Medical Billing Code Search
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8892 results found
| C1204 | Tc 99m tilmanocept | Description: Technetium tc 99m tilmanocept, diagnostic, up to 0.5 millicuries |
| C1879 | Tissue marker, implantable | Description: Tissue marker (implantable) |
| C9130 | Injection, ivig bivigam | Description: Injection, immune globulin (bivigam), 500 mg |
| C9131 | In ado-trastuzumab emtansine | Description: Injection, ado-trastuzumab emtansine, 1 mg |
| C9292 | Injection, pertuzumab | Description: Injection, pertuzumab, 10 mg |
| C9294 | Inj, taliglucerase alfa | Description: Injection, taliglucerase alfa, 10 units |
| C9295 | Injection, carfilzomib | Description: Injection, carfilzomib, 1 mg |
| C9296 | Injection, ziv-aflibercept | Description: Injection, ziv-aflibercept, 1 mg |
| C9297 | Omacetaxine mepesuccinate | Description: Injection, omacetaxine mepesuccinate, 0.01 mg |
| C9298 | Injection, ocriplasmin | Description: Injection, ocriplasmin, 0.125 mg |
| C9736 | Lap ablate uteri fibroid rf | Description: Laparoscopy, surgical, radiofrequency ablations of uterine fibroid(s), including intraoperative guidance and monitoring, when performed |
| G0275 | Renal angio, cardiac cath | Description: Renal angiography, non-selective, one or both kidneys, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of any catheter in the abdominal aorta at or near the origins (ostia) of the renal arteries, injection of dye, flush aortogram, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure) |
| G8459 | Doc pt rec antivir treat | Description: Clinician documented that patient is receiving antiviral treatment for hepatitis c |
| G8462 | Pt inelig couns no antvir tx | Description: Clinician documented that patient is not an eligible candidate for counseling regarding contraception prior to antiviral treatment; patient not receiving antiviral treatment for hepatitis c |
| G8463 | Pt rec antiviral treat doc | Description: Patient receiving antiviral treatment for hepatitis c documented |
| G8556 | Ref to doc otolog eval | Description: Referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation |
| G8557 | Pt inelig ref otolog eval | Description: Patient is not eligible for the referral for otologic evaluation measure |
| G8558 | No ref to doc otolog eval | Description: Not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given |
| G8588 | Sys bp <140 | Description: Most recent systolic blood pressure < 140 mmhg |
| G8589 | Sys bp >= 140 | Description: Most recent systolic blood pressure >= 140 mmhg |
| G8590 | Dia bp < 90 | Description: Most recent diastolic blood pressure < 90 mmhg |
| G8591 | Dia bp >= 90 | Description: Most recent diastolic blood pressure >= 90 mmhg |
| G8592 | No bp measure | Description: No documentation of blood pressure measurement, reason not given |
| G8596 | No ldl perf | Description: Ldl-c was not performed |
| G8603 | Spok lang comp score | Description: Score on the spoken language comprehension functional communication measure at discharge was higher than at admission |
| G8604 | No high score spok lang | Description: Score on the spoken language comprehension functional communication measure at discharge was not higher than at admission, reason not given |
| G8605 | No spok lang comp score | Description: Patient treated for spoken language comprehension but not scored on the spoken language comprehension functional communication measure either at admission or at discharge |
| G8606 | Attention score | Description: Score on the attention functional communication measure at discharge was higher than at admission |
| G8607 | No high score attention | Description: Score on the attention functional communication measure at discharge was not higher than at admission, reason not given |
| G8608 | No attention score | Description: Patient treated for attention but not scored on the attention functional communication measure either at admission or at discharge |
| G8609 | Memory score | Description: Score on the memory functional communication measure at discharge was higher than at admission |
| G8610 | No high score memory | Description: Score on the memory functional communication measure at discharge was not higher than at admission, reason not given |
| G8611 | No memory score | Description: Patient treated for memory but not scored on the memory functional communication measure either at admission or at discharge |
| G8612 | Moto speech score | Description: Score on the motor speech functional communication measure at discharge was higher than at admission |
| G8613 | No high score moto speech | Description: Score on the motor speech functional communication measure at discharge was not higher than at admission, reason not given |
| G8614 | No moto speech score | Description: Patient treated for motor speech but not scored on the motor speech comprehension functional communication measure either at admission or at discharge |
| G8615 | Reading score | Description: Score on the reading functional communication measure at discharge was higher than at admission |
| G8616 | No high score reading | Description: Score on the reading functional communication measure at discharge was not higher than at admission, reason not given |
| G8617 | No reading score | Description: Patient treated for reading but not scored on the reading functional communication measure either at admission or at discharge |
| G8618 | Spok lang exp score | Description: Score on the spoken language expression functional communication measure at discharge was higher than at admission |
| G8619 | No high score spok lang exp | Description: Score on the spoken language expression functional communication measure at discharge was not higher than at admission, reason not given |
| G8620 | No spok lang exp score | Description: Patient treated for spoken language expression but not scored on the spoken language expression functional communication measure either at admission or at discharge |
| G8621 | Writing score | Description: Score on the writing functional communication measure at discharge was higher than at admission |
| G8622 | No high score writing | Description: Score on the writing functional communication measure at discharge was not higher than at admission, reason not given |
| G8623 | No writing score | Description: Patient treated for writing but not scored on the writing functional communication measure either at admission or at discharge |
| G8624 | Swallowing score | Description: Score on the swallowing functional communication measure at discharge was higher than at admission |
| G8625 | No high score swallowing | Description: Score on the swallowing functional communication measure at discharge was not higher than at admission, reason not given |
| G8626 | No swallowing score | Description: Patient treated for swallowing but not scored on the swallowing functional communication measure at admission or at discharge |
| G8642 | Hrdshp rural w/o internet | Description: The eligible professional practices in a rural area without sufficient high speed internet access and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(a) of the social security act |
| G8643 | Hrdshp w/o suff pharm w/erx | Description: The eligible professional practices in an area without sufficient available pharmacies for electronic prescribing and requests a hardship exemption for the application of the payment adjustment under section 1848(a)(5)(a) of the social security act |
| G8644 | Ep no prescribe priv | Description: Eligible professional does not have prescribing privileges |
| G8741 | Not tx spoken lang | Description: Patient not treated for spoken language comprehension disorder |
| G8742 | Not tx attention | Description: Patient not treated for attention disorder |
| G8743 | Not tx memory | Description: Patient not treated for memory disorder |
| G8744 | Not tx motor speech | Description: Patient not treated for motor speech disorder |
