In compliance with the Health Insurance Portability and Accountability Act (HIPAA), CMS eliminated the 3-month grace period for discontinued codes in Change Request (CR) 3093 dated February 6, 2004. Effective for dates of services on/after January 1, 2010, there is no grace period for billing discontinued HCPCS codes.
NOTE: The inclusions of modifiers or codes in this article do not necessarily indicate coverage. New modifiers and HCPCS identified as Durable Medical Equipment (DME) are not included in this listing.
This taken from Noridian website, CMS update: https://med.noridianmedicare.com/web/jeb/article-detail/-/view/10525/modifier-and-hcpcs-changes-for-2014 Also follow this link to see deleted codes for 2014.
New Modifiers for 2014
| Modifier | Description |
|---|---|
| AO | Alternate payment method declined by provider of service |
| JE | Administered via dialysate |
| PM | Post mortem |
New 2014 HCPCS
| HCPCS | Description |
|---|---|
| A4555 | Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only |
| A9520 | Technetium tc-99m, tilmanocept, diagnostic, up to 0.5 millicuries |
| A9575 | Injection, gadoterate meglumine, 0.1 ml |
| A9599 | Radiopharmaceutical, diagnostic, for beta-amyloid positron emission tomography (pet) imaging, per study dose |
| C1841 | Retinal prosthesis, includes all internal and external components |
| C5271 | Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area |
| C5272 | Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure) |
| C5273 | Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children |
| C5274 | Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure) |
| C5275 | Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area |
| C5276 | Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure) |
| C5277 | Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children |
| C5278 | Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure) |
| C9132 | Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity |
| C9133 | Factor ix (antihemophilic factor, recombinant), rixibus, per i.u. |
| C9441 | Injection, ferric carboxymaltose, 1 mg |
| C9497 | Loxapine, inhalation powder, 10 mg |
| C9735 | Anoscopy; with directed submucosal injection(s), any substance |
| C9737 | Laparoscopy, surgical, esophageal sphincter augmentation with device (eg, magnetic band) |
| D0393 | Treatment simulation using 3d image volume |
| D0394 | Digital subtraction of two or more images or image volumes of the same modality |
| D0395 | Fusion of two or more 3d image volumes of one or more modalities |
| D0601 | Caries risk assessment and documentation, with a finding of low risk |
| D0602 | Caries risk assessment and documentation, with a finding of moderate risk |
| D0603 | Caries risk assessment and documentation, with a finding of high risk |
| D1999 | Unspecified preventive procedure, by report |
| D2921 | Reattachment of tooth fragment, incisal edge or cusp |
| D2941 | Interim therapeutic restoration - primary dentition |
| D2949 | Restorative foundation for an indirect restoration |
| D3355 | Pulpal regeneration - initial visit |
| D3356 | Pulpal regeneration - interim medication replacement |
| D3357 | Pulpal regeneration - completion of treatment |
| D3427 | Periradicular surgery without apicoectomy |
| D3428 | Bone graft in conjunction with periradicular surgery - per tooth, single site |
| D3429 | Bone graft in conjunction with periradicular surgery - each additional contiguous tooth in the same surgical site |
| D3431 | Biologic materials to aid in soft and osseous tissue regeneration in conjunction with periradicular surgery |
| D3432 | Guided tissue regeneration, resorbable barrier, per site, in conjunction with periradicular surgery |
| D4921 | Gingival irrigation - per quadrant |
| D5863 | Overdenture - complete maxillary |
| D5864 | Overdenture - partial maxillary |
| D5865 | Overdenture - complete mandibular |
| D5866 | Overdenture - partial mandibular |
| D5994 | Peridontal medicament carrier with peripheral seal - laboratory processed |
| D6011 | Second stage implant surgery |
| D6013 | Surgical placement of mini implant |
| D6052 | Semi-precision attachment abutment |
| D8694 | Repair of fixed retainers, includes reattachment |
| D9985 | Sales tax |
| G0461 | Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain |
| G0462 | Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure) |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient |
| G9187 | Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/management, patient compliance with orders/plan of care, performance of activities of daily living, appropriateness of care setting; (for use only in the meidcare-approved bundled payments for care improvement initiative); may not be billed for a 30-day period covered by a transitional care management code |
| G9188 | Beta-blocker therapy not prescribed, reason not given |
| G9189 | Beta-blocker therapy prescribed or currently being taken |
| G9190 | Documentation of medical reason(s) for not prescribing beta-blocker therapy (eg, allergy, intolerance, other medical reasons) |
| G9191 | Documentation of patient reason(s) for not prescribing beta-blocker therapy (eg, patient declined, other patient reasons) |
| G9192 | Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the health care system) |
