|  | | 3582 | Abatacept(Orencia®)forInjectionforIntravenousUseMA08.028g | Pharmacy (08) | MA08.028g | MA08.028 | b00ed136-3352-4223-b636-58021431bded | Abatacept (Orencia®) for Injection for Intravenous Use | Abatacept (Orencia®) for Injection for Intravenous Use | {"3583": {"Id":3583,"MPAttachmentLetter":"A","Title":"ICD-10 codes","MPPolicyAttachmentInternalSourceId":6282,"PolicyAttachmentPageName":"cf45094d-bd05-4d93-993e-aa5a18b82368"},} | |
|  | | 4328 | AbortionMA11.010a | Surgery (11) | MA11.010a | MA11.010 | 253e7c6f-dfb2-4f79-b7e7-c62680bc12c3 | Abortion | Abortion | | |
|  | | 4499 | AcupunctureMA12.004c | Miscellaneous (12) | MA12.004c | MA12.004 | fe2f068a-caa7-4337-940c-21fff6e5379a | Acupuncture | Acupuncture | {"4500": {"Id":4500,"MPAttachmentLetter":"A","Title":"ICD-10 CM Codes Eligible to be Reported for Acupuncture","MPPolicyAttachmentInternalSourceId":7394,"PolicyAttachmentPageName":"58c5c20d-3385-48f1-ae19-ca766547253b"},} | |
|  | | 3936 | AcuteCareFacilityInpatientTransfersMA12.003b | Miscellaneous (12) | MA12.003b | MA12.003 | 2dd8737a-eb29-4514-acbd-7186ea78b680 | Acute Care Facility Inpatient Transfers | Acute Care Facility Inpatient Transfers | | |
|  | | 4094 | Ado-TrastuzumabEmtansine(Kadcyla®)MA08.066f | Pharmacy (08) | MA08.066f | MA08.066 | 62e04270-b09a-42de-9ba4-248feb04627e | Ado-Trastuzumab Emtansine (Kadcyla®) | Ado-Trastuzumab Emtansine (Kadcyla®) | {"4095": {"Id":4095,"MPAttachmentLetter":"A","Title":"ICD-10 CODES AND NARRATIVES","MPPolicyAttachmentInternalSourceId":6793,"PolicyAttachmentPageName":"16b65577-4b46-4911-94f6-c3c03734729f"},} | |
|  | | 4316 | Agalsidasebeta(Fabrazyme®)MA08.033c | Pharmacy (08) | MA08.033c | MA08.033 | 899c9577-2cf3-4cf9-80dd-865bc7bd577d | Agalsidase beta (Fabrazyme®) | Agalsidase beta (Fabrazyme®) | | |
|  | | 4020 | AirAmbulanceServicesMA12.007b | Miscellaneous (12) | MA12.007b | MA12.007 | 119bad1e-0fbf-441f-81d6-265b76cc87b6 | Air Ambulance Services | Air Ambulance Services | | |
|  | | 4438 | Alemtuzumab(Lemtrada®)MA08.015d | Pharmacy (08) | MA08.015d | MA08.015 | 8067664a-80c3-4d44-a11e-3ced21699339 | Alemtuzumab (Lemtrada®) | Alemtuzumab (Lemtrada®) | | |
|  | | 4476 | Alglucosidasealfa(e.g.,Lumizyme®),Avalglucosidasealfa-ngpt(Nexviazyme®)MA08.036f | Pharmacy (08) | MA08.036f | MA08.036 | 1ae76050-dc9f-4acc-8570-eedd1dd4bb9b | Alglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® ) | Alglucosidase alfa (e.g., Lumizyme®), Avalglucosidase alfa-ngpt (Nexviazyme® ) | | |
|  | | 4006 | AllergyImmunotherapyMA07.055d | Medicine (07) | MA07.055d | MA07.055 | 2e1aa0fd-b9e3-4e44-b29c-e5b32a36e6de | Allergy Immunotherapy | Allergy Immunotherapy | | |
|  | | 4383 | Alpha1-AntitrypsinTherapy(e.g.,Prolastin-C,AralastNP,Glassia,Zemaira)MA08.050b | Pharmacy (08) | MA08.050b | MA08.050 | 18476a80-146f-492a-bf5d-642fda50dc24 | Alpha 1-Antitrypsin Therapy (e.g., Prolastin-C, Aralast NP, Glassia, Zemaira) | Alpha 1-Antitrypsin Therapy (e.g., Prolastin-C, Aralast NP, Glassia, Zemaira) | | |
|  | | 4377 | AlwaysBundledProcedureCodesMA00.026q | Administrative (00) | MA00.026q | MA00.026 | e2563703-a9c3-467d-acee-3661690a1e68 | Always Bundled Procedure Codes | Always Bundled Procedure Codes | {"4378": {"Id":4378,"MPAttachmentLetter":"A","Title":"Always Bundled Procedures (MPFSD Indicator B)","MPPolicyAttachmentInternalSourceId":7239,"PolicyAttachmentPageName":"575d2f5f-bdbb-4545-b891-a4c65f6bda84"},"4379": {"Id":4379,"MPAttachmentLetter":"B","Title":"Procedures/Services Not Eligible for Separate Reimbursement","MPPolicyAttachmentInternalSourceId":7240,"PolicyAttachmentPageName":"fb8d864c-b5ba-4b9c-a071-de794b3cc1e9"},"4380": {"Id":4380,"MPAttachmentLetter":"C","Title":"Procedures/Services Not Eligible for Reimbursement","MPPolicyAttachmentInternalSourceId":7241,"PolicyAttachmentPageName":"91658153-1f1c-481a-89db-1f03e8130ca0"},} | |
|  | | 3955 | AmbulatoryBloodPressureMonitoring(ABPM)andHomeBloodPressureMonitoring(HBPM)DevicesMA07.005c | Medicine (07) | MA07.005c | MA07.005 | 561210e3-3390-4956-b296-c2c2ef91b2f9 | Ambulatory Blood Pressure Monitoring (ABPM) and Home Blood Pressure Monitoring (HBPM) Devices | Ambulatory Blood Pressure Monitoring (ABPM) and Home Blood Pressure Monitoring (HBPM) Devices | | |