| G8745 | Not tx reading | Description: Patient not treated for reading disorder |
| G8746 | Not tx spoken lang express | Description: Patient not treated for spoken language expression disorder |
| G8747 | Not tx writing | Description: Patient not treated for writing disorder |
| G8748 | Not tx swallowing | Description: Patient not treated for swallowing disorder |
| G8790 | Systolic <130mmhg | Description: Most recent office visit systolic blood pressure <130 mm hg |
| G8791 | Systolic 130-139mmhg | Description: Most recent office visit systolic blood pressure, 130 to 139 mm hg |
| G8792 | Systolic >=140mmhg | Description: Most recent office visit systolic blood pressure >=140 mm hg |
| G8793 | Diastolic <80mmhg | Description: Most recent office visit diastolic blood pressure, <80 mm hg |
| G8794 | Diastolic 80-89mmhg | Description: Most recent office visit diastolic blood pressure, 80 - 89 mm hg |
| G8795 | Diastolic >=90mmhg | Description: Most recent office visit diastolic blood pressure >=90 mm hg |
| G8796 | Bp not doc | Description: Blood pressure measurement not documented, reason not given |
| G8799 | Anticoag ordered | Description: Anticoagulation ordered |
| G8800 | Doc reas anticoag not order | Description: Anticoagulation not ordered for reasons documented by clinician |
| G8801 | Anticoag not ordered | Description: Anticoagulation was not ordered, reason not given |
| G8812 | Pt not elig cta, duplex, mra | Description: Patient is not eligible for follow-up cta, duplex, or mra (e.g., patient death, failure to return for scheduled follow-up exam, planned follow-up study which will meet numerator criteria has not yet occurred at the time of reporting) |
| G8813 | Cta, duplex, mra performed | Description: Follow-up cta, duplex, or mra of the abdomen and pelvis performed |
| G8814 | No cta, duplex, mra | Description: Follow-up cta, duplex, or mra of the abdomen and pelvis not performed |
| G8827 | Aneurysm <= 5.5cm for women | Description: Aneurysm minor diameter <= 5.5 cm for women |
| G8835 | Asymptom no trans | Description: Asymptomatic patient with no history of any transient ischemic attack or stroke in any carotid or vertebrobasilar territory |
| G8919 | Mst rcnt sys bp <140mmg | Description: Most recent systolic blood pressure < 140 mmhg |
| G8920 | Mst rcnt sys bp >=140mmhg | Description: Most recent systolic blood pressure >= 140 mmhg |
| G8921 | Mst rcnt dia bp <90mmhg | Description: Most recent diastolic blood pressure < 90 mmhg |
| G8922 | Mst rcnt dia bp >=90mmhg | Description: Most recent diastolic blood pressure >= 90 mmhg |
| G8945 | Aneurysm <=6 cm for men | Description: Aneurysm minor diameter <= 6 cm for men |
| G8954 | Pt data rpt qual clin db reg | Description: Complete and appropriate patient data were reported to a qualified clinical database registry |
| J0152 | Adenosine injection | Description: Injection, adenosine for diagnostic use, 30 mg (not to be used to report any adenosine phosphate compounds; instead use a9270) |
| J0718 | Certolizumab pegol inj | Description: Injection, certolizumab pegol, 1 mg |
| J1441 | Filgrastim 480 mcg injection | Description: Injection, filgrastim (g-csf), 480 mcg |
| J3487 | Zoledronic acid | Description: Injection, zoledronic acid (zometa), 1 mg |
| J3488 | Reclast injection | Description: Injection, zoledronic acid (reclast), 1 mg |
| J9002 | Doxil injection | Description: Injection, doxorubicin hydrochloride, liposomal, doxil, 10 mg |
| L0430 | Dewall posture protector | Description: Spinal orthosis, anterior-posterior-lateral control, with interface material, custom fitted (dewall posture protector only) |
| Q0090 | Skyla 13.5mg | Description: Levonorgestrel-releasing intrauterine contraceptive system, (skyla), 13.5 mg |
| Q0165 | Prochlorperazine maleate10mg | Description: Prochlorperazine maleate, 10 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0168 | Dronabinol 5mg oral | Description: Dronabinol, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0170 | Promethazine hcl 25 mg oral | Description: Promethazine hydrochloride, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0171 | Chlorpromazine hcl 10mg oral | Description: Chlorpromazine hydrochloride, 10 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0172 | Chlorpromazine hcl 25mg oral | Description: Chlorpromazine hydrochloride, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0176 | Perphenazine 8mg oral | Description: Perphenazine, 8mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0178 | Hydroxyzine pamoate 50mg | Description: Hydroxyzine pamoate, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0505 | Miscl supply/accessory vad | Description: Miscellaneous supply or accessory for use with ventricular assist device |
| Q2027 | Sculptra injection | Description: Injection, sculptra, 0.1 ml |
| Q2033 | Influenza vaccine, (flublok) | Description: Influenza vaccine, recombinant hemagglutinin antigens, for intramuscular use (flublok) |
| Q2051 | Zoldedronic acid 1mg | Description: Injection, zoledronic acid, not otherwise specified, 1mg |
| Q3025 | Im inj interferon beta 1-a | Description: Injection, interferon beta-1a, 11 mcg for intramuscular use |
| Q3026 | Subc inj interferon beta-1a | Description: Injection, interferon beta-1a, 11 mcg for subcutaneous use |
| S3625 | Maternal triple screen test | Description: Maternal serum triple marker screen including alpha-fetoprotein (afp), estriol, and human chorionic gonadotropin (hcg) |
| S3626 | Maternal serum quad screen | Description: Maternal serum quadruple marker screen including alpha-fetoprotein (afp), estriol, human chorionic gonadotropin (hcg) and inhibin a |
| S3833 | Comp apc sequence | Description: Complete apc gene sequence analysis for susceptibility to familial adenomatous polyposis (fap) and attenuated fap |
| S3834 | Sing mutation apc | Description: Single-mutation analysis (in individual with a known apc mutation in the family) for susceptibility to familial adenomatous polyposis (fap) and attenuated fap |
| LD | Left ant des coronary artery | Description: Left anterior descending coronary artery |
| LC | Lft circum coronary artery | Description: Left circumflex coronary artery |
| LL | Leaserental (appld to pur) | Description: Leaserental (use the ll modifier when dme equipment rental is to be applied against the purchase price) |
| LM | Left main coronary artery | Description: Left main coronary artery |
| LT | Left side | Description: Left side (used to identify procedures performed on the left side of the body) |
| LR | Laboratory round trip | Description: Laboratory round trip |
| LS | Fda-monitored iol implant | Description: Fda-monitored intraocular lens implant |
| L1 | Separately payable lab test | Description: Provider attestation that the hospital laboratory test(s) is not packaged under the hospital opps |
| A9 | Dressing for 9 or more wound | Description: Dressing for nine or more wounds |
| AH | Clinical psychologist | Description: Clinical psychologist |
| M2 | Medicare secondary payer | Description: Medicare secondary payer (msp) |
| MS | 6-mo maintsvc fee partslbr | Description: Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty |
| PS | Pet tumor subsq tx strategy | Description: Positron emission tomography (pet) or petcomputed tomography (ct) to inform the subsequent treatment strategy of cancerous tumors when the beneficiarys treating physician determines that the pet study is needed to inform subsequent anti-tumor strategy |
| PT | Clrctal screen to diagn | Description: Colorectal cancer screening test converted to diagnostic test or other procedure |
| PB | Surgery wrong patient | Description: Surgical or other invasive procedure on wrong patient |
| PA | Surgery wrong body part | Description: Surgical or other invasive procedure on wrong body part |
| PN | Non-excepted off-campus svc | Description: Non-excepted service provided at an off-campus outpatient provider-based department of a hospital |
| PO | Excepted off-campus service | Description: Excepted service provided at an off-campus outpatient provider-based department of a hospital |
