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08.01.40eLanreotide(Somatuline®Depot)08.01.40ePharmacy (08)Lanreotide (Somatuline® Depot)b23324af-17c8-465d-89a2-a53aa831de7b4618Lanreotide (Somatuline® Depot)08.01.40
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11.08.03mLipectomyandLiposuction11.08.03mSurgery (11)Lipectomy and Liposuctiona9305dbb-78ab-4c4a-888e-280db458b8625702Lipectomy and Liposuction11.08.03
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08.00.59cLoncastuximabtesirine-lpyl(Zynlonta®)08.00.59cPharmacy (08)Loncastuximab tesirine-lpyl (Zynlonta®)a3a2c530-9cbb-478e-8f5d-eb80dcba042f5772Loncastuximab tesirine-lpyl (Zynlonta®)08.00.59
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05.00.59lLowerLimbProstheses05.00.59lDME (05)Lower Limb Prosthesese75ec488-464c-4ff3-8b86-c84539ab60bd5040Lower Limb Prostheses05.00.59
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08.00.10cLuspatercept–aamt(Reblozyl®)08.00.10cPharmacy (08)Luspatercept–aamt (Reblozyl®)0f67d2dd-b927-4f7a-bbad-842856794d675316Luspatercept–aamt (Reblozyl®)08.00.10
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08.01.57Lutathera®(LutetiumLu177Dotatate)(IndependenceAdministrators)08.01.57Pharmacy (08)Lutathera® (Lutetium Lu 177 Dotatate) (Independence Administrators)008dc90f-ae42-4690-a94b-59b4e4d441955825Lutathera® (Lutetium Lu 177 Dotatate) (Independence Administrators)08.01.57
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06.02.01kLymeDisease:DiagnosisandIntravenous(IV)AntibioticTherapy06.02.01kPathology and Laboratory (06)Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Therapyea8b568d-9904-4482-bfac-b0b24d4acb005831Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Therapy06.02.01
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09.00.45kMagneticResonanceImaging(MRI)ContrastAgents09.00.45kRadiology (09)Magnetic Resonance Imaging (MRI) Contrast Agents7a62ee9d-35b3-428e-9f4a-0878c125066e5778Magnetic Resonance Imaging (MRI) Contrast Agents09.00.45
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08.01.37cMaintenanceTreatmentofOpioidorAlcoholUseDisorder08.01.37cPharmacy (08)Maintenance Treatment of Opioid or Alcohol Use Disorder df76937c-c78f-4b13-afb1-eedc0c58be4d5183Maintenance Treatment of Opioid or Alcohol Use Disorder 08.01.37
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11.14.24bManipulationUnderAnesthesia11.14.24bSurgery (11)Manipulation Under Anesthesia1512f401-509b-4e8d-8e8c-66dd81580dfb5033Manipulation Under Anesthesia11.14.24
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05.00.12jManualWheelchairs05.00.12jDME (05)Manual Wheelchairsaad25590-3c6e-4393-abd4-fdc897f4e3575200Manual Wheelchairs05.00.12
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08.01.75cMargetuximab-cmkb(Margenza)08.01.75cPharmacy (08)Margetuximab-cmkb (Margenza)c6110f54-8aba-43e3-ad1b-8f665b4fb3985375Margetuximab-cmkb (Margenza)08.01.75
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00.01.48dMarijuanaforMedicalUse00.01.48dAdministrative (00)Marijuana for Medical Usee2f8796c-a9d5-4675-8532-35b82f7ebbd45488Marijuana for Medical Use00.01.48
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07.11.02fMeasurementofExhaledNitricOxideandBreathCondensateintheDiagnosisandManagementofAsthmaandOtherRespiratoryDisorders07.11.02fMedicine (07)Measurement of Exhaled Nitric Oxide and Breath Condensate in the Diagnosis and Management of Asthma and Other Respiratory Disorders235e6ba3-5d6f-4355-a830-bbb600937b1b5332Measurement of Exhaled Nitric Oxide and Breath Condensate in the Diagnosis and Management of Asthma and Other Respiratory Disorders07.11.02
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06.02.39dMeasurementofSerumAntibodiestoandMeasurementofSerumLevelsofBiologics06.02.39dPathology and Laboratory (06)Measurement of Serum Antibodies to and Measurement of Serum Levels of Biologics7f27ada8-d669-4ec3-b68f-290aef45b5c65331Measurement of Serum Antibodies to and Measurement of Serum Levels of Biologics06.02.39
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05.00.70cMechanicalStretchingDevicesfortheTreatmentofJointStiffnessorContractures05.00.70cDME (05)Mechanical Stretching Devices for the Treatment of Joint Stiffness or Contracturesb7fe7e35-7711-4fdd-82eb-f752fad6f8215296Mechanical Stretching Devices for the Treatment of Joint Stiffness or Contractures05.00.70
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07.08.03hMedicalandSurgicalTreatmentofTemporomandibularJointDisorder07.08.03hMedicine (07)Medical and Surgical Treatment of Temporomandibular Joint Disordercbbd8ae6-e131-4fe3-9e84-de1f8f219fbe4519Medical and Surgical Treatment of Temporomandibular Joint Disorder07.08.03
