATIVE SVCS, PROFESSIONAL PHARMACY SVCS, CARE
HOME THERAPY; ENTERAL NUTRITION VIA BOLUS; ADMINISTRATIVE SVCS, PROFESSIONAL PHARMACY SVCS, CAR
HOME INFUS TX, ANTI-HEMOPHILIC AG INFUS TX (E.G. FACTOR VIII); ADMINISTRATIVE SVCS, PROFSIONAL PHARMA
HOME INFUS TX, ALPHA-1-PROTASE INHIBITOR (E.G., PROLASTIN); ADMINISTRATIVE SVCS, PROFSIONAL PHARMAC
HOME INFUS TX, UNINTER, LONG-TERM, CNTRL RATE IV/SUBQ INFUS TX (E.G. EPOPROSTEN); ADMINISTRATIVE SV
HOME INFUS TX, SYMPATHOMIMETIC/INOTROPIC AG INFUS TX (E.G.,DOBUTAMINE); ADMINISTRATIVE SVCS, PROF
HOME INFUSION THERAPY, TOCOLYTIC INFUSION THERAPY; ADMINISTRATIVE SVCS, PROFESSIONAL PHARMACY
HOME INFUSION THERAPY, CONTINUOUS ANTI-EMETIC INFUSION THERAPY; ADMINISTRATIVE SVCS, PROFESSION
HOME INFUSION THERAPY, CONTINUOUS INSULIN INFUSION THERAPY; ADMINISTRATIVE SVCS, PROFESSIONAL P
HOME INFUSION THERAPY, CHELATION THERAPY; ADMINISTRATIVE SVCS, PROFESSIONAL PHARMACY SVCS, CAR
HOME INFUS TX, ENZYME REPLCMNT IV TX; (E.G. IMIGLUCERASE); ADMINISTRATIVE SVCS, PROFSIONAL PHARMAC
HOME INFUS TX, ANTI-TUMR NECROSIS FACTOR IV TX; (E.G. INFLIXIMAB); ADMINISTRATIVE SVCS, PROFSIONAL PH
HOME INFUSION THERAPY, DIURETIC INTRAVENOUS THERAPY; ADMINISTRATIVE SVCS, PROFESSIONAL PHARMAC
HOME INFUSION THERAPY, ANTI-SPASMOTIC INTRAVENOUS THERAPY; ADMINISTRATIVE SVCS, PROFESSIONAL P
HOME INFUS TX, TTL PARENTERAL NUTR (TPN);ADMIN SVCS, PROFSIONAL PHARMACY SVCS, CARE COORDINATIO
HOME INFUS TX,TTL PARENTERAL NUTR;1 LITER/DAY,ADMINISTRATIVE SVCS,PROFSIONAL PHARMACY SVCS,CAR
HOME INFUS TX,TTL PARENTRAL NUTR;>1 LITER BUT NO>2 LITERS/DAY,ADMIN SVCS,PROFSIONAL RX SVCS,CARE
HOME INFUS TX,TTL PARENTERAL NUTR(TPN);>2 LITERS BUT NO>3 LITERS/DAY,ADMIN SVCS,PROF RX SVCS, CAR
HOME INFUS TX,TTL PARENTERAL NUTR(TPN);>3 LITERS/DAY,ADMIN SVCS,PROF RX SVCS,CARE COORDINATION,S
HOME THERAPY, INTERMITTENT ANTI-EMETIC INJECTION THERAPY; ADMINISTRATIVE SVCS, PROFESSIONAL PHAR
HOME TX;INTERMITT ANTICOAGULANT INJ TX(E.G. HEPARIN);ADMIN SVCS,PROFSIONAL RX SVCS,CARE COORDINA
HOME INFUS TX, HYD TX; ADMINISTRATIVE SVCS, PROFSIONAL PHARMACY SVCS, CARE COORDINATION,SUP&EQU
HOME INFUSION THERAPY, HYDRATION THERAPY; 1 LITER/DAY, ADMINISTRATIVE SVCS, PROFESSIONAL PHARMA
HOME INFUS TX, HYD TX; > 1 LITER BUT NO > 2 LITERS/DAY, ADMINISTRATIVE SVCS, PROFSIONAL PHARMACY SVC
HOME INFUS TX, HYD TX; > 2 LITERS BUT NO > 3 LITERS/DAY, ADMINISTRATIVE SVCS, PROFSIONAL PHARMACY SV
HOME INFUSION THERAPY, HYDRATION THERAPY; > 3 LITERS/DAY, ADMINISTRATIVE SERVICES, PROFESSIONAL P
HOME INFUS TX, INFUS TX, NOT OTHRWISE CLASSFD; ADMIN SVCS, PROFSIONAL PHARMACY SVCS, CARE COORD
DELIVERY OR SERVICE TO HIGH RISK AREAS REQUIRING ESCORT OR EXTRA PROTECTION, PER VISIT
ANTICOAGULATION CLINIC, INCLUSIVE OF ALL SERVICES EXCEPT LABORATORY TESTS, PER SESSION
PHARMACY COMPOUNDING AND DISPENSING SERVICES
MEDICAL FOODS FOR INBORN ERRORS OF METABOLISM
CHILDBIRTH PREPARATION/LAMAZE CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION
CHILDBIRTH REFRESHER CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION
CESAREAN BIRTH CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION
VBAC (VAGINAL BIRTH AFTER CESAREAN) CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION
ASTHMA EDUCATION, NON-PHYSICIAN PROVIDER, PER SESSION
BIRTHING CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION
LACTATION CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION
PARENTING CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION
PATIENT EDUCATION, NOT OTHERWISE CLASSIFIED, NON-PHYSICIAN PROVIDER, INDIVIDUAL, PER SESSION
PATIENT EDUCATION, NOT OTHERWISE CLASSIFIED, NON-PHYSICIAN PROVIDER, GROUP, PER SESSION
INFANT SAFETY (INCLUDING CPR) CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION
WEIGHT MANAGEMENT CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION
EXERCISE CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION
NUTRITION CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION
SMOKING CESSATION CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION
STRESS MANAGEMENT CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION
DIABETIC MANAGEMENT PROGRAM, GROUP SESSION
DIABETIC MANAGEMENT PROGRAM, NURSE VISIT
DIABETIC MANAGEMENT PROGRAM, DIETITIAN VISIT
NUTRITIONAL COUNSELING, DIETITIAN VISIT
CARDIAC REHABILITATION PROGRAM, NON-PHYSICIAN PROVIDER, PER DIEM
PULMONARY REHABILITATION PROGRAM, NON-PHYSICIAN PROVIDER, PER DIEM
ENTEROSTOMAL THERAPY BY A REGISTERED NURSE CERTIFIED IN ENTEROSTOMAL THERAPY, PER DIEM
AMBULATORY SETTING SUBSTANCE ABUSE TREATMENT OR DETOXIFICATION SERVICES, PER DIEM
INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES, PER DIEM
CRISIS INTERBENTION MENTAL HEALTH SERVICES, PER HOUR
CRISIS INTERVENTION MENTAL HEALTH SERVICES, PER DIEM
HOME INFUSION THERAPY, CORTICOSTEROID INFUSION; ADMINISTRATIVE SERVICES, PROFESSIONAL PHARMACY
HOME INFUS TX,ABX,ANTIVIR,/ANTIFUNGAL TX;ADMIN SVCS,PROFSIONAL PHARMACY SVCS,CARE COORDINATION
HOME INFUS TX, ABX, ANTIVIR,/ANTIFUNGAL TX; ONCE EVERY 3 HRS; ADMINISTRATIVE SVCS, PROFSIONAL PHARM
HOME INFUS TX, ABX, ANTIVIR,/ANTIFUNGAL TX; ONCE EVERY 24 HRS; ADMINISTRATIVE SVCS, PROFSIONAL PHAR
HOME INFUS TX, ABX, ANTIVIR,/ANTIFUNGAL TX; ONCE EVERY 12 HRS; ADMINISTRATIVE SVCS, PROFSIONAL PHAR
HOME INFUS TX, ABX, ANTIVIR,/ANTIFUNGAL TX; ONCE EVERY 8 HRS, ADMINISTRATIVE SVCS, PROFSIONAL PHARM
HOME INFUS TX, ABX, ANTIVIR,/ANTIFUNGAL; ONCE EVERY 6 HRS; ADMINISTRATIVE SVCS, PROFSIONAL PHARMAC
HOME INFUS TX, ABX, ANTIVIR,/ANTIFUNGAL; ONCE EVERY 4 HRS; ADMINISTRATIVE SVCS, PROFSIONAL PHARMAC
NURSING SERVICES RELATED TO HOME IV THERAPY, PER DIEM
ROUTINE VENIPUNCTURE FOR COLLECTION OF SPECIMEN(S), SINGLE HOME BOUND, NURSING HOME, OR SKILLE
HOME TX; HEMATOP HORME INJ TX (E.G.CRYTHROPOIETIN, G-CSF, GM-CSF); ADMINISTRATIVE SVCS, PROFSIONA
HOME TRANSFUSION, BLOOD PRODUCT(S); ADMINISTRATIVE SVCS, PROFESSIONAL PHARMACY SVCS, CARE COO
HOME INJABLE TX; NOT OTHRWISE CLASSIFIED, ADMIN SVCS, PROFSIONAL PHARMACY SVCS, COORDINATION, CA
HOME INFUSION OF BLOOD PRODUCTS, NURSING SERVICES, PER VISIT
HOME INJECTABLE THERAPY; GROWTH HORMONE, INCL ADMINISTRATIVE SERVICES, PROFESSIONAL PHARMACY
HOME INJECTABLE THERAPY; INTERFERON, INCL ADMINISTRATIVE SERVICES, PROFESSIONAL PHARMACY SERVIC
HOME INJABLE TX; HORMAL TX (E.G., LEUPROLIDE, GOSERELIN),ADMINISTRATIVE SVCS, PROFSIONAL PHARMACY
HOME INJECTABLE THERAPY,PALIVIZUMAB,ADMINISTRATIVE SERVICES, PROFESSIONAL PHARMACY SERVICES,CA
HOME THERAPY,IRRIGATION THERAPY;ADMINISTRATIVE SERVICES, PROFESSIONAL PHARMACY SERVICES, CARE
HOME INFUSION/SPECIALTY DRUG ADMINISTRATION, NURSING SERVICES; PER VISIT (UP TO 2 HOURS)
EACH ADDITIONAL HOUR (LIST SEPARATELY IN ADDITION TO CODE S9802)
RN SERVICES IN THE INFUSION SUITE OF THE IV THERAPY PROVIDER, PER VISIT
HOME THERAPY; PROFESSIONAL PHARMACY SERVICES, PROVISION, INFUSION, SPECIALTY DRUG ADMINISTRATIO
SERVICES BY AUTHORIZED CHRISTIAN SCIENCE PRACTITIONER FOR THE PROCESS OF HEALING, PER DIEM. NOT
HEALTH CLUB MEMBERSHIP, ANNUAL
TRANSPLANT RELATED LODGING, MEALS AND TRANSPORTATION, PER DIEM
MEDICAL RECORDS COPYING FEE, ADMINISTRATIVE
MEDICAL RECORDS COPYING FEE, PER PAGE
NOT MEDICALLY NECESSARY SERVICE (PATIENT IS AWARE THAT SERVICE NOT MEDICALLY NECESSARY)
SERVICES PROVIDED OUTSIDE OF THE UNITED STATES OF AMERICA (LIST IN ADDITION TO CODE(S) FOR SERVICE
SERVICES PROVIDED AS PART OF A PHASE II CLINICAL TRIAL
SERVICES PROVIDED AS PART OF A PHASE III CLINICAL TRIAL
TRANSPORTATION COSTS TO AND FROM TRIAL LOCATION AND LOCAL TRANSPORTATION COSTS (E.G., FARES FO
LODGING COSTS (E.G., HOTEL CHARGES) FOR CLINICAL TRIAL PARTICIPANT AND ONE CAREGIVER/COMPANION
MEALS FOR CLINICAL TRIAL PARTICIPANT AND ONE CAREGIVER/COMPANION
SALES TAX
PRIVATE DUTY/INDEPENDENT NURSING SERVICE(S) - LICENSED, UP TO 15 MINUTES
NURSING ASSESSMENT/EVALUATION
RN SERVICES, UP TO 15 MINUTES
LPN/LVN SERVICES, UP TO 15 MINUTES
SERVICES OF A QUALIFIED NURSING AIDE, UP TO 15 MINUTES
RESPITE CARE SERVICES, UP TO 15 MINUTES
ALCOHOL AND/OR SUBSTANCE ABUSE SERVICES, FAMILY/COUPLE COUNSELING
ALCOHOL AND/OR SUBSTANCE ABUSE SERVICES, TREATMENT PLAN DEVELOPMENT AND/OR MODIFICATION
DAY TREATMENT FOR INDIVIDUAL ALCOHOL AND/OR SUBSTANCE ABUSE SERVICES
CHILD SITTING SERVICES FOR CHILDREN OF THE INDIVIDUAL RECEIVING ALCOHOL AND/OR SUBSTANCE ABUSE S
MEALS FOR INDIVIDUALS RECEIVING ALCOHOL AND/OR SUBSTANCE ABUSE SERVICES (WHEN MEALS NOT INCLUD
ALCOHOL AND/OR SUBSTANCE ABUSE SERVICES, NOT OTHERWISE CLASSIFIED
ALCOHOL AND/OR SUBSTANCE ABUSE SERVICES, SKILLS DEVELOPMENT
SIGN LANGUAGE OR ORAL INTERPRETIVE SERVICES, PER 15 MINUTE
TELEHEALTH TRANSMISSION, PER MINUTE, PROFESSIONAL SERVICES BILL SEPARATELY
CLINIC VISIT/ENCOUNTER, ALL-INCLUSIVE
CASE MANAGEMENT, EACH 15 MINUTES
TARGETED CASE MANAGEMENT, EACH 15 MINUTES
SCHOOL-BASED INDIVIDUALIZED EDUCATION PROGRAM (IEP) SERVICES, BUNDLED
PERSONAL CARE SERVICES,PER 15 MINUTES,NOT FOR AN INPATIENT/RESIDENT OF A HOSPITAL,NURSING FACILIT
PERSONAL CARE SERVICES, PER DIEM, NOT FOR AN INPATIENT OR RESIDENT OF A HOSPITAL, NURSING FACILITY
HOME HEALTH AIDE OR CERTIFIED NURSE ASSISTANT, PER VISIT
CONTRACTED HOME HEALTH AGENCY SERVICES, ALL SERVICES PROVIDED UNDER CONTRACT, PER DAY
SCREENING TO DETERMINE THE APPROPRIATENESS OF CONSIDERATION OF AN INDIVIDUAL FOR PARTICIPATION
EVALUATION AND TREATMENT BY AN INTEGRATED, SPECIALTY TEAM CONTRACTED TO PROVIDE COORDINATED
INTENSIVE, EXTENDED MULTIDISCIPLINARY SERVICES PROVIDED IN A CLINIC SETTING TO CHILDREN WITH COMP
INTENSIVE, EXTENDED MULTIDISCIPLINARY SERVICES PROVIDED IN A CLINIC SETTING TO CHILDREN WITH COMP
FAMILY TRAINING AND COUNSELING FOR CHILD DEVELOPMENT, PER 15 MINUTES
ASSESSMENT OF HOME, PHYSICAL AND FAMILY ENVIRONMENT, TO DETERMINE SUITABILITY TO MEET PATIENT'S
COMPREHENSIVE ENVIRONMENTAL LEAD INVESTIGATION, NOT INCLUDING LABORATORY ANALYSIS, PER DWELLI
NURSING CARE, IN THE HOME, BY REGISTERED NURSE, PER DIEM
NURSING CARE, IN THE HOME, BY LICENSED PRACTICAL NURSE, PER DIEM
DIAPER/INCONTINENT PANT, REUSABLE/WASHABLE, ANY SIZE, EACH
ADMINISTRATION OF ORAL, INTRAMUSCULAR AND/OR SUBCUTANEOUS MEDICATION BY HEALTH CARE AGENCY/P
MISCELLANEOUS THERAPEUTIC ITEMS AND SUPPLIES, RETAIL PURCHASES, NOT OTHERWISE CLASSIFIED; IDENT
NON-EMERGENCY TRANSPORTATION; PATIENT ATTENDANT/ESCORT
NON-EMERGENCY TRANSPORTATION; PER DIEM
NON-EMERGENCY TRANSPORTATION; ENCOUNTER/TRIP
NON-EMERGENCY TRANSPORT; COMMERCIAL CARRIER, MULTI-PASS
NON-EMERGENCY TRANSPORTATION; NON-AMBULATORY STRETCHER VAN
AMBULANCE RESPONSE AND TREATMENT, NO TRANSPORT
TRANSPORTATION WAITING TIME, AIR AMBULANCE AND NON-EMERGENCY VEHICLE, ONE-HALF (1/2) HOUR INCRE
FRAMES, PURCHASES
DELUXE FRAME
SPHERE, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00, PER LENS
SPHERE, SINGLE VISION, PLUS OR MINUS 4.12 TO PLUS OR MINUS 7.00D, PER LENS
SPHERE, SINGLE VISION, PLUS OR MINUS 7.12 TO PLUS OR MINUS 20.00D, PER LENS
SPHEROCYLINDER, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00D SPHERE, .12 TO 2.00D CYLINDER, PER LENS
SPHEROCYLINDER, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00D SPHERE, 2.12 TO 4.00D CYLINDER, PER LENS
SPHEROCYLINDER, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00D SPHERE, 4.25 TO 6.00D CYLINDER, PER LENS
SPHEROCYLINDER, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00D SPHERE, OVER 6.00D CYLINDER, PER LENS
SPHEROCYLINDER, SINGLE VISION, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00 SPHERE, .12 TO 2.00D CYLINDER
SPHEROCYLINDER, SINGLE VISION, PLUS OR MINUS 4.25D TO PLUS OR MINUS 7.00D SPHERE, 2.12 TO 4.00D CYLIN
SPHEROCYLINDER, SINGLE VISION, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D SPHERE, 4.25 TO 6.00D CYLIND
SPHEROCYLINDER, SINGLE VISION, PLUS OR MINUS 4.25 TO 7.00D SPHERE, OVER 6.00D CYLINDER, PER LENS
SPHEROCYLINDER, SINGLE VISION, PLUS OR MINUS 7.25 TO PLUS OR MINUS 12.00D SPHERE, .25 TO 2.25D CYLIND
SPHEROCYLINDER, SINGLE VISION, PLUS OR MINUS 7.25 TO PLUS OR MINUS 12.00D SPHERE, 2.25D TO 4.00D CYLI
SPHEROCYLINDER, SINGLE VISION, PLUS OR MINUS 7.25 TO PLUS OR MINUS 12.00D SPHERE, 4.25 TO 6.00D CYLIN
SPHEROCYLINDER, SINGLE VISION, SPHERE OVER PLUS OR MINUS 12.00D, PER LENS
LENTICULAR, (MYODISC), PER LENS, SINGLE VISION
LENTICULAR LENS, NONASPHERIC, PER LENS, SINGLE VISION
LENTICULAR, ASPHERIC, PER LENS, SINGLE VISION
ANISEIKONIC LENS, SINGLE VISION
NOT OTHERWISE CLASSIFIED, SINGLE VISION LENS
SPHERE, BIFOCAL, PLANO TO PLUS OR MINUS 4.00D, PER LENS
SPHERE, BIFOCAL, PLUS OR MINUS 4.12 TO PLUS OR MINUS 7.00D, PER LENS
SPHERE, BIFOCAL, PLUS OR MINUS 7.12 TO PLUS OR MINUS 20.00D, PER LENS
SPHEROCYLINDER, BIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, .12 TO 2.00D CYLINDER, PER LENS
SPHEROCYLINDER, BIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, 2.12 TO 4.00D CYLINDER, PER LENS
SPHEROCYLINDER, BIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, 4.25 TO 6.00D CYLINDER, PER LENS
SPHEROCYLINDER, BIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, OVER 6.00D CYLINDER, PER LENS
SPHEROCYLINDER, BIFOCAL, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D SPHERE,.12 TO 2.00D CYLINDER, PER
SPHEROCYLINDER, BIFOCAL, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D SPHERE, 2.12 TO 4.00D CYLINDER, PE
SPHEROCYLINDER, BIFOCAL, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D SPHERE, 4.25 TO 6.00D CYLINDER, PE
SPHEROCYLINDER, BIFOCAL, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D SPHERE, OVER 6.00D CYLINDER,PER
SPHEROCYLINDER, BIFOCAL, PLUS OR MINUS 7.25 TO PLUS OR MINUS 12.00D SPHERE, 0.25 TO 2.25D CYLINDER, P
SPHEROCYLINDER, BIFOCAL, PLUS OR MINUS 7.25 TO PLUS OR MINUS 12.00D SPHERE, 2.25 TO 4.00D CYLINDER, P
SPHEROCYLINDER, BIFOCAL, PLUS OR MINUS 7.25 TO PLUS OR MINUS 12.00D SPHERE, 4.25 TO 6.00D CYLINDER, P
SPHEROCYLINDER, BIFOCAL, SPHERE OVER PLUS OR MINUS 12.00D, PER LENS
LENTICULAR (MYODISC), PER LENS, BIFOCAL
LENTICULAR, NONASPHERIC, PER LENS, BIFOCAL
LENTICULAR, ASPHERIC LENS, BIFOCAL
ANISEIKONIC, PER LENS, BIFOCAL
BIFOCAL SEG WIDTH OVER 28 MM
BIFOCAL ADD OVER 3.25D
SPECIALTY BIFOCAL (BY REPORT)
SPHERE, TRIFOCAL, PLANO TO PLUS OR MINUS 4.00D, PER LENS
SPHERE, TRIFOCAL, PLUS OR MINUS 4.12 TO PLUS OR MINUS 7.00D, PER LENS
SPHERE, TRIFOCAL, PLUS OR MINUS 7.12 TO PLUS OR MINUS 20.00, PER LENS
SPHEROCYLINDER, TRIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, .12-2.00D CYLINDER, PER LENS
SPHEROCYLINDER, TRIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, 2.25-4.00D CYLINDER, PER LENS
SPHEROCYLINDER, TRIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, 4.25 TO 6.00 CYLINDER, PER LENS
SPHEROCYLINDER, TRIFOCAL, PLANO TO PLUS OR MINUS 4.00D SPHERE, OVER 6.00D CYLINDER, PER LENS
SPHEROCYLINDER, TRIFOCAL, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D SPHERE, .12 TO 2.00D CYLINDER, PE
SPHEROCYLINDER, TRIFOCAL, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D SPHERE, 2.12 TO 4.00D CYLINDER, P
SPHEROCYLINDER, TRIFOCAL, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D SPHERE, 4.25 TO 6.00D CYLINDER, P
SPHEROCYLINDER, TRIFOCAL, PLUS OR MINUS 4.25 TO PLUS OR MINUS 7.00D SPHERE, OVER 6.00D CYLINDER, PE
SPHEROCYLINDER, TRIFOCAL, PLUS OR MINUS 7.25 TO PLUS OR MINUS 12.00D SPHERE, .25 TO 2.25D CYLINDER, P
SPHEROCYLINDER, TRIFOCAL, PLUS OR MINUS 7.25 TO PLUS OR MINUS 12.00D SPHERE, 2.25 TO 4.00D CYLINDER,
SPHEROCYLINDER, TRIFOCAL, PLUS OR MINUS 7.25 TO PLUS OR MINUS 12.00D SPHERE, 4.25 TO 6.00D CYLINDER,
SPHEROCYLINDER, TRIFOCAL, SPHERE OVER PLUS OR MINUS 12 .00D, PER LENS
LENTICULAR, (MYODISC), PER LENS, TRIFOCAL
LENTICULAR NONASPHERIC, PER LENS, TRIFOCAL
LENTICULAR, ASPHERIC LENS, TRIFOCAL
ANISEIKONIC LENS, TRIFOCAL
TRIFOCAL SEG WIDTH OVER 28 MM
TRIFOCAL ADD OVER 3.25D
SPECIALTY TRIFOCAL (BY REPORT)
VARIABLE ASPHERICITY LENS, SINGLE VISION, FULL FIELD, GLASS OR PLASTIC, PER LENS
VARIABLE ASPHERICITY LENS, BIFOCAL, FULL FIELD, GLASS OR PLASTIC, PER LENS
VARIABLE SPHERICITY LENS, OTHER TYPE
CONTACT LENS, PMMA, SPHERICAL, PER LENS
CONTACT LENS, PMMA, TORIC OR PRISM BALLAST, PER LENS
CONTACT LENS, PMMA, BIFOCAL, PER LENS
CONTACT LENS, PMMA, COLOR VISION DEFICIENCY, PER LENS
CONTACT LENS, GAS PERMEABLE, SPHERICAL, PER LENS
CONTACT LENS, GAS PERMEABLE, TORIC, PRISM BALLAST, PER LENS
CONTACT LENS, GAS PERMEABLE, BIFOCAL, PER LENS
CONTACT LENS, GAS PERMEABLE, EXTENDED WEAR, PER LENS
CONTACT LENS, HYDROPHILIC, SPHERICAL, PER LENS
CONTACT LENS, HYDROPHILIC, TORIC, OR PRISM BALLAST, PER LENS
CONTACT LENS, HYDROPHILIC, BIFOCAL, PER LENS
CONTACT LENS, HYDROPHILIC, EXTENDED WEAR, PER LENS
CONTACT LENS, SCLERAL, GAS IMPERMEABLE, PER LENS (FOR CONTACT LENS MODIFICATION, SEE 92325)
CONTACT LENS, SCLERAL, GAS PERMEABLE, PER LENS (FOR CONTACT LENS MODIFICATION, SEE 92325)
CONTACT LENS, OTHER TYPE
HAND HELD LOW VISION AIDS AND OTHER NONSPECTACLE MOUNTED AIDS
SINGLE LENS SPECTACLE MOUNTED LOW VISION AIDS
TELESCOPIC AND OTHER COMPOUND LENS SYSTEM, INCLUDING DISTANCE VISION TELESCOPIC, NEAR VISION TE
PROSTHETIC EYE, PLASTIC, CUSTOM
POLISHING/RESURFACING OF OCULAR PROSTHESIS
ENLARGEMENT OF OCULAR PROSTHESIS
REDUCTION OF OCULAR PROSTHESIS
SCLERAL COVER SHELL
FABRICATION AND FITTING OF OCULAR CONFORMER
PROSTHETIC EYE, OTHER TYPE
ANTERIOR CHAMBER INTRAOCULAR LENS
IRIS SUPPORTED INTRAOCULAR LENS
POSTERIOR CHAMBER INTRAOCULAR LENS
BALANCE LENS, PER LENS
SLAB OFF PRISM, GLASS OR PLASTIC, PER LENS
PRISM, PER LENS
PRESS-ON LENS, FRESNELL PRISM, PER LENS
SPECIAL BASE CURVE, GLASS OR PLASTIC, PER LENS
TINT, PLASTIC, ROSE 1 OR 2 PER LENS
TINT, PLASTIC, OTHER THAN ROSE 1-2, PER LENS
TINT, GLASS ROSE 1 OR 2, PER LENS
TINT, GLASS OTHER THAN ROSE 1 OR 2, PER LENS
TINT, PHOTOCHROMATIC, PER LENS
ANTI-REFLECTIVE COATING, PER LENS
U-V LENS, PER LENS
SCRATCH RESISTANT COATING, PER LENS
OCCLUDER LENS, PER LENS
OVERSIZE LENS, PER LENS
PROGRESSIVE LENS, PER LENS
PROCESSING, PRESERVING AND TRANSPORTING CORNEAL TISSUE
AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE
VISION SERVICE, MISCELLANEOUS
HEARING SCREENING
ASSESSMENT FOR HEARING AID
FITTING/ORIENTATION/CHECKING OF HEARING AID
REPAIR/MODIFICATION OF A HEARING AID
CONFORMITY EVALUATION
HEARING AID, MONAURAL, BODY WORN, AIR CONDUCTION
HEARING AID, MONAURAL, BODY WORN, BONE CONDUCTION
HEARING AID, MONAURAL, IN THE EAR
HEARING AID, MONAURAL, BEHIND THE EAR
GLASSES, AIR CONDUCTION
GLASSES, BONE CONDUCTION
DISPENSING FEE, UNSPECIFIED HEARING AID
SEMI-IMPLANTABLE MIDDLE EAR HEARING PROSTHESIS
HEARING AID, BILATERAL, BODY WORN
DISPENSING FEE, BILATERAL
BINAURAL, BODY
BINAURAL, IN THE EAR
BINAURAL, BEHIND THE EAR
BINAURAL, GLASSES
DISPENSING FEE, BINAURAL
HEARING AID, CROS, IN THE EAR
HEARING AID, CROS, BEHIND THE EAR
HEARING AID, CROS, GLASSES
DISPENSING FEE, CROS
HEARING AID, BICROS, IN THE EAR
HEARING AID, BICROS, BEHIND THE EAR
HEARING AID, BICROS, GLASSES
DISPENSING FEE, BICROS
DISPENSING FEE, MONAURAL HEARING AID, ANY TYPE
HEARING AID, ANALOG, MONAURAL, CIC (COMPLETELY IN THE EAR CANAL)
HEARING AID, ANALOG, MONAURAL, ITC (IN THE CANAL)
HEARING AID, DIGITALLY PROGRAMMABLE ANALOG, MONAURAL, CIC
HEARING AID, DIGITALLY PROGRAMMABLE, ANALOG, MONAURAL, ITC
HEARING AID, DIGITALLY PROGRAMMABLE ANALOG, MONAURAL, ITE (IN THE EAR)
HEARING AID, DIGITALLY PROGRAMMABLE ANALOG, MONAURAL, BTE (BEHIND THE EAR)
HEARING AID, ANALOG, BINAURAL, CIC
HEARING AID, ANALOG, BINAURAL, ITC
HEARING AID, DIGITALLY PROGRAMMABLE ANALOG, BINAURAL, CIC
HEARING AID, DIGITALLY PROGRAMMABLE ANALOG, BINAURAL, ITC
HEARING AID, DIGITALLY PROGRAMMABLE, BINAURAL, ITE
HEARING AID, DIGITALLY PROGRAMMABLE, BINAURAL, BTE
HEARING AID, DIGITAL, MONAURAL, CIC
HEARING AID, DIGITAL, MONAURAL, ITC
HEARING AID, DIGITAL, MONAURAL, ITE
HEARING AID, DIGITAL, MONAURAL, BTE
HEARING AID, DIGITAL, BINAURAL, CIC
HEARING AID, DIGITAL, BINAURAL, ITC
HEARING AID, DIGITAL, BINAURAL, ITE
HEARING AID, DIGITAL, BINAURAL, BTE
HEARING AID, DISPOSABLE, ANY TYPE, MONAURAL
HEARING AID, DISPOSABLE, ANY TYPE, BINAURAL
EAR MOLD/INSERT, NOT DISPOSABLE, ANY TYPE
EAR MOLD/INSERT, DISPOSABLE, ANY TYPE
BATTERY FOR USE IN HEARING DEVICE
HEARING AID SUPPLIES/ACCESSORIES
ASSISTIVE LISTENING DEVICE, TELEPHONE AMPLIFIER, ANY TYPE
ASSISTIVE LISTENING DEVICE, ALERTING, ANY TYPE
ASSISTIVE LISTENING DEVICE, TELEVISION AMPLIFIER, ANY TYPE
ASSISTIVE LISTENING DEVICE, TELEVISION CAPTION DECODER
ASSISTIVE LISTENING DEVICE, TDD
ASSISTIVE LISTENING DEVICE, FOR USE WITH COCHLEAR IMPLANT
ASSISTIVE LISTENING DEVICE, NOT OTHERWISE CLASSIFIED
EAR IMPRESSION, EACH
HEARING AID, NOT OTHERWISE CLASSIFIED
HEARING SERVICE, MISCELLANEOUS
REPAIR/MODIFICATION OF AUGMENTATIVE COMMUNICATIVE SYSTEM OR DEVICE (EXCLUDES ADAPTIVE HEARING
SPEECH SCREENING
LANGUAGE SCREENING
DYSPHAGIA SCREENING
MEDONES, CYSTS, PUSTULES)
          IMP      LE OR SINGLE
          OMP      LICATED OR MULTIPLE




