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5e08d9ea-1b0b-41e3-bdb1-b89be8d6a671.aspx
  
07.00.14i​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Low-LevelLaserTherapy07.00.14iMedicine (07)​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Low-Level Laser Therapy5e08d9ea-1b0b-41e3-bdb1-b89be8d6a6718055​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Low-Level Laser Therapy07.00.14
1fb263be-f841-4014-bbd0-1407421bab22.aspx
  
08.00.62sAbatacept(Orencia®)forInjectionforIntravenousUse08.00.62sPharmacy (08)Abatacept (Orencia®) for Injection for Intravenous Use1fb263be-f841-4014-bbd0-1407421bab228810Abatacept (Orencia®) for Injection for Intravenous Use08.00.62
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11.00.16kAblationofLungTumors11.00.16kSurgery (11)Ablation of Lung Tumorsb8d61a09-49ae-4a5d-b3a1-6d4a2ee8490f8452Ablation of Lung Tumors11.00.16
cbf53801-3c3f-4dda-baab-7f1cb85bedc5.aspx
  
12.00.01iAcupuncture12.00.01iMiscellaneous (12)Acupuncturecbf53801-3c3f-4dda-baab-7f1cb85bedc58111Acupuncture12.00.01
{"8112": {"Id":8112,"MPAttachmentLetter":"A","Title":"ICD-10 CM Codes Eligible to be Reported for Acupuncture","MPPolicyAttachmentInternalSourceId":10302,"PolicyAttachmentPageName":"cc063bb2-cfd1-47da-8413-3775023fa7ec"},}
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12.04.04bAcuteCareFacilityInpatientTransfers12.04.04bMiscellaneous (12)Acute Care Facility Inpatient Transferscbbc457d-8295-4def-b941-b90e9316a9078669Acute Care Facility Inpatient Transfers12.04.04
f7a4114a-79c9-40bf-a707-b9706da6b983.aspx
  
08.02.21ADAMTS13,recombinant-krhn(Adzynma)08.02.21Pharmacy (08)ADAMTS13, recombinant-krhn (Adzynma)f7a4114a-79c9-40bf-a707-b9706da6b9837389ADAMTS13, recombinant-krhn (Adzynma)08.02.21
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08.01.11kAdo-TrastuzumabEmtansine(Kadcyla®)08.01.11kPharmacy (08)Ado-Trastuzumab Emtansine (Kadcyla®)a61441ae-a563-43f3-a72d-a0b518a6770b8583Ado-Trastuzumab Emtansine (Kadcyla®)08.01.11
fa233f88-c639-4295-85ca-aafdec293728.aspx
  
08.02.32aAfamitresgeneautoleucel(Tecelra®)08.02.32aPharmacy (08)Afamitresgene autoleucel (Tecelra®)fa233f88-c639-4295-85ca-aafdec2937288197Afamitresgene autoleucel (Tecelra®)08.02.32
805e6e81-b9cd-4d72-a68a-53851354feb5.aspx
  
08.00.69dAgalsidasebeta(Fabrazyme®)andpegunigalsidasealfa-iwxj(Elfabrio)08.00.69dPharmacy (08)Agalsidase beta (Fabrazyme®) and pegunigalsidase alfa-iwxj (Elfabrio) 805e6e81-b9cd-4d72-a68a-53851354feb58198Agalsidase beta (Fabrazyme®) and pegunigalsidase alfa-iwxj (Elfabrio) 08.00.69
7b233fad-4123-45d7-b468-7eab2fcbf43e.aspx
  
12.04.03dAirAmbulanceServices12.04.03dMiscellaneous (12)Air Ambulance Services7b233fad-4123-45d7-b468-7eab2fcbf43e7743Air Ambulance Services12.04.03
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08.01.22eAlemtuzumab(Lemtrada®)08.01.22ePharmacy (08)Alemtuzumab (Lemtrada®)26c88699-61ec-499a-8d4c-c6a6464855d58683Alemtuzumab (Lemtrada®)08.01.22
d2e26bdf-9c89-4298-a81b-d1f8d230c49d.aspx
  
