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 | Claim Payment |
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|  | | Add-on Codes - 00.10.20g | |
| | | Anesthesia Services for a Cancelled or Discontinued Procedure - 01.00.02b | |
| | | Cast and Splint Applications and Associated Supplies Provided in the Office Setting - 00.10.15a | |
| | | Collection and Interpretation of Physiologic Data - 00.10.21b | |
| | | Computer Analysis and Generation of Automated Data in Conjunction with Diagnostic Studies - 06.00.01d | |
| | | Diagnostic and Therapeutic Radiopharmaceutical Agents - 09.00.32g | |
| | | Durable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum - 05.00.48e | |
| | | Echocardiography Contrast Agents - 09.00.11b | |
| | | Electrocardiogram (ECG/EKG) Reported with Single Photon Emission Computed Tomography (SPECT) for Myocardial Perfusion Imaging (MPI) - 03.02.12b | |
| | | Evaluation or Setup of a Cardiac Pacemaker Reported with an Electrocardiogram (ECG/EKG) - 03.02.13b | |
| | | High Osmolar Contrast Agents - 09.00.13b | |
| | | Infusion Therapy Services as Performed by Home Infusion Providers - 00.01.13d | |
| | | Insertion or Application of Urinary Catheters and the Associated Supplies Provided in the Office Setting - 03.12.04c | |
| | | Low Osmolar Contrast Agents - 09.00.31c | |
| | | Magnetic Resonance Imaging (MRI) Contrast Agents - 09.00.45d | |
| | | Modifier 24: Unrelated Evaluation and Management Service by the Same Physician during a Postoperative Period - 03.00.15h | |
| | | Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service - 03.00.06h | |
| | | Modifier 50: Bilateral Procedure - 03.00.05g | |
| | | Modifier 51 Exempt - 03.00.29e | |
| | | Modifier 51: Multiple Procedures - 03.00.07j | |
| | | Modifier 57: Decision for Surgery - 03.00.16h | |
| | | Modifier 59: Distinct Procedural Service - 03.00.08c | |
| | | Modifier 62: Two Surgeons - 00.10.11g | |
| | | Modifier 66: Surgical Team - 00.10.17e | |
| | | Modifier 76: Repeat Procedure by Same Physician - 03.00.02a | |
| | | Modifier 77: Repeat Procedure by Another Physician - 03.00.11a | |
| | | Modifier 78: Unplanned Return to the Operating/Procedure Room by the Same Physician Following the Initial Procedure for a Related Procedure During the Postoperative Period - 03.00.12c | |
| | | Modifier 79: Unrelated Procedure or Service by the Same Physician During the Postoperative Period - 03.00.28h | |
| | | Modifiers 26 (Professional Component) and TC (Technical Component) - 03.00.20e | |
| | | Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS - 00.10.18e | |
| | | Modifiers for Split or Shared Surgical Services (Modifiers 54, 55, and 56) - 03.00.31c | |
| | | Modifiers for Split or Shared Surgical Services (Modifiers 54, 55, and 56) - 03.00.31b | |
| | | Modifiers LT/RT: Left Side/Right Side Procedures - 03.00.10f | |
| | | Mohs' Micrographic Surgery - 11.08.23e | |
| | | Multiple Surgical Reduction Guidelines - 11.00.10i | |
| | | Never Events and Preventable Adverse Events - 00.01.44c | |
| | | Physician Standby Services - 00.10.16c | |
| | | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services - 00.01.25l | |
| | | Preoperative Consultations Performed by Providers in Anesthesia Specialties - 01.00.08b | |
| | | Prolonged Face-to-Face Physician Services - 00.10.32b | |
| | | Radiologic Guidance of a Procedure - 00.10.36h | |
| | | Reimbursement for the Administration of Immunizations - 07.00.15i | |
| | | Reporting and Documentation Requirements for Anesthesia Services - 00.01.14i | |
| | | Team Conferences - 00.10.31b | |
| | | Therapeutic Radiology Port Films - 09.00.23b | |
| | | Use of an Operating Microscope During a Surgical Procedure - 11.00.11e | |
| | | Whole-Body Integumentary Photography and Dermatoscopy - 07.07.05a | |
| DME MAC |
| |
| | | Ankle-Foot/Knee-Ankle-Foot Orthosis - L11527 | |
| | | Automatic External Defibrillators - L13613 | |
| | | Canes and Crutches - L11496 | |
