outpatient code editor (oce) edit 28, line item rejection ... · s0119 ondansetron 4 mg s0122...

Confidential property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. “Cigna” and the “Tree of Life” logo are registered service marks, and “Together, all the way.” is a service mark, of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, Cigna Behavioral Health, Inc., and HMO or service company subsidiaries of Cigna Health Corporation and Cigna Dental Health, Inc. © 2015 Cigna. Some content provided under license.

This edit identifies codes that are not reportable to the Centers for Medicare & Medicaid Services (CMS) for outpatient claims because they require that an alternate code be used. We will apply this edit, but have removed multiple Current Procedural Terminology (CPT®) codes that will be covered and reimbursed at fee schedule and/or reduction from charge level of reimbursement as applicable. Code Description 22526 IDET, SINGLE LEVEL 22527 IDET, 1 OR MORE LEVELS 27216 TREAT PELVIC RING FRACTU 27217 TREAT PELVIC RING FRACTU 27218 TREAT PELVIC RING FRACTU 61640 DILATE IC VASOSPASM, INI 61641 DILATE IC VASOSPASM ADD- 61642 DILATE IC VASOSPASM ADD- 90281 HUMAN IG, IM 90283 HUMAN IG, IV 90287 BOTULINUM ANTITOXIN 90288 BOTULISM IG, IV 90291 CMV IG, IV 90384 RH IG, FULL-DOSE, IM 90386 RH IG, IV 90389 TETANUS IG, IM 90399 IMMUNE GLOBULIN 90658 FLU VACCINE AGE 3 & OVER 90664 FLU VAC PANDM LIVE NASAL 90666 FLU VAC PANDM NO PRSV IM 90667 FLU VACC PANDEMIC ADJ IM 90668 FLU VAC PANDM SPLT V IM

Outpatient Code Editor (OCE) Edit 28, line item rejection: Code not recognized, alternative may be available For Health Care Professionals November 2015


90687 FLU VAC 4 VAL 6-35 MO IM 90723 DTAP-HEP B-IPV VACCINE, 90748 HEP B/HIB VACCINE, IM H0001 ALCOHOL/DRUG ASSESSMNT H0002 ALCOH/DRUG SCREEN-ELIG H0003 ALCOH/DRUG SCREEN-LAB H0004 ALC/DRUG COUNSEL-INDIV H0005 ALC/DRUG COUNSEL-GROUP H0006 ALC/DRUG CASE MANAGEMENT H0007 ALC/DRUG CRISIS INTERVEN H0008 ALC/DRU SUBAC DET-HOS IP H0009 ALC/DRUG AC DETOX-HOS IP H0010 ALC/DRU SUBAC DET-RES IP H0011 ALC/DRUG AC DETOX-RES IP H0012 ALC/DRU SUBAC DET-RES OP H0013 ALC/DRUG AC DETOX-RES OP H0014 ALC/DRUG AMBUL DETOX H0015 ALC/DRUG INTENS OP SERV H0016 ALC/DRUG MED/SOMATIC H0017 ALC/DRUG HOSP RESIDENT H0018 ALC/DRUG SHORT RESIDENT H0019 ALC/DRUG LONG RESIDENT H0020 ALC/DRUG METHADONE SERV H0021 ALC/DRUG TRAINING SERV H0022 ALC/DRUG INTERVENTION H0023 ALCOHOL/DRUG OUTREACH H0024 ALC/DRUG PREV INFO DISS H0025 ALC/DRUG PREV EDUCATION H0026 ALC/DRUG COMM PREV PROC H0027 ALC/DRUG PREV ENVIRONMEN H0028 ALC/DRUG PREV PROB IDENT H0029 ALC/DRUG PREV ALT SERV H0030 ALC/DRUG HOTLINE SERVICE H0031 MH ASSESSMNT BY NON-PHYS H0032 MH SVC PLAN DEV-NON-PHYS H0033 ORAL MED ADM DIRECT OBSV H0034 MED TRAIN & SUPPRT /15 M