|  | | 4121 | AmbulatoryElectrocardiography(AECG)MonitoringandMobileCardiacOutpatientTelemetry(MCOT)MonitoringMA07.026k | Medicine (07) | MA07.026k | MA07.026 | 20d4debf-c979-474b-b325-3dcc70336021 | Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring | Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring | | |
|  | | 4498 | AnesthesiaServicesforEpidural,ParavertebralFacetandSacroiliacJointInjectionsforSpinalJointManagementMA01.008a | Anesthesia (01) | MA01.008a | MA01.008 | 81ec86c6-5be6-4330-914c-0b9ce09b542a | Anesthesia Services for Epidural, Paravertebral Facet and Sacroiliac Joint Injections for Spinal Joint Management | Anesthesia Services for Epidural, Paravertebral Facet and Sacroiliac Joint Injections for Spinal Joint Management | {} | |
|  | | 3571 | Anifrolumab-fnia(Saphnelo™)MA08.140b | Pharmacy (08) | MA08.140b | MA08.140 | 2997254c-1be9-4fd5-9b6b-394b8f40bf96 | Anifrolumab-fnia (Saphnelo™) | Anifrolumab-fnia (Saphnelo™) | | |
|  | | 4312 | Ankle-Foot/Knee-Ankle-FootOrthosesMA05.010h | DME (05) | MA05.010h | MA05.010 | acabd5b9-f1d1-4bdd-ae49-da518c2798e8 | Ankle-Foot/Knee-Ankle-Foot Orthoses | Ankle-Foot/Knee-Ankle-Foot Orthoses | {"4313": {"Id":4313,"MPAttachmentLetter":"A","Title":"HCPCS CODES FOR ANKLE-FOOT/ KNEE-ANKLE FOOT ORTHOSIS","MPPolicyAttachmentInternalSourceId":7045,"PolicyAttachmentPageName":"9b6beacb-0a52-4a50-b171-447055ee9c4f"},} | |
|  | | 4398 | AnorectalManometry,Electromyography(EMG)ofAnorectalorUrethralSphincters;BiofeedbackTrainingforPerinealMusclesandAnorectalorUrethralSphinctersMA07.018c | Medicine (07) | MA07.018c | MA07.018 | de604fb8-ee97-41c4-b98a-5bb8b7fb8a4c | Anorectal Manometry, Electromyography (EMG) of Anorectal or Urethral Sphincters; Biofeedback Training for Perineal Muscles and Anorectal or Urethral Sphincters | Anorectal Manometry, Electromyography (EMG) of Anorectal or Urethral Sphincters; Biofeedback Training for Perineal Muscles and Anorectal or Urethral Sphincters | | |
|  | | 2179 | ApheresisTherapyMA06.001e | Pathology and Laboratory (06) | MA06.001e | MA06.001 | a8e854f7-94e7-4833-a02c-b7fb4214ff25 | Apheresis Therapy | Apheresis Therapy | | |
|  | | 4262 | ApplicationandRemovalofTattoosMA11.072 | Surgery (11) | MA11.072 | MA11.072 | 879ce4a4-c22d-428a-85bb-ad1c18403124 | Application and Removal of Tattoos | Application and Removal of Tattoos | | |
|  | | 4132 | Aprepitant(Cinvanti™),FosaprepitantDimeglumine(Emend®),Granisetron(Sustol®),andRolapitant(Varubi®)MA08.091e | Pharmacy (08) | MA08.091e | MA08.091 | ff104db5-0a07-4d08-9240-ca4aede56f1f | Aprepitant (Cinvanti™), Fosaprepitant Dimeglumine (Emend®), Granisetron (Sustol®), and Rolapitant (Varubi®) | Aprepitant (Cinvanti™), Fosaprepitant Dimeglumine (Emend®), Granisetron (Sustol®), and Rolapitant (Varubi®) | {"4133": {"Id":4133,"MPAttachmentLetter":"A","Title":"Risk of Emesis Without Prophylaxis: Intravenous and Oral Antineoplastic Agents","MPPolicyAttachmentInternalSourceId":7123,"PolicyAttachmentPageName":"558f07dc-00a1-44ad-bfa2-15f8d10d97c4"},} | |
|  | | 4137 | AqueousShunts,Microstents,Viscocanalostomy,andCanaloplastyfortheTreatmentofGlaucomaMA11.105j | Surgery (11) | MA11.105j | MA11.105 | df24c7d1-3b2b-41a3-ba0a-d25c9c5e7d70 | Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma | Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma | {"4138": {"Id":4138,"MPAttachmentLetter":"A","Title":"ICD-10 Codes","MPPolicyAttachmentInternalSourceId":7062,"PolicyAttachmentPageName":"bad39d3e-be8b-4144-b280-a37f967082f1"},} | |
|  | | 4129 | ArtificialIntervertebralLumbarDiscInsertionMA11.114b | Surgery (11) | MA11.114b | MA11.114 | 4d0593ea-c69f-4b0e-8370-ebed3c66e12f | Artificial Intervertebral Lumbar Disc Insertion | Artificial Intervertebral Lumbar Disc Insertion | | |
|  | | 3742 | Asparaginaseerwiniachrysanthemi(Erwinaze®),asparaginaseerwiniachrysanthemi(recombinant)-rywn(Rylaze™)MA08.085f | Pharmacy (08) | MA08.085f | MA08.085 | 53bac0ed-9c15-45d1-a6eb-df0442a11e2a | Asparaginase erwinia chrysanthemi (Erwinaze®), asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze™) | Asparaginase erwinia chrysanthemi (Erwinaze®), asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze™) | | |
|  | | 4272 | Atezolizumab(Tecentriq®)MA08.127c | Pharmacy (08) | MA08.127c | MA08.127 | 38d9e3e1-1b0d-4386-b60a-9b0787ca330f | Atezolizumab (Tecentriq®) | Atezolizumab (Tecentriq®) | {"4273": {"Id":4273,"MPAttachmentLetter":"A","Title":"ICD-10 Codes and Narratives","MPPolicyAttachmentInternalSourceId":7180,"PolicyAttachmentPageName":"9eff91d7-0b43-4fb4-9ac9-6c07148a0eff"},} | |
