Diabetes mellitus in mother complicating pregnancy , childbirth or puerperium. 253.0 Diabetes Mellitus. 648.80-648.84 Diabetes melli-tus. 648.00-648.04 …
LABORATORY / DIAGNOSIS CODE CHECK LIST
|80019, G0058, G0059, G0060 |
| Any diagnosis information submitted must have medical justification in the patient|
|record for components of the test Documentation ICD-9 Ccdes supporting medical |
|necessity of this item must be submitted with each specimen |
|80162 |Digoxin Therapeutic Drug Assay any source |
|V7284 |Pre-operative exam, |4270-42|Cardiac Dysrhythmias |
| |unspecified |79 | |
|3682 |Psychophysical visual |4280-42|Heart Failure |
| |disturbances |89 | |
|3689 |Unspecified visual |5140 |Pulmonary Congestion Hypostatis |
| |disturbance | | |
|40200-4|Hypertensive heart |7830 |Anorexia |
|0291 |disease | | |
|4130 |Angina
decubitus |78701-7|Nausea Vomiting |
| | |873 | |
|4250-42|Cardiomyopahy |9721 |Poisoning by Cardiotonic glycosides |
|59 | | |drugs of similar action |
|4260-42|Conduction disorders | | |
|69 | | | |
|82270 |Blood, Occult; Feces Screening |
|Medicare will pay for gastrointestinal disorders and iron deficiency anemia |
|sectionary to blood loss Other anemias 2801-2899 may be covered under unusual |
|circumstances eg a sudden drop in hemoglobin/hematocrit |
|0060-00|-Amebiasis |
|69 | |
|00841-0|Intestinal Infections |
|088 | |
|
| |
|0222 |Gastrointestinal anthrax |
| | |
|2800-28|Anemias, any and all types |
|99 | |
|4480 |Hereditary hemorrhagic telangiectasia |
|82465 |Total serum Cholesterol |
|Performed to Assess the risk of Coronary artery disease |
|Evaluate fat metabolism |
|aid in diagnosis of nephrotic syndrome, pancreatitis, hepatic disease, and hypo- and |
|hyperthyroidism |
|82728 |Ferritin Level |
|2693 |Mineral deficiency, not |2818 |Anemia associated with other specified |
| |elsewhere classified | |nutritional deficiency
|
|2750 |Disorders of iron |2819 |Unspecified deficiency anemia |
| |metabolism | | |
|2800 |Iron deficiency anemia |2850 |Sideroblastic anemia |
| |secondary to blood loss | | |
| |chronic | | |
|2801 |Iron deficiency anemia |2851 |Acute posthemorrhagic anemia |
| |secondary to inadequate | | |
| |dietary iron intake | | |
|2808 |Other specified iron |2858 |Other specified anemias |
| |deficiency anemia | | |
|2809 |Iron deficiency anemi, |2859 |Anemia, U\unspecified |
| |unspecified | | |
|2810 |Pernicious anemia |5718 |Other chronic nonalcoholic liver disease |
|2811 |Other vitamin B12 |5719 |Unspecified
chronic liver disease without |
| |deficiency anemia | |mentin of alcohol |
|2812 |Folate-deficiency anemia |585 |Chronic renal failure |
|2813 |Other specified | | |
| |megablastic anemias not | | |
| |elsewhere classified | | |
|2814 |protein-deficiency anemia| | |
|82947 Quantitative Glucose |
|82948 Blood Glucose Reagent Strip |
|V728|Preoperative examination, |3483 |Encephalopathy, unspecified |
|4 |unspecified | | |
|1574|Malignancy of pancreas |3579 |Unspecified inflammatory toxic |
| | | |neuropathy |
|2117|Benign neoplasm islets of |3688 |Other specified visual disturbance |