08.00.72lAlglucosidasealfa(e.g.,Lumizyme®),Avalglucosidasealfa-ngpt(Nexviazyme®),Cipaglucosidasealfa-atga(Pombiliti™)08.00.72lPharmacy (08)Alglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® ), Cipaglucosidase alfa-atga (Pombiliti™ )d2e26bdf-9c89-4298-a81b-d1f8d230c49d8321Alglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® ), Cipaglucosidase alfa-atga (Pombiliti™ )08.00.72
d123f64f-cdb4-4ac5-9a74-9b2087031989.aspx
  
07.00.21kAllergyImmunotherapy07.00.21kMedicine (07)Allergy Immunotherapyd123f64f-cdb4-4ac5-9a74-9b20870319898279Allergy Immunotherapy07.00.21
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08.01.88bAllogeneicProcessedThymusTissue-agdc(Rethymic®)08.01.88bPharmacy (08)Allogeneic Processed Thymus Tissue-agdc (Rethymic®)ab56c356-66e4-4393-b78e-4d74ba43b4d78448Allogeneic Processed Thymus Tissue-agdc (Rethymic®)08.01.88
b6caac3b-d99e-42de-8a25-1161543abff4.aspx
  
06.02.29gAlloMap™MolecularExpressionTestingforHeartTransplantRejection(IndependenceAdministrators)06.02.29gPathology and Laboratory (06)AlloMap™ Molecular Expression Testing for Heart Transplant Rejection (Independence Administrators)b6caac3b-d99e-42de-8a25-1161543abff48189AlloMap™ Molecular Expression Testing for Heart Transplant Rejection (Independence Administrators)06.02.29
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08.00.91fAlpha-1AntitrypsinTherapy(e.g.,Prolastin-C®,AralastNP®,Glassia®,Zemaira®)08.00.91fPharmacy (08)Alpha-1 Antitrypsin Therapy (e.g., Prolastin-C®, Aralast NP®, Glassia®, Zemaira®)e5c6775a-632d-4cfb-af0b-8300fe2004da8373Alpha-1 Antitrypsin Therapy (e.g., Prolastin-C®, Aralast NP®, Glassia®, Zemaira®)08.00.91
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07.02.09kAmbulatoryBloodPressureMonitoring(ABPM)andHomeBloodPressureMonitoring(HBPM)Devices07.02.09kMedicine (07)Ambulatory Blood Pressure Monitoring (ABPM) and Home Blood Pressure Monitoring (HBPM) Devicesefb75765-c880-4fa1-bb30-a691d459bbc08300Ambulatory Blood Pressure Monitoring (ABPM) and Home Blood Pressure Monitoring (HBPM) Devices07.02.09
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07.02.21sAmbulatoryElectrocardiography(AECG)MonitoringandMobileCardiacOutpatientTelemetry(MCOT)Monitoring07.02.21sMedicine (07)Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring32acc430-5d20-40bc-a5cf-5681d61b8f0b8767Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring07.02.21
86af145b-25d3-44d4-8808-b51fd576512e.aspx
  
08.01.90dAmivantamab-vmjw(Rybrevant®)andAmivantamabandhyaluronidase-lpuj(RybrevantFaspro™)08.01.90dPharmacy (08)Amivantamab-vmjw (Rybrevant®) and Amivantamab and hyaluronidase-lpuj (Rybrevant Faspro™)86af145b-25d3-44d4-8808-b51fd576512e8536Amivantamab-vmjw (Rybrevant®) and Amivantamab and hyaluronidase-lpuj (Rybrevant Faspro™)08.01.90
43064546-2534-4bc2-8780-5901882eead0.aspx
  