           PRO      CEDURE)
ACTURE(S) AND/OR DISLOCATION(S); SKIN AND SUBCUTANEOUS TISSUES
           SCI      A, AND MUSCLE
           SCI      A, MUSCLE AND BONE




TO FOUR LESIONS
  THAN FOUR LESIONS
            ION
            TE/       ADD LESION (LIST SEP IN ADD TO CODE FOR PRIMARY PROC)
UDING 15 LESIONS
            EDU       RE)
SION DIAMETER 0.5 CM OR LESS
SION DIAMETER 0.6 TO 1.0 CM
SION DIAMETER 1.1 TO 2.0 CM
SION DIAMETER OVER 2.0 CM
 , GENITALIA; LESION DIAMETER 0.5 CM OR LESS
 , GENITALIA; LESION DIAMETER 0.6 TO 1.0 CM
 , GENITALIA; LESION DIAMETER 1.1 TO 2.0 CM
 , GENITALIA; LESION DIAMETER OVER 2.0 CM
E, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 0.5 CM OR LESS
E, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 0.6 TO 1.0 CM
E, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 1.1 TO 2.0 CM
E, LIPS, MUCOUS MEMBRANE; LESION DIAMETER OVER 2.0 CM
WHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 0.5 CM OR LESS
WHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 0.6 TO 1.0 CM
WHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 1.1 TO 2.0 CM
WHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 2.1 TO 3.0 CM
WHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 3.1 TO 4.0 CM
WHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER OVER 4.0 CM
            CM        OR LESS
            TO        1.0 CM
            TO        2.0 CM
            TO        3.0 CM
          TO          4.0 CM
          R4          .0 CM
                  0.5 CM OR LESS
                  0.6 TO 1.0 CM
                  0.1 TO 2.0 C
                  0.1 TO 3.0 CM
                  0.1 TO 4.0 CM
            VER       4.0 CM
 LE OR INTERMEDIATE REPAIR
 PLEX REPAIR
 LE OR INTERMEDIATE REPAIR
 PLEX REPAIR
  OR UMBILICAL; WITH SIMPLE OR INTERMEDIATE REPAIR
  OR UMBILICAL; WITH COMPLEX REPAIR
 METER 0.5 CM OR LESS
 METER 0.6 TO 1.0 CM
 METER 1.1 TO 2.0 CM
 METER 2.1 TO 3.0 CM
 METER 3.1 TO 4.0 CM
 METER OVER 4.0 CM
LIA; EXCISED DIAMETER 0.5 CM OR LESS
LIA; EXCISED DIAMETER 0.6 TO 1.0 CM
LIA; EXCISED DIAMETER 1.1 TO 2.0 CM
LIA; EXCISED DIAMETER 2.1 TO 3.0 CM
LIA; EXCISED DIAMETER 3.1 TO 4.0 CM
LIA; EXCISED DIAMETER OVER 4.0 CM
 CISED DIAMETER 0.5 CM OR LESS
 CISED DIAMETER 0.6 TO 1.0 CM
 CISED DIAMETER 1.1 TO 2.0 CM
 CISED DIAMETER 2.1 TO 3.0 CM
 CISED DIAMETER 3.1 TO 4.0 CM
 CISED DIAMETER OVER 4.0 CM




 (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)

ED NAIL) FOR PERMANENT REMOVAL;
           PHA      LANX
NAIL FOLDS) (SEPARATE PROCEDURE)




          SS
          CM
                 20 .0 SQ CM (LIST SEP IN ADD TO CODE FOR PRIMARY PROC)
           OF      "FILLING" MATERIAL (EG, COLLAGEN); 1 CC OR LESS
 CT COLOR DEFECTS OF SKIN, INCLUDING MICROPIGMENTATION; 1.1 TO 5.0 CC
 CT COLOR DEFECTS OF SKIN, INCLUDING MICROPIGMENTATION; 5.1 TO 10.0 CC
 CT COLOR DEFECTS OF SKIN, INCLUDING MICROPIGMENTATION; OVER 10.0 CC
 EXPANSION




R TESTOSTERONE PELLETS BENEATH THE SKIN)



           LE        SS
                   7 5 CM
                  12 .5 CM
         O2          0.0 CM
         O3          0.0 CM
         CM
MUCOUS MEMBRANES; 2.5 CM OR LESS
MUCOUS MEMBRANES; 2.6 CM TO 5.0 CM
MUCOUS MEMBRANES; 5.1 CM TO 7.5 CM
MUCOUS MEMBRANES; 7.6 CM TO 12.5 CM
MUCOUS MEMBRANES; 12.6 CM TO 20.0 CM
MUCOUS MEMBRANES; 20.1 CM TO 30.0 CM
MUCOUS MEMBRANES; OVER 30.0 CM


 NG HANDS AND FEET); 2.5 CM OR LESS
 NG HANDS AND FEET); 2.6 CM TO 7.5 CM
 NG HANDS AND FEET); 7.6 CM TO 12.5 CM
 NG HANDS AND FEET); 12.6 CM TO 20.0 CM
 NG HANDS AND FEET); 20.1 CM TO 30.0 CM
 NG HANDS AND FEET); OVER 30.0 CM
CM OR LESS
CM TO 7.5 CM
CM TO 12.5 CM
 CM TO 20.0 CM
 CM TO 30.0 CM

MBRANES; 2.5 CM OR LESS
MBRANES; 2.6 CM TO 5.0 CM
MBRANES; 5.1 CM TO 7.5 CM
MBRANES; 7.6 CM TO 12.5 CM
MBRANES; 12.6 CM TO 20.0 CM
MBRANES; 20.1 CM TO 30.0 CM
MBRANES; OVER 30.0 CM


ON TO CODE FOR PRIMARY PROCEDURE)
EPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
 AND/OR FEET; 1.1 CM TO 2.5 CM
 AND/OR FEET; 2.6 CM TO 7.5 CM
          DDI       TION TO CODE FOR PRIMARY PROCEDURE)



LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)



T 10 SQ CM OR LESS
T 10.1 SQ CM TO 30.0 SQ CM
NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; DEFECT 10 SQ CM OR LESS
            0S        Q CM
DEFECT 10 SQ CM OR LESS
DEFECT 10.1 SQ CM TO 30.0 SQ CM
 COMPLICATED, ANY AREA

             SQ       CM OR ONE PERCENT OF BODY AREA OF INFANTS & CHILDREN
             TIO      NAL 100 SQ CM OR EACH ADDITIONAL ONE PERCENT OF BODY
             ER
Y AREA OF INFANTS AND CHILDREN (EXCEPT 15050)
             (L       IST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROC)
             RCE      NT OF BODY AREA OF INFANTS AND CHILDREN (EXC 15050)
             CEN      T OF BODY AREA OF INFANTS & CHILDREN, OR PART THEREOF
SQ CM OR LESS
             IMA      RY PROCEDURE)
MS, AND/OR LEGS; 20 SQ CM OR LESS
             TIO      N TO CODE FOR PRIMARY PROCEDURE)
             ;2       0 SQ CM OR LESS
             ;E       ACH ADDITIONAL 20 SQ CM
 S, EYELIDS, AND/OR LIPS; 20 SQ CM OR LESS
             IN       ADDITION TO CODE FOR PRIMARY PROCEDURE)

(LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)

DDITION TO CODE FOR PRIMARY PROCEDURE)

DDITION TO CODE FOR PRIMARY PROCEDURE)


HEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS OR FEET
E, EARS, LIPS, OR INTRAORAL


CHIN, NECK, AXILLAE, GENITALIA, HANDS (EXCEPT 15625), OR FEET

UBE), ANY LOCATION
LIS, MASSETER MUSCLE, STERNOCLEIDOMASTOID, LEVATOR SCAPULAE)
PRIMARY CLOSURE, DONOR AREA



ERAL KERATOSIS)




