Most services performed by a PCP in the office setting can be reimbursed without obtaining Prior Authorization.
The following office-based services do not require prior authorization. If you plan to offer a service not found on this list you will need to submit a Prior Authorization request to HCP for review.
| 10060 | INCISION AND DRAINAGE OF SINGLE FURUNCLE |
| 10021 | FINE NEEDLE ASPIRATION OF FIRST LESION |
| 10040 | MARSUPIALIZATION OF MULTIPLE COMEDONES |
| 10061 | COMPLICATED INCISION AND DRAINAGE OF PARONYCHIA |
| 10080 | SIMPLE INCISION AND DRAINAGE OF PILONIDAL CYST |
| 10081 | COMPLICATED INCISION AND DRAINAGE OF PILONIDAL CYST |
| 10120 | INCISION OF SUBCUTANEOUS TISSUE WITH REMOVAL OF FOREIGN BODY |
| 10121 | COMPLICATED INCISION OF SUBCUTANEOUS TISSUE WITH REMOVAL OF FOREIGN BODY |
| 10160 | PUNCTURE ASPIRATION OF HEMATOMA |
| 11000 | DEBRIDEMENT OF INFECTED SKIN |
| 11042 | DEBRIDEMENT OF SUBCUTANEOUS TISSUE |
| 11043 | DEBRIDEMENT OF MUSCLE AND FASCIA |
| 11045 | DEBRIDEMENT OF SUBCUTANEOUS TISSUE, INCLUDING EPIDERMIS AND DERMIS, EACH ADDITIONAL 20 SQUARE CMS OR LESS |
| 11046 | DEBRIDEMENT OF MUSCLE AND FASCIA, INCLUDING EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, EACH ADDITIONAL 20 SQUARE CMS OR LESS |
| 11055 | CUTTING OF SINGLE BENIGN HYPERKERATOTIC LESION |
| 11056 | CUTTING OF 2-4 CORNS |
| 11057 | PARING OF MORE THAN 4 CALLUSES |
| 11102 | UNDER BIOPSY PROCEDURES ON THE SKIN |
| 11200 | REMOVAL OF FIBROCUTANEOUS TAG |
| 11201 | REMOVAL OF FIBROCUTANEOUS TAG |
| 11300 | SHAVING OF DERMAL LESION OF LOWER LIMB |
| 11301 | SHAVING OF DERMAL LESION OF LOWER LIMB |
| 11302 | SHAVING OF DERMAL LESION OF UPPER LIMB |
| 11303 | SHAVING OF DERMAL LESION OF UPPER LIMB |
| 11305 | SHAVING OF EPIDERMAL LESION OF FOOT |
| 11306 | SHAVING OF DERMAL LESION OF HAND |
| 11307 | SHAVING OF EPIDERMAL LESION OF FOOT |
| 11308 | SHAVING OF DERMAL LESION OF GENITALIA |
| 11310 | SHAVING OF DERMAL LESION OF MUCOUS MEMBRANE |
| 11311 | SHAVING OF DERMAL LESION OF NOSE |
| 11312 | SHAVING OF DERMAL LESION OF NOSE |
| 11313 | SHAVING OF DERMAL LESION OF EAR |
| 11400 | EXCISION OF BENIGN LESION OF LOWER LIMB, INCLUDING MARGINS, EXCISED DIAMETER 0.5 CM OR LESS |
| 11401 | EXCISION OF BENIGN LESION OF UPPER LIMB |
| 11402 | EXCISION OF BENIGN LESION OF UPPER LIMB, INCLUDING MARGINS, EXCISED DIAMETER 1.1 TO 2.0 CM |
| 11403 | EXCISION OF BENIGN LESION OF TRUNK, INCLUDING MARGINS, EXCISED DIAMETER 2.1 TO 3.0 CM |
| 11404 | EXCISION OF BENIGN LESION OF LOWER LIMB, INCLUDING MARGINS, EXCISED DIAMETER 3.1 TO 4.0 CM |
| 11406 | EXCISION OF BENIGN LESION OF LOWER LIMB, INCLUDING MARGINS, EXCISED DIAMETER OVER 4.0 CM |
| 11420 | EXCISION OF BENIGN LESION OF NECK, INCLUDING MARGINS, EXCISED DIAMETER 0.5 CM OR LESS |
| 11421 | EXCISION OF BENIGN LESION OF GENITALIA |
| 11422 | EXCISION OF BENIGN LESION OF FOOT, INCLUDING MARGINS, EXCISED DIAMETER 1.1 TO 2.0 CM |
| 11423 | EXCISION OF BENIGN LESION OF FOOT, INCLUDING MARGINS, EXCISED DIAMETER 2.1 TO 3.0 CM |
| 11424 | EXCISION OF BENIGN LESION OF GENITALIA |
| 11426 | EXCISION OF BENIGN LESION OF FOOT, INCLUDING MARGINS, EXCISED DIAMETER OVER 4.0 CM |
| 11440 | EXCISION OF BENIGN LESION OF EAR, INCLUDING MARGINS, EXCISED DIAMETER 0.5 CM OR LESS |
| 11441 | EXCISION OF BENIGN LESION OF EAR, INCLUDING MARGINS, EXCISED DIAMETER 0.6 TO 1.0 CM |
| 11442 | EXCISION OF BENIGN LESION OF LIP, INCLUDING MARGINS, EXCISED DIAMETER 1.1 TO 2.0 CM |
| 11443 | EXCISION OF BENIGN LESION OF LIP |
| 11444 | EXCISION OF BENIGN LESION OF EAR |
| 11446 | EXCISION OF BENIGN LESION OF MUCOUS MEMBRANE |
| 11600 | EXCISION OF MALIGNANT LESION OF LOWER LIMB |
| 11601 | EXCISION OF MALIGNANT LESION OF UPPER LIMB |
| 11602 | EXCISION OF MALIGNANT LESION OF UPPER LIMB |
| 11603 | EXCISION OF MALIGNANT LESION OF LOWER LIMB, INCLUDING MARGINS, EXCISED DIAMETER 2.1 TO 3.0 CM |
| 11604 | EXCISION OF MALIGNANT LESION OF LOWER LIMB, INCLUDING MARGINS, EXCISED DIAMETER 3.1 TO 4.0 CM |
| 11606 | EXCISION OF MALIGNANT LESION OF TRUNK |
| 11620 | EXCISION OF MALIGNANT LESION OF GENITALIA, INCLUDING MARGINS, EXCISED DIAMETER 0.5 CM OR LESS |
| 11621 | EXCISION OF MALIGNANT LESION OF SCALP |
| 11622 | EXCISION OF MALIGNANT LESION OF HAND |
| 11623 | EXCISION OF MALIGNANT LESION OF FOOT |
| 11624 | EXCISION OF MALIGNANT LESION OF NECK |
| 11626 | EXCISION OF MALIGNANT LESION OF GENITALIA |
| 11719 | TRIMMING OF NONDYSTROPHIC NAILS |
| 11720 | DEBRIDEMENT OF 1-5 NAILS |
| 11721 | DEBRIDEMENT OF 6 OR MORE NAILS |
| 11730 | PARTIAL AVULSION OF NAIL PLATE |
| 11732 | COMPLETE AVULSION OF NAIL PLATE |
| 11740 | EVACUATION OF SUBUNGUAL HEMATOMA |
| 11750 | PARTIAL EXCISION OF NAIL AND NAIL MATRIX FOR PERMANENT REMOVAL OF DEFORMED NAIL |
| 11765 | WEDGE EXCISION OF SKIN OF NAIL FOLD |
| 11770 | SIMPLE EXCISION OF PILONIDAL SINUS |
| 11900 | INTRALESIONAL INJECTION OF 1 TO 7 LESIONS |
| 11901 | INTRALESIONAL INJECTION |
| 12001 | REPAIR OF WOUND OF AXILLA |
| 12002 | REPAIR OF WOUND OF NECK |
| 12004 | SIMPLE REPAIR OF SUPERFICIAL WOUND OF TRUNK, 7.6 CM TO 12.5 CM |
| 12005 | SIMPLE REPAIR OF SUPERFICIAL WOUND OF SCALP, 12.6 CM TO 20.0 CM |
| 12006 | REPAIR OF WOUND OF EXTERNAL GENITALIA |
| 12007 | SIMPLE REPAIR OF SUPERFICIAL WOUND OF TRUNK, OVER 30.0 CM |
| 12011 | REPAIR OF WOUND OF EYELID |
| 12013 | REPAIR OF WOUND OF EYELID |
| 12014 | REPAIR OF WOUND OF EYELID |
| 12015 | REPAIR OF WOUND OF EAR |
| 12016 | REPAIR OF WOUND OF NOSE |
| 12017 | REPAIR OF WOUND OF FACE |
| 12018 | REPAIR OF WOUND OF MUCOUS MEMBRANE |
| 16000 | INITIAL LOCAL TREATMENT OF FIRST DEGREE BURN |
| 16020 | DEBRIDEMENT OF PARTIAL THICKNESS BURN |
| 17000 | CHEMOSURGERY OF PREMALIGNANT LESION, FIRST LESION |
| 17003 | DESTRUCTION OF ACTINIC KERATOSES, SECOND THROUGH 14 LESIONS |
| 17004 | LASER SURGERY OF PREMALIGNANT LESIONS, 15 OR MORE |
| 17106 | LASER SURGERY OF CUTANEOUS VASCULAR PROLIFERATIVE LESION, LESS THAN 10.0 SQ CM |
| 17107 | LASER SURGERY OF CUTANEOUS VASCULAR PROLIFERATIVE LESION, 10.0 TO 50.0 SQ CM |
| 17108 | LASER DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESION, OVER 50 SQ CM |
| 17110 | LASER SURGERY OF BENIGN LESION |
| 17111 | CHEMOSURGERY OF BENIGN LESION |
| 17250 | CHEMICAL CAUTERIZATION OF GRANULATION TISSUE |
| 17340 | CRYOTHERAPY FOR ACNE USING LIQUID N2 |
| 20520 | REMOVAL OF FOREIGN BODY FROM TENDON SHEATH |
| 20526 | THERAPEUTIC INJECTION OF CARPAL TUNNEL |
| 20550 | INJECTION OF APONEUROSIS OF TENDON SHEATH |
| 20551 | INJECTION OF SINGLE TENDON INSERTION |
| 20552 | INJECTION OF MULTIPLE TRIGGER POINTS OF 1 MUSCLE |
| 20553 | INJECTION OF MULTIPLE TRIGGER POINTS OF 3 OR MORE MUSCLES |
| 20600 | ARTHROCENTESIS AND INJECTION OF JOINT OF FINGER |
| 20605 | ARTHROCENTESIS AND INJECTION OF INTERMEDIATE JOINT |
| 20610 | ARTHROCENTESIS OF KNEE JOINT |
| 20612 | INJECTION OF GANGLION CYST |
| 29130 | APPLICATION OF STATIC TYPE FINGER SPLINT |
| 29131 | APPLICATION OF DYNAMIC TYPE FINGER SPLINT |
| 29580 | STRAPPING OF UNNA BOOT |
| 30300 | REMOVAL OF INTRANASAL FOREIGN BODY |
| 30901 | CONTROL OF ANTERIOR NASAL HEMORRHAGE |
| 31600 | TRACHEOSTOMY |
| 45300 | DIAGNOSTIC RIGID PROCTOSIGMOIDOSCOPY |
| 45305 | RIGID PROCTOSIGMOIDOSCOPY WITH BIOPSY |
| 45307 | RIGID PROCTOSIGMOIDOSCOPY WITH REMOVAL OF FOREIGN BODY |