01.00.12dAnesthesiaServicesforEpidural,ParavertebralFacetandSacroiliacJointInjectionsforSpinalJointManagement01.00.12dAnesthesia (01)Anesthesia Services for Epidural, Paravertebral Facet and Sacroiliac Joint Injections for Spinal Joint Management43064546-2534-4bc2-8780-5901882eead08167Anesthesia Services for Epidural, Paravertebral Facet and Sacroiliac Joint Injections for Spinal Joint Management01.00.12
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5f5612d6-ef42-4231-84d8-17163710e427.aspx
  
08.01.82cAnifrolumab-fnia(Saphnelo®)08.01.82cPharmacy (08)Anifrolumab-fnia (Saphnelo®)5f5612d6-ef42-4231-84d8-17163710e4278381Anifrolumab-fnia (Saphnelo®)08.01.82
242c3799-9add-4ecd-b70f-1e56c60f8408.aspx
  
05.00.39xAnkle-Foot/Knee-Ankle-FootOrthosis05.00.39xDME (05)Ankle-Foot/Knee-Ankle-Foot Orthosis242c3799-9add-4ecd-b70f-1e56c60f84088750Ankle-Foot/Knee-Ankle-Foot Orthosis05.00.39
{"8751": {"Id":8751,"MPAttachmentLetter":"A","Title":"HCPCS Codes","MPPolicyAttachmentInternalSourceId":10938,"PolicyAttachmentPageName":"e91a1c25-41c9-40ea-b802-addf3a9a6a8e"},}
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06.03.04pApheresisTherapy06.03.04pPathology and Laboratory (06)Apheresis Therapy930f52fc-a6f4-4613-86ca-59874fe9b6128221Apheresis Therapy06.03.04
64b4c7d8-0095-4f37-a464-11ddf52d9cba.aspx
  
05.00.84Apos®biomechanicalshoesystem05.00.84DME (05)Apos® biomechanical shoe system64b4c7d8-0095-4f37-a464-11ddf52d9cba7940Apos® biomechanical shoe system05.00.84
7322706a-04b7-4511-9aac-47f2aef58fcb.aspx
  
11.08.05gApplicationandRemovalofTattoos11.08.05gSurgery (11)Application and Removal of Tattoos7322706a-04b7-4511-9aac-47f2aef58fcb8170Application and Removal of Tattoos11.08.05
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14.00.03bAppliedBehaviorAnalysis(ABA)fortheTreatmentofAutismSpectrumDisorder(ASD)14.00.03bBehavioral Health (14)Applied Behavior Analysis (ABA) for the Treatment of Autism Spectrum Disorder (ASD)d805c027-d99b-4e5b-8127-41e3ced256137978Applied Behavior Analysis (ABA) for the Treatment of Autism Spectrum Disorder (ASD)14.00.03
eca9aec5-79eb-4753-b090-289669e9972b.aspx
  
11.05.16nAqueousShunts,MinimallyInvasiveGlaucomaSurgeries(includingMicrostents),Viscocanalostomy,andCanaloplastyfortheTreatmentofGlaucoma11.05.16nSurgery (11)Aqueous Shunts, Minimally Invasive Glaucoma Surgeries (including Microstents), Viscocanalostomy, and Canaloplasty for the Treatment of Glaucomaeca9aec5-79eb-4753-b090-289669e9972b8630Aqueous Shunts, Minimally Invasive Glaucoma Surgeries (including Microstents), Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma11.05.16
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11.14.19pArtificialIntervertebralCervicalDiscInsertion(IndependenceAdministrators)11.14.19pSurgery (11)Artificial Intervertebral Cervical Disc Insertion (Independence Administrators)731122a5-ce6b-4828-8fe1-ed08ddd7f8ee7348Artificial Intervertebral Cervical Disc Insertion (Independence Administrators)11.14.19
7217c1c1-b007-4707-a5ae-20727155c9e9.aspx
  