| |Lagerhans
| | |
|2500|Diabetes mellitus |577 |Acute pancreatitis |
|0-250| | | |
|91 | | | |
|2510|hypoglycemic coma |5771 |Chronic pancreatitis |
|2512|Other specified |60784 |Impotence of Organic origin |
| |hypoglycemia | | |
|2513|Hypoglycemia, unspecified |64800-648|Diabetes mellitus in mother complicating |
| | |04 |pregnancy , childbirth or puerperium |
|2530|Post surgical |64880-648|abnormal glucose tolerance in mother |
| |hypoinsulinemia |84 |complicating pregnancy, childbirth or |
| | | |puerp |
|2760|Hyperosmolality /or |7802 |Syncope collapse |
| |hypoatremia | |
|
|2761|Hyposmolality /or |7804 |Dizziness giddiness |
| |hypoatremia | | |
|2765|Volume depletion |7832 |Abnormal loss of weight |
|2767|Hyperpostassemia |7835 |Polydipsia |
|2768|Hypopotassemia |78841-788|Frequency of urination polyuria |
| | |43 | |
|2769|Electrolyte fluid |7902 |Abnormal glucose tolerance test |
| |disorders of elsewhere | | |
| |classified | | |
|3451|Generalized convulsive |7915 |Glycosuria |
|0-345|epilepsy | | |
|11 | | | |
|82985 |Glycated Protein | | |
|250-00-2|Diabetes Mellitus |64880-6488|Abnormal
glucose tolerance in mother|
|5093 | |4 |complicating pregnancy, childbirth, |
| | | |or puerperium |
|2512 |Unspecified hypoglycemia | | |
|83036 |Glycated hemoglobin |
|250-250|Diabetes melli-tus |64800-648|Diabetes mellitus complicating |
|93 | |04 |pregnancy, childbirth, or the puerperium|
|2512 |Unspecified |64880-648|Abnormal glucose tolerance complicating |
| |hypoglycemia |84 |pregnancy, childbirth, or the puerperium|
|V726 |Not Covered |7902 |Abnormal glucose tolerance test |
| | |7906 |Hyperglycemia |
|84066 Prostatic Acid Phosphatase PAP |
|V1046|Personal Hx of malignant neoplasm, |2334 |Cardinoma in situ; prostate |
| |prostate | | |
|185 |Malignant neoplasm of prostate
|2365 |Neoplasm of uncertain behavior; |
| | | |prostate |
|1985 |Secondary malignant neoplasm of bone|2395 |Neoplasms of unspecified nature;|
| |and bone marrow | |other genitourinary organs |
|2222 |Benign neoplasm of prostate |7903 |Elevated prostate specific |
| | | |antigen PSA |
|84153 |PSA - Prostate Specific Antigen | | |
|V1046|Personal HX of malignant |233|Carcinoma in situ of prostate |
| |neoplasm of prostate |4 | |
|V7284|Pre-operative exam, |236|Neoplasm of uncertain behavior of prostate |
| |unspecified |5 | |
|1850 |Malignant neoplasm of |239|Neoplasm of unspecified nature of prostate |
| |prostate |5 | |
|1885 |Malignant neoplasm of |596|Bladder neck obstruction |
| |bladder neck |0
| |
|1888 |Malignant neoplasm of |790|Elevated prostate specific antigen PSA |
| |other specified sites of |9 | |
| |bladder | | |
|1988 |Secondary malignant | | |
| |neoplasm of genital | | |
| |organs | | |
|84436 Total Thyroxine, T4 |
|0175|Tuberculosis of thyroid |Psychriatic Disorders|3763|Lateral displasement of |
|0 |gland | |6 |globe |
|0175|01753|01755 |30000 |30011|30019|3795|Nystagmus unspecified |
|1 | | | | | |0 | |
|0175|01754|01756 |30001 |30012|3079 |3795|3795|3795|3795|3795|
|2 | | | | | |1 |3 |5 |7 |9 |