| 45308 | RIGID PROCTOSIGMOIDOSCOPY WITH REMOVAL OF POLYP USING HOT BIOPSY FORCEPS |
| 45309 | RIGID PROCTOSIGMOIDOSCOPY WITH REMOVAL OF POLYP USING SNARE |
| 45315 | RIGID PROCTOSIGMOIDOSCOPY WITH REMOVAL OF LESION USING BIPOLAR CAUTERY |
| 45320 | RIGID PROCTOSIGMOIDOSCOPY WITH ABLATION OF LESION |
| 45330 | DIAGNOSTIC FLEXIBLE SIGMOIDOSCOPY WITH COLLECTION OF SPECIMEN BY WASHING |
| 45331 | FLEXIBLE SIGMOIDOSCOPY WITH BIOPSY |
| 45332 | FLEXIBLE SIGMOIDOSCOPY WITH REMOVAL OF FOREIGN BODY |
| 45333 | FLEXIBLE SIGMOIDOSCOPY WITH REMOVAL OF POLYP USING BIPOLAR CAUTERY |
| 45334 | FLEXIBLE SIGMOIDOSCOPY WITH CONTROL OF BLEEDING |
| 45335 | FLEXIBLE SIGMOIDOSCOPY WITH DIRECTED SUBMUCOSAL INJECTION |
| 45337 | FLEXIBLE SIGMOIDOSCOPY WITH DECOMPRESSION OF VOLVULUS |
| 45338 | FLEXIBLE SIGMOIDOSCOPY WITH REMOVAL OF LESION USING SNARE |
| 46600 | DIAGNOSTIC ANOSCOPY |
| 46900 | CHEMICAL DESTRUCTION OF LESION OF ANUS |
| 46910 | ELECTRODESICCATION OF LESION OF ANUS |
| 46916 | CRYOSURGICAL DESTRUCTION OF LESION OF ANUS |
| 46917 | LASER SURGICAL DESTRUCTION OF LESION OF ANUS |
| 51701 | INSERTION OF NON-INDWELLING BLADDER CATHETER |
| 51702 | INSERTION OF FOLEY CATHETER INTO BLADDER |
| 54050 | SIMPLE CHEMICAL DESTRUCTION OF HERPETIC VESICLE OF PENIS |
| 54055 | ELECTRODESICCATION OF PAPILLOMA OF PENIS |
| 54056 | SIMPLE CRYOSURGERY OF CONDYLOMA OF PENIS |
| 54057 | LASER SURGERY OF PAPILLOMA OF PENIS |
| 54060 | EXCISION OF PAPILLOMA OF PENIS |
| 54150 | CIRCUMCISION USING CLAMP WITH REGIONAL DORSAL PENILE BLOCK |
| 54160 | CIRCUMCISION BY SURGICAL EXCISION IN NEONATE |
| 64400 | INJECTION OF ANESTHETIC AGENT INTO TRIGEMINAL NERVE |
| 64402 | INJECTION OF ANESTHETIC AGENT INTO FACIAL NERVE |
| 64405 | INJECTION OF ANESTHETIC AGENT INTO GREATER OCCIPITAL NERVE |
| 64408 | INJECTION OF ANESTHETIC AGENT INTO VAGUS NERVE |
| 64410 | INJECTION OF ANESTHETIC AGENT INTO PHRENIC NERVE |
| 64413 | INJECTION OF ANESTHETIC AGENT INTO CERVICAL PLEXUS |
| 64415 | SINGLE INJECTION OF ANESTHETIC AGENT INTO BRACHIAL PLEXUS |
| 64417 | INJECTION OF ANESTHETIC AGENT INTO AXILLARY NERVE |
| 64418 | INJECTION OF ANESTHETIC AGENT INTO SUPRASCAPULAR NERVE |
| 64420 | INJECTION OF ANESTHETIC AGENT INTO INTERCOSTAL NERVE |
| 64445 | INJECTION OF ANESTHETIC AGENT INTO SCIATIC NERVE |
| 64447 | INJECTION OF ANESTHETIC AGENT INTO FEMORAL NERVE |
| 64450 | INJECTION OF ANESTHETIC AGENT INTO PERIPHERAL NERVE |
| 64455 | INJECTION OF ANESTHETIC AGENT AND STEROID INTO PLANTAR COMMON DIGITAL NERVE |
| 70030 | X-RAY FOR DETECTION OF FOREIGN BODY OF EYE |
| 70100 | PARTIAL X-RAY OF MANDIBLE |
| 70110 | COMPLETE X-RAY OF MANDIBLE, POSTEROANTERIOR, OBLIQUE, AND LATERAL VIEWS |
| 70120 | X-RAY OF MASTOIDS, FRONTAL VIEW |
| 70130 | COMPLETE X-RAY OF MASTOIDS WITH MINIMUM OF 3 VIEWS PER SIDE |
| 70134 | X-RAY OF INTERNAL AUDITORY MEATI |
| 70140 | X-RAY OF FACIAL BONES, WATERS VIEW |
| 70150 | COMPLETE X-RAY OF FACIAL BONES |
| 70160 | COMPLETE X-RAY OF NASAL BONES |
| 70170 | RADIOLOGIC SUPERVISION AND INTERPRETATION FOR DACRYOCYSTOGRAPHY OF NASOLACRIMAL DUCT |
| 70190 | X-RAY OF OPTIC FORAMINA |
| 70200 | X-RAY OF ORBITS |
| 70210 | X-RAY OF PARANASAL SINUSES, FEWER THAN 3 VIEWS |
| 70220 | COMPLETE X-RAY OF PARANASAL SINUSES, WITH WATERS, CALDWELL, AND SUBMENTAL VERTICAL VIEWS |
| 70240 | X-RAY OF SELLA TURCICA |
| 70250 | X-RAY OF SKULL, POSTEROANTERIOR, LATERAL, AND TOWNES VIEWS |
| 70260 | COMPLETE X-RAY OF SKULL WITH MINIMUM OF 4 VIEWS |
| 70328 | UNILATERAL X-RAY OF TEMPOROMANDIBULAR JOINT WITH OPEN AND CLOSED MOUTH VIEWS |
| 70330 | BILATERAL X-RAY OF TEMPOROMANDIBULAR JOINT |
| 70360 | X-RAY OF SOFT TISSUE OF NECK |
| 71045 | X-RAY OF CHEST, SINGLE VIEW |
| 71046 | X-RAY OF CHEST, 2 VIEWS |
| 71047 | X-RAY OF CHEST, 3 VIEWS |
| 71048 | X-RAY OF CHEST, MINIMUM OF 4 VIEWS |
| 71100 | UNILATERAL X-RAY OF RIBS |
| 71101 | UNILATERAL X-RAY OF RIBS AND POSTEROANTERIOR CHEST |
| 71110 | BILATERAL X-RAY OF RIBS, ANTEROPOSTERIOR AND RIGHT AND LEFT POSTERIOR OBLIQUE VIEWS |
| 71111 | BILATERAL X-RAY OF RIBS, POSTEROANTERIOR AND RIGHT AND LEFT ANTEROPOSTERIOR OBLIQUE VIEWS, AND X-RAY OF CHEST, POSTEROANTERIOR VIEW |
| 71120 | X-RAY OF STERNUM |
| 71130 | X-RAY OF STERNOCLAVICULAR JOINTS, POSTEROANTERIOR AND LEFT AND RIGHT ANTERIOR OBLIQUE VIEWS |
| 72020 | X-RAY OF SPINE, ANTEROPOSTERIOR VIEW AT LUMBAR LEVEL |
| 72040 | X-RAY OF CERVICAL SPINE |
| 72050 | X-RAY OF CERVICAL SPINE, 5 VIEWS |
| 72052 | X-RAY OF CERVICAL SPINE, ANTEROPOSTERIOR, LATERAL, ODONTOID, SWIMMER, AND CROSS-TABLE LATERAL VIEWS, INCLUDING FLEXION AND EXTENSION STUDY |
| 72070 | X-RAY OF THORACIC SPINE |
| 72072 | X-RAY OF THORACIC SPINE, 3 VIEWS |
| 72074 | X-RAY OF THORACIC SPINE, MINIMUM OF 4 VIEWS |
| 72080 | X-RAY OF THORACOLUMBAR SPINE |
| 72081 | X-RAY OF THORACOLUMBAR SPINE WITH SKULL, CERVICAL AND SACRAL SPINE, SINGLE VIEW |
| 72082 | X-RAY OF THORACOLUMBAR SPINE, 2 VIEWS |
| 72083 | X-RAY OF THORACOLUMBAR SPINE, 4 OR 5 VIEWS |
| 72084 | X-RAY OF THORACOLUMBAR SPINE, MINIMUM OF 6 VIEWS |
| 72100 | X-RAY OF LUMBOSACRAL SPINE, ANTEROPOSTERIOR, LATERAL, AND OBLIQUE VIEWS |
| 72110 | X-RAY OF LUMBOSACRAL SPINE, ANTEROPOSTERIOR, LATERAL, OBLIQUE, AND CONED-DOWN LATERAL SPOT LUMBOSACRAL JUNCTION VIEWS |
| 72114 | COMPLETE X-RAY OF LUMBOSACRAL SPINE WITH ANTEROPOSTERIOR, LATERAL, RIGHT AND LEFT OBLIQUE, AND RIGHT AND LEFT BENDING VIEWS |
| 72120 | X-RAY OF LUMBOSACRAL SPINE, 2 BENDING VIEWS |
| 72170 | X-RAY OF PELVIS, ANTEROPOSTERIOR AND FROG-LEG LATERAL VIEW |
| 72190 | X-RAY OF PELVIS |
| 72200 | X-RAY OF SACROILIAC JOINTS |
| 72202 | X-RAY OF SACROILIAC JOINTS |
| 72220 | X-RAY OF SACRUM AND COCCYX, ANTEROPOSTERIOR AND LATERAL VIEWS |
| 73000 | X-RAY OF CLAVICLE |
| 73010 | COMPLETE X-RAY OF SCAPULA, SUPINE ANTEROPOSTERIOR AND STANDING LATERAL VIEWS |
| 73020 | X-RAY OF SHOULDER, GRASHEY ANTEROPOSTERIOR VIEW |
| 73030 | X-RAY OF SHOULDER, ANTEROPOSTERIOR AND LATERAL Y VIEWS |
| 73050 | BILATERAL X-RAY OF ACROMIOCLAVICULAR JOINTS |
| 73060 | X-RAY OF HUMERUS |
| 73070 | X-RAY OF ELBOW, 2 VIEWS |
| 73080 | X-RAY OF ELBOW |
| 73090 | X-RAY OF FOREARM |
| 73092 | X-RAY OF UPPER EXTREMITY OF INFANT, MINIMUM OF 2 VIEWS |
| 73100 | X-RAY OF WRIST |
| 73110 | X-RAY OF WRIST |
| 73120 | X-RAY OF HAND, 2 VIEWS |
| 73130 | X-RAY OF HAND, MINIMUM OF 3 VIEWS |
| 73140 | X-RAY OF FINGERS, POSTEROANTERIOR AND OBLIQUE VIEWS |
| 73501 | UNILATERAL X-RAY OF HIPS WITH PELVIS, SINGLE VIEW |
| 73502 | BILATERAL X-RAY OF HIPS, 2 – 3 VIEWS |
| 73503 | BILATERAL X-RAY OF HIPS, MINIMUM OF 4 VIEWS |
| 73521 | BILATERAL X-RAY OF HIPS WITH PELVIS, 2 VIEWS |
| 73522 | BILATERAL X-RAY OF HIPS, 4 VIEWS |
| 73523 | BILATERAL X-RAY OF HIPS, MINIMUM OF 5 VIEWS |
| 73551 | X-RAY OF FEMUR, SINGLE VIEW |
| 73552 | X-RAY OF FEMUR, MINIMUM OF 2 VIEWS |
| 73560 | X-RAY OF KNEE, SUNRISE VIEW |
| 73562 | X-RAY OF KNEE |
| 73564 | COMPLETE X-RAY OF KNEE, ANTEROPOSTERIOR, LATERAL, MEDIAL OBLIQUE, AND SUNRISE VIEWS |
| 73565 | BILATERAL X-RAY OF KNEES, STANDING ANTEROPOSTERIOR VIEW |
| 73590 | X-RAY OF TIBIA AND FIBULA |
| 73592 | X-RAY OF LOWER EXTREMITY OF INFANT |
| 73600 | X-RAY OF ANKLE, ANTEROPOSTERIOR AND LATERAL OBLIQUE VIEWS |
| 73610 | COMPLETE X-RAY OF ANKLE, ANTEROPOSTERIOR, MEDIAL OBLIQUE, AND LATERAL OBLIQUE VIEWS |
| 73620 | X-RAY OF FOOT, ANTEROPOSTERIOR AND OBLIQUE VIEWS |