H0035 MH PARTL HOSP TX < 24 HR H0036 COM PSYCH FACE-FACE /15M H0037 COMM PSYCH TX PER DIEM H0038 SELF-HELP/PEER SVC / 15M H0039 ASSERTIVE COM TX / 15 M H0040 ASSERTIVE COM TX / DIEM H0041 FOSTER CARE CHILD / DIEM H0042 FOSTER CARE, CHILD, / MO H0043 SUPPORTED HOUSING / DIEM H0044 SUPPORTED HOUSING / MO H0045 RESPITE NOT HOME / DIEM H0046 MENTAL HEALTH SVC, NOS H0047 ALCOHL/DRUG ABUS SVC NOS H0048 SPEC COL NON-BLOOD, A/D H0049 ALCOHOL / DRUG SCREENING H0050 ALCOHOL/DRUG SERVICE 15 H1000 PRENATAL CARE ATRISK ASS H1001 ANTEPARTUM MANAGEMENT H1002 CARECOORDINATION PRENATA H1003 PRENATAL AT RISK EDUCATI H1004 FOLLOW UP HOME VISIT/PRE H1005 PRENATALCARE ENHANCED SR H1010 NONMED FAMILY PLAN EDUC H1011 FAMILY ASSESSMENT H2000 COMP MULTIDISPLINRY EVAL H2001 REHAB PROGRAM, PER 1/2 D H2010 COMP MEDICATION SRVC-15' H2011 CRISIS INTERVEN SVC-15' H2012 BEHAV HLTH DAY TREATMENT H2013 PSYCH HLTH FACILITY SRVC H2014 SKILLS TRAINING & DEVEL H2015 COMP COMMUNTY SUPPRT-15' H2016 COMP COMMUNTY SUPPOR-DIE H2017 PSYCHOSOCIAL REHAB-15' H2018 PSYCHOSOC REHAB-DIEM H2019 THERAPEUT BEHAV SVC-15' H2020 THERAPEUT BEHAV SVC-DIEM


H2021 COMMUNTY WRAP-AROUND-15' H2022 COMMUNTY WRAP-AROUN-DIEM H2023 SUPPORTED EMPLOYMNT-15' H2024 SUPPORTED EMPLOYMNT-DIEM H2025 MAINTAIN EMPLOYMENT-15' H2026 MAINTAIN EMPLOYMENT-DIEM H2027 PSYCHOEDUCATIONL SVC-15' H2028 SEX OFFEND TREATMNT-15'

H2029 SEX OFFEND TREATMNT-DIEM

H2030 MENTAL HLTH CLUBHOUS-15' H2031 MENTAL HLTH CLUBHSE-DIEM H2032 ACTIVITY THERAPY-15' H2033 MULTISYST THERAPY JUVEN H2034 HALFWAY HOUSE SVC-DIEM H2035 OTHER TREATMENT PROG-HR H2036 OTHER TREATMNT PROG-DIEM H2037 DEV DELAY PREV DEP CHLD S0012 BUTORPHANOL NASAL SPRAY S0014 TACRINE HYDROCHLORIDE S0017 INJECTION, AMINOCAPROIC S0020 INJECTION, BUPIVICAINE S0021 INJECTION, CEFTOPERAZONE S0023 INJECTION, CIMETIDINE S0028 INJECTION, FAMOTIDINE S0030 INJECTION, METRONIDAZOLE S0032 INJECTION, NAFCILLIN SOD S0034 INJECTION, OFLOXACIN S0039 INJECTION, SULFAMETHOXAZ S0040 INJECTION, TICARCILLIN S0073 INJECTION, AZTREONAM S0074 INJECTION, CEFOTETAN DIS S0077 INJECTION, CLINDAMYCIN S0078 INJECTION, FOSPHENYTOIN S0080 INJECTION, PENTAMIDINE S0081 INJECTION, PIPERACILLIN S0088 IMATINIB 100 MG S0090 SILDENAFIL CITRATE 25 MG


S0091 GRANISETRON HYDROCHLORID S0092 HYDROMORPHONE 250 MG S0093 MORPHINE 500 MG S0104 ZIDOVUDINE ORAL 100MG S0106 BUPROPION HCL SR 60 TABS S0108 MERCAPTOPURINE 50 MG S0109 METHADONE ORAL 5 MG S0117 TOPICAL TRETINON 5 GRAMS S0119 ONDANSETRON 4 MG

S0122 MENOTROPINS INJ, 75 IU S0126 FOLLITROPIN ALFA INJ 75U S0128 FOLLITROPIN BETA INJ 75U S0132 GANIRELIX ACET INJ 250MC S0136 CLOZAPINE 25 MG S0137 DIDANOSINE 25 MG S0138 FINASTERIDE 5 MG S0139 MINOXIDIL, 10 MG S0140 SAQUINAVIR 200 MG S0142 COLISTIMETHATE INH SL MG S0145 PEG INTERFERON ALFA-2A/1 S0148 PEG INTERFERON ALFA2B/10 S0155 EPOPROSTENOL DILUTANT S0156 EXEMESTANE, 25 MG S0157 BECAPLERMIN GEL.01% 5GM S0160 DEXTROAMPHETAMINE SULF S0164 INJECTION PANTROPRAZOLE S0166 OLANZAPINE 2.5MG INJ S0169 CALCITROL S0170 ANASTROZOLE 1 MG S0171 BUMETANIDE 0.5 MG S0172 CHLORAMBUCIL 2 MG S0174 DOLASETRON 50 MG S0175 FLUTAMIDE 125 MG S0176 HYDROXYUREA 500 MG S0177 LEVAMISOLE 50 MG S0178 LOMUSTINE 10 MG S0179 MEGESTROL 20 MG


