code description fee - beaumont, texas€¦ · carcinoma tumor tissue, with alpha-fetoprotein...

Code Description Fee

0001M Infectious disease, HCV, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein

A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic algorithm

reported as scores for fibrosis and necroinflammatory activity in liver

0002U Oncology (colorectal), quantitative assessment of three urine metabolites (ascorbic

acid, succinic acid and carnitine) by liquid chromatography with tandem mass

spectrometry (LC-MS/MS) using multiple reaction monitoring acquisition, algorithm

reported as

0006M Oncology (hepatic), mRNA expression levels of 161 genes, utilizing fresh hepatocellular

carcinoma tumor tissue, with alpha-fetoprotein level, algorithm reported as a risk

classifier

0007U Drug test(s), presumptive, with definitive confirmation of positive results, any number

of drug classes, urine, includes specimen verification including DNA authentication in

comparison to buccal DNA, per date of service

BFWD-I Balance Forward - Insurance

0001F Heart failure assessed (includes assessment of all the following components) (CAD):

Blood pressure measured (2000F) Level of activity assessed (1003F) Clinical symptoms

of volume overload (excess) assessed (1004F) Weight, recorded (2001F) Clinical signs o

0004M Scoliosis, DNA analysis of 53 single nucleotide polymorphisms (SNPs), using saliva,

prognostic algorithm reported as a risk score

0005U Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG, PCA3,

and SPDEF), urine, algorithm reported as risk score

0007M Oncology (gastrointestinal neuroendocrine tumors), real-time PCR expression analysis

of 51 genes, utilizing whole peripheral blood, algorithm reported as a nomogram of

tumor disease index

0008U Helicobacter pylori detection and antibiotic resistance, DNA, 16S and 23S rRNA, gyrA,

pbp1, rdxA and rpoB, next generation sequencing, formalin-fixed paraffin-embedded or

fresh tissue, predictive, reported as positive or negative for resistance to clarith

0010U Infectious disease (bacterial), strain typing by whole genome sequencing, phylogenetic-

based report of strain relatedness, per submitted isolate

00124 Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy

0012U Germline disorders, gene rearrangement detection by whole genome next-generation

sequencing, DNA, whole blood, report of specific gene rearrangement(s)

00142 Anesthesia for procedures on eye; lens surgery

0015F Melanoma follow up completed (includes assessment of all of the following

components) (ML): History obtained regarding new or changing moles (1050F)

Complete physical skin exam performed (2029F) Patient counseled to perform a

monthly self skin examination

00162 Anesthesia for procedures on nose and accessory sinuses; radical surgery

00170 Anesthesia for intraoral procedures, including biopsy; not otherwise specified

00192 Anesthesia for procedures on facial bones or skull; radical surgery (including

prognathism)

0020U Drug test(s), presumptive, with definitive confirmation of positive results, any number

of drug classes, urine, with specimen verification including DNA authentication in

comparison to buccal DNA, per date of service

00212 Anesthesia for intracranial procedures; subdural taps

00216 Anesthesia for intracranial procedures; vascular procedures

00300 Anesthesia for all procedures on the integumentary system, muscles and nerves of

head, neck, and posterior trunk, not otherwise specified

00326 Anesthesia for all procedures on the larynx and trachea in children younger than 1 year

of age

00400 Anesthesia for procedures on the integumentary system on the extremities, anterior

trunk and perineum; not otherwise specified


trunk and perineum; radical or modified radical procedures on breast with internal

mammary node dissection

00472 Anesthesia for partial rib resection; thoracoplasty (any type)

0051T Implantation of a total replacement heart system (artificial heart) with recipient

cardiectomy

00524 Anesthesia for closed chest procedures; pneumocentesis

0052T Replacement or repair of thoracic unit of a total replacement heart system (artificial

heart)

00537 Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation

00540 Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and

mediastinum (including surgical thoracoscopy); not otherwise specified


mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty

00550 Anesthesia for sternal debridement

00567 Anesthesia for direct coronary artery bypass grafting; with pump oxygenator

0059T Cryopreservation; oocyte(s)

00620 Anesthesia for procedures on thoracic spine and cord, not otherwise specified

00626 Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic

approach; utilizing 1 lung ventilation

00700 Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified

0072T Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total

leiomyomata volume greater or equal to 200 cc of tissue

00732 Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced

proximal to duodenum; endoscopic retrograde cholangiopancreatography (ERCP)

00750 Anesthesia for hernia repairs in upper abdomen; not otherwise specified

0075T Transcatheter placement of extracranial vertebral artery stent(s), including radiologic

supervision and interpretation, open or percutaneous; initial vessel

00790 Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not

otherwise specified

00796 Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy;

liver transplant (recipient)

00802 Anesthesia for procedures on lower anterior abdominal wall; panniculectomy

00832 Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias

00840 Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not

otherwise specified

00846 Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy;

radical hysterectomy

0085T Breath test for heart transplant rejection

00870 Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract;

cystolithotomy

00880 Anesthesia for procedures on major lower abdominal vessels; not otherwise specified

00904 Anesthesia for; radical perineal procedure

00910 Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise

specified

00922 Anesthesia for procedures on male genitalia (including open urethral procedures);

seminal vesicles


radical orchiectomy, abdominal


complete amputation of penis

00948 Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or

endometrium); cervical cerclage

0095T Removal of total disc arthroplasty (artificial disc), anterior approach, each additional

interspace, cervical (List separately in addition to code for primary procedure)

0100T Placement of a subconjunctival retinal prosthesis receiver and pulse generator, and

implantation of intraocular retinal electrode array, with vitrectomy

0103T Holotranscobalamin, quantitative

0111T Long-chain (C20-22) omega-3 fatty acids in red blood cell (RBC) membranes

01140 Anesthesia for interpelviabdominal (hindquarter) amputation

01170 Anesthesia for open procedures involving symphysis pubis or sacroiliac joint

01190 Anesthesia for obturator neurectomy; intrapelvic

01220 Anesthesia for all closed procedures involving upper two-thirds of femur

01234 Anesthesia for open procedures involving upper two-thirds of femur; radical resection

01260 Anesthesia for all procedures involving veins of upper leg, including exploration

01360 Anesthesia for all open procedures on lower one-third of femur

01390 Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella

01402 Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee

arthroplasty

01430 Anesthesia for procedures on veins of knee and popliteal area; not otherwise specified

01470 Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle,

and foot; not otherwise specified

01480 Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise

specified

01486 Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle

replacement

01502 Anesthesia for procedures on arteries of lower leg, including bypass graft;

embolectomy, direct or with catheter

01630 Anesthesia for open or surgical arthroscopic procedures on humeral head and neck,

sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise

specified


sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder

replacement

01650 Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified

01682 Anesthesia for shoulder cast application, removal or repair; shoulder spica

01712 Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm

and elbow; tenotomy, elbow to shoulder, open

0171T Insertion of posterior spinous process distraction device (including necessary removal

of bone or ligament for insertion and imaging guidance), lumbar; single level

01732 Anesthesia for diagnostic arthroscopic procedures of elbow joint

0175T Computer-aided detection (CAD) (computer algorithm analysis of digital image data for

lesion detection) with further physician review for interpretation and report, with or

without digitization of film radiographic images, chest radiograph(s), performed r