|0782|Sweating |30002
|30013|311 |3795|3795|3795|3795| |
| | | | | |2 |4 |6 |8 | |
|2400 |Simple Goiter |30009 |30015|3449 |Hearing|3883|3883|3883|389|
| | | | | | |0 |1 |2 |9 |
|2409|2410|2411|2419 |30010 |30016|3483 |Heart|4010 |4239 |4259|4273|
| | | | | | | | | | | |1 |
|Thyroxtoxicosis with or without |3540|Carpel tunnel | |42789 |4279|4293 | |
|goiter: | |syndrome | | | | | |
|All DX codes below will include |3569 |Polyneuropath|Lungs|5119 |5198|5360|5378|
|one of the following fifth 5th| |y | | | | |9 |
|digit subclassifications for use| | | | | | | |
|with every ctegory 242: | | | | | | | |
|0 without mention of thyrotoxic|3593 |Periodic |5601|Paralytic ilius |
|crisis or storm | |Paralysis | | |
|1 with mention of thyrotoxic | |
| | |
|crisis or storm | | | | |
|2420|2440|2451|2461|2752 |Eye |5640|Constipation |
|2421|2441|2452|2462|2761 |3682|3743|37632 |5647|Megacolon |
| | | | | | |4 | | | |
|2422|2442|2453|2463|2810 |3743|3744|37633 |5799|B12-malasorption |
| | | | | |0 |1 | | | |
|2423|2443|2454|2468|2830 |3743|3763|37634 |6111|Gynecomastia |
| | | | | |1 |0 | | | |
|2424|2448|2458|2469|2980 |3743|3763|37635 |6253|Menorrhagia |
| | | | | |2 |1 | | | |
|2428|2449|2459|2720|2981 |3743| | |6481|Thyroid dysfunction |
| | | | | |3 | | | | |
|2429|2450|2460|2721|2989 | | |7011|Dry Skin |
|243 | | | | | | |7018|Other spec hyper-
|
| | | | | | | | |atrophic conditions of |
| | | | | | | | |skin |
|Other and unspecified disorders of JOINT: |7038|Britle nails |
|0 site |3 |6 Lower |8 Other specified |7040|Alopecia, Unspecified |
|unspecified |Forearm |Leg |Sites |0 | |
|1 Shoulder |4 Hand |7 Ankle |9 Multiple sites |7040|Alopecia areata |
|region | |and foot | |1 | |
|2 Upper Arm |5 Pelvic | | | |7040|Telogen effluvim |
| |region and | | | |2 | |
| |thigh | | | | | |
|7194|7330|7805|7813|7831| | |7892|794|7040|Other diseases hair |
| |0 |3 | | | | | |5 |9 |/hair follicles |
|7195|7330|7805|7820|7832| | |7895|796|7090|Intermittent |
| |2 |4 | | | | | |4 |
|exophthalmos |
|7282|7501|7805|7823|7840| | |7904|799| |
| |5 |7 | | | | | |2 | |
|7289|7753|7807|7826|7844| | |7905|992| |
| | | |1 |9 | | | |9 | |
|7291|7805|7808|7826|7846| | |7943| | |
| |1 | |2 |9 | | |1 | | |
| |7805|7809|7830|7850| | | |
|7298|2 | | | | | | |
|2 | | | | | | | |
|84443 |Total Thyroid Stimulating Hormone, TSH |
|Tuberculo| | | | | |Thyrotoxicosis with or without goiter |
|sis | | | | | | |
|01750 |0175|0175|01753|01754|01756| 0 without mention of thyrotoxic crisis or|
| |1 |2 | | | |storm
|
|0782 |Sweating | 1 with mention of thyrotoxic crisis or |
| | |storm |
|193 |Primary malig Neoplasm of |2420|2450|2720|3001|3743|3795|4278|5198 |
| |thyroid gland | | | |2 |1 |2 |9 | |
|19889 |Secondary malignant neoplasm |2421|2451|2721|3001|3743|3795|4279|5360 |
| |of thyroid gland | | | |3 |2 |3 | | |
|226 |Benign neoplasm of thyroid |2422|2451|2469|3001|3743|3765|3883|53789|
| |Glant | | | |5 |3 |4 |0 | |
|Goiter |2400 2409 2410 |2423|2452|2721|3001|3743|3765|3883|5601 |
| |2410 | | | |9 |0 |5 |1 | |
|Other and unspecified disorders of |2424|2452|2752|3079|3744|3765|3883|5640 |