S0182 PROCARBAZINE 5 MG S0183 PROCHLORPERAZINE 5 MG S0187 TAMOXIFEN 10 MG S0189 TESTOSTERONE PELLET 75 M S0190 MIFEPRISTONE ORAL, 200MG S0191 MISOPROSTOL ORAL, 200MCG S0194 VITAMIN SUPPLMNT 100 CAP S0195 PNEUM CONJUGATE VACCINE S0197 PRENATAL VITAMINS 30 DAY S0199 MED ABORT EXCEPT DRUGS S0201 PARTIAL HOSP <24 HRS S0207 PARAMED INTRCPT, NONHOSP S0208 PARAMD INTRCEP HSP NOVOL S0209 WC VAN MILEAGE PER MI S0215 NON-EMERG TRANSP PER MIL S0220 MED. CONFERENCE BY MD S0221 MED. CONFERENCE 60 MIN. S0250 COMP GERIATR ASSMT TEAM S0255 HOSPICE REFER VISIT NONM S0257 END OF LIFE COUNSELING S0260 H&P FOR SURGERY S0265 GENETIC COUNSEL 15 MINS S0270 HOME STD CASE RATE 30 DA S0271 HOME HOSPICE CASE 30 DAY S0272 HOME EPISODIC CASE 30 DA S0273 MD HOME VISIT OUTSIDE CA S0274 NURSE PRACTR VISIT OUTS S0280 MEDICAL HOME, INIT PLN S0281 MEDICAL HM, MAINTENANCE S0302 COMPLETED EPSDT S0310 HOSPITALIST VISIT S0315 DIS MGMT PROG, INITIAL S0316 DIS MGMT PROG, FOLLOWUP S0317 DIS MGMT PROG PER DIEM S0320 RN CALLS DIS MGMT PROG S0340 LIFESTYLE MOD 1ST STAGE S0341 LIFESTYLE MOD 2/3 STAGE


S0342 LIFESTYLE MOD 4TH STAGE S0353 CANCER TREAT PLAN INITIA

S0354 CANCER TREAT PLAN CHANGE

S0390 ROUT FOOT CARE PER VISIT S0395 IMPRESSION CASTING FT S0400 GLOBAL ESWL KIDNEY S0500 DISPOS CONT LENS S0504 SINGL PRSCRP LENS S0506 BIFOC PRSCP LENS S0508 TRIFOC PRSCRP LENS S0510 NON-PRSCRP LENS S0512 DAILY CONTACT LENS S0514 COLOR CONT LENS S0515 SCLER LENS LIQ BANDAGE S0516 SAFETY FRAMES S0518 SUNGLASS FRAMES S0580 POLYCARB LENS S0581 NONSTANDARD LENS S0590 MISC INTEGRAL LENS SERV S0592 COMP CONT LENS EVAL S0595 NEW LENSES PTS OLD FRAME S0596 PHAKIC IOL REFRACT ERROR

S0601 SCREENING PROCTOSCOPY S0610 ANNUAL GYN EXAM, NEW PT S0612 ANNUAL GYN EXAM, EST PT S0613 ANN BREAST EXAM S0618 AUDIOMETRY FOR HEARING A S0620 ROUTINE OPHTH EXAM, NEW S0621 ROUTINE OPHTH EXAM, EST S0622 PHYS EXAM FOR COLLEGE S0630 REMOVAL SUTURES S0800 LASER IN SITU (LASIK) S0810 PHOTOREFRACTIVE KERATECT S0812 PHOTOTHERAP KERATECT S1001 DELUX ITEM S1002 CUSTOM ITEM S1015 IV TUBING EXTENSION KIT


S1016 NON-PVC INTRAVENOUS ADMI S1030 GLUC MONITOR PURCHASE S1031 GLUC MONITOR RENTAL S1040 CRANIAL REMOLD ORTHROSIS S1090 MOMETASONE SINUS IMPLANT S2053 TRANSPLANT OF INTEST LIV S2054 TRANSPLANT OF ORGANS S2055 HARVESTING OF ORGANS S2060 LOBAR LUNG TRANSPLANT S2061 DONOR LOBECTOMY (LUNG) S2065 SIMULT PANC KIDN TRANS S2066 BREAST GAP FLAP RECONST S2067 BREAST STACKED DIEP/GAP S2068 BREAST DIEP OR SIEA FLAP S2070 CYSTO LASER TX URET CALC S2079 LAP ESOPHAGOMYOTOMY S2080 LAUP S2083 GASTRIC BAND ADJUSTMENT S2095 TRANSCATH EMBOLIZ-YTTRIU S2102 ISLET CELL TISSUE TRANSP S2103 ADRENAL TISSUE TRANSPLAN S2107 ADOPTIVE IMMUNOTHERAPY S2112 KNEE ARTHROSCP HARV S2115 PERIACETABULAR OSTEOTOMY S2117 ARTHROEREISIS, SUBTALAR S2118 TOTAL HIP RESURFACING S2120 LOW DENSITY LIPOPROTEIN S2140 CORD BLOOD HARVESTING S2142 CORD BLOOD-STEMCELL DER S2150 BMT HARV/TRANSPL 28D PKG S2152 SOLID ORGAN TRNSPL PKG S2202 ECHOSCLEROTHERAPY S2205 MINI CABG- 1 ARTERY S2206 MINI CABG-2 ART GRAFTS S2207 MINI CABG-1 VEIN GRAFT S2208 MINI CABG-1 ARTERY/VEIN S2209 MINI CABG-2 ARTERY/1VEIN