|  | | 4023 | AutomaticExternalCardioverterDefibrillators(WearableandNonwearable)MA05.005f | DME (05) | MA05.005f | MA05.005 | 31ffd380-3f3a-469d-8a3d-744ef976f1ed | Automatic External Cardioverter Defibrillators (Wearable and Nonwearable) | Automatic External Cardioverter Defibrillators (Wearable and Nonwearable) | {"4024": {"Id":4024,"MPAttachmentLetter":"B","Title":"ICD-10 codes used to represent the Nonwearable Automatic External Defibrillator (AED):","MPPolicyAttachmentInternalSourceId":6579,"PolicyAttachmentPageName":"6ccb9941-dadc-469b-b13e-a3d12330977d"},"4025": {"Id":4025,"MPAttachmentLetter":"A","Title":"ICD-10 codes used to represent the Wearable Automatic External Defibrillator (AED):","MPPolicyAttachmentInternalSourceId":6580,"PolicyAttachmentPageName":"7ee43fa7-62c0-4602-9074-b222f08585e0"},} | |
|  | | 4469 | AutonomicNervousSystemTestingMA07.027f | Medicine (07) | MA07.027f | MA07.027 | ff1221f9-30d9-4ac7-bbab-964e32913b1c | Autonomic Nervous System Testing | Autonomic Nervous System Testing | | |
|  | | 4105 | Avelumab(Bavencio®)MA08.122b | Pharmacy (08) | MA08.122b | MA08.122 | 2940ef19-00de-46de-bbaa-aef9985a3ac2 | Avelumab (Bavencio®) | Avelumab (Bavencio®) | {"4106": {"Id":4106,"MPAttachmentLetter":"A","Title":"ICD-10 Codes and Narratives","MPPolicyAttachmentInternalSourceId":7009,"PolicyAttachmentPageName":"15c6ab29-ebb0-4244-b462-2756d4f993b8"},} | |
|  | | 4250 | BalloonCatheterDilationofSinusOstiaforTreatmentofChronicRhinosinusitisMA11.100e | Surgery (11) | MA11.100e | MA11.100 | 6a0c5929-9fd0-40f2-8aee-a03e3c5d7160 | Balloon Catheter Dilation of Sinus Ostia for Treatment of Chronic Rhinosinusitis | Balloon Catheter Dilation of Sinus Ostia for Treatment of Chronic Rhinosinusitis | | |
|  | | 3532 | belantamabmafodotin-blmf(Blenrep)MA08.119b | Pharmacy (08) | MA08.119b | MA08.119 | cf4b9338-44d8-4be3-b8af-86f6920be908 | belantamab mafodotin-blmf (Blenrep) | belantamab mafodotin-blmf (Blenrep) | | |
|  | | 4436 | Belimumab(Benlysta®)forIntravenousUseMA08.057d | Pharmacy (08) | MA08.057d | MA08.057 | bccd1651-281b-4398-bd5c-64d796fe33fb | Belimumab (Benlysta®) for Intravenous Use | Belimumab (Benlysta®) for Intravenous Use | | |
|  | | 4502 | Bevacizumab(Avastin®)andRelatedBiosimilarsForOncologicUseMA08.072m | Pharmacy (08) | MA08.072m | MA08.072 | 46cea12e-7050-4ace-8a7f-113e18bd0426 | Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use | Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use | {"4503": {"Id":4503,"MPAttachmentLetter":"A","Title":"Dosing and Frequency Requirements","MPPolicyAttachmentInternalSourceId":7281,"PolicyAttachmentPageName":"801fe1a9-7997-4d08-9710-3e524241440b"},"4504": {"Id":4504,"MPAttachmentLetter":"B","Title":"ICD 10 Diagnosis Codes","MPPolicyAttachmentInternalSourceId":7323,"PolicyAttachmentPageName":"ad90e584-84ce-4f28-8798-8e3380ae2f1f"},} | |
|  | | 4226 | BillingforProfessionalOffice-BasedServicesPerformedinanOutpatientOffice-BasedSettingLocatedwithinaFacilityoronaFacilityCampusMA00.037l | Administrative (00) | MA00.037l | MA00.037 | 0a1fbcc2-67dd-4f2a-b41a-45331a445dce | Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus | Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus | {"4227": {"Id":4227,"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 - CPT/HCPCS Codes","MPPolicyAttachmentInternalSourceId":7192,"PolicyAttachmentPageName":"8a9fe128-887e-4070-89b1-d494ccae3f93"},} | |
|  | | 4276 | BiofeedbackTherapyMA07.010a | Medicine (07) | MA07.010a | MA07.010 | 186e43b9-48ee-4ef3-842d-adf5eef12376 | Biofeedback Therapy | Biofeedback Therapy | | |
|  | | 3618 | BioimpedancefortheDetectionofLymphedemaMA07.052 | Medicine (07) | MA07.052 | MA07.052 | fc94fb44-a8a9-41f6-8fe6-687483a6ebc6 | Bioimpedance for the Detection of Lymphedema | Bioimpedance for the Detection of Lymphedema | | |
|  | | 4004 | Blepharoplasty,RepairofBlepharoptosis,RepairofBrowPtosis,andCanthoplasty/CanthopexyMA11.047d | Surgery (11) | MA11.047d | MA11.047 | 471e433d-f780-4d16-882b-1406395273b3 | Blepharoplasty, Repair of Blepharoptosis, Repair of Brow Ptosis, and Canthoplasty/Canthopexy | Blepharoplasty, Repair of Blepharoptosis, Repair of Brow Ptosis, and Canthoplasty/Canthopexy | {"4005": {"Id":4005,"MPAttachmentLetter":"A","Title":"ICD-10 Coding","MPPolicyAttachmentInternalSourceId":6998,"PolicyAttachmentPageName":"dacc12f4-b2a3-4a21-9dd1-580964f7c079"},} | |