| G9193 | Clinician documented that patient with a diagnosis of major depression was not an eligible candidate for antidepressant medication treatment or patient did not have a diagnosis of major depression |
| G9194 | Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 180 day (6 month) continuation treatment phase |
| G9195 | Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 180 day (6 months) continuation treatment phase |
| G9196 | Documentation of medical reason(s) for not ordering first or second generation cephalosporin for antimicrobial prophylaxis |
| G9197 | Documentation of order for first or second generation cephalosporin for antimicrobial prophylaxis |
| G9198 | Order for first or second generation cephalosporin for antimicrobial prophylaxis was not documented, reason not given |
| G9199 | Venous thromboembolism (vte) prophylaxis not administered the day of or the day after hospital admission for documented reasons (eg, patient is ambulatory, patient expired during inpatient stay, patient already on warfarin or another anticoagulant, other medical reason(s) or eg, patient left against medical advice, other patient reason(s)) |
| G9200 | Venous thromboembolism (vte) prophylaxis was not administered the day of or the day after hospital admission, reason not given |
| G9201 | Venous thromboembolism (vte) prophylaxis administered the day of or the day after hospital admission |
| G9202 | Patients with a positive hepatitis c antibody test |
| G9203 | Rna testing for hepatitis c documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c |
| G9204 | Rna testing for hepatitis c was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given |
| G9205 | Patient starting antiviral treatmentfor hepatitis c during the measurement period |
| G9206 | Patient starting antiviral treatment for hepatitis c during the measurement period |
| G9207 | Hepatitis c genotype testing documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c |
| G9208 | Hepatitis c genotype testing was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given |
| G9209 | Hepatitis c quantitative rna testing documented as performed between 4-12 weeks after the initiation of antiviral treatment |
| G9210 | Hepatitis c quantitative rna testing not performed between 4-12 weeks after the initiation of antiviral treatment for reasons documented by clinician (eg, patients whose treatment was discontinued during the testing period prior to testing, other medical reasons, patient declined, other patient reasons) |
| G9211 | Hepatitis c quantitative rna testing was not documented as performed between 4-12 weeks after the initiation of antiviral treatment, reason not given |
| G9212 | Dsm-ivtm criteria for major depressive disorder documented at the initial evaluation |
| G9213 | Dsm-iv-tr criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified |
| G9214 | Cd4+ cell count or cd4+ cell percentage results documented |
| G9215 | Cd4+ cell count or percentage not documented as performed, reason not given |
| G9216 | Pcp prophylaxis was not prescribed at time of diagnosis of hiv, reason not given |
| G9217 | Pcp prophylaxis was not prescribed within 3 months of low cd4+ cell count below 00 cells/mm3, reason not given |
| G9218 | Pcp prophylaxis was not prescribed within 3 months oflow cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%, reason not given |
| G9219 | Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3 for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis) |
| G9220 | Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15% for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis) |
| G9221 | Pneumocystis jiroveci pneumonia prophlaxis prescribed |
| G9222 | Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin 3 months of low cd4+ cell count below 200 cells/mm3 |
| G9223 | Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15% |
| G9224 | Documentation of medical reason for not performing foot exam (e.g., patient with bilateral foot/leg amputation) |
| G9225 | Foot exam was not performed, reason not given |
| G9226 | Foot examination performed (includes examination through visual inspection, sensory exam with monofilament, and pulse exam - report when all of the 3 components are completed) |
| G9227 | Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan |
| G9228 | Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings) |
| G9229 | Chlamydia, gonorrhea, and syphilis not screened, due to documented reason (patient refusal is the only allowed exclusion) |
| G9230 | Chlamydia, gonorrhea, and syphilis not screened, reason not given |
| G9231 | Documentation of end stage renal disease (esrd), dialysis, renal transplant or pregnancy |
| G9232 | Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition for specified patient reason |
| G9233 | All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient |
| G9234 | I intend to report the total knee replacement measures group |
| G9235 | All quality actions for the applicable measures in the general surgery measures group have been performed for this patient |
| G9236 | All quality actions for the applicable measures in the optimizing patient exposure to ionizing radiation measures group have been performed for this patient |
| G9237 | I intend to report the general surgery measures group |
| G9238 | I intend to report the optimizing patient exposure to ionizing radiation measures group |
