Health Care Procedure Coding System

About the 2020 Health Care Procedure Coding System (HCPCS)

Each year, in the United States, health care insurers process over 5 billion claims for payment. For Medicare and other health insurance programs to ensure that these claims are processed in an orderly and consistent manner, standardized coding systems are essential. The HCPCS Level II Code Set is one of the standard code sets used for this purpose. The HCPCS is divided into two principal subsystems, referred to as level I and level II of the HCPCS. Level I of the HCPCS is comprised of CPT (Current Procedural Terminology), a numeric coding system maintained by the American Medical Association (AMA). The CPT is a uniform coding system consisting of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. These health care professionals use the CPT to identify services and procedures for which they bill public or private health insurance programs. Decisions regarding the addition, deletion, or revision of CPT codes are made by the AMA. The CPT codes are republished and updated annually by the AMA. Level I of the HCPCS, the CPT codes, does not include codes needed to separately report medical items or services that are regularly billed by suppliers other than physicians.

Level II of the HCPCS is a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician’s office. Because Medicare and other insurers cover a variety of services, supplies, and equipment that are not identified by CPT codes, the level II HCPCS codes were established for submitting claims for these items. The development and use of level II of the HCPCS began in the 1980’s. Level II codes are also referred to as alpha-numeric codes because they consist of a single alphabetical letter followed by 4 numeric digits, while CPT codes are identified using 5 numeric digits.

• The source for these data is The Centers for Medicare & Medicaid Services

• In some instances, brand names may appear in HCPCS descriptions. These names have been included for indexing purposes only; their inclusion does not convey endorsement of any particular brand.

HCPCS Codes

Short Codes

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
A1	0010	7	Dressing for one wound	Dressing for one wound
A2	0010	7	Dressing for two wounds	Dressing for two wounds
A3	0010	7	Dressing for three wounds	Dressing for three wounds
A4	0010	7	Dressing for four wounds	Dressing for four wounds
A5	0010	7	Dressing for five wounds	Dressing for five wounds
A6	0010	7	Dressing for six wounds	Dressing for six wounds
A7	0010	7	Dressing for seven wounds	Dressing for seven wounds
A8	0010	7	Dressing for eight wounds	Dressing for eight wounds
A9	0010	7	Dressing for nine or more wounds	Dressing for 9 or more wound
AA	0010	7	Anesthesia services performed personally by anesthesiologist	Anesthesia perf by anesgst
AD	0010	7	Medical supervision by a physician: more than four concurrent anesthesia procedures	Md supervision, >4 anes proc
AE	0010	7	Registered dietician	Registered dietician
AF	0010	7	Specialty physician	Specialty physician
AG	0010	7	Primary physician	Primary physician
AH	0010	7	Clinical psychologist	Clinical psychologist
AI	0010	7	Principal physician of record	Principal physician of rec
AJ	0010	7	Clinical social worker	Clinical social worker
AK	0010	7	Non participating physician	Non participating physician
AM	0010	7	Physician, team member service	Physician, team member svc
AO	0010	7	Alternate payment method declined by provider of service	Prov declined alt pmt method
AP	0010	7	Determination of refractive state was not performed in the course of diagnostic ophthalmological examination	No dtmn of refractive state
AQ	0010	7	Physician providing a service in an unlisted health professional shortage area (hpsa)	Physician service hpsa area
AR	0010	7	Physician provider services in a physician scarcity area	Physician scarcity area
AS	0010	7	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Assistant at surgery service
AT	0010	7	Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942)	Acute treatment
AU	0010	7	Item furnished in conjunction with a urological, ostomy, or tracheostomy supply	Uro, ostomy or trach item
AV	0010	7	Item furnished in conjunction with a prosthetic device, prosthetic or orthotic	Item w prosthetic/orthotic
AW	0010	7	Item furnished in conjunction with a surgical dressing	Item w a surgical dressing
AX	0010	7	Item furnished in conjunction with dialysis services	Item w dialysis services
AY	0010	7	Item or service furnished to an esrd patient that is not for the treatment of esrd	Item/service not for esrd tx
AZ	0010	7	Physician providing a service in a dental health professional shortage area for the purpose of an electronic health record incentive payment	Physician serv in dent hpsa
BA	0010	7	Item furnished in conjunction with parenteral enteral nutrition (pen) services	Item w pen services
BL	0010	7	Special acquisition of blood and blood products	Spec acquisition blood prods
BO	0010	7	Orally administered nutrition, not by feeding tube	Nutrition oral admin no tube
BP	0010	7	The beneficiary has been informed of the purchase and rental options and has elected to purchase the item	Bene electd to purchase item
BR	0010	7	The beneficiary has been informed of the purchase and rental options and has elected to rent the item	Bene elected to rent item
BU	0010	7	The beneficiary has been informed of the purchase and rental options and after 30 days has not informed the supplier of his/her decision	Bene undecided on purch/rent
CA	0010	7	Procedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission	Procedure payable inpatient
CB	0010	7	Service ordered by a renal dialysis facility (rdf) physician as part of the esrd beneficiary’s dialysis benefit, is not part of the composite rate, and is separately reimbursable	Esrd bene part a snf-sep pay
CC	0010	7	Procedure code change (use ‘cc’ when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)	Procedure code change
CD	0010	7	Amcc test has been ordered by an esrd facility or mcp physician that is part of the composite rate and is not separately billable	Amcc test for esrd or mcp md
CE	0010	7	Amcc test has been ordered by an esrd facility or mcp physician that is a composite rate test but is beyond the normal frequency covered under the rate and is separately reimbursable based on medical necessity	Med neces amcc tst sep reimb
CF	0010	7	Amcc test has been ordered by an esrd facility or mcp physician that is not part of the composite rate and is separately billable	Amcc tst not composite rate
CG	0010	7	Policy criteria applied	Policy criteria applied
CH	0010	7	0 percent impaired, limited or restricted	0 percent impaired, ltd, res
CI	0010	7	At least 1 percent but less than 20 percent impaired, limited or restricted	1 to <20 percent impaired
CJ	0010	7	At least 20 percent but less than 40 percent impaired, limited or restricted	20 to <40 percent impaired
CK	0010	7	At least 40 percent but less than 60 percent impaired, limited or restricted	40 to <60 percent impaired
CL	0010	7	At least 60 percent but less than 80 percent impaired, limited or restricted	60 to <80 percent impaired
CM	0010	7	At least 80 percent but less than 100 percent impaired, limited or restricted	80 to <100 percent impaired
CN	0010	7	100 percent impaired, limited or restricted	100 percent impaired, ltd
CO	0010	7	Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant	Outpatient ot service by ota
CP	0010	7	Adjunctive service related to a procedure assigned to a comprehensive ambulatory payment classification (c-apc) procedure, but reported on a different claim	C-apc adjunctive service
CQ	0010	7	Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant	Outpatient pt service by pta
CR	0010	7	Catastrophe/disaster related	Catastrophe/disaster related
CS	0010	7	Item or service related, in whole or in part, to an illness, injury, or condition that was caused by or exacerbated by the effects, direct or indirect, of the 2010 oil spill in the gulf of mexico, including but not limited to subsequent clean-up activities	Gulf oil 2010 spill related
CT	0010	7	Computed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (nema) xr-29-2013 standard	Ct does not meet nema standa
DA	0010	7	Oral health assessment by a licensed health professional other than a dentist	Oral health assess, not dent
E1	0010	7	Upper left, eyelid	Upper left eyelid
E2	0010	7	Lower left, eyelid	Lower left eyelid
E3	0010	7	Upper right, eyelid	Upper right eyelid
E4	0010	7	Lower right, eyelid	Lower right eyelid
EA	0010	7	Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer chemotherapy	Esa, anemia, chemo-induced
EB	0010	7	Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer radiotherapy	Esa, anemia, radio-induced
EC	0010	7	Erythropoetic stimulating agent (esa) administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapy	Esa, anemia, non-chemo/radio
ED	0010	7	Hematocrit level has exceeded 39% (or hemoglobin level has exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle	Hct>39% or hgb>13g>=3 cycle
EE	0010	7	Hematocrit level has not exceeded 39% (or hemoglobin level has not exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle	Hct>39% or hgb>13g<3 cycle
EJ	0010	7	Subsequent claims for a defined course of therapy, e.g., epo, sodium hyaluronate, infliximab	Subsequent claim
EM	0010	7	Emergency reserve supply (for esrd benefit only)	Emer reserve supply (esrd)
EP	0010	7	Service provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) program	Medicaid epsdt program svc
ER	0010	7	Items and services furnished by a provider-based, off-campus emergency department	Off-campus ed service
ET	0010	7	Emergency services	Emergency services
EX	0010	7	Expatriate beneficiary	Expatriate beneficiary
EY	0010	7	No physician or other licensed health care provider order for this item or service	No md order for item/service
F1	0010	7	Left hand, second digit	Left hand, second digit
F2	0010	7	Left hand, third digit	Left hand, third digit
F3	0010	7	Left hand, fourth digit	Left hand, fourth digit
F4	0010	7	Left hand, fifth digit	Left hand, fifth digit
F5	0010	7	Right hand, thumb	Right hand, thumb
F6	0010	7	Right hand, second digit	Right hand, second digit
F7	0010	7	Right hand, third digit	Right hand, third digit
F8	0010	7	Right hand, fourth digit	Right hand, fourth digit
F9	0010	7	Right hand, fifth digit	Right hand, fifth digit
FA	0010	7	Left hand, thumb	Left hand, thumb
FB	0010	7	Item provided without cost to provider, supplier or practitioner, or full credit received for replaced device (examples, but not limited to, covered under warranty, replaced due to defect, free samples)	Item provided without cost
FC	0010	7	Partial credit received for replaced device	Part credit, replaced device
FP	0010	7	Service provided as part of family planning program	Svc part of family plan pgm
FX	0010	7	X-ray taken using film	X-ray taken using film
FY	0010	7	X-ray taken using computed radiography technology/cassette-based imaging	Computed radiography x-ray
G0	0010	7	Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute stroke	Telestroke
G1	0010	7	Most recent urr reading of less than 60	Urr reading of less than 60
G2	0010	7	Most recent urr reading of 60 to 64.9	Urr reading of 60 to 64.9
G3	0010	7	Most recent urr reading of 65 to 69.9	Urr reading of 65 to 69.9
G4	0010	7	Most recent urr reading of 70 to 74.9	Urr reading of 70 to 74.9
G5	0010	7	Most recent urr reading of 75 or greater	Urr reading of 75 or greater
G6	0010	7	Esrd patient for whom less than six dialysis sessions have been provided in a month	Esrd patient <6 dialysis/mth
G7	0010	7	Pregnancy resulted from rape or incest or pregnancy certified by physician as life threatening	Payment limits do not apply
G8	0010	7	Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedure	Monitored anesthesia care
G9	0010	7	Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition	Mac for at risk patient
GA	0010	7	Waiver of liability statement issued as required by payer policy, individual case	Liability waiver ind case
GB	0010	7	Claim being re-submitted for payment because it is no longer covered under a global payment demonstration	Claim resubmitted
GC	0010	7	This service has been performed in part by a resident under the direction of a teaching physician	Resident/teaching phys serv
GD	0010	7	Units of service exceeds medically unlikely edit value and represents reasonable and necessary services	Unit of service > mue value
GE	0010	7	This service has been performed by a resident without the presence of a teaching physician under the primary care exception	Resident prim care exception
GF	0010	7	Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital	Nonphysician serv c a hosp
GG	0010	7	Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day	Payment screen mam + diagmam
GH	0010	7	Diagnostic mammogram converted from screening mammogram on same day	Diag mammo to screening mamo
GJ	0010	7	“opt out” physician or practitioner emergency or urgent service	Opt out provider of er srvc
GK	0010	7	Reasonable and necessary item/service associated with a ga or gz modifier	Actual item/service ordered
GL	0010	7	Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)	Upgraded item, no charge
GM	0010	7	Multiple patients on one ambulance trip	Multiple transports
GN	0010	7	Services delivered under an outpatient speech language pathology plan of care	Op speech language service
GO	0010	7	Services delivered under an outpatient occupational therapy plan of care	Op occupational therapy serv
GP	0010	7	Services delivered under an outpatient physical therapy plan of care	Op pt services
GQ	0010	7	Via asynchronous telecommunications system	Telehealth store and forward
GR	0010	7	This service was performed in whole or in part by a resident in a department of veterans affairs medical center or clinic, supervised in accordance with va policy	Service by va resident
GS	0010	7	Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level	Epo/darbepoietin reduced 25%
GT	0010	7	Via interactive audio and video telecommunication systems	Interactivetelecommunication
GU	0010	7	Waiver of liability statement issued as required by payer policy, routine notice	Liability waiver rout notice
GV	0010	7	Attending physician not employed or paid under arrangement by the patient’s hospice provider	Attending phys not hospice
GW	0010	7	Service not related to the hospice patient’s terminal condition	Service unrelated to term co
GX	0010	7	Notice of liability issued, voluntary under payer policy	Voluntary liability notice
GY	0010	7	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit	Statutorily excluded
GZ	0010	7	Item or service expected to be denied as not reasonable and necessary	Not reasonable and necessary
H9	0010	7	Court-ordered	Court-ordered
HA	0010	7	Child/adolescent program	Child/adolescent program
HB	0010	7	Adult program, non geriatric	Adult program non-geriatric
HC	0010	7	Adult program, geriatric	Adult program geriatric
HD	0010	7	Pregnant/parenting women’s program	Pregnant/parenting program
HE	0010	7	Mental health program	Mental health program
HF	0010	7	Substance abuse program	Substance abuse program
HG	0010	7	Opioid addiction treatment program	Opioid addiction tx program
HH	0010	7	Integrated mental health/substance abuse program	Mental hlth/substance abs pr
HI	0010	7	Integrated mental health and intellectual disability/developmental disabilities program	Men hlth intel/dev disab pgm
HJ	0010	7	Employee assistance program	Employee assistance program
HK	0010	7	Specialized mental health programs for high-risk populations	Spec hgh rsk mntl hlth pop p
HL	0010	7	Intern	Intern
HM	0010	7	Less than bachelor degree level	Less than bachelor degree lv
HN	0010	7	Bachelors degree level	Bachelors degree level
HO	0010	7	Masters degree level	Masters degree level
HP	0010	7	Doctoral level	Doctoral level
HQ	0010	7	Group setting	Group setting
HR	0010	7	Family/couple with client present	Family/couple w client prsnt
HS	0010	7	Family/couple without client present	Family/couple w/o client prs
HT	0010	7	Multi-disciplinary team	Multi-disciplinary team
HU	0010	7	Funded by child welfare agency	Child welfare agency funded
HV	0010	7	Funded state addictions agency	Funded state addiction agncy
HW	0010	7	Funded by state mental health agency	State mntl hlth agncy funded
HX	0010	7	Funded by county/local agency	County/local agency funded
HY	0010	7	Funded by juvenile justice agency	Funded by juvenile justice
HZ	0010	7	Funded by criminal justice agency	Criminal justice agncy fund
J1	0010	7	Competitive acquisition program no-pay submission for a prescription number	Cap no-pay for prescript num
J2	0010	7	Competitive acquisition program, restocking of emergency drugs after emergency administration	Cap restock of emerg drugs
J3	0010	7	Competitive acquisition program (cap), drug not available through cap as written, reimbursed under average sales price methodology	Cap drug unavail thru cap
J4	0010	7	Dmepos item subject to dmepos competitive bidding program that is furnished by a hospital upon discharge	Dmepos comp bid furn by hosp
JA	0010	7	Administered intravenously	Administered intravenously
JB	0010	7	Administered subcutaneously	Administered subcutaneously
JC	0010	7	Skin substitute used as a graft	Skin substitute graft
JD	0010	7	Skin substitute not used as a graft	Skin sub not used as a graft
JE	0010	7	Administered via dialysate	Administered via dialysate
JF	0010	7	Compounded drug	Compounded drug
JG	0010	7	Drug or biological acquired with 340b drug pricing program discount	340b acquired drug
JW	0010	7	Drug amount discarded/not administered to any patient	Discarded drug not administe
K0	0010	7	Lower extremity prosthesis functional level 0 - does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance their quality of life or mobility.	Lwr ext prost functnl lvl 0
K1	0010	7	Lower extremity prosthesis functional level 1 - has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. typical of the limited and unlimited household ambulator.	Lwr ext prost functnl lvl 1
K2	0010	7	Lower extremity prosthesis functional level 2 - has the ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs, stairs or uneven surfaces. typical of the limited community ambulator.	Lwr ext prost functnl lvl 2
K3	0010	7	Lower extremity prosthesis functional level 3 - has the ability or potential for ambulation with variable cadence. typical of the community ambulator who has the ability to transverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion.	Lwr ext prost functnl lvl 3
K4	0010	7	Lower extremity prosthesis functional level 4 - has the ability or potential for prosthetic ambulation that exceeds the basic ambulation skills, exhibiting high impact, stress, or energy levels, typical of the prosthetic demands of the child, active adult, or athlete.	Lwr ext prost functnl lvl 4
KA	0010	7	Add on option/accessory for wheelchair	Wheelchair add-on option/acc
KB	0010	7	Beneficiary requested upgrade for abn, more than 4 modifiers identified on claim	>4 modifiers on claim
KC	0010	7	Replacement of special power wheelchair interface	Repl special pwr wc intrface
KD	0010	7	Drug or biological infused through dme	Drug/biological dme infused
KE	0010	7	Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment	Bid under round 1 dmepos cb
KF	0010	7	Item designated by fda as class iii device	Fda class iii device
KG	0010	7	Dmepos item subject to dmepos competitive bidding program number 1	Dmepos comp bid prgm no 1
KH	0010	7	Dmepos item, initial claim, purchase or first month rental	Dmepos ini clm, pur/1 mo rnt
KI	0010	7	Dmepos item, second or third month rental	Dmepos 2nd or 3rd mo rental
KJ	0010	7	Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen	Dmepos pen pmp or 4-15mo rnt
KK	0010	7	Dmepos item subject to dmepos competitive bidding program number 2	Dmepos comp bid prgm no 2
KL	0010	7	Dmepos item delivered via mail	Dmepos mailorder comp bid
KM	0010	7	Replacement of facial prosthesis including new impression/moulage	Rplc facial prosth new imp
KN	0010	7	Replacement of facial prosthesis using previous master model	Rplc facial prosth old mod
KO	0010	7	Single drug unit dose formulation	Single drug unit dose form
KP	0010	7	First drug of a multiple drug unit dose formulation	First drug of multi drug u d
KQ	0010	7	Second or subsequent drug of a multiple drug unit dose formulation	2nd/subsqnt drg multi drg ud
KR	0010	7	Rental item, billing for partial month	Rental item partial month
KS	0010	7	Glucose monitor supply for diabetic beneficiary not treated with insulin	Glucose monitor supply
KT	0010	7	Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item	Item from noncontract supply
KU	0010	7	Dmepos item subject to dmepos competitive bidding program number 3	Dmepos comp bid prgm no 3
KV	0010	7	Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service	Dmepos item, profession serv
KW	0010	7	Dmepos item subject to dmepos competitive bidding program number 4	Dmepos comp bid prgm no 4
KX	0010	7	Requirements specified in the medical policy have been met	Documentation on file
KY	0010	7	Dmepos item subject to dmepos competitive bidding program number 5	Dmepos comp bid prgm no 5
KZ	0010	7	New coverage not implemented by managed care	New cov not implement by m+c
L1	0010	7	Provider attestation that the hospital laboratory test(s) is not packaged under the hospital opps	Separately payable lab test
LC	0010	7	Left circumflex coronary artery	Lft circum coronary artery
LD	0010	7	Left anterior descending coronary artery	Left ant des coronary artery
LL	0010	7	Lease/rental (use the ‘ll’ modifier when dme equipment rental is to be applied against the purchase price)	Lease/rental (appld to pur)
LM	0010	7	Left main coronary artery	Left main coronary artery
LR	0010	7	Laboratory round trip	Laboratory round trip
LS	0010	7	Fda-monitored intraocular lens implant	Fda-monitored iol implant
LT	0010	7	Left side (used to identify procedures performed on the left side of the body)	Left side
M2	0010	7	Medicare secondary payer (msp)	Medicare secondary payer
MA	0010	7	Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition	Emer med cond susp/confirm
MB	0010	7	Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access	Auc hardship, insuf internet
MC	0010	7	Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues	Auc hardship, vendor issues
MD	0010	7	Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of extreme and uncontrollable circumstances	Auc hardship, extreme circ
ME	0010	7	The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional	Order adheres to auc
MF	0010	7	The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional	Order does not adhere to auc
MG	0010	7	The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional	Auc not applicable to order
MH	0010	7	Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider	Auc consult not provided
MS	0010	7	Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty	6-mo maint/svc fee parts/lbr
NB	0010	7	Nebulizer system, any type, fda-cleared for use with specific drug	Drug specific nebulizer
NR	0010	7	New when rented (use the ‘nr’ modifier when dme which was new at the time of rental is subsequently purchased)	New when rented
NU	0010	7	New equipment	New equipment
P1	0010	7	A normal healthy patient	Normal healthy patient
P2	0010	7	A patient with mild systemic disease	Patient w/mild syst disease
P3	0010	7	A patient with severe systemic disease	Patient w/severe sys disease
P4	0010	7	A patient with severe systemic disease that is a constant threat to life	Pt w/sev sys dis threat life
P5	0010	7	A moribund patient who is not expected to survive without the operation	Pt not expect surv w/o oper
P6	0010	7	A declared brain-dead patient whose organs are being removed for donor purposes	Brain-dead pt organs removed
PA	0010	7	Surgical or other invasive procedure on wrong body part	Surgery, wrong body part
PB	0010	7	Surgical or other invasive procedure on wrong patient	Surgery, wrong patient
PC	0010	7	Wrong surgery or other invasive procedure on patient	Wrong surgery on patient
PD	0010	7	Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days	Inp admit w/in 3 days
PI	0010	7	Positron emission tomography (pet) or pet/computed tomography (ct) to inform the initial treatment strategy of tumors that are biopsy proven or strongly suspected of being cancerous based on other diagnostic testing	Pet tumor init tx strat
PL	0010	7	Progressive addition lenses	Progressive addition lenses
PM	0010	7	Post mortem	Post mortem
PN	0010	7	Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital	Non-excepted off-campus svc
PO	0010	7	Excepted service provided at an off-campus, outpatient, provider-based department of a hospital	Excepted off-campus service
PS	0010	7	Positron emission tomography (pet) or pet/computed tomography (ct) to inform the subsequent treatment strategy of cancerous tumors when the beneficiary’s treating physician determines that the pet study is needed to inform subsequent anti-tumor strategy	Pet tumor subsq tx strategy
PT	0010	7	Colorectal cancer screening test; converted to diagnostic test or other procedure	Clrctal screen to diagn
Q0	0010	7	Investigational clinical service provided in a clinical research study that is in an approved clinical research study	Invest clinical research
Q1	0010	7	Routine clinical service provided in a clinical research study that is in an approved clinical research study	Routine clinical research
Q2	0010	7	Demonstration procedure/service	Demo procedure, service
Q3	0010	7	Live kidney donor surgery and related services	Live donor surgery/services
Q4	0010	7	Service for ordering/referring physician qualifies as a service exemption	Svc exempt - ordrg/rfrng md
Q5	0010	7	Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area	Recip bill arr subs md or pt
Q6	0010	7	Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area	Fee/time comp subst md or pt
Q7	0010	7	One class a finding	One class a finding
Q8	0010	7	Two class b findings	Two class b findings
Q9	0010	7	One class b and two class c findings	1 class b & 2 class c fndngs
QA	0010	7	Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is less than 1 liter per minute (lpm)	Avg sta day/night o2 < 1 lpm
QB	0010	7	Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts exceeds 4 liters per minute (lpm) and portable oxygen is prescribed	Avg day/nite o2 > 4 lpm/port
QC	0010	7	Single channel monitoring	Single channel monitoring
QD	0010	7	Recording and storage in solid state memory by a digital recorder	Rcrdg/strg in sld st memory
QE	0010	7	Prescribed amount of stationary oxygen while at rest is less than 1 liter per minute (lpm)	Stationary o2 @ rest <1 lpm
QF	0010	7	Prescribed amount of stationary oxygen while at rest exceeds 4 liters per minute (lpm) and portable oxygen is prescribed	Station o2 @ rest >4lpm/port
QG	0010	7	Prescribed amount of stationary oxygen while at rest is greater than 4 liters per minute (lpm)	Station o2 @ rest > 4 lpm
QH	0010	7	Oxygen conserving device is being used with an oxygen delivery system	Oxygen cnsrvg dvc w del sys
QJ	0010	7	Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)	Patient in state/locl custod
QK	0010	7	Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals	Med dir 2-4 cncrnt anes proc
QL	0010	7	Patient pronounced dead after ambulance called	Patient died after amb call
QM	0010	7	Ambulance service provided under arrangement by a provider of services	Ambulance arr by provider
QN	0010	7	Ambulance service furnished directly by a provider of services	Ambulance furn by provider
QP	0010	7	Documentation is on file showing that the laboratory test(s) was ordered individually or ordered as a cpt-recognized panel other than automated profile codes 80002-80019, g0058, g0059, and g0060.	Individually ordered lab tst
QQ	0010	7	Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional	Qualified cdsm consulted
QR	0010	7	Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is greater than 4 liters per minute (lpm)	Avg sta day/night o2 > 4 lpm
QS	0010	7	Monitored anesthesia care service	Monitored anesthesia care
QT	0010	7	Recording and storage on tape by an analog tape recorder	Rcrdg/strg tape analog recdr
QW	0010	7	Clia waived test	Clia waived test
QX	0010	7	Crna service: with medical direction by a physician	Crna svc w/ md med direction
QY	0010	7	Medical direction of one certified registered nurse anesthetist (crna) by an anesthesiologist	Medically directed crna
QZ	0010	7	Crna service: without medical direction by a physician	Crna svc w/o med dir by md
RA	0010	7	Replacement of a dme, orthotic or prosthetic item	Replacement of dme item
RB	0010	7	Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair	Replacement part, dme item
RC	0010	7	Right coronary artery	Right coronary artery
RD	0010	7	Drug provided to beneficiary, but not administered “incident-to”	Drug admin not incident-to
RE	0010	7	Furnished in full compliance with fda-mandated risk evaluation and mitigation strategy (rems)	Furnish full compliance rems
RI	0010	7	Ramus intermedius coronary artery	Ramus intermedius cor artery
RR	0010	7	Rental (use the ‘rr’ modifier when dme is to be rented)	Rental (dme)
RT	0010	7	Right side (used to identify procedures performed on the right side of the body)	Right side
SA	0010	7	Nurse practitioner rendering service in collaboration with a physician	Nurse practitioner w physici
SB	0010	7	Nurse midwife	Nurse midwife
SC	0010	7	Medically necessary service or supply	Medically necessary serv/sup
SD	0010	7	Services provided by registered nurse with specialized, highly technical home infusion training	Serv by home infusion rn
SE	0010	7	State and/or federally-funded programs/services	State/fed funded program/ser
SF	0010	7	Second opinion ordered by a professional review organization (pro) per section 9401, p.l. 99-272 (100% reimbursement - no medicare deductible or coinsurance)	2nd opinion ordered by pro
SG	0010	7	Ambulatory surgical center (asc) facility service	Asc facility service
SH	0010	7	Second concurrently administered infusion therapy	2nd concurrent infusion ther
SJ	0010	7	Third or more concurrently administered infusion therapy	3rd concurrent infusion ther
SK	0010	7	Member of high risk population (use only with codes for immunization)	High risk population
SL	0010	7	State supplied vaccine	State supplied vaccine
SM	0010	7	Second surgical opinion	Second opinion
SN	0010	7	Third surgical opinion	Third opinion
SQ	0010	7	Item ordered by home health	Item ordered by home health
SS	0010	7	Home infusion services provided in the infusion suite of the iv therapy provider	Hit in infusion suite
ST	0010	7	Related to trauma or injury	Related to trauma or injury
SU	0010	7	Procedure performed in physician’s office (to denote use of facility and equipment)	Performed in phys office
SV	0010	7	Pharmaceuticals delivered to patient’s home but not utilized	Drugs delivered not used
SW	0010	7	Services provided by a certified diabetic educator	Serv by cert diab educator
SY	0010	7	Persons who are in close contact with member of high-risk population (use only with codes for immunization)	Contact w/high-risk pop
SZ	0010	7	Habilitative services	Habilitative services
T1	0010	7	Left foot, second digit	Left foot, second digit
T2	0010	7	Left foot, third digit	Left foot, third digit
T3	0010	7	Left foot, fourth digit	Left foot, fourth digit
T4	0010	7	Left foot, fifth digit	Left foot, fifth digit
T5	0010	7	Right foot, great toe	Right foot, great toe
T6	0010	7	Right foot, second digit	Right foot, second digit
T7	0010	7	Right foot, third digit	Right foot, third digit
T8	0010	7	Right foot, fourth digit	Right foot, fourth digit
T9	0010	7	Right foot, fifth digit	Right foot, fifth digit
TA	0010	7	Left foot, great toe	Left foot, great toe
TB	0010	7	Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes	Tracking 340b acquired drug
TC	0010	7	Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier ‘tc’ to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles	Technical component
TD	0010	7	Rn	Rn
TE	0010	7	Lpn/lvn	Lpn/lvn
TF	0010	7	Intermediate level of care	Intermediate level of care
TG	0010	7	Complex/high tech level of care	Complex/high tech level care
TH	0010	7	Obstetrical treatment/services, prenatal or postpartum	Ob tx/srvcs prenatl/postpart
TJ	0010	7	Program group, child and/or adolescent	Child/adolescent program gp
TK	0010	7	Extra patient or passenger, non-ambulance	Extra patient or passenger
TL	0010	7	Early intervention/individualized family service plan (ifsp)	Early intervention ifsp
TM	0010	7	Individualized education program (iep)	Individualized ed prgrm(iep)
TN	0010	7	Rural/outside providers’ customary service area	Rural/out of service area
TP	0010	7	Medical transport, unloaded vehicle	Med transprt unloaded vehicl
TQ	0010	7	Basic life support transport by a volunteer ambulance provider	Bls by volunteer amb providr
TR	0010	7	School-based individualized education program (iep) services provided outside the public school district responsible for the student	School-based iep out of dist
TS	0010	7	Follow-up service	Follow-up service
TT	0010	7	Individualized service provided to more than one patient in same setting	Additional patient
TU	0010	7	Special payment rate, overtime	Overtime payment rate
TV	0010	7	Special payment rates, holidays/weekends	Holiday/weekend payment rate
TW	0010	7	Back-up equipment	Back-up equipment
U1	0010	7	Medicaid level of care 1, as defined by each state	M/caid care lev 1 state def
U2	0010	7	Medicaid level of care 2, as defined by each state	M/caid care lev 2 state def
U3	0010	7	Medicaid level of care 3, as defined by each state	M/caid care lev 3 state def
U4	0010	7	Medicaid level of care 4, as defined by each state	M/caid care lev 4 state def
U5	0010	7	Medicaid level of care 5, as defined by each state	M/caid care lev 5 state def
U6	0010	7	Medicaid level of care 6, as defined by each state	M/caid care lev 6 state def
U7	0010	7	Medicaid level of care 7, as defined by each state	M/caid care lev 7 state def
U8	0010	7	Medicaid level of care 8, as defined by each state	M/caid care lev 8 state def
U9	0010	7	Medicaid level of care 9, as defined by each state	M/caid care lev 9 state def
UA	0010	7	Medicaid level of care 10, as defined by each state	M/caid care lev 10 state def
UB	0010	7	Medicaid level of care 11, as defined by each state	M/caid care lev 11 state def
UC	0010	7	Medicaid level of care 12, as defined by each state	M/caid care lev 12 state def
UD	0010	7	Medicaid level of care 13, as defined by each state	M/caid care lev 13 state def
UE	0010	7	Used durable medical equipment	Used durable med equipment
UF	0010	7	Services provided in the morning	Services provided, morning
UG	0010	7	Services provided in the afternoon	Services provided, afternoon
UH	0010	7	Services provided in the evening	Services provided, evening
UJ	0010	7	Services provided at night	Services provided, night
UK	0010	7	Services provided on behalf of the client to someone other than the client (collateral relationship)	Svc on behalf client-collat
UN	0010	7	Two patients served	Two patients served
UP	0010	7	Three patients served	Three patients served
UQ	0010	7	Four patients served	Four patients served
UR	0010	7	Five patients served	Five patients served
US	0010	7	Six or more patients served	Six or more patients served
V1	0010	7	Demonstration modifier 1	Demonstration modifier 1
V2	0010	7	Demonstration modifier 2	Demonstration modifier 2
V3	0010	7	Demonstration modifier 3	Demonstration modifier 3
V5	0010	7	Vascular catheter (alone or with any other vascular access)	Vascular catheter
V6	0010	7	Arteriovenous graft (or other vascular access not including a vascular catheter)	Arteriovenous graft
V7	0010	7	Arteriovenous fistula only (in use with two needles)	Arteriovenous fistula
V8	0010	7	Infection present	Infection present
V9	0010	7	No infection present	No infection present
VM	0010	7	Medicare diabetes prevention program (mdpp) virtual make-up session	Mdpp virtual make-up session
VP	0010	7	Aphakic patient	Aphakic patient
X1	0010	7	Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care	Continuous/broad services
X2	0010	7	Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient’s rheumatoid arthritis longitudinally but not providing general primary care services	Continuous/focused services
X3	0010	7	Episodic/broad servies: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist’s services rendered providing comprehensive and general care to a patient while admitted to the hospital	Episodic/broad services
X4	0010	7	Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period	Episodic/focused services
X5	0010	7	Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist’s interpretation of an imaging study requested by another clinician	Svc req by another clinician
XE	0010	7	Separate encounter, a service that is distinct because it occurred during a separate encounter	Separate encounter
XP	0010	7	Separate practitioner, a service that is distinct because it was performed by a different practitioner	Separate practitioner
XS	0010	7	Separate structure, a service that is distinct because it was performed on a separate organ/structure	Separate organ/structure
XU	0010	7	Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service	Unusual separate service
ZA	0010	7	Novartis/sandoz	Novartis/sandoz
ZB	0010	7	Pfizer/hospira	Pfizer/hospira
ZC	0010	7	Merck/samsung bioepis	Merck/samsung bioepis

A0000–A9999: Transportation Services, Including Ambulance Medical and Surgical Supplies