| PL | Progressive addition lenses | Description: Progressive addition lenses |
| PM | Post mortem | Description: Post mortem |
| P2 | Patient wmild syst disease | Description: A patient with mild systemic disease |
| P3 | Patient wsevere sys disease | Description: A patient with severe systemic disease |
| P1 | Normal healthy patient | Description: A normal healthy patient |
| P6 | Brain-dead pt organs removed | Description: A declared brain-dead patient whose organs are being removed for donor purposes |
| P4 | Pt wsev sys dis threat life | Description: A patient with severe systemic disease that is a constant threat to life |
| P5 | Pt not expect surv wo oper | Description: A moribund patient who is not expected to survive without the operation |
| VP | Aphakic patient | Description: Aphakic patient |
| Q1 | Routine clinical research | Description: Routine clinical service provided in a clinical research study that is in an approved clinical research study |
| Q0 | Invest clinical research | Description: Investigational clinical service provided in a clinical research study that is in an approved clinical research study |
| Q3 | Live donor surgeryservices | Description: Live kidney donor surgery and related services |
| Q2 | Demo procedure service | Description: Demonstration procedureservice |
| Q5 | Recip bill arr subs md or pt | Description: Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area a medically underserved area or a rural area |
| Q4 | Svc exempt - ordrgrfrng md | Description: Service for orderingreferring physician qualifies as a service exemption |
| Q7 | One class a finding | Description: One class a finding |
| Q6 | Feetime comp subst md or pt | Description: Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area a medically underserved area or a rura |
| Q9 | 1 class b & 2 class c fndngs | Description: One class b and two class c findings |
| Q8 | Two class b findings | Description: Two class b findings |
| Qualified cdsm consulted | Description: Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional | |
| QP | Individually ordered lab tst | Description: Documentation is on file showing that the laboratory test(s) was ordered individually or ordered as a cpt-recognized panel other than automated profile codes 80002-80019 g0058 g0059 and g0060. |
| QS | Monitored anesthesia care | Description: Monitored anesthesia care service |
| QT | Rcrdgstrg tape analog recdr | Description: Recording and storage on tape by an analog tape recorder |
| QW | Clia waived test | Description: Clia waived test |
| QY | Medically directed crna | Description: Medical direction of one certified registered nurse anesthetist (crna) by an anesthesiologist |
| QX | Crna svc w md med direction | Description: Crna service: with medical direction by a physician |
| QZ | Crna svc wo med dir by md | Description: Crna service: without medical direction by a physician |
| QC | Single channel monitoring | Description: Single channel monitoring |
| QE | Prescribed oxygen < 1 lpm | Description: Prescribed amount of oxygen is less than 1 liter per minute (lpm) |
| QD | Rcrdgstrg in sld st memory | Description: Recording and storage in solid state memory by a digital recorder |
| QG | Prescribed oxygen > 4 lpm | Description: Prescribed amount of oxygen is greater than 4 liters per minute(lpm) |
| QF | Prscrbd oxygen >4 lpm & port | Description: Prescribed amount of oxygen exceeds 4 liters per minute (lpm) and portable oxygen is prescribed |
| QH | Oxygen cnsrvg dvc w del sys | Description: Oxygen conserving device is being used with an oxygen delivery system |
| QK | Med dir 2-4 cncrnt anes proc | Description: Medical direction of two three or four concurrent anesthesia procedures involving qualified individuals |
| QJ | Patient in statelocl custod | Description: Servicesitems provided to a prisoner or patient in state or local custody however the state or local government as applicable meets the requirements in 42 cfr 411.4 (b) |
| QM | Ambulance arr by provider | Description: Ambulance service provided under arrangement by a provider of services |
| QL | Patient died after amb call | Description: Patient pronounced dead after ambulance called |
| QN | Ambulance furn by provider | Description: Ambulance service furnished directly by a provider of services |
| SS | Hit in infusion suite | Description: Home infusion services provided in the infusion suite of the iv therapy provider |
| SC | Medically necessary servsup | Description: Medically necessary service or supply |
| SB | Nurse midwife | Description: Nurse midwife |
| SA | Nurse practitioner w physici | Description: Nurse practitioner rendering service in collaboration with a physician |
| SG | Asc facility service | Description: Ambulatory surgical center (asc) facility service |
| SF | 2nd opinion ordered by pro | Description: Second opinion ordered by a professional review organization (pro) per section 9401 p.l. 99-272 (100% reimbursement - no medicare deductible or coinsurance) |
| RT | Right side | Description: Right side (used to identify procedures performed on the right side of the body) |
| RR | Rental (dme) | Description: Rental (use the rr modifier when dme is to be rented) |
| RD | Drug admin not incident-to | Description: Drug provided to beneficiary but not administered incident-to"" |
| RE | Furnish full compliance rems | Description: Furnished in full compliance with fda-mandated risk evaluation and mitigation strategy (rems) |
| RA | Replacement of dme item | Description: Replacement of a dme orthotic or prosthetic item |
| RB | Replacement part dme item | Description: Replacement of a part of a dme orthotic or prosthetic item furnished as part of a repair |
| RC | Right coronary artery | Description: Right coronary artery |
| RI | Ramus intermedius cor artery | Description: Ramus intermedius coronary artery |
| PC | Wrong surgery on patient | Description: Wrong surgery or other invasive procedure on patient |
| PD | Inp admit win 3 days | Description: Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days |
| PI | Pet tumor init tx strat | Description: Positron emission tomography (pet) or petcomputed tomography (ct) to inform the initial treatment strategy of tumors that are biopsy proven or strongly suspected of being cancerous based on other diagnostic testing |
| G9977 | Dil mac exam no perf rsn nos | Description: Dilated macular exam was not performed reason not otherwise specified |
| G9976 | Doc pat rsn no mac exm perf | Description: Documentation of patient reason(s) for not performing a dilated macular examination |
| SN | Third opinion | Description: Third surgical opinion |
| SM | Second opinion | Description: Second surgical opinion |
| SL | State supplied vaccine | Description: State supplied vaccine |
| SZ | Habilitative services | Description: Habilitative services |
| SY | Contact whigh-risk pop | Description: Persons who are in close contact with member of high-risk population (use only with codes for immunization) |
| SQ | Item ordered by home health | Description: Item ordered by home health |
| SW | Serv by cert diab educator | Description: Services provided by a certified diabetic educator |
| SV | Drugs delivered not used | Description: Pharmaceuticals delivered to patients home but not utilized |
| SU | Performed in phys office | Description: Procedure performed in physicians office (to denote use of facility and equipment) |
| ST | Related to trauma or injury | Description: Related to trauma or injury |
| SK | High risk population | Description: Member of high risk population (use only with codes for immunization) |
| SJ | 3rd concurrent infusion ther | Description: Third or more concurrently administered infusion therapy |
| SH | 2nd concurrent infusion ther | Description: Second concurrently administered infusion therapy |
| SE | Statefed funded programser | Description: State andor federally-funded programsservices |