|  | | 4269 | Blinatumomab(Blincyto®)MA08.058f | Pharmacy (08) | MA08.058f | MA08.058 | 03966d42-a58c-417b-ad2a-bd444959368a | Blinatumomab (Blincyto®) | Blinatumomab (Blincyto®) | | |
|  | | 4164 | Bone-Anchored(Osseointegrated)HearingAidsandImplantableMiddleEarHearingAidsMA11.049e | Surgery (11) | MA11.049e | MA11.049 | cc5a905b-ad8a-487c-a688-6d3af1a4311a | Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids | Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids | | |
|  | | 4160 | Bortezomib(BortezomibforInjection,Velcade®)MA08.037i | Pharmacy (08) | MA08.037i | MA08.037 | ae53fe4a-bce1-43e4-8f29-b3bfd9e5b0f5 | Bortezomib (Bortezomib for Injection, Velcade®) | Bortezomib (Bortezomib for Injection, Velcade®) | {"4161": {"Id":4161,"MPAttachmentLetter":"A","Title":"ICD-10 Codes and Narratives","MPPolicyAttachmentInternalSourceId":7119,"PolicyAttachmentPageName":"571ad3d2-dde6-4cfa-a4f7-d851871d9e28"},} | |
|  | | 4389 | BotulinumToxinAgentsMA08.017i | Pharmacy (08) | MA08.017i | MA08.017 | 68afc6b8-66ce-454a-b8ae-8225ca1a74aa | Botulinum Toxin Agents | Botulinum Toxin Agents | {"4390": {"Id":4390,"MPAttachmentLetter":"A","Title":"ICD-10 Diagnosis Codes","MPPolicyAttachmentInternalSourceId":7187,"PolicyAttachmentPageName":"244ed399-eee3-4e6c-a4bd-c09c6c04da73"},} | |
|  | | 3792 | BrentuximabVedotin(Adcetris®)MA08.068h | Pharmacy (08) | MA08.068h | MA08.068 | 5de87146-f5e7-4927-8264-ff5c323d17a9 | Brentuximab Vedotin (Adcetris®) | Brentuximab Vedotin (Adcetris®) | {"3793": {"Id":3793,"MPAttachmentLetter":"A","Title":"ICD 10 CODES AND NARRATIVES","MPPolicyAttachmentInternalSourceId":6763,"PolicyAttachmentPageName":"53f87106-7279-43a6-9fb7-e70e019e1292"},} | |
|  | | 3417 | BronchialValvesMA11.020 | Surgery (11) | MA11.020 | MA11.020 | 69c14601-19f4-4a22-869a-ce88af536766 | Bronchial Valves | Bronchial Valves | | |
|  | | 4477 | Burosumab-twza(Crysvita®)MA08.099b | Pharmacy (08) | MA08.099b | MA08.099 | 139fe438-ff72-40f7-98d1-4bfe79daf96e | Burosumab-twza (Crysvita®) | Burosumab-twza (Crysvita®) | | |
|  | | 4484 | Canakinumab(Ilaris®)MA08.101b | Pharmacy (08) | MA08.101b | MA08.101 | e823b28a-58d2-4201-8b11-a1e4fd9480f8 | Canakinumab (Ilaris®) | Canakinumab (Ilaris®) | | |
|  | | 4246 | CanesandCrutchesMA05.052b | DME (05) | MA05.052b | MA05.052 | b9a4e942-4f22-4e46-b71d-bb61455dd52a | Canes and Crutches | Canes and Crutches | | |
|  | | 4492 | CapsuleEndoscopyMA07.022e | Medicine (07) | MA07.022e | MA07.022 | f1b3ebed-0d89-4fc1-bfb7-384ea15ad86f | Capsule Endoscopy | Capsule Endoscopy | | |
|  | | 3807 | CardiacRehabilitation(CR)andIntensiveCardiacRehabilitation(ICR)ProgramsMA10.002c | Rehabilitation Services (10) | MA10.002c | MA10.002 | de73d54c-e82e-406d-a1d8-c94d36bf4fc5 | Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs | Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Programs | {"3808": {"Id":3808,"MPAttachmentLetter":"A","Title":"Medically Necessary ICD-10 Codes","MPPolicyAttachmentInternalSourceId":6702,"PolicyAttachmentPageName":"8a00fdd6-dd29-4596-b900-0e494b1c1ce9"},} | |
|  | | 4228 | CareManagementandCarePlanningServicesMA00.006m | Administrative (00) | MA00.006m | MA00.006 | e172f03c-54fe-4e01-8357-866843b8d2b5 | Care Management and Care Planning Services | Care Management and Care Planning Services | | |
|  | | 3969 | Carfilzomib(Kyprolis™)MA08.062g | Pharmacy (08) | MA08.062g | MA08.062 | cc00c34c-5b11-4450-9824-79ca51259fae | Carfilzomib (Kyprolis™) | Carfilzomib (Kyprolis™) | | |
|  | | 3612 | CastandSplintApplicationsandAssociatedSuppliesMA00.012c | Administrative (00) | MA00.012c | MA00.012 | b86099e5-ed74-4f52-9ab4-c534c779cb23 | Cast and Splint Applications and Associated Supplies | Cast and Splint Applications and Associated Supplies | {"3613": {"Id":3613,"MPAttachmentLetter":"A","Title":"Procedures Related to Cast and Splint Applications and Associated Supplies","MPPolicyAttachmentInternalSourceId":6422,"PolicyAttachmentPageName":"eec4f404-030d-42ce-855c-d06522638dd4"},} | |