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
A0021	0010	3	Ambulance service, outside state per mile, transport (medicaid only)	Outside state ambulance serv
A0080	0010	3	Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest	Noninterest escort in non er
A0090	0010	3	Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest	Interest escort in non er
A0100	0010	3	Non-emergency transportation; taxi	Nonemergency transport taxi
A0110	0010	3	Non-emergency transportation and bus, intra or inter state carrier	Nonemergency transport bus
A0120	0010	3	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems	Noner transport mini-bus
A0130	0010	3	Non-emergency transportation: wheelchair van	Noner transport wheelch van
A0140	0010	3	Non-emergency transportation and air travel (private or commercial) intra or inter state	Nonemergency transport air
A0160	0010	3	Non-emergency transportation: per mile - case worker or social worker	Noner transport case worker
A0170	0010	3	Transportation ancillary: parking fees, tolls, other	Transport parking fees/tolls
A0180	0010	3	Non-emergency transportation: ancillary: lodging-recipient	Noner transport lodgng recip
A0190	0010	3	Non-emergency transportation: ancillary: meals-recipient	Noner transport meals recip
A0200	0010	3	Non-emergency transportation: ancillary: lodging escort	Noner transport lodgng escrt
A0210	0010	3	Non-emergency transportation: ancillary: meals-escort	Noner transport meals escort
A0225	0010	3	Ambulance service, neonatal transport, base rate, emergency transport, one way	Neonatal emergency transport
A0380	0010	3	Bls mileage (per mile)	Basic life support mileage
A0382	0010	3	Bls routine disposable supplies	Basic support routine suppls
A0384	0010	3	Bls specialized service disposable supplies; defibrillation (used by als ambulances and bls ambulances in jurisdictions where defibrillation is permitted in bls ambulances)	Bls defibrillation supplies
A0390	0010	3	Als mileage (per mile)	Advanced life support mileag
A0392	0010	3	Als specialized service disposable supplies; defibrillation (to be used only in jurisdictions where defibrillation cannot be performed in bls ambulances)	Als defibrillation supplies
A0394	0010	3	Als specialized service disposable supplies; iv drug therapy	Als iv drug therapy supplies
A0396	0010	3	Als specialized service disposable supplies; esophageal intubation	Als esophageal intub suppls
A0398	0010	3	Als routine disposable supplies	Als routine disposble suppls
A0420	0010	3	Ambulance waiting time (als or bls), one half (1/2) hour increments	Ambulance waiting 1/2 hr
A0422	0010	3	Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation	Ambulance 02 life sustaining
A0424	0010	3	Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review)	Extra ambulance attendant
A0425	0010	3	Ground mileage, per statute mile	Ground mileage
A0426	0010	3	Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)	Als 1
A0427	0010	3	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	Als1-emergency
A0428	0010	3	Ambulance service, basic life support, non-emergency transport, (bls)	Bls
A0429	0010	3	Ambulance service, basic life support, emergency transport (bls-emergency)	Bls-emergency
A0430	0010	3	Ambulance service, conventional air services, transport, one way (fixed wing)	Fixed wing air transport
A0431	0010	3	Ambulance service, conventional air services, transport, one way (rotary wing)	Rotary wing air transport
A0432	0010	3	Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers	Pi volunteer ambulance co
A0433	0010	3	Advanced life support, level 2 (als 2)	Als 2
A0434	0010	3	Specialty care transport (sct)	Specialty care transport
A0435	0010	3	Fixed wing air mileage, per statute mile	Fixed wing air mileage
A0436	0010	3	Rotary wing air mileage, per statute mile	Rotary wing air mileage
A0888	0010	3	Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility)	Noncovered ambulance mileage
A0998	0010	3	Ambulance response and treatment, no transport	Ambulance response/treatment
A0999	0010	3	Unlisted ambulance service	Unlisted ambulance service
A4206	0010	3	Syringe with needle, sterile, 1 cc or less, each	1 cc sterile syringe&needle
A4207	0010	3	Syringe with needle, sterile 2 cc, each	2 cc sterile syringe&needle
A4208	0010	3	Syringe with needle, sterile 3 cc, each	3 cc sterile syringe&needle
A4209	0010	3	Syringe with needle, sterile 5 cc or greater, each	5+ cc sterile syringe&needle
A4210	0010	3	Needle-free injection device, each	Nonneedle injection device
A4211	0010	3	Supplies for self-administered injections	Supp for self-adm injections
A4212	0010	3	Non-coring needle or stylet with or without catheter	Non coring needle or stylet
A4213	0010	3	Syringe, sterile, 20 cc or greater, each	20+ cc syringe only
A4215	0010	3	Needle, sterile, any size, each	Sterile needle
A4216	0010	3	Sterile water, saline and/or dextrose, diluent/flush, 10 ml	Sterile water/saline, 10 ml
A4217	0010	3	Sterile water/saline, 500 ml	Sterile water/saline, 500 ml
A4218	0010	3	Sterile saline or water, metered dose dispenser, 10 ml	Sterile saline or water
A4220	0010	3	Refill kit for implantable infusion pump	Infusion pump refill kit
A4221	0010	3	Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)	Supp non-insulin inf cath/wk
A4222	0010	3	Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)	Infusion supplies with pump
A4223	0010	3	Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)	Infusion supplies w/o pump
A4224	0010	3	Supplies for maintenance of insulin infusion catheter, per week	Supply insulin inf cath/wk
A4225	0010	3	Supplies for external insulin infusion pump, syringe type cartridge, sterile, each	Sup/ext insulin inf pump syr
A4226	0010	3	Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week	Weekly supply maint cgs pump
A4230	0010	3	Infusion set for external insulin pump, non needle cannula type	Infus insulin pump non needl
A4231	0010	3	Infusion set for external insulin pump, needle type	Infusion insulin pump needle
A4232	0010	3	Syringe with needle for external insulin pump, sterile, 3 cc	Syringe w/needle insulin 3cc
A4233	0010	3	Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each	Alkalin batt for glucose mon
A4234	0010	3	Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each	J-cell batt for glucose mon
A4235	0010	3	Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each	Lithium batt for glucose mon
A4236	0010	3	Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each	Silvr oxide batt glucose mon
A4244	0010	3	Alcohol or peroxide, per pint	Alcohol or peroxide per pint
A4245	0010	3	Alcohol wipes, per box	Alcohol wipes per box
A4246	0010	3	Betadine or phisohex solution, per pint	Betadine/phisohex solution
A4247	0010	3	Betadine or iodine swabs/wipes, per box	Betadine/iodine swabs/wipes
A4248	0010	3	Chlorhexidine containing antiseptic, 1 ml	Chlorhexidine antisept
A4250	0010	3	Urine test or reagent strips or tablets (100 tablets or strips)	Urine reagent strips/tablets
A4252	0010	3	Blood ketone test or reagent strip, each	Blood ketone test or strip
A4253	0010	3	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	Blood glucose/reagent strips
A4255	0010	3	Platforms for home blood glucose monitor, 50 per box	Glucose monitor platforms
A4256	0010	3	Normal, low and high calibrator solution / chips	Calibrator solution/chips
A4257	0010	3	Replacement lens shield cartridge for use with laser skin piercing device, each	Replace lensshield cartridge
A4258	0010	3	Spring-powered device for lancet, each	Lancet device each
A4259	0010	3	Lancets, per box of 100	Lancets per box
A4261	0010	3	Cervical cap for contraceptive use	Cervical cap contraceptive
A4262	0010	3	Temporary, absorbable lacrimal duct implant, each	Temporary tear duct plug
A4263	0010	3	Permanent, long term, non-dissolvable lacrimal duct implant, each	Permanent tear duct plug
A4264	0010	3	Permanent implantable contraceptive intratubal occlusion device(s) and delivery system	Intratubal occlusion device
A4265	0010	3	Paraffin, per pound	Paraffin
A4266	0010	3	Diaphragm for contraceptive use	Diaphragm
A4267	0010	3	Contraceptive supply, condom, male, each	Male condom
A4268	0010	3	Contraceptive supply, condom, female, each	Female condom
A4269	0010	3	Contraceptive supply, spermicide (e.g., foam, gel), each	Spermicide
A4270	0010	3	Disposable endoscope sheath, each	Disposable endoscope sheath
A4280	0010	3	Adhesive skin support attachment for use with external breast prosthesis, each	Brst prsths adhsv attchmnt
A4281	0010	3	Tubing for breast pump, replacement	Replacement breastpump tube
A4282	0010	3	Adapter for breast pump, replacement	Replacement breastpump adpt
A4283	0010	3	Cap for breast pump bottle, replacement	Replacement breastpump cap
A4284	0010	3	Breast shield and splash protector for use with breast pump, replacement	Replcmnt breast pump shield
A4285	0010	3	Polycarbonate bottle for use with breast pump, replacement	Replcmnt breast pump bottle
A4286	0010	3	Locking ring for breast pump, replacement	Replcmnt breastpump lok ring
A4290	0010	3	Sacral nerve stimulation test lead, each	Sacral nerve stim test lead
A4300	0010	3	Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access	Cath impl vasc access portal
A4301	0010	3	Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)	Implantable access syst perc
A4305	0010	3	Disposable drug delivery system, flow rate of 50 ml or greater per hour	Drug delivery system >=50 ml
A4306	0010	3	Disposable drug delivery system, flow rate of less than 50 ml per hour	Drug delivery system <=50 ml
A4310	0010	3	Insertion tray without drainage bag and without catheter (accessories only)	Insert tray w/o bag/cath
A4311	0010	3	Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)	Catheter w/o bag 2-way latex
A4312	0010	3	Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone	Cath w/o bag 2-way silicone
A4313	0010	3	Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation	Catheter w/bag 3-way
A4314	0010	3	Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)	Cath w/drainage 2-way latex
A4315	0010	3	Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone	Cath w/drainage 2-way silcne
A4316	0010	3	Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation	Cath w/drainage 3-way
A4320	0010	3	Irrigation tray with bulb or piston syringe, any purpose	Irrigation tray
A4321	0010	3	Therapeutic agent for urinary catheter irrigation	Cath therapeutic irrig agent
A4322	0010	3	Irrigation syringe, bulb or piston, each	Irrigation syringe
A4326	0010	3	Male external catheter with integral collection chamber, any type, each	Male external catheter
A4327	0010	3	Female external urinary collection device; meatal cup, each	Fem urinary collect dev cup
A4328	0010	3	Female external urinary collection device; pouch, each	Fem urinary collect pouch
A4330	0010	3	Perianal fecal collection pouch with adhesive, each	Stool collection pouch
A4331	0010	3	Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each	Extension drainage tubing
A4332	0010	3	Lubricant, individual sterile packet, each	Lube sterile packet
A4333	0010	3	Urinary catheter anchoring device, adhesive skin attachment, each	Urinary cath anchor device
A4334	0010	3	Urinary catheter anchoring device, leg strap, each	Urinary cath leg strap
A4335	0010	3	Incontinence supply; miscellaneous	Incontinence supply
A4336	0010	3	Incontinence supply, urethral insert, any type, each	Urethral insert
A4337	0010	3	Incontinence supply, rectal insert, any type, each	Incontinent rectal insert
A4338	0010	3	Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each	Indwelling catheter latex
A4340	0010	3	Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each	Indwelling catheter special
A4344	0010	3	Indwelling catheter, foley type, two-way, all silicone, each	Cath indw foley 2 way silicn
A4346	0010	3	Indwelling catheter; foley type, three way for continuous irrigation, each	Cath indw foley 3 way
A4349	0010	3	Male external catheter, with or without adhesive, disposable, each	Disposable male external cat
A4351	0010	3	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each	Straight tip urine catheter
A4352	0010	3	Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each	Coude tip urinary catheter
A4353	0010	3	Intermittent urinary catheter, with insertion supplies	Intermittent urinary cath
A4354	0010	3	Insertion tray with drainage bag but without catheter	Cath insertion tray w/bag
A4355	0010	3	Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each	Bladder irrigation tubing
A4356	0010	3	External urethral clamp or compression device (not to be used for catheter clamp), each	Ext ureth clmp or compr dvc
A4357	0010	3	Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each	Bedside drainage bag
A4358	0010	3	Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each	Urinary leg or abdomen bag
A4360	0010	3	Disposable external urethral clamp or compression device, with pad and/or pouch, each	Disposable ext urethral dev
A4361	0010	3	Ostomy faceplate, each	Ostomy face plate
A4362	0010	3	Skin barrier; solid, 4 x 4 or equivalent; each	Solid skin barrier
A4363	0010	3	Ostomy clamp, any type, replacement only, each	Ostomy clamp, replacement
A4364	0010	3	Adhesive, liquid or equal, any type, per oz	Adhesive, liquid or equal
A4366	0010	3	Ostomy vent, any type, each	Ostomy vent
A4367	0010	3	Ostomy belt, each	Ostomy belt
A4368	0010	3	Ostomy filter, any type, each	Ostomy filter
A4369	0010	3	Ostomy skin barrier, liquid (spray, brush, etc.), per oz	Skin barrier liquid per oz
A4371	0010	3	Ostomy skin barrier, powder, per oz	Skin barrier powder per oz
A4372	0010	3	Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each	Skin barrier solid 4x4 equiv
A4373	0010	3	Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each	Skin barrier with flange
A4375	0010	3	Ostomy pouch, drainable, with faceplate attached, plastic, each	Drainable plastic pch w fcpl
A4376	0010	3	Ostomy pouch, drainable, with faceplate attached, rubber, each	Drainable rubber pch w fcplt
A4377	0010	3	Ostomy pouch, drainable, for use on faceplate, plastic, each	Drainable plstic pch w/o fp
A4378	0010	3	Ostomy pouch, drainable, for use on faceplate, rubber, each	Drainable rubber pch w/o fp
A4379	0010	3	Ostomy pouch, urinary, with faceplate attached, plastic, each	Urinary plastic pouch w fcpl
A4380	0010	3	Ostomy pouch, urinary, with faceplate attached, rubber, each	Urinary rubber pouch w fcplt
A4381	0010	3	Ostomy pouch, urinary, for use on faceplate, plastic, each	Urinary plastic pouch w/o fp
A4382	0010	3	Ostomy pouch, urinary, for use on faceplate, heavy plastic, each	Urinary hvy plstc pch w/o fp
A4383	0010	3	Ostomy pouch, urinary, for use on faceplate, rubber, each	Urinary rubber pouch w/o fp
A4384	0010	3	Ostomy faceplate equivalent, silicone ring, each	Ostomy faceplt/silicone ring
A4385	0010	3	Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each	Ost skn barrier sld ext wear
A4387	0010	3	Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each	Ost clsd pouch w att st barr
A4388	0010	3	Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each	Drainable pch w ex wear barr
A4389	0010	3	Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each	Drainable pch w st wear barr
A4390	0010	3	Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each	Drainable pch ex wear convex
A4391	0010	3	Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each	Urinary pouch w ex wear barr
A4392	0010	3	Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each	Urinary pouch w st wear barr
A4393	0010	3	Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each	Urine pch w ex wear bar conv
A4394	0010	3	Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce	Ostomy pouch liq deodorant
A4395	0010	3	Ostomy deodorant for use in ostomy pouch, solid, per tablet	Ostomy pouch solid deodorant
A4396	0010	3	Ostomy belt with peristomal hernia support	Peristomal hernia supprt blt
A4397	0010	3	Irrigation supply; sleeve, each	Irrigation supply sleeve
A4398	0010	3	Ostomy irrigation supply; bag, each	Ostomy irrigation bag
A4399	0010	3	Ostomy irrigation supply; cone/catheter, with or without brush	Ostomy irrig cone/cath w brs
A4400	0010	3	Ostomy irrigation set	Ostomy irrigation set
A4402	0010	3	Lubricant, per ounce	Lubricant per ounce
A4404	0010	3	Ostomy ring, each	Ostomy ring each
A4405	0010	3	Ostomy skin barrier, non-pectin based, paste, per ounce	Nonpectin based ostomy paste
A4406	0010	3	Ostomy skin barrier, pectin-based, paste, per ounce	Pectin based ostomy paste
A4407	0010	3	Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each	Ext wear ost skn barr <=4sq"
A4408	0010	3	Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each	Ext wear ost skn barr >4sq"
A4409	0010	3	Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each	Ost skn barr convex <=4 sq i
A4410	0010	3	Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each	Ost skn barr extnd >4 sq
A4411	0010	3	Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each	Ost skn barr extnd =4sq
A4412	0010	3	Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each	Ost pouch drain high output
A4413	0010	3	Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each	2 pc drainable ost pouch
A4414	0010	3	Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each	Ost sknbar w/o conv<=4 sq in
A4415	0010	3	Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each	Ost skn barr w/o conv >4 sqi
A4416	0010	3	Ostomy pouch, closed, with barrier attached, with filter (1 piece), each	Ost pch clsd w barrier/filtr
A4417	0010	3	Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each	Ost pch w bar/bltinconv/fltr
A4418	0010	3	Ostomy pouch, closed; without barrier attached, with filter (1 piece), each	Ost pch clsd w/o bar w filtr
A4419	0010	3	Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each	Ost pch for bar w flange/flt
A4420	0010	3	Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each	Ost pch clsd for bar w lk fl
A4421	0010	3	Ostomy supply; miscellaneous	Ostomy supply misc
A4422	0010	3	Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each	Ost pouch absorbent material
A4423	0010	3	Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each	Ost pch for bar w lk fl/fltr
A4424	0010	3	Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each	Ost pch drain w bar & filter
A4425	0010	3	Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each	Ost pch drain for barrier fl
A4426	0010	3	Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each	Ost pch drain 2 piece system
A4427	0010	3	Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each	Ost pch drain/barr lk flng/f
A4428	0010	3	Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each	Urine ost pouch w faucet/tap
A4429	0010	3	Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each	Urine ost pouch w bltinconv
A4430	0010	3	Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each	Ost urine pch w b/bltin conv
A4431	0010	3	Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each	Ost pch urine w barrier/tapv
A4432	0010	3	Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each	Os pch urine w bar/fange/tap
A4433	0010	3	Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each	Urine ost pch bar w lock fln
A4434	0010	3	Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each	Ost pch urine w lock flng/ft
A4435	0010	3	Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each	1pc ost pch drain hgh output
A4450	0010	3	Tape, non-waterproof, per 18 square inches	Non-waterproof tape
A4452	0010	3	Tape, waterproof, per 18 square inches	Waterproof tape
A4455	0010	3	Adhesive remover or solvent (for tape, cement or other adhesive), per ounce	Adhesive remover per ounce
A4456	0010	3	Adhesive remover, wipes, any type, each	Adhesive remover, wipes
A4458	0010	3	Enema bag with tubing, reusable	Reusable enema bag
A4459	0010	3	Manual pump-operated enema system, includes balloon, catheter and all accessories, reusable, any type	Manual pump enema, reusable
A4461	0010	3	Surgical dressing holder, non-reusable, each	Surgicl dress hold non-reuse
A4463	0010	3	Surgical dressing holder, reusable, each	Surgical dress holder reuse
A4465	0010	3	Non-elastic binder for extremity	Non-elastic extremity binder
A4466	0010	3	Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, each	Elastic garment/covering
A4467	0010	3	Belt, strap, sleeve, garment, or covering, any type	Belt strap sleev grmnt cover
A4470	0010	3	Gravlee jet washer	Gravlee jet washer
A4480	0010	3	Vabra aspirator	Vabra aspirator
A4481	0010	3	Tracheostoma filter, any type, any size, each	Tracheostoma filter
A4483	0010	3	Moisture exchanger, disposable, for use with invasive mechanical ventilation	Moisture exchanger
A4490	0010	3	Surgical stockings above knee length, each	Above knee surgical stocking
A4495	0010	3	Surgical stockings thigh length, each	Thigh length surg stocking
A4500	0010	3	Surgical stockings below knee length, each	Below knee surgical stocking
A4510	0010	3	Surgical stockings full length, each	Full length surg stocking
A4520	0010	3	Incontinence garment, any type, (e.g., brief, diaper), each	Incontinence garment anytype
A4550	0010	3	Surgical trays	Surgical trays
A4553	0010	3	Non-disposable underpads, all sizes	Nondisp underpads, all sizes
A4554	0010	3	Disposable underpads, all sizes	Disposable underpads
A4555	0010	3	Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only	Ca tx e-stim electr/transduc
A4556	0010	3	Electrodes, (e.g., apnea monitor), per pair	Electrodes, pair
A4557	0010	3	Lead wires, (e.g., apnea monitor), per pair	Lead wires, pair
A4558	0010	3	Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz	Conductive gel or paste
A4559	0010	3	Coupling gel or paste, for use with ultrasound device, per oz	Coupling gel or paste
A4561	0010	3	Pessary, rubber, any type	Pessary rubber, any type
A4562	0010	3	Pessary, non rubber, any type	Pessary, non rubber,any type
A4563	0010	3	Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each	Vag inser rectal control sys
A4565	0010	3	Slings	Slings
A4566	0010	3	Shoulder sling or vest design, abduction restrainer, with or without swathe control, prefabricated, includes fitting and adjustment	Should sling/vest/abrestrain
A4570	0010	3	Splint	Splint
A4575	0010	3	Topical hyperbaric oxygen chamber, disposable	Hyperbaric o2 chamber disps
A4580	0010	3	Cast supplies (e.g., plaster)	Cast supplies (plaster)
A4590	0010	3	Special casting material (e.g., fiberglass)	Special casting material
A4595	0010	3	Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)	Tens suppl 2 lead per month
A4600	0010	3	Sleeve for intermittent limb compression device, replacement only, each	Sleeve, inter limb comp dev
A4601	0010	3	Lithium ion battery, rechargeable, for non-prosthetic use, replacement	Lith ion non prosth recharge
A4602	0010	3	Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each	Replace lithium battery 1.5v
A4604	0010	3	Tubing with integrated heating element for use with positive airway pressure device	Tubing with heating element
A4605	0010	3	Tracheal suction catheter, closed system, each	Trach suction cath close sys
A4606	0010	3	Oxygen probe for use with oximeter device, replacement	Oxygen probe used w oximeter
A4608	0010	3	Transtracheal oxygen catheter, each	Transtracheal oxygen cath
A4611	0010	3	Battery, heavy duty; replacement for patient owned ventilator	Heavy duty battery
A4612	0010	3	Battery cables; replacement for patient-owned ventilator	Battery cables
A4613	0010	3	Battery charger; replacement for patient-owned ventilator	Battery charger
A4614	0010	3	Peak expiratory flow rate meter, hand held	Hand-held pefr meter
A4615	0010	3	Cannula, nasal	Cannula nasal
A4616	0010	3	Tubing (oxygen), per foot	Tubing (oxygen) per foot
A4617	0010	3	Mouth piece	Mouth piece
A4618	0010	3	Breathing circuits	Breathing circuits
A4619	0010	3	Face tent	Face tent
A4620	0010	3	Variable concentration mask	Variable concentration mask
A4623	0010	3	Tracheostomy, inner cannula	Tracheostomy inner cannula
A4624	0010	3	Tracheal suction catheter, any type other than closed system, each	Tracheal suction tube
A4625	0010	3	Tracheostomy care kit for new tracheostomy	Trach care kit for new trach
A4626	0010	3	Tracheostomy cleaning brush, each	Tracheostomy cleaning brush
A4627	0010	3	Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler	Spacer bag/reservoir
A4628	0010	3	Oropharyngeal suction catheter, each	Oropharyngeal suction cath
A4629	0010	3	Tracheostomy care kit for established tracheostomy	Tracheostomy care kit
A4630	0010	3	Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient	Repl bat t.e.n.s. own by pt
A4633	0010	3	Replacement bulb/lamp for ultraviolet light therapy system, each	Uvl replacement bulb
A4634	0010	3	Replacement bulb for therapeutic light box, tabletop model	Replacement bulb th lightbox
A4635	0010	3	Underarm pad, crutch, replacement, each	Underarm crutch pad
A4636	0010	3	Replacement, handgrip, cane, crutch, or walker, each	Handgrip for cane etc
A4637	0010	3	Replacement, tip, cane, crutch, walker, each.	Repl tip cane/crutch/walker
A4638	0010	3	Replacement battery for patient-owned ear pulse generator, each	Repl batt pulse gen sys
A4639	0010	3	Replacement pad for infrared heating pad system, each	Infrared ht sys replcmnt pad
A4640	0010	3	Replacement pad for use with medically necessary alternating pressure pad owned by patient	Alternating pressure pad
A4641	0010	3	Radiopharmaceutical, diagnostic, not otherwise classified	Radiopharm dx agent noc
A4642	0010	3	Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries	In111 satumomab
A4648	0010	3	Tissue marker, implantable, any type, each	Implantable tissue marker
A4649	0010	3	Surgical supply; miscellaneous	Surgical supplies
A4650	0010	3	Implantable radiation dosimeter, each	Implant radiation dosimeter
A4651	0010	3	Calibrated microcapillary tube, each	Calibrated microcap tube
A4652	0010	3	Microcapillary tube sealant	Microcapillary tube sealant
A4653	0010	3	Peritoneal dialysis catheter anchoring device, belt, each	Pd catheter anchor belt
A4657	0010	3	Syringe, with or without needle, each	Syringe w/wo needle
A4660	0010	3	Sphygmomanometer/blood pressure apparatus with cuff and stethoscope	Sphyg/bp app w cuff and stet
A4663	0010	3	Blood pressure cuff only	Dialysis blood pressure cuff
A4670	0010	3	Automatic blood pressure monitor	Automatic bp monitor, dial
A4671	0010	3	Disposable cycler set used with cycler dialysis machine, each	Disposable cycler set
A4672	0010	3	Drainage extension line, sterile, for dialysis, each	Drainage ext line, dialysis
A4673	0010	3	Extension line with easy lock connectors, used with dialysis	Ext line w easy lock connect
A4674	0010	3	Chemicals/antiseptics solution used to clean/sterilize dialysis equipment, per 8 oz	Chem/antisept solution, 8oz
A4680	0010	3	Activated carbon filter for hemodialysis, each	Activated carbon filter, ea
A4690	0010	3	Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each	Dialyzer, each
A4706	0010	3	Bicarbonate concentrate, solution, for hemodialysis, per gallon	Bicarbonate conc sol per gal
A4707	0010	3	Bicarbonate concentrate, powder, for hemodialysis, per packet	Bicarbonate conc pow per pac
A4708	0010	3	Acetate concentrate solution, for hemodialysis, per gallon	Acetate conc sol per gallon
A4709	0010	3	Acid concentrate, solution, for hemodialysis, per gallon	Acid conc sol per gallon
A4714	0010	3	Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon	Treated water per gallon
A4719	0010	3	“y set” tubing for peritoneal dialysis	“y set” tubing
A4720	0010	3	Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis	Dialysat sol fld vol > 249cc
A4721	0010	3	Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis	Dialysat sol fld vol > 999cc
A4722	0010	3	Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis	Dialys sol fld vol > 1999cc
A4723	0010	3	Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis	Dialys sol fld vol > 2999cc
A4724	0010	3	Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysis	Dialys sol fld vol > 3999cc
A4725	0010	3	Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis	Dialys sol fld vol > 4999cc
A4726	0010	3	Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis	Dialys sol fld vol > 5999cc
A4728	0010	3	Dialysate solution, non-dextrose containing, 500 ml	Dialysate solution, non-dex
A4730	0010	3	Fistula cannulation set for hemodialysis, each	Fistula cannulation set, ea
A4736	0010	3	Topical anesthetic, for dialysis, per gram	Topical anesthetic, per gram
A4737	0010	3	Injectable anesthetic, for dialysis, per 10 ml	Inj anesthetic per 10 ml
A4740	0010	3	Shunt accessory, for hemodialysis, any type, each	Shunt accessory
A4750	0010	3	Blood tubing, arterial or venous, for hemodialysis, each	Art or venous blood tubing
A4755	0010	3	Blood tubing, arterial and venous combined, for hemodialysis, each	Comb art/venous blood tubing
A4760	0010	3	Dialysate solution test kit, for peritoneal dialysis, any type, each	Dialysate sol test kit, each
A4765	0010	3	Dialysate concentrate, powder, additive for peritoneal dialysis, per packet	Dialysate conc pow per pack
A4766	0010	3	Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml	Dialysate conc sol add 10 ml
A4770	0010	3	Blood collection tube, vacuum, for dialysis, per 50	Blood collection tube/vacuum
A4771	0010	3	Serum clotting time tube, for dialysis, per 50	Serum clotting time tube
A4772	0010	3	Blood glucose test strips, for dialysis, per 50	Blood glucose test strips
A4773	0010	3	Occult blood test strips, for dialysis, per 50	Occult blood test strips
A4774	0010	3	Ammonia test strips, for dialysis, per 50	Ammonia test strips
A4802	0010	3	Protamine sulfate, for hemodialysis, per 50 mg	Protamine sulfate per 50 mg
A4860	0010	3	Disposable catheter tips for peritoneal dialysis, per 10	Disposable catheter tips
A4870	0010	3	Plumbing and/or electrical work for home hemodialysis equipment	Plumb/elec wk hm hemo equip
A4890	0010	3	Contracts, repair and maintenance, for hemodialysis equipment	Repair/maint cont hemo equip
A4911	0010	3	Drain bag/bottle, for dialysis, each	Drain bag/bottle
A4913	0010	3	Miscellaneous dialysis supplies, not otherwise specified	Misc dialysis supplies noc
A4918	0010	3	Venous pressure clamp, for hemodialysis, each	Venous pressure clamp
A4927	0010	3	Gloves, non-sterile, per 100	Non-sterile gloves
A4928	0010	3	Surgical mask, per 20	Surgical mask
A4929	0010	3	Tourniquet for dialysis, each	Tourniquet for dialysis, ea
A4930	0010	3	Gloves, sterile, per pair	Sterile, gloves per pair
A4931	0010	3	Oral thermometer, reusable, any type, each	Reusable oral thermometer
A4932	0010	3	Rectal thermometer, reusable, any type, each	Reusable rectal thermometer
A5051	0010	3	Ostomy pouch, closed; with barrier attached (1 piece), each	Pouch clsd w barr attached
A5052	0010	3	Ostomy pouch, closed; without barrier attached (1 piece), each	Clsd ostomy pouch w/o barr
A5053	0010	3	Ostomy pouch, closed; for use on faceplate, each	Clsd ostomy pouch faceplate
A5054	0010	3	Ostomy pouch, closed; for use on barrier with flange (2 piece), each	Clsd ostomy pouch w/flange
A5055	0010	3	Stoma cap	Stoma cap
A5056	0010	3	Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each	1 pc ost pouch w filter
A5057	0010	3	Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each	1 pc ost pou w built-in conv
A5061	0010	3	Ostomy pouch, drainable; with barrier attached, (1 piece), each	Pouch drainable w barrier at
A5062	0010	3	Ostomy pouch, drainable; without barrier attached (1 piece), each	Drnble ostomy pouch w/o barr
A5063	0010	3	Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each	Drain ostomy pouch w/flange
A5071	0010	3	Ostomy pouch, urinary; with barrier attached (1 piece), each	Urinary pouch w/barrier
A5072	0010	3	Ostomy pouch, urinary; without barrier attached (1 piece), each	Urinary pouch w/o barrier
A5073	0010	3	Ostomy pouch, urinary; for use on barrier with flange (2 piece), each	Urinary pouch on barr w/flng
A5081	0010	3	Stoma plug or seal, any type	Stoma plug or seal, any type
A5082	0010	3	Continent device; catheter for continent stoma	Continent stoma catheter
A5083	0010	3	Continent device, stoma absorptive cover for continent stoma	Stoma absorptive cover
A5093	0010	3	Ostomy accessory; convex insert	Ostomy accessory convex inse
A5102	0010	3	Bedside drainage bottle with or without tubing, rigid or expandable, each	Bedside drain btl w/wo tube
A5105	0010	3	Urinary suspensory with leg bag, with or without tube, each	Urinary suspensory