01772 Anesthesia for procedures on arteries of upper arm and elbow; embolectomy

0178T Electrocardiogram, 64 leads or greater, with graphic presentation and analysis; with

interpretation and report

01810 Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of

forearm, wrist, and hand

01840 Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise

specified

0184T Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, TEMS),

including muscularis propria (ie, full thickness)

01860 Anesthesia for forearm, wrist, or hand cast application, removal, or repair

0190T Placement of intraocular radiation source applicator (List separately in addition to

primary procedure)

01922 Anesthesia for non-invasive imaging or radiation therapy

01926 Anesthesia for therapeutic interventional radiological procedures involving the arterial

system; intracranial, intracardiac, or aortic

01932 Anesthesia for therapeutic interventional radiological procedures involving the

venous/lymphatic system (not to include access to the central circulation); intrathoracic

or jugular

01936 Anesthesia for percutaneous image guided procedures on the spine and spinal cord;

therapeutic

01961 Anesthesia for cesarean delivery only

01965 Anesthesia for incomplete or missed abortion procedures

01968 Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (List

separately in addition to code for primary procedure performed)

0197T Intra-fraction localization and tracking of target or patient motion during delivery of

radiation therapy (eg, 3D positional tracking, gating, 3D surface tracking), each fraction

of treatment

0199T Physiologic recording of tremor using accelerometer(s) and/or gyroscope(s) (including

frequency and amplitude), including interpretation and report

0202T Posterior vertebral joint(s) arthroplasty (eg, facet joint[s] replacement), including

facetectomy, laminectomy, foraminotomy, and vertebral column fixation, injection of

bone cement, when performed, including fluoroscopy, single level, lumbar spine

0207T Evacuation of meibomian glands, automated, using heat and intermittent pressure,

unilateral

0210T Speech audiometry threshold, automated;

0217T Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint

(or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; second

level (List separately in addition to code for primary procedure)

0220T Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging

and placement of bone graft(s) or synthetic device(s), single level; thoracic

0223T Acoustic cardiography, including automated analysis of combined acoustic and

electrical intervals; single, with interpretation and report

0001U Red blood cell antigen typing, DNA, human erythrocyte antigen gene analysis of 35

antigens from 11 blood groups, utilizing whole blood, common RBC alleles reported

0003M Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total

bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol and triglycerides) utilizing

serum, prognostic algorithm reported as quantitative scores for fibrosis, ste

0004U Infectious disease (bacterial), DNA, 27 resistance genes, PCR amplification and probe

hybridization in microarray format (molecular detection and identification of AmpC,

carbapenemase and ESBL coding genes), bacterial culture colonies, report of genes det

0008M Oncology (breast), mRNA analysis of 58 genes using hybrid capture, on formalin-fixed

paraffin-embedded (FFPE) tissue, prognostic algorithm reported as a risk score

0009U Oncology (breast cancer), ERBB2 (HER2) copy number by FISH, tumor cells from

formalin-fixed paraffin-embedded tissue isolated using image-based dielectrophoresis

(DEP) sorting, reported as ERBB2 gene amplified or non-amplified

00103 Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)

0011U Prescription drug monitoring, evaluation of drugs present by LC-MS/MS, using oral

fluid, reported as a comparison to an estimated steady-state range, per date of service

including all drug compounds and metabolites

00140 Anesthesia for procedures on eye; not otherwise specified

00145 Anesthesia for procedures on eye; vitreoretinal surgery

0014F Comprehensive preoperative assessment performed for cataract surgery with

intraocular lens (IOL) placement (includes assessment of all of the following

components) (EC): Dilated fundus evaluation performed within 12 months prior to

cataract surgery (2020F

0015U Drug metabolism (adverse drug reactions), DNA, 22 drug metabolism and transporter

genes, real-time PCR, blood or buccal swab, genotype and metabolizer status for

therapeutic decision support

00174 Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal

tumor

0018U Oncology (thyroid), microRNA profiling by RT-PCR of 10 microRNA sequences, utilizing

fine needle aspirate, algorithm reported as a positive or negative result for moderate to

high risk of malignancy

0019T Extracorporeal shock wave involving musculoskeletal system, not otherwise specified,

low energy

00215 Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull

fracture, extradural (simple or compound)

0021U Oncology (prostate), detection of 8 autoantibodies (ARF 6, NKX3-1, 5'-UTR-BMI1, CEP

164, 3'-UTR-Ropporin, Desmocollin, AURKAIP-1, CSNK2A2), multiplexed immunoassay

and flow cytometry serum, algorithm reported as risk score

0022U Targeted genomic sequence analysis panel, non-small cell lung neoplasia, DNA and RNA

analysis, 23 genes, interrogation for sequence variants and rearrangements, reported

as presence/absence of variants and associated therapy(ies) to consider

00320 Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic

system of neck; not otherwise specified, age 1 year or older


trunk and perineum; radical or modified radical procedures on breast

0042T Cerebral perfusion analysis using computed tomography with contrast administration,

including post-processing of parametric maps with determination of cerebral blood

flow, cerebral blood volume, and mean transit time

00454 Anesthesia for procedures on clavicle and scapula; biopsy of clavicle

00474 Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)

00529 Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy

utilizing 1 lung ventilation

00532 Anesthesia for access to central venous circulation

00539 Anesthesia for tracheobronchial reconstruction

0054T Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with

image-guidance based on fluoroscopic images (List separately in addition to code for

primary procedure)

00560 Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without

pump oxygenator

00563 Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with

pump oxygenator with hypothermic circulatory arrest

00580 Anesthesia for heart transplant or heart/lung transplant

00625 Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic

approach; not utilizing 1 lung ventilation

00632 Anesthesia for procedures in lumbar region; lumbar sympathectomy

00640 Anesthesia for manipulation of the spine or for closed procedures on the cervical,

thoracic or lumbar spine

00702 Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy

00740 Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced

proximal to duodenum

00754 Anesthesia for hernia repairs in upper abdomen; omphalocele

0076T Transcatheter placement of extracranial vertebral artery stent(s), including radiologic

supervision and interpretation, open or percutaneous; each additional vessel (List

separately in addition to code for primary procedure)