|  | | 4010 | CataractSurgeryMA11.054d | Surgery (11) | MA11.054d | MA11.054 | 35d53c26-0c5b-4b14-b8b8-a5597e77fe0c | Cataract Surgery | Cataract Surgery | {"4011": {"Id":4011,"MPAttachmentLetter":"A","Title":"ICD-10 codes","MPPolicyAttachmentInternalSourceId":6669,"PolicyAttachmentPageName":"00eafbe0-27dc-4b22-bec7-d83dddcb66d7"},} | |
|  | | 3809 | CatheterAblationofCardiacArrhythmiasMA11.060e | Surgery (11) | MA11.060e | MA11.060 | d64fed48-4aef-4817-967f-2e50017c1cb0 | Catheter Ablation of Cardiac Arrhythmias | Catheter Ablation of Cardiac Arrhythmias | | |
|  | | 4103 | Cemiplimab-rwlc(Libtayo®)MA08.124b | Pharmacy (08) | MA08.124b | MA08.124 | 43307a95-4d17-43d5-ae1d-447dee061b11 | Cemiplimab-rwlc (Libtayo®) | Cemiplimab-rwlc (Libtayo®) | | |
|  | | 4473 | Cerliponasealfa(Brineura®)MA08.089c | Pharmacy (08) | MA08.089c | MA08.089 | cbcee004-59ba-4f3d-ace3-5dd2bb9e1992 | Cerliponase alfa (Brineura®) | Cerliponase alfa (Brineura®) | | |
|  | | 4333 | CervicalTractionDevicesforIn-homeUseMA05.009a | DME (05) | MA05.009a | MA05.009 | 758792dc-b695-4e8f-8010-624a774b081b | Cervical Traction Devices for In-home Use | Cervical Traction Devices for In-home Use | | |
|  | | 4156 | Cetuximab(Erbitux®)MA08.031f | Pharmacy (08) | MA08.031f | MA08.031 | da641a6d-6927-4908-a969-1856f88de703 | Cetuximab (Erbitux®) | Cetuximab (Erbitux®) | {"4157": {"Id":4157,"MPAttachmentLetter":"B","Title":"ICD-10 Codes for Cetuximab (Erbitux®)","MPPolicyAttachmentInternalSourceId":7027,"PolicyAttachmentPageName":"d0267e57-e63e-4c96-8294-a9d0b160eff9"},"4158": {"Id":4158,"MPAttachmentLetter":"A","Title":"Dosing and Frequency Requirements","MPPolicyAttachmentInternalSourceId":7028,"PolicyAttachmentPageName":"22127d10-f3f4-472d-9c56-cab879c5de3a"},} | |
|  | | 3787 | ChemicalPeelsMA11.103b | Surgery (11) | MA11.103b | MA11.103 | b89e88bc-c37b-4819-a4ea-af219a5cf05d | Chemical Peels | Chemical Peels | | |
|  | | 3790 | ChimericAntigenReceptor(CAR)TherapyMA08.093k | Pharmacy (08) | MA08.093k | MA08.093 | 2aa985e5-66d4-4c33-9b92-cffca516451e | Chimeric Antigen Receptor (CAR) Therapy | Chimeric Antigen Receptor (CAR) Therapy | {"3791": {"Id":3791,"MPAttachmentLetter":"A","Title":"ICD 10 codes","MPPolicyAttachmentInternalSourceId":6561,"PolicyAttachmentPageName":"c52d4929-1636-4076-b07d-a4a95bdbcd52"},} | |
|  | | 3978 | ChiropracticServicesMA10.004h | Rehabilitation Services (10) | MA10.004h | MA10.004 | 7d3057f3-c09c-492e-8583-c5300b165742 | Chiropractic Services | Chiropractic Services | {"3979": {"Id":3979,"MPAttachmentLetter":"A","Title":"Medically neessary ICD-10 diagnosis codes","MPPolicyAttachmentInternalSourceId":6877,"PolicyAttachmentPageName":"2fddedd7-0de5-4a26-83a9-310b2f845333"},} | |
|  | | 1368 | Circulating Tumor Cell (CTC) Assay | Pathology and Laboratory (06) | MA06.030 | MA06.030 | F371FB2E48AFB33885257DBE00723399 | Circulating Tumor Cell (CTC) Assay | Circulating Tumor Cell (CTC) Assay | | |
|  | | 3958 | CoagulationFactorsMA08.004t | Pharmacy (08) | MA08.004t | MA08.004 | 560ab61f-50a9-4fb5-9b2f-45445ab7a909 | Coagulation Factors | Coagulation Factors | | |
|  | | 4206 | Cobalamin(VitaminB12),FolicAcid,andHomocysteineTestingMA06.032a | Pathology and Laboratory (06) | MA06.032a | MA06.032 | 08299b3d-e691-4b8a-b760-476b6013cdcf | Cobalamin (Vitamin B12), Folic Acid, and Homocysteine Testing | Cobalamin (Vitamin B12), Folic Acid, and Homocysteine Testing | {"4207": {"Id":4207,"MPAttachmentLetter":"A","Title":"ICD 10 CODES FOR MEDICALLY NECESSARY COBALAMIN (VITAMIN B12), FOLIC ACID, AND/OR HOMOCYSTEINE TESTING (CPT CODES 82607, 82746, AND 83090)","MPPolicyAttachmentInternalSourceId":7157,"PolicyAttachmentPageName":"6730a75f-3149-47c6-90ac-aee646ce81f2"},} | |
|  | | 3962 | CochlearImplantationMA11.039e | Surgery (11) | MA11.039e | MA11.039 | 0c6e1f8b-9eb7-4fcf-9e55-88f408e4d4cb | Cochlear Implantation | Cochlear Implantation | | |
|  | | 4297 | Collagenaseclostridiumhistolyticum(Xiaflex®),collagenaseclostridiumhistolyticum-aaes(Qwo™)MA08.128 | Pharmacy (08) | MA08.128 | MA08.128 | eb7a5b5b-9d54-474b-9874-57a8dce573fc | Collagenase clostridium histolyticum ( Xiaflex ®), collagenase clostridium histolyticum-aaes (Qwo™) | Collagenase clostridium histolyticum ( Xiaflex ®), collagenase clostridium histolyticum-aaes (Qwo™) | | |
|  | | 4244 | CommodeChairsMA05.036b | DME (05) | MA05.036b | MA05.036 | e33148b1-aa3c-4791-a297-b5f05efc14bc | Commode Chairs | Commode Chairs | | |