08.01.35kAsparaginaseErwiniaChrysanthemi(recombinant)-rywn(Rylaze®)08.01.35kPharmacy (08)Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)7217c1c1-b007-4707-a5ae-20727155c9e98389Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)08.01.35
357e6ac6-0f1f-47d0-9edf-f5354cd96785.aspx
  
06.02.27pAssaysofGeneticExpressioninTumorTissueforBreastCancerPrognosis(IndependenceAdministrators)06.02.27pPathology and Laboratory (06)Assays of Genetic Expression in Tumor Tissue for Breast Cancer Prognosis (Independence Administrators)357e6ac6-0f1f-47d0-9edf-f5354cd967858701Assays of Genetic Expression in Tumor Tissue for Breast Cancer Prognosis (Independence Administrators)06.02.27
b753c112-cb1c-4a31-a437-b39ee728998e.aspx
  
07.10.06jAssistedReproductiveTechnologyforInfertilityandOocyteCryopreservation07.10.06jMedicine (07)Assisted Reproductive Technology for Infertility and Oocyte Cryopreservationb753c112-cb1c-4a31-a437-b39ee728998e6522Assisted Reproductive Technology for Infertility and Oocyte Cryopreservation07.10.06
dc0c7f86-c63f-4e4c-a6a6-203edc2316a0.aspx
  
08.01.69gAtezolizumab(Tecentriq®)andAtezolizumabwithHyaluronidase-tqjs(TecentriqHybreza™)08.01.69gPharmacy (08)Atezolizumab (Tecentriq®) and Atezolizumab with Hyaluronidase-tqjs (Tecentriq Hybreza™)dc0c7f86-c63f-4e4c-a6a6-203edc2316a08658Atezolizumab (Tecentriq®) and Atezolizumab with Hyaluronidase-tqjs (Tecentriq Hybreza™)08.01.69
{"8659": {"Id":8659,"MPAttachmentLetter":"A","Title":"Duration of Treatment Requirements For Atezolizumab (Tecentriq®) and Atezolizumab with Hyaluronidase-tqjs (Tecentriq Hybreza™)","MPPolicyAttachmentInternalSourceId":10704,"PolicyAttachmentPageName":"ccb90b3b-34ab-4be0-97df-262db53c2db8"},}
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08.02.24Atidarsageneautotemcel(Lenmeldy)08.02.24Pharmacy (08)Atidarsagene autotemcel (Lenmeldy)d8255500-f961-47ca-a99c-66a2b10c11458734Atidarsagene autotemcel (Lenmeldy)08.02.24
4f86484b-c29e-4d08-ab21-1af7dc936b51.aspx
  
05.00.82AuricularProstheses05.00.82DME (05)Auricular Prostheses4f86484b-c29e-4d08-ab21-1af7dc936b518415Auricular Prostheses05.00.82
f143ab2e-1dac-4fea-a702-04fb7ef7a85c.aspx
  
11.14.06jAutologousChondrocyteImplantation(ACI)andOtherCell-basedTreatmentsofFocalArticularCartilageLesions(IndependenceAdministrators)11.14.06jSurgery (11)Autologous Chondrocyte Implantation (ACI) and Other Cell-based Treatments of Focal Articular Cartilage Lesions (Independence Administrators)f143ab2e-1dac-4fea-a702-04fb7ef7a85c8444Autologous Chondrocyte Implantation (ACI) and Other Cell-based Treatments of Focal Articular Cartilage Lesions (Independence Administrators)11.14.06
dbaf113b-75ac-41fa-9e17-0aaaee762709.aspx
  