| 73630 | X-RAY OF FOOT |
| 73650 | X-RAY OF CALCANEUS, MINIMUM OF 2 VIEWS |
| 73660 | X-RAY OF TOE, ANTEROPOSTERIOR AND LATERAL VIEWS |
| 74022 | COMPLETE ACUTE ABDOMEN X-RAY SERIES, SUPINE, ERECT, DECUBITUS VIEWS, AND SINGLE CHEST VIEW |
| 74190 | RADIOLOGIC SUPERVISION AND INTERPRETATION FOR PERITONEOGRAM |
| 74210 | X-RAY OF PHARYNX |
| 74220 | X-RAY OF ESOPHAGUS |
| 74240 | X-RAY OF UPPER GASTROINTESTINAL TRACT WITH DELAYED FILMS, WITHOUT KIDNEY, URETER AND BLADDER (KUB) X-RAY |
| 74241 | X-RAY OF UPPER GASTROINTESTINAL TRACT WITHOUT DELAYED FILMS, WITH KIDNEY, URETER AND BLADDER (KUB) X-RAY |
| 74245 | X-RAY OF UPPER GASTROINTESTINAL TRACT WITH SMALL INTESTINE, WITH MULTIPLE SERIAL FILMS |
| 74250 | X-RAY OF SMALL INTESTINE WITH MULTIPLE SERIAL FILMS |
| 77080* | DUAL-ENERGY X-RAY ABSORPTIOMETRY BONE DENSITY STUDY OF PELVIS |
| 77081* | DUAL-ENERGY X-RAY ABSORPTIOMETRY BONE DENSITY STUDY OF HEEL |
| 81000 | MANUAL URINALYSIS USING TABLET REAGENT AND MICROSCOPY OF URINE |
| 81001 | AUTOMATED URINALYSIS USING DIP STICK AND MICROSCOPY OF URINE |
| 81002 | MANUAL URINALYSIS USING DIP STICK |
| 81003 | AUTOMATED URINALYSIS USING DIP STICK |
| 81005 | SEMIQUANTITATIVE URINALYSIS |
| 81025 | URINE PREGNANCY TEST USING VISUAL COLOR COMPARISON METHOD |
| 82270* | QUALITATIVE ANALYSIS OF OCCULT BLOOD IN FECES BY PEROXIDASE ACTIVITY |
| 82272* | QUALITATIVE ANALYSIS OF OCCULT BLOOD IN FECES BY PEROXIDASE ACTIVITY |
| 82274* | QUALITATIVE IMMUNOASSAY FOR HEMOGLOBIN IN FECES |
| 82947 | MEASUREMENT OF GLUCOSE IN BLOOD |
| 82948 | MEASUREMENT OF GLUCOSE IN BLOOD USING REAGENT STRIP |
| 82950 | MEASUREMENT OF GLUCOSE AFTER GLUCOSE DOSE |
| 82962 | MEASUREMENT OF BLOOD GLUCOSE USING FDA-APPROVED HOME GLUCOSE MONITORING DEVICE |
| 83036 | MEASUREMENT OF GLYCOSYLATED HEMOGLOBIN (HBA1C) |
| 83037 | MEASUREMENT OF GLYCOSYLATED HEMOGLOBIN BY FDA-APPROVED HOME DEVICE |
| 85013 | MEASUREMENT OF SPUN MICROHEMATOCRIT |
| 85014 | MEASUREMENT OF HEMATOCRIT (HCT) |
| 85018 | MEASUREMENT OF HEMOGLOBIN (HGB) |
| 85610 | PROTHROMBIN TIME TEST |
| 86580* | INTRADERMAL TUBERCULOSIS SKIN TEST |
| 87210 | WET MOUNT SMEAR FROM PRIMARY SOURCE WITH INTERPRETATION |
| 87804 | INFLUENZA ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION |
| 87806* | HIV-1 ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION |
| 87810 | CHLAMYDIA TRACHOMATIS ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION |
| 87880 | GROUP A STREPTOCOCCUS ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION |
| 90371* | HUMAN HEPATITIS B IMMUNE GLOBULIN |
| 90389* | HUMAN TETANUS IMMUNE GLOBULIN |
| 90396* | HUMAN VARICELLA-ZOSTER IMMUNE GLOBULIN |
| 90460* | ADMINISTRATION OF FIRST OR ONLY COMPONENT OF EACH VACCINE VIA ANY ROUTE WITH COUNSELING BY NON-PHYSICIAN QUALIFIED HEALTH CARE PROFESSIONAL |
| 90461* | ADMINISTRATION OF EACH ADDITIONAL TOXOID COMPONENT VIA ANY ROUTE WITH COUNSELING BY NON-PHYSICIAN QUALIFIED HEALTH CARE PROFESSIONAL |
| 90471* | INTRADERMAL ADMINISTRATION OF A SINGLE VACCINE |
| 90472* | INTRADERMAL ADMINISTRATION OF EACH ADDITIONAL COMBINATION VACCINE |
| 90473* | INTRANASAL ADMINISTRATION OF SINGLE VACCINE |
| 90474* | INTRANASAL ADMINISTRATION OF SINGLE TOXOID |
| 90620* | MENINGOCOCCAL RECOMBINANT VACCINE, FOR INTRAMUSCULAR USE |
| 90621* | MENINGOCOCCAL RECOMBINANT LIPOPROTEIN VACCINE, FOR INTRAMUSCULAR USE |
| 90625* | CHOLERA VACCINE |
| 90630* | SPLIT VIRUS, PRESERVATIVE-FREE INFLUENZA VIRUS VACCINE |
| 90632* | HEPATITIS A VACCINE, ADULT DOSAGE |
| 90633* | HEPATITIS A VACCINE, ADOLESCENT DOSAGE |
| 90634* | HEPATITIS A VACCINE, ADOLESCENT DOSAGE |
| 90636* | HEPATITIS A AND HEPATITIS B VACCINE |
| 90644* | MENINGOCOCCAL CONJUGATE VACCINE, SEROGROUPS C & Y AND HEMOPHILUS INFLUENZA B VACCINE |
| 90647* | HEMOPHILUS INFLUENZA B VACCINE, PRP-OMP CONJUGATE |
| 90648* | HEMOPHILUS INFLUENZA B VACCINE, PRP-T CONJUGATE |
| 90649* | HPV VACCINE, TYPE 6 (QUADRIVALENT) |
| 90650* | HPV VACCINE, TYPE 18, BIVALENT |
| 90651* | HUMAN PAPILLOMAVIRUS (HPV) VACCINE TYPE 6 (NONAVALENT) |
| 90653* | INFLUENZA VIRUS VACCINE, INACTIVATED |
| 90654* | SPLIT VIRUS, PRESERVATIVE-FREE INFLUENZA VIRUS VACCINE |
| 90655* | SPLIT VIRUS, PRESERVATIVE-FREE INFLUENZA VIRUS VACCINE, TRIVALENT, FOR INTRAMUSCULAR USE |
| 90656* | SPLIT VIRUS, PRESERVATIVE-FREE INFLUENZA VIRUS VACCINE, TRIVALENT, FOR INTRAMUSCULAR USE |
| 90657* | SPLIT VIRUS INFLUENZA VIRUS VACCINE, TRIVALENT, FOR INTRAMUSCULAR USE |
| 90658* | SPLIT VIRUS INFLUENZA VIRUS VACCINE, TRIVALENT, FOR INTRAMUSCULAR USE |
| 90660* | LIVE INFLUENZA VIRUS VACCINE |
| 90661* | INFLUENZA VIRUS VACCINE, DERIVED FROM CELL CULTURES, SUBUNIT, PRESERVATIVE AND ANTIBIOTIC FREE, TRIVALENT, FOR INTRAMUSCULAR USE |
| 90662* | SPLIT VIRUS, PRESERVATIVE FREE INFLUENZA VIRUS VACCINE, ENHANCED IMMUNOGENICITY VIA INCREASED ANTIGEN CONTENT |
| 90664* | LIVE INFLUENZA VIRUS VACCINE, PANDEMIC FORMULATION |
| 90670* | PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT |
| 90672* | INFLUENZA VIRUS VACCINE, LIVE, QUADRIVALENT |
| 90673* | LIVE VIRUS, TRIVALENT PRESERVATIVE-FREE INFLUENZA VIRUS VACCINE |
| 90674* | QUADRIVALENT INFLUENZA VIRUS VACCINE, DERIVED FROM CELL CULTURES, SUBUNIT, PRESERVATIVE AND ANTIBIOTIC FREE, FOR INTRAMUSCULAR USE |
| 90675* | RABIES VACCINE |
| 90676* | RABIES VACCINE |
| 90680* | LIVE ROTAVIRUS VACCINE, PENTAVALENT |
| 90681* | LIVE ROTAVIRUS VACCINE, HUMAN, ATTENUATED |
| 90682* | INFLUENZA VIRUS VACCINE, QUADRIVALENT (RIV4), DERIVED FROM RECOMBINANT DNA, HEMAGGLUTININ (HA) PROTEIN ONLY, PRESERVATIVE AND ANTIBIOTIC FREE, FOR INTRAMUSCULAR USE |
| 90685* | SPLIT VIRUS, PRESERVATIVE FREE INFLUENZA VIRUS VACCINE, QUADRIVALENT, FOR INTRAMUSCULAR USE |
| 90686* | SPLIT VIRUS, PRESERVATIVE FREE INFLUENZA VIRUS VACCINE, QUADRIVALENT, FOR INTRAMUSCULAR USE |
| 90687* | SPLIT VIRUS INFLUENZA VIRUS VACCINE QUADRIVALENT, 0.25 ML DOSAGE, FOR INTRAMUSCULAR USE |
| 90688* | SPLIT VIRUS INFLUENZA VIRUS VACCINE, QUADRIVALENT, 0.5 ML DOSAGE, FOR INTRAMUSCULAR USE |
| 90690* | LIVE TYPHOID VACCINE |
| 90691* | TYPHOID VACCINE, VI CAPSULAR POLYSACCHARIDE |
| 90696* | DIPHTHERIA, TETANUS TOXOIDS, ACELLULAR PERTUSSIS VACCINE AND POLIOVIRUS VACCINE, INACTIVATED |
| 90697* | DIPHTHERIA, TETANUS TOXOIDS, ACELLULAR PERTUSSIS VACCINE, HEMOPHILUS INFLUENZA B, HEPATITIS B, AND POLIOVIRUS VACCINE |
| 90698* | INACTIVATED DIPHTHERIA, TETANUS TOXOIDS, ACELLULAR PERTUSSIS VACCINE, HAEMOPHILUS INFLUENZA TYPE B, AND POLIOVIRUS VACCINE |
| 90700* | DIPHTHERIA, TETANUS TOXOIDS, AND ACELLULAR PERTUSSIS VACCINE |
| 90702* | DIPHTHERIA AND TETANUS TOXOIDS ADSORBED |
| 90707* | LIVE MEASLES, MUMPS AND RUBELLA VIRUS VACCINE |
| 90710* | LIVE MEASLES, MUMPS, RUBELLA, AND VARICELLA VACCINE |
| 90713* | INACTIVATED POLIOVIRUS VACCINE |
| 90714* | PRESERVATIVE FREE TETANUS AND DIPHTHERIA ADSORBED TOXOIDS |
| 90715* | TETANUS, DIPHTHERIA TOXOIDS AND ACELLULAR PERTUSSIS VACCINE |
| 90716* | LIVE VARICELLA VIRUS VACCINE |
| 90717* | LIVE YELLOW VIRUS VACCINE |
| 90723* | INACTIVATED DIPHTHERIA, TETANUS TOXOIDS, ACELLULAR PERTUSSIS VACCINE, HEPATITIS B, AND POLIOVIRUS VACCINE |
| 90732* | PNEUMOCOCCAL POLYSACCHARIDE VACCINE, 23-VALENT |
| 90733* | MENINGOCOCCAL POLYSACCHARIDE VACCINE |
| 90734* | MENINGOCOCCAL CONJUGATE VACCINE, SEROGROUPS A, C, Y AND W-135 (QUADRIVALENT), FOR INTRAMUSCULAR USE |