A5112	0010	3	Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each	Urinary leg bag
A5113	0010	3	Leg strap; latex, replacement only, per set	Latex leg strap
A5114	0010	3	Leg strap; foam or fabric, replacement only, per set	Foam/fabric leg strap
A5120	0010	3	Skin barrier, wipes or swabs, each	Skin barrier, wipe or swab
A5121	0010	3	Skin barrier; solid, 6 x 6 or equivalent, each	Solid skin barrier 6x6
A5122	0010	3	Skin barrier; solid, 8 x 8 or equivalent, each	Solid skin barrier 8x8
A5126	0010	3	Adhesive or non-adhesive; disk or foam pad	Disk/foam pad +or- adhesive
A5131	0010	3	Appliance cleaner, incontinence and ostomy appliances, per 16 oz.	Appliance cleaner
A5200	0010	3	Percutaneous catheter/tube anchoring device, adhesive skin attachment	Percutaneous catheter anchor
A5500	0010	3	For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe	Diab shoe for density insert
A5501	0010	3	For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient’s foot (custom molded shoe), per shoe	Diabetic custom molded shoe
A5503	0010	3	For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe	Diabetic shoe w/roller/rockr
A5504	0010	3	For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe	Diabetic shoe with wedge
A5505	0010	3	For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe	Diab shoe w/metatarsal bar
A5506	0010	3	For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe	Diabetic shoe w/off set heel
A5507	0010	3	For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe	Modification diabetic shoe
A5508	0010	3	For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe	Diabetic deluxe shoe
A5510	0010	3	For diabetics only, direct formed, compression molded to patient’s foot without external heat source, multiple-density insert(s) prefabricated, per shoe	Compression form shoe insert
A5512	0010	3	For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient’s foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each	Multi den insert direct form
A5513	0010	3	For diabetics only, multiple density insert, custom molded from model of patient’s foot, total contact with patient’s foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each	Multi den insert custom mold
A5514	0010	3	For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient’s foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each	Mult den insert dir carv/cam
A6000	0010	3	Non-contact wound warming wound cover for use with the non-contact wound warming device and warming card	Wound warming wound cover
A6010	0010	3	Collagen based wound filler, dry form, sterile, per gram of collagen	Collagen based wound filler
A6011	0010	3	Collagen based wound filler, gel/paste, per gram of collagen	Collagen gel/paste wound fil
A6021	0010	3	Collagen dressing, sterile, size 16 sq. in. or less, each	Collagen dressing <=16 sq in
A6022	0010	3	Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each	Collagen drsg>16<=48 sq in
A6023	0010	3	Collagen dressing, sterile, size more than 48 sq. in., each	Collagen dressing >48 sq in
A6024	0010	3	Collagen dressing wound filler, sterile, per 6 inches	Collagen dsg wound filler
A6025	0010	3	Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each	Silicone gel sheet, each
A6154	0010	3	Wound pouch, each	Wound pouch each
A6196	0010	3	Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing	Alginate dressing <=16 sq in
A6197	0010	3	Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing	Alginate drsg >16 <=48 sq in
A6198	0010	3	Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing	Alginate dressing > 48 sq in
A6199	0010	3	Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches	Alginate drsg wound filler
A6203	0010	3	Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing	Composite drsg <= 16 sq in
A6204	0010	3	Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing	Composite drsg >16<=48 sq in
A6205	0010	3	Composite dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing	Composite drsg > 48 sq in
A6206	0010	3	Contact layer, sterile, 16 sq. in. or less, each dressing	Contact layer <= 16 sq in
A6207	0010	3	Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing	Contact layer >16<= 48 sq in
A6208	0010	3	Contact layer, sterile, more than 48 sq. in., each dressing	Contact layer > 48 sq in
A6209	0010	3	Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing	Foam drsg <=16 sq in w/o bdr
A6210	0010	3	Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing	Foam drg >16<=48 sq in w/o b
A6211	0010	3	Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing	Foam drg > 48 sq in w/o brdr
A6212	0010	3	Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing	Foam drg <=16 sq in w/border
A6213	0010	3	Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing	Foam drg >16<=48 sq in w/bdr
A6214	0010	3	Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing	Foam drg > 48 sq in w/border
A6215	0010	3	Foam dressing, wound filler, sterile, per gram	Foam dressing wound filler
A6216	0010	3	Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing	Non-sterile gauze<=16 sq in
A6217	0010	3	Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing	Non-sterile gauze>16<=48 sq
A6218	0010	3	Gauze, non-impregnated, non-sterile, pad size more than 48 sq. in., without adhesive border, each dressing	Non-sterile gauze > 48 sq in
A6219	0010	3	Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing	Gauze <= 16 sq in w/border
A6220	0010	3	Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing	Gauze >16 <=48 sq in w/bordr
A6221	0010	3	Gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing	Gauze > 48 sq in w/border
A6222	0010	3	Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing	Gauze <=16 in no w/sal w/o b
A6223	0010	3	Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing	Gauze >16<=48 no w/sal w/o b
A6224	0010	3	Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing	Gauze > 48 in no w/sal w/o b
A6228	0010	3	Gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing	Gauze <= 16 sq in water/sal
A6229	0010	3	Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing	Gauze >16<=48 sq in watr/sal
A6230	0010	3	Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. in., without adhesive border, each dressing	Gauze > 48 sq in water/salne
A6231	0010	3	Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing	Hydrogel dsg<=16 sq in
A6232	0010	3	Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing	Hydrogel dsg>16<=48 sq in
A6233	0010	3	Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing	Hydrogel dressing >48 sq in
A6234	0010	3	Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing	Hydrocolld drg <=16 w/o bdr
A6235	0010	3	Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing	Hydrocolld drg >16<=48 w/o b
A6236	0010	3	Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing	Hydrocolld drg > 48 in w/o b
A6237	0010	3	Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing	Hydrocolld drg <=16 in w/bdr
A6238	0010	3	Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing	Hydrocolld drg >16<=48 w/bdr
A6239	0010	3	Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing	Hydrocolld drg > 48 in w/bdr
A6240	0010	3	Hydrocolloid dressing, wound filler, paste, sterile, per ounce	Hydrocolld drg filler paste
A6241	0010	3	Hydrocolloid dressing, wound filler, dry form, sterile, per gram	Hydrocolloid drg filler dry
A6242	0010	3	Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing	Hydrogel drg <=16 in w/o bdr
A6243	0010	3	Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing	Hydrogel drg >16<=48 w/o bdr
A6244	0010	3	Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing	Hydrogel drg >48 in w/o bdr
A6245	0010	3	Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing	Hydrogel drg <= 16 in w/bdr
A6246	0010	3	Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing	Hydrogel drg >16<=48 in w/b
A6247	0010	3	Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing	Hydrogel drg > 48 sq in w/b
A6248	0010	3	Hydrogel dressing, wound filler, gel, per fluid ounce	Hydrogel drsg gel filler
A6250	0010	3	Skin sealants, protectants, moisturizers, ointments, any type, any size	Skin seal protect moisturizr
A6251	0010	3	Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing	Absorpt drg <=16 sq in w/o b
A6252	0010	3	Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing	Absorpt drg >16 <=48 w/o bdr
A6253	0010	3	Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing	Absorpt drg > 48 sq in w/o b
A6254	0010	3	Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing	Absorpt drg <=16 sq in w/bdr
A6255	0010	3	Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing	Absorpt drg >16<=48 in w/bdr
A6256	0010	3	Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing	Absorpt drg > 48 sq in w/bdr
A6257	0010	3	Transparent film, sterile, 16 sq. in. or less, each dressing	Transparent film <= 16 sq in
A6258	0010	3	Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing	Transparent film >16<=48 in
A6259	0010	3	Transparent film, sterile, more than 48 sq. in., each dressing	Transparent film > 48 sq in
A6260	0010	3	Wound cleansers, any type, any size	Wound cleanser any type/size
A6261	0010	3	Wound filler, gel/paste, per fluid ounce, not otherwise specified	Wound filler gel/paste /oz
A6262	0010	3	Wound filler, dry form, per gram, not otherwise specified	Wound filler dry form / gram
A6266	0010	3	Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard	Impreg gauze no h20/sal/yard
A6402	0010	3	Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing	Sterile gauze <= 16 sq in
A6403	0010	3	Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing	Sterile gauze>16 <= 48 sq in
A6404	0010	3	Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing	Sterile gauze > 48 sq in
A6407	0010	3	Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard	Packing strips, non-impreg
A6410	0010	3	Eye pad, sterile, each	Sterile eye pad
A6411	0010	3	Eye pad, non-sterile, each	Non-sterile eye pad
A6412	0010	3	Eye patch, occlusive, each	Occlusive eye patch
A6413	0010	3	Adhesive bandage, first-aid type, any size, each	Adhesive bandage, first-aid
A6441	0010	3	Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard	Pad band w>=3" <5"/yd
A6442	0010	3	Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard	Conform band n/s w<3"/yd
A6443	0010	3	Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard	Conform band n/s w>=3“<5”/yd
A6444	0010	3	Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard	Conform band n/s w>=5"/yd
A6445	0010	3	Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard	Conform band s w <3"/yd
A6446	0010	3	Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard	Conform band s w>=3" <5"/yd
A6447	0010	3	Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard	Conform band s w >=5"/yd
A6448	0010	3	Light compression bandage, elastic, knitted/woven, width less than three inches, per yard	Lt compres band <3"/yd
A6449	0010	3	Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard	Lt compres band >=3" <5"/yd
A6450	0010	3	Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard	Lt compres band >=5"/yd
A6451	0010	3	Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard	Mod compres band w>=3“<5”/yd
A6452	0010	3	High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard	High compres band w>=3“<5”yd
A6453	0010	3	Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard	Self-adher band w <3"/yd
A6454	0010	3	Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard	Self-adher band w>=3" <5"/yd
A6455	0010	3	Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard	Self-adher band >=5"/yd
A6456	0010	3	Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard	Zinc paste band w >=3“<5”/yd
A6457	0010	3	Tubular dressing with or without elastic, any width, per linear yard	Tubular dressing
A6460	0010	3	Synthetic resorbable wound dressing, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing	Synthetic drsg <= 16 sq in
A6461	0010	3	Synthetic resorbable wound dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing	Synthetic drsg >16<=48 sq in
A6501	0010	3	Compression burn garment, bodysuit (head to foot), custom fabricated	Compres burngarment bodysuit
A6502	0010	3	Compression burn garment, chin strap, custom fabricated	Compres burngarment chinstrp
A6503	0010	3	Compression burn garment, facial hood, custom fabricated	Compres burngarment facehood
A6504	0010	3	Compression burn garment, glove to wrist, custom fabricated	Cmprsburngarment glove-wrist
A6505	0010	3	Compression burn garment, glove to elbow, custom fabricated	Cmprsburngarment glove-elbow
A6506	0010	3	Compression burn garment, glove to axilla, custom fabricated	Cmprsburngrmnt glove-axilla
A6507	0010	3	Compression burn garment, foot to knee length, custom fabricated	Cmprs burngarment foot-knee
A6508	0010	3	Compression burn garment, foot to thigh length, custom fabricated	Cmprs burngarment foot-thigh
A6509	0010	3	Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated	Compres burn garment jacket
A6510	0010	3	Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated	Compres burn garment leotard
A6511	0010	3	Compression burn garment, lower trunk including leg openings (panty), custom fabricated	Compres burn garment panty
A6512	0010	3	Compression burn garment, not otherwise classified	Compres burn garment, noc
A6513	0010	3	Compression burn mask, face and/or neck, plastic or equal, custom fabricated	Compress burn mask face/neck
A6530	0010	3	Gradient compression stocking, below knee, 18-30 mmhg, each	Compression stocking bk18-30
A6531	0010	3	Gradient compression stocking, below knee, 30-40 mmhg, each	Compression stocking bk30-40
A6532	0010	3	Gradient compression stocking, below knee, 40-50 mmhg, each	Compression stocking bk40-50
A6533	0010	3	Gradient compression stocking, thigh length, 18-30 mmhg, each	Gc stocking thighlngth 18-30
A6534	0010	3	Gradient compression stocking, thigh length, 30-40 mmhg, each	Gc stocking thighlngth 30-40
A6535	0010	3	Gradient compression stocking, thigh length, 40-50 mmhg, each	Gc stocking thighlngth 40-50
A6536	0010	3	Gradient compression stocking, full length/chap style, 18-30 mmhg, each	Gc stocking full lngth 18-30
A6537	0010	3	Gradient compression stocking, full length/chap style, 30-40 mmhg, each	Gc stocking full lngth 30-40
A6538	0010	3	Gradient compression stocking, full length/chap style, 40-50 mmhg, each	Gc stocking full lngth 40-50
A6539	0010	3	Gradient compression stocking, waist length, 18-30 mmhg, each	Gc stocking waistlngth 18-30
A6540	0010	3	Gradient compression stocking, waist length, 30-40 mmhg, each	Gc stocking waistlngth 30-40
A6541	0010	3	Gradient compression stocking, waist length, 40-50 mmhg, each	Gc stocking waistlngth 40-50
A6544	0010	3	Gradient compression stocking, garter belt	Gc stocking garter belt
A6545	0010	3	Gradient compression wrap, non-elastic, below knee, 30-50 mm hg, each	Grad comp non-elastic bk
A6549	0010	3	Gradient compression stocking/sleeve, not otherwise specified	G compression stocking
A6550	0010	3	Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories	Neg pres wound ther drsg set
A7000	0010	3	Canister, disposable, used with suction pump, each	Disposable canister for pump
A7001	0010	3	Canister, non-disposable, used with suction pump, each	Nondisposable pump canister
A7002	0010	3	Tubing, used with suction pump, each	Tubing used w suction pump
A7003	0010	3	Administration set, with small volume nonfiltered pneumatic nebulizer, disposable	Nebulizer administration set
A7004	0010	3	Small volume nonfiltered pneumatic nebulizer, disposable	Disposable nebulizer sml vol
A7005	0010	3	Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable	Nondisposable nebulizer set
A7006	0010	3	Administration set, with small volume filtered pneumatic nebulizer	Filtered nebulizer admin set
A7007	0010	3	Large volume nebulizer, disposable, unfilled, used with aerosol compressor	Lg vol nebulizer disposable
A7008	0010	3	Large volume nebulizer, disposable, prefilled, used with aerosol compressor	Disposable nebulizer prefill
A7009	0010	3	Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer	Nebulizer reservoir bottle
A7010	0010	3	Corrugated tubing, disposable, used with large volume nebulizer, 100 feet	Disposable corrugated tubing
A7011	0010	3	Corrugated tubing, non-disposable, used with large volume nebulizer, 10 feet	Nondispos corrugated tubing
A7012	0010	3	Water collection device, used with large volume nebulizer	Nebulizer water collec devic
A7013	0010	3	Filter, disposable, used with aerosol compressor or ultrasonic generator	Disposable compressor filter
A7014	0010	3	Filter, nondisposable, used with aerosol compressor or ultrasonic generator	Compressor nondispos filter
A7015	0010	3	Aerosol mask, used with dme nebulizer	Aerosol mask used w nebulize
A7016	0010	3	Dome and mouthpiece, used with small volume ultrasonic nebulizer	Nebulizer dome & mouthpiece
A7017	0010	3	Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen	Nebulizer not used w oxygen
A7018	0010	3	Water, distilled, used with large volume nebulizer, 1000 ml	Water distilled w/nebulizer
A7020	0010	3	Interface for cough stimulating device, includes all components, replacement only	Interface, cough stim device
A7025	0010	3	High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each	Replace chest compress vest
A7026	0010	3	High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each	Replace chst cmprss sys hose
A7027	0010	3	Combination oral/nasal mask, used with continuous positive airway pressure device, each	Combination oral/nasal mask
A7028	0010	3	Oral cushion for combination oral/nasal mask, replacement only, each	Repl oral cushion combo mask
A7029	0010	3	Nasal pillows for combination oral/nasal mask, replacement only, pair	Repl nasal pillow comb mask
A7030	0010	3	Full face mask used with positive airway pressure device, each	Cpap full face mask
A7031	0010	3	Face mask interface, replacement for full face mask, each	Replacement facemask interfa
A7032	0010	3	Cushion for use on nasal mask interface, replacement only, each	Replacement nasal cushion
A7033	0010	3	Pillow for use on nasal cannula type interface, replacement only, pair	Replacement nasal pillows
A7034	0010	3	Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap	Nasal application device
A7035	0010	3	Headgear used with positive airway pressure device	Pos airway press headgear
A7036	0010	3	Chinstrap used with positive airway pressure device	Pos airway press chinstrap
A7037	0010	3	Tubing used with positive airway pressure device	Pos airway pressure tubing
A7038	0010	3	Filter, disposable, used with positive airway pressure device	Pos airway pressure filter
A7039	0010	3	Filter, non disposable, used with positive airway pressure device	Filter, non disposable w pap
A7040	0010	3	One way chest drain valve	One way chest drain valve
A7041	0010	3	Water seal drainage container and tubing for use with implanted chest tube	Water seal drain container
A7042	0010	3	Implanted pleural catheter, each	Implanted pleural catheter
A7043	0010	3	Vacuum drainage bottle and tubing for use with implanted catheter	Vacuum drainagebottle/tubing
A7044	0010	3	Oral interface used with positive airway pressure device, each	Pap oral interface
A7045	0010	3	Exhalation port with or without swivel used with accessories for positive airway devices, replacement only	Repl exhalation port for pap
A7046	0010	3	Water chamber for humidifier, used with positive airway pressure device, replacement, each	Repl water chamber, pap dev
A7047	0010	3	Oral interface used with respiratory suction pump, each	Resp suction oral interface
A7048	0010	3	Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each	Vacuum drain bottle/tube kit
A7501	0010	3	Tracheostoma valve, including diaphragm, each	Tracheostoma valve w diaphra
A7502	0010	3	Replacement diaphragm/faceplate for tracheostoma valve, each	Replacement diaphragm/fplate
A7503	0010	3	Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each	Hmes filter holder or cap
A7504	0010	3	Filter for use in a tracheostoma heat and moisture exchange system, each	Tracheostoma hmes filter
A7505	0010	3	Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each	Hmes or trach valve housing
A7506	0010	3	Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each	Hmes/trachvalve adhesivedisk
A7507	0010	3	Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each	Integrated filter & holder
A7508	0010	3	Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each	Housing & integrated adhesiv
A7509	0010	3	Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each	Heat & moisture exchange sys
A7520	0010	3	Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each	Trach/laryn tube non-cuffed
A7521	0010	3	Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each	Trach/laryn tube cuffed
A7522	0010	3	Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each	Trach/laryn tube stainless
A7523	0010	3	Tracheostomy shower protector, each	Tracheostomy shower protect
A7524	0010	3	Tracheostoma stent/stud/button, each	Tracheostoma stent/stud/bttn
A7525	0010	3	Tracheostomy mask, each	Tracheostomy mask
A7526	0010	3	Tracheostomy tube collar/holder, each	Tracheostomy tube collar
A7527	0010	3	Tracheostomy/laryngectomy tube plug/stop, each	Trach/laryn tube plug/stop
A8000	0010	3	Helmet, protective, soft, prefabricated, includes all components and accessories	Soft protect helmet prefab
A8001	0010	3	Helmet, protective, hard, prefabricated, includes all components and accessories	Hard protect helmet prefab
A8002	0010	3	Helmet, protective, soft, custom fabricated, includes all components and accessories	Soft protect helmet custom
A8003	0010	3	Helmet, protective, hard, custom fabricated, includes all components and accessories	Hard protect helmet custom
A8004	0010	3	Soft interface for helmet, replacement only	Repl soft interface, helmet
A9150	0010	3	Non-prescription drugs	Misc/exper non-prescript dru
A9152	0010	3	Single vitamin/mineral/trace element, oral, per dose, not otherwise specified	Single vitamin nos
A9153	0010	3	Multiple vitamins, with or without minerals and trace elements, oral, per dose, not otherwise specified	Multi-vitamin nos
A9155	0010	3	Artificial saliva, 30 ml	Artificial saliva
A9180	0010	3	Pediculosis (lice infestation) treatment, topical, for administration by patient/caretaker	Lice treatment, topical
A9270	0010	3	Non-covered item or service	Non-covered item or service
A9272	0010	3	Wound suction, disposable, includes dressing, all accessories and components, any type, each	Disp wound suct, drsg/access
A9273	0010	3	Cold or hot fluid bottle, ice cap or collar, heat and/or cold wrap, any type	Hot/cold botle/cap/col/wrap
A9274	0010	3	External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories	Ext amb insulin delivery sys
A9275	0010	3	Home glucose disposable monitor, includes test strips	Disp home glucose monitor
A9276	0010	3	Sensor; invasive (e.g., subcutaneous), disposable, for use with interstitial continuous glucose monitoring system, one unit = 1 day supply	Disposable sensor, cgm sys
A9277	0010	3	Transmitter; external, for use with interstitial continuous glucose monitoring system	External transmitter, cgm
A9278	0010	3	Receiver (monitor); external, for use with interstitial continuous glucose monitoring system	External receiver, cgm sys
A9279	0010	3	Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified	Monitoring feature/devicenoc
A9280	0010	3	Alert or alarm device, not otherwise classified	Alert device, noc
A9281	0010	3	Reaching/grabbing device, any type, any length, each	Reaching/grabbing device
A9282	0010	3	Wig, any type, each	Wig any type
A9283	0010	3	Foot pressure off loading/supportive device, any type, each	Foot press off load supp dev
A9284	0010	3	Spirometer, non-electronic, includes all accessories	Non-electronic spirometer
A9285	0010	3	Inversion/eversion correction device	Inversion eversion cor devic
A9286	0010	3	Hygienic item or device, disposable or non-disposable, any type, each	Any hygienic item, device
A9300	0010	3	Exercise equipment	Exercise equipment
A9500	0010	3	Technetium tc-99m sestamibi, diagnostic, per study dose	Tc99m sestamibi
A9501	0010	3	Technetium tc-99m teboroxime, diagnostic, per study dose	Technetium tc-99m teboroxime
A9502	0010	3	Technetium tc-99m tetrofosmin, diagnostic, per study dose	Tc99m tetrofosmin
A9503	0010	3	Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries	Tc99m medronate
A9504	0010	3	Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries	Tc99m apcitide
A9505	0010	3	Thallium tl-201 thallous chloride, diagnostic, per millicurie	Tl201 thallium
A9507	0010	3	Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries	In111 capromab
A9508	0010	3	Iodine i-131 iobenguane sulfate, diagnostic, per 0.5 millicurie	I131 iodobenguate, dx
A9509	0010	3	Iodine i-123 sodium iodide, diagnostic, per millicurie	Iodine i-123 sod iodide mil
A9510	0010	3	Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries	Tc99m disofenin
A9512	0010	3	Technetium tc-99m pertechnetate, diagnostic, per millicurie	Tc99m pertechnetate
A9513	0010	3	Lutetium lu 177, dotatate, therapeutic, 1 millicurie	Lutetium lu 177 dotatat ther
A9515	0010	3	Choline c-11, diagnostic, per study dose up to 20 millicuries	Choline c-11
A9516	0010	3	Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries	Iodine i-123 sod iodide mic
A9517	0010	3	Iodine i-131 sodium iodide capsule(s), therapeutic, per millicurie	I131 iodide cap, rx
A9520	0010	3	Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuries	Tc99 tilmanocept diag 0.5mci
A9521	0010	3	Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries	Tc99m exametazime
A9524	0010	3	Iodine i-131 iodinated serum albumin, diagnostic, per 5 microcuries	I131 serum albumin, dx
A9526	0010	3	Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries	Nitrogen n-13 ammonia
A9527	0010	3	Iodine i-125, sodium iodide solution, therapeutic, per millicurie	Iodine i-125 sodium iodide
A9528	0010	3	Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie	Iodine i-131 iodide cap, dx
A9529	0010	3	Iodine i-131 sodium iodide solution, diagnostic, per millicurie	I131 iodide sol, dx
A9530	0010	3	Iodine i-131 sodium iodide solution, therapeutic, per millicurie	I131 iodide sol, rx
A9531	0010	3	Iodine i-131 sodium iodide, diagnostic, per microcurie (up to 100 microcuries)	I131 max 100uci
A9532	0010	3	Iodine i-125 serum albumin, diagnostic, per 5 microcuries	I125 serum albumin, dx
A9536	0010	3	Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries	Tc99m depreotide
A9537	0010	3	Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries	Tc99m mebrofenin
A9538	0010	3	Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries	Tc99m pyrophosphate
A9539	0010	3	Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries	Tc99m pentetate
A9540	0010	3	Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries	Tc99m maa
A9541	0010	3	Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries	Tc99m sulfur colloid
A9542	0010	3	Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries	In111 ibritumomab, dx
A9543	0010	3	Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries	Y90 ibritumomab, rx
A9544	0010	3	Iodine i-131 tositumomab, diagnostic, per study dose	I131 tositumomab, dx
A9545	0010	3	Iodine i-131 tositumomab, therapeutic, per treatment dose	I131 tositumomab, rx
A9546	0010	3	Cobalt co-57/58, cyanocobalamin, diagnostic, per study dose, up to 1 microcurie	Co57/58
A9547	0010	3	Indium in-111 oxyquinoline, diagnostic, per 0.5 millicurie	In111 oxyquinoline
A9548	0010	3	Indium in-111 pentetate, diagnostic, per 0.5 millicurie	In111 pentetate
A9550	0010	3	Technetium tc-99m sodium gluceptate, diagnostic, per study dose, up to 25 millicurie	Tc99m gluceptate
A9551	0010	3	Technetium tc-99m succimer, diagnostic, per study dose, up to 10 millicuries	Tc99m succimer
A9552	0010	3	Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries	F18 fdg
A9553	0010	3	Chromium cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuries	Cr51 chromate
A9554	0010	3	Iodine i-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries	I125 iothalamate, dx
A9555	0010	3	Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries	Rb82 rubidium
A9556	0010	3	Gallium ga-67 citrate, diagnostic, per millicurie	Ga67 gallium
A9557	0010	3	Technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries	Tc99m bicisate
A9558	0010	3	Xenon xe-133 gas, diagnostic, per 10 millicuries	Xe133 xenon 10mci
A9559	0010	3	Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurie	Co57 cyano
A9560	0010	3	Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries	Tc99m labeled rbc
A9561	0010	3	Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries	Tc99m oxidronate
A9562	0010	3	Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries	Tc99m mertiatide
A9563	0010	3	Sodium phosphate p-32, therapeutic, per millicurie	P32 na phosphate
A9564	0010	3	Chromic phosphate p-32 suspension, therapeutic, per millicurie	P32 chromic phosphate
A9566	0010	3	Technetium tc-99m fanolesomab, diagnostic, per study dose, up to 25 millicuries	Tc99m fanolesomab
A9567	0010	3	Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries	Technetium tc-99m aerosol
A9568	0010	3	Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries	Technetium tc99m arcitumomab
A9569	0010	3	Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose	Technetium tc-99m auto wbc
A9570	0010	3	Indium in-111 labeled autologous white blood cells, diagnostic, per study dose	Indium in-111 auto wbc
A9571	0010	3	Indium in-111 labeled autologous platelets, diagnostic, per study dose	Indium in-111 auto platelet
A9572	0010	3	Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries	Indium in-111 pentetreotide
A9575	0010	3	Injection, gadoterate meglumine, 0.1 ml	Inj gadoterate meglumi 0.1ml
A9576	0010	3	Injection, gadoteridol, (prohance multipack), per ml	Inj prohance multipack
A9577	0010	3	Injection, gadobenate dimeglumine (multihance), per ml	Inj multihance
A9578	0010	3	Injection, gadobenate dimeglumine (multihance multipack), per ml	Inj multihance multipack
A9579	0010	3	Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml	Gad-base mr contrast nos,1ml
A9580	0010	3	Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries	Sodium fluoride f-18
A9581	0010	3	Injection, gadoxetate disodium, 1 ml	Gadoxetate disodium inj
A9582	0010	3	Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries	Iodine i-123 iobenguane
A9583	0010	3	Injection, gadofosveset trisodium, 1 ml	Gadofosveset trisodium inj
A9584	0010	3	Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries	Iodine i-123 ioflupane
A9585	0010	3	Injection, gadobutrol, 0.1 ml	Gadobutrol injection
A9586	0010	3	Florbetapir f18, diagnostic, per study dose, up to 10 millicuries	Florbetapir f18
A9587	0010	3	Gallium ga-68, dotatate, diagnostic, 0.1 millicurie	Gallium ga-68
A9588	0010	3	Fluciclovine f-18, diagnostic, 1 millicurie	Fluciclovine f-18
A9589	0010	3	Instillation, hexaminolevulinate hydrochloride, 100 mg	Insti hexaminolevulinate hcl
A9590	0010	3	Iodine i-131, iobenguane, 1 millicurie	Iodine i-131 iobenguane 1mci
A9597	0010	3	Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified	Pet, dx, for tumor id, noc
A9598	0010	3	Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified	Pet dx for non-tumor id, noc
A9599	0010	3	Radiopharmaceutical, diagnostic, for beta-amyloid positron emission tomography (pet) imaging, per study dose, not otherwise specified	Radioph dx b amyloid pet nos
A9600	0010	3	Strontium sr-89 chloride, therapeutic, per millicurie	Sr89 strontium
A9604	0010	3	Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries	Sm 153 lexidronam
A9606	0010	3	Radium ra-223 dichloride, therapeutic, per microcurie	Radium ra223 dichloride ther
A9698	0010	3	Non-radioactive contrast imaging material, not otherwise classified, per study	Non-rad contrast materialnoc
A9699	0010	3	Radiopharmaceutical, therapeutic, not otherwise classified	Radiopharm rx agent noc
A9700	0010	3	Supply of injectable contrast material for use in echocardiography, per study	Echocardiography contrast
A9900	0010	3	Miscellaneous dme supply, accessory, and/or service component of another hcpcs code	Supply/accessory/service
A9901	0010	3	Dme delivery, set up, and/or dispensing service component of another hcpcs code	Delivery/set up/dispensing
A9999	0010	3	Miscellaneous dme supply or accessory, not otherwise specified	Dme supply or accessory, nos