|  | | 3614 | ComplementaryandIntegrativeHealthServicesMA12.001d | Miscellaneous (12) | MA12.001d | MA12.001 | a62fd0fa-8e7b-4ed1-bb67-fd235c1159f0 | Complementary and Integrative Health Services | Complementary and Integrative Health Services | | |
|  | | 3617 | CompleteDecongestiveTherapy(CDT)MA07.042 | Medicine (07) | MA07.042 | MA07.042 | 74c1970e-fa1e-40e5-91ce-bd5dd3e8a6f5 | Complete Decongestive Therapy (CDT) | Complete Decongestive Therapy (CDT) | | |
|  | | 4251 | CompositeTissueAllotransplantationoftheHand(s)andFaceMA11.112 | Surgery (11) | MA11.112 | MA11.112 | df7d7068-6c32-45da-b37f-2e979978b0d5 | Composite Tissue Allotransplantation of the Hand(s) and Face | Composite Tissue Allotransplantation of the Hand(s) and Face | | |
|  | | 4388 | CompressionGarmentsMA05.045b | DME (05) | MA05.045b | MA05.045 | f3dad6d9-4a32-4140-a210-b5b592b5812d | Compression Garments | Compression Garments | | |
|  | | 4261 | Computer-AidedDetection(CAD)SystemforUsewithChestRadiographsMA09.014a | Radiology (09) | MA09.014a | MA09.014 | 5280f42d-aefd-4364-b335-f20bb8471cff | Computer-Aided Detection (CAD) System for Use with Chest Radiographs | Computer-Aided Detection (CAD) System for Use with Chest Radiographs | | |
|  | | 4215 | Computer-AssistedMusculoskeletalSurgicalNavigationalOrthopedicProcedureMA11.088c | Surgery (11) | MA11.088c | MA11.088 | ceec4bd5-f2ac-4512-b0e7-b6b2f8aea4b6 | Computer-Assisted Musculoskeletal Surgical Navigational Orthopedic Procedure | Computer-Assisted Musculoskeletal Surgical Navigational Orthopedic Procedure | | |
|  | | 4229 | ConsultationServicesMA00.049b | Administrative (00) | MA00.049b | MA00.049 | 50f137b2-f09b-4bba-bf10-c689ad659402 | Consultation Services | Consultation Services | | |
|  | | 4445 | ContinuousGlucoseMonitorsandHomeBloodGlucoseMonitorsandSuppliesMA00.002k | Administrative (00) | MA00.002k | MA00.002 | a0fd6b96-f1ad-4331-a935-876dfe23a6dd | Continuous Glucose Monitors and Home Blood Glucose Monitors and Supplies | Continuous Glucose Monitors and Home Blood Glucose Monitors and Supplies | {"4446": {"Id":4446,"MPAttachmentLetter":"A","Title":"ICD10: Short-Term Interstitial CGMS","MPPolicyAttachmentInternalSourceId":7184,"PolicyAttachmentPageName":"2deffc76-b612-4947-9bd9-a29e4a29f8d5"},"4447": {"Id":4447,"MPAttachmentLetter":"B","Title":"ICD10: Long-Term Interstitial CGMS (Non-Implantable)","MPPolicyAttachmentInternalSourceId":7185,"PolicyAttachmentPageName":"6489dd5f-014a-4bdb-8caa-78b41066dca9"},"4448": {"Id":4448,"MPAttachmentLetter":"C","Title":"ICD10: Home Blood Glucose Monitors and Supplies","MPPolicyAttachmentInternalSourceId":7186,"PolicyAttachmentPageName":"45f80977-b75b-44cd-9f4f-36d02b808e85"},"4449": {"Id":4449,"MPAttachmentLetter":"D","Title":"Implantable Continuous Glucose Monitors (I-CGM)","MPPolicyAttachmentInternalSourceId":7306,"PolicyAttachmentPageName":"70b2ddc6-692e-4ca4-ab79-43773961135d"},} | |
|  | | 4293 | ContrastAgentsUsedinConjunctionwithEchocardiographyMA09.004c | Radiology (09) | MA09.004c | MA09.004 | d647b737-a9b2-45c6-8d24-5a6b333db1e7 | Contrast Agents Used in Conjunction with Echocardiography | Contrast Agents Used in Conjunction with Echocardiography | | |
|  | | 3636 | CornealPachymetryUsingUltrasoundMA07.046g | Medicine (07) | MA07.046g | MA07.046 | 0d262908-e6ab-4ad9-a017-96491fb35ed8 | Corneal Pachymetry Using Ultrasound | Corneal Pachymetry Using Ultrasound | {"3637": {"Id":3637,"MPAttachmentLetter":"A","Title":"ICD-10-CM Codes Eligible to be Reported for Corneal Pachymetry Using Ultrasound","MPPolicyAttachmentInternalSourceId":6352,"PolicyAttachmentPageName":"67d2afd6-52ba-486d-b170-3ac791273313"},} | |
|  | | 4217 | CosmeticProceduresMA12.009a | Miscellaneous (12) | MA12.009a | MA12.009 | 6db2e8ed-e67a-4ecf-aebd-400834738d29 | Cosmetic Procedures | Cosmetic Procedures | | |
|  | | 3048 | CoverageofMedicalDevicesMA05.040b | DME (05) | MA05.040b | MA05.040 | 69c3f8a1-1044-489c-869e-7e78dbb55b06 | Coverage of Medical Devices | Coverage of Medical Devices | | |
|  | | 3935 | CranialElectrotherapyStimulationMA05.066c | DME (05) | MA05.066c | MA05.066 | 14ef6470-44f4-4099-881a-21521d12fec8 | Cranial Electrotherapy Stimulation | Cranial Electrotherapy Stimulation | | |