| 90736* | LIVE ZOSTER (SHINGLES) VACCINE |
| 90738* | INACTIVATED JAPANESE ENCEPHALITIS VIRUS VACCINE |
| 90739* | HEPATITIS B VACCINE |
| 90740* | HEPATITIS B VACCINE |
| 90743* | HEPATITIS B VACCINE |
| 90744* | HEPATITIS B VACCINE |
| 90746* | HEPATITIS B VACCINE |
| 90747* | HEPATITIS B VACCINE |
| 90748* | HEPATITIS B AND HEMOPHILUS INFLUENZA B VACCINE |
| 90750* | ZOSTER (SHINGLES) VACCINE (HZV), RECOMBINANT, SUBUNIT, ADJUVANTED, FOR INTRAMUSCULAR USE |
| 90751* | Initial History And Examination Related To The Healthy Individual, Including Anticipatory Guidance; Adolescent (age 12 Through 17 Years) |
| 90752* | Initial History And Examination Related To The Healthy Individual, Including Anticipatory Guidance; Late Childhood (age 5 Through 11 Years) |
| 90753* | nitial History And Examination Related To The Healthy Individual, Including Anticipatory Guidance; Early Childhood (age 1 Through 4 Years) |
| 90754* | Initial History And Examination Related To The Healthy Individual, Including Anticipatory Guidance; Infant (age Under 1 Year) |
| 90755* | Newborn Care, In Other Than Hospital Setting, Including Physical Examination Of Baby And Conference(s) With Parent(s) |
| 90756* | INFLUENZA VIRUS VACCINE, QUADRIVALENT (CCIIV4), DERIVED FROM CELL CULTURES, SUBUNIT, ANTIBIOTIC FREE, 0.5 ML DOSAGE, FOR INTRAMUSCULAR USE |
| 93000 | ROUTINE ECG WITH AT LEAST 12 LEADS WITH INTERPRETATION AND REPORT |
| 93005 | TRACING OF ROUTINE ECG WITH AT LEAST 12 LEADS |
| 93010 | INTERPRETATION AND REPORT OF ROUTINE ECG WITH AT LEAST 12 LEADS |
| 93040 | RHYTHM ECG, 1-3 LEADS WITH INTERPRETATION AND REPORT |
| 93041 | TRACING OF RHYTHM ECG, 1-3 LEADS |
| 93042 | INTERPRETATION AND REPORT OF RHYTHM ECG, 1-3 LEADS |
| 93970 | BILATERAL DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS |
| 93971 | UNILATERAL DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS |
| 94010 | SPIROMETRY, INCLUDING GRAPHIC RECORD, TOTAL AND TIMED VITAL CAPACITY, EXPIRATORY FLOW RATE MEASUREMENTS WITH MAXIMAL VOLUNTARY VENTILATION |
| 94060 | BRONCHODILATION RESPONSIVENESS, SPIROMETRY, PRE- AND POST-BRONCHODILATOR ADMINISTRATION |
| 94150 | VITAL CAPACITY |
| 94375 | RESPIRATORY FLOW VOLUME LOOP |
| 94617 | EXERCISE TEST FOR BRONCHOSPASM |
| 94618 | PULMONARY STRESS TESTING BY 6-MINUTE WALK |
| 94640 | PRESSURIZED OR NONPRESSURIZED INHALATION DIAGNOSTIC TREATMENT |
| 96360 | INTRAVENOUS HYDRATION INFUSION |
| 96361 | INTRAVENOUS HYDRATION INFUSION |
| 97597 | DEBRIDEMENT OF OPEN WOUND INCLUDING TOPICAL APPLICATIONS, WOUND ASSESSMENT AND INSTRUCTIONS FOR ONGOING CARE |
| 97602 | NON-SELECTIVE DEBRIDEMENT OF DEVITALIZED TISSUE FROM WOUND, INCLUDING TOPICAL APPLICATIONS, WOUND ASSESSMENT, AND INSTRUCTIONS FOR ONGOING CARE |
| 98925 | OSTEOPATHIC MANIPULATIVE TREATMENT |
| 98926 | OSTEOPATHIC MANIPULATIVE TREATMENT |
| 98927 | OSTEOPATHIC MANIPULATIVE TREATMENT |
| 98928 | OSTEOPATHIC MANIPULATIVE TREATMENT |
| 98929 | OSTEOPATHIC MANIPULATIVE TREATMENT |
| 99201 | LEVEL 1 OUTPATIENT VISIT FOR EVALUATION AND MANAGEMENT OF NEW PATIENT WITH SELF-LIMITED AND/OR MINOR PROBLEM, INCLUDING PROBLEM-FOCUSED HISTORY AND PHYSICAL EXAMINATION, AND STRAIGHTFORWARD MEDICAL DECISION-MAKING – TYPICAL TIME WITH PATIENT AND/OR FAMILY 10 MINUTES OR LESS |
| 99202 | LEVEL 2 OUTPATIENT VISIT FOR EVALUATION AND MANAGEMENT OF NEW PATIENT WITH PROBLEM OF LOW TO MODERATE SEVERITY, INCLUDING EXPANDED PROBLEM-FOCUSED HISTORY AND PHYSICAL EXAMINATION, AND STRAIGHTFORWARD MEDICAL DECISION-MAKING – TYPICAL TIME WITH PATIENT AND/OR FAMILY 20 MINUTES |
| 99203 | LEVEL 3 OUTPATIENT VISIT FOR EVALUATION AND MANAGEMENT OF NEW PATIENT WITH PROBLEM OF MODERATE SEVERITY, INCLUDING DETAILED HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF LOW COMPLEXITY – TYPICAL TIME WITH PATIENT AND/OR FAMILY 30 MINUTES |
| 99204 | LEVEL 4 OUTPATIENT VISIT FOR EVALUATION AND MANAGEMENT OF NEW PATIENT WITH PROBLEM OF MODERATE TO HIGH SEVERITY, INCLUDING COMPREHENSIVE HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY – TYPICAL TIME WITH PATIENT AND/OR FAMILY 45 MINUTES |
| 99205 | LEVEL 5 OUTPATIENT VISIT FOR EVALUATION AND MANAGEMENT OF NEW PATIENT WITH PROBLEM OF MODERATE TO HIGH SEVERITY, INCLUDING COMPREHENSIVE HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF HIGH COMPLEXITY – TYPICAL TIME WITH PATIENT AND/OR FAMILY 60 MINUTES |
| 99211 | LEVEL 1 OUTPATIENT VISIT FOR EVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT WITH MINIMAL PRESENTING PROBLEM, WITHOUT HISTORY, PHYSICAL EXAMINATION, OR MEDICAL DECISION MAKING – TYPICAL TIME LESS THAN 5 MINUTES |
| 99212 | LEVEL 2 OUTPATIENT VISIT FOR EVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT WITH SELF-LIMITED AND/OR MINOR PROBLEM, INCLUDING PROBLEM-FOCUSED PHYSICAL EXAMINATION AND STRAIGHTFORWARD MEDICAL DECISION-MAKING- TYPICAL TIME WITH PATIENT AND/OR FAMILY 10 MINUTES OR LESS |
| 99213 | LEVEL 3 OUTPATIENT VISIT FOR EVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT WITH PROBLEM OF LOW TO MODERATE SEVERITY, INCLUDING EXPANDED HISTORY AND PHYSICAL EXAMINATION – TYPICAL TIME WITH PATIENT AND/OR FAMILY 15 MINUTES |
| 99214 | LEVEL 4 OUTPATIENT VISIT FOR EVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT WITH PROBLEM OF MODERATE TO HIGH SEVERITY, INCLUDING DETAILED PHYSICAL EXAMINATION AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY – TYPICAL TIME WITH PATIENT AND/OR FAMILY 25 MINUTES |
| 99215 | LEVEL 5 OUTPATIENT VISIT FOR EVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT WITH PROBLEM OF MODERATE TO HIGH SEVERITY, INCLUDING COMPREHENSIVE PHYSICAL EXAMINATION AND MEDICAL DECISION MAKING OF HIGH COMPLEXITY – TYPICAL TIME WITH PATIENT AND/OR FAMILY 40 MINUTES |
| 99217 | OBSERVATION CARE DISCHARGE DAY MANAGEMENT, DISCHARGE DAY SUBSEQUENT TO INITIAL OBSERVATION DAY |
| 99218 | LEVEL 1 INITIAL OBSERVATION CARE FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM OF LOW SEVERITY, INCLUDING DETAILED HISTORY AND PHYSICAL EXAMINATION, AND STRAIGHTFORWARD MEDICAL DECISION MAKING – TYPICAL TIME 30 MINUTES |
| 99219 | LEVEL 2 INITIAL OBSERVATION CARE FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM OF MODERATE SEVERITY, INCLUDING COMPREHENSIVE HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY – TYPICAL TIME 50 MINUTES |
| 99220 | LEVEL 3 INITIAL OBSERVATION CARE FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM OF HIGH SEVERITY, INCLUDING COMPREHENSIVE HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF HIGH COMPLEXITY – TYPICAL TIME 70 MINUTES |
| 99221 | LEVEL 1 INITIAL HOSPITAL CARE FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM OF LOW SEVERITY, INCLUDING DETAILED HISTORY AND PHYSICAL EXAMINATION, AND STRAIGHTFORWARD MEDICAL DECISION MAKING – TYPICAL TIME 30 MINUTES |
| 99222 | LEVEL 2 INITIAL HOSPITAL CARE FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM OF MODERATE SEVERITY, INCLUDING COMPREHENSIVE HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION-MAKING OF MODERATE COMPLEXITY – TYPICAL TIME 50 MINUTES |
| 99223 | LEVEL 3 INITIAL HOSPITAL CARE FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM OF HIGH SEVERITY, INCLUDING COMPREHENSIVE HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION-MAKING OF HIGH COMPLEXITY – TYPICAL TIME 70 MINUTES |