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07.03.03hMedicalEvaluationandManagementforAttention-DeficitHyperactivityDisorder(ADHD)07.03.03hMedicine (07)Medical Evaluation and Management for Attention-Deficit Hyperactivity Disorder (ADHD)b9237846-fbc8-493b-a3ec-ae86e6347eed4694Medical Evaluation and Management for Attention-Deficit Hyperactivity Disorder (ADHD)07.03.03
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12.01.02aMedicalNecessity12.01.02aMiscellaneous (12)Medical Necessity90c53478-e5ad-4b94-9834-d76a9defa73c5056Medical Necessity12.01.02
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11.14.03hMeniscalAllograftTransplantationandMeniscalImplants(IndependenceAdministrators)11.14.03hSurgery (11)Meniscal Allograft Transplantation and Meniscal Implants (Independence Administrators)ab9b0f50-63ad-4931-9745-9c521bfc4b025164Meniscal Allograft Transplantation and Meniscal Implants (Independence Administrators)11.14.03
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11.14.01hMentoplastyorGenioplasty11.14.01hSurgery (11)Mentoplasty or Genioplasty86e5fd7e-aad4-4118-b434-e2a0fb9fc6035634Mentoplasty or Genioplasty11.14.01
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11.14.21iMicroprocessor-ControlledProsthesesforLower-ExtremityAmputees11.14.21iSurgery (11)Microprocessor-Controlled Prostheses for Lower-Extremity Amputeesbc4c5498-29e7-4bd2-9c0f-299e58e5fede3078Microprocessor-Controlled Prostheses for Lower-Extremity Amputees11.14.21
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11.15.24aMigraineDeactivationSurgery11.15.24aSurgery (11)Migraine Deactivation Surgery29e06d23-ef41-43a6-9ff1-03d2c121acb25259Migraine Deactivation Surgery11.15.24
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08.02.01aMirvetuximabsoravtansine-gynx(ElahereTM)08.02.01aPharmacy (08)Mirvetuximab soravtansine-gynx (Elahere TM)5a679ac6-c091-4f81-8384-68b9b275f8a15426Mirvetuximab soravtansine-gynx (Elahere TM)08.02.01
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03.00.15pModifier24:UnrelatedEvaluationandManagementServicebytheSamePhysicianorOtherQualifiedHealthCareProfessionalDuringaPostoperativePeriod03.00.15pClinical Logic (03)Modifier 24: Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Periodde9e9c47-3bb4-480c-af79-6d57825dc6175064Modifier 24: Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period03.00.15
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03.00.06yModifier25:Significant,SeparatelyIdentifiableEvaluationandManagementServicebytheSamePhysicianorOtherQualifiedHealthCareProfessionalontheSameDayoftheProcedureorOtherService03.00.06yClinical Logic (03)Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service9a3e3a84-c187-4744-9def-2563824324395694Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service03.00.06
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03.00.05vModifier50:BilateralProcedure03.00.05vClinical Logic (03)Modifier 50: Bilateral Procedure2598d97c-808c-4631-8edc-570f839820265692Modifier 50: Bilateral Procedure03.00.05
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03.00.32bModifier52:ReducedServices03.00.32bClinical Logic (03)Modifier 52: Reduced Servicesc089bb2c-423f-4e85-8d78-7e2522acf4bf5522Modifier 52: Reduced Services03.00.32
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03.00.33bModifier53:DiscontinuedProcedure03.00.33bClinical Logic (03)Modifier 53: Discontinued Procedureb835e172-8f47-42be-a0cf-3f63a7d3133d5523Modifier 53: Discontinued Procedure03.00.33
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03.00.16pModifier57:DecisionforSurgery03.00.16pClinical Logic (03)Modifier 57: Decision for Surgeryb5c59444-0f62-4fcb-8717-62bb24a5bbaf5489Modifier 57:  Decision for Surgery03.00.16
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00.10.11wModifier62:TwoSurgeons00.10.11wAdministrative (00)Modifier 62: Two Surgeonse47573dd-7731-4e9a-bade-cb8ffb2981b45686Modifier 62: Two Surgeons00.10.11
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00.10.17nModifier66:SurgicalTeam00.10.17nAdministrative (00)Modifier 66: Surgical Team8397a464-dfe4-4fe6-bef5-ba2486d9b27c5448Modifier 66: Surgical Team00.10.17
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03.00.02cModifier76:RepeatProcedureorServicebySamePhysicianorOtherQualifiedHealthCareProfessional03.00.02cClinical Logic (03)Modifier 76: Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional42176633-901e-445a-8b52-c1d8653c85bf5104Modifier 76: Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional03.00.02