|JOINT: | | | | |1 |6 |2 | |
|0 site |3 |5 Pelvic |7 Ankle |2428|2453|2854|311 |3763|3795|3883|5799|
|unspec |Forearm|reg
|Foot | | | | |0 |7 |2 | |
| | |thigh | | | | | | | | | |
|1 Shoulder|4 Hand |6 Lower |8 Other |2429|2453|2761|3449|3763|3795|3899|6111|
|region | |Leg |specified | | | | |1 |8 | | |
| | | |Sites | | | | | | | | |
|719|73302|7805|7826|7846|7872|7904|2440|2454|2830|3483|3763|3795|4010|6253 |
|4 | |7 |1 |9 | | | | | |3 |2 |9 | | |
|719|75015|7807|7826|7850|7873|7905|2441|2459|2980| |3763|3883|4230|6481 |
|5 | | |2 | | | | | | |3540|3 |0 | | |
|728|7753 |7808|7830|7851|7884|7905|2442|2460|2981|356|3763|3883|4279|7011 |
|2 | | | | |1 | | | | |9 |4 |1 | | |
|728|78051|7809|7831|7856|7884|7943|2443|2461|2989|3593|3763|3883|4273|7018 |
|9 | | | | |2 |1 | | | | |5 |2 |1 | |
|729|78052|7813|7832|7861|7884|7945|2448|2462|3000|3682|3763|3899|4278|70400 |
|1 | |
| | |3 | | | |0 | |6 | |9 | |
|729|78053|7820|7840|7860|7892|7964|2449|2463|3000|3743|3795|4010|4279|70402 |
|82| | | |9 | | | | |1 |0 |0 | | | |
|733|78054|7823|7844|7870|7895|9929|2450|2468|3000| |3795|4239|4393|70409 |
|00| | |9 | | | | | |2 | |1 | | | |
| | | | | | | | | | | |3795|4273|5119|7090 |
| | | | | | | | | | | |2 |1 | | |
| | | | | | | | | | | | | | | |
|J3420 |Injection, Vitamin B12 | | |
|1234|Diphyllobothriasis, |5790 |Celiac Disease |
| |intestinal | | |
|2662|Other b-complex |5791 |Tropical Sprue |
| |Deficiencies | | |
|2810|Pernicious Anemia |5792 |Blind Loop
Syndrome |
|2813|Other specified |5793 |Other Unspecified postsurgical nonabsorption|
| |magaloblastic anemias not | | |
| |elsewhere classified | | |
|3362|Subacute combined |5798 |Other specified intestinal malabsorption |
| |degeneration of spinal | | |
| |cord in diseases | | |
| |classified elsewhere | | |
|5550|Regional Enteritis of |5799 |Unspecified intestinal malabsorption |
| |Small intestine | | |
|5559|Regional Enteritis of | | |
| |unspecified site | | |
|85023-85027|Hemogram with Platelet | | |
|V4589 |Postsurgiscal state for |4590 |Hemorrhage, unspecified |
|
|splenectomy | | |
|V581 |Chemotherapy |5693 |Hemorrhage of rectum anus |
|V7284 |Pre-operative examination, |5780-5|Gastrointestinal hemorrhage |
| |unspecified |789 | |
|01800-0|Military tuberculosis |5967 |Hemorrhage into bladder wall |
|1896 | | | |
|0380-03|Septicemia |5997 |Hematuria |
|89 | | | |
|042 |Human immunodeficiency virus|6214 |Hematometra |
| |HIV disease | | |
|0661 |Tick-borne fever |6236 |Vaginal hemtoma |
|0820 |Spotted fevers |6266 |Metrorhagia |
|0828 |Other specified tick-borne |6270-6|Menopausal post menopausal disorders |
| |rickettsioses |279 |
|
|0829 |Tick-borne |66620-|Delayed secondary postpartum |
| |rickettsiosis,unspecified |66624 |hemorrhage |
|1400-20|Malignant neoplasms |6663-6|Postpartuum coagulation defects |
|891 | |6634 | |
|2300-23|Carcinoma in situ |67140-|Deep phlebothrombosis, postpartum |
|49 |neoplasms of uncertain |67144 | |
| |behavior | | |
|2352-23|Neoplasms of uncertain |7100 |Systemic lupus erythematosus |
|99 |behavior | | |