| 99224 | LEVEL 1 SUBSEQUENT OBSERVATION CARE FOR EVALUATION AND MANAGEMENT OF PATIENT, INCLUDING PROBLEM FOCUSED INTERVAL HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF LOW COMPLEXITY – TYPICAL TIME 15 MINUTES |
| 99225 | LEVEL 2 SUBSEQUENT OBSERVATION CARE FOR EVALUATION AND MANAGEMENT OF PATIENT, INCLUDING EXPANDED PROBLEM FOCUSED INTERVAL HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY- TYPICAL TIME 25 MINUTES |
| 99226 | LEVEL 3 SUBSEQUENT OBSERVATION CARE FOR EVALUATION AND MANAGEMENT OF PATIENT, INCLUDING DETAILED INTERVAL HISTORY AND MEDICAL DECISION MAKING OF HIGH COMPLEXITY- TYPICAL TIME 35 MINUTES |
| 99231 | LEVEL 1 SUBSEQUENT HOSPITAL CARE FOR EVALUATION AND MANAGEMENT OF PATIENT, INCLUDING DETAILED HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF LOW COMPLEXITY – TYPICAL TIME 15 MINUTES |
| 99232 | LEVEL 2 SUBSEQUENT HOSPITAL CARE FOR EVALUATION AND MANAGEMENT OF PATIENT, INCLUDING EXPANDED PROBLEM FOCUSED INTERVAL HISTORY AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY – TYPICAL TIME 25 MINUTES |
| 99233 | LEVEL 3 SUBSEQUENT HOSPITAL CARE FOR EVALUATION AND MANAGEMENT OF PATIENT, INCLUDING DETAILED INTERVAL HISTORY AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY – TYPICAL TIME 35 MINUTES |
| 99234 | OBSERVATION CARE WITH ADMISSION AND DISCHARGE ON SAME DATE, FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM OF LOW SEVERITY, INCLUDING DETAILED HISTORY AND PHYSICAL EXAMINATION, AND STRAIGHTFORWARD MEDICAL DECISION MAKING |
| 99235 | OBSERVATION CARE WITH ADMISSION AND DISCHARGE ON SAME DATE, FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM OF MODERATE SEVERITY, INCLUDING COMPREHENSIVE HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY |
| 99236 | OBSERVATION CARE WITH ADMISSION AND DISCHARGE ON SAME DATE, FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM OF HIGH SEVERITY, INCLUDING COMPREHENSIVE HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF HIGH COMPLEXITY |
| 99238 | HOSPITAL DISCHARGE DAY MANAGEMENT, 30 MINUTES OR LESS |
| 99239 | HOSPITAL DISCHARGE DAY MANAGEMENT, MORE THAN 30 MINUTES |
| 99281 | LEVEL 1 EMERGENCY DEPARTMENT VISIT FOR EVALUATION AND MANAGEMENT OF PATIENT WITH SELF-LIMITED AND/OR MINOR PROBLEM, INCLUDING PROBLEM-FOCUSED HISTORY AND PHYSICAL EXAMINATION, AND STRAIGHTFORWARD MEDICAL DECISION-MAKING |
| 99282 | LEVEL 2 EMERGENCY DEPARTMENT VISIT FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM OF LOW TO MODERATE SEVERITY, INCLUDING EXPANDED PROBLEM-FOCUSED HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION-MAKING OF LOW COMPLEXITY |
| 99283 | LEVEL 3 EMERGENCY DEPARTMENT VISIT FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM OF MODERATE SEVERITY, INCLUDING EXPANDED PROBLEM-FOCUSED HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION-MAKING OF MODERATE COMPLEXITY |
| 99284 | LEVEL 4 EMERGENCY DEPARTMENT VISIT FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM OF HIGH SEVERITY, INCLUDING DETAILED HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION-MAKING OF MODERATE COMPLEXITY |
| 99285 | LEVEL 5 EMERGENCY DEPARTMENT VISIT FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM IMMEDIATELY THREATENING PHYSIOLOGIC FUNCTION, INCLUDING COMPREHENSIVE HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION-MAKING OF HIGH COMPLEXITY |
| 99291 | CRITICAL CARE FOR EVALUATION AND MANAGEMENT OF CRITICALLY ILL PATIENT, FIRST 30-74 MIN |
| 99292 | CRITICAL CARE FOR EVALUATION AND MANAGEMENT OF CRITICALLY INJURED PATIENT, EACH ADDITIONAL 30 MINUTES |
| 99304 | LEVEL 1 INITIAL NURSING FACILITY CARE FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM OF LOW SEVERITY, INCLUDING DETAILED HISTORY AND PHYSICAL EXAMINATION, AND STRAIGHTFORWARD MEDICAL DECISION MAKING – TYPICAL TIME 25 MINUTES |
| 99305 | LEVEL 2 INITIAL NURSING FACILITY CARE FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM OF MODERATE SEVERITY, INCLUDING COMPREHENSIVE HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY – TYPICAL TIME 35 MINUTES |
| 99306 | LEVEL 3 INITIAL NURSING FACILITY CARE FOR EVALUATION AND MANAGEMENT OF PATIENT WITH PROBLEM OF HIGH SEVERITY, INCLUDING COMPREHENSIVE HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF HIGH COMPLEXITY – TYPICAL TIME 45 MINUTES |
| 99307 | LEVEL 1 SUBSEQUENT NURSING FACILITY CARE FOR EVALUATION AND MANAGEMENT OF PATIENT, INCLUDING PROBLEM FOCUSED INTERVAL HISTORY AND PHYSICAL EXAMINATION – TYPICAL TIME 10 MINUTES |
| 99308 | LEVEL 2 SUBSEQUENT NURSING FACILITY CARE FOR EVALUATION AND MANAGEMENT OF PATIENT, INCLUDING EXPANDED PROBLEM FOCUSED PHYSICAL EXAMINATION AND MEDICAL DECISION MAKING OF LOW COMPLEXITY – TYPICAL TIME 15 MINUTES |
| 99309 | LEVEL 3 SUBSEQUENT NURSING FACILITY CARE FOR EVALUATION AND MANAGEMENT OF PATIENT, INCLUDING DETAILED INTERVAL HISTORY AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY – TYPICAL TIME 25 MINUTES |
| 99310 | LEVEL 4 SUBSEQUENT NURSING FACILITY CARE FOR EVALUATION AND MANAGEMENT OF PATIENT, INCLUDING COMPREHENSIVE PHYSICAL EXAMINATION AND MEDICAL DECISION MAKING OF HIGH COMPLEXITY – TYPICAL TIME 35 MINUTES |
| 99315 | NURSING FACILITY DISCHARGE DAY MANAGEMENT, 30 MINUTES OR LESS |
| 99316 | NURSING FACILITY DAY MANAGEMENT, MORE THAN 30 MINUTES |
| 99318 | ANNUAL NURSING FACILITY ASSESSMENT FOR EVALUATION AND MANAGEMENT OF PATIENT, INCLUDING DETAILED INTERVAL HISTORY, COMPREHENSIVE PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF LOW TO MODERATE COMPLEXITY – TYPICAL TIME 30 MINUTES |
| 99324 | LEVEL 1 REST CUSTODIAL VISIT FOR EVALUATION AND MANAGEMENT OF NEW PATIENT WITH PROBLEM OF LOW SEVERITY, INCLUDING PROBLEM-FOCUSED HISTORY AND PHYSICAL EXAMINATION, AND STRAIGHTFORWARD MEDICAL DECISION-MAKING – TYPICAL TIME WITH PATIENT, FAMILY, AND/OR CAREGIVER 20 MINUTES |
| 99325 | LEVEL 2 DOMICILIARY VISIT FOR EVALUATION AND MANAGEMENT OF NEW PATIENT WITH PROBLEM OF MODERATE SEVERITY, INCLUDING EXPANDED PROBLEM-FOCUSED HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION-MAKING OF LOW COMPLEXITY – TYPICAL TIME WITH PATIENT, FAMILY, AND/OR CAREGIVER 30 MINUTES |
| 99326 | LEVEL 3 REST HOME VISIT FOR EVALUATION AND MANAGEMENT OF NEW PATIENT WITH PROBLEM OF MODERATE TO HIGH SEVERITY, INCLUDING DETAILED HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION-MAKING OF MODERATE COMPLEXITY – TYPICAL TIME WITH PATIENT, FAMILY, AND/OR CAREGIVER 45 MINUTES |
| 99327 | LEVEL 4 REST HOME VISIT FOR EVALUATION AND MANAGEMENT OF NEW PATIENT WITH PROBLEM OF HIGH SEVERITY, INCLUDING COMPREHENSIVE HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION-MAKING OF MODERATE COMPLEXITY – TYPICAL TIME WITH PATIENT, FAMILY, AND/OR CAREGIVER 60 MINUTES |
| 99328 | LEVEL 5 DOMICILIARY VISIT FOR EVALUATION AND MANAGEMENT OF NEW PATIENT WITH PROBLEM OF HIGH SEVERITY, INCLUDING COMPREHENSIVE HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION-MAKING OF HIGH COMPLEXITY – TYPICAL TIME WITH PATIENT, FAMILY, AND/OR CAREGIVER 75 MINUTES |
| 99334 | LEVEL 1 REST HOME VISIT FOR EVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT WITH MINOR AND/OR SELF-LIMITED PROBLEM, INCLUDING PROBLEM-FOCUSED PHYSICAL EXAMINATION AND STRAIGHTFORWARD MEDICAL DECISION-MAKING – TYPICAL TIME WITH PATIENT, FAMILY, AND/OR CAREGIVER 15 MINUTES |
