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PCP Services NOT Requiring Prior Authorization

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
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.