B4000–B9999: Enteral and Perenteral Therapy

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
B4034	0010	3	Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	Enter feed supkit syr by day
B4035	0010	3	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	Enteral feed supp pump per d
B4036	0010	3	Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	Enteral feed sup kit grav by
B4081	0010	3	Nasogastric tubing with stylet	Enteral ng tubing w/ stylet
B4082	0010	3	Nasogastric tubing without stylet	Enteral ng tubing w/o stylet
B4083	0010	3	Stomach tube - levine type	Enteral stomach tube levine
B4087	0010	3	Gastrostomy/jejunostomy tube, standard, any material, any type, each	Gastro/jejuno tube, std
B4088	0010	3	Gastrostomy/jejunostomy tube, low-profile, any material, any type, each	Gastro/jejuno tube, low-pro
B4100	0010	3	Food thickener, administered orally, per ounce	Food thickener oral
B4102	0010	3	Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit	Ef adult fluids and electro
B4103	0010	3	Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit	Ef ped fluid and electrolyte
B4104	0010	3	Additive for enteral formula (e.g., fiber)	Additive for enteral formula
B4105	0010	3	In-line cartridge containing digestive enzyme(s) for enteral feeding, each	Enzyme cartridge enteral nut
B4149	0010	3	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit	Ef blenderized foods
B4150	0010	3	Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit	Ef complet w/intact nutrient
B4152	0010	3	Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit	Ef calorie dense>/=1.5kcal
B4153	0010	3	Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit	Ef hydrolyzed/amino acids
B4154	0010	3	Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit	Ef spec metabolic noninherit
B4155	0010	3	Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit	Ef incomplete/modular
B4157	0010	3	Enteral formula, nutritionally complete, for special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit	Ef special metabolic inherit
B4158	0010	3	Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit	Ef ped complete intact nut
B4159	0010	3	Enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit	Ef ped complete soy based
B4160	0010	3	Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit	Ef ped caloric dense>/=0.7kc
B4161	0010	3	Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit	Ef ped hydrolyzed/amino acid
B4162	0010	3	Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit	Ef ped specmetabolic inherit
B4164	0010	3	Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix	Parenteral 50% dextrose solu
B4168	0010	3	Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - home mix	Parenteral sol amino acid 3.
B4172	0010	3	Parenteral nutrition solution; amino acid, 5.5% through 7%, (500 ml = 1 unit) - home mix	Parenteral sol amino acid 5.
B4176	0010	3	Parenteral nutrition solution; amino acid, 7% through 8.5%, (500 ml = 1 unit) - home mix	Parenteral sol amino acid 7-
B4178	0010	3	Parenteral nutrition solution: amino acid, greater than 8.5% (500 ml = 1 unit) - home mix	Parenteral sol amino acid >
B4180	0010	3	Parenteral nutrition solution; carbohydrates (dextrose), greater than 50% (500 ml = 1 unit) - home mix	Parenteral sol carb > 50%
B4185	0010	3	Parenteral nutrition solution, not otherwise specified, 10 grams lipids	Pn soln nos 10 grams lipids
B4187	0010	3	Omegaven, 10 grams lipids	Omegaven, 10 grams lipids
B4189	0010	3	Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix	Parenteral sol amino acid &
B4193	0010	3	Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix	Parenteral sol 52-73 gm prot
B4197	0010	3	Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix	Parenteral sol 74-100 gm pro
B4199	0010	3	Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix	Parenteral sol > 100gm prote
B4216	0010	3	Parenteral nutrition; additives (vitamins, trace elements, heparin, electrolytes), home mix, per day	Parenteral nutrition additiv
B4220	0010	3	Parenteral nutrition supply kit; premix, per day	Parenteral supply kit premix
B4222	0010	3	Parenteral nutrition supply kit; home mix, per day	Parenteral supply kit homemi
B4224	0010	3	Parenteral nutrition administration kit, per day	Parenteral administration ki
B5000	0010	3	Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, renal-aminosyn-rf, nephramine, renamine-premix	Parenteral sol renal-amirosy
B5100	0010	3	Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, hepatic, hepatamine-premix	Parenteral solution hepatic
B5200	0010	3	Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, stress-branch chain amino acids-freamine-hbc-premix	Parenteral sol hepatic fream
B9000	0010	3	Enteral nutrition infusion pump - without alarm	Enter infusion pump w/o alrm
B9002	0010	3	Enteral nutrition infusion pump, any type	Enter nutr inf pump any type
B9004	0010	3	Parenteral nutrition infusion pump, portable	Parenteral infus pump portab
B9006	0010	3	Parenteral nutrition infusion pump, stationary	Parenteral infus pump statio
B9998	0010	3	Noc for enteral supplies	Enteral supp not otherwise c
B9999	0010	3	Noc for parenteral supplies	Parenteral supp not othrws c

C1000–C9999: Outpatient Prospective Payment System

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
C1300	0010	3	Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval	Hyperbaric oxygen
C1713	0010	3	Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)	Anchor/screw bn/bn,tis/bn
C1714	0010	3	Catheter, transluminal atherectomy, directional	Cath, trans atherectomy, dir
C1715	0010	3	Brachytherapy needle	Brachytherapy needle
C1716	0010	3	Brachytherapy source, non-stranded, gold-198, per source	Brachytx, non-str, gold-198
C1717	0010	3	Brachytherapy source, non-stranded, high dose rate iridium-192, per source	Brachytx, non-str,hdr ir-192
C1719	0010	3	Brachytherapy source, non-stranded, non-high dose rate iridium-192, per source	Brachytx, ns, non-hdrir-192
C1721	0010	3	Cardioverter-defibrillator, dual chamber (implantable)	Aicd, dual chamber
C1722	0010	3	Cardioverter-defibrillator, single chamber (implantable)	Aicd, single chamber
C1724	0010	3	Catheter, transluminal atherectomy, rotational	Cath, trans atherec,rotation
C1725	0010	3	Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability)	Cath, translumin non-laser
C1726	0010	3	Catheter, balloon dilatation, non-vascular	Cath, bal dil, non-vascular
C1727	0010	3	Catheter, balloon tissue dissector, non-vascular (insertable)	Cath, bal tis dis, non-vas
C1728	0010	3	Catheter, brachytherapy seed administration	Cath, brachytx seed adm
C1729	0010	3	Catheter, drainage	Cath, drainage
C1730	0010	3	Catheter, electrophysiology, diagnostic, other than 3d mapping (19 or fewer electrodes)	Cath, ep, 19 or few elect
C1731	0010	3	Catheter, electrophysiology, diagnostic, other than 3d mapping (20 or more electrodes)	Cath, ep, 20 or more elec
C1732	0010	3	Catheter, electrophysiology, diagnostic/ablation, 3d or vector mapping	Cath, ep, diag/abl, 3d/vect
C1733	0010	3	Catheter, electrophysiology, diagnostic/ablation, other than 3d or vector mapping, other than cool-tip	Cath, ep, othr than cool-tip
C1734	0010	3	Orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to bone (implantable)	Orth/devic/drug bn/bn,tis/bn
C1749	0010	3	Endoscope, retrograde imaging/illumination colonoscope device (implantable)	Endo, colon, retro imaging
C1750	0010	3	Catheter, hemodialysis/peritoneal, long-term	Cath, hemodialysis,long-term
C1751	0010	3	Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis)	Cath, inf, per/cent/midline
C1752	0010	3	Catheter, hemodialysis/peritoneal, short-term	Cath,hemodialysis,short-term
C1753	0010	3	Catheter, intravascular ultrasound	Cath, intravas ultrasound
C1754	0010	3	Catheter, intradiscal	Catheter, intradiscal
C1755	0010	3	Catheter, intraspinal	Catheter, intraspinal
C1756	0010	3	Catheter, pacing, transesophageal	Cath, pacing, transesoph
C1757	0010	3	Catheter, thrombectomy/embolectomy	Cath, thrombectomy/embolect
C1758	0010	3	Catheter, ureteral	Catheter, ureteral
C1759	0010	3	Catheter, intracardiac echocardiography	Cath, intra echocardiography
C1760	0010	3	Closure device, vascular (implantable/insertable)	Closure dev, vasc
C1762	0010	3	Connective tissue, human (includes fascia lata)	Conn tiss, human(inc fascia)
C1763	0010	3	Connective tissue, non-human (includes synthetic)	Conn tiss, non-human
C1764	0010	3	Event recorder, cardiac (implantable)	Event recorder, cardiac
C1765	0010	3	Adhesion barrier	Adhesion barrier
C1766	0010	3	Introducer/sheath, guiding, intracardiac electrophysiological, steerable, other than peel-away	Intro/sheath,strble,non-peel
C1767	0010	3	Generator, neurostimulator (implantable), non-rechargeable	Generator, neuro non-recharg
C1768	0010	3	Graft, vascular	Graft, vascular
C1769	0010	3	Guide wire	Guide wire
C1770	0010	3	Imaging coil, magnetic resonance (insertable)	Imaging coil, mr, insertable
C1771	0010	3	Repair device, urinary, incontinence, with sling graft	Rep dev, urinary, w/sling
C1772	0010	3	Infusion pump, programmable (implantable)	Infusion pump, programmable
C1773	0010	3	Retrieval device, insertable (used to retrieve fractured medical devices)	Ret dev, insertable
C1776	0010	3	Joint device (implantable)	Joint device (implantable)
C1777	0010	3	Lead, cardioverter-defibrillator, endocardial single coil (implantable)	Lead, aicd, endo single coil
C1778	0010	3	Lead, neurostimulator (implantable)	Lead, neurostimulator
C1779	0010	3	Lead, pacemaker, transvenous vdd single pass	Lead, pmkr, transvenous vdd
C1780	0010	3	Lens, intraocular (new technology)	Lens, intraocular (new tech)
C1781	0010	3	Mesh (implantable)	Mesh (implantable)
C1782	0010	3	Morcellator	Morcellator
C1783	0010	3	Ocular implant, aqueous drainage assist device	Ocular imp, aqueous drain de
C1784	0010	3	Ocular device, intraoperative, detached retina	Ocular dev, intraop, det ret
C1785	0010	3	Pacemaker, dual chamber, rate-responsive (implantable)	Pmkr, dual, rate-resp
C1786	0010	3	Pacemaker, single chamber, rate-responsive (implantable)	Pmkr, single, rate-resp
C1787	0010	3	Patient programmer, neurostimulator	Patient progr, neurostim
C1788	0010	3	Port, indwelling (implantable)	Port, indwelling, imp
C1789	0010	3	Prosthesis, breast (implantable)	Prosthesis, breast, imp
C1813	0010	3	Prosthesis, penile, inflatable	Prosthesis, penile, inflatab
C1814	0010	3	Retinal tamponade device, silicone oil	Retinal tamp, silicone oil
C1815	0010	3	Prosthesis, urinary sphincter (implantable)	Pros, urinary sph, imp
C1816	0010	3	Receiver and/or transmitter, neurostimulator (implantable)	Receiver/transmitter, neuro
C1817	0010	3	Septal defect implant system, intracardiac	Septal defect imp sys
C1818	0010	3	Integrated keratoprosthesis	Integrated keratoprosthesis
C1819	0010	3	Surgical tissue localization and excision device (implantable)	Tissue localization-excision
C1820	0010	3	Generator, neurostimulator (implantable), with rechargeable battery and charging system	Generator neuro rechg bat sy
C1821	0010	3	Interspinous process distraction device (implantable)	Interspinous implant
C1822	0010	3	Generator, neurostimulator (implantable), high frequency, with rechargeable battery and charging system	Gen, neuro, hf, rechg bat
C1823	0010	3	Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads	Gen, neuro, trans sen/stim
C1824	0010	3	Generator, cardiac contractility modulation (implantable)	Generator, ccm, implant
C1830	0010	3	Powered bone marrow biopsy needle	Power bone marrow bx needle
C1839	0010	3	Iris prosthesis	Iris prosthesis
C1840	0010	3	Lens, intraocular (telescopic)	Telescopic intraocular lens
C1841	0010	3	Retinal prosthesis, includes all internal and external components	Retinal prosth int/ext comp
C1842	0010	3	Retinal prosthesis, includes all internal and external components; add-on to c1841	Retinal prosth, add-on
C1874	0010	3	Stent, coated/covered, with delivery system	Stent, coated/cov w/del sys
C1875	0010	3	Stent, coated/covered, without delivery system	Stent, coated/cov w/o del sy
C1876	0010	3	Stent, non-coated/non-covered, with delivery system	Stent, non-coa/non-cov w/del
C1877	0010	3	Stent, non-coated/non-covered, without delivery system	Stent, non-coat/cov w/o del
C1878	0010	3	Material for vocal cord medialization, synthetic (implantable)	Matrl for vocal cord
C1880	0010	3	Vena cava filter	Vena cava filter
C1881	0010	3	Dialysis access system (implantable)	Dialysis access system
C1882	0010	3	Cardioverter-defibrillator, other than single or dual chamber (implantable)	Aicd, other than sing/dual
C1883	0010	3	Adapter/extension, pacing lead or neurostimulator lead (implantable)	Adapt/ext, pacing/neuro lead
C1884	0010	3	Embolization protective system	Embolization protect syst
C1885	0010	3	Catheter, transluminal angioplasty, laser	Cath, translumin angio laser
C1886	0010	3	Catheter, extravascular tissue ablation, any modality (insertable)	Catheter, ablation
C1887	0010	3	Catheter, guiding (may include infusion/perfusion capability)	Catheter, guiding
C1888	0010	3	Catheter, ablation, non-cardiac, endovascular (implantable)	Endovas non-cardiac abl cath
C1889	0010	3	Implantable/insertable device, not otherwise classified	Implant/insert device, noc
C1890	0010	3	No implantable/insertable device used with device-intensive procedures	No device w/dev-intensive px
C1891	0010	3	Infusion pump, non-programmable, permanent (implantable)	Infusion pump,non-prog, perm
C1892	0010	3	Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, peel-away	Intro/sheath,fixed,peel-away
C1893	0010	3	Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away	Intro/sheath, fixed,non-peel
C1894	0010	3	Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser	Intro/sheath, non-laser
C1895	0010	3	Lead, cardioverter-defibrillator, endocardial dual coil (implantable)	Lead, aicd, endo dual coil
C1896	0010	3	Lead, cardioverter-defibrillator, other than endocardial single or dual coil (implantable)	Lead, aicd, non sing/dual
C1897	0010	3	Lead, neurostimulator test kit (implantable)	Lead, neurostim test kit
C1898	0010	3	Lead, pacemaker, other than transvenous vdd single pass	Lead, pmkr, other than trans
C1899	0010	3	Lead, pacemaker/cardioverter-defibrillator combination (implantable)	Lead, pmkr/aicd combination
C1900	0010	3	Lead, left ventricular coronary venous system	Lead, coronary venous
C1982	0010	3	Catheter, pressure-generating, one-way valve, intermittently occlusive	Cath, pressure,valve-occlu
C2596	0010	3	Probe, image-guided, robotic, waterjet ablation	Probe, robotic, water-jet
C2613	0010	3	Lung biopsy plug with delivery system	Lung bx plug w/del sys
C2614	0010	3	Probe, percutaneous lumbar discectomy	Probe, perc lumb disc
C2615	0010	3	Sealant, pulmonary, liquid	Sealant, pulmonary, liquid
C2616	0010	3	Brachytherapy source, non-stranded, yttrium-90, per source	Brachytx, non-str,yttrium-90
C2617	0010	3	Stent, non-coronary, temporary, without delivery system	Stent, non-cor, tem w/o del
C2618	0010	3	Probe/needle, cryoablation	Probe/needle, cryo
C2619	0010	3	Pacemaker, dual chamber, non rate-responsive (implantable)	Pmkr, dual, non rate-resp
C2620	0010	3	Pacemaker, single chamber, non rate-responsive (implantable)	Pmkr, single, non rate-resp
C2621	0010	3	Pacemaker, other than single or dual chamber (implantable)	Pmkr, other than sing/dual
C2622	0010	3	Prosthesis, penile, non-inflatable	Prosthesis, penile, non-inf
C2623	0010	3	Catheter, transluminal angioplasty, drug-coated, non-laser	Cath, translumin, drug-coat
C2624	0010	3	Implantable wireless pulmonary artery pressure sensor with delivery catheter, including all system components	Wireless pressure sensor
C2625	0010	3	Stent, non-coronary, temporary, with delivery system	Stent, non-cor, tem w/del sy
C2626	0010	3	Infusion pump, non-programmable, temporary (implantable)	Infusion pump, non-prog,temp
C2627	0010	3	Catheter, suprapubic/cystoscopic	Cath, suprapubic/cystoscopic
C2628	0010	3	Catheter, occlusion	Catheter, occlusion
C2629	0010	3	Introducer/sheath, other than guiding, other than intracardiac electrophysiological, laser	Intro/sheath, laser
C2630	0010	3	Catheter, electrophysiology, diagnostic/ablation, other than 3d or vector mapping, cool-tip	Cath, ep, cool-tip
C2631	0010	3	Repair device, urinary, incontinence, without sling graft	Rep dev, urinary, w/o sling
C2634	0010	3	Brachytherapy source, non-stranded, high activity, iodine-125, greater than 1.01 mci (nist), per source	Brachytx, non-str, ha, i-125
C2635	0010	3	Brachytherapy source, non-stranded, high activity, palladium-103, greater than 2.2 mci (nist), per source	Brachytx, non-str, ha, p-103
C2636	0010	3	Brachytherapy linear source, non-stranded, palladium-103, per 1 mm	Brachy linear, non-str,p-103
C2637	0010	3	Brachytherapy source, non-stranded, ytterbium-169, per source	Brachy,non-str,ytterbium-169
C2638	0010	3	Brachytherapy source, stranded, iodine-125, per source	Brachytx, stranded, i-125
C2639	0010	3	Brachytherapy source, non-stranded, iodine-125, per source	Brachytx, non-stranded,i-125
C2640	0010	3	Brachytherapy source, stranded, palladium-103, per source	Brachytx, stranded, p-103
C2641	0010	3	Brachytherapy source, non-stranded, palladium-103, per source	Brachytx, non-stranded,p-103
C2642	0010	3	Brachytherapy source, stranded, cesium-131, per source	Brachytx, stranded, c-131
C2643	0010	3	Brachytherapy source, non-stranded, cesium-131, per source	Brachytx, non-stranded,c-131
C2644	0010	3	Brachytherapy source, cesium-131 chloride solution, per millicurie	Brachytx cesium-131 chloride
C2645	0010	3	Brachytherapy planar source, palladium-103, per square millimeter	Brachytx planar, p-103
C2698	0010	3	Brachytherapy source, stranded, not otherwise specified, per source	Brachytx, stranded, nos
C2699	0010	3	Brachytherapy source, non-stranded, not otherwise specified, per source	Brachytx, non-stranded, nos
C5271	0010	3	Application of low cost 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	Low cost skin substitute app
C5272	0010	3	Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)	Low cost skin substitute app
C5273	0010	3	Application of low cost skin substitute graft to trunk, arms, legs, 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 infants and children	Low cost skin substitute app
C5274	0010	3	Application of low cost 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 thereof (list separately in addition to code for primary procedure)	Low cost skin substitute app
C5275	0010	3	Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area	Low cost skin substitute app
C5276	0010	3	Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)	Low cost skin substitute app
C5277	0010	3	Application of low cost 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 infants and children	Low cost skin substitute app
C5278	0010	3	Application of low cost 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; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)	Low cost skin substitute app
C8900	0010	3	Magnetic resonance angiography with contrast, abdomen	Mra w/cont, abd
C8901	0010	3	Magnetic resonance angiography without contrast, abdomen	Mra w/o cont, abd
C8902	0010	3	Magnetic resonance angiography without contrast followed by with contrast, abdomen	Mra w/o fol w/cont, abd
C8903	0010	3	Magnetic resonance imaging with contrast, breast; unilateral	Mri w/cont, breast, uni
C8904	0010	3	Magnetic resonance imaging without contrast, breast; unilateral	Mri w/o cont, breast, uni
C8905	0010	3	Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral	Mri w/o fol w/cont, brst, un
C8906	0010	3	Magnetic resonance imaging with contrast, breast; bilateral	Mri w/cont, breast, bi
C8907	0010	3	Magnetic resonance imaging without contrast, breast; bilateral	Mri w/o cont, breast, bi
C8908	0010	3	Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral	Mri w/o fol w/cont, breast,
C8909	0010	3	Magnetic resonance angiography with contrast, chest (excluding myocardium)	Mra w/cont, chest
C8910	0010	3	Magnetic resonance angiography without contrast, chest (excluding myocardium)	Mra w/o cont, chest
C8911	0010	3	Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)	Mra w/o fol w/cont, chest
C8912	0010	3	Magnetic resonance angiography with contrast, lower extremity	Mra w/cont, lwr ext
C8913	0010	3	Magnetic resonance angiography without contrast, lower extremity	Mra w/o cont, lwr ext
C8914	0010	3	Magnetic resonance angiography without contrast followed by with contrast, lower extremity	Mra w/o fol w/cont, lwr ext
C8918	0010	3	Magnetic resonance angiography with contrast, pelvis	Mra w/cont, pelvis
C8919	0010	3	Magnetic resonance angiography without contrast, pelvis	Mra w/o cont, pelvis
C8920	0010	3	Magnetic resonance angiography without contrast followed by with contrast, pelvis	Mra w/o fol w/cont, pelvis
C8921	0010	3	Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete	Tte w or w/o fol w/cont, com
C8922	0010	3	Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited study	Tte w or w/o fol w/cont, f/u
C8923	0010	3	Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography	2d tte w or w/o fol w/con,co
C8924	0010	3	Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study	2d tte w or w/o fol w/con,fu
C8925	0010	3	Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report	2d tee w or w/o fol w/con,in
C8926	0010	3	Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report	Tee w or w/o fol w/cont,cong
C8927	0010	3	Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basis	Tee w or w/o fol w/cont, mon
C8928	0010	3	Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report	Tte w or w/o fol w/con,stres
C8929	0010	3	Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography	Tte w or wo fol wcon,doppler
C8930	0010	3	Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision	Tte w or w/o contr, cont ecg
C8931	0010	3	Magnetic resonance angiography with contrast, spinal canal and contents	Mra, w/dye, spinal canal
C8932	0010	3	Magnetic resonance angiography without contrast, spinal canal and contents	Mra, w/o dye, spinal canal
C8933	0010	3	Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents	Mra, w/o&w/dye, spinal canal
C8934	0010	3	Magnetic resonance angiography with contrast, upper extremity	Mra, w/dye, upper extremity
C8935	0010	3	Magnetic resonance angiography without contrast, upper extremity	Mra, w/o dye, upper extr
C8936	0010	3	Magnetic resonance angiography without contrast followed by with contrast, upper extremity	Mra, w/o&w/dye, upper extr
C8937	0010	3	Computer-aided detection, including computer algorithm analysis of breast mri image data for lesion detection/characterization, pharmacokinetic analysis, with further physician review for interpretation (list separately in addition to code for primary procedure)	Cad breast mri
C8957	0010	3	Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump	Prolonged iv inf, req pump
C9014	0010	3	Injection, cerliponase alfa, 1 mg	Injection, cerliponase alfa
C9015	0010	3	Injection, c-1 esterase inhibitor (human), haegarda, 10 units	C-1 esterase, haegarda
C9016	0010	3	Injection, triptorelin extended release, 3.75 mg	Inj, triptorelin ext rel
C9021	0010	3	Injection, obinutuzumab, 10 mg	Injection, obinutuzumab
C9022	0010	3	Injection, elosulfase alfa, 1mg	Injection, elosulfase alfa
C9023	0010	3	Injection, testosterone undecanoate, 1 mg	Inj testosterone undecanoate
C9024	0010	3	Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine	Inj, daunorubicin-cytarabine
C9025	0010	3	Injection, ramucirumab, 5 mg	Injection, ramucirumab
C9026	0010	3	Injection, vedolizumab, 1 mg	Injection, vedolizumab
C9027	0010	3	Injection, pembrolizumab, 1 mg	Injection, pembrolizumab
C9028	0010	3	Injection, inotuzumab ozogamicin, 0.1 mg	Inj. inotuzumab ozogamicin
C9029	0010	3	Injection, guselkumab, 1 mg	Injection, guselkumab
C9030	0010	3	Injection, copanlisib, 1 mg	Inj copanlisib
C9031	0010	3	Lutetium lu 177, dotatate, therapeutic, 1 mci	Lutetium lu 177 dotatate, tx
C9032	0010	3	Injection, voretigene neparvovec-rzyl, 1 billion vector genome	Voretigene neparvovec-rzyl
C9033	0010	3	Injection, fosnetupitant 235 mg and palonosetron 0.25 mg	Inj, akynzeo
C9034	0010	3	Injection, dexamethasone 9%, intraocular, 1 mcg	Injection, dexamethasone 9%
C9035	0010	3	Injection, aripiprazole lauroxil (aristada initio), 1 mg	Injection, aristada initio
C9036	0010	3	Injection, patisiran, 0.1 mg	Injection, patisiran
C9037	0010	3	Injection, risperidone (perseris), 0.5 mg	Injection, risperidone
C9038	0010	3	Injection, mogamulizumab-kpkc, 1 mg	Inj mogamulizumab-kpkc
C9039	0010	3	Injection, plazomicin, 5 mg	Injection, plazomicin
C9040	0010	3	Injection, fremanezumab-vfrm, 1mg	Injection, fremanezumab-vfrm
C9041	0010	3	Injection, coagulation factor xa (recombinant), inactivated (andexxa), 10 mg	Inj, coagulation factor xa
C9042	0010	3	Injection, bendamustine hcl (belrapzo), 1 mg	Inj., belrapzo 1 mg
C9043	0010	3	Injection, levoleucovorin, 1 mg	Injection, levoleucovorin
C9044	0010	3	Injection, cemiplimab-rwlc, 1 mg	Injection, cemiplimab-rwlc
C9045	0010	3	Injection, moxetumomab pasudotox-tdfk, 0.01 mg	Moxetumomab pasudotox-tdfk
C9046	0010	3	Cocaine hydrochloride nasal solution for topical administration, 1 mg	Cocaine hcl nasal solution
C9047	0010	3	Injection, caplacizumab-yhdp, 1 mg	Injection, caplacizumab-yhdp
C9048	0010	3	Dexamethasone, lacrimal ophthalmic insert, 0.1 mg	Dexamethasone ophth insert
C9049	0010	3	Injection, tagraxofusp-erzs, 10 mcg	Injection, tagraxofusp-erzs
C9050	0010	3	Injection, emapalumab-lzsg, 1 mg	Injection, emapalumab-lzsg
C9051	0010	3	Injection, omadacycline, 1 mg	Injection, omadacycline
C9052	0010	3	Injection, ravulizumab-cwvz, 10 mg	Injection, ravulizumab-cwv
C9054	0010	3	Injection, lefamulin (xenleta), 1 mg	Injection, lefamulin
C9055	0010	3	Injection, brexanolone, 1mg	Inj, brexanolone
C9113	0010	3	Injection, pantoprazole sodium, per vial	Inj pantoprazole sodium, via
C9121	0010	3	Injection, argatroban, per 5 mg	Injection, argatroban
C9132	0010	3	Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity	Kcentra, per i.u.
C9133	0010	3	Factor ix (antihemophilic factor, recombinant), rixubis, per i.u.	Factor ix recombinant
C9134	0010	3	Factor xiii (antihemophilic factor, recombinant), tretten, per 10 i.u.	Factor xiii a-subunit recomb
C9135	0010	3	Factor ix (antihemophilic factor, recombinant), alprolix, per i.u.	Factor ix (alprolix)
C9136	0010	3	Injection, factor viii, fc fusion protein, (recombinant), per i.u.	Factor viii (eloctate)
C9137	0010	3	Injection, factor viii (antihemophilic factor, recombinant) pegylated, 1 i.u.	Adynovate factor viii recom
C9138	0010	3	Injection, factor viii (antihemophilic factor, recombinant) (nuwiq), 1 i.u.	Nuwiq factor viii recomb
C9139	0010	3	Injection, factor ix, albumin fusion protein (recombinant), idelvion, 1 i.u.	Idelvion, 1 i.u.
C9140	0010	3	Injection, factor viii (antihemophilic factor, recombinant) (afstyla), 1 i.u.	Afstyla factor viii recomb
C9141	0010	3	Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl (jivi), 1 i.u.	Factor viii pegylated-aucl
C9248	0010	3	Injection, clevidipine butyrate, 1 mg	Inj, clevidipine butyrate
C9250	0010	3	Human plasma fibrin sealant, vapor-heated, solvent-detergent (artiss), 2 ml	Artiss fibrin sealant
C9254	0010	3	Injection, lacosamide, 1 mg	Injection, lacosamide
C9257	0010	3	Injection, bevacizumab, 0.25 mg	Bevacizumab injection
C9275	0010	3	Injection, hexaminolevulinate hydrochloride, 100 mg, per study dose	Hexaminolevulinate hcl
C9285	0010	3	Lidocaine 70 mg/tetracaine 70 mg, per patch	Patch, lidocaine/tetracaine
C9290	0010	3	Injection, bupivacaine liposome, 1 mg	Inj, bupivacaine liposome
C9293	0010	3	Injection, glucarpidase, 10 units	Injection, glucarpidase
C9349	0010	3	Puraply, and puraply antimicrobial, any type, per square centimeter	Puraply, puraply antimic
C9352	0010	3	Microporous collagen implantable tube (neuragen nerve guide), per centimeter length	Neuragen nerve guide, per cm
C9353	0010	3	Microporous collagen implantable slit tube (neurawrap nerve protector), per centimeter length	Neurawrap nerve protector,cm
C9354	0010	3	Acellular pericardial tissue matrix of non-human origin (veritas), per square centimeter	Veritas collagen matrix, cm2
C9355	0010	3	Collagen nerve cuff (neuromatrix), per 0.5 centimeter length	Neuromatrix nerve cuff, cm
C9356	0010	3	Tendon, porous matrix of cross-linked collagen and glycosaminoglycan matrix (tenoglide tendon protector sheet), per square centimeter	Tenoglide tendon prot, cm2
C9358	0010	3	Dermal substitute, native, non-denatured collagen, fetal bovine origin (surgimend collagen matrix), per 0.5 square centimeters	Surgimend, fetal
C9359	0010	3	Porous purified collagen matrix bone void filler (integra mozaik osteoconductive scaffold putty, integra os osteoconductive scaffold putty), per 0.5 cc	Implnt,bon void filler-putty
C9360	0010	3	Dermal substitute, native, non-denatured collagen, neonatal bovine origin (surgimend collagen matrix), per 0.5 square centimeters	Surgimend, neonatal
C9361	0010	3	Collagen matrix nerve wrap (neuromend collagen nerve wrap), per 0.5 centimeter length	Neuromend nerve wrap
C9362	0010	3	Porous purified collagen matrix bone void filler (integra mozaik osteoconductive scaffold strip), per 0.5 cc	Implnt,bon void filler-strip
C9363	0010	3	Skin substitute, integra meshed bilayer wound matrix, per square centimeter	Integra meshed bil wound mat
C9364	0010	3	Porcine implant, permacol, per square centimeter	Porcine implant, permacol
C9399	0010	3	Unclassified drugs or biologicals	Unclassified drugs or biolog
C9407	0010	3	Iodine i-131 iobenguane, diagnostic, 1 millicurie	Iodine i-131 iobenguane, dx
C9408	0010	3	Iodine i-131 iobenguane, therapeutic, 1 millicurie	Iodine i-131 iobenguane, tx
C9441	0010	3	Injection, ferric carboxymaltose, 1 mg	Inj, ferric carboxymaltose
C9442	0010	3	Injection, belinostat, 10 mg	Injection, belinostat
C9443	0010	3	Injection, dalbavancin, 10 mg	Injection, dalbavancin
C9444	0010	3	Injection, oritavancin, 10 mg	Injection, oritavancin
C9445	0010	3	Injection, c-1 esterase inhibitor (recombinant), ruconest, 10 units	C-1 esterase, ruconest
C9446	0010	3	Injection, tedizolid phosphate, 1 mg	Inj, tedizolid phosphate
C9447	0010	3	Injection, phenylephrine and ketorolac, 4 ml vial	Inj, phenylephrine ketorolac
C9448	0010	3	Netupitant 300 mg and palonosetron 0.5 mg, oral	Oral netupitant palonosetron
C9449	0010	3	Injection, blinatumomab, 1 mcg	Inj, blinatumomab
C9450	0010	3	Injection, fluocinolone acetonide intravitreal implant, 0.01 mg	Fluocinolone acetonide implt
C9451	0010	3	Injection, peramivir, 1 mg	Injection, peramivir
C9452	0010	3	Injection, ceftolozane 50 mg and tazobactam 25 mg	Inj, ceftolozane/tazobactam
C9453	0010	3	Injection, nivolumab, 1 mg	Injection, nivolumab
C9454	0010	3	Injection, pasireotide long acting, 1 mg	Inj, pasireotide long acting
C9455	0010	3	Injection, siltuximab, 10 mg	Injection, siltuximab
C9456	0010	3	Injection, isavuconazonium sulfate, 1 mg	Inj, isavuconazonium sulfate
C9457	0010	3	Injection, sulfur hexafluoride lipid microsphere, per ml	Lumason contrast agent
C9458	0010	3	Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries	Florbetaben f18
C9459	0010	3	Flutemetamol f18, diagnostic, per study dose, up to 5 millicuries	Flutemetamol f18
C9460	0010	3	Injection, cangrelor, 1 mg	Injection, cangrelor
C9461	0010	3	Choline c 11, diagnostic, per study dose	Choline c 11, diagnostic
C9462	0010	3	Injection, delafloxacin, 1 mg	Injection, delafloxacin
C9463	0010	3	Injection, aprepitant, 1 mg	Injection, aprepitant
C9464	0010	3	Injection, rolapitant, 0.5 mg	Injection, rolapitant
C9465	0010	3	Hyaluronan or derivative, durolane, for intra-articular injection, per dose	Injection, durolane
C9466	0010	3	Injection, benralizumab, 1 mg	Injection, benralizumab
C9467	0010	3	Injection, rituximab and hyaluronidase, 10 mg	Inj rituximab hyaluronidase
C9468	0010	3	Injection, factor ix (antihemophilic factor, recombinant), glycopegylated, rebinyn, 1 i.u.	Inj, factor ix, rebinyn
C9469	0010	3	Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg	Inj triamcinolone acetonide
C9470	0010	3	Injection, aripiprazole lauroxil, 1 mg	Aripiprazole lauroxil im
C9471	0010	3	Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg	Hymovis, 1 mg
C9472	0010	3	Injection, talimogene laherparepvec, 1 million plaque forming units (pfu)	Inj talimogene laherparepvec
C9473	0010	3	Injection, mepolizumab, 1 mg	Injection, mepolizumab
C9474	0010	3	Injection, irinotecan liposome, 1 mg	Inj, irinotecan liposome
C9475	0010	3	Injection, necitumumab, 1 mg	Injection, necitumumab
C9476	0010	3	Injection, daratumumab, 10 mg	Injection, daratumumab
C9477	0010	3	Injection, elotuzumab, 1 mg	Injection, elotuzumab
C9478	0010	3	Injection, sebelipase alfa, 1 mg	Injection, sebelipase alfa
C9479	0010	3	Instillation, ciprofloxacin otic suspension, 6 mg	Instill, ciprofloxacin otic
C9480	0010	3	Injection, trabectedin, 0.1 mg	Injection, trabectedin
C9481	0010	3	Injection, reslizumab, 1 mg	Injection, reslizumab
C9482	0010	3	Injection, sotalol hydrochloride, 1 mg	Sotalol hydrochloride iv
C9483	0010	3	Injection, atezolizumab, 10 mg	Injection, atezolizumab
C9484	0010	3	Injection, eteplirsen, 10 mg	Injection, eteplirsen
C9485	0010	3	Injection, olaratumab, 10 mg	Injection, olaratumab
C9486	0010	3	Injection, granisetron extended release, 0.1 mg	Inj, granisetron ext
C9487	0010	3	Ustekinumab, for intravenous injection, 1 mg	Ustekinumab iv inj, 1 mg
C9488	0010	3	Injection, conivaptan hydrochloride, 1 mg	Conivaptan hcl
C9489	0010	3	Injection, nusinersen, 0.1 mg	Injection, nusinersen
C9490	0010	3	Injection, bezlotoxumab, 10 mg	Injection, bezlotoxumab
C9491	0010	3	Injection, avelumab, 10 mg	Injection, avelumab
C9492	0010	3	Injection, durvalumab, 10 mg	Injection, durvalumab
C9493	0010	3	Injection, edaravone, 1 mg	Injection, edaravone
C9494	0010	3	Injection, ocrelizumab, 1 mg	Injection, ocrelizumab
C9497	0010	3	Loxapine, inhalation powder, 10 mg	Loxapine, inhalation powder
C9600	0010	3	Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch	Perc drug-el cor stent sing
C9601	0010	3	Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)	Perc drug-el cor stent bran
C9602	0010	3	Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch	Perc d-e cor stent ather s
C9603	0010	3	Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)	Perc d-e cor stent ather br
C9604	0010	3	Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel	Perc d-e cor revasc t cabg s
C9605	0010	3	Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (list separately in addition to code for primary procedure)	Perc d-e cor revasc t cabg b
C9606	0010	3	Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel	Perc d-e cor revasc w ami s
C9607	0010	3	Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; single vessel	Perc d-e cor revasc chro sin
C9608	0010	3	Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft (list separately in addition to code for primary procedure)	Perc d-e cor revasc chro add
C9724	0010	3	Endoscopic full-thickness plication of the stomach using endoscopic plication system (eps); includes endoscopy	Eps stomach plic
C9725	0010	3	Placement of endorectal intracavitary applicator for high intensity brachytherapy	Place endorectal app
C9726	0010	3	Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure	Rxt breast appl place/remov
C9727	0010	3	Insertion of implants into the soft palate; minimum of three implants	Insert palate implants
C9728	0010	3	Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperitoneum, thorax, single or multiple	Place device/marker, non pro
C9733	0010	3	Non-ophthalmic fluorescent vascular angiography	Non-ophthalmic fva
C9734	0010	3	Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (mr) guidance	U/s trtmt, not leiomyomata
C9735	0010	3	Anoscopy; with directed submucosal injection(s), any substance	Anoscopy, submucosal inj
C9737	0010	3	Laparoscopy, surgical, esophageal sphincter augmentation with device (e.g., magnetic band)	Lap esoph augmentation
C9738	0010	3	Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)	Blue light cysto imag agent
C9739	0010	3	Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants	Cystoscopy prostatic imp 1-3
C9740	0010	3	Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants	Cysto impl 4 or more
C9741	0010	3	Right heart catheterization with implantation of wireless pressure sensor in the pulmonary artery, including any type of measurement, angiography, imaging supervision, interpretation, and report	Impl pressure sensor w/angio
C9742	0010	3	Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic, including diagnostic laryngoscopy, if performed	Laryngoscopy with injection
C9743	0010	3	Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies)	Bulking/spacer material impl
C9744	0010	3	Ultrasound, abdominal, with contrast	Abd us w/contrast
C9745	0010	3	Nasal endoscopy, surgical; balloon dilation of eustachian tube	Nasal endo eustachian tube
C9746	0010	3	Transperineal implantation of permanent adjustable balloon continence device, with cystourethroscopy, when performed and/or fluoroscopy, when performed	Trans imp balloon cont
C9747	0010	3	Ablation of prostate, transrectal, high intensity focused ultrasound (hifu), including imaging guidance	Ablation, hifu, prostate
C9748	0010	3	Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy	Prostatic rf water vapor tx
C9749	0010	3	Repair of nasal vestibular lateral wall stenosis with implant(s)	Repair nasal stenosis w/imp
C9750	0010	3	Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretation and peri-operative interrogation and programming; complete system (includes device and electrode)	Ins/rem-replace compl iims
C9751	0010	3	Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including fluoroscopic guidance, when performed, with computed tomography acquisition(s) and 3-d rendering, computer-assisted, image-guided navigation, and endobronchial ultrasound (ebus) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]) and all mediastinal and/or hilar lymph node stations or structures and therapeutic intervention(s)	Microwave bronch, 3d, ebus
C9752	0010	3	Destruction of intraosseous basivertebral nerve, first two vertebral bodies, including imaging guidance (e.g., fluoroscopy), lumbar/sacrum	Intraosseous des lumb/sacrum
C9753	0010	3	Destruction of intraosseous basivertebral nerve, each additional vertebral body, including imaging guidance (e.g., fluoroscopy), lumbar/sacrum (list separately in addition to code for primary procedure)	Intraosseous destruct add’l
C9754	0010	3	Creation of arteriovenous fistula, percutaneous; direct, any site, including all imaging and radiologic supervision and interpretation, when performed and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization, when performed)	Perc av fistula, direct
C9755	0010	3	Creation of arteriovenous fistula, percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, when performed) and fistulogram(s), angiography, venography, and/or ultrasound, with radiologic supervision and interpretation, when performed	Rf magnetic-guide av fistula
C9756	0010	3	Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (icg) (list separately in addition to code for primary procedure)	Fluorescence lymph map w/icg
C9757	0010	3	Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implantation of bone anchored annular closure device, including annular defect measurement, alignment and sizing assessment, and image guidance; 1 interspace, lumbar	Spine/lumbar disk surgery
C9758	0010	3	Blinded procedure for nyha class iii/iv heart failure; transcatheter implantation of interatrial shunt or placebo control, including right heart catheterization, trans-esophageal echocardiography (tee)/intracardiac echocardiography (ice), and all imaging with or without guidance (e.g., ultrasound, fluoroscopy), performed in an approved investigational device exemption (ide) study	Interatrial shunt ide
C9800	0010	3	Dermal injection procedure(s) for facial lipodystrophy syndrome (lds) and provision of radiesse or sculptra dermal filler, including all items and supplies	Dermal filler inj px/suppl
C9898	0010	3	Radiolabeled product provided during a hospital inpatient stay	Inpnt stay radiolabeled item
C9899	0010	3	Implanted prosthetic device, payable only for inpatients who do not have inpatient coverage	Inpt implant pros dev,no cov