| 99335 | LEVEL 2 CUSTODIAL CARE VISIT FOR EVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT WITH PROBLEM OF LOW TO MODERATE SEVERITY, INCLUDING EXPANDED PROBLEM-FOCUSED INTERVAL HISTORY AND MEDICAL DECISION-MAKING OF LOW COMPLEXITY – TYPICAL TIME WITH PATIENT, FAMILY, AND/OR CAREGIVER 25 MINUTES |
| 99336 | LEVEL 3 CUSTODIAL CARE VISIT FOR EVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT WITH PROBLEM OF MODERATE TO HIGH SEVERITY, INCLUDING DETAILED INTERVAL HISTORY AND MEDICAL DECISION-MAKING OF MODERATE COMPLEXITY – TYPICAL TIME WITH PATIENT, FAMILY, AND/OR CAREGIVER 40 MINUTES |
| 99337 | LEVEL 4 DOMICILIARY VISIT FOR EVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT WITH PROBLEM OF MODERATE TO HIGH SEVERITY, INCLUDING DETAILED COMPREHENSIVE PHYSICAL EXAMINATION AND MEDICAL DECISION-MAKING OF MODERATE COMPLEXITY – TYPICAL TIME WITH PATIENT, FAMILY, AND/OR CAREGIVER 40 MINUTES |
| 99341 | LEVEL 1 HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF NEW PATIENT WITH PROBLEM OF LOW SEVERITY, INCLUDING PROBLEM FOCUSED HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF LOW COMPLEXITY – TYPICAL TIME WITH PATIENT AND/OR FAMILY 20 MINUTES |
| 99342 | LEVEL 2 HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF NEW PATIENT WITH PROBLEM OF MODERATE SEVERITY, INCLUDING EXPANDED PROBLEM FOCUSED HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY – TYPICAL TIME WITH PATIENT AND/OR FAMILY 30 MINUTES |
| 99343 | LEVEL 3 HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF NEW PATIENT WITH PROBLEM OF MODERATE TO HIGH SEVERITY, INCLUDING DETAILED HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY – TYPICAL TIME WITH PATIENT AND/OR FAMILY 45 MINUTES |
| 99344 | LEVEL 4 HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF NEW PATIENT WITH PROBLEM OF HIGH SEVERITY, INCLUDING COMPREHENSIVE HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY – TYPICAL TIME 60 MINUTES |
| 99345 | LEVEL 5 HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF NEW PATIENT WITH PROBLEM OF HIGH SEVERITY, INCLUDING COMPREHENSIVE HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF HIGH COMPLEXITY – TYPICAL TIME WITH PATIENT AND/OR FAMILY 75 MINUTES |
| 99347 | LEVEL 1 HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT WITH MINOR AND/OR SELF LIMITED PROBLEM, INCLUDING PROBLEM FOCUSED INTERVAL HISTORY AND PHYSICAL EXAMINATION – TYPICAL TIME WITH PATIENT AND/OR FAMILY 15 MINUTES |
| 99348 | LEVEL 2 HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT WITH PROBLEM OF LOW TO MODERATE SEVERITY, INCLUDING EXPANDED PROBLEM FOCUSED PHYSICAL EXAMINATION AND MEDICAL DECISION MAKING OF LOW COMPLEXITY – TYPICAL TIME WITH PATIENT AND/OR FAMILY 25 MINUTES |
| 99349 | LEVEL 3 HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT WITH PROBLEM OF MODERATE TO HIGH SEVERITY, INCLUDING DETAILED INTERVAL HISTORY AND PHYSICAL EXAMINATION, AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY – TYPICAL TIME WITH PATIENT AND/OR FAMILY 40 MINUTES |
| 99350 | LEVEL 4 HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT WITH PROBLEM OF MODERATE TO HIGH SEVERITY, INCLUDING COMPREHENSIVE INTERVAL HISTORY AND MEDICAL DECISION MAKING OF MODERATE TO HIGH COMPLEXITY – TYPICAL TIME WITH PATIENT AND/OR FAMILY 60 MINUTES |
| 99381 | INITIAL COMPREHENSIVE PREVENTIVE MEDICINE EVALUATION AND MANAGEMENT OF NEW PATIENT LESS THAN 1 YEAR IN AGE, INCLUDING AGE AND GENDER APPROPRIATE HISTORY, PHYSICAL EXAMINATION; COUNSELING, ANTICIPATORY GUIDANCE, AND/OR RISK FACTOR REDUCTION INTERVENTIONS; AND ORDERING OF LABORATORY AND/OR DIAGNOSTIC PROCEDURES |
| 99382 | INITIAL COMPREHENSIVE PREVENTIVE MEDICINE EVALUATION AND MANAGEMENT OF NEW PATIENT 1-4 YEARS IN AGE, INCLUDING AGE AND GENDER APPROPRIATE HISTORY, PHYSICAL EXAMINATION; COUNSELING, ANTICIPATORY GUIDANCE, AND/OR RISK FACTOR REDUCTION INTERVENTIONS; AND ORDERING OF LABORATORY AND/OR DIAGNOSTIC PROCEDURES |
| 99383 | INITIAL COMPREHENSIVE PREVENTIVE MEDICINE EVALUATION AND MANAGEMENT OF NEW PATIENT 5-11 YEARS IN AGE, INCLUDING AGE AND GENDER APPROPRIATE HISTORY, PHYSICAL EXAMINATION; COUNSELING, ANTICIPATORY GUIDANCE, AND/OR RISK FACTOR REDUCTION INTERVENTIONS; AND ORDERING OF LABORATORY AND/OR DIAGNOSTIC PROCEDURES |
| 99384 | INITIAL COMPREHENSIVE PREVENTIVE MEDICINE EVALUATION AND MANAGEMENT OF NEW PATIENT 12-17 YEARS IN AGE, INCLUDING AGE AND GENDER APPROPRIATE HISTORY, PHYSICAL EXAMINATION; COUNSELING, ANTICIPATORY GUIDANCE, AND/OR RISK FACTOR REDUCTION INTERVENTIONS; AND ORDERING OF LABORATORY AND/OR DIAGNOSTIC PROCEDURES |
| 99385 | INITIAL COMPREHENSIVE PREVENTIVE MEDICINE EVALUATION AND MANAGEMENT OF NEW PATIENT 18-39 YEARS IN AGE, INCLUDING AGE AND GENDER APPROPRIATE HISTORY, PHYSICAL EXAMINATION; COUNSELING, ANTICIPATORY GUIDANCE, AND/OR RISK FACTOR REDUCTION INTERVENTIONS; AND ORDERING OF LABORATORY AND/OR DIAGNOSTIC PROCEDURES |
| 99386 | INITIAL COMPREHENSIVE PREVENTIVE MEDICINE EVALUATION AND MANAGEMENT OF NEW PATIENT 40-64 YEARS IN AGE, INCLUDING AGE AND GENDER APPROPRIATE HISTORY, PHYSICAL EXAMINATION; COUNSELING, ANTICIPATORY GUIDANCE, AND/OR RISK FACTOR REDUCTION INTERVENTIONS; AND ORDERING OF LABORATORY AND/OR DIAGNOSTIC PROCEDURES |
| 99387 | INITIAL COMPREHENSIVE PREVENTIVE MEDICINE EVALUATION AND MANAGEMENT OF NEW PATIENT 65 YEARS IN AGE OR OLDER, INCLUDING AGE AND GENDER APPROPRIATE HISTORY, PHYSICAL EXAMINATION; COUNSELING, ANTICIPATORY GUIDANCE, AND/OR RISK FACTOR REDUCTION INTERVENTIONS; AND ORDERING OF LABORATORY AND/OR DIAGNOSTIC PROCEDURES |
| 99391 | PERIODIC COMPREHENSIVE PREVENTIVE MEDICINE REEVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT LESS THAN 1 YEAR IN AGE, INCLUDING AGE AND GENDER APPROPRIATE HISTORY, PHYSICAL EXAMINATION; COUNSELING, ANTICIPATORY GUIDANCE, AND/OR RISK FACTOR REDUCTION INTERVENTIONS; AND ORDERING OF LABORATORY AND/OR DIAGNOSTIC PROCEDURES |
| 99392 | PERIODIC COMPREHENSIVE PREVENTIVE MEDICINE REEVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT 1-4 YEARS IN AGE, INCLUDING AGE AND GENDER APPROPRIATE HISTORY, PHYSICAL EXAMINATION; COUNSELING, ANTICIPATORY GUIDANCE, AND/OR RISK FACTOR REDUCTION INTERVENTIONS; AND ORDERING OF LABORATORY AND/OR DIAGNOSTIC PROCEDURES |
| 99393 | PERIODIC COMPREHENSIVE PREVENTIVE MEDICINE REEVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT 5-11 YEARS IN AGE, INCLUDING AGE AND GENDER APPROPRIATE HISTORY, PHYSICAL EXAMINATION; COUNSELING, ANTICIPATORY GUIDANCE, AND/OR RISK FACTOR REDUCTION INTERVENTIONS; AND ORDERING OF LABORATORY AND/OR DIAGNOSTIC PROCEDURES |
| 99394 | PERIODIC COMPREHENSIVE PREVENTIVE MEDICINE REEVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT 12-17 YEARS IN AGE, INCLUDING AGE AND GENDER APPROPRIATE HISTORY, PHYSICAL EXAMINATION; COUNSELING, ANTICIPATORY GUIDANCE, AND/OR RISK FACTOR REDUCTION INTERVENTIONS; AND ORDERING OF LABORATORY AND/OR DIAGNOSTIC PROCEDURES |
| 99395 | PERIODIC COMPREHENSIVE PREVENTIVE MEDICINE REEVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT 18-39 YEARS IN AGE, INCLUDING AGE AND GENDER APPROPRIATE HISTORY, PHYSICAL EXAMINATION; COUNSELING, ANTICIPATORY GUIDANCE, AND/OR RISK FACTOR REDUCTION INTERVENTIONS; AND ORDERING OF LABORATORY AND/OR DIAGNOSTIC PROCEDURES |