|2660-26|Deficiency of B-complex |7100-7|Diffuse diseases of connective tissue |
|69 |components |109 | |
|2730-27|Disorders of plasma protein |71100-|Arthopathy associted with infections |
|39 |metabolism |71199 | |
|2800 |Iron deficiency anemia |7140 |Rheumatoid arthritis
|
| |secondary to chronic blood | | |
| |loss | | |
|2808 |Other specified iron |7141 |Feltys syndrome |
| |deficiency anemias | | |
|2809 |Iron deficiency anemia, |71910-|Hemarthrosis |
| |unspecified |71919 | |
|2810-28|Other deficiency anemias |7590 |Anomalies of spleen |
|19 | | | |
|2820-28|Hereditary hemolytic anemias|7720-7|Fetal neonatal hemorrhage |
|29 | |729 | |
|2830-28|Acquired hemolytic anemias |7760-7|Hematological disorders of fetus |
|39 | |769 |newborn |
|2840-28|Aplastic anemia |7827 |Spontaneous ecchymoses |
|49 | | |
|
|2850-28|Other and unspecified |7847 |epistasix |
|59 |anemias | | |
|2860-28|Coagulation defects |7848 |Hemorrhage from throat |
|69 | | | |
|2870-28|Purpura and other |7863 |Hemoptysis |
|79 |hemorrhagaic conditions | | |
|2880-28|Diseases of white blood |7892 |splenomegaly |
|89 |cells | | |
|2890-28|Other diseases of blood |79092 |Abnormal coagulation profile |
|99 |blood-forming cells | | |
|36281 |Retinal hemorrhage |85200-|subarachnoid, subdural extradural |
| | |85259 |hemorrhage, following injury |
|4150-41|Acute pulmonary heart |85300-|other unspecified intracranial |
|519 |disease |85319 |hemorrhage
following injury |
|430 |Subarachnoid hemorrhage |9950 |Other anaphylactic shock |
|431 |Intracerebral hemorrhage |9952 |Unspecified adverse aeffect of drug, |
| | | |medicinal biological substance |
|4320-43|Other unspecified |9980 |Postoperative shock |
|29 |intracranial hemorrhage | | |
|43400-4|Occlusion of cerebral |9981 |Hemorrhage or hematoma complicating a |
|3491 |arteries | |procedure |
|4440-44|Arterial embolism | | |
|49 |thrombosis | | |
|4460-44|Polyarteritis nodosa | | |
|67 |allied conditons | | |
|85610 |Prothombin time | | |
|V123 |Personal HX disease of blood |43300-4|Occlusion stenosis of |
| |blood forming organs
|3391 |precerebral arteries |
|V151 |Personal HX surgery to heart |43400-4|Occlusion of cerebral arteries |
| |great vessels |3491 | |
|V422 |Heart valve replaced by |4350-43|transient cerebral ischemia |
| |transplant |59 | |
|V427 |Liver replaced by transplant |436 |Acute, but ill-defined |
| | | |cerebrovascular disease |
|V432 |Heart replacement by means other |4370 |Cerebral atheroslcerosis |
| |than transplant | | |
|V433 |Heart valve replaced by means |4371 |Other generalized ischemic |
| |other than transplant | |cerebrovascular disease |
|V434 |Blood vessel replacement by means|4376 |Nonpyogenic thrombosis of |
| |other than transplant | |intracranial venous sinus |
|V436 |Joint replacement by means other |4400-44|Atherosclerosis |
| |than transpolant
|09 | |
|V4360 |Unspecified joint replacement by |4430-44|Other peripheral vascular |
| |means other than transplant |39 |disease |
|V7284 |Pre-operative examination, |4440-44|Arterial embolism thrombosis |