D0000–D9999: Dental Procedures

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION

E0100–E9999: Durable Medical Equipment

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
E0100	0010	3	Cane, includes canes of all materials, adjustable or fixed, with tip	Cane adjust/fixed with tip
E0105	0010	3	Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips	Cane adjust/fixed quad/3 pro
E0110	0010	3	Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips	Crutch forearm pair
E0111	0010	3	Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips	Crutch forearm each
E0112	0010	3	Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips	Crutch underarm pair wood
E0113	0010	3	Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip	Crutch underarm each wood
E0114	0010	3	Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips	Crutch underarm pair no wood
E0116	0010	3	Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each	Crutch underarm each no wood
E0117	0010	3	Crutch, underarm, articulating, spring assisted, each	Underarm springassist crutch
E0118	0010	3	Crutch substitute, lower leg platform, with or without wheels, each	Crutch substitute
E0130	0010	3	Walker, rigid (pickup), adjustable or fixed height	Walker rigid adjust/fixed ht
E0135	0010	3	Walker, folding (pickup), adjustable or fixed height	Walker folding adjust/fixed
E0140	0010	3	Walker, with trunk support, adjustable or fixed height, any type	Walker w trunk support
E0141	0010	3	Walker, rigid, wheeled, adjustable or fixed height	Rigid wheeled walker adj/fix
E0143	0010	3	Walker, folding, wheeled, adjustable or fixed height	Walker folding wheeled w/o s
E0144	0010	3	Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat	Enclosed walker w rear seat
E0147	0010	3	Walker, heavy duty, multiple braking system, variable wheel resistance	Walker variable wheel resist
E0148	0010	3	Walker, heavy duty, without wheels, rigid or folding, any type, each	Heavyduty walker no wheels
E0149	0010	3	Walker, heavy duty, wheeled, rigid or folding, any type	Heavy duty wheeled walker
E0153	0010	3	Platform attachment, forearm crutch, each	Forearm crutch platform atta
E0154	0010	3	Platform attachment, walker, each	Walker platform attachment
E0155	0010	3	Wheel attachment, rigid pick-up walker, per pair	Walker wheel attachment,pair
E0156	0010	3	Seat attachment, walker	Walker seat attachment
E0157	0010	3	Crutch attachment, walker, each	Walker crutch attachment
E0158	0010	3	Leg extensions for walker, per set of four (4)	Walker leg extenders set of4
E0159	0010	3	Brake attachment for wheeled walker, replacement, each	Brake for wheeled walker
E0160	0010	3	Sitz type bath or equipment, portable, used with or without commode	Sitz type bath or equipment
E0161	0010	3	Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s	Sitz bath/equipment w/faucet
E0162	0010	3	Sitz bath chair	Sitz bath chair
E0163	0010	3	Commode chair, mobile or stationary, with fixed arms	Commode chair with fixed arm
E0165	0010	3	Commode chair, mobile or stationary, with detachable arms	Commode chair with detacharm
E0167	0010	3	Pail or pan for use with commode chair, replacement only	Commode chair pail or pan
E0168	0010	3	Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each	Heavyduty/wide commode chair
E0170	0010	3	Commode chair with integrated seat lift mechanism, electric, any type	Commode chair electric
E0171	0010	3	Commode chair with integrated seat lift mechanism, non-electric, any type	Commode chair non-electric
E0172	0010	3	Seat lift mechanism placed over or on top of toilet, any type	Seat lift mechanism toilet
E0175	0010	3	Foot rest, for use with commode chair, each	Commode chair foot rest
E0181	0010	3	Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty	Press pad alternating w/ pum
E0182	0010	3	Pump for alternating pressure pad, for replacement only	Replace pump, alt press pad
E0184	0010	3	Dry pressure mattress	Dry pressure mattress
E0185	0010	3	Gel or gel-like pressure pad for mattress, standard mattress length and width	Gel pressure mattress pad
E0186	0010	3	Air pressure mattress	Air pressure mattress
E0187	0010	3	Water pressure mattress	Water pressure mattress
E0188	0010	3	Synthetic sheepskin pad	Synthetic sheepskin pad
E0189	0010	3	Lambswool sheepskin pad, any size	Lambswool sheepskin pad
E0190	0010	3	Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories	Positioning cushion
E0191	0010	3	Heel or elbow protector, each	Protector heel or elbow
E0193	0010	3	Powered air flotation bed (low air loss therapy)	Powered air flotation bed
E0194	0010	3	Air fluidized bed	Air fluidized bed
E0196	0010	3	Gel pressure mattress	Gel pressure mattress
E0197	0010	3	Air pressure pad for mattress, standard mattress length and width	Air pressure pad for mattres
E0198	0010	3	Water pressure pad for mattress, standard mattress length and width	Water pressure pad for mattr
E0199	0010	3	Dry pressure pad for mattress, standard mattress length and width	Dry pressure pad for mattres
E0200	0010	3	Heat lamp, without stand (table model), includes bulb, or infrared element	Heat lamp without stand
E0202	0010	3	Phototherapy (bilirubin) light with photometer	Phototherapy light w/ photom
E0203	0010	3	Therapeutic lightbox, minimum 10,000 lux, table top model	Therapeutic lightbox tabletp
E0205	0010	3	Heat lamp, with stand, includes bulb, or infrared element	Heat lamp with stand
E0210	0010	3	Electric heat pad, standard	Electric heat pad standard
E0215	0010	3	Electric heat pad, moist	Electric heat pad moist
E0217	0010	3	Water circulating heat pad with pump	Water circ heat pad w pump
E0218	0010	3	Fluid circulating cold pad with pump, any type	Fluid circ cold pad w pump
E0221	0010	3	Infrared heating pad system	Infrared heating pad system
E0225	0010	3	Hydrocollator unit, includes pads	Hydrocollator unit
E0231	0010	3	Non-contact wound warming device (temperature control unit, ac adapter and power cord) for use with warming card and wound cover	Wound warming device
E0232	0010	3	Warming card for use with the non contact wound warming device and non contact wound warming wound cover	Warming card for nwt
E0235	0010	3	Paraffin bath unit, portable (see medical supply code a4265 for paraffin)	Paraffin bath unit portable
E0236	0010	3	Pump for water circulating pad	Pump for water circulating p
E0239	0010	3	Hydrocollator unit, portable	Hydrocollator unit portable
E0240	0010	3	Bath/shower chair, with or without wheels, any size	Bath/shower chair
E0241	0010	3	Bath tub wall rail, each	Bath tub wall rail
E0242	0010	3	Bath tub rail, floor base	Bath tub rail floor
E0243	0010	3	Toilet rail, each	Toilet rail
E0244	0010	3	Raised toilet seat	Toilet seat raised
E0245	0010	3	Tub stool or bench	Tub stool or bench
E0246	0010	3	Transfer tub rail attachment	Transfer tub rail attachment
E0247	0010	3	Transfer bench for tub or toilet with or without commode opening	Trans bench w/wo comm open
E0248	0010	3	Transfer bench, heavy duty, for tub or toilet with or without commode opening	Hdtrans bench w/wo comm open
E0249	0010	3	Pad for water circulating heat unit, for replacement only	Pad water circulating heat u
E0250	0010	3	Hospital bed, fixed height, with any type side rails, with mattress	Hosp bed fixed ht w/ mattres
E0251	0010	3	Hospital bed, fixed height, with any type side rails, without mattress	Hosp bed fixd ht w/o mattres
E0255	0010	3	Hospital bed, variable height, hi-lo, with any type side rails, with mattress	Hospital bed var ht w/ mattr
E0256	0010	3	Hospital bed, variable height, hi-lo, with any type side rails, without mattress	Hospital bed var ht w/o matt
E0260	0010	3	Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress	Hosp bed semi-electr w/ matt
E0261	0010	3	Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress	Hosp bed semi-electr w/o mat
E0265	0010	3	Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress	Hosp bed total electr w/ mat
E0266	0010	3	Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress	Hosp bed total elec w/o matt
E0270	0010	3	Hospital bed, institutional type includes: oscillating, circulating and stryker frame, with mattress	Hospital bed institutional t
E0271	0010	3	Mattress, innerspring	Mattress innerspring
E0272	0010	3	Mattress, foam rubber	Mattress foam rubber
E0273	0010	3	Bed board	Bed board
E0274	0010	3	Over-bed table	Over-bed table
E0275	0010	3	Bed pan, standard, metal or plastic	Bed pan standard
E0276	0010	3	Bed pan, fracture, metal or plastic	Bed pan fracture
E0277	0010	3	Powered pressure-reducing air mattress	Powered pres-redu air mattrs
E0280	0010	3	Bed cradle, any type	Bed cradle
E0290	0010	3	Hospital bed, fixed height, without side rails, with mattress	Hosp bed fx ht w/o rails w/m
E0291	0010	3	Hospital bed, fixed height, without side rails, without mattress	Hosp bed fx ht w/o rail w/o
E0292	0010	3	Hospital bed, variable height, hi-lo, without side rails, with mattress	Hosp bed var ht no sr w/matt
E0293	0010	3	Hospital bed, variable height, hi-lo, without side rails, without mattress	Hosp bed var ht no sr no mat
E0294	0010	3	Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress	Hosp bed semi-elect w/ mattr
E0295	0010	3	Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress	Hosp bed semi-elect w/o matt
E0296	0010	3	Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress	Hosp bed total elect w/ matt
E0297	0010	3	Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress	Hosp bed total elect w/o mat
E0300	0010	3	Pediatric crib, hospital grade, fully enclosed, with or without top enclosure	Enclosed ped crib hosp grade
E0301	0010	3	Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress	Hd hosp bed, 350-600 lbs
E0302	0010	3	Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress	Ex hd hosp bed > 600 lbs
E0303	0010	3	Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress	Hosp bed hvy dty xtra wide
E0304	0010	3	Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress	Hosp bed xtra hvy dty x wide
E0305	0010	3	Bed side rails, half length	Rails bed side half length
E0310	0010	3	Bed side rails, full length	Rails bed side full length
E0315	0010	3	Bed accessory: board, table, or support device, any type	Bed accessory brd/tbl/supprt
E0316	0010	3	Safety enclosure frame/canopy for use with hospital bed, any type	Bed safety enclosure
E0325	0010	3	Urinal; male, jug-type, any material	Urinal male jug-type
E0326	0010	3	Urinal; female, jug-type, any material	Urinal female jug-type
E0328	0010	3	Hospital bed, pediatric, manual, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress	Ped hospital bed, manual
E0329	0010	3	Hospital bed, pediatric, electric or semi-electric, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress	Ped hospital bed semi/elect
E0350	0010	3	Control unit for electronic bowel irrigation/evacuation system	Control unit bowel system
E0352	0010	3	Disposable pack (water reservoir bag, speculum, valving mechanism and collection bag/box) for use with the electronic bowel irrigation/evacuation system	Disposable pack w/bowel syst
E0370	0010	3	Air pressure elevator for heel	Air elevator for heel
E0371	0010	3	Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width	Nonpower mattress overlay
E0372	0010	3	Powered air overlay for mattress, standard mattress length and width	Powered air mattress overlay
E0373	0010	3	Nonpowered advanced pressure reducing mattress	Nonpowered pressure mattress
E0424	0010	3	Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing	Stationary compressed gas 02
E0425	0010	3	Stationary compressed gas system, purchase; includes regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing	Gas system stationary compre
E0430	0010	3	Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing	Oxygen system gas portable
E0431	0010	3	Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing	Portable gaseous 02
E0433	0010	3	Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge	Portable liquid oxygen sys
E0434	0010	3	Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing	Portable liquid 02
E0435	0010	3	Portable liquid oxygen system, purchase; includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor	Oxygen system liquid portabl
E0439	0010	3	Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing	Stationary liquid 02
E0440	0010	3	Stationary liquid oxygen system, purchase; includes use of reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing	Oxygen system liquid station
E0441	0010	3	Stationary oxygen contents, gaseous, 1 month’s supply = 1 unit	Stationary o2 contents, gas
E0442	0010	3	Stationary oxygen contents, liquid, 1 month’s supply = 1 unit	Stationary o2 contents, liq
E0443	0010	3	Portable oxygen contents, gaseous, 1 month’s supply = 1 unit	Portable 02 contents, gas
E0444	0010	3	Portable oxygen contents, liquid, 1 month’s supply = 1 unit	Portable 02 contents, liquid
E0445	0010	3	Oximeter device for measuring blood oxygen levels non-invasively	Oximeter non-invasive
E0446	0010	3	Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories	Topical ox deliver sys, nos
E0447	0010	3	Portable oxygen contents, liquid, 1 month’s supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)	Port o2 cont, liq over 4 lpm
E0450	0010	3	Volume control ventilator, without pressure support mode, may include pressure control mode, used with invasive interface (e.g., tracheostomy tube)	Vol control vent invasiv int
E0455	0010	3	Oxygen tent, excluding croup or pediatric tents	Oxygen tent excl croup/ped t
E0457	0010	3	Chest shell (cuirass)	Chest shell
E0459	0010	3	Chest wrap	Chest wrap
E0460	0010	3	Negative pressure ventilator; portable or stationary	Neg press vent portabl/statn
E0461	0010	3	Volume control ventilator, without pressure support mode, may include pressure control mode, used with non-invasive interface (e.g., mask)	Vol control vent noninv int
E0462	0010	3	Rocking bed with or without side rails	Rocking bed w/ or w/o side r
E0463	0010	3	Pressure support ventilator with volume control mode, may include pressure control mode, used with invasive interface (e.g., tracheostomy tube)	Press supp vent invasive int
E0464	0010	3	Pressure support ventilator with volume control mode, may include pressure control mode, used with non-invasive interface (e.g., mask)	Press supp vent noninv int
E0465	0010	3	Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)	Home vent invasive interface
E0466	0010	3	Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)	Home vent non-invasive inter
E0467	0010	3	Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions	Home vent multi-function
E0470	0010	3	Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)	Rad w/o backup non-inv intfc
E0471	0010	3	Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)	Rad w/backup non inv intrfc
E0472	0010	3	Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)	Rad w backup invasive intrfc
E0480	0010	3	Percussor, electric or pneumatic, home model	Percussor elect/pneum home m
E0481	0010	3	Intrapulmonary percussive ventilation system and related accessories	Intrpulmnry percuss vent sys
E0482	0010	3	Cough stimulating device, alternating positive and negative airway pressure	Cough stimulating device
E0483	0010	3	High frequency chest wall oscillation system, includes all accessories and supplies, each	Hi freq chest wall oscil sys
E0484	0010	3	Oscillatory positive expiratory pressure device, non-electric, any type, each	Non-elec oscillatory pep dvc
E0485	0010	3	Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment	Oral device/appliance prefab
E0486	0010	3	Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment	Oral device/appliance cusfab
E0487	0010	3	Spirometer, electronic, includes all accessories	Electronic spirometer
E0500	0010	3	Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source	Ippb all types
E0550	0010	3	Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery	Humidif extens supple w ippb
E0555	0010	3	Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter	Humidifier for use w/ regula
E0560	0010	3	Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery	Humidifier supplemental w/ i
E0561	0010	3	Humidifier, non-heated, used with positive airway pressure device	Humidifier nonheated w pap
E0562	0010	3	Humidifier, heated, used with positive airway pressure device	Humidifier heated used w pap
E0565	0010	3	Compressor, air power source for equipment which is not self-contained or cylinder driven	Compressor air power source
E0570	0010	3	Nebulizer, with compressor	Nebulizer with compression
E0572	0010	3	Aerosol compressor, adjustable pressure, light duty for intermittent use	Aerosol compressor adjust pr
E0574	0010	3	Ultrasonic/electronic aerosol generator with small volume nebulizer	Ultrasonic generator w svneb
E0575	0010	3	Nebulizer, ultrasonic, large volume	Nebulizer ultrasonic
E0580	0010	3	Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter	Nebulizer for use w/ regulat
E0585	0010	3	Nebulizer, with compressor and heater	Nebulizer w/ compressor & he
E0600	0010	3	Respiratory suction pump, home model, portable or stationary, electric	Suction pump portab hom modl
E0601	0010	3	Continuous positive airway pressure (cpap) device	Cont airway pressure device
E0602	0010	3	Breast pump, manual, any type	Manual breast pump
E0603	0010	3	Breast pump, electric (ac and/or dc), any type	Electric breast pump
E0604	0010	3	Breast pump, hospital grade, electric (ac and / or dc), any type	Hosp grade elec breast pump
E0605	0010	3	Vaporizer, room type	Vaporizer room type
E0606	0010	3	Postural drainage board	Drainage board postural
E0607	0010	3	Home blood glucose monitor	Blood glucose monitor home
E0610	0010	3	Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)	Pacemaker monitr audible/vis
E0615	0010	3	Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems	Pacemaker monitr digital/vis
E0616	0010	3	Implantable cardiac event recorder with memory, activator and programmer	Cardiac event recorder
E0617	0010	3	External defibrillator with integrated electrocardiogram analysis	Automatic ext defibrillator
E0618	0010	3	Apnea monitor, without recording feature	Apnea monitor
E0619	0010	3	Apnea monitor, with recording feature	Apnea monitor w recorder
E0620	0010	3	Skin piercing device for collection of capillary blood, laser, each	Cap bld skin piercing laser
E0621	0010	3	Sling or seat, patient lift, canvas or nylon	Patient lift sling or seat
E0625	0010	3	Patient lift, bathroom or toilet, not otherwise classified	Patient lift bathroom or toi
E0627	0010	3	Seat lift mechanism, electric, any type	Seat lift mech, electric any
E0628	0010	3	Separate seat lift mechanism for use with patient owned furniture-electric	Seat lift for pt furn-electr
E0629	0010	3	Seat lift mechanism, non-electric, any type	Seat lift mech, non-electric
E0630	0010	3	Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)	Patient lift hydraulic
E0635	0010	3	Patient lift, electric with seat or sling	Patient lift electric
E0636	0010	3	Multipositional patient support system, with integrated lift, patient accessible controls	Pt support & positioning sys
E0637	0010	3	Combination sit to stand frame/table system, any size including pediatric, with seat lift feature, with or without wheels	Combination sit to stand sys
E0638	0010	3	Standing frame/table system, one position (e.g., upright, supine or prone stander), any size including pediatric, with or without wheels	Standing frame sys
E0639	0010	3	Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories	Moveable patient lift system
E0640	0010	3	Patient lift, fixed system, includes all components/accessories	Fixed patient lift system
E0641	0010	3	Standing frame/table system, multi-position (e.g., three-way stander), any size including pediatric, with or without wheels	Multi-position stnd fram sys
E0642	0010	3	Standing frame/table system, mobile (dynamic stander), any size including pediatric	Dynamic standing frame
E0650	0010	3	Pneumatic compressor, non-segmental home model	Pneuma compresor non-segment
E0651	0010	3	Pneumatic compressor, segmental home model without calibrated gradient pressure	Pneum compressor segmental
E0652	0010	3	Pneumatic compressor, segmental home model with calibrated gradient pressure	Pneum compres w/cal pressure
E0655	0010	3	Non-segmental pneumatic appliance for use with pneumatic compressor, half arm	Pneumatic appliance half arm
E0656	0010	3	Segmental pneumatic appliance for use with pneumatic compressor, trunk	Segmental pneumatic trunk
E0657	0010	3	Segmental pneumatic appliance for use with pneumatic compressor, chest	Segmental pneumatic chest
E0660	0010	3	Non-segmental pneumatic appliance for use with pneumatic compressor, full leg	Pneumatic appliance full leg
E0665	0010	3	Non-segmental pneumatic appliance for use with pneumatic compressor, full arm	Pneumatic appliance full arm
E0666	0010	3	Non-segmental pneumatic appliance for use with pneumatic compressor, half leg	Pneumatic appliance half leg
E0667	0010	3	Segmental pneumatic appliance for use with pneumatic compressor, full leg	Seg pneumatic appl full leg
E0668	0010	3	Segmental pneumatic appliance for use with pneumatic compressor, full arm	Seg pneumatic appl full arm
E0669	0010	3	Segmental pneumatic appliance for use with pneumatic compressor, half leg	Seg pneumatic appli half leg
E0670	0010	3	Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk	Seg pneum int legs/trunk
E0671	0010	3	Segmental gradient pressure pneumatic appliance, full leg	Pressure pneum appl full leg
E0672	0010	3	Segmental gradient pressure pneumatic appliance, full arm	Pressure pneum appl full arm
E0673	0010	3	Segmental gradient pressure pneumatic appliance, half leg	Pressure pneum appl half leg
E0675	0010	3	Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)	Pneumatic compression device
E0676	0010	3	Intermittent limb compression device (includes all accessories), not otherwise specified	Inter limb compress dev nos
E0691	0010	3	Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less	Uvl pnl 2 sq ft or less
E0692	0010	3	Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel	Uvl sys panel 4 ft
E0693	0010	3	Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel	Uvl sys panel 6 ft
E0694	0010	3	Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection	Uvl md cabinet sys 6 ft
E0700	0010	3	Safety equipment, device or accessory, any type	Safety equipment
E0705	0010	3	Transfer device, any type, each	Transfer device
E0710	0010	3	Restraints, any type (body, chest, wrist or ankle)	Restraints any type
E0720	0010	3	Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation	Tens two lead
E0730	0010	3	Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation	Tens four lead
E0731	0010	3	Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient’s skin by layers of fabric)	Conductive garment for tens/
E0740	0010	3	Non-implanted pelvic floor electrical stimulator, complete system	Non-implant pelv flr e-stim
E0744	0010	3	Neuromuscular stimulator for scoliosis	Neuromuscular stim for scoli
E0745	0010	3	Neuromuscular stimulator, electronic shock unit	Neuromuscular stim for shock
E0746	0010	3	Electromyography (emg), biofeedback device	Electromyograph biofeedback
E0747	0010	3	Osteogenesis stimulator, electrical, non-invasive, other than spinal applications	Elec osteogen stim not spine
E0748	0010	3	Osteogenesis stimulator, electrical, non-invasive, spinal applications	Elec osteogen stim spinal
E0749	0010	3	Osteogenesis stimulator, electrical, surgically implanted	Elec osteogen stim implanted
E0755	0010	3	Electronic salivary reflex stimulator (intra-oral/non-invasive)	Electronic salivary reflex s
E0760	0010	3	Osteogenesis stimulator, low intensity ultrasound, non-invasive	Osteogen ultrasound stimltor
E0761	0010	3	Non-thermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device	Nontherm electromgntc device
E0762	0010	3	Transcutaneous electrical joint stimulation device system, includes all accessories	Trans elec jt stim dev sys
E0764	0010	3	Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program	Functional neuromuscularstim
E0765	0010	3	Fda approved nerve stimulator, with replaceable batteries, for treatment of nausea and vomiting	Nerve stimulator for tx n&v
E0766	0010	3	Electrical stimulation device used for cancer treatment, includes all accessories, any type	Elec stim cancer treatment
E0769	0010	3	Electrical stimulation or electromagnetic wound treatment device, not otherwise classified	Electric wound treatment dev
E0770	0010	3	Functional electrical stimulator, transcutaneous stimulation of nerve and/or muscle groups, any type, complete system, not otherwise specified	Functional electric stim nos
E0776	0010	3	Iv pole	Iv pole
E0779	0010	3	Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater	Amb infusion pump mechanical
E0780	0010	3	Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours	Mech amb infusion pump <8hrs
E0781	0010	3	Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient	External ambulatory infus pu
E0782	0010	3	Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)	Non-programble infusion pump
E0783	0010	3	Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)	Programmable infusion pump
E0784	0010	3	External ambulatory infusion pump, insulin	Ext amb infusn pump insulin
E0785	0010	3	Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement	Replacement impl pump cathet
E0786	0010	3	Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)	Implantable pump replacement
E0787	0010	3	External ambulatory infusion pump, insulin, dosage rate adjustment using therapeutic continuous glucose sensing	Cgs dose adj insulin inf pmp
E0791	0010	3	Parenteral infusion pump, stationary, single or multi-channel	Parenteral infusion pump sta
E0830	0010	3	Ambulatory traction device, all types, each	Ambulatory traction device
E0840	0010	3	Traction frame, attached to headboard, cervical traction	Tract frame attach headboard
E0849	0010	3	Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible	Cervical pneum trac equip
E0850	0010	3	Traction stand, free standing, cervical traction	Traction stand free standing
E0855	0010	3	Cervical traction equipment not requiring additional stand or frame	Cervical traction equipment
E0856	0010	3	Cervical traction device, with inflatable air bladder(s)	Cervic collar w air bladders
E0860	0010	3	Traction equipment, overdoor, cervical	Tract equip cervical tract
E0870	0010	3	Traction frame, attached to footboard, extremity traction, (e.g., buck’s)	Tract frame attach footboard
E0880	0010	3	Traction stand, free standing, extremity traction, (e.g., buck’s)	Trac stand free stand extrem
E0890	0010	3	Traction frame, attached to footboard, pelvic traction	Traction frame attach pelvic
E0900	0010	3	Traction stand, free standing, pelvic traction, (e.g., buck’s)	Trac stand free stand pelvic
E0910	0010	3	Trapeze bars, a/k/a patient helper, attached to bed, with grab bar	Trapeze bar attached to bed
E0911	0010	3	Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar	Hd trapeze bar attach to bed
E0912	0010	3	Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar	Hd trapeze bar free standing
E0920	0010	3	Fracture frame, attached to bed, includes weights	Fracture frame attached to b
E0930	0010	3	Fracture frame, free standing, includes weights	Fracture frame free standing
E0935	0010	3	Continuous passive motion exercise device for use on knee only	Cont pas motion exercise dev
E0936	0010	3	Continuous passive motion exercise device for use other than knee	Cpm device, other than knee
E0940	0010	3	Trapeze bar, free standing, complete with grab bar	Trapeze bar free standing
E0941	0010	3	Gravity assisted traction device, any type	Gravity assisted traction de
E0942	0010	3	Cervical head harness/halter	Cervical head harness/halter
E0944	0010	3	Pelvic belt/harness/boot	Pelvic belt/harness/boot
E0945	0010	3	Extremity belt/harness	Belt/harness extremity
E0946	0010	3	Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)	Fracture frame dual w cross
E0947	0010	3	Fracture frame, attachments for complex pelvic traction	Fracture frame attachmnts pe
E0948	0010	3	Fracture frame, attachments for complex cervical traction	Fracture frame attachmnts ce
E0950	0010	3	Wheelchair accessory, tray, each	Tray
E0951	0010	3	Heel loop/holder, any type, with or without ankle strap, each	Loop heel
E0952	0010	3	Toe loop/holder, any type, each	Toe loop/holder, each
E0953	0010	3	Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each	W/c lateral thigh/knee sup
E0954	0010	3	Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot	Foot box, any type each foot
E0955	0010	3	Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each	Cushioned headrest
E0956	0010	3	Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each	W/c lateral trunk/hip suppor
E0957	0010	3	Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each	W/c medial thigh support
E0958	0010	3	Manual wheelchair accessory, one-arm drive attachment, each	Whlchr att- conv 1 arm drive
E0959	0010	3	Manual wheelchair accessory, adapter for amputee, each	Amputee adapter
E0960	0010	3	Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware	W/c shoulder harness/straps
E0961	0010	3	Manual wheelchair accessory, wheel lock brake extension (handle), each	Wheelchair brake extension
E0966	0010	3	Manual wheelchair accessory, headrest extension, each	Wheelchair head rest extensi
E0967	0010	3	Manual wheelchair accessory, hand rim with projections, any type, replacement only, each	Man wc rim/projection rep ea
E0968	0010	3	Commode seat, wheelchair	Wheelchair commode seat
E0969	0010	3	Narrowing device, wheelchair	Wheelchair narrowing device
E0970	0010	3	No. 2 footplates, except for elevating leg rest	Wheelchair no. 2 footplates
E0971	0010	3	Manual wheelchair accessory, anti-tipping device, each	Wheelchair anti-tipping devi
E0973	0010	3	Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each	W/ch access det adj armrest
E0974	0010	3	Manual wheelchair accessory, anti-rollback device, each	W/ch access anti-rollback
E0978	0010	3	Wheelchair accessory, positioning belt/safety belt/pelvic strap, each	W/c acc,saf belt pelv strap
E0980	0010	3	Safety vest, wheelchair	Wheelchair safety vest
E0981	0010	3	Wheelchair accessory, seat upholstery, replacement only, each	Seat upholstery, replacement
E0982	0010	3	Wheelchair accessory, back upholstery, replacement only, each	Back upholstery, replacement
E0983	0010	3	Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control	Add pwr joystick
E0984	0010	3	Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control	Add pwr tiller
E0985	0010	3	Wheelchair accessory, seat lift mechanism	W/c seat lift mechanism
E0986	0010	3	Manual wheelchair accessory, push-rim activated power assist system	Man w/c push-rim powr system
E0988	0010	3	Manual wheelchair accessory, lever-activated, wheel drive, pair	Lever-activated wheel drive
E0990	0010	3	Wheelchair accessory, elevating leg rest, complete assembly, each	Wheelchair elevating leg res
E0992	0010	3	Manual wheelchair accessory, solid seat insert	Wheelchair solid seat insert
E0994	0010	3	Arm rest, each	Wheelchair arm rest
E0995	0010	3	Wheelchair accessory, calf rest/pad, replacement only, each	Wc calf rest, pad replacemnt
E1002	0010	3	Wheelchair accessory, power seating system, tilt only	Pwr seat tilt
E1003	0010	3	Wheelchair accessory, power seating system, recline only, without shear reduction	Pwr seat recline
E1004	0010	3	Wheelchair accessory, power seating system, recline only, with mechanical shear reduction	Pwr seat recline mech
E1005	0010	3	Wheelchair accessory, power seatng system, recline only, with power shear reduction	Pwr seat recline pwr
E1006	0010	3	Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction	Pwr seat combo w/o shear
E1007	0010	3	Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction	Pwr seat combo w/shear
E1008	0010	3	Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction	Pwr seat combo pwr shear
E1009	0010	3	Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each	Add mech leg elevation
E1010	0010	3	Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair	Add pwr leg elevation
E1011	0010	3	Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)	Ped wc modify width adjustm
E1012	0010	3	Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each	Ctr mount pwr elev leg rest
E1014	0010	3	Reclining back, addition to pediatric size wheelchair	Reclining back add ped w/c
E1015	0010	3	Shock absorber for manual wheelchair, each	Shock absorber for man w/c
E1016	0010	3	Shock absorber for power wheelchair, each	Shock absorber for power w/c
E1017	0010	3	Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each	Hd shck absrbr for hd man wc
E1018	0010	3	Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each	Hd shck absrber for hd powwc
E1020	0010	3	Residual limb support system for wheelchair, any type	Residual limb support system
E1028	0010	3	Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory	W/c manual swingaway
E1029	0010	3	Wheelchair accessory, ventilator tray, fixed	W/c vent tray fixed
E1030	0010	3	Wheelchair accessory, ventilator tray, gimbaled	W/c vent tray gimbaled
E1031	0010	3	Rollabout chair, any and all types with casters 5" or greater	Rollabout chair with casters
E1035	0010	3	Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs	Patient transfer system <300
E1036	0010	3	Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs	Patient transfer system >300
E1037	0010	3	Transport chair, pediatric size	Transport chair, ped size
E1038	0010	3	Transport chair, adult size, patient weight capacity up to and including 300 pounds	Transport chair pt wt<=300lb
E1039	0010	3	Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds	Transport chair pt wt >300lb
E1050	0010	3	Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests	Whelchr fxd full length arms
E1060	0010	3	Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests	Wheelchair detachable arms
E1070	0010	3	Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest	Wheelchair detachable foot r
E1083	0010	3	Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest	Hemi-wheelchair fixed arms
E1084	0010	3	Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests	Hemi-wheelchair detachable a
E1085	0010	3	Hemi-wheelchair, fixed full length arms, swing away detachable foot rests	Hemi-wheelchair fixed arms
E1086	0010	3	Hemi-wheelchair detachable arms desk or full length, swing away detachable footrests	Hemi-wheelchair detachable a
E1087	0010	3	High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests	Wheelchair lightwt fixed arm
E1088	0010	3	High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests	Wheelchair lightweight det a
E1089	0010	3	High strength lightweight wheelchair, fixed length arms, swing away detachable footrest	Wheelchair lightwt fixed arm
E1090	0010	3	High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable foot rests	Wheelchair lightweight det a
E1092	0010	3	Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests	Wheelchair wide w/ leg rests
E1093	0010	3	Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests	Wheelchair wide w/ foot rest
E1100	0010	3	Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests	Whchr s-recl fxd arm leg res
E1110	0010	3	Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest	Wheelchair semi-recl detach
E1130	0010	3	Standard wheelchair, fixed full length arms, fixed or swing away detachable footrests	Whlchr stand fxd arm ft rest
E1140	0010	3	Wheelchair, detachable arms, desk or full length, swing away detachable footrests	Wheelchair standard detach a
E1150	0010	3	Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests	Wheelchair standard w/ leg r
E1160	0010	3	Wheelchair, fixed full length arms, swing away detachable elevating legrests	Wheelchair fixed arms
E1161	0010	3	Manual adult size wheelchair, includes tilt in space	Manual adult wc w tiltinspac
E1170	0010	3	Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests	Whlchr ampu fxd arm leg rest
E1171	0010	3	Amputee wheelchair, fixed full length arms, without footrests or legrest	Wheelchair amputee w/o leg r
E1172	0010	3	Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest	Wheelchair amputee detach ar
E1180	0010	3	Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests	Wheelchair amputee w/ foot r
E1190	0010	3	Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests	Wheelchair amputee w/ leg re
E1195	0010	3	Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests	Wheelchair amputee heavy dut
E1200	0010	3	Amputee wheelchair, fixed full length arms, swing away detachable footrest	Wheelchair amputee fixed arm
E1220	0010	3	Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification	Whlchr special size/constrc
E1221	0010	3	Wheelchair with fixed arm, footrests	Wheelchair spec size w foot
E1222	0010	3	Wheelchair with fixed arm, elevating legrests	Wheelchair spec size w/ leg
E1223	0010	3	Wheelchair with detachable arms, footrests	Wheelchair spec size w foot
E1224	0010	3	Wheelchair with detachable arms, elevating legrests	Wheelchair spec size w/ leg
E1225	0010	3	Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each	Manual semi-reclining back
E1226	0010	3	Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each	Manual fully reclining back
E1227	0010	3	Special height arms for wheelchair	Wheelchair spec sz spec ht a
E1228	0010	3	Special back height for wheelchair	Wheelchair spec sz spec ht b
E1229	0010	3	Wheelchair, pediatric size, not otherwise specified	Pediatric wheelchair nos
E1230	0010	3	Power operated vehicle (three or four wheel nonhighway) specify brand name and model number	Power operated vehicle
E1231	0010	3	Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system	Rigid ped w/c tilt-in-space
E1232	0010	3	Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system	Folding ped wc tilt-in-space
E1233	0010	3	Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system	Rig ped wc tltnspc w/o seat
E1234	0010	3	Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system	Fld ped wc tltnspc w/o seat
E1235	0010	3	Wheelchair, pediatric size, rigid, adjustable, with seating system	Rigid ped wc adjustable
E1236	0010	3	Wheelchair, pediatric size, folding, adjustable, with seating system	Folding ped wc adjustable
E1237	0010	3	Wheelchair, pediatric size, rigid, adjustable, without seating system	Rgd ped wc adjstabl w/o seat
E1238	0010	3	Wheelchair, pediatric size, folding, adjustable, without seating system	Fld ped wc adjstabl w/o seat
E1239	0010	3	Power wheelchair, pediatric size, not otherwise specified	Ped power wheelchair nos
E1240	0010	3	Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest	Whchr litwt det arm leg rest
E1250	0010	3	Lightweight wheelchair, fixed full length arms, swing away detachable footrest	Wheelchair lightwt fixed arm
E1260	0010	3	Lightweight wheelchair, detachable arms (desk or full length) swing away detachable footrest	Wheelchair lightwt foot rest
E1270	0010	3	Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests	Wheelchair lightweight leg r
E1280	0010	3	Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests	Whchr h-duty det arm leg res
E1285	0010	3	Heavy duty wheelchair, fixed full length arms, swing away detachable footrest	Wheelchair heavy duty fixed
E1290	0010	3	Heavy duty wheelchair, detachable arms (desk or full length) swing away detachable footrest	Wheelchair hvy duty detach a
E1295	0010	3	Heavy duty wheelchair, fixed full length arms, elevating legrest	Wheelchair heavy duty fixed
E1296	0010	3	Special wheelchair seat height from floor	Wheelchair special seat heig
E1297	0010	3	Special wheelchair seat depth, by upholstery	Wheelchair special seat dept
E1298	0010	3	Special wheelchair seat depth and/or width, by construction	Wheelchair spec seat depth/w
E1300	0010	3	Whirlpool, portable (overtub type)	Whirlpool portable
E1310	0010	3	Whirlpool, non-portable (built-in type)	Whirlpool non-portable
E1352	0010	3	Oxygen accessory, flow regulator capable of positive inspiratory pressure	O2 flow reg pos inspir press
E1353	0010	3	Regulator	Oxygen supplies regulator
E1354	0010	3	Oxygen accessory, wheeled cart for portable cylinder or portable concentrator, any type, replacement only, each	Wheeled cart, port cyl/conc
E1355	0010	3	Stand/rack	Oxygen supplies stand/rack
E1356	0010	3	Oxygen accessory, battery pack/cartridge for portable concentrator, any type, replacement only, each	Batt pack/cart, port conc
E1357	0010	3	Oxygen accessory, battery charger for portable concentrator, any type, replacement only, each	Battery charger, port conc
E1358	0010	3	Oxygen accessory, dc power adapter for portable concentrator, any type, replacement only, each	Dc power adapter, port conc
E1372	0010	3	Immersion external heater for nebulizer	Oxy suppl heater for nebuliz
E1390	0010	3	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	Oxygen concentrator
E1391	0010	3	Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each	Oxygen concentrator, dual
E1392	0010	3	Portable oxygen concentrator, rental	Portable oxygen concentrator
E1399	0010	3	Durable medical equipment, miscellaneous	Durable medical equipment mi
E1405	0010	3	Oxygen and water vapor enriching system with heated delivery	O2/water vapor enrich w/heat
E1406	0010	3	Oxygen and water vapor enriching system without heated delivery	O2/water vapor enrich w/o he
E1500	0010	3	Centrifuge, for dialysis	Centrifuge
E1510	0010	3	Kidney, dialysate delivery syst kidney machine, pump recirculating, air removal syst, flowrate meter, power off, heater and temperature control with alarm, i.v. poles, pressure gauge, concentrate container	Kidney dialysate delivry sys
E1520	0010	3	Heparin infusion pump for hemodialysis	Heparin infusion pump
E1530	0010	3	Air bubble detector for hemodialysis, each, replacement	Replacement air bubble detec
E1540	0010	3	Pressure alarm for hemodialysis, each, replacement	Replacement pressure alarm
E1550	0010	3	Bath conductivity meter for hemodialysis, each	Bath conductivity meter
E1560	0010	3	Blood leak detector for hemodialysis, each, replacement	Replace blood leak detector
E1570	0010	3	Adjustable chair, for esrd patients	Adjustable chair for esrd pt
E1575	0010	3	Transducer protectors/fluid barriers, for hemodialysis, any size, per 10	Transducer protect/fld bar
E1580	0010	3	Unipuncture control system for hemodialysis	Unipuncture control system
E1590	0010	3	Hemodialysis machine	Hemodialysis machine
E1592	0010	3	Automatic intermittent peritoneal dialysis system	Auto interm peritoneal dialy
E1594	0010	3	Cycler dialysis machine for peritoneal dialysis	Cycler dialysis machine
E1600	0010	3	Delivery and/or installation charges for hemodialysis equipment	Deli/install chrg hemo equip
E1610	0010	3	Reverse osmosis water purification system, for hemodialysis	Reverse osmosis h2o puri sys
E1615	0010	3	Deionizer water purification system, for hemodialysis	Deionizer h2o puri system
E1620	0010	3	Blood pump for hemodialysis, replacement	Replacement blood pump
E1625	0010	3	Water softening system, for hemodialysis	Water softening system
E1630	0010	3	Reciprocating peritoneal dialysis system	Reciprocating peritoneal dia
E1632	0010	3	Wearable artificial kidney, each	Wearable artificial kidney
E1634	0010	3	Peritoneal dialysis clamps, each	Peritoneal dialysis clamp
E1635	0010	3	Compact (portable) travel hemodialyzer system	Compact travel hemodialyzer
E1636	0010	3	Sorbent cartridges, for hemodialysis, per 10	Sorbent cartridges per 10
E1637	0010	3	Hemostats, each	Hemostats for dialysis, each
E1639	0010	3	Scale, each	Scale, each
E1699	0010	3	Dialysis equipment, not otherwise specified	Dialysis equipment noc
E1700	0010	3	Jaw motion rehabilitation system	Jaw motion rehab system
E1701	0010	3	Replacement cushions for jaw motion rehabilitation system, pkg. of 6	Repl cushions for jaw motion
E1702	0010	3	Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200	Repl measr scales jaw motion
E1800	0010	3	Dynamic adjustable elbow extension/flexion device, includes soft interface material	Adjust elbow ext/flex device
E1801	0010	3	Static progressive stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories	Sps elbow device
E1802	0010	3	Dynamic adjustable forearm pronation/supination device, includes soft interface material	Adjst forearm pro/sup device
E1805	0010	3	Dynamic adjustable wrist extension / flexion device, includes soft interface material	Adjust wrist ext/flex device
E1806	0010	3	Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories	Sps wrist device
E1810	0010	3	Dynamic adjustable knee extension / flexion device, includes soft interface material	Adjust knee ext/flex device
E1811	0010	3	Static progressive stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories	Sps knee device
E1812	0010	3	Dynamic knee, extension/flexion device with active resistance control	Knee ext/flex w act res ctrl
E1815	0010	3	Dynamic adjustable ankle extension/flexion device, includes soft interface material	Adjust ankle ext/flex device
E1816	0010	3	Static progressive stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories	Sps ankle device
E1818	0010	3	Static progressive stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories	Sps forearm device
E1820	0010	3	Replacement soft interface material, dynamic adjustable extension/flexion device	Soft interface material
E1821	0010	3	Replacement soft interface material/cuffs for bi-directional static progressive stretch device	Replacement interface spsd
E1825	0010	3	Dynamic adjustable finger extension/flexion device, includes soft interface material	Adjust finger ext/flex devc
E1830	0010	3	Dynamic adjustable toe extension/flexion device, includes soft interface material	Adjust toe ext/flex device
E1831	0010	3	Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories	Static str toe dev ext/flex
E1840	0010	3	Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material	Adj shoulder ext/flex device
E1841	0010	3	Static progressive stretch shoulder device, with or without range of motion adjustment, includes all components and accessories	Static str shldr dev rom adj
E1902	0010	3	Communication board, non-electronic augmentative or alternative communication device	Aac non-electronic board
E2000	0010	3	Gastric suction pump, home model, portable or stationary, electric	Gastric suction pump hme mdl
E2100	0010	3	Blood glucose monitor with integrated voice synthesizer	Bld glucose monitor w voice
E2101	0010	3	Blood glucose monitor with integrated lancing/blood sample	Bld glucose monitor w lance
E2120	0010	3	Pulse generator system for tympanic treatment of inner ear endolymphatic fluid	Pulse gen sys tx endolymp fl
E2201	0010	3	Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches	Man w/ch acc seat w>=20“<24”
E2202	0010	3	Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches	Seat width 24-27 in
E2203	0010	3	Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches	Frame depth less than 22 in
E2204	0010	3	Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches	Frame depth 22 to 25 in
E2205	0010	3	Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each	Manual wc accessory, handrim
E2206	0010	3	Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each	Man wc whl lock comp repl ea
E2207	0010	3	Wheelchair accessory, crutch and cane holder, each	Crutch and cane holder
E2208	0010	3	Wheelchair accessory, cylinder tank carrier, each	Cylinder tank carrier
E2209	0010	3	Accessory, arm trough, with or without hand support, each	Arm trough each
E2210	0010	3	Wheelchair accessory, bearings, any type, replacement only, each	Wheelchair bearings
E2211	0010	3	Manual wheelchair accessory, pneumatic propulsion tire, any size, each	Pneumatic propulsion tire
E2212	0010	3	Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each	Pneumatic prop tire tube
E2213	0010	3	Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each	Pneumatic prop tire insert
E2214	0010	3	Manual wheelchair accessory, pneumatic caster tire, any size, each	Pneumatic caster tire each
E2215	0010	3	Manual wheelchair accessory, tube for pneumatic caster tire, any size, each	Pneumatic caster tire tube
E2216	0010	3	Manual wheelchair accessory, foam filled propulsion tire, any size, each	Foam filled propulsion tire
E2217	0010	3	Manual wheelchair accessory, foam filled caster tire, any size, each	Foam filled caster tire each
E2218	0010	3	Manual wheelchair accessory, foam propulsion tire, any size, each	Foam propulsion tire each
E2219	0010	3	Manual wheelchair accessory, foam caster tire, any size, each	Foam caster tire any size ea
E2220	0010	3	Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each	Solid propuls tire, repl, ea
E2221	0010	3	Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each	Solid caster tire repl, each
E2222	0010	3	Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each	Solid caster integ whl, repl
E2224	0010	3	Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each	Propulsion whl excl tire rep
E2225	0010	3	Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each	Caster wheel excludes tire
E2226	0010	3	Manual wheelchair accessory, caster fork, any size, replacement only, each	Caster fork replacement only
E2227	0010	3	Manual wheelchair accessory, gear reduction drive wheel, each	Gear reduction drive wheel
E2228	0010	3	Manual wheelchair accessory, wheel braking system and lock, complete, each	Mwc acc, wheelchair brake
E2230	0010	3	Manual wheelchair accessory, manual standing system	Manual standing system
E2231	0010	3	Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware	Solid seat support base
E2291	0010	3	Back, planar, for pediatric size wheelchair including fixed attaching hardware	Planar back for ped size wc
E2292	0010	3	Seat, planar, for pediatric size wheelchair including fixed attaching hardware	Planar seat for ped size wc
E2293	0010	3	Back, contoured, for pediatric size wheelchair including fixed attaching hardware	Contour back for ped size wc
E2294	0010	3	Seat, contoured, for pediatric size wheelchair including fixed attaching hardware	Contour seat for ped size wc
E2295	0010	3	Manual wheelchair accessory, for pediatric size wheelchair, dynamic seating frame, allows coordinated movement of multiple positioning features	Ped dynamic seating frame
E2300	0010	3	Wheelchair accessory, power seat elevation system, any type	Pwr seat elevation sys
E2301	0010	3	Wheelchair accessory, power standing system, any type	Pwr standing
E2310	0010	3	Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware	Electro connect btw control
E2311	0010	3	Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware	Electro connect btw 2 sys
E2312	0010	3	Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware	Mini-prop remote joystick
E2313	0010	3	Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each	Pwc harness, expand control
E2321	0010	3	Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware	Hand interface joystick
E2322	0010	3	Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware	Mult mech switches
E2323	0010	3	Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated	Special joystick handle
E2324	0010	3	Power wheelchair accessory, chin cup for chin control interface	Chin cup interface
E2325	0010	3	Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware	Sip and puff interface
E2326	0010	3	Power wheelchair accessory, breath tube kit for sip and puff interface	Breath tube kit
E2327	0010	3	Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware	Head control interface mech
E2328	0010	3	Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware	Head/extremity control inter
E2329	0010	3	Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware	Head control nonproportional
E2330	0010	3	Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware	Head control proximity switc
E2331	0010	3	Power wheelchair accessory, attendant control, proportional, including all related electronics and fixed mounting hardware	Attendant control
E2340	0010	3	Power wheelchair accessory, nonstandard seat frame width, 20-23 inches	W/c wdth 20-23 in seat frame
E2341	0010	3	Power wheelchair accessory, nonstandard seat frame width, 24-27 inches	W/c wdth 24-27 in seat frame
E2342	0010	3	Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches	W/c dpth 20-21 in seat frame
E2343	0010	3	Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches	W/c dpth 22-25 in seat frame
E2351	0010	3	Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface	Electronic sgd interface
E2358	0010	3	Power wheelchair accessory, group 34 non-sealed lead acid battery, each	Gr 34 nonsealed leadacid
E2359	0010	3	Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)	Gr34 sealed leadacid battery
E2360	0010	3	Power wheelchair accessory, 22nf non-sealed lead acid battery, each	22nf nonsealed leadacid
E2361	0010	3	Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)	22nf sealed leadacid battery
E2362	0010	3	Power wheelchair accessory, group 24 non-sealed lead acid battery, each	Gr24 nonsealed leadacid
E2363	0010	3	Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)	Gr24 sealed leadacid battery
E2364	0010	3	Power wheelchair accessory, u-1 non-sealed lead acid battery, each	U1nonsealed leadacid battery
E2365	0010	3	Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)	U1 sealed leadacid battery
E2366	0010	3	Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each	Battery charger, single mode
E2367	0010	3	Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each	Battery charger, dual mode
E2368	0010	3	Power wheelchair component, drive wheel motor, replacement only	Pwr wc drivewheel motor repl
E2369	0010	3	Power wheelchair component, drive wheel gear box, replacement only	Pwr wc drivewheel gear repl
E2370	0010	3	Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only	Pwr wc dr wh motor/gear comb
E2371	0010	3	Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each	Gr27 sealed leadacid battery
E2372	0010	3	Power wheelchair accessory, group 27 non-sealed lead acid battery, each	Gr27 non-sealed leadacid
E2373	0010	3	Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware	Hand/chin ctrl spec joystick
E2374	0010	3	Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only	Hand/chin ctrl std joystick
E2375	0010	3	Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only	Non-expandable controller
E2376	0010	3	Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only	Expandable controller, repl
E2377	0010	3	Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue	Expandable controller, initl
E2378	0010	3	Power wheelchair component, actuator, replacement only	Pw actuator replacement
E2381	0010	3	Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each	Pneum drive wheel tire
E2382	0010	3	Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each	Tube, pneum wheel drive tire
E2383	0010	3	Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each	Insert, pneum wheel drive
E2384	0010	3	Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each	Pneumatic caster tire
E2385	0010	3	Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each	Tube, pneumatic caster tire
E2386	0010	3	Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each	Foam filled drive wheel tire
E2387	0010	3	Power wheelchair accessory, foam filled caster tire, any size, replacement only, each	Foam filled caster tire
E2388	0010	3	Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each	Foam drive wheel tire
E2389	0010	3	Power wheelchair accessory, foam caster tire, any size, replacement only, each	Foam caster tire
E2390	0010	3	Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each	Solid drive wheel tire
E2391	0010	3	Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each	Solid caster tire
E2392	0010	3	Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each	Solid caster tire, integrate
E2394	0010	3	Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each	Drive wheel excludes tire
E2395	0010	3	Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each	Caster wheel excludes tire
E2396	0010	3	Power wheelchair accessory, caster fork, any size, replacement only, each	Caster fork
E2397	0010	3	Power wheelchair accessory, lithium-based battery, each	Pwc acc, lith-based battery
E2398	0010	3	Wheelchair accessory, dynamic positioning hardware for back	Wc dynamic pos back hardware
E2402	0010	3	Negative pressure wound therapy electrical pump, stationary or portable	Neg press wound therapy pump
E2500	0010	3	Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time	Sgd digitized pre-rec <=8min
E2502	0010	3	Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time	Sgd prerec msg >8min <=20min
E2504	0010	3	Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time	Sgd prerec msg>20min <=40min
E2506	0010	3	Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time	Sgd prerec msg > 40 min
E2508	0010	3	Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device	Sgd spelling phys contact
E2510	0010	3	Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access	Sgd w multi methods msg/accs
E2511	0010	3	Speech generating software program, for personal computer or personal digital assistant	Sgd sftwre prgrm for pc/pda
E2512	0010	3	Accessory for speech generating device, mounting system	Sgd accessory, mounting sys
E2599	0010	3	Accessory for speech generating device, not otherwise classified	Sgd accessory noc
E2601	0010	3	General use wheelchair seat cushion, width less than 22 inches, any depth	Gen w/c cushion wdth < 22 in
E2602	0010	3	General use wheelchair seat cushion, width 22 inches or greater, any depth	Gen w/c cushion wdth >=22 in
E2603	0010	3	Skin protection wheelchair seat cushion, width less than 22 inches, any depth	Skin protect wc cus wd <22in
E2604	0010	3	Skin protection wheelchair seat cushion, width 22 inches or greater, any depth	Skin protect wc cus wd>=22in
E2605	0010	3	Positioning wheelchair seat cushion, width less than 22 inches, any depth	Position wc cush wdth <22 in
E2606	0010	3	Positioning wheelchair seat cushion, width 22 inches or greater, any depth	Position wc cush wdth>=22 in
E2607	0010	3	Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth	Skin pro/pos wc cus wd <22in
E2608	0010	3	Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth	Skin pro/pos wc cus wd>=22in
E2609	0010	3	Custom fabricated wheelchair seat cushion, any size	Custom fabricate w/c cushion
E2610	0010	3	Wheelchair seat cushion, powered	Powered w/c cushion
E2611	0010	3	General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware	Gen use back cush wdth <22in
E2612	0010	3	General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware	Gen use back cush wdth>=22in
E2613	0010	3	Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware	Position back cush wd <22in
E2614	0010	3	Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware	Position back cush wd>=22in
E2615	0010	3	Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware	Pos back post/lat wdth <22in
E2616	0010	3	Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware	Pos back post/lat wdth>=22in
E2617	0010	3	Custom fabricated wheelchair back cushion, any size, including any type mounting hardware	Custom fab w/c back cushion
E2619	0010	3	Replacement cover for wheelchair seat cushion or back cushion, each	Replace cover w/c seat cush
E2620	0010	3	Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware	Wc planar back cush wd <22in
E2621	0010	3	Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware	Wc planar back cush wd>=22in
E2622	0010	3	Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth	Adj skin pro w/c cus wd<22in
E2623	0010	3	Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth	Adj skin pro wc cus wd>=22in
E2624	0010	3	Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth	Adj skin pro/pos cus<22in
E2625	0010	3	Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth	Adj skin pro/pos wc cus>=22
E2626	0010	3	Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable	Seo mobile arm sup att to wc
E2627	0010	3	Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type	Arm supp att to wc rancho ty
E2628	0010	3	Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining	Mobile arm supports reclinin
E2629	0010	3	Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)	Friction dampening arm supp
E2630	0010	3	Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support	Monosuspension arm/hand supp
E2631	0010	3	Wheelchair accessory, addition to mobile arm support, elevating proximal arm	Elevat proximal arm support
E2632	0010	3	Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control	Offset/lat rocker arm w/ela
E2633	0010	3	Wheelchair accessory, addition to mobile arm support, supinator	Mobile arm support supinator
E8000	0010	3	Gait trainer, pediatric size, posterior support, includes all accessories and components	Posterior gait trainer
E8001	0010	3	Gait trainer, pediatric size, upright support, includes all accessories and components	Upright gait trainer
E8002	0010	3	Gait trainer, pediatric size, anterior support, includes all accessories and components	Anterior gait trainer