00800 Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified

00811 Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to

duodenum; not otherwise specified

00820 Anesthesia for procedures on lower posterior abdominal wall

00834 Anesthesia for hernia repairs in the lower abdomen not otherwise specified, younger

than 1 year of age


tubal ligation/transection


renal procedures, including upper one-third of ureter, or donor nephrectomy


adrenalectomy

00872 Anesthesia for lithotripsy, extracorporeal shock wave; with water bath

00908 Anesthesia for; perineal prostatectomy

00914 Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral

resection of prostate

00920 Anesthesia for procedures on male genitalia (including open urethral procedures); not

otherwise specified


orchiopexy, unilateral or bilateral


radical amputation of penis with bilateral inguinal and iliac lymphadenectomy


endometrium); colpotomy, vaginectomy, colporrhaphy, and open urethral procedures


endometrium); culdoscopy

0102T Extracorporeal shock wave, high energy, performed by a physician, requiring anesthesia

other than local, involving lateral humeral epicondyle

0107T Quantitative sensory testing (QST), testing and interpretation per extremity; using

vibration stimuli to assess large diameter fiber sensation

0110T Quantitative sensory testing (QST), testing and interpretation per extremity; using other

stimuli to assess sensation

01120 Anesthesia for procedures on bony pelvis

01180 Anesthesia for obturator neurectomy; extrapelvic

01202 Anesthesia for arthroscopic procedures of hip joint

01214 Anesthesia for open procedures involving hip joint; total hip arthroplasty

01230 Anesthesia for open procedures involving upper two-thirds of femur; not otherwise

specified

01250 Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper

leg

01270 Anesthesia for procedures involving arteries of upper leg, including bypass graft; not

otherwise specified

01320 Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee

and/or popliteal area

01380 Anesthesia for all closed procedures on knee joint

01420 Anesthesia for all cast applications, removal, or repair involving knee joint

01440 Anesthesia for procedures on arteries of knee and popliteal area; not otherwise

specified

01462 Anesthesia for all closed procedures on lower leg, ankle, and foot

01472 Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle,

and foot; repair of ruptured Achilles tendon, with or without graft

01500 Anesthesia for procedures on arteries of lower leg, including bypass graft; not

otherwise specified

01522 Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or with

catheter

01620 Anesthesia for all closed procedures on humeral head and neck, sternoclavicular joint,

acromioclavicular joint, and shoulder joint


sternoclavicular joint, acromioclavicular joint, and shoulder joint; shoulder

disarticulation

01654 Anesthesia for procedures on arteries of shoulder and axilla; bypass graft

0230T Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with ultrasound

guidance, lumbar or sacral; single level

0233T Skin advanced glycation endproducts (AGE) measurement by multi-wavelength

fluorescent spectroscopy

0236T Transluminal peripheral atherectomy, open or percutaneous, including radiological

supervision and interpretation; abdominal aorta

0239T Bioimpedance spectroscopy (BIS), measuring 100 frequencies or greater, direct

measurement of extracellular fluid differences between the limbs

0247T Open treatment of rib fracture requiring internal fixation, unilateral; 5-6 ribs

0253T Insertion of anterior segment aqueous drainage device, without extraocular reservoir,

internal approach, into the suprachoroidal space

0262T Implantation of catheter-delivered prosthetic pulmonary valve, endovascular approach

0265T Intramuscular autologous bone marrow cell therapy, with preparation of harvested

cells, multiple injections, one leg, including ultrasound guidance, if performed;

unilateral or bilateral bone marrow harvest only for intramuscular autologous bone

marrow ce

0272T Interrogation device evaluation (in person), carotid sinus baroreflex activation system,

including telemetric iterative communication with the implantable device to monitor

device diagnostics and programmed therapy values, with interpretation and report (

0275T Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of

neural elements, (with or without ligamentous resection, discectomy, facetectomy

and/or foraminotomy), any method, under indirect image guidance (eg, fluoroscopic,

CT), singl

0282T Percutaneous or open implantation of neurostimulator electrode array(s),

subcutaneous (peripheral subcutaneous field stimulation), including imaging guidance,

when performed, cervical, thoracic or lumbar; for trial, including removal at the

conclusion of

0289T Corneal incisions in the donor cornea created using a laser, in preparation for

penetrating or lamellar keratoplasty (List separately in addition to code for primary

procedure)

0292T Intravascular optical coherence tomography (coronary native vessel or graft) during

diagnostic evaluation and/or therapeutic intervention, including imaging supervision,

interpretation, and report; each additional vessel (List separately in addition to pr

0295T External electrocardiographic recording for more than 48 hours up to 21 days by

continuous rhythm recording and storage; includes recording, scanning analysis with

report, review and interpretation


continuous rhythm recording and storage; review and interpretation

0305T Programming device evaluation (in person) of intracardiac ischemia monitoring system

with iterative adjustment of programmed values, with analysis, review, and report

0308T Insertion of ocular telescope prosthesis including removal of crystalline lens or

intraocular lens prosthesis

0311T Non-invasive calculation and analysis of central arterial pressure waveforms with


0314T Vagus nerve blocking therapy (morbid obesity); laparoscopic removal of vagal trunk

neurostimulator electrode array and pulse generator

0322T Removal of subcutaneous implantable defibrillator pulse generator only

0325T Repositioning of subcutaneous implantable defibrillator electrode and/or pulse

generator

0328T Programming device evaluation (in person) with iterative adjustment of the implantable

device to test the function of the device and select optimal permanent programmed

values with analysis, implantable subcutaneous lead defibrillator system

0335T Extra-osseous subtalar joint implant for talotarsal stabilization

0338T Transcatheter renal sympathetic denervation, percutaneous approach including arterial

puncture, selective catheter placement(s) renal artery(ies), fluoroscopy, contrast

injection(s), intraprocedural roadmapping and radiological supervision and interpretat

0341T Quantitative pupillometry with interpretation and report, unilateral or bilateral

0344T Transcatheter mitral valve repair percutaneous approach including transseptal puncture

when performed; additional prosthesis (es) during same session (List separately in

addition to code for primary procedure)

0351T Optical coherence tomography of breast or axillary lymph node, excised tissue, each

specimen; real-time intraoperative

0354T Optical coherence tomography of breast, surgical cavity; interpretation and report, real-

time or referred

0357T Cryopreservation; immature oocyte(s)

0360T Observational behavioral follow-up assessment, includes physician or other qualified

health care professional direction with interpretation and report, administered by one

technician; first 30 minutes of technician time, face-to-face with the patient

0367T Group adaptive behavior treatment by protocol, administered by technician, face-to-

face with two or more patients; each additional 30 minutes of technician time (List


0370T Family adaptive behavior treatment guidance, administered by physician or other

qualified health care professional (without the patient present)

0373T Exposure adaptive behavior treatment with protocol modification requiring two or

more technicians for severe maladaptive behavior(s); first 60 minutes of technicians'

time, face-to-face with patient


internal approach, into the trabecular meshwork; each additional device insertion (List


0380T Computer-aided animation and analysis of time series retinal images for the monitoring

of disease progression, unilateral or bilateral, with interpretation and report

0383T External heart rate and 3-axis accelerometer data recording from 15 to 30 days to

assess changes in heart rate and to monitor motion analysis for the purposes of

diagnosing nocturnal epilepsy seizure events; includes report, scanning analysis with

report,

0386T External heart rate and 3-axis accelerometer data recording more than 30 days to

assess changes in heart rate and to monitor motion analysis for the purposes of

diagnosing nocturnal epilepsy seizure events; review and interpretation only



values with analysis, review and report, leadless pacemaker system

0398T Magnetic resonance image guided high intensity focused ultrasound (MRgFUS),

stereotactic ablation lesion, intracranial for movement disorder including stereotactic

navigation and frame placement when performed

0401T Multi-spectral digital skin lesion analysis of clinically atypical cutaneous pigmented

lesions for detection of melanomas and high risk melanocytic atypia; six or more lesions

0404T Transcervical uterine fibroid(s) ablation with ultrasound guidance, radiofrequency

