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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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11.06.10Laparoscopic,Percutaneous,andTranscervicalTechniquesforUterineFibroidMyolysis11.06.10Surgery (11)Laparoscopic, Percutaneous, and Transcervical Techniques for Uterine Fibroid Myolysis3729b42d-5f69-4566-9e55-579670af00fa4268Laparoscopic, Percutaneous, and Transcervical Techniques for Uterine Fibroid Myolysis11.06.10
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11.08.03lLipectomyandLiposuction11.08.03lSurgery (11)Lipectomy and Liposuction6cc36479-c47c-404c-93f8-1ae85fe79e7d4490Lipectomy and Liposuction11.08.03
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08.00.59aLoncastuximabtesirine-lpyl(Zynlonta™)08.00.59aPharmacy (08)Loncastuximab tesirine-lpyl (Zynlonta™)8d3f871e-99c0-4888-bf2a-c58629e9c9a34106Loncastuximab tesirine-lpyl (Zynlonta™)08.00.59
95e7ec8f-ea9e-439e-8808-f619b3fb846a.aspx
  
05.00.59kLowerLimbProstheses05.00.59kDME (05)Lower Limb Prostheses95e7ec8f-ea9e-439e-8808-f619b3fb846a3578Lower Limb Prostheses05.00.59
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07.00.14gLow-levelLaserTherapy(LLLT)07.00.14gMedicine (07)Low-level Laser Therapy (LLLT)821c1131-09eb-4314-b14b-8c160a36e4494231Low-level Laser Therapy (LLLT)07.00.14
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09.00.31dLowOsmolarContrastAgents09.00.31dRadiology (09)Low Osmolar Contrast Agents1b345950-8a8c-4c42-9eac-cb89223eed313043Low Osmolar Contrast Agents09.00.31
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08.01.67bLurbinectedin(Zepzelca)08.01.67bPharmacy (08)Lurbinectedin (Zepzelca)28c5f973-427f-4257-9474-e8f8e1b591c24162Lurbinectedin (Zepzelca)08.01.67
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08.00.10bLuspatercept–aamt(Reblozyl®)08.00.10bPharmacy (08)Luspatercept–aamt (Reblozyl®)effc7383-610d-4467-af57-6f772be87d5f4342Luspatercept–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)587ca64c-5670-4915-946a-b3a7c38e6ee64410Lutathera® (Lutetium Lu 177 Dotatate) (Independence Administrators)08.01.57
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06.02.01jLymeDisease:DiagnosisandIntravenous(IV)AntibioticTherapy06.02.01jPathology and Laboratory (06)Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Therapydc9cc665-c1f1-4d2d-9657-13778abf42da3005Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Therapy06.02.01
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11.15.13dLysisofEpiduralAdhesions11.15.13dSurgery (11)Lysis of Epidural Adhesionsd932d50c-7af9-4ea5-9681-0ab5022227f44225Lysis of Epidural Adhesions11.15.13
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09.00.45iMagneticResonanceImaging(MRI)ContrastAgents09.00.45iRadiology (09)Magnetic Resonance Imaging (MRI) Contrast Agentsd4d87368-119f-4422-92aa-840a1f8266103131Magnetic Resonance Imaging (MRI) Contrast Agents09.00.45
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11.06.06gMagneticResonanceImaging(MRI)-GuidedFocusedUltrasoundAblation11.06.06gSurgery (11)Magnetic Resonance Imaging (MRI)-Guided Focused Ultrasound Ablation8287f8b2-8716-445d-b2e8-ca6bc054a51b4508Magnetic Resonance Imaging (MRI)-Guided Focused Ultrasound Ablation11.06.06
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11.14.24bManipulationUnderAnesthesia11.14.24bSurgery (11)Manipulation Under Anesthesiad6e16a25-c7d5-4c06-8ad3-ea55a2f0b8694115Manipulation Under Anesthesia11.14.24
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05.00.12iManualWheelchairs05.00.12iDME (05)Manual Wheelchairse6e4ee3d-9748-42c9-9038-ae92bc2b83f54235Manual Wheelchairs05.00.12
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08.01.75bMargetuximab-cmkb(Margenza)08.01.75bPharmacy (08)Margetuximab-cmkb (Margenza)abeb37e5-c94c-4424-a11c-29b39466749c4315Margetuximab-cmkb (Margenza)08.01.75
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00.01.48dMarijuanaforMedicalUse00.01.48dAdministrative (00)Marijuana for Medical Use383e59e4-a92b-4bc7-885a-4106604996fa3436Marijuana 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 Disorders5303ac94-4891-45ee-8b37-27b66be9552d3847Measurement 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 Biologicsa5a7daba-4abd-42e4-a041-3efbd77c1c793816Measurement 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 Contractures29b043b6-208e-4400-a817-f838480cec1e4126Mechanical Stretching Devices for the Treatment of Joint Stiffness or Contractures05.00.70