G0000–G9999: Procedures/Professional Services

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
G0008	0010	3	Administration of influenza virus vaccine	Admin influenza virus vac
G0009	0010	3	Administration of pneumococcal vaccine	Admin pneumococcal vaccine
G0010	0010	3	Administration of hepatitis b vaccine	Admin hepatitis b vaccine
G0027	0010	3	Semen analysis; presence and/or motility of sperm excluding huhner	Semen analysis
G0068	0010	3	Professional services for the administration of anti-infective, pain management, chelation, pulmonary hypertension, and/or inotropic infusion drug(s) for each infusion drug administration calendar day in the individual’s home, each 15 minutes	Adm of infusion drug in home
G0069	0010	3	Professional services for the administration of subcutaneous immunotherapy for each infusion drug administration calendar day in the individual’s home, each 15 minutes	Adm of immune drug in home
G0070	0010	3	Professional services for the administration of chemotherapy for each infusion drug administration calendar day in the individual’s home, each 15 minutes	Adm of chemo drug in home
G0071	0010	3	Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only	Comm svcs by rhc/fqhc 5 min
G0076	0010	3	Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility)	Care manag h vst new pt 20 m
G0077	0010	3	Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility)	Care manag h vst new pt 30 m
G0078	0010	3	Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility)	Care manag h vst new pt 45 m
G0079	0010	3	Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility)	Care manag h vst new pt 60 m
G0080	0010	3	Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility)	Care manag h vst new pt 75 m
G0081	0010	3	Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility)	Care man h v ext pt 20 mi
G0082	0010	3	Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility)	Care man h v ext pt 30 m
G0083	0010	3	Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility)	Care man h v ext pt 45 m
G0084	0010	3	Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility)	Care man h v ext pt 60 m
G0085	0010	3	Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility)	Care man h v ext pt 75 m
G0086	0010	3	Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility)	Care man home care plan 30 m
G0087	0010	3	Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility)	Care man home care plan 60 m
G0101	0010	3	Cervical or vaginal cancer screening; pelvic and clinical breast examination	Ca screen;pelvic/breast exam
G0102	0010	3	Prostate cancer screening; digital rectal examination	Prostate ca screening; dre
G0103	0010	3	Prostate cancer screening; prostate specific antigen test (psa)	Psa screening
G0104	0010	3	Colorectal cancer screening; flexible sigmoidoscopy	Ca screen;flexi sigmoidscope
G0105	0010	3	Colorectal cancer screening; colonoscopy on individual at high risk	Colorectal scrn; hi risk ind
G0106	0010	3	Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enema	Colon ca screen;barium enema
G0108	0010	3	Diabetes outpatient self-management training services, individual, per 30 minutes	Diab manage trn per indiv
G0109	0010	3	Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes	Diab manage trn ind/group
G0117	0010	3	Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist	Glaucoma scrn hgh risk direc
G0118	0010	3	Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist	Glaucoma scrn hgh risk direc
G0120	0010	3	Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.	Colon ca scrn; barium enema
G0121	0010	3	Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	Colon ca scrn not hi rsk ind
G0122	0010	3	Colorectal cancer screening; barium enema	Colon ca scrn; barium enema
G0123	0010	3	Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision	Screen cerv/vag thin layer
G0124	0010	3	Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician	Screen c/v thin layer by md
G0127	0010	3	Trimming of dystrophic nails, any number	Trim nail(s)
G0128	0010	3	Direct (face-to-face with patient) skilled nursing services of a registered nurse provided in a comprehensive outpatient rehabilitation facility, each 10 minutes beyond the first 5 minutes	Corf skilled nursing service
G0129	0010	3	Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization treatment program, per session (45 minutes or more)	Partial hosp prog service
G0130	0010	3	Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)	Single energy x-ray study
G0141	0010	3	Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician	Scr c/v cyto,autosys and md
G0143	0010	3	Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision	Scr c/v cyto,thinlayer,rescr
G0144	0010	3	Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision	Scr c/v cyto,thinlayer,rescr
G0145	0010	3	Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision	Scr c/v cyto,thinlayer,rescr
G0147	0010	3	Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision	Scr c/v cyto, automated sys
G0148	0010	3	Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening	Scr c/v cyto, autosys, rescr
G0151	0010	3	Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes	Hhcp-serv of pt,ea 15 min
G0152	0010	3	Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes	Hhcp-serv of ot,ea 15 min
G0153	0010	3	Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes	Hhcp-svs of s/l path,ea 15mn
G0154	0010	3	Direct skilled nursing services of a licensed nurse (lpn or rn) in the home health or hospice setting, each 15 minutes	Hhcp-svs of rn,ea 15 min
G0155	0010	3	Services of clinical social worker in home health or hospice settings, each 15 minutes	Hhcp-svs of csw,ea 15 min
G0156	0010	3	Services of home health/hospice aide in home health or hospice settings, each 15 minutes	Hhcp-svs of aide,ea 15 min
G0157	0010	3	Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes	Hhc pt assistant ea 15
G0158	0010	3	Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes	Hhc ot assistant ea 15
G0159	0010	3	Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes	Hhc pt maint ea 15 min
G0160	0010	3	Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes	Hhc occup therapy ea 15
G0161	0010	3	Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes	Hhc slp ea 15 min
G0162	0010	3	Skilled services by a registered nurse (rn) for management and evaluation of the plan of care; each 15 minutes (the patient’s underlying condition or complication requires an rn to ensure that essential non-skilled care achieves its purpose in the home health or hospice setting)	Hhc rn e&m plan svs, 15 min
G0163	0010	3	Skilled services of a licensed nurse (lpn or rn) for the observation and assessment of the patient’s condition, each 15 minutes (the change in the patient’s condition requires skilled nursing personnel to identify and evaluate the patient’s need for possible modification of treatment in the home health or hospice setting)	Hhc lpn/rn obs/asses ea 15
G0164	0010	3	Skilled services of a licensed nurse (lpn or rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes	Hhc lis nurse train ea 15
G0166	0010	3	External counterpulsation, per treatment session	Extrnl counterpulse, per tx
G0168	0010	3	Wound closure utilizing tissue adhesive(s) only	Wound closure by adhesive
G0173	0010	3	Linear accelerator based stereotactic radiosurgery, complete course of therapy in one session	Linear acc stereo radsur com
G0175	0010	3	Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present	Opps service,sched team conf
G0176	0010	3	Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient’s disabling mental health problems, per session (45 minutes or more)	Opps/php;activity therapy
G0177	0010	3	Training and educational services related to the care and treatment of patient’s disabling mental health problems per session (45 minutes or more)	Opps/php; train & educ serv
G0179	0010	3	Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care that meets patient’s needs, per re-certification period	Md recertification hha pt
G0180	0010	3	Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care that meets patient’s needs, per certification period	Md certification hha patient
G0181	0010	3	Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient’s care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more	Home health care supervision
G0182	0010	3	Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient’s care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more	Hospice care supervision
G0186	0010	3	Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions)	Dstry eye lesn,fdr vssl tech
G0202	0010	3	Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed	Scr mammo bi incl cad
G0204	0010	3	Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral	Dx mammo incl cad bi
G0206	0010	3	Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral	Dx mammo incl cad uni
G0219	0010	3	Pet imaging whole body; melanoma for non-covered indications	Pet img wholbod melano nonco
G0235	0010	3	Pet imaging, any site, not otherwise specified	Pet not otherwise specified
G0237	0010	3	Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)	Therapeutic procd strg endur
G0238	0010	3	Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)	Oth resp proc, indiv
G0239	0010	3	Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)	Oth resp proc, group
G0245	0010	3	Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education	Initial foot exam pt lops
G0246	0010	3	Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education	Followup eval of foot pt lop
G0247	0010	3	Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails	Routine footcare pt w lops
G0248	0010	3	Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the inr monitor, obtaining at least one blood sample, provision of instructions for reporting home inr test results, and documentation of patient’s ability to perform testing and report results	Demonstrate use home inr mon
G0249	0010	3	Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests	Provide inr test mater/equip
G0250	0010	3	Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests	Md inr test revie inter mgmt
G0251	0010	3	Linear accelerator based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, maximum five sessions per course of treatment	Linear acc based stero radio
G0252	0010	3	Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes)	Pet imaging initial dx
G0255	0010	3	Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve	Current percep threshold tst
G0257	0010	3	Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility	Unsched dialysis esrd pt hos
G0259	0010	3	Injection procedure for sacroiliac joint; arthrography	Inject for sacroiliac joint
G0260	0010	3	Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography	Inj for sacroiliac jt anesth
G0268	0010	3	Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing	Removal of impacted wax md
G0269	0010	3	Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug)	Occlusive device in vein art
G0270	0010	3	Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes	Mnt subs tx for change dx
G0271	0010	3	Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes	Group mnt 2 or more 30 mins
G0276	0010	3	Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial	Pild/placebo control clin tr
G0277	0010	3	Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval	Hbot, full body chamber, 30m
G0278	0010	3	Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure)	Iliac art angio,cardiac cath
G0279	0010	3	Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)	Tomosynthesis, mammo
G0281	0010	3	Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care	Elec stim unattend for press
G0282	0010	3	Electrical stimulation, (unattended), to one or more areas, for wound care other than described in g0281	Elect stim wound care not pd
G0283	0010	3	Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care	Elec stim other than wound
G0288	0010	3	Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery	Recon, cta for surg plan
G0289	0010	3	Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee	Arthro, loose body + chondro
G0293	0010	3	Noncovered surgical procedure(s) using conscious sedation, regional, general or spinal anesthesia in a medicare qualifying clinical trial, per day	Non-cov surg proc,clin trial
G0294	0010	3	Noncovered procedure(s) using either no anesthesia or local anesthesia only, in a medicare qualifying clinical trial, per day	Non-cov proc, clinical trial
G0295	0010	3	Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses	Electromagnetic therapy onc
G0296	0010	3	Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)	Visit to determ ldct elig
G0297	0010	3	Low dose ct scan (ldct) for lung cancer screening	Ldct for lung ca screen
G0299	0010	3	Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes	Hhs/hospice of rn ea 15 min
G0300	0010	3	Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes	Hhs/hospice of lpn ea 15 min
G0302	0010	3	Pre-operative pulmonary surgery services for preparation for lvrs, complete course of services, to include a minimum of 16 days of services	Pre-op service lvrs complete
G0303	0010	3	Pre-operative pulmonary surgery services for preparation for lvrs, 10 to 15 days of services	Pre-op service lvrs 10-15dos
G0304	0010	3	Pre-operative pulmonary surgery services for preparation for lvrs, 1 to 9 days of services	Pre-op service lvrs 1-9 dos
G0305	0010	3	Post-discharge pulmonary surgery services after lvrs, minimum of 6 days of services	Post op service lvrs min 6
G0306	0010	3	Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count	Cbc/diffwbc w/o platelet
G0307	0010	3	Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)	Cbc without platelet
G0328	0010	3	Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	Fecal blood scrn immunoassay
G0329	0010	3	Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care	Electromagntic tx for ulcers
G0333	0010	3	Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary	Dispense fee initial 30 day
G0337	0010	3	Hospice evaluation and counseling services, pre-election	Hospice evaluation preelecti
G0339	0010	3	Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment	Robot lin-radsurg com, first
G0340	0010	3	Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment	Robt lin-radsurg fractx 2-5
G0341	0010	3	Percutaneous islet cell transplant, includes portal vein catheterization and infusion	Percutaneous islet celltrans
G0342	0010	3	Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion	Laparoscopy islet cell trans
G0343	0010	3	Laparotomy for islet cell transplant, includes portal vein catheterization and infusion	Laparotomy islet cell transp
G0364	0010	3	Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service	Bone marrow aspirate &biopsy
G0365	0010	3	Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)	Vessel mapping hemo access
G0372	0010	3	Physician service required to establish and document the need for a power mobility device	Md service required for pmd
G0378	0010	3	Hospital observation service, per hour	Hospital observation per hr
G0379	0010	3	Direct admission of patient for hospital observation care	Direct refer hospital observ
G0380	0010	3	Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)	Lev 1 hosp type b ed visit
G0381	0010	3	Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)	Lev 2 hosp type b ed visit
G0382	0010	3	Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)	Lev 3 hosp type b ed visit
G0383	0010	3	Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)	Lev 4 hosp type b ed visit
G0384	0010	3	Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)	Lev 5 hosp type b ed visit
G0389	0010	3	Ultrasound b-scan and/or real time with image documentation; for abdominal aortic aneurysm (aaa) screening	Ultrasound exam aaa screen
G0390	0010	3	Trauma response team associated with hospital critical care service	Trauma respons w/hosp criti
G0396	0010	3	Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes	Alcohol/subs interv 15-30mn
G0397	0010	3	Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes	Alcohol/subs interv >30 min
G0398	0010	3	Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation	Home sleep test/type 2 porta
G0399	0010	3	Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation	Home sleep test/type 3 porta
G0400	0010	3	Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels	Home sleep test/type 4 porta
G0402	0010	3	Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	Initial preventive exam
G0403	0010	3	Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report	Ekg for initial prevent exam
G0404	0010	3	Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination	Ekg tracing for initial prev
G0405	0010	3	Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination	Ekg interpret & report preve
G0406	0010	3	Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth	Inpt/tele follow up 15
G0407	0010	3	Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth	Inpt/tele follow up 25
G0408	0010	3	Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth	Inpt/tele follow up 35
G0409	0010	3	Social work and psychological services, directly relating to and/or furthering the patient’s rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf)	Corf related serv 15 mins ea
G0410	0010	3	Group psychotherapy other than of a multiple-family group, in a partial hospitalization setting, approximately 45 to 50 minutes	Grp psych partial hosp 45-50
G0411	0010	3	Interactive group psychotherapy, in a partial hospitalization setting, approximately 45 to 50 minutes	Inter active grp psych parti
G0412	0010	3	Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed	Open tx iliac spine uni/bil
G0413	0010	3	Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)	Pelvic ring fracture uni/bil
G0414	0010	3	Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)	Pelvic ring fx treat int fix
G0415	0010	3	Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)	Open tx post pelvic fxcture
G0416	0010	3	Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method	Prostate biopsy, any mthd
G0417	0010	3	Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 21-40 specimens	Sat biopsy prostate 21-40
G0418	0010	3	Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 41-60 specimens	Sat biopsy prostate 41-60
G0419	0010	3	Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, >60 specimens	Sat biopsy prostate: >60
G0420	0010	3	Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour	Ed svc ckd ind per session
G0421	0010	3	Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour	Ed svc ckd grp per session
G0422	0010	3	Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session	Intens cardiac rehab w/exerc
G0423	0010	3	Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session	Intens cardiac rehab no exer
G0424	0010	3	Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day	Pulmonary rehab w exer
G0425	0010	3	Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth	Inpt/ed teleconsult30
G0426	0010	3	Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth	Inpt/ed teleconsult50
G0427	0010	3	Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth	Inpt/ed teleconsult70
G0428	0010	3	Collagen meniscus implant procedure for filling meniscal defects (e.g., cmi, collagen scaffold, menaflex)	Collagen meniscus implant
G0429	0010	3	Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)	Dermal filler injection(s)
G0431	0010	3	Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter	Drug screen multiple class
G0432	0010	3	Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening	Eia hiv-1/hiv-2 screen
G0433	0010	3	Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening	Elisa hiv-1/hiv-2 screen
G0434	0010	3	Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter	Drug screen multi drug class
G0435	0010	3	Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening	Oral hiv-1/hiv-2 screen
G0436	0010	3	Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes	Tobacco-use counsel 3-10 min
G0437	0010	3	Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes	Tobacco-use counsel>10min
G0438	0010	3	Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	Ppps, initial visit
G0439	0010	3	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	Ppps, subseq visit
G0442	0010	3	Annual alcohol misuse screening, 15 minutes	Annual alcohol screen 15 min
G0443	0010	3	Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes	Brief alcohol misuse counsel
G0444	0010	3	Annual depression screening, 15 minutes	Depression screen annual
G0445	0010	3	High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes	High inten beh couns std 30m
G0446	0010	3	Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	Intens behave ther cardio dx
G0447	0010	3	Face-to-face behavioral counseling for obesity, 15 minutes	Behavior counsel obesity 15m
G0448	0010	3	Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ventricular pacing	Place perm pacing cardiovert
G0451	0010	3	Development testing, with interpretation and report, per standardized instrument form	Devlopment test interpt&rep
G0452	0010	3	Molecular pathology procedure; physician interpretation and report	Molecular pathology interpr
G0453	0010	3	Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)	Cont intraop neuro monitor
G0454	0010	3	Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist	Md document visit by npp
G0455	0010	3	Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen	Fecal microbiota prep instil
G0456	0010	3	Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area less than or equal to 50 square centimeters	Neg pre wound <=50 sq cm
G0457	0010	3	Negative pressure wound therapy, (e.g. vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session; total wounds(s) surface area greater than 50 square centimeters	Neg pres wound >50 sq cm
G0458	0010	3	Low dose rate (ldr) prostate brachytherapy services, composite rate	Ldr prostate brachy comp rat
G0459	0010	3	Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy	Telehealth inpt pharm mgmt
G0460	0010	3	Autologous platelet rich plasma for chronic wounds/ulcers, including phlebotomy, centrifugation, and all other preparatory procedures, administration and dressings, per treatment	Autologous prp for ulcers
G0461	0010	3	Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain	Immunohisto/cyto chem 1st st
G0462	0010	3	Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure)	Immunohisto/cyto chem add
G0463	0010	3	Hospital outpatient clinic visit for assessment and management of a patient	Hospital outpt clinic visit
G0464	0010	3	Colorectal cancer screening; stool-based dna and fecal occult hemoglobin (e.g., kras, ndrg4 and bmp3)	Colorec ca scr, sto bas dna
G0466	0010	3	Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit	Fqhc visit new patient
G0467	0010	3	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit	Fqhc visit, estab pt
G0468	0010	3	Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv	Fqhc visit, ippe or awv
G0469	0010	3	Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit	Fqhc visit, mh new pt
G0470	0010	3	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit	Fqhc visit, mh estab pt
G0471	0010	3	Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha)	Ven blood coll snf/hha
G0472	0010	3	Hepatitis c antibody screening, for individual at high risk and other covered indication(s)	Hep c screen high risk/other
G0473	0010	3	Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes	Group behave couns 2-10
G0475	0010	3	Hiv antigen/antibody, combination assay, screening	Hiv combination assay
G0476	0010	3	Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test	Hpv combo assay ca screen
G0477	0010	3	Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) capable of being read by direct optical observation only (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service	Drug test presump optical
G0478	0010	3	Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) read by instrument-assisted direct optical observation (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service	Drug test presump opt inst
G0479	0010	3	Drug test(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, tof, maldi, ldtd, desi, dart, ghpc, gc mass spectrometry), includes sample validation when performed, per date of service	Drug test presump not opt
G0480	0010	3	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed	Drug test def 1-7 classes
G0481	0010	3	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed	Drug test def 8-14 classes
G0482	0010	3	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed	Drug test def 15-21 classes
G0483	0010	3	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed	Drug test def 22+ classes
G0490	0010	3	Face-to-face home health nursing visit by a rural health clinic (rhc) or federally qualified health center (fqhc) in an area with a shortage of home health agencies; (services limited to rn or lpn only)	Home visit rn, lpn by rhc/fq
G0491	0010	3	Dialysis procedure at a medicare certified esrd facility for acute kidney injury without esrd	Dialysis acu kidney no esrd
G0492	0010	3	Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without esrd	Md/oth eval acut kid no esrd
G0493	0010	3	Skilled services of a registered nurse (rn) for the observation and assessment of the patient’s condition, each 15 minutes (the change in the patient’s condition requires skilled nursing personnel to identify and evaluate the patient’s need for possible modification of treatment in the home health or hospice setting)	Rn care ea 15 min hh/hospice
G0494	0010	3	Skilled services of a licensed practical nurse (lpn) for the observation and assessment of the patient’s condition, each 15 minutes (the change in the patient’s condition requires skilled nursing personnel to identify and evaluate the patient’s need for possible modification of treatment in the home health or hospice setting)	Lpn care ea 15min hh/hospice
G0495	0010	3	Skilled services of a registered nurse (rn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes	Rn care train/edu in hh
G0496	0010	3	Skilled services of a licensed practical nurse (lpn), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes	Lpn care train/edu in hh
G0498	0010	3	Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion	Chemo extend iv infus w/pump
G0499	0010	3	Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result	Hepb screen high risk indiv
G0500	0010	3	Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)	Mod sedat endo service >5yrs
G0501	0010	3	Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables, patient lift, and adjustable padded leg supports) is medically necessary and used during the provision of an office/outpatient, evaluation and management visit (list separately in addition to primary service)	Resource-inten svc during ov
G0502	0010	3	Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outreach to and engagement in treatment of a patient directed by the treating physician or other qualified health care professional; initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan; review by the psychiatric consultant with modifications of the plan if recommended; entering patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatric consultant; and provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies	Init psych care manag, 70min
G0503	0010	3	Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking patient follow-up and progress using the registry, with appropriate documentation; participation in weekly caseload consultation with the psychiatric consultant; ongoing collaboration with and coordination of the patient’s mental health care with the treating physician or other qualified health care professional and any other treating mental health providers; additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatric consultant; provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies; monitoring of patient outcomes using validated rating scales; and relapse prevention planning with patients as they achieve remission of symptoms and/or other treatment	Subseq psych care man,60mi
G0503	0020	4	goals and are prepared for discharge from active treatment
G0504	0010	3	Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separately in addition to code for primary procedure); (use g0504 in conjunction with g0502, g0503)	Init/sub psych care add 30 m
G0505	0010	3	Cognition and functional assessment using standardized instruments with development of recorded care plan for the patient with cognitive impairment, history obtained from patient and/or caregiver, in office or other outpatient setting or home or domiciliary or rest home	Cog/func assessment outpt
G0506	0010	3	Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)	Comp asses care plan ccm svc
G0507	0010	3	Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team	Care manage serv minimum 20
G0508	0010	3	Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth	Crit care telehea consult 60
G0509	0010	3	Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth	Crit care telehea consult 50
G0511	0010	3	Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month	Ccm/bhi by rhc/fqhc 20min mo
G0512	0010	3	Rural health clinic or federally qualified health center (rhc/fqhc) only, psychiatric collaborative care model (psychiatric cocm), 60 minutes or more of clinical staff time for psychiatric cocm services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm) and including services furnished by a behavioral health care manager and consultation with a psychiatric consultant, per calendar month	Cocm by rhc/fqhc 60 min mo
G0513	0010	3	Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)	Prolong prev svcs, first 30m
G0514	0010	3	Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service)	Prolong prev svcs, addl 30m
G0515	0010	3	Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes	Cognitive skills development
G0516	0010	3	Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)	Insert drug del implant, >=4
G0517	0010	3	Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)	Remove drug implant
G0518	0010	3	Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)	Remove w insert drug implant
G0659	0010	3	Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes	Drug test def simple all cl
G0908	0010	3	Most recent hemoglobin (hgb) level > 12.0 g/dl	Hgb > 12 g/dl
G0909	0010	3	Hemoglobin level measurement not documented, reason not given	Hbg not doc
G0910	0010	3	Most recent hemoglobin level <= 12.0 g/dl	Hgb <= 12 g/dl
G0913	0010	3	Improvement in visual function achieved within 90 days following cataract surgery	Improve visual funct
G0914	0010	3	Patient care survey was not completed by patient	Survey not complete
G0915	0010	3	Improvement in visual function not achieved within 90 days following cataract surgery	No improve visual funct
G0916	0010	3	Satisfaction with care achieved within 90 days following cataract surgery	Satisfy with care
G0917	0010	3	Patient satisfaction survey was not completed by patient	Satisfy survey not complete
G0918	0010	3	Satisfaction with care not achieved within 90 days following cataract surgery	No satisfy with care
G0919	0010	3	Influenza immunization ordered or recommended (to be given at alternate location or alternate provider); vaccine not available at time of visit	Flu immunize not avail
G0920	0010	3	Type, anatomic location, and activity all documented	Type loc act doc
G0921	0010	3	Documentation of patient reason(s) for not being able to assess (e.g., patient refuses endoscopic and/or radiologic assessment)	Doc pt reas no assess
G0922	0010	3	No documentation of disease type, anatomic location, and activity, reason not given	Type loc act not doc
G1000	0010	3	Clinical decision support mechanism applied pathways, as defined by the medicare appropriate use criteria program	Cdsm applied pathways
G1001	0010	3	Clinical decision support mechanism evicore, as defined by the medicare appropriate use criteria program	Cdsm evicore
G1002	0010	3	Clinical decision support mechanism medcurrent, as defined by the medicare appropriate use criteria program	Cdsm medcurrent
G1003	0010	3	Clinical decision support mechanism medicalis, as defined by the medicare appropriate use criteria program	Cdsm medicalis
G1004	0010	3	Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program	Cdsm ndsc
G1005	0010	3	Clinical decision support mechanism national imaging associates, as defined by the medicare appropriate use criteria program	Cdsm nia
G1006	0010	3	Clinical decision support mechanism test appropriate, as defined by the medicare appropriate use criteria program	Cdsm test approp
G1007	0010	3	Clinical decision support mechanism aim specialty health, as defined by the medicare appropriate use criteria program	Cdsm aim
G1008	0010	3	Clinical decision support mechanism cranberry peak, as defined by the medicare appropriate use criteria program	Cdsm cranberry pk
G1009	0010	3	Clinical decision support mechanism sage health management solutions, as defined by the medicare appropriate use criteria program	Cdsm sage health
G1010	0010	3	Clinical decision support mechanism stanson, as defined by the medicare appropriate use criteria program	Cdsm stanson
G1011	0010	3	Clinical decision support mechanism, qualified tool not otherwise specified, as defined by the medicare appropriate use criteria program	Cdsm qualified nos
G2000	0010	3	Blinded administration of convulsive therapy procedure, either electroconvulsive therapy (ect, current covered gold standard) or magnetic seizure therapy (mst, non-covered experimental therapy), performed in an approved ide-based clinical trial, per treatment session	Blinded conv. tx mdd clin tr
G2001	0010	3	Brief (20 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)	Post d/c h vst new pt 20 m
G2002	0010	3	Limited (30 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)	Post-d/c h vst new pt 30 m
G2003	0010	3	Moderate (45 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)	Post-d/c h vst new pt 45 m
G2004	0010	3	Comprehensive (60 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)	Post-d/c h vst new pt 60 m
G2005	0010	3	Extensive (75 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)	Post-d/c h vst new pt 75 m
G2006	0010	3	Brief (20 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)	Post-d/c h vst ext pt 20 m
G2007	0010	3	Limited (30 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)	Post-d/c h vst ext pt 30 m
G2008	0010	3	Moderate (45 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)	Post-d/c h vst ext pt 45 m
G2009	0010	3	Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)	Post-d/c h vst ext pt 60 m
G2010	0010	3	Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment	Remot image submit by pt
G2011	0010	3	Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes	Alcohol/sub abuse assess
G2012	0010	3	Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion	Brief check in by md/qhp
G2013	0010	3	Extensive (75 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)	Post-d/c h vst ext pt 75 m
G2014	0010	3	Limited (30 minutes) care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)	Post-d/c care plan overs 30m
G2015	0010	3	Comprehensive (60 mins) home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiary’s home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility.)	Post-d/c care plan overs 60m
G2021	0010	3	Health care practitioners rendering treatment in place (tip)	Hea care pract tx in place
G2022	0010	3	A model participant (ambulance supplier/provider), the beneficiary refuses services covered under the model (transport to an alternate destination/treatment in place)	Benef refuses service, mod
G2058	0010	3	Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 for care management services of less than 20 minutes additional to the first 20 minutes of chronic care management services during a calendar month). (use g2058 in conjunction with 99490). (do not report 99490, g2058 in the same calendar month as 99487, 99489, 99491)).	Ccm add 20min
G2061	0010	3	Qualified nonphysician healthcare professional online assessment, for an established patient, for up to seven days, cumulative time during the 7 days; 5-10 minutes	Qual nonmd est pt 5-10m
G2062	0010	3	Qualified nonphysician healthcare professional online assessment service, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutes	Qual nonmd est pt 11-20m
G2063	0010	3	Qualified nonphysician qualified healthcare professional assessment service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes	Qual nonmd est pt 21>min
G2064	0010	3	Comprehensive care management services for a single high-risk disease, e.g., principal care management, at least 30 minutes of physician or other qualified health care professional time per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been the cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities	Md mang high risk dx 30
G2065	0010	3	Comprehensive care management for a single high-risk disease services, e.g. principal care management, at least 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month with the following elements: one complex chronic condition lasting at least 3 months, which is the focus of the care plan, the condition is of sufficient severity to place patient at risk of hospitalization or have been cause of a recent hospitalization, the condition requires development or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities	Clin mang h risk dx 30
G2066	0010	3	Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results	Inter devc remote 30d
G2067	0010	3	Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program)	Med assist tx meth wk
G2068	0010	3	Medication assisted treatment, buprenorphine (oral); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)	Med assist tx bupre oral
G2069	0010	3	Medication assisted treatment, buprenorphine (injectable); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)	Med assist tx inject
G2070	0010	3	Medication assisted treatment, buprenorphine (implant insertion); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)	Med assist tx implant
G2071	0010	3	Medication assisted treatment, buprenorphine (implant removal); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)	Med tx remove implant
G2072	0010	3	Medication assisted treatment, buprenorphine (implant insertion and removal); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)	Med tx insert/remove imp
G2073	0010	3	Medication assisted treatment, naltrexone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)	Med tx naltrexone
G2074	0010	3	Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program)	Med assist tx no drug
G2075	0010	3	Medication assisted treatment, medication not otherwise specified; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program)	Med tx meds nos
G2076	0010	3	Intake activities, including initial medical examination that is a complete, fully documented physical evaluation and initial assessment by a program physician or a primary care physician, or an authorized healthcare professional under the supervision of a program physician qualified personnel that includes preparation of a treatment plan that includes the patient’s short-term goals and the tasks the patient must perform to complete the short-term goals; the patient’s requirements for education, vocational rehabilitation, and employment; and the medical, psycho- social, economic, legal, or other supportive services that a patient needs, conducted by qualified personnel (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure	Intake act w/med exam
G2077	0010	3	Periodic assessment; assessing periodically by qualified personnel to determine the most appropriate combination of services and treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure	Periodic assessment
G2078	0010	3	Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure	Take-home meth
G2079	0010	3	Take-home supply of buprenorphine (oral); up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure	Take-hom buprenorphine
G2080	0010	3	Each additional 30 minutes of counseling in a week of medication assisted treatment, (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure	Add 30 mins counsel
G2081	0010	3	Patients age 66 and older in institutional special needs plans (snp) or residing in long-term care with a pos code 32, 33, 34, 54 or 56 for more than 90 days during the measurement period	Pt 66+ snp or ltc pos > 90d
G2082	0010	3	Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self-administration, includes 2 hours post-administration observation	Visit esketamine 56m or less
G2083	0010	3	Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administration, includes 2 hours post-administration observation	Visit esketamine, > 56m
G2086	0010	3	Office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling; at least 70 minutes in the first calendar month	Off base opioid tx 70min
G2087	0010	3	Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month	Off base opioid tx, 60 m
G2088	0010	3	Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; each additional 30 minutes beyond the first 120 minutes (list separately in addition to code for primary procedure)	Off base opioid tx, add30
G2089	0010	3	Most recent hemoglobin a1c (hba1c) level 7.0 to 9.0%	A1c level 7 to 9%
G2090	0010	3	Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period	Pt 66+ frailty and med dem
G2091	0010	3	Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period	Pt 66+ frailty and adv ill
G2092	0010	3	Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) or angiotensin receptor-neprilysin inhibitor (arni) therapy prescribed or currently being taken	Ace arb arni
G2093	0010	3	Documentation of medical reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., hypotensive patients who are at immediate risk of cardiogenic shock, hospitalized patients who have experienced marked azotemia, allergy, intolerance, other medical reasons)	Med doc rsn no ace arn arni
G2094	0010	3	Documentation of patient reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., patient declined, other patient reasons)	Pt rsn no ace arn arni
G2095	0010	3	Documentation of system reason(s) for not prescribing ace inhibitor or arb or arni therapy (e.g., other system reasons)	Sys rsn no ace arn arni
G2096	0010	3	Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) or angiotensin receptor-neprilysin inhibitor (arni) therapy was not prescribed, reason not given	No rsn ace arb arni
G2097	0010	3	Children with a competing diagnosis for upper respiratory infection within three days of diagnosis of pharyngitis (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti	Child dx uri 3d of other dx
G2098	0010	3	Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period	Pt 66+ frailty and med dem
G2099	0010	3	Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period	Pt 66+ frailty and adv ill
G2100	0010	3	Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period	Pt 66+ frailty and med dem
G2101	0010	3	Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period	Pt 66+ frailty and adv ill
G2102	0010	3	Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewed	Dil retinal eye exam
G2103	0010	3	Seven standard field stereoscopic photos with interpretation by an ophthalmologist or optometrist documented and reviewed	7 stereo photos interpret
G2104	0010	3	Eye imaging validated to match diagnosis from seven standard field stereoscopic photos results documented and reviewed	Eye img valid w/7 stereo
G2105	0010	3	Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 days during the measurement period	Pt 66+ lt ints > 90
G2106	0010	3	Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period	Pt 66+ lt ints > 90
G2107	0010	3	Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period	Pt 66+ frailty and adv ill
G2108	0010	3	Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 days during the measurement period	Pt 66+ lt ints > 90
G2109	0010	3	Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period	Pt 66+ frailty and med dem
G2110	0010	3	Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period	Pt 66+ frailty and adv ill
G2112	0010	3	Patient receiving <=5 mg daily prednisone (or equivalent), or ra activity is worsening, or glucocorticoid use is for less than 6 months	Pred<=5 mg ra glu <6m
G2113	0010	3	Patient receiving >5 mg daily prednisone (or equivalent) for longer than 6 months, and improvement or no change in disease activity	Pred>5 mg >6m, no chg da
G2114	0010	3	Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period	Pt 66-80 frailty and med dem
G2115	0010	3	Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period	Pt 66+ frailty and med dem
G2116	0010	3	Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period	Pt 66+ frailty and adv ill
G2117	0010	3	Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period	Pt 66-80 frailty and adv ill
G2118	0010	3	Patients 81 years of age and older with a evidence of frailty during the measurement period	Pt 81+ frailty
G2119	0010	3	Within the past 2 years, calcium and/or vitamin d optimization has been ordered or performed	Calc vitd opt
G2120	0010	3	Within the past 2 years, calcium and/or vitamin d optimization has not been ordered or performed	No calc vitd opt
G2121	0010	3	Psychosis, depression, anxiety, apathy, and impulse control disorder assessed	Psy dep anx ap and icd asse
G2122	0010	3	Psychosis, depression, anxiety, apathy, and impulse control disorder not assessed	Psy/dep/anx/apandicd noasse
G2123	0010	3	Patients 66-80 years of age and had at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period	Pt 66-80 frailty med dem
G2124	0010	3	Patients 66-80 years of age and had at least one claim/encounter for frailty during the measurement period and a dispensed dementia medication	Pt 66-80 frailty adv ill
G2125	0010	3	Patients 81 years of age and older with evidence of frailty during the measurement period	Pt 81+ frailty
G2126	0010	3	Patients 66 years of age or older and had at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period	Pt 66+ frailty adv ill
G2127	0010	3	Patients 66 years of age or older and had at least one claim/encounter for frailty during the measurement period and a dispensed dementia medication	Pt 66+ frailty med dem
G2128	0010	3	Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g. history of gastrointestinal bleed, intra-cranial bleed, blood disorders, idiopathic thrombocytopenic purpura (itp), gastric bypass or documentation of active anticoagulant use during the measurement period)	No aspirin med rsn
G2129	0010	3	Procedure-related bp’s not taken during an outpatient visit. examples include same day surgery, ambulatory service center, g.i. lab, dialysis, infusion center, chemotherapy	No bp outpt
G2130	0010	3	Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 days during the measurement period	Pt 66+ lt inst > 90
G2131	0010	3	Patients 81 years and older with a diagnosis of frailty	Pt 81+ frailty
G2132	0010	3	Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period	Pt 66-80 frailty and med dem
G2133	0010	3	Patients 66-80 years of age with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period	Pt 66-80 frailty and adv ill
G2134	0010	3	Patients 66 years of age or older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period	Pt 66+ frailty and med dem
G2135	0010	3	Patients 66 years of age or older with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period	Pt 66+ frailty and adv ill
G2136	0010	3	Back pain measured by the visual analog scale (vas) at three months (6 ? 20 weeks) postoperatively was less than or equal to 3.0 or back pain measured by the visual analog scale (vas) within three months preoperatively and at three months (6 ? 20 weeks) postoperatively demonstrated an improvement of 5.0 points or greater	Bk pain vas 6-20wk = 3
G2137	0010	3	Back pain measured by the visual analog scale (vas) at three months (6 ? 20 weeks) postoperatively was greater than 3.0 and back pain measured by the visual analog scale (vas) within three months preoperatively and at three months (6 ? 20 weeks) postoperatively demonstrated a change of less than an improvement of 5.0 points	Bk pain vas 6-20wk > 3
G2138	0010	3	Back pain as measured by the visual analog scale (vas) at one year (9 to 15 months) postoperatively was less than or equal to 3.0 or back pain measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated a change of 5.0 points or greater	Bk pain vas 9-15mo = 3
G2139	0010	3	Back pain measured by the visual analog scale (vas) pain at one year (9 to 15 months) postoperatively was greater than 3.0 and back pain measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated a change of less than 5.0	Bk pain vas 9-20mo > 3
G2140	0010	3	Leg pain measured by the visual analog scale (vas) at three months (6 ? 20 weeks) postoperatively was less than or equal to 3.0 or leg pain measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated an improvement of 5.0 points or greater	Leg pain vas 6-20wk = 3
G2141	0010	3	Leg pain measured by the visual analog scale (vas) at three months (6 ? 20 weeks) postoperatively was greater than 3.0 and leg pain measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated less than an improvement of 5.0 points	Leg pain vas 6-20wk > 3
G2142	0010	3	Functional status measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively was less than or equal to 22 or functional status measured by the odi version 2.1a within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated a change of 30 points or greater	Fs odi 9-15mo postop<= 22
G2143	0010	3	Functional status measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively was greater than 22 and functional status measured by the odi version 2.1a within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated a change of less than 30 points	Fs odi 9-15mo > 22
G2144	0010	3	Functional status measured by the oswestry disability index (odi version 2.1a) at three months (6 ? 20 weeks) postoperatively was less than or equal to 22 or functional status measured by the odi version 2.1a within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated a change of 30 points or greater	Fs odi 6-20wk postop > 22
G2145	0010	3	Functional status measured by the oswestry disability index (odi version 2.1a) at three months (6 ? 20 weeks) postoperatively was greater than 22 and functional status measured by the odi version 2.1a within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated a change of less than 30 points	Fsodi 6-20wk >22 or chg 30pt
G2146	0010	3	Leg pain as measured by the visual analog scale (vas) at one year (9 to 15 months) postoperatively was less than or equal to 3.0 or leg pain measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated an improvement of 5.0 points or greater	Leg pain vas 9-15mo <= 3
G2147	0010	3	Leg pain measured by the visual analog scale (vas) at one year (9 to 15 months) postoperatively was greater than 3.0 and leg pain measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated less than an improvement of 5.0 points	Leg pain vas 9-15mo > 3
G2148	0010	3	Performance met: multimodal pain management was used	Mpm used
G2149	0010	3	Documentation of medical reason(s) for not using multimodal pain management (e.g., allergy to multiple classes of analgesics, intubated patient, hepatic failure, patient reports no pain during pacu stay, other medical reason(s))	No mpm med rsn
G2150	0010	3	Performance not met: multimodal pain management was not used	No mpm
G2151	0010	3	Patients with diagnosis of a degenerative neurological condition such as als, ms, parkinson’s diagnosed at any time before or during the episode of care	Dx degen neuro
G2152	0010	3	Performance met: the residual change score is equal to or greater than 0	Res change sc =0
G2153	0010	3	In hospice or using hospice services during the measurement period	Hosp dur meas pd
G2154	0010	3	Patient received at least one td vaccine or one tdap vaccine between nine years prior to the start of the measurement period and the end of the measurement period	Td 9 yrs start end meas
G2155	0010	3	Patient had history of at least one of the following contraindications any time during or before the measurement period: anaphylaxis due to tdap vaccine, anaphylaxis due to td vaccine or its components; encephalopathy due to tdap or td vaccination (post tetanus vaccination encephalitis, post diphtheria vaccination encephalitis or post pertussis vaccination encephalitis.)	Hist contraindications
G2156	0010	3	Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the start of the measurement period and the end of the measurement period; or have history of at least one of the following contraindications any time during or before the measurement period: anaphylaxis due to tdap vaccine, anaphylaxis due to td vaccine or its components; encephalopathy due to tdap or td vaccination (post tetanus vaccination encephalitis, post diphtheria vaccination encephalitis or post pertussis vaccination encephalitis.)	No prior td or hx contra
G2157	0010	3	Patients received both the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine at least 12 months apart, with the first occurrence after the age of 60 before or during the measurement period	Pneum vacc 12 mo 60+
G2158	0010	3	Patient had prior pneumococcal vaccine adverse reaction any time during or before the measurement period	Pneum vacc adv rx
G2159	0010	3	Patient did not receive both the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine at least 12 months apart, with the first occurrence after the age of 60 before or during measurement period; or have prior pneumococcal vaccine adverse reaction any time during or before the measurement period	No pneum vacc 12 mo 60+
G2160	0010	3	Patient received at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the patient’s 50th birthday before or during the measurement period	Herpzos 50+
G2161	0010	3	Patient had prior adverse reaction caused by zoster vaccine or its components any time during or before the measurement period	Adv rx zos
G2162	0010	3	Patient did not receive at least one dose of the herpes zoster live vaccine or two doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the patient’s 50th birthday before or during the measurement period; or have prior adverse reaction caused by zoster vaccine or its components any time during or before the measurement period	No herpzos 50+
G2163	0010	3	Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period	Infl vacc 07/01 to 06/30
G2164	0010	3	Patient had a prior influenza virus vaccine adverse reaction any time before or during the measurement period	Adv rx infl vacc
G2165	0010	3	Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period; or did not have a prior influenza virus vaccine adverse reaction any time before or during the measurement period	No infl vacc 07/01 to 06/30
G2166	0010	3	Patient refused to participate at admission and/or discharge; patient unable to complete the neck fs prom at admission or discharge due to cognitive deficit, visual deficit, motor deficit, language barrier, or low reading level, and a suitable proxy/recorder is not available; patient self-discharged early; medical reason	No pt adm dx no neck fs prom
G2167	0010	3	Performance not met: the residual change score is less than 0	Res change sc < 0
G3001	0010	3	Administration and supply of tositumomab, 450 mg	Admin + supply, tositumomab
G6001	0010	3	Ultrasonic guidance for placement of radiation therapy fields	Echo guidance radiotherapy
G6002	0010	3	Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy	Stereoscopic x-ray guidance
G6003	0010	3	Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: up to 5 mev	Radiation treatment delivery
G6004	0010	3	Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 6-10 mev	Radiation treatment delivery
G6005	0010	3	Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 11-19 mev	Radiation treatment delivery
G6006	0010	3	Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 20 mev or greater	Radiation treatment delivery
G6007	0010	3	Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: up to 5 mev	Radiation treatment delivery
G6008	0010	3	Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 6-10 mev	Radiation treatment delivery
G6009	0010	3	Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 11-19 mev	Radiation treatment delivery
G6010	0010	3	Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 20 mev or greater	Radiation treatment delivery
G6011	0010	3	Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; up to 5 mev	Radiation treatment delivery
G6012	0010	3	Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 6-10 mev	Radiation treatment delivery
G6013	0010	3	Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 11-19 mev	Radiation treatment delivery
G6014	0010	3	Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 20 mev or greater	Radiation treatment delivery
G6015	0010	3	Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session	Radiation tx delivery imrt
G6016	0010	3	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	Delivery comp imrt
G6017	0010	3	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	Intrafraction track motion