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03.00.11cModifier77:RepeatProcedureorServicebyAnotherPhysicianorOtherQualifiedHealthCareProfessional03.00.11cClinical Logic (03)Modifier 77: Repeat Procedure or Service by Another Physician or Other Qualified Health Care Professional37236b28-776f-4b06-9c4f-02834e0559845101Modifier 77: Repeat Procedure or Service by Another Physician or Other Qualified Health Care Professional03.00.11
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03.00.12gModifier78:UnplannedReturntotheOperating/ProcedureRoombytheSamePhysicianorOtherQualifiedHealthCareProfessionalFollowingtheInitialProcedureforaRelatedProcedureDuringthePostoperativePeriod03.00.12gClinical Logic (03)Modifier 78: Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following the Initial Procedure for a Related Procedure During the Postoperative Periode6f338ca-9339-4559-a434-d115fab590e05105Modifier 78: Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following the Initial Procedure for a Related Procedure During the Postoperative Period03.00.12
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03.00.28nModifier79:UnrelatedProcedureorServicebytheSamePhysicianorOtherQualifiedHealthCareProfessionalDuringthePostoperativePeriod03.00.28nClinical Logic (03)Modifier 79: Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Periodeda29625-d354-43e3-a2cf-888ee03cc8975102Modifier 79:  Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period03.00.28
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03.00.20qModifiers26(ProfessionalComponent)andTC(TechnicalComponent)03.00.20qClinical Logic (03)Modifiers 26 (Professional Component) and TC (Technical Component)06addacf-aba2-4801-8002-4a02e8d31b725445Modifiers 26 (Professional Component) and TC (Technical Component)03.00.20
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00.10.18uModifiersforAssistant-at-SurgeryServices:80,81,82,andAS00.10.18uAdministrative (00)Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS22975769-6113-410d-a49f-948a4743c4835790Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS00.10.18
0e19258a-b273-40cc-97ad-49f9bf2c9f4c.aspx
  
03.00.31gModifiersforSplitorSharedSurgicalServices(Modifiers54,55,and56)03.00.31gClinical Logic (03)Modifiers for Split or Shared Surgical Services (Modifiers 54, 55, and 56)0e19258a-b273-40cc-97ad-49f9bf2c9f4c5520Modifiers for Split or Shared Surgical Services (Modifiers 54, 55, and 56)03.00.31
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03.00.08fModifiersXE,XS,XP,XU,and5903.00.08fClinical Logic (03)Modifiers XE, XS, XP, XU, and 59d0e4489b-c807-4e43-9abb-a90f6f1cebdd4018Modifiers XE, XS, XP, XU, and 5903.00.08
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08.01.52eMogamulizumab-kpkc(Poteligeo®)08.01.52ePharmacy (08)Mogamulizumab-kpkc (Poteligeo®)7c095e43-8c2f-4cc6-bde8-ff7ce5d0d0665764Mogamulizumab-kpkc (Poteligeo®)08.01.52
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11.08.23kMohsMicrographicSurgery11.08.23kSurgery (11)Mohs Micrographic Surgery425d19c0-3f9f-4c60-81b3-44fa9ab11ba65703Mohs Micrographic Surgery11.08.23
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00.01.68Multiple Procedure Payment Reduction Guidelines for Physical, Occupational, and Speech Therapy ServicesAdministrative (00)Multiple Procedure Payment Reduction Guidelines for Physical, Occupational, and Speech Therapy Services5A317727AACA768F8525846600442DF82131Multiple Procedure Payment Reduction Guidelines for Physical, Occupational, and Speech Therapy Services00.01.68
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00.01.60iMultipleProcedurePaymentReduction(MPPR)onCertainDiagnosticServices00.01.60iAdministrative (00)Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Services29f4d728-6d59-4a42-9d5a-5024c351e0cf5701Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Services00.01.60
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11.00.10xMultipleSurgeryPaymentReduction11.00.10xSurgery (11)Multiple Surgery Payment Reductionafb5dab9-c104-4a32-9f0f-0165854ddf754729Multiple Surgery Payment Reduction11.00.10
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00.01.66jMusculoskeletalServices(Independence)00.01.66jAdministrative (00)Musculoskeletal Services (Independence)d550e9ec-ec5d-409c-b804-4c8ca7f5654e5827Musculoskeletal Services (Independence)00.01.66
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