| SD | Serv by home infusion rn | Description: Services provided by registered nurse with specialized highly technical home infusion training |
| TV | Holidayweekend payment rate | Description: Special payment rates holidaysweekends |
| TW | Back-up equipment | Description: Back-up equipment |
| TT | Additional patient | Description: Individualized service provided to more than one patient in same setting |
| TU | Overtime payment rate | Description: Special payment rate overtime |
| TR | School-based iep out of dist | Description: School-based individualized education program (iep) services provided outside the public school district responsible for the student |
| TS | Follow-up service | Description: Follow-up service |
| TP | Med transprt unloaded vehicl | Description: Medical transport unloaded vehicle |
| TQ | Bls by volunteer amb providr | Description: Basic life support transport by a volunteer ambulance provider |
| TN | Ruralout of service area | Description: Ruraloutside providers customary service area |
| TL | Early intervention ifsp | Description: Early interventionindividualized family service plan (ifsp) |
| TM | Individualized ed prgrm(iep) | Description: Individualized education program (iep) |
| TJ | Childadolescent program gp | Description: Program group child andor adolescent |
| TK | Extra patient or passenger | Description: Extra patient or passenger non-ambulance |
| TH | Ob txsrvcs prenatlpostpart | Description: Obstetrical treatmentservices prenatal or postpartum |
| A6 | Dressing for six wounds | Description: Dressing for six wounds |
| TF | Intermediate level of care | Description: Intermediate level of care |
| A8 | Dressing for eight wounds | Description: Dressing for eight wounds |
| TD | Rn | Description: Rn |
| TE | Lpnlvn | Description: Lpnlvn |
| TB | Tracking 340b acquired drug | Description: Drug or biological acquired with 340b drug pricing program discount reported for informational purposes |
| TA | Left foot great toe | Description: Left foot great toe |
| AA | Anesthesia perf by anesgst | Description: Anesthesia services performed personally by anesthesiologist |
| AE | Registered dietician | Description: Registered dietician |
| AD | Md supervision >4 anes proc | Description: Medical supervision by a physician: more than four concurrent anesthesia procedures |
| T8 | Right foot fourth digit | Description: Right foot fourth digit |
| T9 | Right foot fifth digit | Description: Right foot fifth digit |
| T6 | Right foot second digit | Description: Right foot second digit |
| T7 | Right foot third digit | Description: Right foot third digit |
| T4 | Left foot fifth digit | Description: Left foot fifth digit |
| T5 | Right foot great toe | Description: Right foot great toe |
| T2 | Left foot third digit | Description: Left foot third digit |
| T3 | Left foot fourth digit | Description: Left foot fourth digit |
| AO | Prov declined alt pmt method | Description: Alternate payment method declined by provider of service |
| T1 | Left foot second digit | Description: Left foot second digit |
| AQ | Physician service hpsa area | Description: Physician providing a service in an unlisted health professional shortage area (hpsa) |
| AP | No dtmn of refractive state | Description: Determination of refractive state was not performed in the course of diagnostic ophthalmological examination |
| AS | Assistant at surgery service | Description: Physician assistant nurse practitioner or clinical nurse specialist services for assistant at surgery |
| AR | Physician scarcity area | Description: Physician provider services in a physician scarcity area |
| AU | Uro ostomy or trach item | Description: Item furnished in conjunction with a urological ostomy or tracheostomy supply |
| AT | Acute treatment | Description: Acute treatment (this modifier should be used when reporting service 98940 98941 98942) |
| AW | Item w a surgical dressing | Description: Item furnished in conjunction with a surgical dressing |
| AV | Item w prostheticorthotic | Description: Item furnished in conjunction with a prosthetic device prosthetic or orthotic |
| AY | Itemservice not for esrd tx | Description: Item or service furnished to an esrd patient that is not for the treatment of esrd |
| AX | Item w dialysis services | Description: Item furnished in conjunction with dialysis services |
| AZ | Physician serv in dent hpsa | Description: Physician providing a service in a dental health professional shortage area for the purpose of an electronic health record incentive payment |
| BA | Item w pen services | Description: Item furnished in conjunction with parenteral enteral nutrition (pen) services |
| BL | Spec acquisition blood prods | Description: Special acquisition of blood and blood products |
| BU | Bene undecided on purchrent | Description: The beneficiary has been informed of the purchase and rental options and after 30 days has not informed the supplier of hisher decision |
| BP | Bene electd to purchase item | Description: The beneficiary has been informed of the purchase and rental options and has elected to purchase the item |
| BR | Bene elected to rent item | Description: The beneficiary has been informed of the purchase and rental options and has elected to rent the item |
| CK | 40 to <60 percent impaired | Description: At least 40 percent but less than 60 percent impaired limited or restricted |
| CJ | 20 to <40 percent impaired | Description: At least 20 percent but less than 40 percent impaired limited or restricted |
| CI | 1 to <20 percent impaired | Description: At least 1 percent but less than 20 percent impaired limited or restricted |
| CH | 0 percent impaired ltd res | Description: 0 percent impaired limited or restricted |
| CN | 100 percent impaired ltd | Description: 100 percent impaired limited or restricted |
| CM | 80 to <100 percent impaired | Description: At least 80 percent but less than 100 percent impaired limited or restricted |
| CL | 60 to <80 percent impaired | Description: At least 60 percent but less than 80 percent impaired limited or restricted |
| CC | Procedure code change | Description: Procedure code change (use cc when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) |
| CB | Esrd bene part a snf-sep pay | Description: Service ordered by a renal dialysis facility (rdf) physician as part of the esrd beneficiarys dialysis benefit is not part of the composite rate and is separately reimbursable |
| CA | Procedure payable inpatient | Description: Procedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission |
| CG | Policy criteria applied | Description: Policy criteria applied |
| CF | Amcc tst not composite rate | Description: Amcc test has been ordered by an esrd facility or mcp physician that is not part of the composite rate and is separately billable |
| CE | Med neces amcc tst sep reimb | Description: Amcc test has been ordered by an esrd facility or mcp physician that is a composite rate test but is beyond the normal frequency covered under the rate and is separately reimbursable based on medical necessity |
| CD | Amcc test for esrd or mcp md | Description: Amcc test has been ordered by an esrd facility or mcp physician that is part of the composite rate and is not separately billable |
| CS | Gulf oil 2010 spill related | Description: Item or service related in whole or in part to an illness injury or condition that was caused by or exacerbated by the effects direct or indirect of the 2010 oil spill in the gulf of mexico including but not limited to subsequent clean-up activitie |
| CR | Catastrophedisaster related | Description: Catastrophedisaster related |
| CP | C-apc adjunctive service | Description: Adjunctive service related to a procedure assigned to a comprehensive ambulatory payment classification (c-apc) procedure but reported on a different claim |
| CT | Ct does not meet nema standa | Description: Computed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (nema) xr-29-2013 standard |