| | | Cervical Traction Devices - L15844 | |
| | | Cold Therapy - L5038 | |
| | | Commodes - L11497 | |
| | | Enteral Nutrition - L5041 | |
| | | External Breast Prostheses - L5043 | |
| | | External Infusion Pumps - L5044 | |
| | | Eye Prosthesis
- L11529 | |
| | | Facial Prostheses - L5046 | |
| | | Glucose Monitors - L11530 | |
| | | Heating Pads and Heat Lamps - L28480 | |
| | | High Frequency Chest Wall Oscillation Devices - L12870 | |
| | | Hospital Beds And Accessories - L5049 | |
| | | Immunosuppressive Drugs - L11531 | |
| | | Infrared Heating Pad Systems - L12873 | |
| | | Intrapulmonary Percussive Ventilation System - L5051 | |
| | | Intravenous Immune Globulin - L27260 | |
| | | Knee Orthoses - L27263 | |
| | | Lower Limb Prostheses - L11464 | |
| | | Manual Wheelchair Bases - L11465 | |
| | | Mechanical In-exsufflation Devices - L12872 | |
| | | Nebulizers - L11499 | |
| | | Negative Pressure Wound Therapy Pumps - L11500 | |
| | | Oral Anticancer Drugs - L5057 | |
| | | Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - L5058 | |
| | | Oral Appliances for Obstructive Sleep Apnea - L28603 | |
| | | Orthopedic Footwear - L11467 | |
| | | Osteogenesis Stimulators - L11501 | |
| | | Ostomy Supplies - L11502 | |
| | | Oxygen and Oxygen Equipment - L11468 | |
| | | Parenteral Nutrition - L5063 | |
| | | Patient Lifts - L5064 | |
| | | Pneumatic Compression Devices - L11503 | |
| | | Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea - L11528 | |
| | | Power Mobility Devices - L21271 | |
| | | Pressure Reducing Support Surfaces - Group 1 - L5067 | |
| | | Pressure Reducing Support Surfaces - Group 2 - L5068 | |
| | | Pressure Reducing Support Surfaces - Group 3 - L5069 | |
| | | Refractive Lenses - L11532 | |
| | | Respiratory Assist Devices - L11504 | |
| | | Seat Lift Mechanisms - L11533 | |
| | | Speech Generating Devices - L11534 | |
| | | Spinal Orthoses: TLSO and LSO - L11470 | |
| | | Suction Pumps - L11505 | |
| | | Surgical Dressings - L11471 | |
| | | Therapeutic Shoes for Persons with Diabetes - L11535 | |
| | | Tracheostomy Care Supplies - L11536 | |
| | | Transcutaneous Electrical Nerve Stimulators (TENS) - L11506 | |
| | | Urological Supplies - L5080 | |
| | | Walkers - L11472 | |
| | | Wheelchair Options/Accessories - L11473 | |
| | | Wheelchair Seating - L15845 | |
| NCD |
| |
| | | (FDG) PET for Brain, Cervical, Ovarian, Pancreatic, Small Cell Lung, and Testicular Cancers - 220.6.14 | |
| | | (FDG) PET for Colorectal Cancer - 220.6.4 | |
| | | 24-Hour Ambulatory Esophageal pH Monitoring - 100.3 | |
| | | Abarelix for the Treatment of Prostate Cancer - 110.19 | |
| | | Abortion - 140.1 | |
| | | Acupuncture - 30.3 | |
| | | Acupuncture for Fibromyalgia - 30.3.1 | |
| | | Acupuncture for Osteoarthritis - 30.3.2 | |
| | | Adult Liver Transplantation - 260.1 | |
| | | Air-Fluidized Bed - 280.8 | |
| | | Alpha-fetoprotein (AFP) - 190.25 | |
| | | Ambulatory Blood Pressure Monitoring - 20.19 | |
| | | Ambulatory EEG Monitoring - 160.22 | |
| | | Anesthesia in Cardiac Pacemaker Surgery - 10.6 | |
| | | Anti-Cancer Chemotherapy for Colorectal Cancer - 110.17 | |
| | | Anti-Inhibitor Coagulant Complex (AICC) - 110.3 | |
| | | Antigens Prepared for Sublingual Administration - 110.9 | |
| | | Apheresis (Therapeutic Pheresis) - 110.14 | |
| | | Aprepitant for Chemotherapy-Induced Emesis - 110.18 | |
| | | Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee - 150.9 | |
| | | Artificial Hearts and Related Devices - 20.9 | |
| | | Assessing Patient's Suitability for Electrical Nerve Stimulation Therapy - 160.7.1 | |
| | | Autogenous Epidural Blood Graft - 10.5 | |
| | | Autologous Cellular Immunotherapy Treatment for Metastatic Prostate Cancer - 110.22 | |
| | | Bariatric Surgery for Treatment of Morbid Obesity - 100.1 | |
| | | Biofeedback Therapy - 30.1 | |
| | | Biofeedback Therapy for the Treatment of Urinary Incontinence - 30.1.1 | |
| | | Bladder Stimulators (Pacemakers) - 230.16 | |