S2225 LASR ASSIST MYRINGOTOMY S2230 IMPL MAG COMP OSSICLE S2235 IMPL AUDITORY BRAIN IMPL S2260 INDUCED ABORTION 17-24 W S2265 ABORT-FETL INDIC 25-28WK S2266 ABORT-FETL INDIC 29-31WK S2267 ABORT-FETL INDIC 32+ WKS S2300 ARTHROSCOPY, SHOULDER S2325 HIP CORE DECOMPRESSION S2340 CHEMODENERVATION ABDUCTO S2341 CHEMODENERV ADDUCT VOCAL S2342 NASAL ENDOSCOP PO DEBRID S2348 DECOMPRESS DISC RF LUMBA S2350 DISKECTOMY, LUMBAR, SING S2351 DISKECTOMY LUMBAR EA ADD S2360 VERTEBROPLAST CERV 1ST S2361 VERTEBROPLAST CERV ADDL S2400 FETAL SURG DIAPHR HERNIA S2401 FETAL SURG URIN TRAC OBS S2402 FETAL SURG CYSTIC MALFOR S2403 FETAL SURG PULM SEQUEST S2404 FETAL SURG MYELOMENINGOC S2405 FETAL SURG SACR TERATOMA S2409 FETAL SURG NOC S2411 FETOSCOP LASER THER TTTS S2900 ROBOTIC SURGICAL SYSTEM S3000 BILAT DILAT RETINAL EXAM S3005 EVAL SELF-ASSESS DEPRESS S3600 STAT LAB S3601 EMERGENCY STAT LAB S3620 NEWBORN METBLC SCREENING S3630 EOSINOPHIL BLOOD COUNT S3645 HIV-1 ANTIBODY TESTING S3650 SALIVA TEST, HORMONE LEV S3652 SALIVA TEST, PRETERM LAB S3655 ANTISPERM ANTIBODY TEST S3708 GI FAT ABSORPTION


S3721 CIRCULATING TUMOR CELL T S3722 KRAS MUTATION ANALYSIS S3800 GENETIC TESTING ALS S3834 SINGLE MUTATION APC S3840 DNA ANALY RET-ONCOGENE S3841 GENE TEST RETINOBLASTOMA S3842 GENE TEST HIPPEL-LINDAU S3844 DNA ANALYSIS DEAFNESS S3845 GENE TEST ALPHA-THALASS S3846 GENE TEST BETA-THALASS S3849 GENE TEST NEIMANN-PICK S3850 GENE TEST SICKLE CELL S3852 DNA ANALY APOE ALZHEIM S3853 GENE TEST MYOMUSCLR DYST S3854 GENE PROFILE PANEL BREAS S3855 GENE TEST PRESENILIN-1 G S3861 GENETIC TEST BRUGADA S3865 COMP GENE TEST HYP CARDI S3866 SPEC GENE TEST HYP CARDI S3870 CGH TEST DEVELOPMENT DEL S3890 FECAL DNA ANALYSIS S3900 SURFACE EMG S3902 BALLISTOCARDIOGRAM S3904 MASTERS TWO STEP S4005 INTERIM LABOR FACILITY S4011 IN VITRO FERTIL PACKAGE S4013 COMP GIFT CASE RATE S4014 COMPL ZIFT CASE RATE S4015 COMPLETE IVF CASE RATE S4016 FROZEN IVF CASE RATE S4017 IVF CANC A STIM CSE RATE S4018 F EMB TRNS CANC CASE RTE S4020 IVF CANC A ASPIR CASE RT S4021 IVF CANC P ASPIR CASE RT S4022 AST OOCYTE FERT CASE RTE S4023 INCOMPL DONOR EGG RATE S4025 DONOR SERV IVF CASE RATE