| |unspecified |49 | |
|07000-07|Viral hepatitis |4471 |Stricture of artery |
|093 | | | |
|2851 |Acute post hemorrhagic anemia |4510-45|Phlebitis thrombophlebitis |
| | |19 | |
|2860-286|Coagulation defects |452 |Portal vein thrombosis |
|9 | | | |
|2870-287|Purpura other hemorrhagic |4530-45|Other venous embolism |
|9 |conditions |39 |thrombosis |
|29040-29|arteriosclerotic dementia |4590 |Hemorrhage, unspecified |
|043 |
| | |
|325 |Phlebitis thrombophlebitis of |4591 |Postphlebitis syndrome |
| |intracranial venous sinuses | | |
|36230-36|Retinal vascular occlusion |4592 |Compression of vein |
|237 | | | |
|3862 |Vertigo of central origin |45981 |Venous peripheral |
| | | |insufficiency, unspecified |
|38650 |Labyrinthine dysfunction, |514 |Pulmonary congestion |
| |unspecified | |hypostasis |
|3940-394|Diseases of mitral valve |5693 |Hemorrhage of rectum and anus |
|9 | | | |
|3950 |Rheumatic aortic stenosis |5710-57|Chronic leiver disease |
| | |19 |cirrhosis |
|3952 |Rheumatic aortic stenosis |5722 |Hepatic coma |
|
|w/insufficiency | | |
|3960-396|Diseases of mitral aortic |5724 |Hepatorenal syndrome |
|9 |valves | | |
|41000-41|Acute myocardial infarction |5728 |Other sequel of chronic liver |
|092 | | |disease |
|4111 |Intermediate coronary syndrome |5733 |Hepatitisl, unspecified |
|41181-41|Other acute coronary occlusion |5739 |Unspecified disorder of liver |
|189 |w/out myocardial infarction | | |
|4130-413|Angina pectoris |5770 |Acute pancreatitis |
|9 | | | |
|41400-41|Coronary atherosclerosis |5780-57|Gastrointestinal hemorrhage |
|403 | |89 | |
|4148 |Other specified forms of chronic |5792 |Blind loop syndrome |
| |ischemic heart disease | |
|
|4149 |Chronic ischemic heart disease, |5997 |Hematuria |
| |unspecified | | |
|4150-415|Acute pulmonary heart disease |67120-6|Venous complications in |
|1 | |7154 |pregnancy the puerperium |
|4169 |Chronic pulmonary heart disease |67190-6|Unspecified enous complication |
| | |7194 | |
|4240-424|Mitral Valve disorders |673 |Obstetrical pulmonary embolism |
|1 | | | |
|4250-425|Cardiomyopathy |71910-7|Hemorthrosis 5th digits, 5,6, |
|9 | |1999 |9 allowed only |
|4270-427|Cardiac dysrhythmias |7450-74|Other congenital anomalies of |
|9 | |69 |heart |
|42731 |Atrial Fibrillation |7827 |Spontaneous echymosis |
|42732 |atrial flutter |7847 |Epistaxis
|
|4280-428|Heart failure |7848 |Hemorrhage from throat |
|9 | | | |
|4291-429|Ill-defined descriptions |7863 |Hemoptysis |
|4 |complications of heart disease | | |
|42979 |Mural thrombus |7891 |Hepatomegaly |
|4320-432|Other unspecified intracranial |7895 |Ascites |
|9 |hemorrhage | | |
| | |79092 |Abnormal coagulation profile |
| | |85200-8|Subarachnoid subdural |
| | |5259 |extradural hemorrhage, following|
| | | |injury |
| | |9642 |Poisoning by anticoagulant |
|86316 |Immunoassay for Tumor Antigen CA| | |
| |125 | |
|
|1830 |Malignant Neoplasm of Ovary |7893 |Abdominal or pelvic swelling, |
| | | |mass or lump |
|1986 |Secondary Malignant Neoplasm of |7895 |Ascites |
| |Ovary | | |
|2333 |CA in situ of Ovary |V1043 |Personal HX of malignant |