| | | Blood-Derived Products for Chronic Non-Healing Wounds - 270.3 | |
| | | Blood Brain Barrier Osmotic Disruption for Treatment of Brain Tumors - 110.20 | |
| | | Blood Counts - 190.15 | |
| | | Blood Glucose Testing - 190.20 | |
| | | Blood Platelet Transfusions - 110.8 | |
| | | Blood Transfusions - 110.7 | |
| | | Bone (Mineral) Density Studies - 150.3 | |
| | | Breast Reconstruction Following Mastectomy - 140.2 | |
| | | Carcinoembryonic Antigen (CEA) - 190.26 | |
| | | Cardiac Catheterization Performed in Other than a Hospital Setting - 20.25 | |
| | | Cardiac Output Monitoring by Thoracic Electrical Bioimpedance (TEB) - 20.16 | |
| | | Cardiac Pacemaker Evaluation Services - 20.8.1 | |
| | | Cardiac Pacemakers - 20.8 | |
| | | Cardiac Rehabilitation Programs - 20.10 | |
| | | Cardiointegram (CIG) as an Alternative to Stress Test or Thallium Stress Test - 20.27 | |
| | | Carotid Body Resection/Carotid Body Denervation - 20.18 | |
| | | Carotid Sinus Nerve Stimulator - 160.6 | |
| | | Cavernous Nerves by Electrical Stimulation with Penile Plethysmography - 160.26 | |
| | | Cellular Therapy - 30.8 | |
| | | Certain Drugs Distributed by the National Cancer Institute - 110.2 | |
| | | Challenge Ingestion Food Testing - 110.12 | |
| | | Chelation Therapy for Treatment of Atherosclerosis - 20.21 | |
| | | Chemical Aversion Therapy for Treatment of Alcoholism - 130.3 | |
| | | Closed-Loop Blood Glucose Control Device (CBGCD) - 40.3 | |
| | | Cochlear Implantation - 50.3 | |
| | | Cochleostomy with Neurovascular Transplant for Meniere's Disease - 50.7 | |
| | | Collagen Crosslinks, any Method - 190.19 | |
| | | Collagen Meniscus Implant - 150.12 | |
| | | Colonic Irrigation - 100.7 | |
| | | Colorectal Cancer Screening Tests - 210.3 | |
| | | Computed Tomography - 220.1 | |
| | | Computer Enhanced Perimetry - 80.9 | |
| | | Consultation Services Rendered by a Podiatrist in a Skilled Nursing Facility - 70.2 | |
| | | Consultations with a Beneficiary's Family and Associates - 70.1 | |
| | | Continuous Positive Airway Pressure (CPAP) Therapy For Obstructive Sleep Apnea (OSA) - 240.4 | |
| | | Corset Used as Hernia Support - 280.11 | |
| | | Counseling to Prevent Tobacco Use - 210.4.1 | |
| | | Cryosurgery of Prostate - 230.9 | |
| | | Cytogenetic Studies - 190.3 | |
| | | Cytotoxic Food Tests - 110.13 | |
| | | Deep Brain Stimulation for Essential Tremor and Parkinson's Disease - 160.24 | |
| | | Dental Examination Prior to Kidney Transplantation - 260.6 | |
| | | Dermal Injections for Treatment of Facial Lipodystrophy Syndrome (LDS) - 250.5 | |
| | | Diabetes Outpatient Self-Management Training - 40.1 | |
| | | Diagnosis and Treatment of Impotence - 230.4 | |
| | | Diagnostic Breath Analyses - 100.5 | |
| | | Diagnostic Endocardial Electrical Stimulation (Pacing) - 20.12 | |
| | | Diagnostic Pap Smears - 190.2 | |
| | | Diathermy Treatment - 150.5 | |
| | | Digital Subtraction Angiography - 220.9 | |
| | | Digoxin Therapeutic Drug Assay - 190.24 | |
| | | Dimethyl Sulfoxide (DMSO) - 230.12 | |
| | | Displacement Cardiography - 20.24 | |
| | | Durable Medical Equipment Reference List - 280.1 | |
| | | Electrical Aversion Therapy for Treatment of Alcoholism - 130.4 | |
| | | Electrical Continence Aid - 230.15 | |
| | | Electrical Nerve Stimulators - 160.7 | |
| | | Electrical Stimulation (ES) and Electromagnetic Therapy for the Treatment of Wounds - 270.1 | |
| | | Electrocardiographic (EKG) Services - 20.15 | |
| | | Electroencephalographic (EEG) Monitoring During Surgical Procedures Involving the Cerebral Vasculature - 160.8 | |
| | | Electron Microscope - 190.4 | |
| | | Electronecephalographic (EEG) Monitoring During Open-Heart Surgery - 160.9 | |
| | | Electronic Speech Aids - 50.2 | |
| | | Electrosleep Therapy - 30.4 | |
| | | Electrotherapy for Treatment of Facial Nerve Paralysis (Bell's Palsy) - 160.15 | |
| | | Endoscopy - 100.2 | |
| | | Endothelial Cell Photography - 80.8 | |
| | | Enteral and Parenteral Nutritional Therapy - 180.2 | |