 CODE FOR PRIMARY PROCEDURE)




MEN (ABDOMINOPLASTY)




ARM OR HAND
ENTAL FAT PAD
S FLAP OR SKIN GRAFT CLOSURE
; WITH OSTECTOMY




OR MYOCUTANEOUS FLAP OR SKIN GRAFT CLOSURE




 ANEOUS FLAP OR SKIN GRAFT CLOSURE
 ANEOUS FLAP OR SKIN GRAFT CLOSURE; WITH OSTECTOMY



UM OR LARGE, OR WITH MAJOR DEBRIDEMENT
FICE OR HOSPITAL, SMALL
DIUM (EG, WHOLE FACE OR WHOLE EXTREMITY)
 GE (EG, MORE THAN ONE EXTREMITY)

R PRIMARY PROCEDURE)
ANEOUS VASCULAR PROLIFERATIVE LESIONS; FIRST LESION
              CH
ANEOUS VASCULAR PROLIFERATIVE LESIONS; 15 OR MORE LESIONS
UE); LESS THAN 10 SQ CM
UE); 10.0 - 50.0 SQ CM
UE); OVER 50.0 SQ CM




ETER 0.5 CM OR LESS
ETER 0.6 TO 1.0 CM
ETER 1.1 TO 2.0 CM
ETER 2.1 TO 3.0 CM
ETER 3.1 TO 4.0 CM
ETER OVER 4.0 CM
NE; LESION DIAMETER 0.5 CM OR LESS
NE; LESION DIAMETER 0.6 TO 1.0 CM
NE; LESION DIAMETER 1.1 TO 2.0 CM
NE; LESION DIAMETER 2.1 TO 3.0 CM
NE; LESION DIAMETER 3.1 TO 4.0 CM
NE; LESION DIAMETER OVER 4.0 CM
           NE      STAIN;1ST STAGE,FRESH TISSUE TECH,UP TO 5 SPECIMEN
           AIN     ; 2ND STAGE,FIXED / FRESH TISSUE,UP TO 5 SPECIMENS
           ES      TAIN;3RD STAGE,FIXED / FRESH TISSUE,UP TO 5 SPECIM
           INE     STAIN ADDL STAGE,UP TO 5 SPECIMENS, EACH STAGE
           PEC     I,AFTER THE 1ST 5 SPECI,FIXED /FRESH TISSUE,ANY STAGE




IN ADDITION TO CODE FOR PRIMARY PROCEDURE)


PARATE PROCEDURE)


PSY DEVICE, USING IMAGING GUIDANCE
OR A PAPILLOMA LACTIFEROUS DUCT

         ,O        PEN, MALE OR FEMALE, ONE OR MORE LESIONS
AL MARKER, OPEN; SINGLE LESION
         RKE       R (LIST SEP IN ADD TO CODE FOR PRIM PROC)




MARY LYMPH NODES (URBAN TYPE OPERATION)
UT PECTORALIS MINOR MUSCLE, BUT EXCLUDING PECTORALIS MAJOR MUSCLE

THOUT MEDIASTINAL LYMPHADENECTOMY
TH MEDIASTINAL LYMPHADENECTOMY

 LESION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
            RE)




OR IN RECONSTRUCTION
R IN RECONSTRUCTION


G SUBSEQUENT EXPANSION
IC IMPLANT


P (TRAM), SINGLE PEDICLE, INCLUDING CLOSURE OF DONOR SITE;
           CUL      AR ANASTOMOSIS (SUPERCHARGING)
P (TRAM), DOUBLE PEDICLE, INCLUDING CLOSURE OF DONOR SITE




AINED THROUGH SAME FASCIAL INCISION




 TROCHANTER OF FEMUR)




            NON       BURSA)
DER, HIP, KNEE JOINT, SUBACROMIAL BURSA)


OVAL (SEPARATE PROCEDURE)
VAL (SEPARATE PROCEDURE)



             ENE   SIS IMPERFECTA), REQUIRING GENERAL ANESTHESIA



ATION SYSTEM
, EXTERNAL FIXATION SYSTEM (EG, ILIZAROV, MONTICELLI TYPE)
, NEW PIN(S) OR WIRE(S) AND/OR NEW RING(S) OR BAR(S))

  COMPLETE AMPUTATION
PLETE AMPUTATION
 MPLETE AMPUTATION
O INSERTION OF FLEXOR SUBLIMIS TENDON); COMPLETE AMPUTATION
 SERTION); COMPLETE AMPUTATION
 AMPUTATION




          CIS     ION
ED (THROUGH SEPARATE SKIN OR FASCIAL INCISION)
          ION     )
          OF      MUSCLE COMPARTMENT SYNDROME



R METATARSAL
LIAC CREST, METATARSAL, OR GREAT TOE


WEB SPACE




 Y (EG, LOCALLY AGGRESSIVE OR DESTRUCTIVE LESION(S))
            ON(     S))
 (EG, LOCALLY AGGRESSIVE OR DESTRUCTIVE LESION(S))
            ION     (S))
VAL (SEPARATE PROCEDURE)
RE OR DISLOCATION, INCLUDES REMOVAL



 ON OR BONE WEDGE REVERSAL FOR ASYMMETRICAL CHIN)
 S OBTAINING AUTOGRAFTS)

ITIONAL (INCLUDES OBTAINING AUTOGRAFT)

 ONE GRAFT (INCLUDES OBTAINING AUTOGRAFT)

CTION (EG, FOR LONG FACE SYNDROME), WITHOUT BONE GRAFT
 TION, WITHOUT BONE GRAFT
N ANY DIRECTION, WITHOUT BONE GRAFT
CTION, REQUIRING BONE GRAFTS (INCLUDES OBTAINING AUTOGRAFTS)
           RAF      TED UNILATERAL ALVEOLAR CLEFT)
           NGR      AFTED BILAT ALVEOLAR CLEFT OR MULT OSTEOTOMIES)

UDES OBTAINING AUTOGRAFTS)
RAFTS (INCLUDES OBTAINING AUTOGRAFTS); WITHOUT LEFORT I
RAFTS (INCLUDES OBTAINING AUTOGRAFTS); WITH LEFORT I
            GA      UTOGRAFTS); WITHOUT LEFORT I
            GA      UTOGRAFTS); WITH LEFORT I
            S)
            HYC     EPHALY), W W/O GRAFTS (INC OBTAINING AUTOGRAFTS)
 ITH GRAFTS (ALLOGRAFT OR PROSTHETIC MATERIAL)
 ITH AUTOGRAFT (INCLUDES OBTAINING GRAFTS)
S DYSPLASIA), EXTRACRANIAL
            LE      AUTOGRAFTS; TOTAL AREA, BONE GRAFTING < 40 SQ CM
            RAF     TS; TOTAL AREA, BONE GRAFT > 40 SQ CM BUT < 80 SQ CM
            LE      AUTOGRAFTS; TOTAL AREA, BONE GRAFTING > 80 SQ CM
 FTS (INCLUDES OBTAINING AUTOGRAFTS)
 Y; WITHOUT BONE GRAFT
OMY; WITH BONE GRAFT (INCLUDES OBTAINING GRAFT)
RNAL RIGID FIXATION
AL RIGID FIXATION



 IC IMPLANT)




 S OBTAINING GRAFT)


NDIBULAR STAPLE BONE PLATE)


  (INCLUDES OBTAINING GRAFTS) (EG, FOR HEMIFACIAL MICROSOMIA)
 R); PARTIAL
 R); COMPLETE
GE (INCLUDES OBTAINING AUTOGRAFTS)
FTS (INCLUDES OBTAINING AUTOGRAFTS) (EG, MICRO-OPHTHALMIA)
CRANIAL APPROACH
NED INTRA- AND EXTRACRANIAL APPROACH
 OREHEAD ADVANCEMENT
 ; EXTRACRANIAL APPROACH
 ; COMBINED INTRA- AND EXTRACRANIAL APPROACH




ERIC HYPERTROPHY); EXTRAORAL APPROACH
ERIC HYPERTROPHY); INTRAORAL APPROACH




AL SKELETAL FIXATION
CTURED SEPTUM




           NA         SOLACRIMAL APPARATUS

) FRONTAL SINUS FRACTURE, VIA CORONAL OR MULTIPLE APPROACHES
 TERDENTAL WIRE FIXATION OR FIXATION OF DENTURE OR SPLINT
 NG AND/OR LOCAL FIXATION
G MULTIPLE OPEN APPROACHES
E GRAFTING (INCLUDES OBTAINING GRAFT)
CH AND MALAR TRIPOD, WITH MANIPULATION
MALAR TRIPOD
          RT     RIPOD; WITH INTERNAL FIXATION & MULT SURG APPROACHES
          RT     RIPOD; WITH BONE GRAFTING (INCLUDES OBTAINING GRAFT)
(CALDWELL-LUC TYPE OPERATION)


WITH ALLOPLASTIC OR OTHER IMPLANT
WITH BONE GRAFT (INCLUDES OBTAINING GRAFT)




 INCLUDES OBTAINING GRAFT)
RDENTAL WIRE FIXATION OR FIXATION OF DENTURE OR SPLINT

           HES
AL WIRE FIXATION OF DENTURE OR SPLINT
R INTERNAL FIXATION
           LA      PPROACHES
           HA      LO DEVICE, AND/OR INTERMAXILLARY FIXATION)
           INC     LUDES OBTAINING GRAFT)
RATE PROCEDURE)
TE PROCEDURE)




          ING      OF DENTURES OR SPLINTS

          QUE      NT




ORAX; WITH PARTIAL RIB OSTECTOMY
SCESS), THORAX
ST APPLICATION
PPLICATION

APPROACH (NUSS PROCEDURE), WITHOUT THORACOSCOPY
APPROACH (NUSS PROCEDURE), WITH THORACOSCOPY




          ERV      ICAL


          ACH      ADDITIONAL SEG (LIST SEPARATE FROM PRIMARY PROC)
          CE       RVICAL


          DED      VERTEBRAL SEG (LIST SEPARATE FROM PRIMARY PROC)
SEGMENT; CERVICAL
SEGMENT; THORACIC
SEGMENT; LUMBAR
          TO       PRIMARY PROCEDURE)
RAL SEGMENT; CERVICAL
RAL SEGMENT; THORACIC
RAL SEGMENT; LUMBAR
          DIT      ION TO PRIMARY PROCEDURE)

UIRING AND INCLUDING CASTING OR BRACING
           RW       ITHOUT ANESTHESIA, BY MANIPULATION OR TRACTION
           TO       F INTERNAL FIXATION; WITHOUT GRAFTING
           TO       F INTERNAL FIXATION; WITH GRAFTING
           NT;      LUMBAR
           NT;      CERVICAL
           NT;      THORACIC
           TV       ERT OR DISLOC SEG (LIST SEPARATE FROM PRIMARY PROC)

NJECTION; THORACIC
NJECTION; LUMBAR
            ARA     TELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
-AXIS), WITH OR WITHOUT EXCISION OF ODONTOID PROCESS
PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); CERVICAL BELOW C2
PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); THORACIC
PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); LUMBAR
          NTE     RSPACE (LIST SEPARATE FROM PRIMARY PROC)


BELOW C2 SEGMENT
 (WITH OR WITHOUT LATERAL TRANSVERSE TECHNIQUE)
WITH OR WITHOUT LATERAL TRANSVERSE TECHNIQUE)
           IMA     RY PROCEDURE)
           EI      NTERSPACE; LUMBAR
           EDU     RE)
 ERTEBRAL SEGMENTS
ERTEBRAL SEGMENTS
RE VERTEBRAL SEGMENTS
TEBRAL SEGMENTS
TEBRAL SEGMENTS
 VERTEBRAL SEGMENTS
           TS
SEGMENT(S) (INCLUDING BODY AND POSTERIOR ELEMENTS); 3 OR MORE SEGMENTS



ULTIPLE HOOKS AND SUBLAMINAL WIRES); 3 TO 6 VERTEBRAL SEGMENTS
ULTIPLE HOOKS AND SUBLAMINAL WIRES); 7 TO 12 VERTEBRAL SEGMENTS
ULTIPLE HOOKS AND SUBLAMINAL WIRES); 13 OR MORE VERTEBRAL SEGMENTS



 STRUCTURES) OTHER THAN SACRUM


          RI       NTERSPACE




AL OF FOREIGN BODY
 ON, DRAINAGE, OR REMOVAL OF FOREIGN BODY




 OPSY AND/OR EXCISION OF TORN CARTILAGE
MOVAL OF LOOSE OR FOREIGN BODY


L LIGAMENT RELEASE

WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)
WITH ALLOGRAFT

TH AUTOGRAFT (INCLUDES OBTAINING GRAFT)
TH ALLOGRAFT


 RGICAL NECK
STEOMYELITIS), CLAVICLE
STEOMYELITIS), SCAPULA
STEOMYELITIS), PROXIMAL HUMERUS




TAINING GRAFT)




ER ARTHROGRAPHY




LUDES ACROMIOPLASTY)




MERAL REPLACEMENT (EG, TOTAL SHOULDER))

         ATI    ON)
METHYLMETHACRYLATE; CLAVICLE
METHYLMETHACRYLATE; PROXIMAL HUMERUS
AL FIXATION



CIAL GRAFT (INCLUDES OBTAINING GRAFT)



SCIAL GRAFT (INCLUDES OBTAINING GRAFT)

SKELETAL TRACTION (WITH OR WITHOUT SHOULDER JOINT INVOLVEMENT)
THOUT INTERNAL FIXATION
RE; WITHOUT MANIPULATION
RE; WITH MANIPULATION, WITH OR WITHOUT SKELETAL TRACTION
          RO       F TUBEROSITY(-IES);
          SIT      Y(-IES); W/ PROXIMAL HUMERAL PROSTHETIC REPLACEMENT


TERNAL OR EXTERNAL FIXATION



 AL TUBEROSITY, WITH MANIPULATION
 TUBEROSITY, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
K FRACTURE, WITH MANIPULATION
 RACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
TION APPARATUS (DISLOCATION EXCLUDED)




SCESS), HUMERUS OR ELBOW

ARATE PROCEDURE)




M OR ELBOW AREA

WITHOUT REMOVAL OF LOOSE OR FOREIGN BODY



FT (INCLUDES OBTAINING GRAFT)
US OR OLECRANON PROCESS
US OR OLECRANON PROCESS; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)
US OR OLECRANON PROCESS; WITH ALLOGRAFT




STEOMYELITIS), HUMERUS
STEOMYELITIS), RADIAL HEAD OR NECK
STEOMYELITIS), OLECRANON PROCESS
 CONTRACTURE RELEASE (SEPARATE PROCEDURE)

DES OBTAINING GRAFT)

OBTAINING GRAFT)




MUSCULAR)


24320-24331)


ULDER, SINGLE (SEDDON-BROOKES TYPE PROCEDURE)




RY OR SECONDARY (EXCLUDES ROTATOR CUFF)
NDON GRAFT

UDES HARVESTING OF GRAFT)

DES HARVESTING OF GRAFT)

NSOR ORIGIN DETACHMENT
LAR LIGAMENT RESECTION

AL OSTECTOMY



           RV      ALGUS, DISTAL HUMERUS)



FT (SOFIELD TYPE PROCEDURE)


 UDES OBTAINING GRAFT)
METHYLMETHACRYLATE, HUMERAL SHAFT

 HOUT SKELETAL TRACTION
OUT CERCLAGE
 ANT, WITH OR WITHOUT CERCLAGE AND/OR LOCKING SCREWS
 ITH OR WITHOUT INTERCONDYLAR EXTENSION; WITHOUT MANIPULATION
           TS       KIN OR SKELETAL TRACTION
AL FRACTURE, WITH OR WITHOUT INTERCONDYLAR EXTENSION
           ON
H OR WITHOUT INTERNAL OR EXTERNAL FIXATION; WITH INTERCONDYLAR EXTENSION
OUT MANIPULATION
 MANIPULATION
 LATERAL, WITH MANIPULATION
R WITHOUT INTERNAL OR EXTERNAL FIXATION
T MANIPULATION
 NIPULATION
 THOUT INTERNAL OR EXTERNAL FIXATION
TERAL, WITH MANIPULATION
 FRACTURE DISTAL HUMERUS AND PROXIMAL ULNA AND/OR PROXIMAL RADIUS)
           TH       IMPLANT ARTHROPLASTY



          ULA     TION
          OUT     INTERNAL OR EXTERNAL FIXATION
H MANIPULATION


XATION OR RADIAL HEAD EXCISION
          ENT
HOUT MANIPULATION
H MANIPULATION
R WITHOUT INTERNAL OR EXTERNAL FIXATION




ARTMENT; WITHOUT DEBRIDEMENT OF NONVIABLE MUSCLE AND/OR NERVE

PARTMENT; WITHOUT DEBRIDEMENT OF NONVIABLE MUSCLE AND/OR NERVE
PARTMENT; WITH DEBRIDEMENT OF NONVIABLE MUSCLE AND/OR NERVE
REMOVAL OF FOREIGN BODY




 AND/OR WRIST AREA


H OR WITHOUT REMOVAL OF LOOSE OR FOREIGN BODY

 E, COMPLEX



           IS)       ; FLEXORS
           )E        XTENSORS, WITH W/O TRANSPOSITION DORSAL RETINACULUM

ECTION OF DISTAL ULNA
UDING HEAD OR NECK OF RADIUS AND OLECRANON PROCESS);
           INC      LUDES OBTAINING GRAFT)
UDING HEAD OR NECK OF RADIUS AND OLECRANON PROCESS); WITH ALLOGRAFT

UTOGRAFT (INCLUDES OBTAINING GRAFT)


 FOR OSTEOMYELITIS); ULNA
 FOR OSTEOMYELITIS); RADIUS




H TENDON OR MUSCLE
 ACH TENDON OR MUSCLE
 E GRAFT (INCLUDES OBTAINING GRAFT), EACH TENDON OR MUSCLE
 ACH TENDON OR MUSCLE
E, EACH TENDON OR MUSCLE
FREE GRAFT, EACH TENDON OR MUSCLE
 UDES OBTAINING GRAFT) (EG, FOR EXTENSOR CARPI ULNARIS SUBLUXATION)
WRIST, SINGLE, EACH TENDON
ACH TENDON



 RIST, SINGLE; EACH TENDON
          DON
 AND/OR WRIST;
 AND/OR WRIST; WITH TENDON(S) TRANSFER
          DO        PEN REDUCTION) FOR CARPAL INSTABILITY
 OR INTERNAL FIXATION

          NDO      N GRAFT/WEAVE, OR TENODESIS) W W/O OPEN REDUC




 PROCEDURE); RADIUS OR ULNA
 PROCEDURE); RADIUS AND ULNA




ION TECHNIQUE)

SION TECHNIQUE)




NCLUDES OBTAINING GRAFT AND NECESSARY FIXATION), EACH BONE




RE CARPUS ("TOTAL WRIST")




METHYLMETHACRYLATE; RADIUS
METHYLMETHACRYLATE; ULNA
METHYLMETHACRYLATE; RADIUS AND ULNA


NAL FIXATION
TION OF DISTAL RADIOULNAR JOINT
           ,W      ITH OR WITHOUT PERCUTANEOUS SKELETAL FIXATION
           IN      CLUDES REPAIR, TRIANGULAR FIBROCARTILAGE COMPLEX


NAL FIXATION


NAL FIXATION; OF RADIUS OR ULNA
NAL FIXATION; OF RADIUS AND ULNA
           OUT      MANIPULATION
           MA       NIPULATION
           YLO      ID, REQUIRING MANIPULATION, W W/O EXTERNAL FIXATION
           RW       ITHOUT INTERNAL OR EXTERNAL FIXATION


TERNAL OR EXTERNAL FIXATION
CULAR)); WITHOUT MANIPULATION, EACH BONE
CULAR)); WITH MANIPULATION, EACH BONE




ONES, WITH MANIPULATION




WITH MANIPULATION



 /OR INTERCARPAL AND/OR CARPOMETACARPAL JOINTS)
  ITH SLIDING GRAFT
  ITH ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT)


 OR WITHOUT BONE GRAFT (EG, SAUVE-KAPANDJI PROCEDURE)
DY; CARPOMETACARPAL JOINT
DY; METACARPOPHALANGEAL JOINT, EACH
N BODY; INTERPHALANGEAL JOINT, EACH



BCUTANEOUS


NGEMENT, OR SKIN GRAFTING (INCLUDES OBTAINING GRAFT)
          ENT      , OR SKIN GRAFTING (INCL. OBTAINING GRAFT);
          EA.      ADDIT. DGT(LIST SEP. IN ADDIT. TO PRIM. PROC.)