| G9239 | Documentation of reasons for patient initiaiting maintenance hemodialysis with a catheter as the mode of vascular access (eg, patient has a maturing avf/avg, time-limited trial of hemodialysis, patients undergoing palliative dialysis, other medical reasons, patient declined avf/avg, other patient reasons, patient followed by reporting nephrologist for fewer than 90 days, other system reasons) |
| G9240 | Patient whose mode of vascular access is a catheter at the time maintenance hemodialysis is initiated |
| G9241 | Patient whose mode of vascular access is not a catheter at the time maintenance hemodialysis is initiated |
| G9242 | Documentation of viral load equal to or greater than 200 copies/ml |
| G9243 | Documentation of viral load less than 200 copies/ml |
| G9244 | Antiretroviral thereapy not prescribed |
| G9245 | Antiretroviral therapy prescribed |
| G9246 | Patient did not have at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits |
| G9247 | Patient had at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits |
| G9248 | Patient did not have a medical visit in the last 6 months |
| G9249 | Patient had a medical visit in the last 6 months |
| G9250 | Documentation of patient pain brought to a comfortable level within 48 hours from initial assessment |
| G9251 | Documentation of patient with pain not brought to a comfortable level within 48 hours from initial assessment |
| G9252 | Adenoma(s) or other neoplasm detected during screening colonoscopy |
| G9253 | Adenoma(s) or other neoplasm not detected during screening colonoscopy |
| G9254 | Documentation of patient discharged to home later than post-operative day 2 following cas |
| G9255 | Documentation of patient discharged to home no later than post operative day 2 following cas |
| G9256 | Documentation of patient death following cas |
| G9257 | Documentation of patient stroke following cas |
| G9258 | Documentation of patient stroke following cea |
| G9259 | Documentation of patient survival and absence of stroke following cas |
| G9260 | Documentation of patient death following cea |
| G9261 | Documentation of patient survival and absence of stroke following cea |
| G9262 | Documentation of patient death in the hospital following endovascular aaa repair |
| G9263 | Documentation of patient survival in the hospital following endovascular aaa repair |
| G9264 | Documentation of patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter for documented reasons (eg, patient is undergoing palliative dialysis with a catheter, patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant, other medical reasons, patient declined avf/avg, other patient reasons) |
| G9265 | Patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter as the mode of vascular access |
| G9266 | Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular access |
| G9267 | Documentation of patient with one or more complications or mortality within 30 days |
| G9268 | Documentation of patient with one or more complications within 90 days |
| G9269 | Documentation of patient without one or more complications and without mortality within 30 days |
| G9270 | Documentation of patient without one or more complications within 90 days |
| G9271 | Ldl value < 100 |
| G9272 | Ldl value >= 100 |
| G9273 | Blood pressure has a systolic value of < 140 and a diastolic value of < 90 |
| G9274 | Blood pressure has a systolic value of =140 and a diastolic value of = 90 or systolic value < 140 and diastolic value = 90 or systolic value = 140 and diastolic value < 90 |
| G9275 | Documentation that patient is a current non-tobacco user |
| G9276 | Documentation that patient is a current tobacco user |
| G9277 | Documentation that the patient is on daily aspirin or has documentation of a valid contraindication to aspirin automatic contraindications include anti-coagulant use, allergy, and history of gastrointestinal bleed; additionally, any reason documented by the physician as a reason for not taking daily aspirin is acceptable (examples include non-steroidal anti-inflammatory agents, risk for drug interaction, or uncontrolled hypertension defined as > 180 systolic or > 110 diastolic) |
| G9278 | Documentation that the patient is not on daily aspirin regimen |
| G9279 | Pneumococcal screening performed and documentation of vaccination received prior to discharge |
| G9280 | Pneumococcal vaccination not administered prior to discharge, reason not specified |
| G9281 | Screening performed and documentation that vaccination not indicated/patient refusal |
| G9282 | Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of non-small cell lung cancer or other documented medical reasons) |
| G9283 | Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation |
| G9284 | Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation |
| G9285 | Specimen site other than anatomic location of lung or is not classified as non small cell lung cancer |
| G9286 | Documentation of antibiotic regimen prescribed within 7 days of diagnosis or within 10 days after onset of symptoms |
| G9287 | No antibiotic regimen prescribed within 7 days of diagnosis or within 10 days after onset of symptoms |
| G9288 | Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., a solitary fibrous tumor in a person with a history of non-small cell carcinoma or other documented medical reasons ) |