G6018	0010	3	Ileoscopy, through stoma; with transendoscopic stent placement (includes predilation)	Ileoscopy w/stent
G6019	0010	3	Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique	Colonoscopy lesion removal
G6020	0010	3	Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)	Colonoscopy w/stent
G6021	0010	3	Unlisted procedure, intestine	Unlisted px small intestine
G6022	0010	3	Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesions(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique	Sigmoidoscopy w/ablate tumr
G6023	0010	3	Sigmoidoscopy, flexible; with transendoscopic stent placement (includes predilation)	Sigmoidoscopy w/stent
G6024	0010	3	Colonoscopy, flexible; proximal to splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique	Lesion removal colonoscopy
G6025	0010	3	Colonoscopy, flexible, proximal to splenic flexure; with transendoscopic stent placement (includes predilation)	Colonoscopy w/stent
G6027	0010	3	Anoscopy, high resolution (hra) (with magnification and chemical agent enhancement); diagnostic, including collection of specimen(s) by brushing or washing when performed	Anoscopy hra w/spec collect
G6028	0010	3	Anoscopy, high resolution (hra) (with magnification and chemical agent enhancement); with biopsy(ies)	Anoscopy hra w/biopsy
G6030	0010	3	Amitriptyline	Assay of amitriptyline
G6031	0010	3	Benzodiazepines	Assay of benzodiazepines
G6032	0010	3	Desipramine	Assay of desipramine
G6034	0010	3	Doxepin	Assay of doxepin
G6035	0010	3	Gold	Assay of gold
G6036	0010	3	Assay of imipramine	Assay of imipramine
G6037	0010	3	Nortriptyline	Assay of nortiptyline
G6038	0010	3	Salicylate	Assay of salicylate
G6039	0010	3	Acetaminophen	Assay of acetaminophen
G6040	0010	3	Alcohol (ethanol); any specimen except breath	Assay of ethanol
G6041	0010	3	Alkaloids, urine, quantitative	Assay of urine alkaloids
G6042	0010	3	Amphetamine or methamphetamine	Assay of amphetamines
G6043	0010	3	Barbiturates, not elsewhere specified	Assay of barbiturates
G6044	0010	3	Cocaine or metabolite	Assay of cocaine
G6045	0010	3	Dihydrocodeinone	Assay of dihydrocodeinone
G6046	0010	3	Dihydromorphinone	Assay of dihydromorphinone
G6047	0010	3	Dihydrotestosterone	Assay of dihydrotestosterone
G6048	0010	3	Dimethadione	Assay of dimethadione
G6049	0010	3	Epiandrosterone	Asssay of epiandrosterone
G6050	0010	3	Ethchlorvynol	Assay of ethchlorvynol
G6051	0010	3	Flurazepam	Assay of flurazepam
G6052	0010	3	Meprobamate	Assay of meprobamate
G6053	0010	3	Methadone	Assay of methadone
G6054	0010	3	Methsuximide	Assay of methsuximide
G6055	0010	3	Nicotine	Assay of nicotine
G6056	0010	3	Opiate(s), drug and metabolites, each procedure	Assay of opiates
G6057	0010	3	Phenothiazine	Assay of phenothiazine
G6058	0010	3	Drug confirmation, each procedure	Drug confirmation
G8126	0010	3	Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phase	Pt treat w/antidepress12wks
G8127	0010	3	Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phase	Pt not treat w/antidepres12w
G8128	0010	3	Clinician documented that patient was not an eligible candidate for antidepressant medication during the entire 12 week acute treatment phase measure	Pt inelig for antidepres med
G8395	0010	3	Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function	Lvef>=40% doc normal or mild
G8396	0010	3	Left ventricular ejection fraction (lvef) not performed or documented	Lvef not performed
G8397	0010	3	Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy	Dil macula/fundus exam/w doc
G8398	0010	3	Dilated macular or fundus exam not performed	Dil macular/fundus not perfo
G8399	0010	3	Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed	Pt w/dxa results document
G8400	0010	3	Patient with central dual-energy x-ray absorptiometry (dxa) results not documented, reason not given	Pt w/dxa no results doc
G8401	0010	3	Clinician documented that patient was not an eligible candidate for screening	Pt inelig osteo screen measu
G8404	0010	3	Lower extremity neurological exam performed and documented	Low extemity neur exam docum
G8405	0010	3	Lower extremity neurological exam not performed	Low extemity neur not perfor
G8406	0010	3	Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure	Pt inelig lower extrem neuro
G8410	0010	3	Footwear evaluation performed and documented	Eval on foot documented
G8415	0010	3	Footwear evaluation was not performed	Eval on foot not performed
G8416	0010	3	Clinician documented that patient was not an eligible candidate for footwear evaluation measure	Pt inelig footwear evaluatio
G8417	0010	3	Bmi is documented above normal parameters and a follow-up plan is documented	Calc bmi abv up param f/u
G8418	0010	3	Bmi is documented below normal parameters and a follow-up plan is documented	Calc bmi blw low param f/u
G8419	0010	3	Bmi documented outside normal parameters, no follow-up plan documented, no reason given	Calc bmi out nrm param nof/u
G8420	0010	3	Bmi is documented within normal parameters and no follow-up plan is required	Calc bmi norm parameters
G8421	0010	3	Bmi not documented and no reason is given	Bmi not calculated
G8422	0010	3	Bmi not documented, documentation the patient is not eligible for bmi calculation	Pt inelig bmi calculation
G8427	0010	3	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient’s current medications	Docrev cur meds by elig clin
G8428	0010	3	Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given	Cur meds not document
G8430	0010	3	Eligible clinician attests to documenting in the medical record the patient is not eligible for a current list of medications being obtained, updated, or reviewed by the eligible clinician	Ec at doc medrec pt not elig
G8431	0010	3	Screening for depression is documented as being positive and a follow-up plan is documented	Pos clin depres scrn f/u doc
G8432	0010	3	Depression screening not documented, reason not given	Dep scr not doc, rng
G8433	0010	3	Screening for depression not completed, documented reason	Scr for dep not cpt doc rsn
G8442	0010	3	Pain assessment not documented as being performed, documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter	Doc pain as nt perf, not elg
G8450	0010	3	Beta-blocker therapy prescribed	Beta-bloc rx pt w/abn lvef
G8451	0010	3	Beta-blocker therapy for lvef < 40% not prescribed for reasons documented by the clinician (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons, patient declined, other patient reasons, or other reasons attributable to the healthcare system)	Pt w/abn lvef inelig b-bloc
G8452	0010	3	Beta-blocker therapy not prescribed	Pt w/abn lvef b-bloc no rx
G8458	0010	3	Clinician documented that patient is not an eligible candidate for genotype testing; patient not receiving antiviral treatment for hepatitis c during the measurement period (e.g. genotype test done prior to the reporting period, patient declines, patient not a candidate for antiviral treatment)	Pt inelig geno no antvir tx
G8460	0010	3	Clinician documented that patient is not an eligible candidate for quantitative rna testing at week 12; patient not receiving antiviral treatment for hepatitis c	Pt inelig rna no antvir tx
G8461	0010	3	Patient receiving antiviral treatment for hepatitis c during the measurement period	Pt rec antivir treat hep c
G8464	0010	3	Clinician documented that prostate cancer patient is not an eligible candidate for adjuvant hormonal therapy; low or intermediate risk of recurrence or risk of recurrence not determined	Pt inelig; lo to no dter rsk
G8465	0010	3	High or very high risk of recurrence of prostate cancer	High risk recurrence pro ca
G8473	0010	3	Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy prescribed	Ace/arb thxpy rx’d
G8474	0010	3	Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed for reasons documented by the clinician (e.g., allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (e.g., patient declined, other patient reasons) or (e.g., lack of drug availability, other reasons attributable to the health care system)	Ace/arb not rx’d; doc reas
G8475	0010	3	Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed, reason not given	Ace/arb thxpy not rx’d
G8476	0010	3	Most recent blood pressure has a systolic measurement of < 140 mmhg and a diastolic measurement of < 90 mmhg	Bp sys <140 and dias <90
G8477	0010	3	Most recent blood pressure has a systolic measurement of >= 140 mmhg and/or a diastolic measurement of >= 90 mmhg	Bp sys>=140 and/or dias >=90
G8478	0010	3	Blood pressure measurement not performed or documented, reason not given	Bp not performed/doc
G8482	0010	3	Influenza immunization administered or previously received	Flu immunize order/admin
G8483	0010	3	Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)	Flu imm no admin doc rea
G8484	0010	3	Influenza immunization was not administered, reason not given	Flu immunize no admin
G8485	0010	3	I intend to report the diabetes mellitus (dm) measures group	Report, diabetes measures
G8486	0010	3	I intend to report the preventive care measures group	Report, prev care measures
G8487	0010	3	I intend to report the chronic kidney disease (ckd) measures group	Report ckd measures
G8489	0010	3	I intend to report the coronary artery disease (cad) measures group	Cad measures grp
G8490	0010	3	I intend to report the rheumatoid arthritis (ra) measures group	Ra measures grp
G8491	0010	3	I intend to report the hiv/aids measures group	Hiv/aids measures grp
G8492	0010	3	I intend to report the perioperative care measures group	Periop care measures grp
G8493	0010	3	I intend to report the back pain measures group	Back pain measures grp
G8494	0010	3	All quality actions for the applicable measures in the diabetes mellitus (dm) measures group have been performed for this patient	Dm meas qual act perform
G8495	0010	3	All quality actions for the applicable measures in the chronic kidney disease (ckd) measures group have been performed for this patient	Ckd meas qual act perform
G8496	0010	3	All quality actions for the applicable measures in the preventive care measures group have been performed for this patient	Prev care mg qual act perfrm
G8497	0010	3	All quality actions for the applicable measures in the coronary artery bypass graft (cabg) measures group have been performed for this patient	Cabg meas qual act perform
G8498	0010	3	All quality actions for the applicable measures in the coronary artery disease (cad) measures group have been performed for this patient	Cad meas qual act perform
G8499	0010	3	All quality actions for the applicable measures in the rheumatoid arthritis (ra) measures group have been performed for this patient	Ra meas qual act perform
G8500	0010	3	All quality actions for the applicable measures in the hiv/aids measures group have been performed for this patient	Hiv meas qual act perform
G8501	0010	3	All quality actions for the applicable measures in the perioperative care measures group have been performed for this patient	Perio meas qual act perform
G8502	0010	3	All quality actions for the applicable measures in the back pain measures group have been performed for this patient	Back pain mg qual act perfrm
G8506	0010	3	Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy	Pt rec ace/arb
G8509	0010	3	Pain assessment documented as positive using a standardized tool, follow-up plan not documented, reason not given	Pos pain assess no f/u doc
G8510	0010	3	Screening for depression is documented as negative, a follow-up plan is not required	Scr dep neg, no plan reqd
G8511	0010	3	Screening for depression documented as positive, follow-up plan not documented, reason not given	Scr dep pos, no plan doc rng
G8530	0010	3	Autogenous av fistula received	Auto av fistula recd
G8531	0010	3	Clinician documented that patient was not an eligible candidate for autogenous av fistula	Pt inelig; auto av fistula
G8532	0010	3	Clinician documented that patient received vascular access other than autogenous av fistula, reason not given	No auto av fistula; no reas
G8535	0010	3	Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter	Eld maltreatment not doc
G8536	0010	3	No documentation of an elder maltreatment screen, reason not given	No doc elder mal scrn
G8539	0010	3	Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies on the date of functional outcome assessment, is documented	Doc funct and care plan
G8540	0010	3	Functional outcome assessment not documented as being performed, documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the time of the encounter	Foa not doc as being perf
G8541	0010	3	Functional outcome assessment using a standardized tool not documented, reason not given	No doc cur funct assess
G8542	0010	3	Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required	Doc funct no deficiencies
G8543	0010	3	Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented, reason not given	Cur funct asses; no care pln
G8544	0010	3	I intend to report the coronary artery bypass graft (cabg) measures group	Cabg measures grp
G8545	0010	3	I intend to report the hepatitis c measures group	Hepc measures grp
G8547	0010	3	I intend to report the ischemic vascular disease (ivd) measures group	Ivd measures grp
G8548	0010	3	I intend to report the heart failure (hf) measures group	Hf measures grp
G8549	0010	3	All quality actions for the applicable measures in the hepatitis c measures group have been performed for this patient	Hepc mg qual act perform
G8551	0010	3	All quality actions for the applicable measures in the heart failure (hf) measures group have been performed for this patient	Hf mg qual act perform
G8552	0010	3	All quality actions for the applicable measures in the ischemic vascular disease (ivd) measures group have been performed for this patient	Ivd mg qual act perform
G8559	0010	3	Patient referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation	Pt ref doc oto eval
G8560	0010	3	Patient has a history of active drainage from the ear within the previous 90 days	Pt hx act drain prev 90 days
G8561	0010	3	Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure	Pt inelig for ref oto eval
G8562	0010	3	Patient does not have a history of active drainage from the ear within the previous 90 days	Pt no hx act drain 90 d
G8563	0010	3	Patient not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given	Pt no ref oto reas no spec
G8564	0010	3	Patient was referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not specified)	Pt ref oto eval
G8565	0010	3	Verification and documentation of sudden or rapidly progressive hearing loss	Ver doc hear loss
G8566	0010	3	Patient is not eligible for the “referral for otologic evaluation for sudden or rapidly progressive hearing loss” measure	Pt inelig ref oto eval
G8567	0010	3	Patient does not have verification and documentation of sudden or rapidly progressive hearing loss	Pt no doc hear loss
G8568	0010	3	Patient was not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given	Pt no ref otolo no spec
G8569	0010	3	Prolonged postoperative intubation (> 24 hrs) required	Prol intubation req
G8570	0010	3	Prolonged postoperative intubation (> 24 hrs) not required	No prol intub req
G8571	0010	3	Development of deep sternal wound infection/mediastinitis within 30 days postoperatively	Ster wd ifx 30 d postop
G8572	0010	3	No deep sternal wound infection/mediastinitis	No ster wd ifx
G8573	0010	3	Stroke following isolated cabg surgery	Stk cabg
G8574	0010	3	No stroke following isolated cabg surgery	No strk cabg
G8575	0010	3	Developed postoperative renal failure or required dialysis	Postop ren fail
G8576	0010	3	No postoperative renal failure/dialysis not required	No postop ren fail
G8577	0010	3	Re-exploration required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason	Reop req bld grft oth
G8578	0010	3	Re-exploration not required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason	No reop req bld grft oth
G8579	0010	3	Antiplatelet medication at discharge	Antplt med disch
G8580	0010	3	Antiplatelet medication contraindicated	Antplt med contraind
G8581	0010	3	No antiplatelet medication at discharge	No antplt med disch
G8582	0010	3	Beta-blocker at discharge	Bblock disch
G8583	0010	3	Beta-blocker contraindicated	Bblock contraind
G8584	0010	3	No beta-blocker at discharge	No bblock disch
G8585	0010	3	Anti-lipid treatment at discharge	Antilipid treat disch
G8586	0010	3	Anti-lipid treatment contraindicated	Antlip disch contra
G8587	0010	3	No anti-lipid treatment at discharge	No antlipid treat disch
G8593	0010	3	Lipid profile results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)	Lipid pn results
G8594	0010	3	Lipid profile not performed, reason not given	No lipid prof perf
G8595	0010	3	Most recent ldl-c < 100 mg/dl	Ldl < 100
G8597	0010	3	Most recent ldl-c >= 100 mg/dl	Ldl >= 100
G8598	0010	3	Aspirin or another antiplatelet therapy used	Asa/antiplat ther used
G8599	0010	3	Aspirin or another antiplatelet therapy not used, reason not given	No asa/antiplat ther use rng
G8600	0010	3	Iv t-pa initiated within three hours (<= 180 minutes) of time last known well	Tpa initi w/in 3 hrs
G8601	0010	3	Iv t-pa not initiated within three hours (<= 180 minutes) of time last known well for reasons documented by clinician	No elig tpa init w/in 3 hrs
G8602	0010	3	Iv t-pa not initiated within three hours (<= 180 minutes) of time last known well, reason not given	No tpa init w/in 3 hrs
G8627	0010	3	Surgical procedure performed within 30 days following cataract surgery for major complications (e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence)	Surg proc w/in 30 days
G8628	0010	3	Surgical procedure not performed within 30 days following cataract surgery for major complications (e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence)	No surg proc w/in 30 days
G8629	0010	3	Documentation of order for prophylactic parenteral antibiotic to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required)	Doc antibio order b/4 surg
G8630	0010	3	Documentation that administration of prophylactic parenteral antibiotics was initiated within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required), as ordered	Doc antibio given b/4 surg
G8631	0010	3	Clinician documented that patient was not an eligible candidate for ordering prophylactic parenteral antibiotics to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required)	Pt no elg 4 order antbi give
G8632	0010	3	Prophylactic parenteral antibiotics were not ordered to be given or given within one hour (if fluoroquinolone or vancomycin, two hours) prior to the surgical incision (or start of procedure when no incision is required), reason not given	Doc no antibi order b/4 surg
G8633	0010	3	Pharmacologic therapy (other than minierals/vitamins) for osteoporosis prescribed	Pharm ther osteo rx
G8634	0010	3	Clinician documented patient not an eligible candidate to receive pharmacologic therapy for osteoporosis	Pt no elg phar ther osteo
G8635	0010	3	Pharmacologic therapy for osteoporosis was not prescribed, reason not given	No pharm ther osteo rx
G8645	0010	3	I intend to report the asthma measures group	Asthma measures grp
G8646	0010	3	All quality actions for the applicable measures in the asthma measures group have been performed for this patient	Asthma mg qual act perform
G8647	0010	3	Risk-adjusted functional status change residual score for the knee impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)	Rafscrs ki scor >= 0
G8648	0010	3	Risk-adjusted functional status change residual score for the knee impairment successfully calculated and the score was less than zero (< 0)	Rafscrs ki scor < 0
G8649	0010	3	Risk-adjusted functional status change residual score for the knee impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate	Rafscrs ki no scor
G8650	0010	3	Risk-adjusted functional status change residual score for the knee impairment not measured because the patient did not complete the knee fs prom at initial evaluation and/or near discharge, reason not given	Rafs crs ki no scor no surv
G8651	0010	3	Risk-adjusted functional status change residual score for the hip impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)	Rafscrs hi scor >=0
G8652	0010	3	Risk-adjusted functional status change residual score for the hip impairment successfully calculated and the score was less than zero (< 0)	Rafscrs hi scor < 0
G8653	0010	3	Risk-adjusted functional status change residual scores for the hip impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate	Rafscrs hi no scor
G8654	0010	3	Risk-adjusted functional status change residual score for the hip impairment not measured because the patient did not complete the fs intake survey on admission and/or follow up fs status survey near discharge, reason not given	Rafs crs hi no scor no surv
G8655	0010	3	Risk-adjusted functional status change residual score for the lower leg, foot or ankle impairment successfully calculated and the score was equal to zero (0) or greater than zero ( > 0)	Rafscrs llfai scor >= 0
G8656	0010	3	Risk-adjusted functional status change residual score for the lower leg, foot or ankle impairment successfully calculated and the score was less than zero (< 0)	Rafscrs llfai scor < 0
G8657	0010	3	Risk-adjusted functional status change residual score for the lower leg, foot or ankle impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate	Rafscrs llfai no scor
G8658	0010	3	Risk-adjusted functional status change residual score for the lower leg, foot or ankle impairment not measured because the patient did not complete the fs intake survey on admission and/or follow up fs status survey near discharge, reason not given	Rafscrs llfai no scor + surv
G8659	0010	3	Risk-adjusted functional status change residual score for the low back impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)	Rafscrs lbi scor >= 0
G8660	0010	3	Risk-adjusted functional status change residual score for the low back impairment successfully calculated and the score was less than zero (< 0)	Rafscrs lbi scor < 0
G8661	0010	3	Risk-adjusted functional status change residual score for the low back impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate	Rafscrs lbi no scor
G8662	0010	3	Risk-adjusted functional status change residual score for the low back impairment not measured because the patient did not complete the low back fs prom at initial evaluation and/or near discharge, reason not given	Rafs crs lbi no scor no surv
G8663	0010	3	Risk-adjusted functional status change residual score for the shoulder impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)	Rafscrs si scor >= 0
G8664	0010	3	Risk-adjusted functional status change residual score for the shoulder impairment successfully calculated and the score was less than zero (< 0)	Rafscrs si scor < 0
G8665	0010	3	Risk-adjusted functional status change residual score for the shoulder impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate	Rafscrs si no scor
G8666	0010	3	Risk-adjusted functional status change residual score for the shoulder impairment not measured because the patient did not complete the shoulder fs prom at initial evaluation and/or near discharge, reason not given	Rafs crs si no scor no surv
G8667	0010	3	Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)	Rafscrs ewh scor >= 0
G8668	0010	3	Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment successfully calculated and the score was less than zero (< 0)	Rafscrs ewh scor < 0
G8669	0010	3	Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate	Rafscrs
G8670	0010	3	Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment not measured because the patient did not complete the elbow/wrist/hand fs prom at initial evaluation and/or near discharge, reason not given	Rafs crs ewh no scor no surv
G8671	0010	3	Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)	Rafscrs goi scor >= 0
G8672	0010	3	Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was less than zero (< 0)	Rafscrs goi scor < 0
G8673	0010	3	Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate	Rafscrs goi no scor
G8674	0010	3	Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment not measured because the patient did not complete the general orthopedic fs prom at initial evaluation and/or near discharge, reason not given	Rafscrs neck, no msr/no foto
G8682	0010	3	Lvf testing documented as being performed prior to discharge or in the previous 12 months	Lvg test perf
G8683	0010	3	Lvf testing not performed prior to discharge or in the previous 12 months for a medical or patient documented reason	Pt not elig for lvf test
G8685	0010	3	Lvf testing not documented as being performed prior to discharge or in the previous 12 months, reason not given	Lvf test not perf
G8694	0010	3	Left ventricular ejection fraction (lvef) < 40%	Lvef <40%
G8696	0010	3	Antithrombotic therapy prescribed at discharge	Antithromb thx presc
G8697	0010	3	Antithrombotic therapy not prescribed for documented reasons (e.g., patient had stroke during hospital stay, patient expired during inpatient stay, other medical reason(s)); (e.g., patient left against medical advice, other patient reason(s))	Antithromb no presc doc reas
G8698	0010	3	Antithrombotic therapy was not prescribed at discharge, reason not given	Antithromb no presc no reas
G8699	0010	3	Rehabilitation services (occupational, physical or speech) ordered at or prior to discharge	Rehab ordered disch
G8700	0010	3	Rehabilitation services (occupational, physical or speech) not indicated at or prior to discharge	Rehab not indicated disch
G8701	0010	3	Rehabilitation services were not ordered, reason not otherwise specified	Rehab not ordered
G8702	0010	3	Documentation that prophylactic antibiotics were given within 4 hours prior to surgical incision or intraoperatively	Antiobiotics 4 hr prior surg
G8703	0010	3	Documentation that prophylactic antibiotics were neither given within 4 hours prior to surgical incision nor intraoperatively	Antibiotics not prior surg
G8704	0010	3	12-lead electrocardiogram (ecg) performed	Ecg performed
G8705	0010	3	Documentation of medical reason(s) for not performing a 12-lead electrocardiogram (ecg)	Med reas no ecg
G8706	0010	3	Documentation of patient reason(s) for not performing a 12-lead electrocardiogram (ecg)	Pt reas no ecg
G8707	0010	3	12-lead electrocardiogram (ecg) not performed, reason not given	Ecg not performed
G8708	0010	3	Patient not prescribed or dispensed antibiotic	Antibiotic not pres
G8709	0010	3	Patient prescribed or dispensed antibiotic for documented medical reason(s) within three days after the initial diagnosis of uri (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases (female reproductive organs)), infections of the kidney, cystitis or uti, and acne)	Pt presc doc med rsn id uri
G8710	0010	3	Patient prescribed or dispensed antibiotic	Pt pres antibiotic
G8711	0010	3	Prescribed or dispensed antibiotic	Pres antibiotic
G8712	0010	3	Antibiotic not prescribed or dispensed	Not pres antibiotic
G8713	0010	3	Spkt/v greater than or equal to 1.2 (single-pool clearance of urea [kt] / volume [v])	Spkt/v great 1.2 kt/v
G8714	0010	3	Hemodialysis treatment performed exactly three times per week for > 90 days	Hemodialysis 3 times week
G8717	0010	3	Spkt/v less than 1.2 (single-pool clearance of urea [kt] / volume [v]), reason not given	Less 1.2 kt/v
G8718	0010	3	Total kt/v greater than or equal to 1.7 per week (total clearance of urea [kt] / volume [v])	Great 1.7 kt/v per week
G8720	0010	3	Total kt/v less than 1.7 per week (total clearance of urea [kt] / volume [v])	Less 1.7 kt/v per week
G8721	0010	3	Pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report	Pt, pn, hist grade doc
G8722	0010	3	Documentation of medical reason(s) for not including the pt category, the pn category or the histologic grade in the pathology report (e.g., re-excision without residual tumor; non-carcinomasanal canal)	Med reas pt, pn, not doc
G8723	0010	3	Specimen site is other than anatomic location of primary tumor	Spec sit not prim tumor
G8724	0010	3	Pt category, pn category and histologic grade were not documented in the pathology report, reason not given	Pt, pn, hist grade not doc
G8725	0010	3	Fasting lipid profile performed (triglycerides, ldl-c, hdl-c and total cholesterol)	Lipid profile perf doc
G8726	0010	3	Clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons)	Doc reas no lipid profile
G8728	0010	3	Fasting lipid profile not performed, reason not given	Lipid profile not perf
G8730	0010	3	Pain assessment documented as positive using a standardized tool and a follow-up plan is documented	Pain doc pos and plan
G8731	0010	3	Pain assessment using a standardized tool is documented as negative, no follow-up plan required	Pain neg no plan
G8732	0010	3	No documentation of pain assessment, reason not given	No doc of pain
G8733	0010	3	Elder maltreatment screen documented as positive and a follow-up plan is documented	Doc pos elder mal scrn plan
G8734	0010	3	Elder maltreatment screen documented as negative, no follow-up required	Doc neg elder mal no plan
G8735	0010	3	Elder maltreatment screen documented as positive, follow-up plan not documented, reason not given	Eld mal scrn pos no plan
G8736	0010	3	Most current ldl-c <100mg/dl	Ldl-c <100mg/dl
G8737	0010	3	Most current ldl-c >=100mg/dl	Ldl-c >=100mg/dl
G8738	0010	3	Left ventricular ejection fraction (lvef) < 40% or documentation of severely or moderately depressed left ventricular systolic function	Lvef < 40%
G8739	0010	3	Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function	Lvef >= 40%
G8740	0010	3	Left ventricular ejection fraction (lvef) not performed or assessed, reason not given	Lvef not perfrmd
G8749	0010	3	Absence of signs of melanoma (tenderness, jaundice, localized neurologic signs such as weakness, or any other sign suggesting systemic spread) or absence of symptoms of melanoma (cough, dyspnea, pain, paresthesia, or any other symptom suggesting the possibility of systemic spread of melanoma)	No signs melanoma
G8751	0010	3	Smoking status and exposure to second hand smoke in the home not assessed, reason not given	Smkg status not assess
G8752	0010	3	Most recent systolic blood pressure < 140 mmhg	Sys bp less 140
G8753	0010	3	Most recent systolic blood pressure >= 140 mmhg	Sys bp > or = 140
G8754	0010	3	Most recent diastolic blood pressure < 90 mmhg	Dias bp less 90
G8755	0010	3	Most recent diastolic blood pressure >= 90 mmhg	Dias bp > or = 90
G8756	0010	3	No documentation of blood pressure measurement, reason not given	No bp measure doc
G8757	0010	3	All quality actions for the applicable measures in the chronic obstructive pulmonary disease (copd) measures group have been performed for this patient	Copd mg qual act perform
G8758	0010	3	All quality actions for the applicable measures in the inflammatory bowel disease (ibd) measures group have been performed for this patient	Ibd mg qual act perform
G8759	0010	3	All quality actions for the applicable measures in the sleep apnea measures group have been performed for this patient	Osa mg qual act perform
G8761	0010	3	All quality actions for the applicable measures in the dementia measures group have been performed for this patient	Dementia mg qual act perform
G8762	0010	3	All quality actions for the applicable measures in the parkinson’s disease measures group have been performed for this patient	Pd mg qual act perform
G8763	0010	3	All quality actions for the applicable measures in the hypertension (htn) measures group have been performed for this patient	Hyperten mg qual act perform
G8764	0010	3	All quality actions for the applicable measures in the cardiovascular prevention measures group have bee performed for this patient	Car prev mg qual act perform
G8765	0010	3	All quality actions for the applicable measures in the cataract measures group have been performed for this patient	Cataract mg qual act perform
G8767	0010	3	Lipid panel results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)	Lipid panel res doc rev
G8768	0010	3	Documentation of medical reason(s) for not performing lipid profile (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)	Doc med reas no lipid profle
G8769	0010	3	Lipid profile not performed, reason not given	Lipid profile not perform
G8770	0010	3	Urine protein test result documented and reviewed	Urine protein test doc rev
G8771	0010	3	Documentation of diagnosis of chronic kidney disease	Doc dx ckd
G8772	0010	3	Documentation of medical reason(s) for not performing urine protein test (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not cllinically appropriate)	Doc med reas no urine protn
G8773	0010	3	Urine protein test was not performed, reason not given	No urine protein test
G8774	0010	3	Serum creatinine test result documented and reviewed	Serum creatinine doc rev
G8775	0010	3	Documentation of medical reason(s) for not performing serum creatinine test (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)	Doc med reas no serum crtn
G8776	0010	3	Serum creatinine test not performed, reason not given	No serum creatinine test
G8777	0010	3	Diabetes screening test performed	Diabetes screen
G8778	0010	3	Documentation of medical reason(s) for not performing diabetes screening test (e.g., patients with a diagnosis of diabetes, or with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)	Doc med reas no diabete scrn
G8779	0010	3	Diabetes screening test not performed, reason not given	No diabetes screen
G8780	0010	3	Counseling for diet and physical activity performed	Counsel diet phys activity
G8781	0010	3	Documentation of medical reason(s) for patient not receiving counseling for diet and physical activity (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)	Doc med reas no counsel diet
G8782	0010	3	Counseling for diet and physical activity not performed, reason not given	No counsel diet phys act
G8783	0010	3	Normal blood pressure reading documented, follow-up not required	Bp scrn perf rec interval
G8784	0010	3	Patient not eligible (e.g., documentation the patient is not eligible due to active diagnosis of hypertension, patient refuses, urgent or emergent situation)	Pt no elig for bp assess
G8785	0010	3	Blood pressure reading not documented, reason not given	Bp scrn no perf at interval
G8797	0010	3	Specimen site other than anatomic location of esophagus	Specimen site not esophagus
G8798	0010	3	Specimen site other than anatomic location of prostate	Specimen site not prostate
G8806	0010	3	Performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documented	Perf ultrsnd to lct preg doc
G8807	0010	3	Trans-abdominal or trans-vaginal ultrasound not performed for reasons documented by clinician (e.g., patient has visited the ed multiple times within 72 hours, patient has a documented intrauterine pregnancy [iup])	No ta tv ultrasnd
G8808	0010	3	Trans-abdominal or trans-vaginal ultrasound not performed, reason not given	Ultrasound not perf, rng
G8809	0010	3	Rh-immunoglobulin (rhogam) ordered	Rh-immunoglobulin order
G8810	0010	3	Rh-immunoglobulin (rhogam) not ordered for reasons documented by clinician (e.g., patient had prior documented receipt of rhogam within 12 weeks, patient refusal)	Doc reas no rh-immuno
G8811	0010	3	Documentation rh-immunoglobulin (rhogam) was not ordered, reason not given	No rh-immunoglobulin order
G8815	0010	3	Documented reason in the medical records for why the statin therapy was not prescribed (i.e., lower extremity bypass was for a patient with non-artherosclerotic disease)	Doc reas no statin therapy
G8816	0010	3	Statin medication prescribed at discharge	Statin med pres at disch
G8817	0010	3	Statin therapy not prescribed at discharge, reason not given	Doc reas no statin med disch
G8818	0010	3	Patient discharge to home no later than post-operative day #7	Pt disch to home by day#7
G8825	0010	3	Patient not discharged to home by post-operative day #7	Pt not disch to home day#7
G8826	0010	3	Patient discharge to home no later than post-operative day #2 following evar	Pt disch home day #2 evar
G8833	0010	3	Patient not discharged to home by post-operative day #2 following evar	Pt not disch home day#2 evar
G8834	0010	3	Patient discharged to home no later than post-operative day #2 following cea	Pt disch home day #2 cea
G8838	0010	3	Patient not discharged to home by post-operative day #2 following cea	Not disch home by day #2
G8839	0010	3	Sleep apnea symptoms assessed, including presence or absence of snoring and daytime sleepiness	Sleep apnea assess
G8840	0010	3	Documentation of reason(s) for not documenting an assessment of sleep symptoms (e.g., patient didn’t have initial daytime sleepiness, patient visited between initial testing and initiation of therapy)	Doc reas no sleep apnea
G8841	0010	3	Sleep apnea symptoms not assessed, reason not given	No sleep apnea assess
G8842	0010	3	Apnea hypopnea index (ahi) or respiratory disturbance index (rdi) measured at the time of initial diagnosis	Ahi or rdi initial dx
G8843	0010	3	Documentation of reason(s) for not measuring an apnea hypopnea index (ahi) or a respiratory disturbance index (rdi) at the time of initial diagnosis (e.g., psychiatric disease, dementia, patient declined, financial, insurance coverage, test ordered but not yet completed)	Doc reas no ahi or rdi
G8844	0010	3	Apnea hypopnea index (ahi) or respiratory disturbance index (rdi) not measured at the time of initial diagnosis, reason not given	No ahi or rdi initial dx
G8845	0010	3	Positive airway pressure therapy prescribed	Pos airway press prescribed
G8846	0010	3	Moderate or severe obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of 15 or greater)	Mod or severe osa
G8848	0010	3	Mild obstructive sleep apnea (apnea hypopnea index (ahi) or respiratory disturbance index (rdi) of less than 15)	Mild osa
G8849	0010	3	Documentation of reason(s) for not prescribing positive airway pressure therapy (e.g., patient unable to tolerate, alternative therapies use, patient declined, financial, insurance coverage)	Doc reas no pos air press
G8850	0010	3	Positive airway pressure therapy not prescribed, reason not given	No pap prescribed
G8851	0010	3	Objective measurement of adherence to positive airway pressure therapy, documented	Adhere pos air press therapy
G8852	0010	3	Positive airway pressure therapy prescribed	Pos air press prescribe
G8853	0010	3	Positive airway pressure therapy not prescribed	Pos air press not prescribe
G8854	0010	3	Documentation of reason(s) for not objectively measuring adherence to positive airway pressure therapy (e.g., patient didn’t bring data from continous positive airway pressure [cpap], therapy not yet initiated, not available on machine)	Reas no adhere pos air pres
G8855	0010	3	Objective measurement of adherence to positive airway pressure therapy not performed, reason not given	Pos air press adhere no perf
G8856	0010	3	Referral to a physician for an otologic evaluation performed	Ref for oto eval
G8857	0010	3	Patient is not eligible for the referral for otologic evaluation measure (e.g., patients who are already under the care of a physician for acute or chronic dizziness)	No elig ref for oto eval
G8858	0010	3	Referral to a physician for an otologic evaluation not performed, reason not given	Not ref for oto eval
G8859	0010	3	Patient receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days	Corticosteroids 10mg 60 days
G8860	0010	3	Patients who have received dose of corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days	Corticosteroid 10 mg 60 days
G8861	0010	3	Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) ordered and documented, review of systems and medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed	Dxa ordered for osteo
G8862	0010	3	Patients not receiving corticosteroids greater than or equal to 10mg/day for 60 or greater consecutive days	No corticostrd 10mg 60 days
G8863	0010	3	Patients not assessed for risk of bone loss, reason not given	No assess bone loss
G8864	0010	3	Pneumococcal vaccine administered or previously received	Pneumococcal vaccine admin
G8865	0010	3	Documentation of medical reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient allergic reaction, potential adverse drug reaction)	Doc med reas no pneumococcal
G8866	0010	3	Documentation of patient reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient refusal)	Doc pt reas no pneumococcal
G8867	0010	3	Pneumococcal vaccine not administered or previously received, reason not given	No pneumococcal admin
G8868	0010	3	Patients receiving a first course of anti-tnf therapy	1st course antitnf
G8869	0010	3	Patient has documented immunity to hepatitis b and initiating anti-tnf therapy	Doc immune hep b antitnf
G8870	0010	3	Hepatitis b vaccine injection administered or previously received and is receiving a first course of anti-tnf therapy	Hepb admin 1st antitnf
G8871	0010	3	Patient not receiving a first course of anti-tnf therapy	No 1st antitnf
G8872	0010	3	Excised tissue evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion	Intraop image confirm excise
G8873	0010	3	Patients with needle localization specimens which are not amenable to intraoperative imaging such as mri needle wire localization, or targets which are tentatively identified on mammogram or ultrasound which do not contain a biopsy marker but which can be verified on intraoperative inspection or pathology (e.g., needle biopsy site where the biopsy marker is remote from the actual biopsy site)	Specimen not intraop image
G8874	0010	3	Excised tissue not evaluated by imaging intraoperatively to confirm successful inclusion of targeted lesion	Tissue not image intraop
G8875	0010	3	Clinician diagnosed breast cancer preoperatively by a minimally invasive biopsy method	Breast cancer dx min invsive
G8876	0010	3	Documentation of reason(s) for not performing minimally invasive biopsy to diagnose breast cancer preoperatively (e.g., lesion too close to skin, implant, chest wall, etc., lesion could not be adequately visualized for needle biopsy, patient condition prevents needle biopsy [weight, breast thickness, etc.], duct excision without imaging abnormality, prophylactic mastectomy, reduction mammoplasty, excisional biopsy performed by another physician)	Doc reas no min inv dx
G8877	0010	3	Clinician did not attempt to achieve the diagnosis of breast cancer preoperatively by a minimally invasive biopsy method, reason not given	No brst cncr dx min invasive
G8878	0010	3	Sentinel lymph node biopsy procedure performed	Sent lymph node biopsy
G8879	0010	3	Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer	Node neg inv brst cncr
G8880	0010	3	Documentation of reason(s) sentinel lymph node biopsy not performed (e.g., reasons could include but not limited to; non-invasive cancer, incidental discovery of breast cancer on prophylactic mastectomy, incidental discovery of breast cancer on reduction mammoplasty, pre-operative biopsy proven lymph node (ln) metastases, inflammatory carcinoma, stage 3 locally advanced cancer, recurrent invasive breast cancer, clinically node positive after neoadjuvant systemic therapy, patient refusal after informed consent, patient with significant age, comorbidities, or limited life expectancy and favorable tumor; adjuvant systemic therapy unlikely to change)	Sen lym p node biop not perf
G8881	0010	3	Stage of breast cancer is greater than t1n0m0 or t2n0m0	Brst cncr stage > t1n0m0
G8882	0010	3	Sentinel lymph node biopsy procedure not performed, reason not given	No sent lymph node biopsy
G8883	0010	3	Biopsy results reviewed, communicated, tracked and documented	Rev, comm, track, doc biopsy
G8884	0010	3	Clinician documented reason that patient’s biopsy results were not reviewed	Doc reas biopsy not review
G8885	0010	3	Biopsy results not reviewed, communicated, tracked or documented	No rev, comm, track biopsy
G8886	0010	3	Most recent blood pressure under control	Bp under control
G8887	0010	3	Documentation of medical reason(s) for most recent blood pressure not being under control (e.g., patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)	Doc med reas bp not control
G8888	0010	3	Most recent blood pressure not under control, results documented and reviewed	Bp not under control
G8889	0010	3	No documentation of blood pressure measurement, reason not given	No doc bp
G8890	0010	3	Most recent ldl-c under control, results documented and reviewed	Ldl-c under control
G8891	0010	3	Documentation of medical reason(s) for most recent ldl-c not under control (e.g., patients with palliative goals for whom treatment of hypertension with standard treatment goals is not clinically appropriate)	Doc med reas no ldl-c contrl
G8892	0010	3	Documentation of medical reason(s) for not performing ldl-c test (e.g. patients with palliative goals or for whom treatment of hypertension with standard treatment goals is not clinically appropriate)	Doc med reas no ldl-c test
G8893	0010	3	Most recent ldl-c not under control, results documented and reviewed	Ldl-c not under control
G8894	0010	3	Ldl-c not performed, reason not given	Ldl-c not performed
G8895	0010	3	Oral aspirin or other antithrombotic therapy prescribed	Antrom prescribe
G8896	0010	3	Documentation of medical reason(s) for not prescribing oral aspirin or other antithrombotic therapy (e.g., patient documented to be low risk or patient with terminal illness or treatment of hypertension with standard treatment goals is not clinically appropriate, or for whom risk of aspirin or other antithrombotic therapy exceeds potential benefits such as for individuals whose blood pressure is poorly controlled)	Doc med reas no antihtrom
G8897	0010	3	Oral aspirin or other antithrombotic therapy was not prescribed, reason not given	Antithrom not prescribe
G8898	0010	3	I intend to report the chronic obstructive pulmonary disease (copd) measures group	Copd measures group
G8899	0010	3	I intend to report the inflammatory bowel disease (ibd) measures group	Inflammatory bowel dis mg
G8900	0010	3	I intend to report the sleep apnea measures group	Obstructive sleep apnea mg
G8902	0010	3	I intend to report the dementia measures group	Dementia measures group
G8903	0010	3	I intend to report the parkinson’s disease measures group	Parkinson’s disease mg
G8904	0010	3	I intend to report the hypertension (htn) measures group	Hypertension mg
G8905	0010	3	I intend to report the cardiovascular prevention measures group	Cardiovascular prevention mg
G8906	0010	3	I intend to report the cataract measures group	Cataract measures group
G8907	0010	3	Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer or hospital admission upon discharge from the facility	Pt doc no events on discharg
G8908	0010	3	Patient documented to have received a burn prior to discharge	Pt doc w burn prior to d/c
G8909	0010	3	Patient documented not to have received a burn prior to discharge	Pt doc no burn prior to d/c
G8910	0010	3	Patient documented to have experienced a fall within asc	Pt doc to have fall in asc
G8911	0010	3	Patient documented not to have experienced a fall within ambulatory surgical center	Pt doc no fall in asc
G8912	0010	3	Patient documented to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event	Pt doc with wrong event
G8913	0010	3	Patient documented not to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event	Pt doc no wrong event
G8914	0010	3	Patient documented to have experienced a hospital transfer or hospital admission upon discharge from asc	Pt trans to hosp post d/c
G8915	0010	3	Patient documented not to have experienced a hospital transfer or hospital admission upon discharge from asc	Pt not trans to hosp at d/c
G8916	0010	3	Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic initiated on time	Pt w iv ab given on time
G8917	0010	3	Patient with preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis, antibiotic not initiated on time	Pt w iv ab not given on time
G8918	0010	3	Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis	Pt w/o preop order iv ab pro
G8923	0010	3	Left ventricular ejection fraction (lvef) < 40% or documentation of moderately or severely depressed left ventricular systolic function	Lvef < 40% or lvsd
G8924	0010	3	Spirometry test results demonstrate fev1/fvc < 70%, fev < 60% predicted and patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)	Spir fev1/fvc<70%,fev<60%
G8925	0010	3	Spirometry test results demonstrate fev1 >= 60% fev1/fvc >= 70%, predicted or patient does not have copd symptoms	Spir fev1/fvc>=60% & no copd
G8926	0010	3	Spirometry test not performed or documented, reason not given	Spiro no perf or doc
G8927	0010	3	Adjuvant chemotherapy referred, prescribed or previously received for ajcc stage iii, colon cancer	Adj chem pres ajcc iii
G8928	0010	3	Adjuvant chemotherapy not prescribed or previously received, for documented reasons (e.g., medical co-morbidities, diagnosis date more than 5 years prior to the current visit date, patient’s diagnosis date is within 120 days of the end of the 12 month reporting period, patient’s cancer has metastasized, medical contraindication/allergy, poor performance status, other medical reasons, patient refusal, other patient reasons, patient is currently enrolled in a clinical trial that precludes prescription of chemotherapy, other system reasons)	Adj chem not pres rsn spec
G8929	0010	3	Adjuvant chemotherapy not prescribed or previously received, reason not given	Adj cmo not pres rsn not gvn
G8930	0010	3	Assessment of depression severity at the initial evaluation	Assess of dep @ initial eval
G8931	0010	3	Assessment of depression severity not documented, reason not given	Asses of dep not documented
G8932	0010	3	Suicide risk assessed at the initial evaluation	Suicd rsk assessed init eval
G8933	0010	3	Suicide risk not assessed at the initial evaluation, reason not given	Suicide risk not assessed
G8934	0010	3	Left ventricular ejection fraction (lvef) <40% or documentation of moderately or severely depressed left ventricular systolic function	Lvef <40% or dep lv sys fcn
G8935	0010	3	Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy	Rx ace or arb therapy
G8936	0010	3	Clinician documented that patient was not an eligible candidate for angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy (eg, allergy, intolerance, pregnancy, renal failure due to ace inhibitor, diseases of the aortic or mitral valve, other medical reasons) or (eg, patient declined, other patient reasons) or (eg, lack of drug availability, other reasons attributable to the health care system)	Pt not eligible ace/arb
G8937	0010	3	Clinician did not prescribe angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy, reason not given	No rx ace/arb therapy
G8938	0010	3	Bmi is documented as being outside of normal limits, follow-up plan is not documented, documentation the patient is not eligible	Bmi doc onl fup nt doc
G8939	0010	3	Pain assessment documented as positive, follow-up plan not documented, documentation the patient is not eligible at the time of the encounter	Pain as doc positive, no f/u
G8940	0010	3	Screening for depression documented as positive, a follow-up plan not completed, documented reason	Scr dep pos, no plan done
G8941	0010	3	Elder maltreatment screen documented as positive, follow-up plan not documented, documentation the patient is not eligible for follow-up plan at the time of the encounter	Eld maltreatment doc as pos
G8942	0010	3	Functional outcomes assessment using a standardized tool is documented within the previous 30 days and care plan, based on identified deficiencies on the date of the functional outcome assessment, is documented	Doc fcn/care plan w/30 days
G8943	0010	3	Ldl-c result not present or not within 12 months prior	Ldlc not pres w/i 12 mo prir
G8944	0010	3	Ajcc melanoma cancer stage 0 through iic melanoma	Ajcc mel cnr stg 0 - iic
G8946	0010	3	Minimally invasive biopsy method attempted but not diagnostic of breast cancer (e.g., high risk lesion of breast such as atypical ductal hyperplasia, lobular neoplasia, atypical lobular hyperplasia, lobular carcinoma in situ, atypical columnar hyperplasia, flat epithelial atypia, radial scar, complex sclerosing lesion, papillary lesion, or any lesion with spindle cells)	Mibm but no dx of breast ca
G8947	0010	3	One or more neuropsychiatric symptoms	1 or more neuropsych
G8948	0010	3	No neuropsychiatric symptoms	No neuropsych symptoms
G8949	0010	3	Documentation of patient reason(s) for patient not receiving counseling for diet and physical activity (e.g., patient is not willing to discuss diet or exercise interventions to help control blood pressure, or the patient said he/she refused to make these changes)	Doc pt reas on counsel diet
G8950	0010	3	Pre-hypertensive or hypertensive blood pressure reading documented, and the indicated follow-up is documented	Pre-htn or htn doc, f/u indc
G8951	0010	3	Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, documentation the patient is not eligible	Pre-htn/htn doc, no pt f/u
G8952	0010	3	Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given	Pre-htn/htn, no f/u, not gvn
G8953	0010	3	All quality actions for the applicable measures in the oncology measures group have been performed for this patient	Oncology mg qual act perform
G8955	0010	3	Most recent assessment of adequacy of volume management documented	Most recent assess vol mgmt
G8956	0010	3	Patient receiving maintenance hemodialysis in an outpatient dialysis facility	Pt rcv hedia outpt dyls fac
G8957	0010	3	Patient not receiving maintenance hemodialysis in an outpatient dialysis facility	Pt no hedia in outpt fac
G8958	0010	3	Assessment of adequacy of volume management not documented, reason not given	Assess vol mgmt not doc
G8959	0010	3	Clinician treating major depressive disorder communicates to clinician treating comorbid condition	Clin tx mdd comm to tx clin
G8960	0010	3	Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition, reason not given	Clin tx mdd not comm
G8961	0010	3	Cardiac stress imaging test primarily performed on low-risk surgery patient for preoperative evaluation within 30 days preceding this surgery	Csit lowrisk surg pts preop
G8962	0010	3	Cardiac stress imaging test performed on patient for any reason including those who did not have low risk surgery or test that was performed more than 30 days preceding low risk surgery	Csit on pt any reas 30 days
G8963	0010	3	Cardiac stress imaging performed primarily for monitoring of asymptomatic patient who had pci within 2 years	Csi per asx pt w/pci 2 yrs
G8964	0010	3	Cardiac stress imaging test performed primarily for any other reason than monitoring of asymptomatic patient who had pci within 2 years (e.g., symptomatic patient, patient greater than 2 years since pci, initial evaluation, etc)	Csi any other than pci 2 yr
G8965	0010	3	Cardiac stress imaging test primarily performed on low chd risk patient for initial detection and risk assessment	Csit perf on low chd rsk
G8966	0010	3	Cardiac stress imaging test performed on symptomatic or higher than low chd risk patient or for any reason other than initial detection and risk assessment	Csit perf sx or high chd rsk
G8967	0010	3	Warfarin or another fda approved oral anticoagulant is prescribed	Warf or other fda drug presc
G8968	0010	3	Documentation of medical reason(s) for not prescribing warfarin or another fda-approved anticoagulant (e.g., atrial appendage device in place)	Doc med not presb
G8969	0010	3	Documentation of patient reason(s) for not prescribing warfarin or another fda-approved oral anticoagulant that is fda approved for the prevention of thromboembolism (e.g., patient choice of having atrial appendage device placed)	Doc pt rsn no presc warf/fda
G8970	0010	3	No risk factors or one moderate risk factor for thromboembolism	No rsk fac or 1 mod risk te
G8971	0010	3	Warfarin or another oral anticoagulant that is fda approved not prescribed, reason not given	Warfrn or othr antcog no rx
G8972	0010	3	One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism	1>=risk or>= mod risk for te
G8973	0010	3	Most recent hemoglobin (hgb) level < 10 g/dl	Mst rcnt hbb < 10g/dl
G8974	0010	3	Hemoglobin level measurement not documented, reason not given	Hgb not doc rns not gvn
G8975	0010	3	Documentation of medical reason(s) for patient having a hemoglobin level < 10 g/dl (e.g., patients who have non-renal etiologies of anemia [e.g., sickle cell anemia or other hemoglobinopathies, hypersplenism, primary bone marrow disease, anemia related to chemotherapy for diagnosis of malignancy, postoperative bleeding, active bloodstream or peritoneal infection], other medical reasons)	Hgb <10g/dl, med rsn
G8976	0010	3	Most recent hemoglobin (hgb) level >= 10 g/dl	Hgb >= 10 g/dl
G8977	0010	3	I intend to report the oncology measures group	Oncology measures grp
G8978	0010	3	Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals	Mobility current status
G8979	0010	3	Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting	Mobility goal status
G8980	0010	3	Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting	Mobility d/c status
G8981	0010	3	Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals	Body pos current status
G8982	0010	3	Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting	Body pos goal status
G8983	0010	3	Changing & maintaining body position functional limitation, discharge status, at discharge from therapy or to end reporting	Body pos d/c status