TENSOR HOOD RECONSTRUCTION, EACH DIGIT
UCTION, EACH INTERPHALANGEAL JOINT
 M AND/OR FINGER, EACH TENDON




 OGRAFT (INCLUDES OBTAINING GRAFT)
 ISTAL PHALANX OF FINGER;
 ISTAL PHALANX OF FINGER; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)
STEOMYELITIS); METACARPAL
 , FOR OSTEOMYELITIS); PROXIMAL OR MIDDLE PHALANX OF FINGER
 , FOR OSTEOMYELITIS); DISTAL PHALANX OF FINGER



 ER; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)



HEATH; PRIMARY OR SECONDARY WITHOUT FREE GRAFT, EACH TENDON
HEATH; SECONDARY WITH FREE GRAFT, EACH TENDON
H; PRIMARY OR SECONDARY WITHOUT FREE GRAFT, EACH TENDON
H; SECONDARY, EACH TENDON
H; SECONDARY WITH FREE GRAFT, EACH TENDON
 N; PRIMARY, EACH TENDON
 N; SECONDARY WITH FREE GRAFT (INCLUDES OBTAINING GRAFT), EACH TENDON
 N; SECONDARY WITHOUT FREE GRAFT, EACH TENDON
 ON GRAFT, HAND OR FINGER, EACH ROD
GER, EACH ROD
ACH TENDON
 FREE GRAFT (INCLUDES OBTAINING GRAFT), EACH TENDON
D TENDON GRAFT, HAND OR FINGER, EACH ROD
 INGER, EACH ROD
EACH TENDON
 H FREE GRAFT (INCLUDES OBTAINING GRAFT) EACH TENDON
CLUDING LATERAL BAND(S), EACH FINGER
CUTANEOUS PINNING (EG, MALLET FINGER)
GRAFT (EG, MALLET FINGER)
ECONDARY REPAIR; WITH FREE GRAFT (INCLUDES OBTAINING GRAFT)




 D; WITHOUT FREE GRAFT, EACH TENDON
SINGLE; WITH FREE TENDON GRAFT (INCLUDES OBTAINING GRAFT), EACH TENDON

ON GRAFT (INCLUDES OBTAINING GRAFT), EACH TENDON




 PROCEDURE)
NING GRAFT) (SEPARATE PROCEDURE)




ON OR FASCIAL GRAFT (INCLUDES OBTAINING GRAFT)
AL TISSUE (EG, ADDUCTOR ADVANCEMENT)
G GRAFT, EACH JOINT
H OR WITHOUT EXTERNAL OR INTERNAL FIXATION)


OUND" WITH BONE GRAFT
 FIXATION, EACH BONE

 EXTERNAL FIXATION, EACH BONE

T FRACTURE), WITH MANIPULATION
            IXA     TION
 RACTURE), WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
MANIPULATION, EACH JOINT; WITHOUT ANESTHESIA
MANIPULATION, EACH JOINT; REQUIRING ANESTHESIA
N THUMB, WITH MANIPULATION, EACH JOINT
 WITHOUT INTERNAL OR EXTERNAL FIXATION, EACH JOINT
X, MULTIPLE OR DELAYED REDUCTION
 ATION; WITHOUT ANESTHESIA
 ATION; REQUIRING ANESTHESIA
 , WITH MANIPULATION
 T INTERNAL OR EXTERNAL FIXATION
 , FINGER OR THUMB; WITHOUT MANIPULATION, EACH
            TR      ACTION, EACH
 XIMAL OR MIDDLE PHALANX, FINGER OR THUMB, WITH MANIPULATION, EACH
 INGER OR THUMB, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION, EACH
  INTERPHALANGEAL JOINT; WITHOUT MANIPULATION, EACH
  INTERPHALANGEAL JOINT; WITH MANIPULATION, EACH
            CH
MANIPULATION, EACH
PULATION, EACH

HOUT INTERNAL OR EXTERNAL FIXATION, EACH
ATION; WITHOUT ANESTHESIA
ATION; REQUIRING ANESTHESIA
 WITH MANIPULATION
NAL OR EXTERNAL FIXATION, SINGLE


 N; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)
WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)

           DE       FOR PRIMARY PROCEDURE)
 UTOGRAFT (INCLUDES OBTAINING GRAFT)
           EPA      RATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
OR WITHOUT INTEROSSEOUS TRANSFER
 GLE, INCLUDING NEURECTOMIES; WITH DIRECT CLOSURE
           D)




 F SCIATIC, FEMORAL, OR OBTURATOR NERVES
             MI      NIMUS, TENSOR FASCIA LATAE, RECTUS FEMORIS, SARTORIUS




NEOPLASM)




UBIS, OR GREATER TROCHANTER OF FEMUR) WITH OR WITHOUT AUTOGRAFT


            RT       ROCHANTER OF FEMUR)
CESS); DEEP (SUBFASCIAL OR INTRAMUSCULAR)
AMUS OR SYMPHYSIS PUBIS
 BIC RAMI, OR ISCHIUM AND ACETABULUM

CHANTER OF FEMUR
CHANTER OF FEMUR, WITH SKIN FLAPS




YLMETHACRYLATE WITH OR WITHOUT INSERTION OF SPACER
OR TENDON EXTENSION (GRAFT)




TH OR WITHOUT AUTOGRAFT OR ALLOGRAFT
OUT AUTOGRAFT OR ALLOGRAFT
 RAFT OR ALLOGRAFT
HOUT AUTOGRAFT OR ALLOGRAFT
 T ALLOGRAFT




D WITH OPEN REDUCTION OF HIP


TERNAL FIXATION AND/OR CAST
 (INCLUDES OBTAINING BONE GRAFT)


ONE GRAFT (INCLUDES OBTAINING GRAFT)
E OR MULTIPLE PINNING
HEYMAN TYPE PROCEDURE)


METHYLMETHACRYLATE, FEMORAL NECK AND PROXIMAL FEMUR
TION; WITHOUT MANIPULATION
TION; WITH MANIPULATION, REQUIRING MORE THAN LOCAL ANESTHESIA


            WI      TH INTERNAL FIXATION
 LOCATION (INCLUDES ILIUM, SACROILIAC JOINT AND/OR SACRUM)
FIXATION, (INCLUDES PUBIC SYMPHYSIS AND/OR RAMI)
L FIXATION (INCLUDES ILIUM, SACROILIAC JOINT AND/OR SACRUM)

 WITH OR WITHOUT SKELETAL TRACTION
TERNAL FIXATION
          ,W       ITH INTERNAL FIXATION
          MEN      T, SINGLE COLUMN OR TRANSVERSE FRACTURE

N, WITH OR WITHOUT SKELETAL TRACTION

R PROSTHETIC REPLACEMENT
RIC FEMORAL FRACTURE; WITHOUT MANIPULATION
          LT       RACTION
ORAL FRACTURE; WITH PLATE/SCREW TYPE IMPLANT, WITH OR WITHOUT CERCLAGE
          SC       REWS AND/OR CERCLAGE
L OR EXTERNAL FIXATION



ORAL HEAD FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
          HES     IA, WITHOUT MANIPULATION
          TIO     N, REQUIRING ANESTHESIA
          (IN     CLUDING TENOTOMY, ETC);
          (IN     CLUDING TENOTOMY, ETC) WITH FEMORAL SHAFT SHORTENING

OR GENERAL ANESTHESIA




 OR BONE ABSCESS)

ROCEDURE)

 G, INFECTION)




 KNEE AREA

OR FOREIGN BODIES
 L OR LATERAL
AL AND LATERAL

 TEAL AREA




FT (INCLUDES OBTAINING GRAFT)
 FIXATION (LIST IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
R, PROXIMAL TIBIA AND/OR FIBULA (EG, OSTEOMYELITIS OR BONE ABSCESS)
AL OR TENDON GRAFT

TION, INCLUDING FASCIAL OR TENDON GRAFT




 LIGAMENTS


USCLE ADVANCEMENT OR RELEASE (EG, CAMPBELL, GOLDWAITE TYPE PROCEDURE)




D EXTRA-ARTICULAR




ND PARTIAL SYNOVECTOMY


WITH OR WITHOUT PATELLA RESURFACING


T (EG, SOFIELD TYPE PROCEDURE)
            FOR      E EPIPHYSEAL CLOSURE
            TER      EPIPHYSEAL CLOSURE


 MENT TRANSFER
(EG, COMPRESSION TECHNIQUE)
HER AUTOGENOUS BONE GRAFT (INCLUDES OBTAINING GRAFT)



US OR VALGUS)

D ENTIRE TIBIAL COMPONENT
E WITH OR WITHOUT INSERTION OF SPACER, KNEE
METHYLMETHACRYLATE, FEMUR
XTENSOR OR ADDUCTOR);
         E

DEBRIDEMENT OF NONVIABLE MUSCLE AND/OR NERVE

 TH OR WITHOUT INTERCONDYLAR EXTENSION, WITHOUT MANIPULATION
 HOUT SKIN OR SKELETAL TRACTION
           SK       IN OR SKELETAL TRACTION
           AN       D/OR LOCKING SCREWS
OUT CERCLAGE
 E, WITHOUT MANIPULATION
           ENS      ION, OR DISTAL FEMORAL EPIPHYSEAL SEPARATION
 E, WITH MANIPULATION
           N
  INTERCONDYLAR EXTENSION, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION

N, WITH OR WITHOUT SKIN OR SKELETAL TRACTION
 ERNAL OR EXTERNAL FIXATION

OR COMPLETE PATELLECTOMY AND SOFT TISSUE REPAIR

NIPULATION, WITH SKELETAL TRACTION
WITHOUT INTERNAL OR EXTERNAL FIXATION
 THOUT INTERNAL FIXATION
F KNEE, WITH OR WITHOUT MANIPULATION
 HE KNEE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION


           CTI     ON
XATION; WITH PRIMARY LIGAMENTOUS REPAIR
           CTI     ON


TELLECTOMY
F TRACTION OR OTHER FIXATION DEVICES)


UDING FIRST CAST




PARTMENT(S)
NDON LENGTHENING




ITHOUT REMOVAL OF LOOSE OR FOREIGN BODY


D/OR ANKLE

OGRAFT (INCLUDES OBTAINING GRAFT)

STEOMYELITIS OR EXOSTOSIS); TIBIA
 , FOR OSTEOMYELITIS OR EXOSTOSIS); FIBULA




T (INCLUDES OBTAINING GRAFT)




HROUGH SEPARATE INCISION(S))
 PROCEDURE)
 GH SAME INCISION), EACH

TING); SUPERFICIAL (EG, ANTERIOR TIBIAL EXTENSORS INTO MIDFOOT)
           ,F        LX HALLICUS LNG, OR PERONEAL TENDON TO MIDFT/HINDFT)
           OCE       DURE)

 LIGAMENTS
ROCEDURE)




PE PROCEDURE)
S OBTAINING GRAFT)




L TIBIA AND FIBULA
AL TIBIA AND FIBULA; AND DISTAL FEMUR
METHYLMETHACRYLATE, TIBIA
E); WITHOUT MANIPULATION
E); WITH MANIPULATION, WITH OR WITHOUT SKELETAL TRACTION
 ULAR FRACTURE) (EG, PINS OR SCREWS)
 WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE
            CLA       GE

WITHOUT SKIN OR SKELETAL TRACTION
XTERNAL FIXATION


NAL OR EXTERNAL FIXATION
ANIPULATION

OUT INTERNAL OR EXTERNAL FIXATION
MANIPULATION

EXTERNAL FIXATION


          OF       POSTERIOR LIP
          PO       STERIOR LIP
          HOU      T MANIPULATION
          HS       KELETAL TRACTION AND/OR REQUIRING MANIPULATION
          FI       XATION; OF FIBULA ONLY
          FI       XATION; OF TIBIA ONLY
          FI       XATION; OF BOTH TIBIA AND FIBULA
 WITHOUT INTERNAL OR EXTERNAL FIXATION


NTERNAL OR EXTERNAL FIXATION, OR WITH EXCISION OF PROXIMAL FIBULA

UT PERCUTANEOUS SKELETAL FIXATION
 L FIXATION; WITHOUT REPAIR OR INTERNAL FIXATION
 L FIXATION; WITH REPAIR OR INTERNAL OR EXTERNAL FIXATION
 CTION OR OTHER FIXATION APPARATUS)



CLUDING APPLICATION OF FIRST CAST
PE PROCEDURES), WITH PLASTIC CLOSURE AND RESECTION OF NERVES

, WITH DEBRIDEMENT OF NONVIABLE MUSCLE AND/OR NERVE
EMENT OF NONVIABLE MUSCLE AND/OR NERVE
PARTMENT(S), WITH DEBRIDEMENT OF NONVIABLE MUSCLE AND/OR NERVE


ENT, FOOT; SINGLE BURSAL SPACE
NDON SHEATH INVOLVEMENT; MULTIPLE AREAS




N BODY; INTERTARSAL OR TARSOMETATARSAL JOINT
Y; METATARSOPHALANGEAL JOINT
Y; INTERPHALANGEAL JOINT




Y) (EG, CYST OR GANGLION); FOOT
Y) (EG, CYST OR GANGLION); TOE(S), EACH

TH ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT)
TH ALLOGRAFT
EXCEPT TALUS OR CALCANEUS;
EXCEPT TALUS OR CALCANEUS; WITH ILIAC OR OTHER AUTOGRAFT
EXCEPT TALUS OR CALCANEUS; WITH ALLOGRAFT




          )



CTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); TALUS OR CALCANEUS
          E,       EXCEPT TALUS OR CALCANEUS
CTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); PHALANX OF TOE
HALANX, EACH




 EACH TENDON (INCLUDES OBTAINING GRAFT)

FT, EACH TENDON (INCLUDES OBTAINING GRAFT)




PROCEDURE)


NAVICULAR BONE




Y AND TENDON(S) LENGTHENING (EG, RESISTANT CLUBFOOT DEFORMITY)

H JOINT (SEPARATE PROCEDURE)



 ROCEDURE)
ETATARSAL HEAD
ASE OF THE FIRST METATARSOPHALANGEAL JOINT
EXOSTECTOMY (EG, SILVER TYPE PROCEDURE)
MCBRIDE OR MAYO TYPE PROCEDURE
ON OF JOINT WITH IMPLANT
 NDON TRANSPLANTS (EG, JOPLIN TYPE PROCEDURE)
           RES     )
 TYPE PROCEDURE
ANX OSTEOTOMY

OUT INTERNAL FIXATION


CLUDES OBTAINING GRAFT) (EG, FOWLER TYPE)
N, METATARSAL; FIRST METATARSAL
N, METATARSAL; FIRST METATARSAL WITH AUTOGRAFT (OTHER THAN FIRST TOE)
N, METATARSAL; OTHER THAN FIRST METATARSAL, EACH
N, METATARSAL; MULTIPLE (EG, SWANSON TYPE CAVUS FOOT PROCEDURE)
X, FIRST TOE (SEPARATE PROCEDURE)
NGES, ANY TOE
 OVERLAPPING SECOND TOE, FIFTH TOE, CURLY TOES)


LUDES OBTAINING GRAFT)




 L FIXATION;
            SO        BTAINING GRAFT)




ANIPULATION, EACH
ULATION, EACH
ALCANEUS), WITH MANIPULATION, EACH
OR WITHOUT INTERNAL OR EXTERNAL FIXATION, EACH



NAL FIXATION, EACH
NIPULATION

S, WITH MANIPULATION
UT INTERNAL OR EXTERNAL FIXATION
 WITHOUT MANIPULATION, EACH
 WITH MANIPULATION, EACH
ITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION, EACH


UT ANESTHESIA
 ING ANESTHESIA
TARSAL, WITH MANIPULATION
ERNAL FIXATION



R EXTERNAL FIXATION


MANIPULATION
 NAL OR EXTERNAL FIXATION


WITH MANIPULATION
NTERNAL OR EXTERNAL FIXATION


ANIPULATION
NAL OR EXTERNAL FIXATION




 TEOTOMY (EG, FLATFOOT CORRECTION)
AVICULAR-CUNEIFORM



ECK, GREAT TOE, INTERPHALANGEAL JOINT (EG, JONES TYPE PROCEDURE)
L BIOPSY (SEPARATE PROCEDURE)

TE PROCEDURE)




ICULAR SURFACE (MUMFORD PROCEDURE)
H OR WITHOUT MANIPULATION
 PARTIAL ACROMIOPLASTY, WITH OR WITHOUT CORACOACROMIAL RELEASE

ROCEDURE)




ROCEDURE)



TILAGE AND/OR JOINT DEBRIDEMENT


            ERN   AL OR EXTERNAL FIXATION (INCLUDES ARTHROSCOPY)
          AL       OR EXTERNAL FIXATION (INCLUDES ARTHROSCOPY)
          RTH      ROSCOPY)
          THR      OSCOPY)


 (CHONDROPLASTY), ABRASION ARTHROPLASTY, AND/OR RESECTION OF LABRUM




 , OSTEOCHONDRITIS DISSECANS FRAGMENTATION, CHONDRAL FRAGMENTATION)
 ON) (SEPARATE PROCEDURE)
TS (EG, MEDIAL OR LATERAL)
 ONDROPLASTY)
TY WHERE NECESSARY) OR MULTIPLE DRILLING OR MICROFRACTURE
NG ANY MENISCAL SHAVING)
G ANY MENISCAL SHAVING)


 LATION (SEPARATE PROCEDURE)
           TO      F BASE OF LESION)

LESION WITH INTERNAL FIXATION
RECONSTRUCTION
 RECONSTRUCTION
D/OR TIBIA, INCLUDING DRILLING OF THE DEFECT
            NAL     FIXATION (INCLUDES ARTHROSCOPY)

AL OF LOOSE BODY OR FOREIGN BODY
MY, PARTIAL

T, EXTENSIVE
ARTHRODESIS


ACED ULNAR COLLATERAL LIGAMENT (EG, STENAR LESION)
RAL AND ALAR CARTILAGES, AND/OR ELEVATION OF NASAL TIP




ALATE, INCLUDING COLUMELLAR LENGTHENING; TIP ONLY
ALATE, INCLUDING COLUMELLAR LENGTHENING; TIP, SEPTUM, OSTEOTOMIES
LL RECONSTRUCTION)
NTOURING OR REPLACEMENT WITH GRAFT




METHOD,; SUPERFICIAL
METHOD; INTRAMURAL
 ANY METHOD
CKING) ANY METHOD
 UTERY, ANY METHOD; INITIAL
 UTERY, ANY METHOD; SUBSEQUENT




OF ANTROCHOANAL POLYPS
NTROCHOANAL POLYPS


 OVAL OF POLYP(S)


NCLUDES ABLATION)
ON (INCLUDES ABLATION)




 , ETHMOID, SPHENOID)
 EATUS OR CANINE FOSSA PUNCTURE)
OF SPHENOIDAL FACE OR CANNULATION OF OSTIUM)
 EPARATE PROCEDURE)




F TISSUE FROM MAXILLARY SINUS
HOUT REMOVAL OF TISSUE FROM FRONTAL SINUS

E FROM THE SPHENOID SINUS
HMOID REGION
HENOID REGION

AL WALL DECOMPRESSION


GOCELE, CORDECTOMY




TING MICROSCOPE




MICROSCOPE
VOCAL CORDS OR EPIGLOTTIS;
VOCAL CORDS OR EPIGLOTTIS; WITH OPERATING MICROSCOPE



ERATING MICROSCOPE




RACHEOTOMY




R PARTIAL LARYNGECTOMY)




          )