|  | | 4169 | CriteriaforReimbursementofEmergencyRoomServicesMA00.044c | Administrative (00) | MA00.044c | MA00.044 | bd8724e2-053c-46e0-ad5a-4e5dbf9cf587 | Criteria for Reimbursement of Emergency Room Services | Criteria for Reimbursement of Emergency Room Services | | |
|  | | 4224 | crizanlizumab-tmca(Adakveo®)MA08.109a | Pharmacy (08) | MA08.109a | MA08.109 | 9034c0d4-d181-4395-aca9-6863f186539d | crizanlizumab-tmca (Adakveo®) | crizanlizumab-tmca (Adakveo®) | | |
|  | | 3623 | CryosurgicalAblationoftheProstateGlandMA11.022a | Surgery (11) | MA11.022a | MA11.022 | 4262ba16-e187-42a1-a358-5309ce6b6ea5 | Cryosurgical Ablation of the Prostate Gland | Cryosurgical Ablation of the Prostate Gland | | |
|  | | 3746 | Daratumumab(Darzalex®),Daratumumab,andHyaluronidase-fihj(DarzalexFaspro®)MA08.079j | Pharmacy (08) | MA08.079j | MA08.079 | fc8bc0fe-8bb5-4590-830c-71eb68cd8fce | Daratumumab (Darzalex®), Daratumumab, and Hyaluronidase-fihj (Darzalex Faspro®) | Daratumumab (Darzalex®), Daratumumab, and Hyaluronidase-fihj (Darzalex Faspro®) | | |
|  | | 4493 | DayRehabilitationMA10.005b | Rehabilitation Services (10) | MA10.005b | MA10.005 | ee92c759-ee9f-4de2-8688-6082eef33136 | Day Rehabilitation | Day Rehabilitation | | |
|  | | 4278 | DebridementofMycoticandSymptomaticNon-MycoticHypertrophicToeNailsMA11.014g | Surgery (11) | MA11.014g | MA11.014 | 8aa69314-d990-40ec-a294-8971cc5c5e5b | Debridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Toe Nails | Debridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Toe Nails | {"4279": {"Id":4279,"MPAttachmentLetter":"E","Title":"ICD-10 CM Codes Eligible to be Reported for Debridement of mycotic hypertrophic toe nails (S86.892A - Z79.01), Continued","MPPolicyAttachmentInternalSourceId":7205,"PolicyAttachmentPageName":"1957de27-3b5a-409f-b455-3f1b04cc7e46"},"4280": {"Id":4280,"MPAttachmentLetter":"A","Title":"ICD-10 CM Codes Eligible to be Reported for Debridement of mycotic hypertrophic toe nails (A30.0 -E10.21)","MPPolicyAttachmentInternalSourceId":7206,"PolicyAttachmentPageName":"94ee1983-7988-4fe6-a254-86aa041df790"},"4281": {"Id":4281,"MPAttachmentLetter":"D","Title":"ICD-10 CM Codes Eligible to be Reported for Debridement of mycotic hypertrophic toe nails (I87.099 - S86.891S), Continued","MPPolicyAttachmentInternalSourceId":7207,"PolicyAttachmentPageName":"efc99947-4c38-4bd5-8a59-f023e5132f48"},"4282": {"Id":4282,"MPAttachmentLetter":"C","Title":"ICD-10 CM Codes Eligible to be Reported for Debridement of mycotic hypertrophic toe nails (E13.3513 - I87.093), Continued","MPPolicyAttachmentInternalSourceId":7208,"PolicyAttachmentPageName":"22f0eb11-922b-4f0a-8a0b-c3b947ee5213"},"4283": {"Id":4283,"MPAttachmentLetter":"B","Title":"ICD-10 CM Codes Eligible to be Reported for Debridement of mycotic hypertrophic toe nails (E10.22 - E13.3512), Continued","MPPolicyAttachmentInternalSourceId":7209,"PolicyAttachmentPageName":"16a5b6ea-586f-4f36-b28f-7c8b503ded37"},} | |
|  | | 4358 | DeepBrainStimulation(DBS)MA11.005f | Surgery (11) | MA11.005f | MA11.005 | 6f2033a3-bd4d-455e-9fb9-866627c45d2f | Deep Brain Stimulation (DBS) | Deep Brain Stimulation (DBS) | | |
|  | | 3522 | Denosumab(Prolia®,Xgeva®),Romosozumab-aqqg(Evenity®)MA08.052j | Pharmacy (08) | MA08.052j | MA08.052 | 116bf5f6-59fe-4c5b-b271-9a90bf62beb6 | Denosumab (Prolia®, Xgeva®), Romosozumab-aqqg (Evenity®) | Denosumab (Prolia®, Xgeva®), Romosozumab-aqqg (Evenity®) | {"3523": {"Id":3523,"MPAttachmentLetter":"A","Title":"ICD-10-CM Codes","MPPolicyAttachmentInternalSourceId":6189,"PolicyAttachmentPageName":"dd04c740-d70b-48c8-b128-cde0f0c0b1f9"},} | |
|  | | 4139 | DermabrasionforRhinophyma,Septoplasty,Rhinoplasty,andSeptorhinoplastyMA11.099c | Surgery (11) | MA11.099c | MA11.099 | 0254b636-2a8f-4b02-a7ca-0ea8002e8852 | Dermabrasion for Rhinophyma, Septoplasty, Rhinoplasty, and Septorhinoplasty | Dermabrasion for Rhinophyma, Septoplasty, Rhinoplasty, and Septorhinoplasty | | |
|  | | 4236 | DirectAccesstoObstetrics/Gynecology(OB/GYN)ServicesMA00.032e | Administrative (00) | MA00.032e | MA00.032 | feaa2fd7-6fab-4ba8-8f44-0a0c428ccaa0 | Direct Access to Obstetrics/Gynecology (OB/GYN) Services | Direct Access to Obstetrics/Gynecology (OB/GYN) Services | {} | |
|  | | 3575 | Dofetilide(Tikosyn®)UseintheInpatientSettingMA08.021b | Pharmacy (08) | MA08.021b | MA08.021 | 062b48a0-26a9-4077-805d-713072908f88 | Dofetilide (Tikosyn®) Use in the Inpatient Setting | Dofetilide (Tikosyn®) Use in the Inpatient Setting | | |