| | | |neoplasm of ovary |
|86592 |Syphilis |
|2898 |Hypergammaglobulinemia |
|7100 |systemic lupus erythematosus |
|86689 |AIDS Western Blot Confirmatory Test |
|Medicare covered if a test for antibodies for AIDS virus CPT86701 or 86687, etc is|
|positive |
|DX: must indicate medical necessity for the testing Non-specific codes or no |
|diagnosis will result in denial of service
Patients being tested for screening |
|purposes must sign WAIVER and make payment for service |
|87086 |Culture, Bacterial, Urine, Quantitative, Colony Count |
|87088 |Culture, Bacterial, Urine, identification, in addition to quantitative or |
| |commercial kit |
|038 |Septicemia |7880-78|Symptoms involving urinary system|
| | |89 | |
|5080-589|Nephritis, neophretic syndrome |7907 |Bacteremia |
|9 |nephrosis | | |
|590-0-599|Other Diseases of Urinary System |7917 |Proteinuria |
|9 | | | |
|600- | | | |
CORRECT CODING INITIATIVE
|Q0136 |EPO Epoetin Alpha for NON End Stage Renal Disease |
|042-0449 2849, 2858, |Anemia in quidovudine
AZT treated HIV infected patient |
|or 2859 | |
|V581, 2849, 2858, or |Chemotherapy with symptomatic anemia |
|2859 | |
|2387, 2849,2858, |Myelodysplastic syndrome with symptomatic anemia |
|2859 | |
|J3490 |Granisetron Hydrochloride Kytril claim must include name of drug and|
| |dosage |
|DX |Drug will be covered when used for cancer related condition Must be |
| |billed on same claim as chemotherpy drug being administered 13959 |
| |per 1 mg/ml |
|90780 |IV INFUSION for therapy/DX administered by physician or under direct |
| |supervision of physician; up to one hour REHYDRATION THERAPY |
|90781 |IV infusion for therapy/diagnosis administered by physician or under |
| |direct
supervision of physician; each additional 1/2 hour up to 8 hours|
|DX 2765 |Volume depletion bill office visit in addition to IV infusion therapy|
| |DO NOT code prolonged service codes 99354, 99356, and 99357 |
|J0640 |Calcium Leucovorin Injection |
| |Bill to Medicare when injection given include a statement that 5-FU or|
| |Methotrexate has been prescribed to patient as oral medication |
| |Attachment required with same to provide statement about the oral |
| |medication |
|G0001 |ROUTINE VENIPUNCTURE for collection of specimen MEDICARE ONLY |
|36415 |Routine venipuncture for collection of specimen COMMERCIAL INSURANCE |
|A4550 |SURGICAL TRAY covered charge for specific Procedures codes ie Breast |
| |Bx arthrocentesis, lesion removal, laceration repair not included |
| | |
ROUTINE SCREENING SERVICES NOT Eligible for MedicarePayment
Medicare does not
pay for items or services which are not reasonable and
necessary for he diagnosis or treatment of illness or injury, or to improve
a functioning of malformed body member This means that there must be an
illness or injury known to be in existence to diagnosis and treat An
illness can be a sign or symptom or abnormal laboratory finding, etc
indicative of an underlying disease process A screening is a search for
a disease which may or may not be present Routine physical checkups are