| 99396 | PERIODIC COMPREHENSIVE PREVENTIVE MEDICINE REEVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT 40-64 YEARS IN AGE, INCLUDING AGE AND GENDER APPROPRIATE HISTORY, PHYSICAL EXAMINATION; COUNSELING, ANTICIPATORY GUIDANCE, AND/OR RISK FACTOR REDUCTION INTERVENTIONS; AND ORDERING OF LABORATORY AND/OR DIAGNOSTIC PROCEDURES |
| 99397 | PERIODIC COMPREHENSIVE PREVENTIVE MEDICINE REEVALUATION AND MANAGEMENT OF ESTABLISHED PATIENT 65 YEARS IN AGE OR OLDER, INCLUDING AGE AND GENDER APPROPRIATE HISTORY, PHYSICAL EXAMINATION; COUNSELING, ANTICIPATORY GUIDANCE, AND/OR RISK FACTOR REDUCTION INTERVENTIONS; AND ORDERING OF LABORATORY AND/OR DIAGNOSTIC PROCEDURES |
| 99460 | INITIAL BIRTHING CENTER CARE FOR EVALUATION AND MANAGEMENT OF NORMAL NEWBORN – EACH 24 HOURS |
| 99461 | INITIAL OUTPATIENT CARE FOR EVALUATION AND MANAGEMENT OF NORMAL NEWBORN, EACH 24 HOURS |
| 99462 | SUBSEQUENT HOSPITAL CARE FOR EVALUATION AND MANAGEMENT OF NORMAL NEWBORN – EACH 24 HOURS |
| 99463 | INITIAL BIRTHING CENTER CARE FOR EVALUATION AND MANAGEMENT OF NORMAL NEWBORN WITH ADMISSION AND DISCHARGE ON SAME DATE |
| 99471 | INITIAL INPATIENT PEDIATRIC CRITICAL CARE FOR EVALUATION AND MANAGEMENT OF PATIENT 29 DAYS-24 MONTHS IN AGE |
| 99472 | SUBSEQUENT INPATIENT PEDIATRIC CRITICAL CARE FOR EVALUATION AND MANAGEMENT OF PATIENT 29 DAYS-24 MONTHS IN AGE |
| 99475 | INITIAL INPATIENT PEDIATRIC CRITICAL CARE FOR EVALUATION AND MANAGEMENT OF PATIENT 2-5 YEARS IN AGE |
| 99476 | SUBSEQUENT INPATIENT PEDIATRIC CRITICAL CARE FOR EVALUATION AND MANAGEMENT OF PATIENT 2-5 YEARS IN AGE |
| 99477 | INITIAL HOSPITAL CARE FOR EVALUATION AND MANAGEMENT OF NEONATE 0-28 DAYS IN AGE REQUIRING INTENSIVE OBSERVATION AND FREQUENT INTERVENTIONS |
| 99478 | SUBSEQUENT INTENSIVE CARE FOR EVALUATION AND MANAGEMENT OF RECOVERING INFANT WITH PRESENT BODY WEIGHT OF LESS THAN 1500 GRAMS |
| 99479 | SUBSEQUENT INTENSIVE CARE FOR EVALUATION AND MANAGEMENT OF RECOVERING INFANT WITH PRESENT BODY WEIGHT OF 1500-2500 GRAMS |
| 99480 | SUBSEQUENT INTENSIVE CARE FOR EVALUATION AND MANAGEMENT OF RECOVERING INFANT WITH PRESENT BODY WEIGHT OF 2501-5000 GRAMS |
| G0104 | COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY |
| G0105 | COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK |
| G0130 | SINGLE ENERGY X-RAY ABSORPTIOMETRY (SEXA) BONE DENSITY STUDY, ONE OR MORE SITES; APPENDICULAR SKELETON (PERIPHERAL) (E.G., RADIUS, WRIST, HEEL) |
| G0328* | COLORECTAL CANCER SCREENING; FECAL OCCULT BLOOD TEST, IMMUNOASSAY, 1-3 SIMULTANEOUS |
| G0337 | HOSPICE EVALUATION AND COUNSELING SERVICES, PRE-ELECTION |
| G0378 | HOSPITAL OBSERVATION SERVICE, PER HOUR |
| G0379 | DIRECT ADMISSION OF PATIENT FOR HOSPITAL OBSERVATION CARE |
| G0380 | LEVEL 1 HOSPITAL EMERGENCY DEPARTMENT VISIT PROVIDED IN A TYPE B EMERGENCY DEPARTMENT; (THE ED MUST MEET AT LEAST ONE OF THE FOLLOWING REQUIREMENTS: (1) IT IS LICENSED BY THE STATE IN WHICH IT IS LOCATED UNDER APPLICABLE STATE LAW AS AN EMERGENCY ROOM OR |
| G0381 | LEVEL 2 HOSPITAL EMERGENCY DEPARTMENT VISIT PROVIDED IN A TYPE B EMERGENCY DEPARTMENT; (THE ED MUST MEET AT LEAST ONE OF THE FOLLOWING REQUIREMENTS: (1) IT IS LICENSED BY THE STATE IN WHICH IT IS LOCATED UNDER APPLICABLE STATE LAW AS AN EMERGENCY ROOM OR |
| G0382 | LEVEL 3 HOSPITAL EMERGENCY DEPARTMENT VISIT PROVIDED IN A TYPE B EMERGENCY DEPARTMENT; (THE ED MUST MEET AT LEAST ONE OF THE FOLLOWING REQUIREMENTS: (1) IT IS LICENSED BY THE STATE IN WHICH IT IS LOCATED UNDER APPLICABLE STATE LAW AS AN EMERGENCY ROOM OR |
| G0383 | LEVEL 4 HOSPITAL EMERGENCY DEPARTMENT VISIT PROVIDED IN A TYPE B EMERGENCY DEPARTMENT; (THE ED MUST MEET AT LEAST ONE OF THE FOLLOWING REQUIREMENTS: (1) IT IS LICENSED BY THE STATE IN WHICH IT IS LOCATED UNDER APPLICABLE STATE LAW AS AN EMERGENCY ROOM OR |
| G0384 | LEVEL 5 HOSPITAL EMERGENCY DEPARTMENT VISIT PROVIDED IN A TYPE B EMERGENCY DEPARTMENT; (THE ED MUST MEET AT LEAST ONE OF THE FOLLOWING REQUIREMENTS: (1) IT IS LICENSED BY THE STATE IN WHICH IT IS LOCATED UNDER APPLICABLE STATE LAW AS AN EMERGENCY ROOM OR |
| G0402 | POSTIMMUNIZATION ACUTE DISSEMINATED ENCEPHALITIS, MYELITIS AND ENCEPHALOMYELITIS |
| G0403 | ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; PERFORMED AS A SCREENING FOR THE INITIAL PREVENTIVE PHYSICAL EXAMINATION WITH INTERPRETATION AND REPORT |
| G0404 | ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; TRACING ONLY, WITHOUT INTERPRETATION AND REPORT, PERFORMED AS A SCREENING FOR THE INITIAL PREVENTIVE PHYSICAL EXAMINATION |
| G0405 | ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; INTERPRETATION AND REPORT ONLY, PERFORMED AS A SCREENING FOR THE INITIAL PREVENTIVE PHYSICAL EXAMINATION |
| G0433* | INFECTIOUS AGENT ANTIBODY DETECTION BY ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA) TECHNIQUE, HIV-1 AND/OR HIV-2, SCREENING |
| G0438 | ANNUAL WELLNESS VISIT; INCLUDES A PERSONALIZED PREVENTION PLAN OF SERVICE (PPS), INITIAL VISIT |
| G0439 | OTHER ACUTE NECROTIZING HEMORRHAGIC ENCEPHALOPATHY |
| G0463 | HOSPITAL OUTPATIENT CLINIC VISIT FOR ASSESSMENT AND MANAGEMENT OF A PATIENT |
| G0466 | FEDERALLY QUALIFIED HEALTH CENTER (FQHC) VISIT, NEW PATIENT; A MEDICALLY-NECESSARY, FACE-TO-FACE ENCOUNTER (ONE-ON-ONE) BETWEEN A NEW PATIENT AND A FQHC PRACTITIONER DURING WHICH TIME ONE OR MORE FQHC SERVICES ARE RENDERED AND INCLUDES A TYPICAL BUNDLE OF |
| G0467 | FEDERALLY QUALIFIED HEALTH CENTER (FQHC) VISIT, ESTABLISHED PATIENT; A MEDICALLY-NECESSARY, FACE-TO-FACE ENCOUNTER (ONE-ON-ONE) BETWEEN AN ESTABLISHED PATIENT AND A FQHC PRACTITIONER DURING WHICH TIME ONE OR MORE FQHC SERVICES ARE RENDERED AND INCLUDES A |
| G0468 | FEDERALLY QUALIFIED HEALTH CENTER (FQHC) VISIT, IPPE OR AWV; A FQHC VISIT THAT INCLUDES AN INITIAL PREVENTIVE PHYSICAL EXAMINATION (IPPE) OR ANNUAL WELLNESS VISIT (AWV) AND INCLUDES A TYPICAL BUNDLE OF MEDICARE-COVERED SERVICES THAT WOULD BE FURNISHED PER |
| G0469 | FEDERALLY QUALIFIED HEALTH CENTER (FQHC) VISIT, MENTAL HEALTH, NEW PATIENT; A MEDICALLY-NECESSARY, FACE-TO-FACE MENTAL HEALTH ENCOUNTER (ONE-ON-ONE) BETWEEN A NEW PATIENT AND A FQHC PRACTITIONER DURING WHICH TIME ONE OR MORE FQHC SERVICES ARE RENDERED AND |
| G0470 | FEDERALLY QUALIFIED HEALTH CENTER (FQHC) VISIT, MENTAL HEALTH, ESTABLISHED PATIENT; A MEDICALLY-NECESSARY, FACE-TO-FACE MENTAL HEALTH ENCOUNTER (ONE-ON-ONE) BETWEEN AN ESTABLISHED PATIENT AND A FQHC PRACTITIONER DURING WHICH TIME ONE OR MORE FQHC SERVICES |
| G0506 | Chronic Care Management Care Planning, billed once per beneficiary during the initiation of the patient into Chronic Care Management |
| J0120 | INJECTION, TETRACYCLINE, UP TO 250 MG |
| J0171 | INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG |
| J0280 | INJECTION, AMINOPHYLLIN, UP TO 250 MG |
| J0558 | INJECTION, PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE, 100,000 UNITS |
| J0561 | INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS |
| J0670 | INJECTION, MEPIVACAINE HYDROCHLORIDE, PER 10 ML |
| J0690 | INJECTION, CEFAZOLIN SODIUM, 500 MG |
| J0696 | INJECTION, CEFTRIAXONE SODIUM, PER 250 MG |
| J0702 | INJECTION, BETAMETHASONE ACETATE 3 MG AND BETAMETHASONE SODIUM PHOSPHATE 3 MG |
| J0780 | INJECTION, PROCHLORPERAZINE, UP TO 10 MG |
| J1000 | INFLUENZA DUE TO OTHER IDENTIFIED INFLUENZA VIRUS WITH UNSPECIFIED TYPE OF PNEUMONIA |
| J1020 | INJECTION, METHYLPREDNISOLONE ACETATE, 20 MG |
| J1030 | INJECTION, METHYLPREDNISOLONE ACETATE, 40 MG |
| J1040 | INJECTION, METHYLPREDNISOLONE ACETATE, 80 MG |