S4026 PROCURE DONOR SPERM S4027 STORE PREV FROZ EMBRYOS S4028 MICROSURG EPI SPERM ASP S4030 SPERM PROCURE INIT VISIT S4031 SPERM PROCURE SUBS VISIT S4035 STIMULATED IUI CASE RATE S4037 CRYO EMBRYO TRANSFR RATE S4040 MONIT STORE CRYO EMBRYO S4042 OVULATION MGMT PER CYCLE S4981 INSERT LEVONORGESTREL IU S4989 CONTRACEPT IUD S4990 NICOTINE PATCH LEGEND S4991 NICOTINE PATCH NONLEGEND S4993 CONTRACEPTIVE PILLS S4995 SMOKING CESSATION GUM S5000 PRESCIPT. DRUG GENERIC S5001 PRESCIPT. DRUG BRANDNAME S5010 5% DEXTROSE/0.45% SALINE S5011 5% DEXTROSE LACT RING S5012 5% DEXTR WITH POTASSIUM S5013 5% DEX/.45%SALINE 1000ML S5014 D5W/.45% NS W KCL& MGSO4 S5035 HIT ROUTINE DEVICE MAINT S5036 HIT DEVICE REPAIR S5100 ADULT DAY CARE-PER 15' S5101 ADULT DAY CARE-HALF DAY S5102 ADULT DAY CARE-PER DIEM S5105 CENTER-BASED DAY CARE S5108 HOMECARE TRAINING-15' S5109 HOMECARE TRAIN-SESSION S5110 FAM HOME CARE TRAIN-15' S5111 FAM HOME CARE TRAIN-SESS S5115 OTH HOME CARE TRAIN-15' S5116 OTH HOME CARE TRAIN-SESS S5120 CHORE SERVICES-PER 15' S5121 CHORE SERVICES-PER DIEM S5125 ATTENDANT CARE-PER 15'


S5126 ATTENDANT CARE-PER DIEM S5130 HOMEMAKER SERV NOS-15' S5131 HOMEMAKER SERV NOS-DIEM S5135 ADULT COMPANION-PER 15' S5136 ADULT COMPANION-PER DIEM S5140 ADULT FOSTER-PER DIEM S5141 ADULT FOSTER-PER MONTH S5145 CHILD FOSTER-PER DIEM S5146 CHILD FOSTER-PER MONTH S5150 UNSKILLED RESPITE-PER 15 S5151 UNSKILL RESPITE-PER DIEM S5160 EMERG RESPONSE SYST S5161 EMERG RESP SERV FEE S5162 EMERG RESP PURCH ONLY S5165 HOME MODIFICATIONS S5170 HOME MEAL DELIVERY S5175 PROF EXT LAUNDRY SERVICE S5180 HOME RESP THERAPY-INIT S5181 HOME RESP TX NOS-DIEM S5185 NON-FACE MED REMINDER S5190 NON-PHYS WELLNESS ASSESS S5199 PERSONAL CARE ITEM NOS S5497 HIT CATH CARE NOC S5498 HIT SIMPLE CATH CARE S5501 HIT COMPLEX CATH CARE S5502 HIT INTERIM CATH CARE S5517 HIT DECLOTTNG KIT S5518 HIT CATH REPAIR KIT S5520 HIT PICC INSERT KIT S5521 HIT MIDLNE CATH INSR KIT S5522 HIT PICC INSERT NO SUPP S5523 HIP MIDLN CATH INST KIT S5550 RAPID ONSET INSULIN 5 UN S5551 MOST RAPID ONSET INSULIN S5552 INTERMED ACTING INSULIN S5553 LONG ACTING INSULIN 5 UN S5560 INSULIN REUSE PEN 1.5 ML


S5561 INSULIN REUSE PEN 3 ML S5565 INSULIN CARTRIDGE 150 UN S5566 INSULIN CARTRIDGE 300 UN S5570 INSULN DISPOS PEN 1.5 ML S5571 INSULN DISPOS PEN 3 ML S8030 TANTALUM RING APPLICATN S8035 MAGNETIC SOURCE IMAGING S8037 MRCP S8040 TOPOGRAPHIC BRAIN MAPPIN S8042 MRI LOW FIELD S8055 US GUIDANCE FETAL REDUCT S8080 SCINTIMAMMOGRAPHY S8085 FLUORINE-18 FLUORODEOX S8092 ELECTRON BEAM COM TOMOGR S8096 PORTABLE PEAK FLOW METER S8097 ASTHMA KIT S8100 SPACER WITHOUT MASK S8101 SPACER WITH MASK S8110 PEAK EXPIR FLOW RATE S8120 O2 CONTENTS GAS CUBIC FT S8121 O2 CONTENTS LIQUID-POUND S8130 INTERFRNTIAL STIM 2 CHAN