SEPARATE PROCEDURE)



PIC GUIDANCE




 OD OTHER THAN EXCISION
NT APPLICATION




THOUT CATHETERIZATION
ST MATERIAL
E, BEDSIDE
INDWELLING TUBE FOR OXYGEN THERAPY




EUMOTHORAX) (SEPARATE PROCEDURE)

X, EMPYEMA) (SEPARATE PROCEDURE)




F LUNG TEAR



LEURAL PROCEDURE




EA FOLLOWED BY BRONCHO-TRACHEAL ANASTOMOSIS (SLEEVE PNEUMONECTOMY)
         S(      SLEEVE LOBECTOMY)
WING PREVIOUS REMOVAL OF A PORTION OF LUNG (COMPLETION PNEUMONECTOMY)
         LIT     /TRANSTHORACIC APPRCH, W/OR W/O PLEURAL PROC.
OR MULTIPLE
         OC      ODE FOR PRIMARY PROCEDURE)




THOUT BIOPSY




APLEURAL PNEUMONOLYSIS


URAL PROCEDURE



ECTION OF PERICARDIAL SAC FOR DRAINAGE




YPE PROCEDURE)




LMONARY BYPASS
NARY BYPASS


RONCHOPLEURAL FISTULA
          TO       CODE FOR PRIMARY PROCEDURE)


 ODE(S); ATRIAL
 ODE(S); VENTRICULAR
 ODE(S); ATRIAL AND VENTRICULAR
C ELECTRODE OR PACEMAKER CATHETER (SEPARATE PROCEDURE)
LECTRODES (SEPARATE PROCEDURE)
ER, ATRIAL OR VENTRICULAR

          LEA      D, INSERT NEW LEAD, INSERT NEW PULSE GENERATOR)
RDIOVERTER-DEFIBRILLATOR (RIGHT ATRIAL OR RIGHT VENTRICULAR) ELECTRODE
ANENT PACEMAKER OR SINGLE CHAMBER PACING CARDIOVERTER-DEFIBRILLATOR
ANENT PACEMAKER OR DUAL CHAMBER PACING CARDIOVERTER-DEFIBRILLATOR
CEMAKER OR SINGLE CHAMBER PACING CARDIOVERTER-DEFIBRILLATOR
 AKER OR DUAL CHAMBER PACING CARDIOVERTER-DEFIBRILLATOR


          IS,      POCKET, REM, INSRT &/ REPLCMNT, GEN)
          PA       CEMAKER PULSE GENERATOR
          NER      ATOR)

OR VENTRICULAR

Y; SINGLE LEAD SYSTEM, ATRIAL OR VENTRICULAR
Y; DUAL LEAD SYSTEM

E GENERATOR
 RILLATOR PULSE GENERATOR
RODE(S); BY THORACOTOMY
RODE(S); BY TRANSVENOUS EXTRACTION
LATOR ELECTRODES BY THORACOTOMY
LATOR ELECTRODES BY THORACOTOMY; WITH INSERTION OF PULSE GENERATOR
PACING CARDIOVERTER-DEFIBRILLATOR AND INSERTION OF PULSE GENERATOR
 TRACT(S) AND/OR FOCUS; WITHOUT CARDIOPULMONARY BYPASS
 TRACT(S) AND/OR FOCUS (FOCI); WITH CARDIOPULMONARY BYPASS
RILLATION OR ATRIAL FLUTTER (EG, MAZE PROCEDURE)
NARY BYPASS




 MONARY BYPASS
ARY BYPASS




 MONARY BYPASS

LVE OTHER THAN HOMOGRAFT OR STENTLESS VALVE



 NT (KONNO PROCEDURE)
E WITH ALLOGRAFT REPLACEMENT OF PULMONARY VALVE
T OF THE OUTFLOW TRACT

OSIS (EG, ASYMMETRIC SEPTAL HYPERTROPHY)




UCTION, WITH OR WITHOUT RING




MISSUROTOMY
 NFUNDIBULAR RESECTION
 RY BYPASS (SEPARATE PROCEDURE)
CARDIOPULMONARY BYPASS
OUT CARDIOPULMONARY BYPASS



Y ARTERY TUNNEL (TAKEUCHI PROCEDURE)
TERY TO AORTA
          PRI      MARY PROCEDURE)
VEIN GRAFT (LIST SEPARATELY IN ADDITION TO CODE FOR ARTERIAL GRAFT)
NOUS GRAFTS (LIST SEPARATELY IN ADDITION TO CODE FOR ARTERIAL GRAFT)
          T)
          )
          )
          LG        RAFT)
          COD       E FOR PRIMARY PROCEDURE)



TERIAL GRAFTS

 DIAL RESECTION
           ASS     GRAFT PROCEDURE, EACH VESSEL (LIST SEPARATELY)



          GHT      OR LEFT VENTRICLE TO PULMONARY ARTERY
R SEPTAL DEFECT

 ; WITH REPAIR OF RIGHT VENTRICULAR OUTFLOW TRACT OBSTRUCTION
           RY        ARTERY (SIMPLE FONTAN PROCEDURE)
N PROCEDURE
 HYPOPLASIA (HYPOPLASTIC LEFT HEART SYNDROME) (EG, NORWOOD PROCEDURE)
R WITHOUT PATCH
 RY VENOUS DRAINAGE
 PATCH CLOSURE
L SEPTAL DEFECT), WITH OR WITHOUT ATRIOVENTRICULAR VALVE REPAIR
OUT ATRIOVENTRICULAR VALVE REPAIR


 Y VALVOTOMY OR INFUNDIBULAR RESECTION (ACYANOTIC)
OF PULMONARY ARTERY BAND, WITH OR WITHOUT GUSSET


ANNULAR PATCH
         RE        OF VENTRICULAR SEPTAL DEFECT;

F VENTRICULAR SEPTAL DEFECT


R INFRACARDIAC TYPES)
ATRIAL MEMBRANE




CAL GLENN PROCEDURE)
RECTIONAL GLENN PROCEDURE)
          ULA      R SEPTAL DEFECT
          RS       EPTAL DEFECT
MUSTARD OR SENNING TYPE) WITH CARDIOPULMONARY BYPASS;
          OF       PULMONARY BAND
          OF       VENTRICULAR SEPTAL DEFECT
          FS       UBPULMONIC OBSTRUCTION
ONSTRUCTION (EG, JATENE TYPE)
ONSTRUCTION (EG, JATENE TYPE); WITH REMOVAL OF PULMONARY BAND
          ECT
ONSTRUCTION (EG, JATENE TYPE); WITH REPAIR OF SUBPULMONIC OBSTRUCTION


 MALACIA) (SEPARATE PROCEDURE)




 ARTERIOSUS; WITH DIRECT ANASTOMOSIS
 ARTERIOSUS; WITH GRAFT
          MA       TERIAL AS GUSSET FOR ENLARGEMENT
THETIC MATERIAL; WITHOUT CARDIOPULMONARY BYPASS
THETIC MATERIAL; WITH CARDIOPULMONARY BYPASS
SUSPENSION;
SUSPENSION; WITH CORONARY RECONSTRUCTION
          ND       CORONARY RECONSTRUCTION


RDIOPULMONARY BYPASS


ONARY BYPASS

 ON OF PULMONARY ARTERIES; WITHOUT CARDIOPULMONARY BYPASS
 ON OF PULMONARY ARTERIES; WITH CARDIOPULMONARY BYPASS
          AR      TERY

          DDI      TION TO CODE FOR PRIMARY PROCEDURE)




INITIAL 24 HOURS
            RY     PROCEDURE)


 OPEN APPROACH
RTERY, WITH OR WITHOUT GRAFT

LUDING REPAIR OF THE ASCENDING AORTA, WITH OR WITHOUT GRAFT
AN OR INNOMINATE ARTERY, BY NECK INCISION
 AVIAN ARTERY, BY THORACIC INCISION
L, INNOMINATE, SUBCLAVIAN ARTERY, BY ARM INCISION
RTERY, BY ARM INCISION
 ENTERY, AORTOILIAC ARTERY, BY ABDOMINAL INCISION
 AORTOILIAC ARTERY, BY LEG INCISION
 RONEAL ARTERY, BY LEG INCISION

N, BY LEG INCISION
N, BY ABDOMINAL AND LEG INCISION




 ; USING AORTO-AORTIC TUBE PROSTHESIS
 ; USING MODULAR BIFURCATED PROSTHESIS (ONE DOCKING LIMB)
 ; USING UNIBODY BIFURCATED PROSTHESIS
ADDITION TO CODE FOR PRIMARY PROCEDURE)
GROIN INCISION, UNILATERAL
            DUR      E)
            EAL      INCISION, UNILATERAL
            OR       DISSECTION; INITIAL VESSEL
            DIT      ION VESSEL (LIST SEPARATELY ADDITION CD, 1 PROCEDU
            TU       BE PROSTHESIS
            AO       RTO-BI-ILIAC PROSTHESIS
            AO       RTO-BIFEMORAL PROSTHESIS
            LI       NCISION, UNILATERAL
RTIC OR ILIAC ENDOVASCULAR PROSTHESIS BY ARM INCISION, UNILATERAL
EUDOANEURYSM, ARTERIOVENOUS MALFORMATION, TRAUMA)
            DIS      EASE, CAROTID, SUBCLAVIAN ARTERY, BY NECK INCISION
            VIA      N ARTERY, BY NECK INCISION
            CIA      TED OCCLUSIVE DISEASE, VERTEBRAL ARTERY
            DIS      EASE, AXILLARY-BRACHIAL ARTERY, BY ARM INCISION
            AL       ARTERY, BY ARM INCISION
            ASE      , INNOMINATE, SUBCLAVIAN ARTERY, THORACIC INCISION
            CLA      VIAN ARTERY, BY THORACIC INCISION
            CIA      TED OCCLUSIVE DISEASE, RADIAL OR ULNAR ARTERY
            CIA      TED OCCLUSIVE DISEASE, ABDOMINAL AORTA
  WITH OR WITHOUT PATCH GRAFT; FOR RUPTURED ANEURYSM, ABDOMINAL AORTA
            DIS      EASE, ABDOMINAL AORTA INVOLVING VISCERAL VESSELS
            IN       VOLVING VISCERAL VESSELS
            LUS      IVE DISEASE, ABDOMINAL AORTA INVOLVING ILIAC VESSELS
          IN      VOLVING ILIAC VESSELS
          CIA     TED OCCLUSIVE DISEASE, SPLENIC ARTERY
 WITH OR WITHOUT PATCH GRAFT; FOR RUPTURED ANEURYSM, SPLENIC ARTERY
          ISE     ASE, HEPATIC, CELIAC, RENAL/MESENTERIC ARTERY
          ,R      ENAL, OR MESENTERIC ARTERY
          CIA     TED OCCLUSIVE DISEASE, ILIAC ARTERY
 WITH OR WITHOUT PATCH GRAFT; FOR RUPTURED ANEURYSM, ILIAC ARTERY
          CIA     TED OCCLUSIVE DISEASE, COMMON FEMORAL ARTERY
          ART     ERY
          CIA     TED OCCLUSIVE DISEASE, POPLITEAL ARTERY
          Y
          CIA     TED OCCLUSIVE DISEASE, OTHER ARTERIES
 WITH OR WITHOUT PATCH GRAFT; FOR RUPTURED ANEURYSM, OTHER ARTERIES




SUBCLAVIAN, BY NECK INCISION
TE, BY THORACIC INCISION




ITEAL, AND/OR TIBIOPERONEAL
           EDU      RE)
ON (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
, EACH VESSEL


ANCHES, EACH VESSEL




BRANCHES, EACH VESSEL




CHES, EACH VESSEL




K OR BRANCHES, EACH VESSEL
ND BRANCHES
          PRI      MARY PROCEDURE)




RTERY OR OTHER DISTAL VESSELS
          SE      PARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)




SS PROCEDURE




NASTOMOSIS)




OR PERONEAL ARTERY

ODE FOR PRIMARY PROCEDURE)
IONS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
           PRO     CEDURE)
           DUR     E)
           ARY     PROCEDURE)




          EM       ONTH AFTER ORIGINAL OPERATION (LIST SEPARATELY)
RY; CAROTID ARTERY
RY; FEMORAL ARTERY
RY; POPLITEAL ARTERY
RY; OTHER VESSELS




OR FISTULA)
OUS GRAFT
H VEIN PATCH ANGIOPLASTY
H SEGMENTAL VEIN INTERPOSITION




TY PSEUDOANEURYSM


VEIN, JUGULAR VEIN)
IVE, BRANCH (EG, LEFT ADRENAL VEIN, PETROSAL SINUS)




DIALYSIS (CANNULA, FISTULA, OR GRAFT)


R BRACHIOCEPHALIC BRANCH, WITHIN A VASCULAR FAMILY
C OR BRACHIOCEPHALIC BRANCH, WITHIN A VASCULAR FAMILY
           LY
           LIS     T IN ADD TO CODE FOR INIT 2ND/3RD ORDER VESS AS APP)
PELVIC, OR LOWER EXTREMITY ARTERY BRANCH, WITHIN A VASCULAR FAMILY
           LY
           NA      VASCULAR FAMILY
           ST      IN ADD TO CODE FOR INIT 2ND/3RD ORDER VESS AS APP)




          TT       O BE USED FOR ROUTINE VENIPUNCTURE.




CTASIA); LIMB OR TRUNK
CTASIA); FACE



          CH       EMOTHERAPY); PERCUTANEOUS, AGE 2 YEARS OR UNDER
          CH       EMOTHERAPY); PERCUTANEOUS, OVER AGE 2
          CH      EMOTHERAPY); CUTDOWN, AGE 2 YEARS OR UNDER
          CH      EMOTHERAPY); CUTDOWN, OVER AGE 2
COPIC GUIDANCE




IVE FILTRATION AND PLASMA REINFUSION




US RESERVOIR


FROM CENTRAL VENOUS DEVICE VIA SEPARATE VENOUS ACCESS
OM CENTRAL VENOUS DEVICE THROUGH DEVICE LUMEN



USION (SEPARATE PROCEDURE); PERCUTANEOUS
USION (SEPARATE PROCEDURE); CUTDOWN



 VEIN TO VEIN
 ARTERIOVENOUS, EXTERNAL (SCRIBNER TYPE)
 ARTERIOVENOUS, EXTERNAL REVISION, OR CLOSURE



DIOPULMONARY INSUFFICIENCY (ECMO) (SEPARATE PROCEDURE)
          W       REM, CANNULA(S)&REPAIR, ARTERIOTOMY&VENOTOMY SITES
TOMOSIS (SEPARATE PROCEDURE); AUTOGENOUS GRAFT
          AGE     N, THERMOPLASTIC GRAFT)
R NONAUTOGENOUS DIALYSIS GRAFT (SEPARATE PROCEDURE)
 R NONAUTOGENOUS DIALYSIS GRAFT (SEPARATE PROCEDURE)
ONAUTOGENOUS DIALYSIS GRAFT (SEPARATE PROCEDURE)




          HRO     MBOLYSIS)




ESOPHAGOGASTRIC VARICES, ANY TECHNIQUE)
         ION     /DILATATION, STNT PLCMNT&ALL ASSOC IMAG GDNCE&DOCENT
SPASMOLYTIC, VASOCONSTRICTIVE)
FRACTURED VENOUS OR ARTERIAL CATHETER)
            NY       METHOD, NON-CENTRAL NERVOUS SYSTEM, NON-HEAD OR NECK
L), PERCUTANEOUS; INITIAL VESSEL
            TO       CODE FOR PRIMARY PROCEDURE)
L), OPEN; INITIAL VESSEL
            FOR      PRIMARY PROCEDURE)

           AD       DITION TO CODE FOR PRIMARY PROCEDURE)
ENTION; EACH ADDITIONAL VESSEL




H SELVERSTONE OR CRUTCHFIELD CLAMP




PLICATION, CLIP, EXTRAVASCULAR, INTRAVASCULAR (UMBRELLA DEVICE)


 DISTAL INTERRUPTIONS


          CO        MMUNICATING VEINS LOWER LEG, WITH EXCIS DEEP FASCIA
UT SKIN GRAFT, OPEN
SEPARATE PROCEDURE)
(CLUSTERS), ONE LEG




R PROCEDURE (LIST IN ADDITION TO CODE FOR PRIMARY PROCEDURE)




 ELL ACQUISITION
ON, PER COLLECTION; ALLOGENIC
ON, PER COLLECTION; AUTOLOGOUS
ON AND STORAGE
 IOUSLY FROZEN HARVEST
PLETION WITHIN HARVEST, T-CELL DEPLETION



 DEPLETION
TION IN PLASMA, MONONUCLEAR, OR BUFFY COAT LAYER




ENEIC DONOR LYMPHOCYTE INFUSIONS




NAL, AXILLARY)

 SCALENE FAT PAD



AR DISSECTION


L (AORTIC AND/OR SPLENIC)
NGLE OR MULTIPLE

I-AORTIC LYMPH NODE SAMPLING (BIOPSY), SINGLE OR MULTIPLE




L NODES (LIST IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
           SEP       ARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
 ARATE PROCEDURE)
           DES       (SEPARATE PROCEDURE)
OR NODES (SEPARATE PROCEDURE)
VIC, AORTIC, AND RENAL NODES (SEPARATE PROCEDURE)




PSY; CERVICAL APPROACH
           ST      ERNOTOMY
OPLASTY, VAGOTOMY, AND/OR PYLOROPLASTY, EXCEPT NEONATAL
AND WITH OR WITHOUT CREATION OF VENTRAL HERNIA


AL, WITH DILATION OF STRICTURE (WITH OR WITHOUT GASTROPLASTY)


 , PARALYTIC OR NONPARALYTIC

SCLE FLAP)




ECT AND RECLOSURE
ESTLANDER TYPE), INCLUDING SECTIONING AND INSERTING OF PEDICLE




TH EXCISION OF UNDERLYING MUSCLE


 , LASER, THERMAL, CRYO, CHEMICAL)




FLOOR OF MOUTH; LINGUAL
FLOOR OF MOUTH; SUBLINGUAL, SUPERFICIAL
FLOOR OF MOUTH; SUBLINGUAL, DEEP, SUPRAMYLOHYOID
FLOOR OF MOUTH; SUBMENTAL SPACE
FLOOR OF MOUTH; SUBMANDIBULAR SPACE
FLOOR OF MOUTH; MASTICATOR SPACE

OUTH; SUBLINGUAL
OUTH; SUBMENTAL
OUTH; SUBMANDIBULAR
OUTH; MASTICATOR SPACE




 DICAL NECK DISSECTION
 ERAL RADICAL NECK DISSECTION
 IBULAR RESECTION, WITHOUT RADICAL NECK DISSECTION
 RAHYOID NECK DISSECTION
LAR RESECTION, AND RADICAL NECK DISSECTION (COMMANDO TYPE)
 DS OF TONGUE




S; WITHOUT REPAIR
S; WITH SIMPLE REPAIR
S; WITH COMPLEX REPAIR
AFT TO ALVEOLAR RIDGE (INCLUDES OBTAINING GRAFT)




LICATED, INTRAORAL




D PRESERVATION OF FACIAL NERVE
 RVATION OF FACIAL NERVE
RIFICE OF FACIAL NERVE
ECK DISSECTION




E SUBMANDIBULAR GLAND
TH SUBMANDIBULAR GLANDS
TH SUBMANDIBULAR (WHARTON'S) DUCTS
 AL APPROACH
AL APPROACH




ANEOUS TISSUES AND/OR INTO PHARYNX




ITHOUT CLOSURE
LOSURE WITH LOCAL FLAP (EG, TONGUE, BUCCAL)
LOSURE WITH OTHER FLAP



 DVANCEMENT OF LATERAL AND POSTERIOR PHARYNGEAL WALLS




ECTOMY); SIMPLE
ECTOMY); COMPLICATED, REQUIRING HOSPITALIZATION
ECTOMY); WITH SECONDARY SURGICAL INTERVENTION
 POSTERIOR NASAL PACKS, WITH OR WITHOUT ANTERIOR PACKS AND/OR CAUTERY
D, REQUIRING HOSPITALIZATION
DARY SURGICAL INTERVENTION