0407T Nasal endoscopy, surgical, ethmoid sinus, placement of drug eluting implant; with

biopsy, polypectomy or debridement

0414T Removal and replacement of permanent cardiac contractility modulation system pulse

generator only



values with analysis, including review and report, implantable cardiac contractility m

0420T Destruction of neurofibroma, extensive (cutaneous, dermal extending into

subcutaneous); trunk and extremities, extensive, greater than 100 neurofibromas

0423T Secretory type II phospholipase A2 (sPLA2-IIA)

0430T Removal of neurostimulator system for treatment of central sleep apnea; stimulation

lead only

0433T Repositioning of neurostimulator system for treatment of central sleep apnea; sensing

lead only

0436T Programming device evaluation of implanted neurostimulator pulse generator system

for central sleep apnea; during sleep study

0444T Initial placement of a drug-eluting ocular insert under one or more eyelids, including

fitting, training, and insertion, unilateral or bilateral

0447T Removal of implantable interstitial glucose sensor from subcutaneous pocket via

incision

0450T Insertion of aqueous drainage device, without extraocular reservoir, internal approach,

into the subconjunctival space; each additional device (List separately in addition to

code for primary procedure)

0453T Insertion or replacement of a permanently implantable aortic counterpulsation

ventricular assist system, endovascular approach, and programming of sensing and

therapeutic parameters; mechano-electrical skin interface

0460T Repositioning of previously implanted aortic counterpulsation ventricular assist device;

subcutaneous electrode

0463T Interrogation device evaluation (in person) with analysis, review and report, includes

connection, recording and disconnection per patient encounter, implantable aortic

counterpulsation ventricular assist system, per day

0466T Insertion of chest wall respiratory sensor electrode or electrode array, including

connection to pulse generator (List separately in addition to code for primary

procedure)

0469T Retinal polarization scan, ocular screening with on-site automated results, bilateral

0476T Recording of fetal magnetic cardiac signal using at least 3 channels; patient recording,

data scanning, with raw electronic signal transfer of data and storage

0479T Fractional ablative laser fenestration of burn and traumatic scars for functional

improvement; first 100 cm2 or part thereof, or 1% of body surface area of infants and

children

0482T Absolute quantitation of myocardial blood flow, positron emission tomography (PET),

rest and stress (List separately in addition to code for primary procedure)

0489T Autologous adipose-derived regenerative cell therapy for scleroderma in the hands;

adipose tissue harvesting, isolation and preparation of harvested cells including

incubation with cell dissociation enzymes, removal of non-viable cells and debris,

determi

0492T Ablative laser treatment, non-contact, full field and fractional ablation, open wound,

per day, total treatment surface area; each additional 20 sq cm, or part thereof (List


0495T Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion

system by physician or qualified health care professional, including physiological and

laboratory assessment (eg, pulmonary artery flow, pulmonary artery pressure, left at

0498T External patient-activated, physician- or other qualified health care professional-

prescribed, electrocardiographic rhythm derived event recorder without 24 hour

attended monitoring; review and interpretation by a physician or other qualified health

care

0502T Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary

computed tomography angiography data using computation fluid dynamics physiologic

simulation software analysis of functional data to assess the severity of coronary artery




0509F Urinary incontinence plan of care documented (GER)

0516F Anemia plan of care documented (ESRD)

0526F Subsequent visit for episode (BkP)

0535F Dyspnea management plan of care, documented (Pall Cr)

0550F Cytopathology report on routine nongynecologic specimen finalized within two working

days of accession date (PATH)

0581F Patient transferred directly from anesthetizing location to critical care unit (Peri2)

0584F Transfer of care checklist not used (Peri2)

10022 Fine needle aspiration; with imaging guidance

10035 Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle,

radioactive seeds), percutaneous, including imaging guidance; first lesion

10061 Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or

subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple

$1,864.80

10080 Incision and drainage of pilonidal cyst; simple $3,437.10

1010F Severity of angina assessed by level of activity (CAD)

10121 Incision and removal of foreign body, subcutaneous tissues; complicated $8,088.18

1019F Dyspnea assessed, present (COPD)

1030F Influenza immunization status assessed (CAP)

1033F Current tobacco non-smoker and not currently exposed to secondhand smoke (Asthma)

1036F Current tobacco non-user (CAD, CAP, COPD, PV) (DM) (IBD)

1050F History obtained regarding new or changing moles (ML)

1060F Documentation of permanent or persistent or paroxysmal atrial fibrillation (STR)

1066F Ischemic stroke symptom onset greater than or equal to 3 hours prior to arrival (STR)

1090F Presence or absence of urinary incontinence assessed (GER)

11008 Removal of prosthetic material or mesh, abdominal wall for infection (eg, for chronic or

recurrent mesh infection or necrotizing soft tissue infection) (List separately in addition

to code for primary procedure)

11011 Debridement including removal of foreign material at the site of an open fracture

and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue,

muscle fascia, and muscle

$3,437.10

11042 Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first

20 sq cm or less

$1,864.80

11045 Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each

additional 20 sq cm, or part thereof (List separately in addition to code for primary

procedure)

11101 Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple

closure), unless otherwise listed; each separate/additional lesion (List separately in


1116F Auricular or periauricular pain assessed (AOE)

11200 Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15

lesions

$517.74

1123F Advance Care Planning discussed and documented advance care plan or surrogate

decision maker documented in the medical record (DEM) (GER, Pall Cr)

1127F New episode for condition (NMA-No Measure Associated)

11301 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter

0.6 to 1.0 cm

11305 Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia;

lesion diameter 0.5 cm or less

11308 Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia;

lesion diameter over 2.0 cm

1135F Episode of back pain lasting longer than 6 weeks (BkP)

11400 Excision, benign lesion including margins, except skin tag (unless listed elsewhere),

trunk, arms or legs; excised diameter 0.5 cm or less

$723.96


trunk, arms or legs; excised diameter 2.1 to 3.0 cm


scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less

11441 Excision, other benign lesion including margins, except skin tag (unless listed

elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to

1.0 cm

11444 Excision, other benign lesion including margins, except skin tag (unless listed

elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to

4.0 cm

11451 Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair

11470 Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or

umbilical; with simple or intermediate repair

1158F Advance care planning discussion documented in the medical record (COA)

11601 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6

to 1.0 cm

11604 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1

to 4.0 cm

11624 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised

diameter 3.1 to 4.0 cm

11641 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised


11644 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised


11719 Trimming of nondystrophic nails, any number

11752 Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for

permanent removal; with amputation of tuft of distal phalanx

11760 Repair of nail bed $2,929.20

11770 Excision of pilonidal cyst or sinus; simple

1180F All specified thromboembolic risk factors assessed (AFIB)

0009M Fetal aneuploidy (trisomy 21, and 18) DNA sequence analysis of selected regions using

maternal plasma, algorithm reported as a risk score for each trisomy

00102 Anesthesia for procedures involving plastic repair of cleft lip

00126 Anesthesia for procedures on external, middle, and inner ear including biopsy;

tympanotomy

0013U Oncology (solid organ neoplasia), gene rearrangement detection by whole genome next-

generation sequencing, DNA, fresh or frozen tissue or cells, report of specific gene

rearrangement(s)