S8131 INTERFRNTIAL STIM 4 CHAN

S8185 FLUTTER DEVICE S8186 SWIVEL ADAPTOR S8189 TRACH SUPPLY NOC S8210 MUCUS TRAP S8262 MANDIBULAR ORTHO REPOS S8265 HABERMAN FEEDER S8270 ENURESIS ALARM S8301 INFECTION CONTROL SUPPL S8415 SUPPLIES FOR HOME DELIVE S8420 CUST GRADIENT SLEEV/GLOV S8421 READY GRADIENT SLEEV/GLO S8422 CUSTOM GRAD SLEEVE MED S8423 CUSTOM GRAD SLEEVE HEAVY S8424 READY GRADIENT SLEEVE


S8425 CUSTOM GRAD GLOVE MED S8426 CUSTOM GRAD GLOVE HEAVY S8427 READY GRADIENT GLOVE S8428 READY GRADIENT GAUNTLET S8429 GRADIENT PRESSURE WRAP S8430 PADDING FOR COMPRSSN BDG S8431 COMPRESSION BANDAGE S8450 SPLINT DIGIT S8451 SPLINT WRIST OR ANKLE S8452 SPLINT ELBOW S8460 POSTMASTECTOMY CAMISOLE S8490 100 INSULIN SYRINGES S8930 AURICULAR ELECTROSTIMUL

S8940 HIPPOTHERAPY PER SESSION S8948 LOW-LEVEL LASER TX 15' S8950 COMPLEX LYMPHEDEMA THERA S8990 PT OR MANIP FOR MAINT S8999 RESUSCITATION BAG S9001 HOME UTERINE MONITOR S9007 ULTRAFILTRATION MONITOR S9015 AUTOMATED EEG MONITORING S9024 PARANASAL SINUS ULTRASOU S9025 OMNICARDIOGRAM S9034 ESWL FOR GALLSTONES S9055 PROCUREN S9056 COMA STIMULATION S9061 MEDICAL SUPPLY AND EQUIP S9083 URGENT CARE CENTER GLOBA S9088 SERV URGENT CARE CENTER S9090 VERT AXIAL DECOMPRESSION S9097 HOME VISIT WOUND CARE S9098 HOME PHOTOTHERAPY VISIT S9110 TELEMONTRNG/HOME PR MNTH S9117 BACK SCHOOL VISIT S9122 HOME HEALTH AIDE S9123 NURSING CARE IN HOME RN S9124 NURSING CARE IN HOME LPN


S9125 RESPITE CARE IN THE HOME S9126 HOSPICE CARE IN THE HOME S9127 SOCIAL WORK IN THE HOME S9128 SPEECH THER IN THE HOME S9129 OCCUP THERAPY IN THE HOM S9131 PT IN THE HOME PER DIEM S9140 DIABETIC MGMT PROG NONMD S9141 DIABETIC MGMT PROG MD S9145 INSULIN PUMP INITIATION S9150 EVALUATION BY OCULARIST S9152 SPEECH THERAPY RE-EVAL S9208 HOME MGMT PRETERM LABOR S9209 HOME MGMT PPROM S9211 HOME MGMT GEST HYPERTENS S9212 HM POSTPAR HYPER PER DIE S9213 HM PREECLAMP PER DIEM S9214 HM GEST DM PER DIEM S9325 HIT PAIN MGMT PER DIEM S9326 HIT CONT PAIN PER DIEM S9327 HIT INT PAIN PER DIEM S9328 HIT PAIN IMP PUMP DIEM S9329 HIT CHEMO PER DIEM S9330 HIT CONT CHEM DIEM S9331 HIT INTERMIT CHEMO DIEM S9335 HT HEMODIALYSIS PER DIEM S9336 HIT CONT ANTICOAG DIEM S9338 HIT IMMUNOTHERAPY DIEM S9339 HIT PERIT DIALYSIS DIEM S9340 HIT ENTERAL PER DIEM S9341 HIT ENTERAL GRAV DIEM S9342 HIT ENTERAL PUMP DIEM S9343 HIT ENTERAL BOLUS NURS S9345 HIT ANTI-HEMOPHIL DIEM S9346 HIT ALPH-1-PROTEINA DIEM S9347 HIT LONGTERM INFUS DIEM S9348 HIT SYMPATHOMIM DIEM S9349 HIT TOCOLYSIS DIEM