OF FOREIGN BODY


         (TR      ANSHIATAL)
         ATI      ON, PREPARATION AND ANASTOMOSIS(ES)
ROSTOMY OR CERVICAL ESOPHAGOGASTROSTOMY, WITH OR WITHOUT PYLOROPLASTY
         ON,      PREPARATION, AND ANASTOMOSIS(ES)
         TIO      N
         AST      ROSTOMY, W W/O PYLOROPLASTY (IVOR LEWIS)
          N,       INCL INTSTINE MOBILIZATION, PREP,&ANASTOMOSIS(ES)
          OR       WITHOUT PYLOROPLASTY
          PYL      OROPLASTY
          ING      INTESTINE MOBILIZATION, PREPARATION,&ANASTOMOSIS(ES)
TH CERVICAL ESOPHAGOSTOMY
ERVICAL APPROACH
HORACIC APPROACH
SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)
SUBSTANCE




R LESION(S) BY HOT BIOPSY FORCEPS OR BIPOLAR CAUTERY
R LESION(S) BY SNARE TECHNIQUE


ILATION OVER GUIDE WIRE
          SMA      COAGULATOR)
          AR       CAUTERY OR SNARE TECHNIQUE

NTRAMURAL OR TRANSMURAL FINE NEEDLE ASPIRATION/BIOPSY(S)
TER FLEXIBLE ENDOSCOPE) (SEPARATE PROCEDURE)
          ION     OF SPECIMEN(S) BY BRUSHING/WASHING (SEP PROCEDURE)
          INJ     ECTION(S), ANY SUBSTANCE
          LTI     PLE
          OF      PSEUDOCYST
          ALU     MINAL TUBE OR CATHETER PLACEMENT
          INT     RAMURAL/TRANSMURAL FINE NEEDLE ASPIRATION/BIOPS
          OF      ESOPHAGEAL AND/OR GASTRIC VARICES
          PHA     GEAL AND/OR GASTRIC VARICES
          OUT     LET FOR OBSTRUCTION (EG, BALLOON, GUIDE WIRE, BOUGIE)
          FP      ERCUTANEOUS GASTROSTOMY TUBE
          ODY
          IRE     FOLLOWED BY DILATION OF ESOPHAGUS OVER GUIDE WIRE
          ESO     PHAGUS (LESS THAN 30 MM DIAMETER)
          PO      LYP(S), OR OTH LESION(S) HOT BIOPSY FORCEPS CAUTERY
          PO      LYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE
          AN      Y METHOD
          TP      LACEMENT (INCLUDES PREDILATION)
          OLY     P,OR OTH LESION(S) NOT AMENABLE TO TECHNIQUE
          DE      XAM
          ROC     EDURE)



           CTS
 RETROGRADE DESTRUCTION, LITHOTRIPSY OF CALCULUS/CALCULI, ANY METHOD
 IC DRAINAGE TUBE
NCREATIC DUCT
F TUBE OR STENT
R PANCREATIC DUCT(S)
REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE


HOUT REPAIR OF TRACHEOESOPHAGEAL FISTULA
H REPAIR OF TRACHEOESOPHAGEAL FISTULA
HOUT REPAIR OF TRACHEOESOPHAGEAL FISTULA
H REPAIR OF TRACHEOESOPHAGEAL FISTULA
           TUL     A
           A
OPLASTY, TRANSABDOMINAL OR TRANSTHORACIC APPROACH




          MAC      H,W W/O PYLOROPLASTY
          ONS      , INCL INTSTINE MOBILIZATION, PREP,&ANASTOMOSIS(ES)


 EAL PERFORATION




 (EG, MALLORY-WEISS)
NAL TUBE (EG, CELESTIN OR MOUSSEAUX-BARBIN)
IN ADDITION TO CODE(S) FOR PRIMARY PROCEDURE)
SOPHAGOGASTROSTOMY, WITH VAGOTOMY;
SOPHAGOGASTROSTOMY, WITH VAGOTOMY; WITH PYLOROPLASTY OR PYLOROMYOTOMY
  SELECTIVE
 LL (HIGHLY SELECTIVE)


 (EG, STAMM PROCEDURE) (SEPARATE PROCEDURE)




 M FOR ENTERIC NUTRITION




DURE) (SEPARATE PROCEDURE)
 NATAL, FOR FEEDING


VERTICAL-BANDED GASTROPLASTY
OTHER THAN VERTICAL-BANDED GASTROPLASTY
 SHORT LIMB (LESS THAN 100 CM) ROUX-EN-Y GASTROENTEROSTOMY
 SMALL INTESTINE RECONSTRUCTION TO LIMIT ABSORPTION

STRUCTION; WITHOUT VAGOTOMY
STRUCTION; WITH VAGOTOMY
         OUT      VAGOTOMY
         VA       GOTOMY




 IVE, ANY METHOD (LIST SEPARATELY IN ADDITION TO PRIMARY PROCEDURE)
S), OR FOREIGN BODY REMOVAL
 AKER TUBE)


MIDGUT VOLVULUS (EG, LADD PROCEDURE)

ASTOMOSIS, EXTERIORIZATION, OR FISTULIZATION; SINGLE ENTEROTOMY
ASTOMOSIS, EXTERIORIZATION, OR FISTULIZATION; MULTIPLE ENTEROTOMIES

          )

         PER     ING
         ING
         TOM     OSIS (LIST SEPARATELY ADDITION CODE, 1 PROCEDURE)
NTEROSTOMY (SEPARATE PROCEDURE)
ROM CADAVER DONOR
 ARTIAL, FROM LIVING DONOR


ARTIAL COLECTOMY (LIST SEPARATELY IN ADDITION TO PRIMARY PROCEDURE)


MANN TYPE PROCEDURE)
ON OF MUCOFISTULA



ROCTOSTOMY

MY, ILEOANAL ANASTOMOSIS, WITH OR WITHOUT LOOP ILEOSTOMY
           WIT     HOUT LOOP ILEOSTOMY



E PROCEDURE)

SECTION AND ANASTOMOSIS
 MOSIS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)

ITH ILEOCOLOSTOMY
OF DISTAL SEGMENT (HARTMANN TYPE PROCEDURE)
TOSTOMY (LOW PELVIC ANASTOMOSIS)
TOSTOMY (LOW PELVIC ANASTOMOSIS) WITH COLOSTOMY
TOSTOMY (LOW PELVIC ANASTOMOSIS) WITH COLOSTOMY
           PI      LEOSTOMY, WITH OR WITHOUT RECTAL MUCOSECTOMY
 ILEOSTOMY


 TE PROCEDURE)




AL MEGACOLON) (SEPARATE PROCEDURE)



           MEN      (S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)
UM, NOT INCLUDING ILEUM; WITH BIOPSY, SINGLE OR MULTIPLE
UM, NOT INCLUDING ILEUM; WITH REMOVAL OF FOREIGN BODY
           SIO      N(S) BY SNARE TECHNIQUE
           SIO      N(S) BY HOT BIOPSY FORCEPS OR BIPOLAR CAUTERY
           AUT      ERY, LASER, HEATER PROBE, STAPLER, PLASMA COAGULATOR)
           ION      (S) NOT AMENABLE TO BIOPSY FORCEPS, CAUTERY OR SNARE
           PRE      DILATION)
UM, NOT INCLUDING ILEUM; WITH PLACEMENT OF PERCUTANEOUS JEJUNOSTOMY TUBE
           ET       OPERCUTANEOUS JEJUNOSTOMY TUBE
           S)       BYBRUSHING OR WASHING (SEPARATE PROCEDURE)
UM, INCLUDING ILEUM; WITH BIOPSY, SINGLE OR MULTIPLE
           UTE      RY, LASER, HEATER PROBE, STAPLER, PLASMA COAGULATOR)
           ILA      TION)
EN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)

PREDILATION)
           HIN      G(SEPARATE PROCEDURE)
BIOPSY, SINGLE OR MULTIPLE
CIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)


           GUL      ATOR)
SION(S) BY HOT BIOPSY FORCEPS OR BIPOLAR CAUTERY
           RY       ORSNARE TECHNIQUE
SION(S) BY SNARE TECHNIQUE
ES PREDILATION)

UM, WOUND, INJURY OR RUPTURE; SINGLE PERFORATION
UM, WOUND, INJURY OR RUPTURE; MULTIPLE PERFORATIONS
            CO       LOSTOMY
            LOS      TOMY
T DILATION, FOR INTESTINAL OBSTRUCTION

OMOSIS OTHER THAN COLORECTAL
ECTAL ANASTOMOSIS (EG, CLOSURE OF HARTMANN TYPE PROCEDURE)




 IVE TISSUE (EG, BLADDER OR OMENTUM)
RY PROCEDURE)




          FO       R PRIMARY PROCEDURE)
O-ANAL ANASTOMOSIS)
TION OF ILEAL RESERVOIR (S OR J), WITH OR WITHOUT LOOP ILEOSTOMY


          TH       ORWITHOUT PROXIMAL DIVERTING OSTOMY
          HAM      EL, OR SOAVE TYPE OPERATION)
 APPROACH; WITH SUBTOTAL OR TOTAL COLECTOMY, WITH MULTIPLE BIOPSIES

           ICE     CTOMY, WWO REM OF TUBE(S), OVARY(S)/ANY COMB THEREOF




R ABLATION, LASER RESECTION, CRYOSURGERY) TRANSANAL APPROACH
MEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)



 ESION BY HOT BIOPSY FORCEPS OR BIPOLAR CAUTERY
 ESION BY SNARE TECHNIQUE
HER LESIONS BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE
           AGU      LATOR)
           ERY      OR SNARE TECHNIQUE (EG, LASER)

 S PREDILATION)
 S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)


S) BY HOT BIOPSY FORCEPS OR BIPOLAR CAUTERY
            LAT     OR)


S) BY SNARE TECHNIQUE
           OR      SNARE TECHNIQUE


AL OR TRANSMURAL FINE NEEDLE ASPIRATION/BIOPSY(S)


           UTC     OLON DECOMPRESSION (SEPARATE PROCEDURE)


AL INJECTION(S), ANY SUBSTANCE
             ROB     E, STAPLER, PLASMA COAGULATOR)
             SY      FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE
             TER     Y
 ), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE
  1 OR MORE STRICTURES
TENT PLACEMENT (INCLUDES PREDILATION)
TRANSANAL, UNDER ANESTHESIA

MY OR FISTULOTOMY, SUBMUSCULAR, WITH OR WITHOUT PLACEMENT OF SETON




R WITHOUT FISSURECTOMY


ECTOMY, WITH OR WITHOUT FISSURECTOMY


ULTIPLE, WITH OR WITHOUT PLACEMENT OF SETON




 OR WASHING (SEPARATE PROCEDURE)



Y FORCEPS OR BIPOLAR CAUTERY
BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE
CAUTERY, LASER, HEATER PROBE, STAPLER, PLASMA COAGULATOR)
          IQU      E




STIBULAR FISTULA

ND SACROPERINEAL APPROACHES
A; PERINEAL OR SACROPERINEAL APPROACH
A; COMBINED TRANSABDOMINAL AND SACROPERINEAL APPROACHES
 ROPERINEAL APPROACH
MBINED ABDOMINAL AND SACROPERINEAL APPROACH
           IN      TESTINAL GRAFT OR PEDICLE FLAPS




(PARK POSTERIOR ANAL REPAIR)

OSUM, HERPETIC VESICLE), SIMPLE; CHEMICAL
OSUM, HERPETIC VESICLE), SIMPLE; ELECTRODESICCATION
OSUM, HERPETIC VESICLE), SIMPLE; CRYOSURGERY
OSUM, HERPETIC VESICLE), SIMPLE; LASER SURGERY
OSUM, HERPETIC VESICLE), SIMPLE; SURGICAL EXCISION
          Y,       CRYOSURGERY, CHEMOSURGERY)




SEPARATE PROCEDURE); INITIA
SEPARATE PROCEDURE); SUBSEQUENT




          EDU      RE)


C OR ECHINOCOCCAL) CYST(S) OR ABSCESS(ES)




ADAVER DONOR
, FROM LIVING DONOR
VING DONOR, ANY AGE
IVING DONOR, ANY AGE
WITH OR WITHOUT HEPATIC ARTERY LIGATION
          R
OVAL OF PACKING




           INC     TEROTOMY OR SPHINCTEROPLASTY
           TER     OTOMY OR SPHINCTEROPLASTY
 DUODENAL EXTRACTION OF CALCULUS (SEPARATE PROCEDURE)
AL OF CALCULUS (SEPARATE PROCEDURE)


 PERCUTANEOUS TRANSHEPATIC OR T-TUBE)

L BILIARY DRAINAGE


 TION TO CODE FOR PRIMARY PROCEDURE)
           PAR      ATE PROCEDURE)
LE OR MULTIPLE
CALCULUS/CALCULI
BILIARY DUCT STRICTURE(S) WITHOUT STENT
BILIARY DUCT STRICTURE(S) WITH STENT




HINCTEROTOMY OR SPHINCTEROPLASTY, WITH OR WITHOUT CHOLANGIOGRAPHY
RE (EG, BURHENNE TECHNIQUE)
THOUT LIVER BIOPSY, WITH OR WITHOUT CHOLANGIOGRAPHY
OSTOMY, GASTROSTOMY, AND JEJUNOSTOMY
NECROTIZING PANCREATITIS

GE BIOPSY)


CREATICOJEJUNOSTOMY
ATICOJEJUNOSTOMY
PE PROCEDURE)

             DUR   E); WITH PANCREATOJEJUNOSTOMY
             DUR   E); WITHOUT PANCREATOJEJUNOSTOMY
             CED   URE); WITH PANCREATOJEJUNOSTOMY
             CED   URE); WITHOUT PANCREATOJEJUNOSTOMY

NCREAS OR PANCREATIC ISLET CELLS

 ADDITION TO CODE FOR PRIMARY PROCEDURE)




M CADAVER DONOR, WITH OR WITHOUT DUODENAL SEGMENT FOR TRANSPLANTATION



SEPARATE PROCEDURE)


ICEAL ABSCESS; OPEN
ICEAL ABSCESS; PERCUTANEOUS




C OR THERAPEUTIC); INITIAL
C OR THERAPEUTIC); SUBSEQUENT
R CYSTS OR ENDOMETRIOMAS;
R CYSTS OR ENDOMETRIOMAS; EXTENSIVE

          OMI       NAL NODE &/ BONE MARROW BIOPSIES, OVARIAN REPOSITION)


          )

NGLE OR MULTIPLE)



VOIR, PERMANENT (IE, TOTALLY IMPLANTABLE)
EMPORARY
ERMANENT

DIOLOGICAL GUIDANCE (SEPARATE PROCEDURE)
 DRAINAGE CATHETER OR TUBE (SEPARATE PROCEDURE)


D PERITONEAL-VENOUS SHUNT


        E,       WITH OR WITHOUT HYDROCELECTOMY; REDUCIBLE
        TH/      WITHOUT HYDROCELECTOMY; INCARCERATED/STRANGULATED
        TI       ME, SURGERY, WITH/WITHOUT HYDROCELECTOMY; REDUCIBLE
        WW       O HYDROCELECTOMY; INCARCERATED/STRANGULATED
HYDROCELECTOMY; REDUCIBLE
HYDROCELECTOMY; INCARCERATED OR STRANGULATED




          TRA       LHERNIA REPAIR)
FINAL REDUCTION AND CLOSURE, IN OPERATING ROOM




 WALL DEFECTS)
Y PROCEDURE)




ND CALYCES (INCLUDING ANATROPHIC PYELOLITHOTOMY)
         CM
         M



UDING COAGULUM PYELOLITHOTOMY)



RIB RESECTION;
RIB RESECTION; COMPLICATED BECAUSE OF PREVIOUS SURGERY ON SAME KIDNEY
          TH       ROMBECTOMY




 ADAVER DONOR, UNILATERAL OR BILATERAL
NTENANCE OF ALLOGRAFT)

PIENT NEPHRECTOMY




ND/OR INJECTION, PERCUTANEOUS
 IS FOR DRAINAGE AND/OR INJECTION, PERCUTANEOUS
           DWE      LLING URETERAL CATHETER
LISH NEPHROSTOMY TRACT, PERCUTANEOUS
G URETERAL CATHETER

          RU        RETERAL SPLINTING; SIMPLE
          RU        RETERAL SPLINTING; COMPLICATED (CONGENITAL)


ABDOMINAL APPROACH
THORACIC APPROACH
HER PLASTIC PROCEDURE, UNILATERAL OR BILATERAL (ONE OPERATION)




          AND       ADRENALECTOMY)

EPARATION AND MAINTENANCE OF ALLOGRAFT)


           E;
           E;     WITH URETERAL CATH, W W/O DILATION URETER
           E;     WITH BIOPSY
           E;     WITH FULGURATION AND/OR INCISION, W W/O BIOPSY
           E;     WITH INSERT RADIOACTIVE SUBSTANCE W W/O BIOPSY
           E;     WITH REMOVAL OF FOREIGN BODY OR CALCULUS
           DIO    LOGIC SERVICE; WITH RESECTION OF TUMOR
LATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE;
           AL     CATHETERIZATION, WITH OR WITHOUT DILATION OF URETER
LATION, OR URETEROPYELOGRAPHY, EXCL OF RADIOLOGIC SERVICE; WITH BIOPSY
           (I     NCCYSTO, URETEROSCOPY, DILATION URETER AND URETERAL)
           CE;    WITH FULGURATION AND/OR INCISION, W W/O BIOPSY
           CE;    WITH INSERT RAD SUBSTANCE, W W/O BIOPSY
           CE;    WITH REMOVAL OF FOREIGN BODY OR CALCULUS




PERINEAL APPROACH
RETEROSTOMY OR INDWELLING URETERAL CATHETER


GRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE



RACT OR VENA CAVA

OF FASCIAL DEFECT AND HERNIA
OF ABDOMINAL OR PERINEAL COLOSTOMY, INCLUDING INTESTINE ANASTOMOSIS

R OPERATION)
MALL AND/OR LARGE INTESTINE (KOCK POUCH OR CAMEY ENTEROCYSTOPLASTY)
          CYS      TOSTOMY)
NE ANASTOMOSIS




AL STENT PLACEMENT
TERAL STENT PLACEMENT

           ERV     ICE;
           ERV     ICE; WITH URETERAL CATH, W W/O DILATION OF URETER
           ERV     ICE; WITH BIOPSY
           ERV     ICE; WITH FULGURATION AND/OR INCISION, W W/O BIOPSY
           ERV     ICE; WITH INSERTION OF RAD SUBSTANCE, W W/O BIOPSY
           ERV     ICE; WITH REMOVAL OF FOREIGN BODY OR CALCULUS
LLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE;
           URE     TERAL CATHETERIZATION, W W/O DILATION OF URETER
           BIO     PSY
           FUL     GURATION AND/OR INCISION, WITH OR WITHOUT BIOPSY
           INS     ERTION OF RADIOACTIVE SUBSTANCE, W W/O BIOPSY
           REM     OVAL OF FOREIGN BODY OR CALCULUS




RESECTION

YDRAULIC FRAGMENTATION OF URETERAL CALCULUS



E PROCEDURE)
 ULT LOCATION)
NEOCYSTOSTOMY)

ERNAL ILIAC, HYPOGASTRIC AND OBTURATOR NODES
ANSPLANTATIONS;
           IL      IAC, HYPOGASTRIC AND OBTURATOR NODES
NG INTESTINE ANASTOMOSIS;
           LUD     ING EXTERNAL ILIAC, HYPOGASTRIC, AND OBTURATOR NODES
NY SEGMENT OF SMALL AND/OR LARGE INTESTINE TO CONSTRUCT NEOBLADDER
           CT      OFRECTUM, COLON & COLOSTOMY, OR ANY COMBINATION

HROCYSTOGRAPHY


FOR RESIDUAL URINE)

ED ANATOMY, FRACTURED CATHETER/BALLOON)