|  | | 4310 | Dostarlimab-gxly(Jemperli)MA08.136d | Pharmacy (08) | MA08.136d | MA08.136 | 18ff969a-7c89-4261-acdf-6c16773efc05 | Dostarlimab-gxly (Jemperli) | Dostarlimab-gxly (Jemperli) | | |
|  | | 3916 | Drug-ElutingBeadsandBlandEmbolizationfortheTreatmentofHepaticMalignanciesMA07.041b | Medicine (07) | MA07.041b | MA07.041 | 9b4d3cea-ae30-4134-98bd-9481da9fc035 | Drug-Eluting Beads and Bland Embolization for the Treatment of Hepatic Malignancies | Drug-Eluting Beads and Bland Embolization for the Treatment of Hepatic Malignancies | | |
|  | | 4416 | DurableMedicalEquipment(DME)MA05.044n | DME (05) | MA05.044n | MA05.044 | 4106fc5f-592e-4c4c-b9cb-a19406747053 | Durable Medical Equipment (DME) | Durable Medical Equipment (DME) | {"4417": {"Id":4417,"MPAttachmentLetter":"B","Title":"Items that Do Not Meet the Definition of Durable Medical Equipment (DME) or Excluded from Coverage by Medicare","MPPolicyAttachmentInternalSourceId":7375,"PolicyAttachmentPageName":"56e4f4f0-d13a-482f-8eaa-9534c380e45c"},"4418": {"Id":4418,"MPAttachmentLetter":"A2","Title":"Equipment that Meets the Definition of Durable Medical Equipment (DME)","MPPolicyAttachmentInternalSourceId":7376,"PolicyAttachmentPageName":"0199d55c-0045-4707-a381-ceee6af374e6"},"4419": {"Id":4419,"MPAttachmentLetter":"A1","Title":"Equipment that Meets the Definition of Durable Medical Equipment (DME)","MPPolicyAttachmentInternalSourceId":7377,"PolicyAttachmentPageName":"92c5d35e-a291-429c-97bf-156f7bc30dc5"},} | |
|  | | 4015 | DurableMedicalEquipment(DME)NotSubjecttoaRentaltoPurchaseMaximumMA05.028e | DME (05) | MA05.028e | MA05.028 | 1b12ffb5-60aa-4123-895e-6165136f7204 | Durable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum | Durable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum | | |
|  | | 4113 | Durvalumab(Imfinzi®)MA08.123b | Pharmacy (08) | MA08.123b | MA08.123 | 2c99c5d8-b866-4945-9fed-9fbc3712a42c | Durvalumab (Imfinzi®) | Durvalumab (Imfinzi®) | {"4114": {"Id":4114,"MPAttachmentLetter":"A","Title":"ICD-10 Codes and Narratives","MPPolicyAttachmentInternalSourceId":6592,"PolicyAttachmentPageName":"bf714cae-91e4-4520-bd99-4856938f8f7a"},} | |
|  | | 4321 | Eculizumab(Soliris®)andRelatedBiosimilars,Ravulizumab-cwvz(Ultomiris™)MA08.044h | Pharmacy (08) | MA08.044h | MA08.044 | 75362d2f-b4f7-4f18-90c0-e39dc57aaea7 | Eculizumab (Soliris®) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris™) | Eculizumab (Soliris®) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris™) | | |
|  | | 3578 | Edaravone(Radicava®)MA08.092a | Pharmacy (08) | MA08.092a | MA08.092 | 93ee35b6-d0d3-4c1a-b0e0-152e9dd153e8 | Edaravone (Radicava®) | Edaravone (Radicava®) | | |
|  | | 4441 | Efgartigimod-alfa(VyvgartTM)MA08.142a | Pharmacy (08) | MA08.142a | MA08.142 | 2e1307f8-6d9b-42c0-bcb3-f8a1d8130e7a | Efgartigimod-alfa (VyvgartTM) | Efgartigimod-alfa (VyvgartTM) | | |
|  | | 4365 | Eflapegrastim-xnst(Rolvedon™),Pegfilgrastim(Neulasta®)andRelatedBiosimilarsMA08.082j | Pharmacy (08) | MA08.082j | MA08.082 | b1ce6a6e-dd13-40a1-bfda-991f36ee8d46 | Eflapegrastim-xnst (Rolvedon™), Pegfilgrastim (Neulasta®) and Related Biosimilars | Eflapegrastim-xnst (Rolvedon™), Pegfilgrastim (Neulasta®) and Related Biosimilars | {"4366": {"Id":4366,"MPAttachmentLetter":"A","Title":"EXAMPLES OF DISEASE SETTINGS AND CHEMOTHERAPY REGIMENS WITH A HIGH (>20%) OR INTERMEDIATE (10-20%) RISK FOR FEBRILE NEUTROPENIA","MPPolicyAttachmentInternalSourceId":7289,"PolicyAttachmentPageName":"073d1324-e0f7-4423-8859-0c20e57e2ae1"},} | |
|  | | 4287 | ElectricalStimulationandElectromagneticStimulationfortheTreatmentofWoundsMA07.013d | Medicine (07) | MA07.013d | MA07.013 | 4d2edd4d-cda6-4f0a-90ca-019dfd361a62 | Electrical Stimulation and Electromagnetic Stimulation for the Treatment of Wounds | Electrical Stimulation and Electromagnetic Stimulation for the Treatment of Wounds | {"4288": {"Id":4288,"MPAttachmentLetter":"A","Title":"ICD-10 Coding","MPPolicyAttachmentInternalSourceId":7197,"PolicyAttachmentPageName":"682701e8-a236-4e4c-b4cc-69923e3999b7"},} | |
|  | | 3937 | ElectroconvulsiveTherapy(ECT)MA14.001 | Behavioral Health (14) | MA14.001 | MA14.001 | 78280621-f992-4f8a-9825-368ec185cde4 | Electroconvulsive Therapy (ECT) | Electroconvulsive Therapy (ECT) | | |