S9351 HIT CONT ANTIEMETIC DIEM S9353 HIT CONT INSULIN DIEM S9355 HIT CHELATION DIEM S9357 HIT ENZYME REPLACE DIEM S9359 HIT ANTI-TNF PER DIEM S9361 HIT DIURETIC INFUS DIEM S9363 HIT ANTI-SPASMOTIC DIEM S9364 HIT TPN TOTAL PERDIEM S9365 HIT TPN 1 LITER DIEM S9366 HIT TPN 2 LITER DIEM S9367 HIT TPN 3 LITER DIEM S9368 HIT TPN OVER 3L DIEM S9370 HT INJ ANTIEMETIC DIEM S9372 HT INJ ANTICOAG DIEM S9373 HIT HYDRA TOTAL DIEM S9374 HIT HYDRA 1 LITER DIEM S9375 HIT HYDRA 2 LITER DIEM S9376 HIT HYDRA 3 LITER DIEM S9377 HIT HYDRA OVER 3L DIEM S9379 HIT NOC PER DIEM S9381 HIT HIGH RISK/ESCORT S9401 ANTICOAG CLINIC PER SESS S9430 PHARM COMPND/DISPEN SERV S9433 MEDICAL FOOD ORAL 100% N S9434 MOD SOLID FOOD SUPPLMNT S9435 MEDICAL FOOD INBORN ERR S9436 LAMAZE CLASS S9437 CHILDBIRTH REFRESH CLASS S9438 CESAREAN BIRTH CLASS S9439 VBAC CLASS S9441 ASTHMA EDUCATION S9442 BIRTHING CLASS S9443 LACTATION CLASS S9444 PARENTING CLASS S9445 PT EDUCATION NOC INDIVID S9446 PT EDUCATION NOC GROUP S9447 INFANT SAFETY CLASS


S9449 WEIGHT MANAGEMENT CLASS S9451 EXERCISE CLASS S9452 NUTRITION CLASS S9453 SMOKING CESSATION CLASS S9454 STRESS MANAGEMENT CLASS S9455 DIABETIC MGMT PRO GROUP S9460 DIABETIC MGMT PRO NURSE S9465 DIABETIC MGMT DIETITIAN S9470 NUTRITIONAL COUNSELING S9472 CARDIAC REHAB PROGRAM S9473 PULMONARY REHAB PROGRAM S9474 ENTEROSTOMAL THERAPY S9475 AMB SET SUBSTANCE ABUSE S9476 VESTIBUL REHAB PER DIEM S9480 INTENSIVE OUTPT PSYCH S9482 FAMILY STABILIZATION 15 S9484 CRISIS INTERVENT PERHOUR S9485 CRISIS INTERVENT PERDIEM S9490 HIT CORTICOSTERIOD DIEM S9494 HIT ANTIBIOTIC TOTL DIEM S9497 HIT ANTIBIOTIC Q3H DIEM S9500 HIT ANTIBIOTIC Q24H DIEM S9501 HIT ANTIBIOTIC Q12H DIEM S9502 HIT ANTIBIOTIC Q8H DIEM S9503 HIT ANTIBIOTIC Q6H DIEM S9504 HIT ANTIBIOTIC Q4H DIEM S9529 VENIPUNCTURE HOME/SNF S9537 HT HEM HORM INJ DIEM S9538 HIT BLOOD PRODUCTS DIEM S9542 HT INJ NOC PER DIEM S9558 HT INJ GROWTH HORM DIEM S9559 HIT INJ INTERFERON DIEM S9560 HT INJ HORMONE DIEM S9562 PALIVIZUMAB HOME INJ S9590 IN HOME IRRIGATION THER S9810 HT PHARM PER HOUR S9900 CHRIST SCIEN PRACT VISIT


S9970 HEALTH CLUB MEMBERSHIP S9975 TRANSPLANT RELAT PERDIEM S9976 LODGING NOS PER DIEM S9977 MEALS NOS PER DIEM S9981 MED RECORD COPY ADMIN S9982 MED RECORD COPY PER PAGE S9986 NOT MED NEC SERVICE S9988 SERV PART OF PHASE I TRI S9989 SERVICES OUTSIDE US S9990 SERV OF A PHASE II TRIAL S9991 SER OF A PHASE III TRIAL S9992 TRANSPORTATION COSTS S9994 LODGING COSTS S9996 MEALS FOR CLINICAL TRIAL S9999 SALES TAX T1000 PRIVATE DUTY/INDEPEN NSG T1001 NURSING ASSESSMENT/EVAL T1002 RN SERVICES UP TO 15 MIN T1003 LPN/LVN SERVICE TO 15M T1004 NSG AIDE SERVICE TO 15M T1005 RESPITE CARE SERVICE 15M T1006 FAMILY/COUPLE COUNSELING T1007 TREATMENT PLAN DEVELPMNT T1009 CHILD SITTING SERVICES T1010 MEALS WHEN RECEIVE SRVC T1012 ALCOHOL/SUBS ABUSE SKILL T1013 SIGN LANG/ORAL INTERPR T1014 TELEHEALTH TRANSM,P MINI T1015 CLINIC SERVICE T1016 CASE MANAGEMENT 15 MINS T1017 TARGETED CASE MGMT 15MIN T1018 SCHOOL-BASED IEP SRVCS T1019 PERSONAL CARE SVC 15 MIN T1020 PERSONL CARE SVC PERDIEM T1021 HH AIDE OR CNA PER VISIT T1022 CONTRACT HH SRVC PER DAY T1023 PROGRAM INTAKE ASSESSMNT