| V1 | Demonstration modifier 1 | Description: Demonstration modifier 1 |
| V2 | Demonstration modifier 2 | Description: Demonstration modifier 2 |
| V3 | Demonstration modifier 3 | Description: Demonstration modifier 3 |
| V5 | Vascular catheter | Description: Vascular catheter (alone or with any other vascular access) |
| V6 | Arteriovenous graft | Description: Arteriovenous graft (or other vascular access not including a vascular catheter) |
| V7 | Arteriovenous fistula | Description: Arteriovenous fistula only (in use with two needles) |
| V8 | Infection present | Description: Infection present |
| V9 | No infection present | Description: No infection present |
| VM | Mdpp virtual make-up session | Description: Medicare diabetes prevention program (mdpp) virtual make-up session |
| DA | Oral health assess not dent | Description: Oral health assessment by a licensed health professional other than a dentist |
| A1 | Dressing for one wound | Description: Dressing for one wound |
| A3 | Dressing for three wounds | Description: Dressing for three wounds |
| A2 | Dressing for two wounds | Description: Dressing for two wounds |
| A5 | Dressing for five wounds | Description: Dressing for five wounds |
| A4 | Dressing for four wounds | Description: Dressing for four wounds |
| A7 | Dressing for seven wounds | Description: Dressing for seven wounds |
| TG | Complexhigh tech level care | Description: Complexhigh tech level of care |
| AG | Primary physician | Description: Primary physician |
| AF | Specialty physician | Description: Specialty physician |
| AI | Principal physician of rec | Description: Principal physician of record |
| AK | Non participating physician | Description: Non participating physician |
| AJ | Clinical social worker | Description: Clinical social worker |
| AM | Physician team member svc | Description: Physician team member service |
| E4 | Lower right eyelid | Description: Lower right eyelid |
| E1 | Upper left eyelid | Description: Upper left eyelid |
| E3 | Upper right eyelid | Description: Upper right eyelid |
| E2 | Lower left eyelid | Description: Lower left eyelid |
| EM | Emer reserve supply (esrd) | Description: Emergency reserve supply (for esrd benefit only) |
| EJ | Subsequent claim | Description: Subsequent claims for a defined course of therapy e.g. epo sodium hyaluronate infliximab |
| EE | Hct>39% or hgb>13g<3 cycle | Description: Hematocrit level has not exceeded 39% (or hemoglobin level has not exceeded 13.0 gdl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle |
| ED | Hct>39% or hgb>13g>=3 cycle | Description: Hematocrit level has exceeded 39% (or hemoglobin level has exceeded 13.0 gdl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle |
| EA | Esa anemia chemo-induced | Description: Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer chemotherapy |
| EC | Esa anemia non-chemoradio | Description: Erythropoetic stimulating agent (esa) administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapy |
| EB | Esa anemia radio-induced | Description: Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer radiotherapy |
| EP | Medicaid epsdt program svc | Description: Service provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) program |
| TC | Technical component | Description: Technical component under certain circumstances a charge may be made for the technical component alone under those circumstances the technical component charge is identified by adding modifier tc to the usual procedure number technical component cha |
| G7 | Payment limits do not apply | Description: Pregnancy resulted from rape or incest or pregnancy certified by physician as life threatening |
| G6 | Esrd patient <6 dialysismth | Description: Esrd patient for whom less than six dialysis sessions have been provided in a month |
| G5 | Urr reading of 75 or greater | Description: Most recent urr reading of 75 or greater |
| G4 | Urr reading of 70 to 74.9 | Description: Most recent urr reading of 70 to 74.9 |
| G3 | Urr reading of 65 to 69.9 | Description: Most recent urr reading of 65 to 69.9 |
| G2 | Urr reading of 60 to 64.9 | Description: Most recent urr reading of 60 to 64.9 |
| G1 | Urr reading of less than 60 | Description: Most recent urr reading of less than 60 |
| G9 | Mac for at risk patient | Description: Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition |
| G8 | Monitored anesthesia care | Description: Monitored anesthesia care (mac) for deep complex complicated or markedly invasive surgical procedure |
| GW | Service unrelated to term co | Description: Service not related to the hospice patients terminal condition |
| GV | Attending phys not hospice | Description: Attending physician not employed or paid under arrangement by the patients hospice provider |
| GU | Liability waiver rout notice | Description: Waiver of liability statement issued as required by payer policy routine notice |
| GT | Interactivetelecommunication | Description: Via interactive audio and video telecommunication systems |
| GS | Epodarbepoietin reduced 25% | Description: Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level |
| GR | Service by va resident | Description: This service was performed in whole or in part by a resident in a department of veterans affairs medical center or clinic supervised in accordance with va policy |
| GQ | Telehealth store and forward | Description: Via asynchronous telecommunications system |
| GP | Op pt services | Description: Services delivered under an outpatient physical therapy plan of care |
| GZ | Not reasonable and necessary | Description: Item or service expected to be denied as not reasonable and necessary |
| GY | Statutorily excluded | Description: Item or service statutorily excluded does not meet the definition of any medicare benefit or for non-medicare insurers is not a contract benefit |
| GX | Voluntary liability notice | Description: Notice of liability issued voluntary under payer policy |
| GG | Payment screen mam diagmam | Description: Performance and payment of a screening mammogram and diagnostic mammogram on the same patient same day |
| GF | Nonphysician serv c a hosp | Description: Non-physician (e.g. nurse practitioner (np) certified registered nurse anesthetist (crna) certified registered nurse (crn) clinical nurse specialist (cns) physician assistant (pa)) services in a critical access hospital |
| GE | Resident prim care exception | Description: This service has been performed by a resident without the presence of a teaching physician under the primary care exception |
| GD | Unit of service > mue value | Description: Units of service exceeds medically unlikely edit value and represents reasonable and necessary services |
| GC | Residentteaching phys serv | Description: This service has been performed in part by a resident under the direction of a teaching physician |
| GB | Claim resubmitted | Description: Claim being re-submitted for payment because it is no longer covered under a global payment demonstration |
| GA | Liability waiver ind case | Description: Waiver of liability statement issued as required by payer policy individual case |
| GO | Op occupational therapy serv | Description: Services delivered under an outpatient occupational therapy plan of care |
| GN | Op speech language service | Description: Services delivered under an outpatient speech language pathology plan of care |
| GM | Multiple transports | Description: Multiple patients on one ambulance trip |
| GL | Upgraded item no charge | Description: Medically unnecessary upgrade provided instead of non-upgraded item no charge no advance beneficiary notice (abn) |
| GK | Actual itemservice ordered | Description: Reasonable and necessary itemservice associated with a ga or gz modifier |
| GJ | Opt out provider of er srvc | Description: opt out" physician or practitioner emergency or urgent service" |
| GH | Diag mammo to screening mamo | Description: Diagnostic mammogram converted from screening mammogram on same day |