| J1050 | INJECTION, MEDROXYPROGESTERONE ACETATE, 1 MG |
| J1071 | INJECTION, TESTOSTERONE CYPIONATE, 1 MG |
| J1094 | INJECTION, DEXAMETHASONE ACETATE, 1 MG |
| J1100 | INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG |
| J1200 | INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG |
| J1580 | INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG |
| J1630 | INJECTION, HALOPERIDOL, UP TO 5 MG |
| J1642 | INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS |
| J1670 | INJECTION, TETANUS IMMUNE GLOBULIN, HUMAN, UP TO 250 UNITS |
| J1720 | INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG |
| J1815 | INJECTION, INSULIN, PER 5 UNITS |
| J1817 | INSULIN FOR ADMINISTRATION THROUGH DME (I.E., INSULIN PUMP) PER 50 UNITS |
| J1885 | INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG |
| J1940 | INJECTION, FUROSEMIDE, UP TO 20 MG |
| J2010 | INJECTION, LINCOMYCIN HCL, UP TO 300 MG |
| J2175 | INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG |
| J2405 | INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG |
| J2510 | INJECTION, PENICILLIN G PROCAINE, AQUEOUS, UP TO 600,000 UNITS |
| J2550 | INJECTION, PROMETHAZINE HCL, UP TO 50 MG |
| J2765 | INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG |
| J3121 | INJECTION, TESTOSTERONE ENANTHATE, 1 MG |
| J3230 | INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG |
| J3250 | INJECTION, TRIMETHOBENZAMIDE HCL, UP TO 200 MG |
| J3300 | INJECTION, TRIAMCINOLONE ACETONIDE, PRESERVATIVE FREE, 1 MG |
| J3303 | INJECTION, TRIAMCINOLONE HEXACETONIDE, PER 5 MG |
| J3420 | INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG |
| J7030 | INFUSION, NORMAL SALINE SOLUTION , 1000 CC |
| J7040 | INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML = 1 UNIT) |
| J7050 | INFUSION, NORMAL SALINE SOLUTION, 250 CC |
| J7608 | ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM |
| J7609 | ALBUTEROL, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG |
| J7611 | ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 1 MG |
| J7612 | LEVALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 0.5 MG |
| J7613 | ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG |
| J7614 | LEVALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 0.5 MG |
| J7620 | ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME |
| J7626 | BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG |
| J7644 | IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM |
| Q0111 | WET MOUNTS, INCLUDING PREPARATIONS OF VAGINAL, CERVICAL OR SKIN SPECIMENS |
| Q2034* | INFLUENZA VIRUS VACCINE, SPLIT VIRUS, FOR INTRAMUSCULAR USE (AGRIFLU) |
| Q2035* | INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER, FOR INTRAMUSCULAR USE (AFLURIA) |
| Q2036* | INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER, FOR INTRAMUSCULAR USE (FLULAVAL) |
| Q2037* | INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER, FOR INTRAMUSCULAR USE (FLUVIRIN) |
| Q2038* | INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER, FOR INTRAMUSCULAR USE (FLUZONE) |
| Q2039* | INFLUENZA VIRUS VACCINE, NOT OTHERWISE SPECIFIED |
| Q4003 | CAST SUPPLIES, SHOULDER CAST, ADULT (11 YEARS +), PLASTER |
| Q4004 | CAST SUPPLIES, SHOULDER CAST, ADULT (11 YEARS +), FIBERGLASS |
| Q4005 | CAST SUPPLIES, LONG ARM CAST, ADULT (11 YEARS +), PLASTER |
| Q4006 | CAST SUPPLIES, LONG ARM CAST, ADULT (11 YEARS +), FIBERGLASS |
| Q4007 | CAST SUPPLIES, LONG ARM CAST, PEDIATRIC (0-10 YEARS), PLASTER |
| Q4008 | CAST SUPPLIES, LONG ARM CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS |
| Q4009 | CAST SUPPLIES, SHORT ARM CAST, ADULT (11 YEARS +), PLASTER |
| Q4010 | CAST SUPPLIES, SHORT ARM CAST, ADULT (11 YEARS +), FIBERGLASS |
| Q4011 | CAST SUPPLIES, SHORT ARM CAST, PEDIATRIC (0-10 YEARS), PLASTER |
| Q4012 | CAST SUPPLIES, SHORT ARM CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS |
| Q4013 | CAST SUPPLIES, GAUNTLET CAST (INCLUDES LOWER FOREARM AND HAND), ADULT (11 YEARS +), PLASTER |
| Q4014 | CAST SUPPLIES, GAUNTLET CAST (INCLUDES LOWER FOREARM AND HAND), ADULT (11 YEARS +), FIBERGLASS |
| Q4015 | CAST SUPPLIES, GAUNTLET CAST (INCLUDES LOWER FOREARM AND HAND), PEDIATRIC (0-10 YEARS), PLASTER |
| Q4016 | CAST SUPPLIES, GAUNTLET CAST (INCLUDES LOWER FOREARM AND HAND), PEDIATRIC (0-10 YEARS), FIBERGLASS |
| Q4017 | CAST SUPPLIES, LONG ARM SPLINT, ADULT (11 YEARS +), PLASTER |
| Q4018 | CAST SUPPLIES, LONG ARM SPLINT, ADULT (11 YEARS +), FIBERGLASS |
| Q4019 | CAST SUPPLIES, LONG ARM SPLINT, PEDIATRIC (0-10 YEARS), PLASTER |
| Q4020 | CAST SUPPLIES, LONG ARM SPLINT, PEDIATRIC (0-10 YEARS), FIBERGLASS |
| Q4021 | CAST SUPPLIES, SHORT ARM SPLINT, ADULT (11 YEARS +), PLASTER |
| Q4022 | CAST SUPPLIES, SHORT ARM SPLINT, ADULT (11 YEARS +), FIBERGLASS |
| Q4023 | CAST SUPPLIES, SHORT ARM SPLINT, PEDIATRIC (0-10 YEARS), PLASTER |
| Q4024 | CAST SUPPLIES, SHORT ARM SPLINT, PEDIATRIC (0-10 YEARS), FIBERGLASS |
| Q4025 | CAST SUPPLIES, HIP SPICA (ONE OR BOTH LEGS), ADULT (11 YEARS +), PLASTER |
| Q4026 | CAST SUPPLIES, HIP SPICA (ONE OR BOTH LEGS), ADULT (11 YEARS +), FIBERGLASS |
| Q4027 | CAST SUPPLIES, HIP SPICA (ONE OR BOTH LEGS), PEDIATRIC (0-10 YEARS), PLASTER |
| Q4028 | CAST SUPPLIES, HIP SPICA (ONE OR BOTH LEGS), PEDIATRIC (0-10 YEARS), FIBERGLASS |
| Q4029 | CAST SUPPLIES, LONG LEG CAST, ADULT (11 YEARS +), PLASTER |
| Q4030 | CAST SUPPLIES, LONG LEG CAST, ADULT (11 YEARS +), FIBERGLASS |
| Q4031 | CAST SUPPLIES, LONG LEG CAST, PEDIATRIC (0-10 YEARS), PLASTER |
| Q4032 | CAST SUPPLIES, LONG LEG CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS |
| Q4033 | CAST SUPPLIES, LONG LEG CYLINDER CAST, ADULT (11 YEARS +), PLASTER |
| Q4034 | CAST SUPPLIES, LONG LEG CYLINDER CAST, ADULT (11 YEARS +), FIBERGLASS |
| Q4035 | CAST SUPPLIES, LONG LEG CYLINDER CAST, PEDIATRIC (0-10 YEARS), PLASTER |
| Q4036 | CAST SUPPLIES, LONG LEG CYLINDER CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS |
| Q4037 | CAST SUPPLIES, SHORT LEG CAST, ADULT (11 YEARS +), PLASTER |
| Q4038 | CAST SUPPLIES, SHORT LEG CAST, ADULT (11 YEARS +), FIBERGLASS |
| Q4039 | CAST SUPPLIES, SHORT LEG CAST, PEDIATRIC (0-10 YEARS), PLASTER |
| Q4040 | CAST SUPPLIES, SHORT LEG CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS |
| Q4041 | CAST SUPPLIES, LONG LEG SPLINT, ADULT (11 YEARS +), PLASTER |
| Q4042 | CAST SUPPLIES, LONG LEG SPLINT, ADULT (11 YEARS +), FIBERGLASS |
| Q4043 | CAST SUPPLIES, LONG LEG SPLINT, PEDIATRIC (0-10 YEARS), PLASTER |
| Q4044 | CAST SUPPLIES, LONG LEG SPLINT, PEDIATRIC (0-10 YEARS), FIBERGLASS |
| Q4045 | CAST SUPPLIES, SHORT LEG SPLINT, ADULT (11 YEARS +), PLASTER |
| Q4046 | CAST SUPPLIES, SHORT LEG SPLINT, ADULT (11 YEARS +), FIBERGLASS |
| Q4047 | CAST SUPPLIES, SHORT LEG SPLINT, PEDIATRIC (0-10 YEARS), PLASTER |
| Q4048 | CAST SUPPLIES, SHORT LEG SPLINT, PEDIATRIC (0-10 YEARS), FIBERGLASS |
| Q4049 | FINGER SPLINT, STATIC |
| Q4050 | CAST SUPPLIES, FOR UNLISTED TYPES AND MATERIALS OF CASTS |
| Q4051 | SPLINT SUPPLIES, MISCELLANEOUS (INCLUDES THERMOPLASTICS, STRAPPING, FASTENERS, PADDING AND OTHER SUPPLIES) |
| 86701* | ASSAY FOR HUMAN IMMUNODEFICIENCY VIRUS 1 (HIV-1) ANTIBODY |
| G0475* | HIV ANTIGEN/ANTIBODY, COMBINATION ASSAY, SCREENING |
* Where applicable, service reimbursed in addition to capitation.