00144 Anesthesia for procedures on eye; corneal transplant

00148 Anesthesia for procedures on eye; ophthalmoscopy

00164 Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue

00172 Anesthesia for intraoral procedures, including biopsy; repair of cleft palate

0017U Oncology (hematolymphoid neoplasia), JAK2 mutation, DNA, PCR amplification of exons

12-14 and sequence analysis, blood or bone marrow, report of JAK2 mutation not

detected or detected

00210 Anesthesia for intracranial procedures; not otherwise specified

00214 Anesthesia for intracranial procedures; burr holes, including ventriculography

00218 Anesthesia for intracranial procedures; procedures in sitting position

00222 Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve

00350 Anesthesia for procedures on major vessels of neck; not otherwise specified


trunk and perineum; reconstructive procedures on breast (eg, reduction or

augmentation mammoplasty, muscle flaps)


trunk and perineum; electrical conversion of arrhythmias

00452 Anesthesia for procedures on clavicle and scapula; radical surgery

00520 Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise

specified

00528 Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy

not utilizing 1 lung ventilation

00530 Anesthesia for permanent transvenous pacemaker insertion


mediastinum (including surgical thoracoscopy); utilizing 1 lung ventilation


mediastinum (including surgical thoracoscopy); intrathoracic procedures on the trachea

and bronchi

0055T Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with

image-guidance based on CT/MRI images (List separately in addition to code for

primary procedure)

00562 Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with

pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve

procedures) or for re-operation for coronary bypass more than 1 month after origin

00600 Anesthesia for procedures on cervical spine and cord; not otherwise specified

00622 Anesthesia for procedures on thoracic spine and cord; thoracolumbar sympathectomy

00630 Anesthesia for procedures in lumbar region; not otherwise specified

00635 Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture

00730 Anesthesia for procedures on upper posterior abdominal wall

0073T Compensator-based beam modulation treatment delivery of inverse planned treatment

using 3 or more high resolution (milled or cast) compensator convergent beam

modulated fields, per treatment session

00752 Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias

and/or wound dehiscence


partial hepatectomy or management of liver hemorrhage (excluding liver biopsy)


gastric restrictive procedure for morbid obesity

00810 Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to

duodenum

00813 Anesthesia for combined upper and lower gastrointestinal endoscopic procedures,

endoscope introduced both proximal to and distal to the duodenum


amniocentesis


pelvic exenteration


not otherwise specified


radical prostatectomy (suprapubic, retropubic)

00882 Anesthesia for procedures on major lower abdominal vessels; inferior vena cava ligation

00906 Anesthesia for; vulvectomy

00912 Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral

resection of bladder tumor(s)

00918 Anesthesia for transurethral procedures (including urethrocystoscopy); with

fragmentation, manipulation and/or removal of ureteral calculus


undescended testis, unilateral or bilateral

01670 Anesthesia for all procedures on veins of shoulder and axilla

0169T Stereotactic placement of infusion catheter(s) in the brain for delivery of therapeutic

agent(s), including computerized stereotactic planning and burr hole(s)

01730 Anesthesia for all closed procedures on humerus and elbow

01742 Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of

humerus

01756 Anesthesia for open or surgical arthroscopic procedures of the elbow; radical

procedures

01760 Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow

replacement

0180T Electrocardiogram, 64 leads or greater, with graphic presentation and analysis;

interpretation and report only

01820 Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones

01830 Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius,

distal ulna, wrist, or hand joints; not otherwise specified

01842 Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy

0189T Remote real-time interactive video-conferenced critical care, evaluation and

management of the critically ill or critically injured patient; each additional 30 minutes

(List separately in addition to code for primary service)


internal approach, into the trabecular meshwork; initial insertion

01924 Anesthesia for therapeutic interventional radiological procedures involving the arterial

system; not otherwise specified

01935 Anesthesia for percutaneous image guided procedures on the spine and spinal cord;

diagnostic

01952 Anesthesia for second- and third-degree burn excision or debridement with or without

skin grafting, any site, for total body surface area (TBSA) treated during anesthesia and

surgery; between 4% and 9% of total body surface area

0195T Arthrodesis, pre-sacral interbody technique, disc space preparation, discectomy,

without instrumentation, with image guidance, includes bone graft when performed; L5-

S1 interspace

01962 Anesthesia for urgent hysterectomy following delivery

0196T Arthrodesis, pre-sacral interbody technique, disc space preparation, discectomy,

without instrumentation, with image guidance, includes bone graft when performed; L4-

L5 interspace (List separately in addition to code for primary procedure)

01990 Physiological support for harvesting of organ(s) from brain-dead patient

01996 Daily hospital management of epidural or subarachnoid continuous drug administration

0200T Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the

use of a balloon or mechanical device, when used, 1 or more needles, includes imaging

guidance and bone biopsy, when performed

0209T Pure tone audiometry (threshold), automated; air and bone

0212T Comprehensive audiometry threshold evaluation and speech recognition (0209T, 0211T

combined), automated


(or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; third

and any additional level(s) (List separately in addition to code for primary


and placement of bone graft(s) or synthetic device(s), single level; each additional

vertebral segment (List separately in addition to code for primary procedure)


electrical intervals; multiple, including serial trended analysis and limited

reprogramming of device parameter, AV and VV delays, with interpretation and report


guidance, cervical or thoracic; single level


guidance, lumbar or sacral; each additional level (List separately in addition to code for

primary procedure)


supervision and interpretation; iliac artery, each vessel

0241T Esophageal motility (manometric study of the esophagus and/or gastroesophageal

junction) study with interpretation and report; with stimulation or perfusion during high

resolution esophageal pressure topography study (eg, stimulant, acid or alkali perfusi

0245T Open treatment of rib fracture requiring internal fixation, unilateral; 1-2 ribs

0248T Open treatment of rib fracture requiring internal fixation, unilateral; 7 or more ribs



complete procedure excluding bone marrow harvest

0267T Implantation or replacement of carotid sinus baroreflex activation device; lead only,

unilateral (includes intra-operative interrogation, programming, and repositioning,

when performed)

0270T Revision or removal of carotid sinus baroreflex activation device; lead only, unilateral

(includes intra-operative interrogation, programming, and repositioning, when

performed)

0273T Interrogation device evaluation (in person), carotid sinus baroreflex activation system,

including telemetric iterative communication with the implantable device to monitor

device diagnostics and programmed therapy values, with interpretation and report (

0281T Percutaneous transcatheter closure of the left atrial appendage with implant, including

fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left

atrial appendage angiography, radiological supervision and interpretation

0284T Revision or removal of pulse generator or electrodes, including imaging guidance, when

performed, including addition of new electrodes, when performed

0287T Near-infrared guidance for vascular access requiring real-time digital visualization of

subcutaneous vasculature for evaluation of potential access sites and vessel patency

0290T Corneal incisions in the recipient cornea created using a laser, in preparation for

penetrating or lamellar keratoplasty (List separately in addition to code for primary

procedure)


continuous rhythm recording and storage; scanning analysis with report

0300T Extracorporeal shock wave for integumentary wound healing, high energy, including

topical application and dressing care; each additional wound (List separately in addition