05.00.29pAutomaticExternalCardioverterDefibrillators(WearableandNonwearable)05.00.29pDME (05)Automatic External Cardioverter Defibrillators (Wearable and Nonwearable)dbaf113b-75ac-41fa-9e17-0aaaee7627098757Automatic External Cardioverter Defibrillators (Wearable and Nonwearable)05.00.29
{"8758": {"Id":8758,"MPAttachmentLetter":"B","Title":"ICD-10 codes used to represent the Nonwearable Automatic External Defibrillator (AED):","MPPolicyAttachmentInternalSourceId":11020,"PolicyAttachmentPageName":"1f7c7b5e-3ce3-49e4-99ef-7091bb9c2675"},"8759": {"Id":8759,"MPAttachmentLetter":"A","Title":"ICD-10 Codes used to represent the Wearable Automatic External Defibrillator (AED):","MPPolicyAttachmentInternalSourceId":11021,"PolicyAttachmentPageName":"2780bf26-8684-4985-bd6e-e5cad53cb1e4"},}
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07.03.23hAutonomicNervousSystemTesting07.03.23hMedicine (07)Autonomic Nervous System Testing8d28731e-69dd-46c3-9ccd-1f7c40580ff88186Autonomic Nervous System Testing07.03.23
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08.01.64eAvelumab(Bavencio®)08.01.64ePharmacy (08)Avelumab (Bavencio®)daa39d63-ad21-4f2f-9707-5a304116216c7970Avelumab (Bavencio®)08.01.64
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08.02.34Axatilimab-csfr(Niktimvo™)forIntravenousUse08.02.34Pharmacy (08)Axatilimab-csfr (Niktimvo™) for Intravenous Use07ebee84-3d60-462e-a2ab-67aa08472e7b8284Axatilimab-csfr (Niktimvo™) for Intravenous Use08.02.34
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11.16.06kBalloonCatheterDilationofSinusOstiaforTreatmentofChronicRhinosinusitisorRecurrentAcuteRhinosinusitis11.16.06kSurgery (11)Balloon Catheter Dilation of Sinus Ostia for Treatment of Chronic Rhinosinusitis or Recurrent Acute Rhinosinusitis06478bb4-9c20-4f00-abbb-6302983f60f07209Balloon Catheter Dilation of Sinus Ostia for Treatment of Chronic Rhinosinusitis or Recurrent Acute Rhinosinusitis11.16.06
10568152-7c5d-4c3a-938d-f948bd08aa91.aspx
  
11.03.02xBariatricSurgery11.03.02xSurgery (11)Bariatric Surgery10568152-7c5d-4c3a-938d-f948bd08aa917946Bariatric Surgery11.03.02
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08.02.53aBelantamabmafodotin-blmf(Blenrep)08.02.53aPharmacy (08)Belantamab mafodotin-blmf (Blenrep)2034e81a-5527-4fea-8588-3f63a26135728540Belantamab mafodotin-blmf (Blenrep)08.02.53
0cec878a-3fe6-4a0f-8b22-4262096497d2.aspx
  
08.00.99eBelimumab(Benlysta®)forIntravenousUse08.00.99ePharmacy (08)Belimumab (Benlysta®) for Intravenous Use0cec878a-3fe6-4a0f-8b22-4262096497d28605Belimumab (Benlysta®) for Intravenous Use08.00.99
a7873711-965e-488a-bbf2-7e39b7a29da0.aspx
  
08.02.10bBeremageneGeperpavec(Vyjuvek™)08.02.10bPharmacy (08)Beremagene Geperpavec (Vyjuvek™)a7873711-965e-488a-bbf2-7e39b7a29da07953Beremagene Geperpavec (Vyjuvek™)08.02.10
9bc3c0c4-11e7-429a-bc7c-7184504e0383.aspx
  
08.01.89aBetibeglogeneAutotemcel[Beti-Cel(ZYNTEGLO®)]08.01.89aPharmacy (08)Betibeglogene Autotemcel [Beti-Cel (ZYNTEGLO®)]9bc3c0c4-11e7-429a-bc7c-7184504e03837388Betibeglogene Autotemcel [Beti-Cel (ZYNTEGLO®)]08.01.89
3e6cc57f-8a22-44be-a614-18e1d5baaad8.aspx
  