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12.01.02aMedical NecessityMiscellaneous (12)Medical Necessity85256AA800623D7A85258566004C91B62400Medical Necessity12.01.02
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07.08.03gMedicalandSurgicalTreatmentofTemporomandibularJointDisorder07.08.03gMedicine (07)Medical and Surgical Treatment of Temporomandibular Joint Disorderc6a8b3a5-a31f-4a5d-a85f-3eee9c7ac8b33302Medical and Surgical Treatment of Temporomandibular Joint Disorder07.08.03
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07.03.03gMedicalEvaluationandManagementforAttention-DeficitHyperactivityDisorder(ADHD)07.03.03gMedicine (07)Medical Evaluation and Management for Attention-Deficit Hyperactivity Disorder (ADHD)f65084f8-ae09-40ee-bafb-6c5b79167fc53416Medical Evaluation and Management for Attention-Deficit Hyperactivity Disorder (ADHD)07.03.03
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11.14.03hMeniscalAllograftTransplantationandMeniscalImplants(IndependenceAdministrators)11.14.03hSurgery (11)Meniscal Allograft Transplantation and Meniscal Implants (Independence Administrators)c2b6581a-a4d5-4561-9368-f81dc5c7908a4380Meniscal Allograft Transplantation and Meniscal Implants (Independence Administrators)11.14.03
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11.14.01gMentoplastyorGenioplasty11.14.01gSurgery (11)Mentoplasty or Genioplasty8ff597e5-0dbf-4a5f-a84e-2f6ee37b08ba4228Mentoplasty 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 Surgeryc696f70d-0184-4427-8768-959ec7f5863f4346Migraine Deactivation Surgery11.15.24
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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 Periodf8d7e646-0584-45eb-91dc-27d2c67fb1ab3435Modifier 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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03.00.06vModifier25:Significant,SeparatelyIdentifiableEvaluationandManagementServicebytheSamePhysicianorOtherQualifiedHealthCareProfessionalontheSameDayoftheProcedureorOtherService03.00.06vClinical 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 Service068d8103-31c0-4cdd-abc8-a2547a002d5c3972Modifier 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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03.00.05tModifier50:BilateralProcedure03.00.05tClinical Logic (03)Modifier 50: Bilateral Procedure41922b73-cc56-449b-a8a7-90c5abc953074516Modifier 50: Bilateral Procedure03.00.05
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03.00.32bModifier52:ReducedServices03.00.32bClinical Logic (03)Modifier 52: Reduced Services6492c677-6217-4645-aa98-51b1c2e00d7c3835Modifier 52: Reduced Services03.00.32
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03.00.33bModifier53:DiscontinuedProcedure03.00.33bClinical Logic (03)Modifier 53: Discontinued Procedure4a23f8b3-7157-4c86-a465-0aa8180110603828Modifier 53: Discontinued Procedure03.00.33
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03.00.16pModifier57:DecisionforSurgery03.00.16pClinical Logic (03)Modifier 57: Decision for Surgerye7ced3e4-15a1-420e-8929-f0d159ec16703325Modifier 57:  Decision for Surgery03.00.16
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00.10.11tModifier62:TwoSurgeons00.10.11tAdministrative (00)Modifier 62: Two Surgeonscda610af-58a4-4e51-8f42-c39f87b85ca74517Modifier 62: Two Surgeons00.10.11
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00.10.17mModifier66:SurgicalTeam00.10.17mAdministrative (00)Modifier 66: Surgical Teamfcd892e5-213b-4cbc-9d79-164181bab86b4166Modifier 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 Professional3f390070-f6ea-4ccc-b8e9-dbc89fffb1ab3327Modifier 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 Professionale47367e6-a014-4f26-b8a3-eded6b029b5b3328Modifier 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 Period24cabd61-2a54-4eda-bcd2-8049fafc5e733525Modifier 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 Period99b98586-29b5-497a-b30c-28b14bef62a53526Modifier 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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03.00.20oModifiers26(ProfessionalComponent)andTC(TechnicalComponent)03.00.20oClinical Logic (03)Modifiers 26 (Professional Component) and TC (Technical Component)4a96f7b9-2cb0-44da-83e0-d73a09cd9d324518Modifiers 26 (Professional Component) and TC (Technical Component)03.00.20
006c2e8e-0cb5-482b-9d50-83154da54fe4.aspx
  