0303T Insertion or removal and replacement of intracardiac ischemia monitoring system

including imaging supervision and interpretation when performed and intra-operative

interrogation and programming when performed; electrode only

0306T Interrogation device evaluation (in person) of intracardiac ischemia monitoring system

with analysis, review, and report

0313T Vagus nerve blocking therapy (morbid obesity); laparoscopic revision or replacement of

vagal trunk neurostimulator electrode array, including connection to existing pulse

generator

0316T Vagus nerve blocking therapy (morbid obesity); replacement of pulse generator

0320T Insertion of subcutaneous defibrillator electrode

0323T Removal of subcutaneous implantable defibrillator pulse generator with replacement of

subcutaneous implantable defibrillator pulse generator only

0330T Tear film imaging, unilateral or bilateral, with interpretation and report

0333T Visual evoked potential, screening of visual acuity, automated, with report

0336T Laparoscopy, surgical, ablation of uterine fibroid(s), including intraoperative ultrasound

guidance and monitoring, radiofrequency

0343T Transcatheter mitral valve repair percutaneous approach including transseptal puncture

when performed; initial prosthesis

0346T Ultrasound, elastography (List separately in addition to code for primary procedure)

0349T Radiologic examination, radiostereometric analysis (RSA); upper extremity(ies),

(includes shoulder, elbow, and wrist, when performed)

0352T Optical coherence tomography of breast or axillary lymph node, excised tissue, each

specimen; interpretation and report, real-time or referred

0359T Behavior identification assessment, by the physician or other qualified health care

professional, face-to-face with patient and caregiver(s), includes administration of

standardized and non-standardized tests, detailed behavioral history, patient observat

0362T Exposure behavioral follow-up assessment, includes physician or other qualified health

care professional direction with interpretation and report, administered by physician or

other qualified health care professional with the assistance of one or more tec

0365T Adaptive behavior treatment by protocol, administered by technician, face-to-face with

one patient; each additional 30 minutes of technician time (List separately in addition


0368T Adaptive behavior treatment with protocol modification administered by physician or

other qualified health care professional with one patient; first 30 minutes of patient

face-to-face time

0375T Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end

plate preparation (includes osteophytectomy for nerve root or spinal cord

decompression and microdissection), cervical, three or more levels

0378T Visual field assessment, with concurrent real time data analysis and accessible data

storage with patient initiated data transmitted to a remote surveillance center for up to

30 days; review and interpretation with report by a physician or other qualified

0381T External heart rate and 3-axis accelerometer data recording up to 14 days to assess

changes in heart rate and to monitor motion analysis for the purposes of diagnosing

nocturnal epilepsy seizure events; includes report, scanning analysis with report, revi

0388T Transcatheter removal of permanent leadless pacemaker, ventricular

0391T Interrogation device evaluation (in person) with analysis, review and report, includes

connection, recording and disconnection per patient encounter, leadless pacemaker

system

0396T Intra-operative use of kinetic balance sensor for implant stability during knee

replacement arthroplasty (List separately in addition to code for primary procedure)

0399T Myocardial strain imaging (quantitative assessment of myocardial mechanics using

image-based analysis of local myocardial dynamics) (List separately in addition to code

for primary procedure)

0406T Nasal endoscopy, surgical, ethmoid sinus, placement of drug eluting implant;

0409T Insertion or replacement of permanent cardiac contractility modulation system,

including contractility evaluation when performed, and programming of sensing and

therapeutic parameters; pulse generator only

0412T Removal of permanent cardiac contractility modulation system; pulse generator only

0415T Repositioning of previously implanted cardiac contractility modulation transvenous

electrode (atrial or ventricular lead)

0422T Tactile breast imaging by computer-aided tactile sensors, unilateral or bilateral

0425T Insertion or replacement of neurostimulator system for treatment of central sleep

apnea; sensing lead only

0428T Removal of neurostimulator system for treatment of central sleep apnea; pulse

generator only

0435T Programming device evaluation of implanted neurostimulator pulse generator system

for central sleep apnea; single session

0439T Myocardial contrast perfusion echocardiography, at rest or with stress, for assessment

of myocardial ischemia or viability (List separately in addition to code for primary

procedure)

0442T Ablation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other

truncal nerve (eg, brachial plexus, pudendal nerve)

0445T Subsequent placement of a drug-eluting ocular insert under one or more eyelids,

including re-training, and removal of existing insert, unilateral or bilateral

0452T Insertion or replacement of a permanently implantable aortic counterpulsation

ventricular assist system, endovascular approach, and programming of sensing and

therapeutic parameters; aortic counterpulsation device and vascular hemostatic seal

0455T Removal of permanently implantable aortic counterpulsation ventricular assist system;

complete system (aortic counterpulsation device, vascular hemostatic seal, mechano-

electrical skin interface and electrodes)

0458T Removal of permanently implantable aortic counterpulsation ventricular assist system;


0461T Repositioning of previously implanted aortic counterpulsation ventricular assist device;

aortic counterpulsation device

0468T Removal of chest wall respiratory sensor electrode or electrode array

0471T Optical coherence tomography (OCT) for microstructural and morphological imaging of

skin, image acquisition, interpretation, and report; each additional lesion (List


0474T Insertion of anterior segment aqueous drainage device, with creation of intraocular

reservoir, internal approach, into the supraciliary space

0477T Recording of fetal magnetic cardiac signal using at least 3 channels; signal extraction,

technical analysis, and result

0481T Injection(s), autologous white blood cell concentrate (autologous protein solution), any

site, including image guidance, harvesting and preparation, when performed

0484T Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve;

transthoracic exposure (eg, thoracotomy, transapical)

0487T Biomechanical mapping, transvaginal, with report

0490T Autologous adipose-derived regenerative cell therapy for scleroderma in the hands;

multiple injections in one or both hands

0497T External patient-activated, physician- or other qualified health care professional-

prescribed, electrocardiographic rhythm derived event recorder without 24 hour

attended monitoring; in-office connection

0500F Initial prenatal care visit (report at first prenatal encounter with health care

professional providing obstetrical care. Report also date of visit and, in a separate field,

the date of the last menstrual period [LMP]) (Prenatal)




0503F Postpartum care visit (Prenatal)

0514F Plan of care for elevated hemoglobin level documented for patient receiving

Erythropoiesis-Stimulating Agent therapy (ESA) (CKD)

0518F Falls plan of care documented (GER)

0521F Plan of care to address pain documented (COA) (ONC)

0528F Recommended follow-up interval for repeat colonoscopy of at least 10 years

documented in colonoscopy report (End/Polyp)

0555F Symptom management plan of care documented (HF)

0575F HIV RNA control plan of care, documented (HIV)

0582F Patient not transferred directly from anesthetizing location to critical care unit (Peri2)

10030 Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma,

lymphocele, cyst), soft tissue (eg, extremity, abdominal wall, neck), percutaneous

1003F Level of activity assessed (NMA-No Measure Associated)

1005F Asthma symptoms evaluated (includes documentation of numeric frequency of

symptoms or patient completion of an asthma assessment tool/survey/questionnaire)

(NMA-No Measure Associated)

1006F Osteoarthritis symptoms and functional status assessed (may include the use of a

standardized scale or the completion of an assessment questionnaire, such as the SF-