| HR | Familycouple w client prsnt | Description: Familycouple with client present |
| HS | Familycouple wo client prs | Description: Familycouple without client present |
| HP | Doctoral level | Description: Doctoral level |
| HQ | Group setting | Description: Group setting |
| HV | Funded state addiction agncy | Description: Funded state addictions agency |
| HW | State mntl hlth agncy funded | Description: Funded by state mental health agency |
| HT | Multi-disciplinary team | Description: Multi-disciplinary team |
| HU | Child welfare agency funded | Description: Funded by child welfare agency |
| HJ | Employee assistance program | Description: Employee assistance program |
| HK | Spec hgh rsk mntl hlth pop p | Description: Specialized mental health programs for high-risk populations |
| HH | Mental hlthsubstance abs pr | Description: Integrated mental healthsubstance abuse program |
| HI | Men hlth inteldev disab pgm | Description: Integrated mental health and intellectual disabilitydevelopmental disabilities program |
| HN | Bachelors degree level | Description: Bachelors degree level |
| HO | Masters degree level | Description: Masters degree level |
| HL | Intern | Description: Intern |
| HM | Less than bachelor degree lv | Description: Less than bachelor degree level |
| HB | Adult program non-geriatric | Description: Adult program non geriatric |
| HC | Adult program geriatric | Description: Adult program geriatric |
| HF | Substance abuse program | Description: Substance abuse program |
| HG | Opioid addiction tx program | Description: Opioid addiction treatment program |
| HE | Mental health program | Description: Mental health program |
| H9 | Court-ordered | Description: Court-ordered |
| HZ | Criminal justice agncy fund | Description: Funded by criminal justice agency |
| HX | Countylocal agency funded | Description: Funded by countylocal agency |
| HY | Funded by juvenile justice | Description: Funded by juvenile justice agency |
| HA | Childadolescent program | Description: Childadolescent program |
| HD | Pregnantparenting program | Description: Pregnantparenting womens program |
| EY | No md order for itemservice | Description: No physician or other licensed health care provider order for this item or service |
| EX | Expatriate beneficiary | Description: Expatriate beneficiary |
| ET | Emergency services | Description: Emergency services |
| JW | Discarded drug not administe | Description: Drug amount discardednot administered to any patient |
| JD | Skin sub not used as a graft | Description: Skin substitute not used as a graft |
| JE | Administered via dialysate | Description: Administered via dialysate |
| JF | Compounded drug | Description: Compounded drug |
| JG | 340b acquired drug | Description: Drug or biological acquired with 340b drug pricing program discount |
| JA | Administered intravenously | Description: Administered intravenously |
| JB | Administered subcutaneously | Description: Administered subcutaneously |
| JC | Skin substitute graft | Description: Skin substitute used as a graft |
| BO | Nutrition oral admin no tube | Description: Orally administered nutrition not by feeding tube |
| J4 | Dmepos comp bid furn by hosp | Description: Dmepos item subject to dmepos competitive bidding program that is furnished by a hospital upon discharge |
| J1 | Cap no-pay for prescript num | Description: Competitive acquisition program no-pay submission for a prescription number |
| J2 | Cap restock of emerg drugs | Description: Competitive acquisition program restocking of emergency drugs after emergency administration |
| J3 | Cap drug unavail thru cap | Description: Competitive acquisition program (cap) drug not available through cap as written reimbursed under average sales price methodology |
| K3 | Lwr ext prost functnl lvl 3 | Description: Lower extremity prosthesis functional level 3 - has the ability or potential for ambulation with variable cadence. typical of the community ambulator who has the ability to transverse most environmental barriers and may have vocational therapeutic or ex |
| K2 | Lwr ext prost functnl lvl 2 | Description: Lower extremity prosthesis functional level 2 - has the ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs stairs or uneven surfaces. typical of the limited community ambulator. |
| K1 | Lwr ext prost functnl lvl 1 | Description: Lower extremity prosthesis functional level 1 - has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. typical of the limited and unlimited household ambulator. |
| K0 | Lwr ext prost functnl lvl 0 | Description: Lower extremity prosthesis functional level 0 - does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance their quality of life or mobility. |
| K4 | Lwr ext prost functnl lvl 4 | Description: Lower extremity prosthesis functional level 4 - has the ability or potential for prosthetic ambulation that exceeds the basic ambulation skills exhibiting high impact stress or energy levels typical of the prosthetic demands of the child active adult |
| KC | Repl special pwr wc intrface | Description: Replacement of special power wheelchair interface |
| KB | >4 modifiers on claim | Description: Beneficiary requested upgrade for abn more than 4 modifiers identified on claim |
| KA | Wheelchair add-on optionacc | Description: Add on optionaccessory for wheelchair |
| KG | Dmepos comp bid prgm no 1 | Description: Dmepos item subject to dmepos competitive bidding program number 1 |
| KF | Fda class iii device | Description: Item designated by fda as class iii device |
| KE | Bid under round 1 dmepos cb | Description: Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment |
| KD | Drugbiological dme infused | Description: Drug or biological infused through dme |
| KK | Dmepos comp bid prgm no 2 | Description: Dmepos item subject to dmepos competitive bidding program number 2 |
| KJ | Dmepos pen pmp or 4-15mo rnt | Description: Dmepos item parenteral enteral nutrition (pen) pump or capped rental months four to fifteen |
| KI | Dmepos 2nd or 3rd mo rental | Description: Dmepos item second or third month rental |
| KH | Dmepos ini clm pur1 mo rnt | Description: Dmepos item initial claim purchase or first month rental |
| KO | Single drug unit dose form | Description: Single drug unit dose formulation |
| KN | Rplc facial prosth old mod | Description: Replacement of facial prosthesis using previous master model |
| KM | Rplc facial prosth new imp | Description: Replacement of facial prosthesis including new impressionmoulage |
| KL | Dmepos mailorder comp bid | Description: Dmepos item delivered via mail |
| KS | Glucose monitor supply | Description: Glucose monitor supply for diabetic beneficiary not treated with insulin |
| KR | Rental item partial month | Description: Rental item billing for partial month |
| KQ | 2ndsubsqnt drg multi drg ud | Description: Second or subsequent drug of a multiple drug unit dose formulation |
| KP | First drug of multi drug u d | Description: First drug of a multiple drug unit dose formulation |
| KW | Dmepos comp bid prgm no 4 | Description: Dmepos item subject to dmepos competitive bidding program number 4 |
| KV | Dmepos item profession serv | Description: Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service |
| KU | Dmepos comp bid prgm no 3 | Description: Dmepos item subject to dmepos competitive bidding program number 3 |
| KT | Item from noncontract supply | Description: Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item |
| KZ | New cov not implement by mc | Description: New coverage not implemented by managed care |
| KY | Dmepos comp bid prgm no 5 | Description: Dmepos item subject to dmepos competitive bidding program number 5 |
| KX | Documentation on file | Description: Requirements specified in the medical policy have been met |
| D0419 | Assess of salivary flow | Description: Assessment of salivary flow by measurement |
| D1551 | Recement space maint - max | Description: Re-cement or re-bond bilateral space maintainer - maxillary |