T1024 TEAM EVALUATION & MGMT T1025 PEDI COMPR CARE PKG/DAY T1026 PEDI COMPR CARE PKG/HOUR T1027 FAMLY TRAINING&COUNSELIN T1028 HOME ENVIRONMT ASSESMENT T1029 DWELLING LEAD INVEST T1030 RN HOME CARE PER DIEM T1031 LPN HOME CARE PER DIEM T1502 MEDICATION ADMIN VISIT T1503 MED ADMIN, NOT ORAL/INJE T1505 ELEC MED COMP DEV, NOC T1999 MISC RETAIL SUPPLIES NOC T2001 N-ET; PATIENT ATTEND/ESC T2002 N-ET; PER DIEM T2003 N-ET; ENCOUNTER/TRIP T2004 N-ET; COMMERCL CARRIER T2005 NON-EMERG STRETCHER VAN T2007 NONEMER TRNSPRT WAITTIME T2010 PASRR LEVEL I T2011 PASRR LEVEL II T2012 EDUC HABILIT WAIVER-DIEM T2013 EDUC HABILIT WAIVER-HOUR T2014 PREVOC HABIL WAIVER-DIEM T2015 PREVOC HABIL WAIVER-HOUR T2016 RESID HABIL WAIVER-DIEM T2017 RESID HABIL WAIVER-15' T2018 SUP EMPL HABIL WAIV-DIEM T2019 SUP EMPL HABIL WAIV-15' T2020 DAY HABILIT WAIVER-DIEM T2021 DAY HABILITAT WAIVER-15' T2022 CASE MANAGEMENT PER MO T2023 TARGET CASE MANAGEMENT T2024 SERV ASMNT/CARE PLN WAIV T2025 WAIVER SERVICES NOS T2026 SPEC CHILDCARE WAIV-DIEM T2027 SPEC CHILDCARE WAIVR-15' T2028 SPECL SUPPLY NOS WAIVER


T2029 SPEC MED EQUIP NOS WAIVR T2030 ASSISTD LIVING WAIVER-MO T2031 ASSIST LIVING WAIVR-DIEM T2032 RES CARE NOS WAIVER-MO T2033 RES CARE NOS WAIVER-DIEM T2034 CRISIS INTERV WAIVR-DIEM T2035 UTILITY SERVICES WAIVER T2036 CAMP OVERNITE WAIVER-EA T2037 CAMP DAY WAIVER-EA SESSN T2038 COMM TRANSITION WAIVER T2039 VEHICLE MODIFICAT WAIVER T2040 FINANCIAL MANAGMT WAIVER T2041 SUPPORT BROKERAGE WAIVER T2042 HOSPICE ROUTIN HOME CARE T2043 HOSPICE CONTIN HOME CARE T2044 HOSPICE INPT RESPIT CARE T2045 HOSPICE GENRL INPT CARE T2046 HOSPICE LONG TERM R&B T2048 BEHAV HLTH LTC RES R&B T2049 N-ET; STRETCHER VAN, MIL T2101 BRST MILK PROC/STORE/DIS T4521 ADLT SZ BRIEF/DIAPER SM T4522 ADLT SZ BRIEF/DIAPER MED T4523 ADLT SZ BRIEF/DIAPER LG T4524 ADLT SZ BRIEF/DIAPER XL T4525 ADULT SIZE PULL-ON SM T4526 ADULT SIZE PULL-ON MED T4527 ADULT SIZE PULL-ON LG T4528 ADULT SIZE PULL-ON XL T4529 PED SIZE BRIEF/DIAP SM/M T4530 PED SIZE BRIEF/DIAP LG T4531 PED SIZE PULL-ON SM/MED T4532 PED SIZE PULL-ON LG T4533 YOUTH SIZE BRIEF/DIAPER T4534 YOUTH SIZE PULL-ON T4535 DISP LINER/SHIELD/PAD T4536 REUSABLE PULL-ON ANY SIZ


T4537 REUSABLE UNDERPAD BED SI T4538 DIAPER SERV REUSABLE DIA T4539 REUSE DIAPER/BRIEF ANY S T4540 REUSABL UNDERPAD CHR PAD T4541 LARGE DISPOSABLE UNDERPA T4542 SMALL DISPOSABLE UNDERPA T4543 DISP BARIATRIC BRIEF/DIA T5001 SPECIAL POSITIONING SEAT T5999 SUPPLY NOS

outpatient code editor (oce) edit 28, line item rejection ... · s0119 ondansetron 4 mg s0122...

Documents