36, AAOS Hip & Knee Questionnaire) (OA) [Instructions: Report when osteoarthritis is

addre

10120 Incision and removal of foreign body, subcutaneous tissues; simple $1,864.80

10140 Incision and drainage of hematoma, seroma or fluid collection $8,088.18

10180 Incision and drainage, complex, postoperative wound infection

1022F Pneumococcus immunization status assessed (CAP, COPD)

1035F Current smokeless tobacco user (eg, chew, snuff) (PV)

1039F Intermittent asthma (Asthma)

1052F Type, anatomic location, and activity all assessed (IBD)

0092T Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end

plate preparation (includes osteophytectomy for nerve root or spinal cord

decompression and microdissection), each additional interspace, cervical (List

separately


radical amputation of penis with bilateral inguinal lymphadenectomy


endometrium); not otherwise specified

0098T Revision including replacement of total disc arthroplasty (artificial disc), anterior

approach, each additional interspace, cervical (List separately in addition to code for

primary procedure)

0101T Extracorporeal shock wave involving musculoskeletal system, not otherwise specified,

high energy

0106T Quantitative sensory testing (QST), testing and interpretation per extremity; using

touch pressure stimuli to assess large diameter sensation

0109T Quantitative sensory testing (QST), testing and interpretation per extremity; using heat-

pain stimuli to assess small nerve fiber sensation and hyperalgesia

01150 Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation

01173 Anesthesia for open repair of fracture disruption of pelvis or column fracture involving

acetabulum

01200 Anesthesia for all closed procedures involving hip joint

01212 Anesthesia for open procedures involving hip joint; hip disarticulation

0123T Fistulization of sclera for glaucoma, through ciliary body

0126T Common carotid intima-media thickness (IMT) study for evaluation of atherosclerotic

burden or coronary heart disease risk factor assessment

01274 Anesthesia for procedures involving arteries of upper leg, including bypass graft;

femoral artery embolectomy

01392 Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella

01404 Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at

knee

01432 Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula

01444 Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and

graft or repair for occlusion or aneurysm

01482 Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical

resection (including below knee amputation)

01490 Anesthesia for lower leg cast application, removal, or repair

01520 Anesthesia for procedures on veins of lower leg; not otherwise specified

01610 Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of

shoulder and axilla

0163T Total disc arthroplasty (artificial disc), anterior approach, including discectomy to

prepare interspace (other than for decompression), each additional interspace, lumbar

(List separately in addition to code for primary procedure)

01652 Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm

0165T Revision including replacement of total disc arthroplasty (artificial disc), anterior

approach, each additional interspace, lumbar (List separately in addition to code for

primary procedure)

01714 Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm

and elbow; tenoplasty, elbow to shoulder

0172T Insertion of posterior spinous process distraction device (including necessary removal

of bone or ligament for insertion and imaging guidance), lumbar; each additional level


01740 Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise

specified

0174T Computer-aided detection (CAD) (computer algorithm analysis of digital image data for

lesion detection) with further physician review for interpretation and report, with or

without digitization of film radiographic images, chest radiograph(s), performed c

01780 Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified

0179T Electrocardiogram, 64 leads or greater, with graphic presentation and analysis; tracing

and graphics only, without interpretation and report

0181T Corneal hysteresis determination, by air impulse stimulation, bilateral, with


0182T High dose rate electronic brachytherapy, per fraction

01850 Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified

0188T Remote real-time interactive video-conferenced critical care, evaluation and

management of the critically ill or critically injured patient; first 30-74 minutes

01916 Anesthesia for diagnostic arteriography/venography


venous/lymphatic system (not to include access to the central circulation); not

otherwise specified


venous/lymphatic system (not to include access to the central circulation); intracranial

01951 Anesthesia for second- and third-degree burn excision or debridement with or without

skin grafting, any site, for total body surface area (TBSA) treated during anesthesia and

surgery; less than 4% total body surface area

01958 Anesthesia for external cephalic version procedure

01966 Anesthesia for induced abortion procedures

1071F Alarm symptoms (involuntary weight loss, dysphagia, or gastrointestinal bleeding)

assessed; 1 or more present (GERD)

11000 Debridement of extensive eczematous or infected skin; up to 10% of body surface $2,929.20

11005 Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue

infection; abdominal wall, with or without fascial closure

1100F Patient screened for future fall risk; documentation of 2 or more falls in the past year or

any fall with injury in the past year (GER)

11044 Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or

fascia, if performed); first 20 sq cm or less

11047 Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or

fascia, if performed); each additional 20 sq cm, or part thereof (List separately in


11057 Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); more than 4

lesions

1110F Patient discharged from an inpatient facility (eg, hospital, skilled nursing facility, or

rehabilitation facility) within the last 60 days (GER)

01969 Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia

(List separately in addition to code for primary procedure performed)

0198T Measurement of ocular blood flow by repetitive intraocular pressure sampling, with


01992 Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or

injection is performed by a different physician or other qualified health care

professional); prone position

0205T Intravascular catheter-based coronary vessel or graft spectroscopy (eg, infrared) during

diagnostic evaluation and/or therapeutic intervention including imaging supervision,

interpretation, and report, each vessel (List separately in addition to code for

0208T Pure tone audiometry (threshold), automated; air only

0211T Speech audiometry threshold, automated; with speech recognition


(or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; second

level (List separately in addition to code for primary procedure)


(or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; third and

any additional level(s) (List separately in addition to code for primary proc


and placement of bone graft(s) or synthetic device(s), single level; lumbar


electrical intervals; multiple, including serial trended analysis and limited

reprogramming of device parameter, AV or VV delays only, with interpretation and

report

0227T Anoscopy, high resolution (HRA) (with magnification and chemical agent enhancement);

with biopsy(ies)


supervision and interpretation; renal artery


supervision and interpretation; brachiocephalic trunk and branches, each vessel

0240T Esophageal motility (manometric study of the esophagus and/or gastroesophageal

junction) study with interpretation and report; with high resolution esophageal

pressure topography

0244T Continuous measurement of wheeze rate during treatment assessment or during sleep

for documentation of nocturnal wheeze and cough for diagnostic evaluation 3 to 24

hours, with interpretation and report

0254T Endovascular repair of iliac artery bifurcation (eg, aneurysm, pseudoaneurysm,

arteriovenous malformation, trauma, dissection) using bifurcated endograft from the

common iliac artery into both the external and internal iliac artery, including all selectiv



complete procedure including unilateral or bilateral bone marrow harvest

0266T Implantation or replacement of carotid sinus baroreflex activation device; total system

(includes generator placement, unilateral or bilateral lead placement, intra-operative

interrogation, programming, and repositioning, when performed)

0269T Revision or removal of carotid sinus baroreflex activation device; total system (includes

generator placement, unilateral or bilateral lead placement, intra-operative

interrogation, programming, and repositioning, when performed)

0278T Transcutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each

treatment session (includes placement of electrodes)

0283T Percutaneous or open implantation of neurostimulator electrode array(s),

subcutaneous (peripheral subcutaneous field stimulation), including imaging guidance,

when performed, cervical, thoracic or lumbar; permanent, with implantation of a pulse

generator

0286T Near-infrared spectroscopy studies of lower extremity wounds (eg, for oxyhemoglobin

measurement)