00.10.18sModifiersforAssistant-at-SurgeryServices:80,81,82,andAS00.10.18sAdministrative (00)Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS006c2e8e-0cb5-482b-9d50-83154da54fe44174Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS00.10.18
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03.00.31gModifiersforSplitorSharedSurgicalServices(Modifiers54,55,and56)03.00.31gClinical Logic (03)Modifiers for Split or Shared Surgical Services (Modifiers 54, 55, and 56)7748849d-668f-44a3-b385-64d7e4b3a0183725Modifiers 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
5ad79e01-f20d-4edd-93a6-e9211bfab048.aspx
  
08.01.52dMogamulizumab-kpkc(Poteligeo®)08.01.52dPharmacy (08)Mogamulizumab-kpkc (Poteligeo®)5ad79e01-f20d-4edd-93a6-e9211bfab0484469Mogamulizumab-kpkc (Poteligeo®)08.01.52
2af498eb-f6e4-4e26-9f63-f30ad42b2ff3.aspx
  
11.08.23jMohs'MicrographicSurgery11.08.23jSurgery (11)Mohs' Micrographic Surgery2af498eb-f6e4-4e26-9f63-f30ad42b2ff34191Mohs' Micrographic Surgery11.08.23
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06.02.36cMolecularTestingfortheManagementofPancreaticCystsorBarrett'sEsophagus(IndependenceAdministrators)06.02.36cPathology and Laboratory (06)Molecular Testing for the Management of Pancreatic Cysts or Barrett's Esophagus (Independence Administrators)d15cd425-f061-4fbc-a119-14d64d51bcb84420Molecular Testing for the Management of Pancreatic Cysts or Barrett's Esophagus (Independence Administrators)06.02.36
f4a173bd-a9ca-4582-9357-b941c3ae36ba.aspx
  
08.01.53bMoxetumomabPasudotox-tdfk(Lumoxiti™)08.01.53bPharmacy (08)Moxetumomab Pasudotox-tdfk (Lumoxiti™)f4a173bd-a9ca-4582-9357-b941c3ae36ba4493Moxetumomab Pasudotox-tdfk (Lumoxiti™)08.01.53
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06.02.32dMultigeneExpressionAssaysforPredictingRecurrenceinColonCancer(IndependenceAdministrators)06.02.32dPathology and Laboratory (06)Multigene Expression Assays for Predicting Recurrence in Colon Cancer (Independence Administrators)56cef71d-72dd-45ed-ab0c-e989f8be35a94419Multigene Expression Assays for Predicting Recurrence in Colon Cancer (Independence Administrators)06.02.32
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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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00.01.60hMultipleProcedurePaymentReduction(MPPR)onCertainDiagnosticServices00.01.60hAdministrative (00)Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Services5a4ae1ad-0ca0-4ecd-bf79-ff4a1156bec34024Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Services00.01.60
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11.00.10xMultipleSurgeryPaymentReduction11.00.10xSurgery (11)Multiple Surgery Payment Reductionf192767b-6f0c-4518-abac-46230420b92d2937Multiple Surgery Payment Reduction11.00.10
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00.01.66fMusculoskeletalServices(Independence)00.01.66fAdministrative (00)Musculoskeletal Services (Independence)0f8ad31b-d5a8-4b9c-8db3-d202c109b3634520Musculoskeletal Services (Independence)00.01.66
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08.00.64gNatalizumab(Tysabri®)08.00.64gPharmacy (08)Natalizumab (Tysabri®)54ab77b9-f40a-4e10-bb27-cba214f22cdf4252Natalizumab (Tysabri®)08.00.64
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07.12.01ePelvic Floor Stimulation as a Treatment of IncontinenceMedicine (07)Pelvic Floor Stimulation as a Treatment of Incontinence85256AA800623D7A85258596007D8BBB1777Pelvic Floor Stimulation as a Treatment of Incontinence07.12.01
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