| G9289 | Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation |
| G9290 | Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation |
| G9291 | Specimen site other than anatomic location of lung, is not classified as non small cell lung cancer or classified as nsclc-nos |
| G9292 | Documentation of medical reason(s) for not reporting pt category and a statement on thickness and ulceration and for pt1, mitotic rate (e.g., negative skin biopsies in a patient with a history of melanoma or other documented medical reasons) |
| G9293 | Pathology report does not include the pt category and a statement on thickness and ulceration and for pt1, mitotic rate |
| G9294 | Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate |
| G9295 | Specimen site other than anatomic cutaneous location |
| G9296 | Patients with documented shared decision-making including discussion of conservative (non-surgical) therapy prior to the procedure |
| G9297 | Shared decision-making including discussion of conservative (non-surgical) therapy prior to the procedure not documented, reason not given |
| G9298 | Patients who are evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure including history of dvt, pe, mi, arrhythmia and stroke |
| G9299 | Patients who are not evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure including history of dvt, pe, mi, arrhythmia and stroke, reason not given |
| G9300 | Documentation of medical reason(s) for not completely infusing the prophylactic antibiotic prior to the inflation of the proximal tourniquet (e.g., a tourniquet was not used) |
| G9301 | Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet |
| G9302 | Prophylactic antibiotic not completely infused prior to the inflation of the proximal tourniquet, reason not given |
| G9303 | Operative report does not identify the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of the prosthetic implant, reason not given |
| G9304 | Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of the prosthetic implant |
| G9305 | Intervention for presence of leak of endoluminal contents through an anastomosis not required |
| G9306 | Intervention for presence of leak of endoluminal contents through an anastomosis required |
| G9307 | No return to the operating room for a surgical procedure, for any reason, within 30 days of the principal operative procedure |
| G9308 | Unplanned return to the operating room for a surgical procedure, for any reason, within 30 days of the principal operative procedure |
| G9309 | No unplanned hospital readmission within 30 days of principal procedure |
| G9310 | Unplanned hospital readmission within 30 days of principal procedure |
| G9311 | No surgical site infection |
| G9312 | Surgical site infection |
| G9313 | Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason (eg, cystic fibrosis, immotile cilia disorders, ciliary dyskinesia, immune deficiency, prior history of sinus surgery within the past 12 months, and anatomic abnormalities, such as deviated nasal septum, resistant organisms, allergy to medication, recurrent sinusitis, chronic sinusitis, or other reasons) |
| G9314 | Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis, reason not given |
| G9315 | Documentation amoxicillin, with or without clavulanate, prescribed as a first line antibiotic at the time of diagnosis |
| G9316 | Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family |
| G9317 | Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family not completed |
| G9318 | Imaging study named according to standardized nomenclature |
| G9319 | Imaging study not named according to standardized nomenclature, reason not given |
| G9320 | Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery) |
| G9321 | Count of previous ct (any type of ct) and cardiac nuclear medicine (myocardial perfusion) studies documented in the 12-month period prior to the current study |
| G9322 | Count of previous ct and cardiac nuclear medicine (myocardial perfusion) studies not documented in the 12-month period prior to the current study, reason not given |
| G9323 | Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery) |
| G9324 | All necessary data elements not included, reason not given |
| G9325 | Ct studies not reported to a radiation dose index registry due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery) |
| G9326 | Ct studies performed not reported to a radiation dose index registry, reason not given |
| G9327 | Ct studies performed reported to a radiation dose index registry with all necessary data elements |
| G9328 | Dicom format image data availability not documented in final report due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery) |
| G9329 | Dicom format image data available to non-affiliated external entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study not documented in final report, reason not given |
| G9340 | Final report documented that dicom format image data available to non-affiliated external entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study |
| G9341 | Search conducted for prior patient ct imaging studies completed at non-affiliated external entities within the past 12-months and are available through a secure, authorized, media-free, shared archive prior to an imaging study being performed |