0293T Insertion of left atrial hemodynamic monitor; complete system, includes implanted

communication module and pressure sensor lead in left atrium including transseptal

access, radiological supervision and interpretation, and associated injection procedures,


continuous rhythm recording and storage; recording (includes connection and initial

recording)

0299T Extracorporeal shock wave for integumentary wound healing, high energy, including

topical application and dressing care; initial wound

0302T Insertion or removal and replacement of intracardiac ischemia monitoring system

including imaging supervision and interpretation when performed and intra-operative

interrogation and programming when performed; complete system (includes device

and electrod

0309T Arthrodesis, pre-sacral interbody technique, including disc space preparation,

discectomy, with posterior instrumentation, with image guidance, includes bone graft,

when performed, lumbar, L4-L5 interspace (List separately in addition to code for

primary

0312T Vagus nerve blocking therapy (morbid obesity); laparoscopic implantation of

neurostimulator electrode array, anterior and posterior vagal trunks adjacent to

esophagogastric junction (EGJ), with implantation of pulse generator, includes

programming

0315T Vagus nerve blocking therapy (morbid obesity); removal of pulse generator

0319T Insertion or replacement of subcutaneous implantable defibrillator system with


0326T Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes

defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for

arrhythmia termination, and programming or reprogramming of sensing or therapeutic

pa

0329T Monitoring of intraocular pressure for 24 hours or longer, unilateral or bilateral, with


11921 Tattooing, intradermal introduction of insoluble opaque pigments to correct color

defects of skin, including micropigmentation; 6.1 to 20.0 sq cm

11951 Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc

11960 Insertion of tissue expander(s) for other than breast, including subsequent expansion

11983 Removal with reinsertion, non-biodegradable drug delivery implant

12004 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk

and/or extremities (including hands and feet); 7.6 cm to 12.5 cm

$1,013.70

12007 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk

and/or extremities (including hands and feet); over 30.0 cm

12013 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous

membranes; 2.6 cm to 5.0 cm

$1,013.70

12021 Treatment of superficial wound dehiscence; with packing

12034 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding

hands and feet); 7.6 cm to 12.5 cm

$1,864.80

12037 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding

hands and feet); over 30.0 cm

12044 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to

12.5 cm

$2,929.20

12054 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous

membranes; 7.6 cm to 12.5 cm

$2,086.26

12057 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous

membranes; over 30.0 cm

13100 Repair, complex, trunk; 1.1 cm to 2.5 cm $2,929.20

13132 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or

feet; 2.6 cm to 7.5 cm

$2,929.20

13152 Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm $2,929.20

14000 Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less

14020 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or

less

14302 Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part

thereof (List separately in addition to code for primary procedure)

1451F Symptoms demonstrated clinically important deterioration since last assessment (HF)

1490F Dementia severity classified, mild (DEM)

1494F Cognition assessed and reviewed (DEM)

1502F Patient queried about pain and pain interference with function using a valid and reliable

instrument (DSP)

1504F Patient has respiratory insufficiency (ALS)

15100 Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of

infants and children (except 15050)

15111 Epidermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1%

of body area of infants and children, or part thereof (List separately in addition to code

for primary procedure)

15121 Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands,

feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body

area of infants and children, or part thereof (List separately in addition

15135 Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet,

and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children

15151 Tissue cultured skin autograft, trunk, arms, legs; additional 1 sq cm to 75 sq cm (List


15156 Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia,

hands, feet, and/or multiple digits; additional 1 sq cm to 75 sq cm (List separately in


15241 Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin,

mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part

thereof (List separately in addition to code for primary procedure)

15271 Application of skin substitute graft to trunk, arms, legs, total wound surface area up to

100 sq cm; first 25 sq cm or less wound surface area

15274 Application of skin substitute graft to trunk, arms, legs, total wound surface area

greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or

part thereof, or each additional 1% of body area of infants and children, or part ther

15277 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits,

genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or

equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of

15610 Delay of flap or sectioning of flap (division and inset); at scalp, arms, or legs

15650 Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, Walking tube), any

location

15732 Muscle, myocutaneous, or fasciocutaneous flap; head and neck (eg, temporalis,

masseter muscle, sternocleidomastoid, levator scapulae)

15736 Muscle, myocutaneous, or fasciocutaneous flap; upper extremity

15760 Graft; composite (eg, full thickness of external ear or nasal ala), including primary

closure, donor area

15776 Punch graft for hair transplant; more than 15 punch grafts

15781 Dermabrasion; segmental, face

15792 Chemical peel, nonfacial; epidermal

15820 Blepharoplasty, lower eyelid;

15823 Blepharoplasty, upper eyelid; with excessive skin weighting down lid

15826 Rhytidectomy; glabellar frown lines

15835 Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock

15838 Excision, excessive skin and subcutaneous tissue (includes lipectomy); submental fat

pad

15841 Graft for facial nerve paralysis; free muscle graft (including obtaining graft)

15847 Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (eg,

abdominoplasty) (includes umbilical transposition and fascial plication) (List separately

in addition to code for primary procedure)

15878 Suction assisted lipectomy; upper extremity

15922 Excision, coccygeal pressure ulcer, with coccygectomy; with flap closure

15934 Excision, sacral pressure ulcer, with skin flap closure;

15945 Excision, ischial pressure ulcer, with skin flap closure; with ostectomy

15951 Excision, trochanteric pressure ulcer, with primary suture; with ostectomy

15956 Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or

skin graft closure;

16000 Initial treatment, first degree burn, when no more than local treatment is required $1,013.70

17003 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical

curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions,

each (List separately in addition to code for first lesion)

17107 Destruction of cutaneous vascular proliferative lesions (eg, laser technique); 10.0 to

50.0 sq cm

17111 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical

curettement), of benign lesions other than skin tags or cutaneous vascular proliferative

lesions; 15 or more lesions

17261 Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery,

chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.6 to 1.0 cm


chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter

1.1 to 2.0 cm


chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter

over 4.0 cm


chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane;

lesion diameter 1.1 to 2.0 cm

17314 Mohs micrographic technique, including removal of all gross tumor, surgical excision of

tissue specimens, mapping, color coding of specimens, microscopic examination of

specimens by the surgeon, and histopathologic preparation including routine stain(s) (

17360 Chemical exfoliation for acne (eg, acne paste, acid)

19000 Puncture aspiration of cyst of breast;

19030 Injection procedure only for mammary ductogram or galactogram

19100 Biopsy of breast; percutaneous, needle core, not using imaging guidance (separate

procedure)

19110 Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma

lactiferous duct

19125 Excision of breast lesion identified by preoperative placement of radiological marker,

open; single lesion

19271 Excision of chest wall tumor involving ribs, with plastic reconstruction; without

mediastinal lymphadenectomy

19286 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle,

radioactive seeds), percutaneous; each additional lesion, including ultrasound guidance


19294 Preparation of tumor cavity, with placement of a radiation therapy applicator for

intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List


19298 Placement of radiotherapy after loading brachytherapy catheters (multiple tube and

button type) into the breast for interstitial radioelement ap

code description fee - beaumont, texas€¦ · carcinoma tumor tissue, with alpha-fetoprotein...

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