URETHRA AND/OR BLADDER NECK




), ANY TECHNIQUE
NEEDLE, ANY TECHNIQUE



GASTRIC, INTRAPERITONEAL)
ASOUND, NON-IMAGING
           E,       WW/O WEDGE RESECT OF POSTERIOR VESICAL NECK

Z, BURCH); SIMPLE
PE); COMPLICATED (EG, SECONDARY REPAIR)
ROL (EG, STAMEY, RAZ, MODIFIED PEREYRA)




R SYNTHETIC)


          ICE         ;
          BRU         SHBIOPSY OF URETER AND/OR RENAL PELVIS
           CS      ERVICE

           LG      LANDS
           BI      OPSY
GERY) AND/OR RESECTION OF; SMALL BLADDER TUMOR(S) (0.5 TO 2.0 CM)
GERY) AND/OR RESECTION OF; MEDIUM BLADDER TUMOR(S) (2.0 TO 5.0 CM)
GERY) AND/OR RESECTION OF; LARGE BLADDER TUMOR(S)
UT BIOPSY OR FULGURATION
 AL OR CONDUCTION (SPINAL) ANESTHESIA
 ANESTHESIA




           CED     URE FOR CYSTOGRAPHY, MALE OR FEMALE


           SEP     TAL FIBROSIS, POLYP(S) URETHRA, BLADDER NECK

CELE(S), UNILATERAL OR BILATERAL
 (S), UNILATERAL OR BILATERAL
CULUM, SINGLE OR MULTIPLE
  ENT FROM URETHRA OR BLADDER (SEPARATE PROCEDURE); SIMPLE
  ENT FROM URETHRA OR BLADDER (SEPARATE PROCEDURE); COMPLICATED
  AND REMOVAL OF FRAGMENTS; SIMPLE OR SMALL (LESS THAN 2.5 CM)
  AND REMOVAL OF FRAGMENTS; COMPLICATED OR LARGE (OVER 2.5 CM)
 RETERAL CALCULUS
ON OF URETERAL CALCULUS (EG, ULTRASONIC OR ELECTRO-HYDRAULIC TECHNIQUE)
 NJECTION OF IMPLANT MATERIAL
  WITHOUT REMOVAL OF URETERAL CALCULUS
 S OR DOUBLE-J TYPE)
O ESTABLISH A PERCUTANEOUS NEPHROSTOMY, RETROGRADE
 TION, LASER, ELECTROCAUTERY, AND INCISION)
G, BALLOON DILATION, LASER, ELECTROCAUTERY, AND INCISION)
 LATION, LASER, ELECTROCAUTERY, AND INCISION)
URE (EG, BALLOON DILATION, LASER, ELECTROCAUTERY, AND INCISION)
             ION      )
CTURE (EG, BALLOON DILATION, LASER, ELECTROCAUTERY, AND INCISION)


R MANIPULATION OF CALCULUS (URETERAL CATHETERIZATION IS INCLUDED)
Y (URETERAL CATHETERIZATION IS INCLUDED)
 OR FULGURATION OF URETERAL OR RENAL PELVIC LESION
OF URETERAL OR RENAL PELVIC TUMOR
          SAL      FOLDS



           THR     ALCALIBRATION AND/OR DILATION, INTERNAL URETHROTOMY)
E USUAL FOLLOW-UP TIME
 ARTIAL RESECTION)
N (RESECTION COMPLETED)
NE YEAR POSTOPERATIVE

          HRA      LCALIBRATION AND/OR DILATION INTERNAL URETHROTOMY)
          THR      OSCOPY, URETHRAL CALIBRATION DILATION, URETHROTOMY)


ETHRA, EXTERNAL




NNSEN TYPE)


EPAIR OF PROSTATIC OR MEMBRANOUS URETHRA
ANOUS URETHRA; FIRST STAGE
ANOUS URETHRA; SECOND STAGE

DER FOR INCONTINENCE (EG, TENAGO, LEADBETTER PROCEDURE)



NT OF PUMP, RESERVOIR, AND CUFF
ERVOIR, AND CUFF
 LUDING PUMP, RESERVOIR, AND CUFF AT THE SAME OPERATIVE SESSION
            SSI    ON INCLUDING IRRIGATION&DEBRIDEMENT, INFECTED TISSUE
 VOIR, AND CUFF

ARDSON TYPE PROCEDURE)




 E; SUBSEQUENT
HRAL DILATOR, MALE, GENERAL OR CONDUCTION (SPINAL) ANESTHESIA
OSUM, HERPETIC VESICLE), SIMPLE; CHEMICAL
OSUM, HERPETIC VESICLE), SIMPLE; ELECTRODESICCATION
OSUM, HERPETIC VESICLE), SIMPLE; CRYOSURGERY
OSUM, HERPETIC VESICLE), SIMPLE; LASER SURGERY
OSUM, HERPETIC VESICLE), SIMPLE; SURGICAL EXCISION
         RY,      CRYOSURGERY, CHEMOSURGERY)




TOMY, INCLUDING EXTERNAL ILIAC, HYPOGASTRIC AND OBTURATOR NODES



PT NEWBORN




 DRUGS (EG, PAPAVERINE, PHENTOLAMINE)
E, PHENTOLAMINE)


 ITH OR WITHOUT MOBILIZATION OF URETHRA
            IN       FLAPS
RSION); LESS THAN 3 CM
RSION); GREATER THAN 3 CM
RSION) WITH FREE SKIN GRAFT OBTAINED FROM SITE OTHER THAN GENITALIA
ROTUM (EG, THIRD STAGE CECIL REPAIR)
ON); WITH SIMPLE MEATAL ADVANCEMENT (EG, MAGPI, V-FLAP)
            FL       AP)
            RA
          ITH       LOCAL SKIN FLAPS, SKIN GRAFT PATCH, ISLAND FLAP
          GRA       FTTUBE AND/OR ISLAND FLAP
          ND        FLAP
OSURE, INCISION, OR EXCISION, SIMPLE
          PAT       CHGRAFT
          TU        BED GRAFT (INCLUDES URINARY DIVERSION)
          URE       THRA & PENIS; LOCAL SKIN GRAFTS & ISLAND FLAPS


NCONTINENCE
EXSTROPHY OF BLADDER


 ENT OF PUMP, CYLINDERS, AND RESERVOIR
SIS WITHOUT REPLACEMENT OF PROSTHESIS

BLE PENILE PROSTHESIS AT THE SAME OPERATIVE SESSION
           INC      LUDING IRRIGATION&DEBRIDEMENT OF INFECTED TISSUE
ROSTHESIS, WITHOUT REPLACEMENT OF PROSTHESIS
ONTAINED) PENILE PROSTHESIS AT THE SAME OPERATIVE SESSION
           SIO      N, INCLUDING IRRIGATION&DEBRIDEMENT, INFECTED TISSUE
 BILATERAL
AL OR BILATERAL
EDURE, RONGEUR, OR PUNCH) FOR PRIAPISM




STHESIS, SCROTAL OR INGUINAL APPROACH




LATERAL TESTIS




OR HEMATOMA)
N OF MEDICATION




 RAL (SEPARATE PROCEDURE)
RATIVE SEMEN EXAM(S)
ERAL OR BILATERAL

ROCEDURE)


ATE PROCEDURE)
NAL APPROACH
 RNIA REPAIR




          IN       TERNAL URETHROTOMY)

MPHADENECTOMY)
 LUDING EXTERNAL ILIAC, HYPOGASTRIC AND OBTURATOR NODES
           Y);      SUPRAPUBIC, SUBTOTAL, ONE OR TWO STAGES
           Y);      RETROPUBIC, SUBTOTAL

PH NODE BIOPSY(S) (LIMITED PELVIC LYMPHADENECTOMY)
           AND      OBTURATOR NODES
ITIAL RADIOELEMENT APPLICATION, WITH OR WITHOUT CYSTOSCOPY

; WITH LYMPH NODE BIOPSY(S) (LIMITED PELVIC LYMPHADENECTOMY)
          POG      ASTRIC AND OBTURATOR NODES


TERSTITIAL CRYOSURGICAL PROBE PLACEMENT)
RYOSURGERY, CHEMOSURGERY)
Y, CRYOSURGERY, CHEMOSURGERY)

LESION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)




DENECTOMY




SPONTANEOUS BLEEDING)
CRYOSURGERY, CHEMOSURGERY)
RY, CRYOSURGERY, CHEMOSURGERY)



ISSUE (RADICAL VAGINECTOMY)
          OMY      AND PARA-AORTIC LYMPH NODE SAMPLING (BIOPSY)

L TISSUE (RADICAL VAGINECTOMY)
           TOM      Y AND PARA-AORTIC LYMPH NODE SAMPLING (BIOPSY)



ERIAL, PARASITIC, OR FUNGOID DISEASE



C NONOBSTETRICAL VAGINAL HEMORRHAGE (SEPARATE PROCEDURE)


AL PLICATION)
ONTINENCE, AND/OR INCOMPLETE VAGINAL PROLAPSE)




Y RECONSTRUCTION, WITH OR WITHOUT LEVATOR PLICATION




THE CERVIX AND ENDOCERVICAL CURETTAGE
THE CERVIX
 L CURETTAGE
ODE BIOPSY(S) OF THE CERVIX
ODE CONIZATION OF THE CERVIX
 RATION (SEPARATE PROCEDURE)




AND CURETTAGE, WITH OR WITHOUT REPAIR; COLD KNIFE OR LASER
AND CURETTAGE, WITH OR WITHOUT REPAIR; LOOP ELECTRODE EXCISION

          S),     WITH OR WITHOUT REMOVAL OF OVARY(S)




), WITHOUT CERVICAL DILATION, ANY METHOD (SEPARATE PROCEDURE)
           MY       OMAS; ABDOMINAL APPROACH
           MY       OMAS; VAGINAL APPROACH
           MS,      ABDOMINAL APPROACH
 OF TUBE(S), WITH OR WITHOUT REMOVAL OF OVARY(S);
           STO      PEXY (EG, MARSHALL-MARCHETTI-KRANTZ, BURCH)
THOUT REMOVAL OF TUBE(S), WITH OR WITHOUT REMOVAL OF OVARY(S)
           ),       WITH OR WITHOUT REMOVAL OF OVARY(S)
           AL       OFTUBE(S), WITH OR WITHOUT REMOVAL OF OVARY(S)
           VAL      OF BLADDER AND URETERAL TRANSPLANT; ANY COMBINATION

, AND/OR OVARY(S)
, AND/OR OVARY(S), WITH REPAIR OF ENTEROCELE
           END      OSCOPIC CONTROL




UBE(S) AND/OR OVARY(S)
UBE(S) AND/OR OVARY(S), WITH REPAIR OF ENTEROCELE
          HOU     T ENDOSCOPIC CONTROL




          OGR     APHY



 WITHOUT SHORTENING OF SACROUTERINE LIGAMENTS; (SEPARATE PROCEDURE)
          ECT     OMY


 TOTAL WEIGHT OF 250 GRAMS OR LESS AND/OR REMOVAL OF SURFACE MYOMAS
AND/OR INTRAMURAL MYOMAS WITH TOTAL WEIGHT GREATER THAN 250 GRAMS

ESS; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)
250 GRAMS;
250 GRAMS; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)

ECTOMY, WITH OR WITHOUT D & C

NY METHOD)


ON, ELECTROSURGICAL ABLATION, THERMOABLATION)
UNILATERAL OR BILATERAL
           SEP      ARATE PROCEDURE)
           ST       SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
R SUPRAPUBIC APPROACH
EPARATE PROCEDURE)
L OOPHORECTOMY AND/OR SALPINGECTOMY)
 PELVIC VISCERA, OR PERITONEAL SURFACE BY ANY METHOD

R FALOPE RING)




ATE PROCEDURE)




AGINAL APPROACH
BDOMINAL APPROACH


NEOUS (EG, OVARIAN, PERICOLIC)




          RAG     M ASSESS, W/W/O SALPINGECT, W/W/O OMENTECT
 SALPINGO-OOPHORECTOMY AND OMENTECTOMY;
          PA      RA-AORTIC LYMPHADENECTOMY
          UCT     , INTRA-ABDOMINAL/RETROPERITONEAL TUMORS)
RECTOMY AND RADICAL DISSECTION FOR DEBULKING;
          YA      ND LIMITED PARA-AORTIC LYMPHADENECTOMY
          AS      SESS W/PELV& LTD PARA-AORT LYMPHADENECTOMY




SICIAN) WITH WRITTEN REPORT; SUPERVISION AND INTERPRETATION
           LY

GECTOMY AND/OR OOPHORECTOMY, ABDOMINAL OR VAGINAL APPROACH
ECTOMY AND/OR OOPHORECTOMY
EQUIRING TOTAL HYSTERECTOMY
 TH PARTIAL RESECTION OF UTERUS

R OOPHORECTOMY
OPHORECTOMY




 WITHOUT EPISIOTOMY, AND/OR FORCEPS) AND POSTPARTUM CARE

 POSTPARTUM CARE




OSTPARTUM CARE


ADDITION TO CODE FOR PRIMARY PROCEDURE)
          IOU     SCESAREAN DELIVERY
SIOTOMY AND/OR FORCEPS);
SIOTOMY AND/OR FORCEPS); INCLUDING POSTPARTUM CARE
          ESA     REAN DELIVERY
S CESAREAN DELIVERY;
S CESAREAN DELIVERY; INCLUDING POSTPARTUM CARE




          ES;
          ES;      WITH DILATION AND CURETTAGE AND/OR EVACUATION
          ES;      WITH HYSTEROTOMY (FAILED INTRA-AMNIOTIC INJECTION)
          ,D       ELIVERY OF FETUS & SECUNDINES;
          RY       FETUS & SECUNDINES; WITH D&C &/OR EVAC
          RY       FETUS & SECUNDINES; W HYSTEROTOMY (FAILED MED EVAL)
OMY, INCLUDING ISTHMUSECTOMY

 Y, INCLUDING ISTHMUSECTOMY



REMOVAL OF A PORTION OF THYROID
C APPROACH




RATION, STERNAL SPLIT OR TRANSTHORACIC APPROACH
IMARY PROCEDURE)

HOUT RADICAL MEDIASTINAL DISSECTION (SEPARATE PROCEDURE)
H RADICAL MEDIASTINAL DISSECTION (SEPARATE PROCEDURE)
           E);
           E);     WITH EXCISION OF ADJACENT RETROPERITONEAL TUMOR


          OR         DORSAL



  SUBSEQUENT TAPS
MPLANTED VENTRICULAR CATHETER/RESERVOIR; WITHOUT INJECTION
          OR      OTHER SUBSTANCE FOR DIAGNOSIS OR TREATMENT
 ROCEDURE)
OR OTHER SUBSTANCE FOR DIAGNOSIS OR TREATMENT (EG, C1-C2)


RICULAR CATHETER OR PRESSURE RECORDING DEVICE
OR DRAINAGE OF SUBDURAL HEMATOMA
 MEDIA, DYE, OR RADIOACTIVE MATERIAL)


AL ABSCESS OR CYST


(S) OR PRESSURE RECORDING DEVICE (SEPARATE PROCEDURE)
OR CONNECTION TO VENTRICULAR CATHETER
ER SURGERY



TRADURAL OR SUBDURAL
 RACEREBRAL
RADURAL OR SUBDURAL
RACEREBELLAR
IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
          ARE     NCHYMAL HEMATOMA; WITHOUT LOBECTOMY
          TED     INTRAPARENCHYMAL HEMATOMA; WITH LOBECTOMY




          IM      ALFORMATION)


ENSORY ROOT OF GASSERIAN GANGLION




R, SUPRATENTORIAL, EXCEPT MENINGIOMA
 , SUPRATENTORIAL
ESS, SUPRATENTORIAL
ON OF CYST, SUPRATENTORIAL
 DDITION TO CODE FOR PRIMARY PROCEDURE)
            TB      ASE OF SKULL
  MENINGIOMA
  CEREBELLOPONTINE ANGLE TUMOR
  MIDLINE TUMOR AT BASE OF SKULL


 CEREBELLOPONTINE ANGLE TUMOR;
          RAN       IOTOMY/CRANIECTOMY
EPHINE HOLE(S) FOR LONG TERM SEIZURE MONITORING
CTRODE ARRAY, FOR LONG TERM SEIZURE MONITORING
 WITHOUT ELECTROCORTICOGRAPHY DURING SURGERY
          EDU       RE)
          LO        FELECTRODE ARRAY)
 GRAPHY DURING SURGERY, TEMPORAL LOBE
 GRAPHY DURING SURGERY, OTHER THAN TEMPORAL LOBE, PARTIAL OR TOTAL



ROID PLEXUS

L APPROACH
APPROACH, NONSTEREOTACTIC




OVERLEAF SKULL); NOT REQUIRING BONE GRAFTS
           G,       BARREL-STAVE PROCEDURE) (INC OBTAINING GRAFTS)
YSPLASIA); WITHOUT OPTIC NERVE DECOMPRESSION
YSPLASIA); WITH OPTIC NERVE DECOMPRESSION


SY, DECOMPRESSION OR EXCISION OF LESION;
           EA       ND/OR MANDIBLE (INCLUDING TRACHEOSTOMY)
           RO       RBITAL EXENTERATION
           ND/      ORMAXILLECTOMY
           OMY      OF BASE OF ANTERIOR CRANIAL FOSSA
           BE,      OSTEOTOMY OF BASE OF ANTERIOR CRANIAL FOSSA
           OBE      (S); WITHOUT ORBITAL EXENTERATION
           OBE      (S); WITH ORBITAL EXENTERATION
 CRANIAL FOSSA WITH OR WITHOUT INTERNAL FIXATION, WITHOUT BONE GRAFT
           ICU      LATION OF MANDIBLE, INC PAROTIDECTOMY, CRANIOTOMY
           ,I       NFRATEMPORAL FOSSA) INC MASTOIDECTOMY
           GOM      A,CRANIOTOMY, EXTRA/INTRADURAL ELEV TEMPORAL LOBE
           US       AND/OR FACIAL NERVE, WITH OR WITHOUT MOBILIZATION
           IZA      TION OF FACIAL NERVE AND/OR PETROUS CAROTID ARTERY
           MY,      RESECTION OF C1-C3 VERTEBRAL BODY(S)
NUM, INCLUDING LIGATION OF SUPERIOR PETROSAL SINUS AND/OR SIGMOID SINUS
F ANTERIOR CRANIAL FOSSA; EXTRADURAL
           OR       WITHOUT GRAFT
EMPORAL FOSSA, PARAPHARYNGEAL SPACE, PETROUS APEX; EXTRADURAL
           UDI      NGDURAL REPAIR, WITH OR WITHOUT GRAFT
           L
           L,       INCLUDING DURAL REPAIR, WITH OR WITHOUT GRAFT
LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
           YP       ROCEDURE)
 T SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
           PRO      CEDURE)
CAVERNOUS FISTULA BY DISSECTION WITHIN CAVERNOUS SINUS
           EBR      AL BODIES; EXTRADURAL
           EBR      AL BODIES; INTRADURAL, INC DURAL REPAIR, W W/O GRAFT
           OR       FASCIA LATA, ADIPOSE TISS, HOMOLOGOUS/SYNTH GFS)
           NEO      US FLAP(GALEA,TEMPIS,FRONTALIS/OCCIPITALIS MUSC)
           OR       BALOON OCLSIN & EXCLDE VASCU INJRY POST OCLSIN
           TAN      EOUS, ANY METHOD; CENTRAL NERVOUS SYSTEM
           SS       YST, HD/NCK (EXTRACRANIAL,BRACHIOCEPHALIC BRANCH)




CIRCULATION
OBASILAR CIRCULATION

ASILAR CIRCULATION
UDING CLAMP TO CERVICAL CAROTID ARTERY (SELVERSTONE-CRUTCHFIELD TYPE)
 BY INTRACRANIAL AND CERVICAL OCCLUSION OF CAROTID ARTERY
 BY INTRACRANIAL ELECTROTHROMBOSIS
            ER
 AL) ARTERIES
            LLI     DUS OR THALAMUS
            AL      STRUCTURE(S) OTHER THAN GLOBUS PALLIDUS OR THALAMUS
 CRANIAL LESION;
            CE      GUIDANCE
TERM SEIZURE MONITORING
R(S) OR PROBE(S) FOR PLACEMENT OF RADIATION SOURCE
            LIO     N
            ULL     ARY TRACT
 ), ONE OR MORE SESSIONS
            FOR     PRIMARY PROCEDURE)