08.00.66xBevacizumab(Avastin®)andRelatedBiosimilarsForOncologicUse08.00.66xPharmacy (08)Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use3e6cc57f-8a22-44be-a614-18e1d5baaad88341Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use08.00.66
{"8342": {"Id":8342,"MPAttachmentLetter":"A","Title":"ICD 10 Diagnosis Codes","MPPolicyAttachmentInternalSourceId":10203,"PolicyAttachmentPageName":"cec8128a-b9f8-4393-a584-224ca8122447"},}
3bf2f4cf-199d-4b1d-bccd-f34eb5875d86.aspx
  
00.10.39sBillingforProfessionalOffice-BasedServicesPerformedinanOutpatientOffice-BasedSettingLocatedWithinaFacilityoronaFacilityCampus00.10.39sAdministrative (00)Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located Within a Facility or on a Facility Campus3bf2f4cf-199d-4b1d-bccd-f34eb5875d868563Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located Within a Facility or on a Facility Campus00.10.39
{"8564": {"Id":8564,"MPAttachmentLetter":"A","Title":"Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus","MPPolicyAttachmentInternalSourceId":10626,"PolicyAttachmentPageName":"fe85666e-b694-4862-87bb-a2e90183a197"},}
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00.10.38aBillingRequirementsforMultipleBirthsforProfessionalProviders00.10.38aAdministrative (00)Billing Requirements for Multiple Births for Professional Providers21ae79a9-3406-47c5-bb6d-1fae803679986302Billing Requirements for Multiple Births for Professional Providers00.10.38
{"6303": {"Id":6303,"MPAttachmentLetter":"C","Title":"CODING SCENARIOS FOR REPORTING HIGH-ORDER MULTIPLE (TRIPLETS, QUADRUPLETS, ETC) BIRTHS WHEN ROUTINE OBSTETRIC (GLOBAL MATERNITY/OBSTETRIC [OB]) CARE WAS PROVIDED","MPPolicyAttachmentInternalSourceId":8677,"PolicyAttachmentPageName":"eb66d5c6-6236-4d27-97a4-bcdd186ff868"},"6304": {"Id":6304,"MPAttachmentLetter":"A","Title":"MULTIPLE BIRTH CODING SCENARIOS FOR DELIVERY OF TWINS WHEN ROUTINE OBSTETRIC (GLOBALE MATERNITY/OBSTETRIC [OB]) CARE WAS PROVIDED","MPPolicyAttachmentInternalSourceId":8678,"PolicyAttachmentPageName":"d50dbf13-85a1-46a6-ba08-f3aa39e2c495"},"6305": {"Id":6305,"MPAttachmentLetter":"D","Title":"MULTIPLE BIRTH CODING SCENARIOS FOR DELIVERY OF HIGH-ORDER MULTIPLES WHEN ANTEPARTUM CARE IS NOT PROVIDED","MPPolicyAttachmentInternalSourceId":8679,"PolicyAttachmentPageName":"e4baa2eb-649c-4057-b59a-482ec93d4622"},"6306": {"Id":6306,"MPAttachmentLetter":"B","Title":"MULTIPLE BIRTH CODING SCENARIOS FOR DELIVERY OF TWINS WHEN ANETEPARTUM CARE IS NOT PROVIDED","MPPolicyAttachmentInternalSourceId":8680,"PolicyAttachmentPageName":"c6801920-f2e5-42bd-8e26-0f6161437f1b"},}
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11.08.20atBioengineeredSkinSubstitutes11.08.20atSurgery (11)Bioengineered Skin Substitutesbd85a15f-3d5f-47f3-a0b5-d946217178768696Bioengineered Skin Substitutes11.08.20
{"8697": {"Id":8697,"MPAttachmentLetter":"A","Title":"Skin Substitutes That Are Experimental/Investigational For All Indications.","MPPolicyAttachmentInternalSourceId":10497,"PolicyAttachmentPageName":"daf86ee9-ba06-47cb-9d67-0845e4233bfb"},}
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c671d1f8-9e2d-48d4-9922-435f032431bd.aspx
  
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