| D1552 | Recement space maint - man | Description: Re-cement or re-bond bilateral space maintainer - mandibular |
| D1553 | Recement unilat space maint | Description: Re-cement or re-bond unilateral space maintainer - per quadrant |
| D1556 | Rem fixed unilat space maint | Description: Removal of fixed unilateral space maintainer - per quadrant |
| D1557 | Remove fixed bilat maint max | Description: Removal of fixed bilateral space maintainer - maxillary |
| D1558 | Remove fixed bilat man | Description: Removal of fixed bilateral space maintainer - mandibular |
| D2753 | Crown porc fused to titanium | Description: Crown - porcelain fused to titanium and titanium alloys |
| D5284 | Rem unilat dent flex base | Description: Removable unilateral partial denture - one piece flexible base (including clasps and teeth) - per quadrant |
| D5286 | Rem unilat dent 1 pc resin | Description: Removable unilateral partial denture - one piece resin (including clasps and teeth) - per quadrant |
| D6082 | Imp crown porc to base alloy | Description: Implant supported crown - porcelain fused to predominantly base alloys |
| D6083 | Imp crown porc to noble allo | Description: Implant supported crown - porcelain fused to noble alloys |
| D6084 | Imp crown porc to titanium | Description: Implant supported crown - porcelain fused to titanium and titanium alloys |
| D6086 | Imp crown base alloys | Description: Implant supported crown - predominantly base alloys |
| D6087 | Implant crown noble alloys | Description: Implant supported crown - noble alloys |
| D6088 | Imp crown titanium alloys | Description: Implant supported crown - titanium and titanium alloys |
| D6097 | Abut crown porc to titanium | Description: Abutment supported crown - porcelain fused to titanium and titanium alloys |
| D6098 | Imp retain porc to base allo | Description: Implant supported retainer - porcelain fused to predominantly base alloys |
| D6099 | Imp retainer for fpd | Description: Implant supported retainer for fpd - porcelain fused to noble alloys |
| D6120 | Imp retain porc to titanium | Description: Implant supported retainer - porcelain fused to titanium and titanium alloys |
| D6121 | Retain metal fpd base alloys | Description: Implant supported retainer for metal fpd - predominantly base alloys |
| D6122 | Retain metal fpd noble alloy | Description: Implant supported retainer for metal fpd - noble alloys |
| D6123 | Retain metal fpd titanium | Description: Implant supported retainer for metal fpd - titanium and titanum alloys |
| D6195 | Abut retain porc to titanium | Description: Abutment supported retainer - porcelain fused to titanium and titanium alloys |
| D6243 | Pontic porcelain to titanium | Description: Pontic - porcelain fused to titanium and titanium alloys |
| D6753 | Retain crown porc to titaniu | Description: Retainer crown - porcelain fused to titanium and titanium alloys |
| D6784 | Retainer crown 3/4 titanium | Description: Retainer crown 3/4 - titanium and titanium alloys |
| D7922 | Place intra-socket bio dress | Description: Placement of intra-socket biological dressing to aid in hemostasis or clot stabilization, per site |
| D8696 | Rep of ortho appliance max | Description: Repair of orthodontic appliance - maxillary |
| D8697 | Rep of ortho appliance man | Description: Repair of orthodontic appliance - mandibular |
| D8698 | Recement fixed retainer max | Description: Re-cement or re-bond fixed retainer - maxillary |
| D8699 | Recement fixed retainer man | Description: Re-cement or re-bond fixed retainer - mandibular |
| D8701 | Repair fixed retainer max | Description: Repair of fixed retainer, includes reattachment - maxillary |
| D8702 | Repair of fixed retainer man | Description: Repair of fixed retainer, includes reattachment - mandibular |
| D8703 | Replace broken retainer max | Description: Replacement of lost or broken retainer - maxillary |
| D8704 | Replace broken retainer man | Description: Replacement of lost or broken retainer - mandibular |
| D9997 | Dent case mgmt special needs | Description: Dental case management - patients with special health care needs |
| D1510 | Space maintainer fxd unilat | Description: Space maintainer - fixed, unilateral - per quadrant |
| D1520 | Remove unilat space maintain | Description: Space maintainer - removable, unilateral - per quadrant |
| D1575 | Dist space maint, fixed unil | Description: Distal shoe space maintainer - fixed, unilateral - per quadrant |
| D2794 | Crown-titanium | Description: Crown - titanium and titanium alloys |
| D5213 | Dentures maxill part metal | Description: Maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth) |
| D5214 | Dentures mandibl part metal | Description: Mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials,rests and teeth) |
| D5221 | Immed max part denture resin | Description: Immediate maxillary partial denture - resin base (including retentive/clasping materials, rest and teeth) |
| D5222 | Immed man part denture resin | Description: Immediate mandibular partial denture - resin base (including retentive/clasping materials, rests and teeth) |
| D5223 | Immed max part dent metal | Description: Immediate maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth) |
| D5224 | Immed mand part dent metal | Description: Immediate mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth) |
| D6066 | Implant supported mtl crown | Description: Implant supported crown - porcelain fused to high noble alloys |
| D6067 | Implant supported mtl crown | Description: Implant supported crown - high noble alloys |
| D6076 | Implant supported retainer | Description: Implant supported retainer for fpd - porcelain fused to high noble alloys |
| D6077 | Implant supported retainer | Description: Implant supported retainer for metal fpd - high noble alloys |
| D6094 | Abut support crown titanium | Description: Abutment supported crown - titanium and titanium alloys |
| D6194 | Abut support retainer titani | Description: Abutment supported retainer crown for fpd - titanium and titanium alloys |
| D6214 | Pontic titanium | Description: Pontic - titanium and titanium alloys |
| D6794 | Crown titanium | Description: Retainer crown - titanium and titanium alloys |
| D9310 | Consultation | Description: Diagnostic service provided by dentist or physician other than requesting dentist or physician |
| D0330 | Panoramic radiographic image | Description: Panoramic radiographic image |
| D0120 | Periodic oral evaluation | Description: Established patient |
| D0470 | Diagnostic casts | Description: Diagnostic casts |
| D7899 | Unspecified TMD therapy, by report | Description: Unspecified TMD therapy, by report |
| 0164A | ADM SRSCV2 BVL 10MCG/0.2ML B | Description: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 10 mcg/0.2 mL dosage, booster dose |
| 0173A | ADM SARSCV2 BVL 3MCG/0.2ML 3 | Description: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, third dose |
| 0306U | Onc mrd nxt-gnrj alys 1st | Description: Oncology (minimal residual disease [MRD]), nextgeneration targeted sequencing analysis, cell-free DNA, initial (baseline) assessment to determine a patient specific panel for future comparisons to evaluate for MRD |
| 0307U | Onc mrd nxt-gnrj alys sbsq | Description: Oncology (minimal residual disease [MRD]), nextgeneration targeted sequencing analysis of a patientspecific panel, cell-free DNA, subsequent assessment with comparison to previously analyzed patient specimens to evaluate for MRD |
| 0308U | Crd cad alys 3 prtn plsm alg | Description: Cardiology (coronary artery disease [CAD]), analysis of 3 proteins (high sensitivity [hs] troponin, adiponectin, and kidney injury molecule-1 [KIM-1]), plasma, algorithm reported as a risk score for obstructive CAD |
| 0309U | Crd cv ds aly 4 prtn plm alg | Description: Cardiology (cardiovascular disease), analysis of 4 proteins (NT-proBNP, osteopontin, tissue inhibitor of metalloproteinase-1 [TIMP-1], and kidney injury molecule-1 [KIM-1]), plasma, algorithm reported as a risk score for major adverse cardiac event |