S, CEREBRAL, CORTICAL
          LLI      DUS,SUBTHALAM NUCL,PERIVENTRIC,PERIAQUEDUCTAL GRAY)

UBCORTICAL

          SIN     GLE ELECTRODE ARRAY
          OO      R MORE ELECTRODE ARRAYS



ENT OF BRAIN
FOR RHINORRHEA/OTORRHEA
G BONE GRAFTS OR CRANIOPLASTY
RANIOPLASTY
          INI     NG GRAFTS)




 CM DIAMETER
 (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
           PAR      ATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
           EPL      ACEMENT, OR REMOVAL OF VENTRICULAR CATHETER)
T, INCLUDING PLACEMENT OF EXTERNAL VENTRICULAR CATHETER FOR DRAINAGE

MENT OF EXTERNAL VENTRICULAR CATHETER FOR DRAINAGE
OR TRANS-SPHENOIDAL APPROACH
 DISTAL CATHETER IN SHUNT SYSTEM


 SIMILAR OR OTHER SHUNT AT SAME OPERATION
           WH      EN ADMINISTERED), MULTI ADHESIOL SESSNS; 2/MORE DA
           LIZ     ATION, MULTIPLE ADHESIOLYSIS SESSIONS; 1 DAY



E OR CATHETER)

            OID
S); EPIDURAL, CERVICAL OR THORACIC
            LU       MBAR, SACRAL (CAUDAL)
 OTHER THAN C1-C2 AND POSTERIOR FOSSA)
            (EG      , MAN/AUTO PERCUT DISKECTOMY,PERCUT LASER DISKECTOMY)


TEBRAL DISK, SINGLE OR MULTIPLE LEVELS, LUMBAR

          SM,      OPIOID,STER,OTH SOL), EPIDUR/SUBARACHNOID;CERV/THORAC
          PIO      ID,STER,OTH SOL),EPIDUR/SUBARACHN;LUMBAR,SACRAL(CAUD)
          NTI      SP,OPIOID,STER,OTH SOL),EPIDUR/SUBARACH;CERV/THORACIC
          SP,      OPIOID,STER,OTH SOL),EPIDUR/SUBARACH;LUMB,SACRL(CAUD)
          BLE      RESERVOIR/INFUSION PUMP; W/O LAMINECTOMY
          ECT      OMY

USION; SUBCUTANEOUS RESERVOIR
USION; NON-PROGRAMMABLE PUMP
           OUT     PROGRAMMING
 THECAL OR EPIDURAL INFUSION
           TAT     US, DRUG PRESCRIPTION STATUS); WITHOUT REPROGRAMMING
           TAT     US, DRUG PRESCRIPTION STATUS); WITH REPROGRAMMING
           NAL     STENOSIS), ONE OR TWO VERTEBRAL SEGMENTS; CERVICAL
           NAL     STENOSIS), ONE OR TWO VERTEBRAL SEGMENTS; THORACIC
           GME     NTS; LUMBAR, EXCEPT SPONDYLOLISTHESIS
           NAL     STENOSIS), ONE OR TWO VERTEBRAL SEGMENTS; SACRAL
           SIS     ,LUMBAR (GILL TYPE PROCEDURE)
           NAL     STENOSIS), MORE THAN 2 VERTEBRAL SEGMENTS; CERVICAL
           NAL     STENOSIS), MORE THAN 2 VERTEBRAL SEGMENTS; THORACIC
           NAL     STENOSIS), MORE THAN 2 VERTEBRAL SEGMENTS; LUMBAR
           ERV     ERTEBRAL DISK; ONE INTERSPACE, CERVICAL
                 1 INTERSPACE, LUMBAR (INCL OPEN/ENDOSCOPIC-ASSIST APPR)
           TER     SP, CERV/LUMB (LIST SEP IN ADD TO CODE FOR PRIM PROC)
           ISK     , REEXPLORATION, SNGL INTERSPACE; CERVICAL
           ERV     ERTEBRAL DISK, RE-EXPLORATION; LUMBAR
           PLO     RATION,SINGLE INTERSPACE;EA ADDTL CERVICAL INTE
           EXP     LORATION,SINGLE INTERSPACE;EA ADDTL LUMBAR INTE
           REC     ESS STENOSIS)), SINGLE VERTEBRAL SEGMENT; CERVICAL
           REC     ESS STENOSIS)), SINGLE VERTEBRAL SEGMENT; THORACIC
           REC     ESS STENOSIS)), SINGLE SEGMENT; LUMBAR
             DD       SEG, CERV, THOR/LUMB (LIST SEP,ADD TO CODE,PRIM PROC)
             RAC      IC
             CET      /LAT EXTRAFORAMIN APPR) (EG,FAR LAT HERN INTERV DISK)
             HA       DDITIONAL SEGMENT, THORACIC OR LUMBAR
 (S), (EG, HERNIATED INTERVERTEBRAL DISK), THORACIC; SINGLE SEGMENT
             ENT      (LIST SEPARATELY IN ADD TO CODE FOR PRIMARY PROC)
 S), INCLUDING OSTEOPHYTECTOMY; CERVICAL, SINGLE INTERSPACE
             (LI      ST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROC)
 S), INCLUDING OSTEOPHYTECTOMY; THORACIC, SINGLE INTERSPACE
             (LI      ST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROC)
             CE       RVICAL, SINGLE SEGMENT
             CE       RVICAL, EACH ADDITIONAL SEGMENT
             T(S      );THORACIC, SINGLE SEGMENT
             T(S      ); THORACIC, EACH ADDITIONAL SEGMENT
             NER      VEROOT(S), LOWER THORACIC OR LUMBAR; SINGLE SEGMENT
             EQU      INA OR NERVE ROOT(S), LOWER THORACIC OR LUMBAR; EACH
             ERV      EROOT(S), LOWER THORACIC, LUMBAR, SACRAL; 1 SEGMENT
             ER       OOT(S), LOWER THORACIC, LUMBAR, OR SACRAL; EA ADD SEG
R THORACOLUMBAR


 CERVICAL; ONE OR TWO SEGMENTS
 CERVICAL; MORE THAN TWO SEGMENTS



 TAGE; CERVICAL
 TAGE; THORACIC
E STAGE; CERVICAL
E STAGE; THORACIC
O STAGES WITHIN 14 DAYS; CERVICAL
O STAGES WITHIN 14 DAYS; THORACIC

PINAL CORD; CERVICAL
PINAL CORD; THORACIC
PINAL CORD; THORACOLUMBAR
OPLASM, EXTRADURAL; CERVICAL
OPLASM, EXTRADURAL; THORACIC
OPLASM, EXTRADURAL; LUMBAR
OPLASM, EXTRADURAL; SACRAL
 RAL; CERVICAL
 RAL; THORACIC
 RAL; LUMBAR
 RAL; SACRAL




EDULLARY, CERVICAL
EDULLARY, THORACIC
EDULLARY, LUMBAR
EDULLARY, CERVICAL
EDULLARY, THORACIC
EDULLARY, THORACOLUMBAR
 AL-INTRADURAL LESION, ANY LEVEL
EXCISION OF INTRASPINAL LESION, SINGLE SEGMENT; EXTRADURAL, CERVICAL
           BY       TRANSTHORACIC APPROACH
           BY       THORACOLUMBAR APPROACH
           SA       CRAL BY TRANSPERITONEAL OR RETROPERITONEAL APPROACH
EXCISION OF INTRASPINAL LESION, SINGLE SEGMENT; INTRADURAL, CERVICAL
           BY       TRANSTHORACIC APPROACH
           BY       THORACOLUMBAR APPROACH
           SA       CRAL BY TRANSPERITONEAL OR RETROPERITONEAL APPROACH
           NT       (LIST SEP IN ADD TO CODES FOR SINGLE SEGMENT)
Y MODALITY (INCLUDING STIMULATION AND/OR RECORDING)
  NOT FOLLOWED BY OTHER SURGERY



RAY(S) OR PLATE/PADDLE(S)
RATOR OR RECEIVER, DIRECT OR INDUCTIVE COUPLING
 R RECEIVER




UDING LAMINECTOMY
CUTANEOUS, NOT REQUIRING LAMINECTOMY




          STH      ETIC AGENT ADMINISTRATION




          THE      TIC AGENT ADMINISTRATION

          HET      IC AGENT ADMINISTRATION
ET JOINT NERVE; CERVICAL OR THORACIC, SINGLE LEVEL
          EPA      RATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
ET JOINT NERVE; LUMBAR OR SACRAL, SINGLE LEVEL
          ATE      LY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
L OR THORACIC, SINGLE LEVEL
          OC       ODE FOR PRIMARY PROCEDURE)
OR SACRAL, SINGLE LEVEL
          DE       FOR PRIMARY PROCEDURE)




VE (EXCLUDES SACRAL NERVE)

RANSFORAMINAL PLACEMENT)


EXCLUDES SACRAL NERVE)


NSFORAMINAL PLACEMENT)

GENERATOR OR RECEIVER, DIRECT OR INDUCTIVE COUPLING

AL, MENTAL, OR INFERIOR ALVEOLAR BRANCH
  BRANCHES AT FORAMEN OVALE
  BRANCHES AT FORAMEN OVALE UNDER RADIOLOGIC MONITORING
R BLEPHAROSPASM, HEMIFACIAL SPASM)
 TORTICOLLIS)
 DYSTONIA, CEREBRAL PALSY, MULTIPLE SCLEROSIS)

R SACRAL, SINGLE LEVEL
          FOR      PRIMARY PROCEDURE)
OR THORACIC, SINGLE LEVEL
          ODE      FOR PRIMARY PROCEDURE)


MONITORING
          NE         UROLYSIS)




          OTO        MY, SUPRA- OR HIGHLY SELECTIVE VAGOTOMY)


DDUCTOR TENOTOMY
DDUCTOR TENOTOMY




DDITION TO CODE FOR PRIMARY PROCEDURE)

LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)


 NEUROMA EXCISION)




ARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)



CODE FOR PRIMARY PROCEDURE)




N TO CODE FOR PRIMARY PROCEDURE)
ADDITION TO CODE FOR PRIMARY NEURORRHAPHY)
  (LIST SEPARATELY IN ADDITION TO CODE FOR NERVE SUTURE)
 IN ADDITION TO CODE FOR NERVE SUTURE)



AN 4 CM LENGTH

4 CM LENGTH
T; UP TO 4 CM LENGTH
T; MORE THAN 4 CM LENGTH
UP TO 4 CM LENGTH
MORE THAN 4 CM LENGTH
 TO CODE FOR PRIMARY PROCEDURE)
IN ADDITION TO CODE FOR PRIMARY PROCEDURE)




ENTS; ONLY
ENTS; WITH THERAPEUTIC REMOVAL OF BONE
ENTS; WITH MUSCLE OR MYOCUTANEOUS FLAP
RILLING RECEPTACLE FOR PROSTHESIS APPENDAGE) (SEPARATE PROCEDURE)

CHED TO IMPLANT
D TO IMPLANT

 NT AND/OR ATTACHMENT OF MUSCLES TO IMPLANT


 CRETIONS), SUBCONJUNCTIVAL, OR SCLERAL NONPERFORATING



TRACTION, ANTERIOR OR POSTERIOR ROUTE
C EXTRACTION
 ON SCLERA, DIRECT CLOSURE
 UT HOSPITALIZATION
HOSPITALIZATION


RESECTION OF UVEAL TISSUE
ON, CURETTAGE)

MOCAUTERIZATION




STIC ASPIRATION OF AQUEOUS
EUTIC RELEASE OF AQUEOUS
           WIT      HOUT AIR INJECTION
 L OF BLOOD, WITH OR WITHOUT IRRIGATION AND/OR AIR INJECTION




          ECH      IAE
          SY       NECHIAE, EXCEPT GONIOSYNECHIAE
          RS       YNECHIAE
          TRE      ALADHESIONS




WITH IRIDECTOMY

E OF PREVIOUS SURGERY
           IFI     BROTIC AGENTS)




OR LATE, MAJOR OR MINOR PROCEDURE
A (SEPARATE PROCEDURE)
EPARATE PROCEDURE)


 ROUGH SMALL INCISION (EG, MCCANNEL SUTURE)




T OF VISION, FOR WIDENING OF ANTERIOR CHAMBER ANGLE)

         ELE       RKNIFE)
         ORE       STAGES)
E PROCEDURE)
         TI        RIDECTOMY (IRIDOCAPSULOTOMY, IRIDOCAPSULECTOMY)

 RASONIC) (EG, PHACOEMULSIFICATION), WITH ASPIRATION




          LOR      RHEXIS)/PERF PTS THE AMBLYOGENIC DEVEL STAGE
THESIS (ONE STAGE PROCEDURE)
          ION      AND ASPIRATION OR PHACOEMULSIFICATION)
D WITH CONCURRENT CATARACT REMOVAL

Y PROCEDURE)

ON); PARTIAL REMOVAL
ON); SUBTOTAL REMOVAL WITH MECHANICAL VITRECTOMY
 APPROACH (POSTERIOR SCLEROTOMY)
XCHANGE), WITH OR WITHOUT ASPIRATION (SEPARATE PROCEDURE)
NCLUDES CONCOMITANT REMOVAL OF VITREOUS


R OPACITIES, LASER SURGERY (ONE OR MORE STAGES)


 AGULATION
OTOCOAGULATION
 MY, WITH OR WITHOUT DRAINAGE OF SUBRETINAL FLUID
           BRE     TINAL FLUID
           RAP     Y,PHOTOCOAGULATION, & DRAINAGE OF SUBRETINAL FLUID
           ,S      CLERAL BUCKLING, &/OR LENS REMOVAL BY SAME TECHNIQUE
 HER GAS (EG, PNEUMATIC RETINOPEXY)
           RAL     BUCKLING OR VITECTOMY TECHNIQUES
WITHOUT DRAINAGE, ONE OR MORE SESSIONS; CRYOTHERAPY, DIATHERMY
           XEN      ONARC)
 R MORE SESSIONS; CRYOTHERAPY, DIATHERMY
 R MORE SESSIONS; PHOTOCOAGULATION
           URC      E(INCLUDES REMOVAL OF SOURCE)
ON); PHOTOCOAGULATION (EG, LASER), ONE OR MORE SESSIONS
ON); PHOTODYNAMIC THERAPY (INCLUDES INTRAVENOUS INFUSION)
           TEL      Y IN ADDITION TO CODE FOR PRIMARY EYE TREATMENT)
 HY), ONE OR MORE SESSIONS; CRYOTHERAPY, DIATHERMY
 HY), ONE OR MORE SESSIONS; PHOTOCOAGULATION (LASER OR XENON ARC)




SLY OPERATED ON); TWO HORIZONTAL MUSCLES
SLY OPERATED ON); ONE VERTICAL MUSCLE (EXCLUDING SUPERIOR OBLIQUE)
         IQU       E)

          PR      OCEDURE)
          COD     E FOR PRIMARY PROCEDURE)
          ICT     IVE MYOPATHY (EG, DYSTHYROID OPHTHALMOPATHY)
          OCE     DURE)
          CO      DE FOR SPECIFIC STRABISMUS SURGERY)
          DUR     E)
PARATE PROCEDURE)



R EXPLORATION, WITH OR WITHOUT BIOPSY
 H DRAINAGE ONLY
 H REMOVAL OF LESION
 H REMOVAL OF FOREIGN BODY
 H REMOVAL OF BONE FOR DECOMPRESSION

 REMOVAL OF LESION
 REMOVAL OF FOREIGN BODY
 DRAINAGE
 REMOVAL OF BONE FOR DECOMPRESSION
EXPLORATION, WITH OR WITHOUT BIOPSY
PPLY OF MEDICATION)
ATION, SINGLE OR MULTIPLE


GERY, CRYOTHERAPY, LASER SURGERY)


E DIRECT CLOSURE



RHAPHY; WITH TRANSPOSITION OF TARSAL PLATE


LUDES OBTAINING FASCIA)
 L APPROACH
AL APPROACH
UDES OBTAINING FASCIA)
TION (EG, FASANELLA-SERVAT TYPE)




RSAL STRIP OPERATIONS)




AL CONJUNCTIVA DIRECT CLOSURE; PARTIAL THICKNESS
AL CONJUNCTIVA DIRECT CLOSURE; FULL THICKNESS


          AP      WITH ADJ TISSUE TRF/REARRANGE; <1/4TH OF LID MARGIN
          AP      WITH ADJ TISSUE TRF/REARRANGE; >1/4TH OF LID MARGIN
          IRS     TSTAGE
          AGE
          AGE
FLAP FROM OPPOSING EYELID; SECOND STAGE




EXTENSIVE REARRANGEMENT
NE GRAFT (INCLUDES OBTAINING GRAFT)
BRANE (INCLUDES OBTAINING GRAFT)
 OF CONFORMER OR CONTACT LENS




NSERTION OF TUBE OR STENT




 ANESTHESIA
TUBE OR STENT




AN ROUTINE CLEANING)

DUE TO INJURY, INFECTION) (SEPARATE PROCEDURE)
G GENERAL ANESTHESIA




FOR CLOSURE, WITH OR WITHOUT PATCH

          CTI     ON
          OST     FENESTRATION)
          NTH     ETIC PROSTHESIS (PORP/TORP)
          OSS     ICULAR CHAIN RECONSTRUCTION
          ICU     LAR CHAIN RECONSTRUCTION
          ICU     LAR CHAIN RECONSTRUCTION AND SYNTHETIC PROSTHESIS
RY, TYMPANIC MEMBRANE REPAIR); WITHOUT OSSICULAR CHAIN RECONSTRUCTION
RY, TYMPANIC MEMBRANE REPAIR); WITH OSSICULAR CHAIN RECONSTRUCTION
          OUT     OSSICULAR CHAIN RECONSTRUCTION
          ,W      ITH OSSICULAR CHAIN RECONSTRUCTION
          CHA     INRECONSTRUCTION
          IN      RECONSTRUCTION

Y, WITH OR WITHOUT USE OF FOREIGN MATERIAL;
Y, WITH OR WITHOUT USE OF FOREIGN MATERIAL; WITH FOOTPLATE DRILL OUT




DEVICE IN TEMPORAL BONE
MPORAL BONE
            STO     IDECTOMY
          IDE     CTOMY
          CES     SOR/COCHLEAR STIMULATOR; WITHOUT MASTOIDECTOMY
          CES     SOR/COCHLEAR STIMULATOR; WITH MASTOIDECTOMY


N; LATERAL TO GENICULATE GANGLION
N; INCLUDING MEDIAL TO GENICULATE GANGLION

          OR     MULTIPLE PERFUSIONS); TRANSCANAL
RUCTIVE PROCEDURES OR TACK PROCEDURE; WITH MASTOIDECTOMY




RATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)




OUT STEREO
GNIFICATION TECHNIQUE




BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS
 NNER EAR; WITHOUT CONTRAST MATERIAL
 NNER EAR; WITH CONTRAST MATERIAL(S)
           S)      AND FURTHER SECTIONS


WED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS


ED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS
          ST-     PROCESSING
          ST-     PROCESSING
 RAST MATERIAL(S)
T MATERIAL(S)
          ENC     ES


WED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES


WED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES
 T CONTRAST MATERIAL
ONTRAST MATERIAL(S)
          SEQ      UENCES



 RDOTIC PROCEDURE
PROJECTIONS




N AND INTERPRETATION

NIMUM OF THREE VIEWS

IMUM OF FOUR VIEWS
TRAST MATERIAL(S) AND FURTHER SECTIONS
         OST        #NAME?
ND MEDIASTINAL LYMPHADENOPATHY); WITHOUT CONTRAST MATERIAL(S)
ND MEDIASTINAL LYMPHADENOPATHY); WITH CONTRAST MATERIAL(S)
         LOW       ED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES
HOUT CONTRAST MATERIAL(S)




ON A