| G9342 | Search conducted for prior patient imaging studies completed at non-affiliated external entities within the past 12-months and are available through a secure, authorized, media-free, shared archive prior to an imaging study being performed not completed, reason not given |
| G9343 | Search for prior patient completed dicom format images not completed due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery) |
| G9344 | Search for prior patient completed dicom format images not completed due to system reasons (ie, facility does not have archival abilities through a shared archival system) |
| G9345 | Follow-up recommendations according to recommended guidelines for incidentally detected pulmonary nodules (eg, follow-up ct imaging studies needed or that no follow-up is needed) based at a minimum on nodule size and patient risk factors documented |
| G9346 | Follow-up recommendations according to recommended guidelines for incidentally detected pulmonary nodules not documented due to medical reasons (eg, patients with known malignant disease, patients with unexplained fever, ct studied performed for radiation treatment planning or image-guided radiation treatment delivery) |
| G9347 | Follow-up recommendations according to recommended guidelines for incidentally detected pulmonary nodules not documented, reason not given |
| G9348 | Ct scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons (eg, persons with sinusitis symptoms lasting at least 7 to 10 days, antibiotic resistance, immunocompromised, recurrent sinusitis, acute frontal sinusitis, acute sphenoid sinusitis, periorbital cellulitis, or other medical) |
| G9349 | Documentation of a ct scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis |
| G9350 | Ct scan of the paranasal sinuses not ordered at the time of diagnosis or received within 28 days after date of diagnosis |
| G9351 | More than one ct scan of the paranasal sinuses ordered or received within 90 days after diagnosis |
| G9352 | More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis, reason not given |
| G9353 | More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis for documented reasons (eg, patients with complications, second ct obtained prior to surgery, other medical reasons) |
| G9354 | More than one ct scan of the paranasal sinuses not ordered within 90 days after the date of diagnosis |
| G9355 | Elective delivery or early induction not performed |
| G9356 | Elective delivery or early induction performed |
| G9357 | Post-partum screenings, evaluations and education performed |
| G9358 | Post-partum screenings, evaluations and education not performed |
| G9359 | Documentation of negative or managed positive tb screen with further evidence that tb is not active |
| G9360 | No documentation of negative or managed positive tb screen |
| J0401 | Injection, aripiprazole, extended release, 1 mg |
| J0717 | Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) |
| J1442 | Injection, filgrastim (g-csf), 1 microgram |
| J1446 | Injection, tbo-filgrastim, 5 micrograms |
| J1556 | Injection, immune globulin (bivigam), 500 mg |
| J1602 | Injection, golimumab, 1 mg, for intravenous use |
| J3060 | Injection, taliglucerace alfa, 10 units |
| J3489 | Injection, zoledronic acid, 1 mg |
| J7301 | Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg |
| J9047 | Injection, carfilzomib, 1 mg |
| J9262 | Injection, omacetaxine mepesuccinate, 0.01 mg |
| J9306 | Injection, pertuzumab, 1 mg |
| J9354 | Injection, ado-trastuzumab emtansine, 1 mg |
| J9371 | Injection, vincristine sulfate liposome, 1 mg |
| J9400 | Injection, ziv-aflibercept, 1 mg |
| L8679 | Implantable neurostimulator, pulse generator, any type |
| Q0507 | Miscellaneous supply or accessory for use with an external ventricular assist device |
| Q0508 | Miscellaneous supply or accessory for use with an implanted ventricular assist device |
| Q0509 | Miscellaneous supply or accessory for use with any implanted ventricular assist device for which payment was not made under medicare part a |
| Q2028 | Injection, sculptra, 0.5 mg |
| Q2050 | Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10mg |
| Q2052 | Services, supplies and accessories used in the home under the medicare intravenous immune globulin (ivig) demonstration |
| Q3027 | Injection, interferon beta-1a, 1 mcg for intramuscular use |
| Q3028 | Injection, interferon beta-1a, 1 mcg for subcutaneous use |
| Q4137 | Amnioexcel or biodexcel, per square centimeter |
| Q4138 | Biodfence dryflex, per square centimeter |
| Q4139 | Amniomatrix or biodmatrix, injectable, 1 cc |
| Q4140 | Biodfence, per square centimeter |
| Q4141 | Alloskin ac, per square centimeter |
| Q4142 | Xcm biologic tissue matrix, per square centimeter |
| Q4143 | Repriza, per square centimeter |
| Q4145 | Epifix, injectable, 1 mg |
| Q4146 | Tensix, per square centimeter |
| Q4147 | Architect extracellular matrix, per square centimeter |
| Q4148 | Neox 1k, per square centimeter |
| Q4149 | Excellagen, 0.1 cc |
| S9960 | Ambulance service, conventional air services, nonemergency transport, one way (fixed wing) |
| S9961 | Ambulance service, conventional air service, nonemergency transport, one way (rotary wing) |
| T4544 | Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
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