| 0310U | Ped vsclts kd alys 3 bmrks | Description: Pediatrics (vasculitis, Kawasaki disease [KD]), analysis of 3 biomarkers (NT-proBNP, C-reactive protein, and T-uptake), plasma, algorithm reported as a risk score for KD |
| 0311U | Nfct ds bct quan antmcrb sc | Description: Infectious disease (bacterial), quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)–based antimicrobial susceptibility for each organisms identified |
| 0312U | Ai ds sle alys 8 igg autoant | Description: Autoimmune diseases (eg, systemic lupus erythematosus [SLE]), analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorbent immunoassay (ELISA), flow cytometry and indirect immunofluorescence, serum, or plasma and whole blood, individual components reported along with an algorithmic SLE-likelihood assessment |
| 0313U | Onc pncrs dna&mrna seq 74 | Description: Oncology (pancreas), DNA and mRNA nextgeneration sequencing analysis of 74 genes and analysis of CEA (CEACAM5) gene expression, pancreatic cyst fluid, algorithm reported as a categorical result (ie, negative, low probability of neoplasia or positive, high probability of neoplasia) |
| 0314U | Onc cutan mlnma mrna 35 gene | Description: Oncology (cutaneous melanoma), mRNA gene expression profiling by RT-PCR of 35 genes (32 content and 3 housekeeping), utilizing formalinfixed paraffin-embedded (FFPE) tissue, algorithm reported as a categorical result (ie, benign, intermediate, malignant) |
| 0315U | Onc cutan sq cll ca mrna 40 | Description: Oncology (cutaneous squamous cell carcinoma), mRNA gene expression profiling by RT-PCR of 40 genes (34 content and 6 housekeeping), utilizing formalin-fixed paraffin-embedded (FFPE) tissue, algorithm reported as a categorical risk result (ie, Class 1, Class 2A, Class 2B) |
| 0316U | B brgdrferi lyme ds ospa evl | Description: Borrelia burgdorferi (Lyme disease), OspA protein evaluation, urine |
| 0317U | Onc lung ca 4-prb fish assay | Description: Oncology (lung cancer), four-probe FISH (3q29, 3p22.1, 10q22.3, 10cen) assay, whole blood, predictive algorithm-generated evaluation reported as decreased or increased risk for lung cancer |
| 0318U | Ped whl gen mthyltn alys 50+ | Description: Pediatrics (congenital epigenetic disorders), whole genome methylation analysis by microarray for 50 or more genes, blood |
| 0319U | Neph rna pretrnspl perph bld | Description: Nephrology (renal transplant), RNA expression by select transcriptome sequencing, using pretransplant peripheral blood, algorithm reported as a risk score for early acute rejection |
| 0320U | Neph rna psttrnspl perph bld | Description: Nephrology (renal transplant), RNA expression by select transcriptome sequencing, using posttransplant peripheral blood, algorithm reported as a risk score for acute cellular rejection |
| 0321U | Iadna gu pthgn 20bct&fng org | Description: Infectious agent detection by nucleic acid (DNA or RNA), genitourinary pathogens, identification of 20 bacterial and fungal organisms and identification of 16 associated antibioticresistance genes, multiplex amplified probe technique |
| 0322U | Neuro asd meas 14 acyl carn | Description: Neurology (autism spectrum disorder [ASD]), quantitative measurements of 14 acyl carnitines and microbiome-derived metabolites, liquid chromatography with tandem mass spectrometry (LC-MS/MS), plasma, results reported as negative or positive for risk of metabolic subtypes associated with ASD |
| 0323U | Iadna cns pthgn next gen seq | Description: Infectious agent detection by nucleic acid (DNA and RNA), central nervous system pathogen, metagenomic next-generation sequencing, cerebrospinal fluid (CSF), identification of pathogenic bacteria, viruses, parasites, or fungi |
| 0324U | ONC OVAR SPHRD CELL 4 RX PN | Description: Oncology (ovarian), spheroid cell culture, 4-drug panel (carboplatin, doxorubicin, gemcitabine, paclitaxel), tumor chemotherapy response prediction for each drug |
| 0325U | ONC OVAR SPHRD CELL PARP | Description: Oncology (ovarian), spheroid cell culture, poly (ADP-ribose) polymerase (PARP) inhibitors (niraparib, olaparib, rucaparib, velparib), tumor response prediction for each drug |
| 0326U | Trgt gen seq alys pnl 83+ | Description: Targeted genomic sequence analysis panel, solid organ neoplasm, cell-free circulating DNA analysis of 83 or more genes, interrogation for sequence variants, gene copy number amplifications, gene rearrangements, microsatellite instability and tumor mutational burden |
| 0327U | Ftl aneuploidy trsmy dna seq | Description: Fetal aneuploidy (trisomy 13, 18, and 21), DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy, includes sex reporting, if performed |
| 0328U | Drug assay 120+ rx&metablt | Description: Drug assay, definitive, 120 or more drugs and metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS), includes specimen validity and algorithmic analysis describing drug or metabolite and presence or absence of risks for a significant patient-adverse event, per date of service |
| 0329U | Onc neo xome&trns seq alys | Description: Oncology (neoplasia), exome and transcriptome sequence analysis for sequence variants, gene copy number amplifications and deletions, gene rearrangements, microsatellite instability and tumor mutational burden utilizing DNA and RNA from tumor with DNA from normal blood or saliva for subtraction, report of clinically significant mutation(s) with therapy associations |
| 0330U | Iadna vag pthgn panel 27 org | Description: Infectious agent detection by nucleic acid (DNA or RNA), vaginal pathogen panel, identification of 27 organisms, amplified probe technique, vaginal swab |
| 0331U | Onc hl neo opt gen mapping | Description: Oncology (hematolymphoid neoplasia), optical genome mapping for copy number alterations and gene rearrangements utilizing DNA from blood or bone marrow, report of clinically significant alterations |
| 0332U | Onc pan tum gen prflg 8 dna | Description: Oncology (pan-tumor), genetic profiling of 8 DNA-regulatory (epigenetic) markers by quantitative polymerase chain reaction (qPCR), whole blood, reported as a high or low probability of responding to immune checkpoint–inhibitor therapy |
| 0333U | Onc lvr surveilanc hcc cfdna | Description: Oncology (liver), surveillance for hepatocellular carcinoma (HCC) in high-risk patients, analysis of methylation patterns on circulating cell-free DNA (cfDNA) plus measurement of serum of AFP/AFP-L3 and oncoprotein des-gamma-carboxy-prothrombin (DCP), algorithm reported as normal or abnormal result |
| 0334U | Onc sld orgn tgsa dna 84/+ | Description: Oncology (solid organ), targeted genomic sequence analysis, formalin-fixed paraffin-embedded (FFPE) tumor tissue, DNA analysis, 84 or more genes, interrogation for sequence variants, gene copy number amplifications, gene rearrangements, microsatellite instability and tumor mutational burden |
| 0335U | Rare ds whl gen seq feta | Description: Rare diseases (constitutional/heritable disorders), whole genome sequence analysis, including small sequence changes, copy number variants, deletions, duplications, mobile element insertions, uniparental disomy (UPD), inversions, aneuploidy, mitochondrial genome sequence analysis with heteroplasmy and large deletions, short tandem repeat (STR) gene expansions, fetal sample, identification and categorization of genetic variants u(Do not report 0335U in conjunction with 81425, 0212U)t |
| 0336U | Rare ds whl gen seq bld/slv | Description: Rare diseases (constitutional/heritable disorders), whole genome sequence analysis, including small sequence changes, copy number variants, deletions, duplications, mobile element insertions, uniparental disomy (UPD), inversions, aneuploidy, mitochondrial genome sequence analysis with heteroplasmy and large deletions, short tandem repeat (STR) gene expansions, blood or saliva, identification and categorization of genetic variants, each comparator genome (eg, parent) u(Do not report 0336U in conjunction with 81426, 0213U)t |