also excluded from coverage by Medicare
DIAGNOSTIC PAP SMEARS do not use screening pap smears CPT code for this
service
|88150 |Cytopathology, smears, cervical or vaginal , up to three smears; under |
| |physician supervision |
|88151 |Cytopathology, smears, cervical or vaginal, up to three smears; requires|
| |inter by Physician |
|COVERED DX |HX cancer of cervix or presenty being treated, previous abnormal pap, |
| |abnormal findings of vagina, etc, sign or symptoms reasonably related to|
| |a gynecologic disorder
|
|SCREENING PAP SMEAR | |
|P3000 |Screening Papanicolau smear, up to three smears, by technician under physician|
| |supervision |
|93001 |Screening Papanicolau smear, cervical or vaginal up to three smears REQUIRING |
| |INTERP by Physician |
|DX |If Pt has not had test during preceding 3 years |
|V762 |Special screening for malignant neoplasms, cervix |
|DX |If Pt is at high risk of developing cervical cancer qualifies for PAP more |
|V726 |frequently than every 3 years |
| |Laboratory examination AND |
|V1589|Other specified personal history present hazards to health |
|PRE-OPERATIVE LABORATORY TESTING | |
|V7484|Preoperative testing unspecified Use V code along with appropriate CPT codes|
|17340 |CRYOTHERAPY NOT covered
by MCR because code description includes words |
| |for acne use the following codes instead of 17340 |
|17100-1711|Destruction by any method including electrocautery, electrodesication, |
|0 |CRYOSURGERY, laser, chemical treatment |
|17260-1728|The type lesions may include condylomata, papillomata, molluscum |
|6 |contagiosum, herpetic lesions, flat warts, milia, or other benign |
| |premalignant or malignant lesions |
|J9070, |Cyclophosphamide 100 mg must code drug with appropriate dosage code |
|J9080 |Cyclophosphamide 200 mg |
|J9090 |Cyclophosphamide, 500 mg |
|J9091 |Cyclophosphamide 1 mg |
|J9092 |Cyclophosphamide 20 gm |
|J9181 |Etoposide 10 mg must code the accurate dosage code |
|J9182 |Etoposide 100 mg |
|ALLERGEN
IMMUNOTHERAPY EM Service on | |
|same day | |
|-25 |Must use modifier to indicate that Separately Identifiable Service |
|modifier |performed on the same day Check for efficacy of, and reactions to, the |
| |allergy shots is not considered a separately identifiable service |
| |Preferably you should use a different DX code with the office visit |
|SEPARATE PAYMENT for A4550 Surgical | |Use only if performed in Physician | |
|Tray | |office - Commercial Ins ONLY Do not | |
| | |use with MCR/MCD split billing | |
|19101 |32000 |45382 |52275 |
|19120 |37609 |45383 |52276 |
|19125 |38500 |45384 |52277 |
|19126 |43200 |45385 |52283 |
|20200 |43202 |49080
|52290 |
|20205 |43220 |49081 |52300 |
|20220 |43226 |52205 |52305 |
|20225 |43234 |52007 |52310 |
|20240 |42235 |52010 |52315 |
|25111 |43239 |52204 |57520 |
|28290 |43245 |52214 |58120 |
|28292 |43247 |52224 |62270 |
|28293 |43250 |52234 |85095 |
|28294 |43251 |52235 |85102 |
|28296 |43458 |52240 |96440 |
|28297 |45378 |52250 |96445 |
|28298 |45379 |52260 |96450 |
|28299 |45380 |52270 |
|
Source:aipm.net