G8984	0010	3	Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals	Carry current status
G8985	0010	3	Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting	Carry goal status
G8986	0010	3	Carrying, moving & handling objects functional limitation, discharge status, at discharge from therapy or to end reporting	Carry d/c status
G8987	0010	3	Self care functional limitation, current status, at therapy episode outset and at reporting intervals	Self care current status
G8988	0010	3	Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting	Self care goal status
G8989	0010	3	Self care functional limitation, discharge status, at discharge from therapy or to end reporting	Self care d/c status
G8990	0010	3	Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals	Other pt/ot current status
G8991	0010	3	Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting	Other pt/ot goal status
G8992	0010	3	Other physical or occupational therapy primary functional limitation, discharge status, at discharge from therapy or to end reporting	Other pt/ot d/c status
G8993	0010	3	Other physical or occupational therapy subsequent functional limitation, current status, at therapy episode outset and at reporting intervals	Sub pt/ot current status
G8994	0010	3	Other physical or occupational therapy subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting	Sub pt/ot goal status
G8995	0010	3	Other physical or occupational therapy subsequent functional limitation, discharge status, at discharge from therapy or to end reporting	Sub pt/ot d/c status
G8996	0010	3	Swallowing functional limitation, current status at therapy episode outset and at reporting intervals	Swallow current status
G8997	0010	3	Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting	Swallow goal status
G8998	0010	3	Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting	Swallow d/c status
G8999	0010	3	Motor speech functional limitation, current status at therapy episode outset and at reporting intervals	Motor speech current status
G9001	0010	3	Coordinated care fee, initial rate	Mccd, initial rate
G9002	0010	3	Coordinated care fee, maintenance rate	Mccd,maintenance rate
G9003	0010	3	Coordinated care fee, risk adjusted high, initial	Mccd, risk adj hi, initial
G9004	0010	3	Coordinated care fee, risk adjusted low, initial	Mccd, risk adj lo, initial
G9005	0010	3	Coordinated care fee, risk adjusted maintenance	Mccd, risk adj, maintenance
G9006	0010	3	Coordinated care fee, home monitoring	Mccd, home monitoring
G9007	0010	3	Coordinated care fee, scheduled team conference	Mccd, sch team conf
G9008	0010	3	Coordinated care fee, physician coordinated care oversight services	Mccd,phys coor-care ovrsght
G9009	0010	3	Coordinated care fee, risk adjusted maintenance, level 3	Mccd, risk adj, level 3
G9010	0010	3	Coordinated care fee, risk adjusted maintenance, level 4	Mccd, risk adj, level 4
G9011	0010	3	Coordinated care fee, risk adjusted maintenance, level 5	Mccd, risk adj, level 5
G9012	0010	3	Other specified case management service not elsewhere classified	Other specified case mgmt
G9013	0010	3	Esrd demo basic bundle level i	Esrd demo bundle level i
G9014	0010	3	Esrd demo expanded bundle including venous access and related services	Esrd demo bundle-level ii
G9016	0010	3	Smoking cessation counseling, individual, in the absence of or in addition to any other evaluation and management service, per session (6-10 minutes) [demo project code only]	Demo-smoking cessation coun
G9017	0010	3	Amantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)	Amantadine hcl 100mg oral
G9018	0010	3	Zanamivir, inhalation powder, administered through inhaler, per 10 mg (for use in a medicare-approved demonstration project)	Zanamivir,inhalation pwd 10m
G9019	0010	3	Oseltamivir phosphate, oral, per 75 mg (for use in a medicare-approved demonstration project)	Oseltamivir phosphate 75mg
G9020	0010	3	Rimantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project)	Rimantadine hcl 100mg oral
G9033	0010	3	Amantadine hydrochloride, oral brand, per 100 mg (for use in a medicare-approved demonstration project)	Amantadine hcl oral brand
G9034	0010	3	Zanamivir, inhalation powder, administered through inhaler, brand, per 10 mg (for use in a medicare-approved demonstration project)	Zanamivir, inh pwdr, brand
G9035	0010	3	Oseltamivir phosphate, oral, brand, per 75 mg (for use in a medicare-approved demonstration project)	Oseltamivir phosp, brand
G9036	0010	3	Rimantadine hydrochloride, oral, brand, per 100 mg (for use in a medicare-approved demonstration project)	Rimantadine hcl, brand
G9050	0010	3	Oncology; primary focus of visit; work-up, evaluation, or staging at the time of cancer diagnosis or recurrence (for use in a medicare-approved demonstration project)	Oncology work-up evaluation
G9051	0010	3	Oncology; primary focus of visit; treatment decision-making after disease is staged or restaged, discussion of treatment options, supervising/coordinating active cancer directed therapy or managing consequences of cancer directed therapy (for use in a medicare-approved demonstration project)	Oncology tx decision-mgmt
G9052	0010	3	Oncology; primary focus of visit; surveillance for disease recurrence for patient who has completed definitive cancer-directed therapy and currently lacks evidence of recurrent disease; cancer directed therapy might be considered in the future (for use in a medicare-approved demonstration project)	Onc surveillance for disease
G9053	0010	3	Oncology; primary focus of visit; expectant management of patient with evidence of cancer for whom no cancer directed therapy is being administered or arranged at present; cancer directed therapy might be considered in the future (for use in a medicare-approved demonstration project)	Onc expectant management pt
G9054	0010	3	Oncology; primary focus of visit; supervising, coordinating or managing care of patient with terminal cancer or for whom other medical illness prevents further cancer treatment; includes symptom management, end-of-life care planning, management of palliative therapies (for use in a medicare-approved demonstration project)	Onc supervision palliative
G9055	0010	3	Oncology; primary focus of visit; other, unspecified service not otherwise listed (for use in a medicare-approved demonstration project)	Onc visit unspecified nos
G9056	0010	3	Oncology; practice guidelines; management adheres to guidelines (for use in a medicare-approved demonstration project)	Onc prac mgmt adheres guide
G9057	0010	3	Oncology; practice guidelines; management differs from guidelines as a result of patient enrollment in an institutional review board approved clinical trial (for use in a medicare-approved demonstration project)	Onc pract mgmt differs trial
G9058	0010	3	Oncology; practice guidelines; management differs from guidelines because the treating physician disagrees with guideline recommendations (for use in a medicare-approved demonstration project)	Onc prac mgmt disagree w/gui
G9059	0010	3	Oncology; practice guidelines; management differs from guidelines because the patient, after being offered treatment consistent with guidelines, has opted for alternative treatment or management, including no treatment (for use in a medicare-approved demonstration project)	Onc prac mgmt pt opt alterna
G9060	0010	3	Oncology; practice guidelines; management differs from guidelines for reason(s) associated with patient comorbid illness or performance status not factored into guidelines (for use in a medicare-approved demonstration project)	Onc prac mgmt dif pt comorb
G9061	0010	3	Oncology; practice guidelines; patient’s condition not addressed by available guidelines (for use in a medicare-approved demonstration project)	Onc prac cond noadd by guide
G9062	0010	3	Oncology; practice guidelines; management differs from guidelines for other reason(s) not listed (for use in a medicare-approved demonstration project)	Onc prac guide differs nos
G9063	0010	3	Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage i (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx nsclc stgi no progres
G9064	0010	3	Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage ii (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx nsclc stg2 no progres
G9065	0010	3	Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage iii a (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx nsclc stg3a no progre
G9066	0010	3	Oncology; disease status; limited to non-small cell lung cancer; stage iii b- iv at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)	Onc dx nsclc stg3b-4 metasta
G9067	0010	3	Oncology; disease status; limited to non-small cell lung cancer; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)	Onc dx nsclc dx unknown nos
G9068	0010	3	Oncology; disease status; limited to small cell and combined small cell/non-small cell; extent of disease initially established as limited with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx sclc/nsclc limited
G9069	0010	3	Oncology; disease status; small cell lung cancer, limited to small cell and combined small cell/non-small cell; extensive stage at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)	Onc dx sclc/nsclc ext at dx
G9070	0010	3	Oncology; disease status; small cell lung cancer, limited to small cell and combined small cell/non-small; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)	Onc dx sclc/nsclc ext unknwn
G9071	0010	3	Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage i or stage iia-iib; or t3, n1, m0; and er and/or pr positive; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx brst stg1-2b hr,nopro
G9072	0010	3	Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage i, or stage iia-iib; or t3, n1, m0; and er and pr negative; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx brst stg1-2 noprogres
G9073	0010	3	Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage iiia-iiib; and not t3, n1, m0; and er and/or pr positive; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx brst stg3-hr, no pro
G9074	0010	3	Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; stage iiia-iiib; and not t3, n1, m0; and er and pr negative; with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx brst stg3-noprogress
G9075	0010	3	Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)	Onc dx brst metastic/ recur
G9077	0010	3	Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t1-t2c and gleason 2-7 and psa < or equal to 20 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx prostate t1no progres
G9078	0010	3	Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t2 or t3a gleason 8-10 or psa > 20 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx prostate t2no progres
G9079	0010	3	Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; t3b-t4, any n; any t, n1 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx prostate t3b-t4noprog
G9080	0010	3	Oncology; disease status; prostate cancer, limited to adenocarcinoma; after initial treatment with rising psa or failure of psa decline (for use in a medicare-approved demonstration project)	Onc dx prostate w/rise psa
G9083	0010	3	Oncology; disease status; prostate cancer, limited to adenocarcinoma; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)	Onc dx prostate unknwn nos
G9084	0010	3	Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-3, n0, m0 with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx colon t1-3,n1-2,no pr
G9085	0010	3	Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t4, n0, m0 with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx colon t4, n0 w/o prog
G9086	0010	3	Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-4, n1-2, m0 with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx colon t1-4 no dx prog
G9087	0010	3	Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive with current clinical, radiologic, or biochemical evidence of disease (for use in a medicare-approved demonstration project)	Onc dx colon metas evid dx
G9088	0010	3	Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive without current clinical, radiologic, or biochemical evidence of disease (for use in a medicare-approved demonstration project)	Onc dx colon metas noevid dx
G9089	0010	3	Oncology; disease status; colon cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)	Onc dx colon extent unknown
G9090	0010	3	Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-2, n0, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx rectal t1-2 no progr
G9091	0010	3	Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t3, n0, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx rectal t3 n0 no prog
G9092	0010	3	Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t1-3, n1-2, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence or metastases (for use in a medicare-approved demonstration project)	Onc dx rectal t1-3,n1-2noprg
G9093	0010	3	Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as t4, any n, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx rectal t4,n,m0 no prg
G9094	0010	3	Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)	Onc dx rectal m1 w/mets prog
G9095	0010	3	Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)	Onc dx rectal extent unknwn
G9096	0010	3	Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; extent of disease initially established as t1-t3, n0-n1 or nx (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx esophag t1-t3 noprog
G9097	0010	3	Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; extent of disease initially established as t4, any n, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx esophageal t4 no prog
G9098	0010	3	Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)	Onc dx esophageal mets recur
G9099	0010	3	Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)	Onc dx esophageal unknown
G9100	0010	3	Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; post r0 resection (with or without neoadjuvant therapy) with no evidence of disease recurrence, progression, or metastases (for use in a medicare-approved demonstration project)	Onc dx gastric no recurrence
G9101	0010	3	Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; post r1 or r2 resection (with or without neoadjuvant therapy) with no evidence of disease progression, or metastases (for use in a medicare-approved demonstration project)	Onc dx gastric p r1-r2noprog
G9102	0010	3	Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; clinical or pathologic m0, unresectable with no evidence of disease progression, or metastases (for use in a medicare-approved demonstration project)	Onc dx gastric unresectable
G9103	0010	3	Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; clinical or pathologic m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)	Onc dx gastric recurrent
G9104	0010	3	Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)	Onc dx gastric unknown nos
G9105	0010	3	Oncology; disease status; pancreatic cancer, limited to adenocarcinoma as predominant cell type; post r0 resection without evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx pancreatc p r0 res no
G9106	0010	3	Oncology; disease status; pancreatic cancer, limited to adenocarcinoma; post r1 or r2 resection with no evidence of disease progression, or metastases (for use in a medicare-approved demonstration project)	Onc dx pancreatc p r1/r2 no
G9107	0010	3	Oncology; disease status; pancreatic cancer, limited to adenocarcinoma; unresectable at diagnosis, m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)	Onc dx pancreatic unresectab
G9108	0010	3	Oncology; disease status; pancreatic cancer, limited to adenocarcinoma; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)	Onc dx pancreatic unknwn nos
G9109	0010	3	Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; extent of disease initially established as t1-t2 and n0, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx head/neck t1-t2no prg
G9110	0010	3	Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; extent of disease initially established as t3-4 and/or n1-3, m0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx head/neck t3-4 noprog
G9111	0010	3	Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; m1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)	Onc dx head/neck m1 mets rec
G9112	0010	3	Oncology; disease status; head and neck cancer, limited to cancers of oral cavity, pharynx and larynx with squamous cell as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)	Onc dx head/neck ext unknown
G9113	0010	3	Oncology; disease status; ovarian cancer, limited to epithelial cancer; pathologic stage ia-b (grade 1) without evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx ovarian stg1a-b no pr
G9114	0010	3	Oncology; disease status; ovarian cancer, limited to epithelial cancer; pathologic stage ia-b (grade 2-3); or stage ic (all grades); or stage ii; without evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx ovarian stg1a-b or 2
G9115	0010	3	Oncology; disease status; ovarian cancer, limited to epithelial cancer; pathologic stage iii-iv; without evidence of progression, recurrence, or metastases (for use in a medicare-approved demonstration project)	Onc dx ovarian stg3/4 noprog
G9116	0010	3	Oncology; disease status; ovarian cancer, limited to epithelial cancer; evidence of disease progression, or recurrence, and/or platinum resistance (for use in a medicare-approved demonstration project)	Onc dx ovarian recurrence
G9117	0010	3	Oncology; disease status; ovarian cancer, limited to epithelial cancer; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)	Onc dx ovarian unknown nos
G9123	0010	3	Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; chronic phase not in hematologic, cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)	Onc dx cml chronic phase
G9124	0010	3	Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; accelerated phase not in hematologic cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)	Onc dx cml acceler phase
G9125	0010	3	Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; blast phase not in hematologic, cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)	Onc dx cml blast phase
G9126	0010	3	Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; in hematologic, cytogenetic, or molecular remission (for use in a medicare-approved demonstration project)	Onc dx cml remission
G9128	0010	3	Oncology; disease status; limited to multiple myeloma, systemic disease; smoldering, stage i (for use in a medicare-approved demonstration project)	Onc dx multi myeloma stage i
G9129	0010	3	Oncology; disease status; limited to multiple myeloma, systemic disease; stage ii or higher (for use in a medicare-approved demonstration project)	Onc dx mult myeloma stg2 hig
G9130	0010	3	Oncology; disease status; limited to multiple myeloma, systemic disease; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)	Onc dx multi myeloma unknown
G9131	0010	3	Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration project)	Onc dx brst unknown nos
G9132	0010	3	Oncology; disease status; prostate cancer, limited to adenocarcinoma; hormone-refractory/androgen-independent (e.g., rising psa on anti-androgen therapy or post-orchiectomy); clinical metastases (for use in a medicare-approved demonstration project)	Onc dx prostate mets no cast
G9133	0010	3	Oncology; disease status; prostate cancer, limited to adenocarcinoma; hormone-responsive; clinical metastases or m1 at diagnosis (for use in a medicare-approved demonstration project)	Onc dx prostate clinical met
G9134	0010	3	Oncology; disease status; non-hodgkin’s lymphoma, any cellular classification; stage i, ii at diagnosis, not relapsed, not refractory (for use in a medicare-approved demonstration project)	Onc nhlstg 1-2 no relap no
G9135	0010	3	Oncology; disease status; non-hodgkin’s lymphoma, any cellular classification; stage iii, iv, not relapsed, not refractory (for use in a medicare-approved demonstration project)	Onc dx nhl stg 3-4 not relap
G9136	0010	3	Oncology; disease status; non-hodgkin’s lymphoma, transformed from original cellular diagnosis to a second cellular classification (for use in a medicare-approved demonstration project)	Onc dx nhl trans to lg bcell
G9137	0010	3	Oncology; disease status; non-hodgkin’s lymphoma, any cellular classification; relapsed/refractory (for use in a medicare-approved demonstration project)	Onc dx nhl relapse/refractor
G9138	0010	3	Oncology; disease status; non-hodgkin’s lymphoma, any cellular classification; diagnostic evaluation, stage not determined, evaluation of possible relapse or non-response to therapy, or not listed (for use in a medicare-approved demonstration project)	Onc dx nhl stg unknown
G9139	0010	3	Oncology; disease status; chronic myelogenous leukemia, limited to philadelphia chromosome positive and/or bcr-abl positive; extent of disease unknown, staging in progress, not listed (for use in a medicare-approved demonstration project)	Onc dx cml dx status unknown
G9140	0010	3	Frontier extended stay clinic demonstration; for a patient stay in a clinic approved for the cms demonstration project; the following measures should be present: the stay must be equal to or greater than 4 hours; weather or other conditions must prevent transfer or the case falls into a category of monitoring and observation cases that are permitted by the rules of the demonstration; there is a maximum frontier extended stay clinic (fesc) visit of 48 hours, except in the case when weather or other conditions prevent transfer; payment is made on each period up to 4 hours, after the first 4 hours	Frontier extended stay demo
G9143	0010	3	Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s)	Warfarin respon genetic test
G9147	0010	3	Outpatient intravenous insulin treatment (oivit) either pulsatile or continuous, by any means, guided by the results of measurements for: respiratory quotient; and/or, urine urea nitrogen (uun); and/or, arterial, venous or capillary glucose; and/or potassium concentration	Outpt iv insulin tx any mea
G9148	0010	3	National committee for quality assurance - level 1 medical home	Medical home level 1
G9149	0010	3	National committee for quality assurance - level 2 medical home	Medical home level ii
G9150	0010	3	National committee for quality assurance - level 3 medical home	Medical home level iii
G9151	0010	3	Mapcp demonstration - state provided services	Mapcp demo state
G9152	0010	3	Mapcp demonstration - community health teams	Mapcp demo community
G9153	0010	3	Mapcp demonstration - physician incentive pool	Mapcp demo physician
G9156	0010	3	Evaluation for wheelchair requiring face to face visit with physician	Evaluation for wheelchair
G9157	0010	3	Transesophageal doppler measurement of cardiac output (including probe placement, image acquisition, and interpretation per course of treatment) for monitoring purposes	Transesoph doppl cardiac mon
G9158	0010	3	Motor speech functional limitation, discharge status, at discharge from therapy or to end reporting	Motor speech d/c status
G9159	0010	3	Spoken language comprehension functional limitation, current status at therapy episode outset and at reporting intervals	Lang comp current status
G9160	0010	3	Spoken language comprehension functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting	Lang comp goal status
G9161	0010	3	Spoken language comprehension functional limitation, discharge status, at discharge from therapy or to end reporting	Lang comp d/c status
G9162	0010	3	Spoken language expression functional limitation, current status at therapy episode outset and at reporting intervals	Lang express current status
G9163	0010	3	Spoken language expression functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting	Lang express goal status
G9164	0010	3	Spoken language expression functional limitation, discharge status at discharge from therapy or to end reporting	Lang express d/c status
G9165	0010	3	Attention functional limitation, current status at therapy episode outset and at reporting intervals	Atten current status
G9166	0010	3	Attention functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting	Atten goal status
G9167	0010	3	Attention functional limitation, discharge status at discharge from therapy or to end reporting	Atten d/c status
G9168	0010	3	Memory functional limitation, current status at therapy episode outset and at reporting intervals	Memory current status
G9169	0010	3	Memory functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting	Memory goal status
G9170	0010	3	Memory functional limitation, discharge status at discharge from therapy or to end reporting	Memory d/c status
G9171	0010	3	Voice functional limitation, current status at therapy episode outset and at reporting intervals	Voice current status
G9172	0010	3	Voice functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting	Voice goal status
G9173	0010	3	Voice functional limitation, discharge status at discharge from therapy or to end reporting	Voice d/c status
G9174	0010	3	Other speech language pathology functional limitation, current status at therapy episode outset and at reporting intervals	Speech lang current status
G9175	0010	3	Other speech language pathology functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting	Speech lang goal status
G9176	0010	3	Other speech language pathology functional limitation, discharge status at discharge from therapy or to end reporting	Speech lang d/c status
G9186	0010	3	Motor speech functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting	Motor speech goal status
G9187	0010	3	Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/management, patient compliance with orders/plan of care, performance of activities of daily living, appropriateness of care setting; (for use only in the meidcare-approved bundled payments for care improvement initiative); may not be billed for a 30-day period covered by a transitional care management code	Bpci home visit
G9188	0010	3	Beta-blocker therapy not prescribed, reason not given	Beta not given no reason
G9189	0010	3	Beta-blocker therapy prescribed or currently being taken	Beta pres or already taking
G9190	0010	3	Documentation of medical reason(s) for not prescribing beta-blocker therapy (eg, allergy, intolerance, other medical reasons)	Medical reason for no beta
G9191	0010	3	Documentation of patient reason(s) for not prescribing beta-blocker therapy (eg, patient declined, other patient reasons)	Pt reason for no beta
G9192	0010	3	Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the health care system)	System reason for no beta
G9193	0010	3	Clinician documented that patient with a diagnosis of major depression was not an eligible candidate for antidepressant medication treatment or patient did not have a diagnosis of major depression	Doc not eligible for dep med
G9194	0010	3	Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 180 day (6 month) continuation treatment phase	Mdd pt treated for 180d
G9195	0010	3	Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 180 day (6 months) continuation treatment phase	Mdd pt not treated for 180d
G9196	0010	3	Documentation of medical reason(s) for not ordering a first or second generation cephalosporin for antimicrobial prophylaxis (e.g., patients enrolled in clinical trials, patients with documented infection prior to surgical procedure of interest, patients who were receiving antibiotics more than 24 hours prior to surgery [except colon surgery patients taking oral prophylactic antibiotics], patients who were receiving antibiotics within 24 hours prior to arrival [except colon surgery patients taking oral prophylactic antibiotics], other medical reason(s))	Med reason for no ceph
G9197	0010	3	Documentation of order for first or second generation cephalosporin for antimicrobial prophylaxis	Order for ceph
G9198	0010	3	Order for first or second generation cephalosporin for antimicrobial prophylaxis was not documented, reason not given	No order for ceph no reason
G9199	0010	3	Venous thromboembolism (vte) prophylaxis not administered the day of or the day after hospital admission for documented reasons (eg, patient is ambulatory, patient expired during inpatient stay, patient already on warfarin or another anticoagulant, other medical reason(s) or eg, patient left against medical advice, other patient reason(s))	Doc reason for no vte
G9200	0010	3	Venous thromboembolism (vte) prophylaxis was not administered the day of or the day after hospital admission, reason not given	No reason for no vte
G9201	0010	3	Venous thromboembolism (vte) prophylaxis administered the day of or the day after hospital admission	Vte given upon admission
G9202	0010	3	Patients with a positive hepatitis c antibody test	Hep c aby pos
G9203	0010	3	Rna testing for hepatitis c documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c	Hep c rna done prior to med
G9204	0010	3	Rna testing for hepatitis c was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given	No reason for no hep c rna
G9205	0010	3	Patient starting antiviral treatmentfor hepatitis c during the measurement period	Hep c antiviral started
G9206	0010	3	Patient starting antiviral treatment for hepatitis c during the measurement period	Hep c therapy started
G9207	0010	3	Hepatitis c genotype testing documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c	Hep c genotype prior to med
G9208	0010	3	Hepatitis c genotype testing was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given	No reason for no hep c geno
G9209	0010	3	Hepatitis c quantitative rna testing documented as performed between 4-12 weeks after the initiation of antiviral treatment	Hep c rna 4to12 wk after med
G9210	0010	3	Hepatitis c quantitative rna testing not performed between 4-12 weeks after the initiation of antiviral treatment for documented reason(s) (e.g., patients whose treatment was discontinued during the testing period prior to testing, other medical reasons, patient declined, other patient reasons)	No hepc rna after med docrsn
G9211	0010	3	Hepatitis c quantitative rna testing was not documented as performed between 4-12 weeks after the initiation of antiviral treatment, reason not given	No hepc rna after med no rsn
G9212	0010	3	Dsm-ivtm criteria for major depressive disorder documented at the initial evaluation	Doc of dsm-iv init eval
G9213	0010	3	Dsm-iv-tr criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified	No doc of dsm-iv
G9214	0010	3	Cd4+ cell count or cd4+ cell percentage results documented	Cd4 count documented
G9215	0010	3	Cd4+ cell count or percentage not documented as performed, reason not given	No cd4 count no reason
G9216	0010	3	Pcp prophylaxis was not prescribed at time of diagnosis of hiv, reason not given	No pcp proph at dx no reason
G9217	0010	3	Pcp prophylaxis was not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3, reason not given	No pcp proph low cd4 norsn
G9218	0010	3	Pcp prophylaxis was not prescribed within 3 months oflow cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%, reason not given	No pcp prop low at cd4 norsn
G9219	0010	3	Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3 for medical reason (i.e., patient’s cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient’s cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)	No oder pjp for med reason
G9220	0010	3	Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15% for medical reason (i.e., patient’s cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient’s cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)	No order for pjp for medrsn
G9221	0010	3	Pneumocystis jiroveci pneumonia prophlaxis prescribed	Pjp proph prescribed
G9222	0010	3	Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin 3 months of low cd4+ cell count below 200 cells/mm3	Pjp proph ordered low cd4
G9223	0010	3	Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%	Pjp proph ordered cd4 low
G9224	0010	3	Documentation of medical reason for not performing foot exam (e.g., patient with bilateral foot/leg amputation)	Medrsn no foot exam
G9225	0010	3	Foot exam was not performed, reason not given	Norsn no foot exam
G9226	0010	3	Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed)	3 comp foot exam completed
G9227	0010	3	Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounter	Foa doc, care plan not doc
G9228	0010	3	Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings)	Gc chl syp documented
G9229	0010	3	Chlamydia, gonorrhea, and syphilis screening results not documented (patient refusal is the only allowed exception)	Ptrsn no gc chl syp test
G9230	0010	3	Chlamydia, gonorrhea, and syphilis not screened, reason not given	Norsn for gc chl syp test
G9231	0010	3	Documentation of end stage renal disease (esrd), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement period	Doc esrd dia trans preg
G9232	0010	3	Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition for specified patient reason (e.g., patient is unable to communicate the diagnosis of a comorbid condition; the patient is unwilling to communicate the diagnosis of a comorbid condition; or the patient is unaware of the comorbid condition, or any other specified patient reason)	Ptrsn no comm comorbid
G9233	0010	3	All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient	Tkr composite
G9234	0010	3	I intend to report the total knee replacement measures group	Tkr intent
G9235	0010	3	All quality actions for the applicable measures in the general surgery measures group have been performed for this patient	Gs mg composite
G9236	0010	3	All quality actions for the applicable measures in the optimizing patient exposure to ionizing radiation measures group have been performed for this patient	Op rad mg composite
G9237	0010	3	I intend to report the general surgery measures group	Gs mg intent
G9238	0010	3	I intend to report the optimizing patient exposure to ionizing radiation measures group	Op rad mg intent
G9239	0010	3	Documentation of reasons for patient initiating maintenance hemodialysis with a catheter as the mode of vascular access (e.g., patient has a maturing arteriovenous fistula (avf)/arteriovenous graft (avg), time-limited trial of hemodialysis, other medical reasons, patient declined avf/avg, other patient reasons, patient followed by reporting nephrologist for fewer than 90 days, other system reasons)	Doc rsn hemod & cath acc
G9240	0010	3	Patient whose mode of vascular access is a catheter at the time maintenance hemodialysis is initiated	Doc pt w cath maint dia
G9241	0010	3	Patient whose mode of vascular access is not a catheter at the time maintenance hemodialysis is initiated	Doc pt w out cath maint dia
G9242	0010	3	Documentation of viral load equal to or greater than 200 copies/ml or viral load not performed	Doc viral load >=200
G9243	0010	3	Documentation of viral load less than 200 copies/ml	Doc viral load <200
G9244	0010	3	Antiretroviral thereapy not prescribed	Antiviral not ordered
G9245	0010	3	Antiretroviral therapy prescribed	Antiviral ordered
G9246	0010	3	Patient did not have at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits	No med visit in 24mo
G9247	0010	3	Patient had at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits	1 med visit in 24mo
G9248	0010	3	Patient did not have a medical visit in the last 6 months	No med visit 6mo
G9249	0010	3	Patient had a medical visit in the last 6 months	Med visit w in 6mo
G9250	0010	3	Documentation of patient pain brought to a comfortable level within 48 hours from initial assessment	Doc of pain comfort 48hr
G9251	0010	3	Documentation of patient with pain not brought to a comfortable level within 48 hours from initial assessment	Doc no pain comfort 48hr
G9252	0010	3	Adenoma(s) or other neoplasm detected during screening colonoscopy	Neo detect scrn colo
G9253	0010	3	Adenoma(s) or other neoplasm not detected during screening colonoscopy	No neo detect scrn colo
G9254	0010	3	Documentation of patient discharged to home later than post-operative day 2 following cas	Doc pt dischg >2d
G9255	0010	3	Documentation of patient discharged to home no later than post operative day 2 following cas	Doc pt dischg <=2d
G9256	0010	3	Documentation of patient death following cas	Doc of pat death after cas
G9257	0010	3	Documentation of patient stroke following cas	Doc of pat stroke after cas
G9258	0010	3	Documentation of patient stroke following cea	Doc of pat stroke after cea
G9259	0010	3	Documentation of patient survival and absence of stroke following cas	Survive/no stroke post cas
G9260	0010	3	Documentation of patient death following cea	Doc of pat death after cea
G9261	0010	3	Documentation of patient survival and absence of stroke following cea	Survive/no stroke post cea
G9262	0010	3	Documentation of patient death in the hospital following endovascular aaa repair	Doc of death post-aaa repair
G9263	0010	3	Documentation of patient discharged alive following endovascular aaa repair	Doc of disch post-aaa repair
G9264	0010	3	Documentation of patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter for documented reasons (e.g., other medical reasons, patient declined arteriovenous fistula (avf)/arteriovenous graft (avg), other patient reasons)	Doc rsn hemod w/cath >=90d
G9265	0010	3	Patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter as the mode of vascular access	Doc cath >90d for maint dia
G9266	0010	3	Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular access	Norsn pt cath >=90d
G9267	0010	3	Documentation of patient with one or more complications or mortality within 30 days	Doc comp or mort w in 30d
G9268	0010	3	Documentation of patient with one or more complications within 90 days	Doc comp or mort w in 90d
G9269	0010	3	Documentation of patient without one or more complications and without mortality within 30 days	Doc no comp or mort w in 30d
G9270	0010	3	Documentation of patient without one or more complications within 90 days	Doc no comp or mort w in 90d
G9271	0010	3	Ldl value < 100	Ldl under 100
G9272	0010	3	Ldl value >= 100	Ldl 100 and over
G9273	0010	3	Blood pressure has a systolic value of < 140 and a diastolic value of < 90	Sys<140 and dia<90
G9274	0010	3	Blood pressure has a systolic value of =140 and a diastolic value of = 90 or systolic value < 140 and diastolic value = 90 or systolic value = 140 and diastolic value < 90	Bp out of nrml limits
G9275	0010	3	Documentation that patient is a current non-tobacco user	Doc of non tobacco user
G9276	0010	3	Documentation that patient is a current tobacco user	Doc of tobacco user
G9277	0010	3	Documentation that the patient is on daily aspirin or anti-platelet or has documentation of a valid contraindication or exception to aspirin/anti-platelet; contraindications/exceptions include anti-coagulant use, allergy to aspirin or anti-platelets, history of gastrointestinal bleed and bleeding disorder; additionally, the following exceptions documented by the physician as a reason for not taking daily aspirin or anti-platelet are acceptable (use of non-steroidal anti-inflammatory agents, documented risk for drug interaction, uncontrolled hypertension defined as >180 systolic or >110 diastolic or gastroesophageal reflux)	Doc daily aspirin or contra
G9278	0010	3	Documentation that the patient is not on daily aspirin or anti-platelet regimen	Doc no daily aspirin
G9279	0010	3	Pneumococcal screening performed and documentation of vaccination received prior to discharge	Pne scrn done doc vac done
G9280	0010	3	Pneumococcal vaccination not administered prior to discharge, reason not specified	Pne not given norsn
G9281	0010	3	Screening performed and documentation that vaccination not indicated/patient refusal	Pne scrn done doc not ind
G9282	0010	3	Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of non-small cell lung cancer or other documented medical reasons)	Doc medrsn no histo type
G9283	0010	3	Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation	Hist type doc on report
G9284	0010	3	Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation	No hist type doc on report
G9285	0010	3	Specimen site other than anatomic location of lung or is not classified as non small cell lung cancer	Site not small cell lung ca
G9286	0010	3	Antibiotic regimen prescribed within 10 days after onset of symptoms	Antibio rx w in 10d of sympt
G9287	0010	3	Antibiotic regimen not prescribed within 10 days after onset of symptoms	No antibio w in 10d of sympt
G9288	0010	3	Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., a solitary fibrous tumor in a person with a history of non-small cell carcinoma or other documented medical reasons)	Doc medrsn no hist type rpt
G9289	0010	3	Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation	Doc type nsm lung ca
G9290	0010	3	Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation	No doc type nsm lung ca
G9291	0010	3	Specimen site other than anatomic location of lung, is not classified as non small cell lung cancer or classified as nsclc-nos	Not nsm lung ca
G9292	0010	3	Documentation of medical reason(s) for not reporting pt category and a statement on thickness and ulceration and for pt1, mitotic rate (e.g., negative skin biopsies in a patient with a history of melanoma or other documented medical reasons)	Medrsn no pt category
G9293	0010	3	Pathology report does not include the pt category and a statement on thickness and ulceration and for pt1, mitotic rate	No pt category on report
G9294	0010	3	Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate	Pt cat and thck on report
G9295	0010	3	Specimen site other than anatomic cutaneous location	Non cutaneous loc
G9296	0010	3	Patients with documented shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure	Doc share dec prior proc
G9297	0010	3	Shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure, not documented, reason not given	No doc share dec prior proc
G9298	0010	3	Patients who are evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of dvt, pe, mi, arrhythmia and stroke)	Eval risk vte card 30d prior
G9299	0010	3	Patients who are not evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure including (e.g., history of dvt, pe, mi, arrhythmia and stroke, reason not given)	No eval riskk vte card prior
G9300	0010	3	Documentation of medical reason(s) for not completely infusing the prophylactic antibiotic prior to the inflation of the proximal tourniquet (e.g., a tourniquet was not used)	Doc medrsn no compl antibio
G9301	0010	3	Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet	Doc compl inf antibio
G9302	0010	3	Prophylactic antibiotic not completely infused prior to the inflation of the proximal tourniquet, reason not given	Norsn incomp inf antibio
G9303	0010	3	Operative report does not identify the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant, reason not given	Norsn no pros info op rpt
G9304	0010	3	Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant	Pros info op rpt
G9305	0010	3	Intervention for presence of leak of endoluminal contents through an anastomosis not required	No interv req for leak
G9306	0010	3	Intervention for presence of leak of endoluminal contents through an anastomosis required	Interv req for leak
G9307	0010	3	No return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure	No ret for surg w in 30d
G9308	0010	3	Unplanned return to the operating room for a surgical procedure, for complications of the principal operative procedure, within 30 days of the principal operative procedure	Unpl ret or w/compl w/in 30d
G9309	0010	3	No unplanned hospital readmission within 30 days of principal procedure	No unplnd hosp readm in 30d
G9310	0010	3	Unplanned hospital readmission within 30 days of principal procedure	Unplnd hosp readm in 30d
G9311	0010	3	No surgical site infection	No surg site infection
G9312	0010	3	Surgical site infection	Surgical site infection
G9313	0010	3	Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason	Amoxic not presc as 1st line
G9314	0010	3	Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis, reason not given	Norsn not first line amox
G9315	0010	3	Documentation amoxicillin, with or without clavulanate, prescribed as a first line antibiotic at the time of diagnosis	Doc first line amox
G9316	0010	3	Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family	Doc comm risk calc
G9317	0010	3	Documentation of patient-specific risk assessment with a risk calculator based on multi-institutional clinical data, the specific risk calculator used, and communication of risk assessment from risk calculator with the patient or family not completed	No doc comm risk calc
G9318	0010	3	Imaging study named according to standardized nomenclature	Image std nomenclature
G9319	0010	3	Imaging study not named according to standardized nomenclature, reason not given	Image not std nomenclature
G9320	0010	3	Documentation of medical reason(s) for not naming ct studies according to a standardized nomenclature provided (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)	Medrsn no std nomenclature
G9321	0010	3	Count of previous ct (any type of ct) and cardiac nuclear medicine (myocardial perfusion) studies documented in the 12-month period prior to the current study	Doc count of ct in 12mo
G9322	0010	3	Count of previous ct and cardiac nuclear medicine (myocardial perfusion) studies not documented in the 12-month period prior to the current study, reason not given	No doc count of ct in 12mo
G9323	0010	3	Documentation of medical reason(s) for not counting previous ct and cardiac nuclear medicine (myocardial perfusion) studies (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)	Mdrsn no doc cnt of ct
G9324	0010	3	All necessary data elements not included, reason not given	Not all data norsn
G9325	0010	3	Ct studies not reported to a radiation dose index registry due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)	Medrsn no ct rpt to reg
G9326	0010	3	Ct studies performed not reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements, reason not given	Ct done no rad ds index, nrg
G9327	0010	3	Ct studies performed reported to a radiation dose index registry that is capable of collecting at a minimum all necessary data elements	Ct done rad ds index
G9328	0010	3	Dicom format image data availability not documented in final report due to medical reasons (eg, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)	Medrsn no dicom format doc
G9329	0010	3	Dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study not documented in final report, reason not given	Norsn no dicom format doc
G9340	0010	3	Final report documented that dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study	Dicom format doc on rpt
G9341	0010	3	Search conducted for prior patient ct studies completed at non-affiliated external healthcare facilities or entities within the past 12-months and are available through a secure, authorized, media-free, shared archive prior to an imaging study being performed	Srch for ct w in 12 mos
G9342	0010	3	Search not conducted prior to an imaging study being performed for prior patient ct studies completed at non-affiliated external healthcare facilities or entities within the past 12-months and are available through a secure, authorized, media-free, shared archive, reason not given	No srch for ct in 12mo norsn
G9343	0010	3	Due to medical reasons, search not conducted for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)	Medrsn no dicom srch
G9344	0010	3	Due to system reasons search not conducted for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., non-affiliated external healthcare facilities or entities does not have archival abilities through a shared archival system)	Sysrsn no dicom srch
G9345	0010	3	Follow-up recommendations documented according to recommended guidelines for incidentally detected pulmonary nodules (e.g., follow-up ct imaging studies needed or that no follow-up is needed) based at a minimum on nodule size and patient risk factors	Follow up pulm nod
G9346	0010	3	Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules due to medical reasons (e.g., patients with known malignant disease, patients with unexplained fever, ct studies performed for radiation treatment planning or image-guided radiation treatment delivery)	No follow up pulm nod
G9347	0010	3	Follow-up recommendations not documented according to recommended guidelines for incidentally detected pulmonary nodules, reason not given	No follow up pulm nod norsn
G9348	0010	3	Ct scan of the paranasal sinuses ordered at the time of diagnosis for documented reasons	Doc rsn for ord ct scan
G9349	0010	3	Ct scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis	Ct within 28 days
G9350	0010	3	Ct scan of the paranasal sinuses not ordered at the time of diagnosis or received within 28 days after date of diagnosis	No doc sinus ct 28d or dx
G9351	0010	3	More than one ct scan of the paranasal sinuses ordered or received within 90 days after diagnosis	Doc >1 sinus ct w 90d dx
G9352	0010	3	More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis, reason not given	Not >1 sinus ct w 90d dx
G9353	0010	3	More than one ct scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis for documented reasons (eg, patients with complications, second ct obtained prior to surgery, other medical reasons)	Medrsn >1 sinus ct w 90d dx
G9354	0010	3	One ct scan or no ct scan of the paranasal sinuses ordered within 90 days after the date of diagnosis	1 or no ct sinus w/in 90d dx
G9355	0010	3	Early elective delivery or early induction not performed (less than 39 weeks gestation)	No early ind/delivery
G9356	0010	3	Early elective delivery or early induction performed (less than 39 week gestation)	Early ind/delivery
G9357	0010	3	Post-partum screenings, evaluations and education performed	Pp eval/edu perf
G9358	0010	3	Post-partum screenings, evaluations and education not performed	Pp eval/edu not perf
G9359	0010	3	Documentation of negative or managed positive tb screen with further evidence that tb is not active prior to the treatment with a biologic immune response modifier	Neg mgd pos tb notact
G9360	0010	3	No documentation of negative or managed positive tb screen	No doc of neg or man pos tb
G9361	0010	3	Medical indication for induction [documentation of reason(s) for elective delivery (c-section) or early induction (e.g., hemorrhage and placental complications, hypertension, preeclampsia and eclampsia, rupture of membranes-premature or prolonged, maternal conditions complicating pregnancy/delivery, fetal conditions complicating pregnancy/delivery, late pregnancy, prior uterine surgery, or participation in clinical trial)]	Doc rsn elect c-sec/induct
G9362	0010	3	Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure 60 minutes or longer, as documented in the anesthesia record	Mac or pnb w/o genanes >60m
G9363	0010	3	Duration of monitored anesthesia care (mac) or peripheral nerve block (pnb) without the use of general anesthesia during an applicable procedure or general or neuraxial anesthesia less than 60 minutes, as documented in the anesthesia record	Mac or pnb w/o genanes <60m
G9364	0010	3	Sinusitis caused by, or presumed to be caused by, bacterial infection	Sinus caus bac inx
G9365	0010	3	One high-risk medication ordered	1high risk med ord
G9366	0010	3	One high-risk medication not ordered	1high risk no ord
G9367	0010	3	At least two orders for the same high-risk medication	>= 2 same hi-rsk med ord
G9368	0010	3	At least two orders for the same high-risk medications not ordered	>= 2 same hi-rsk med not ord
G9369	0010	3	Individual filled at least two prescriptions for any antipsychotic medication and had a pdc of 0.8 or greater	Fill 2 rx antipsych
G9370	0010	3	Individual who did not fill at least two prescriptions for any antipsychotic medication or did not have a pdc of 0.8 or greater	Not fill 2 rx antipsych
G9376	0010	3	Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month) following only one surgery	Contd ret attach at 6mth f/u
G9377	0010	3	Patient did not have the retina attached after 6 months following only one surgery	No ret attach after 6mt
G9378	0010	3	Patient continued to have the retina attached at the 6 months follow up visit (+/- 1 month)	Contd ret attach f/u vis
G9379	0010	3	Patient did not achieve flat retinas six months post surgery	No acheive flat ret 6mth
G9380	0010	3	Patient offered assistance with end of life issues during the measurement period	Off assis eol iss
G9381	0010	3	Documentation of medical reason(s) for not offering assistance with end of life issues (e.g., patient in hospice care, patient in terminal phase) during the measurement period	Doc med reas no offer eol
G9382	0010	3	Patient not offered assistance with end of life issues during the measurement period	No off assis eol
G9383	0010	3	Patient received screening for hcv infection within the 12 month reporting period	Recd scrn hcv infec
G9384	0010	3	Documentation of medical reason(s) for not receiving annual screening for hcv infection (e.g., decompensated cirrhosis indicating advanced disease [i.e., ascites, esophageal variceal bleeding, hepatic encephalopathy], hepatocellular carcinoma, waitlist for organ transplant, limited life expectancy, other medical reasons)	Doc med rsn no hcv scrn
G9385	0010	3	Documentation of patient reason(s) for not receiving annual screening for hcv infection (e.g., patient declined, other patient reasons)	Doc pt reas not rec hcv srn
G9386	0010	3	Screening for hcv infection not received within the 12 month reporting period, reason not given	Scrn hcv infec not recd
G9389	0010	3	Unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery	Unpln rup post cap
G9390	0010	3	No unplanned rupture of the posterior capsule requiring vitrectomy during cataract surgery	No unpln rup post cap
G9391	0010	3	Patient achieves refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit	Achv refrac +1d
G9392	0010	3	Patient does not achieve refraction +-1 d for the eye that underwent cataract surgery, measured at the one month follow up visit	Not achv refrac +1d
G9393	0010	3	Patient with an initial phq-9 score greater than nine who achieves remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score of less than five	Ini phq9 >9 remiss <5
G9394	0010	3	Patient who had a diagnosis of bipolar disorder or personality disorder, death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement or assessment period	Dx bipol, death, nhres, hosp
G9395	0010	3	Patient with an initial phq-9 score greater than nine who did not achieve remission at twelve months as demonstrated by a twelve month (+/- 30 days) phq-9 score greater than or equal to five	Ini phq9 >9 no remiss >=5
G9396	0010	3	Patient with an initial phq-9 score greater than nine who was not assessed for remission at twelve months (+/- 30 days)	Ini phq9 >9 not assess
G9399	0010	3	Documentation in the patient record of a discussion between the physician/clinician and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward the outcome of the treatment	Doc disc tx choices
G9400	0010	3	Documentation of medical or patient reason(s) for not discussing treatment options; medical reasons: patient is not a candidate for treatment due to advanced physical or mental health comorbidity (including active substance use); currently receiving antiviral treatment; successful antiviral treatment (with sustained virologic response) prior to reporting period; other documented medical reasons; patient reasons: patient unable or unwilling to participate in the discussion or other patient reasons	Doc reas no disc tx opt
G9401	0010	3	No documentation of a discussion in the patient record of a discussion between the physician or other qualfied healthcare professional and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward treatment	No disc tx choices
G9402	0010	3	Patient received follow-up on the date of discharge or within 30 days after discharge	Recd f/u w/in 30d disch
G9403	0010	3	Clinician documented reason patient was not able to complete 30 day follow-up from acute inpatient setting discharge (e.g., patient death prior to follow-up visit, patient non-compliant for visit follow-up)	Doc reas no 30 day f/u
G9404	0010	3	Patient did not receive follow-up on the date of discharge or within 30 days after discharge	No 30 day f/u
G9405	0010	3	Patient received follow-up within 7 days after discharge	Recd f/u w/in 7d dc
G9406	0010	3	Clinician documented reason patient was not able to complete 7 day follow-up from acute inpatient setting discharge (i.e patient death prior to follow-up visit, patient non-compliance for visit follow-up)	Doc reas no 7d f/u
G9407	0010	3	Patient did not receive follow-up on or within 7 days after discharge	No 7d f/u
G9408	0010	3	Patients with cardiac tamponade and/or pericardiocentesis occurring within 30 days	Card tamp w/in 30d
G9409	0010	3	Patients without cardiac tamponade and/or pericardiocentesis occurring within 30 days	No card tamp e/in 30d
G9410	0010	3	Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision	Admit w/in 180d req remov
G9411	0010	3	Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision	No admit w/in 180d req remov
G9412	0010	3	Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision	Admit w/in 180d req surg rev
G9413	0010	3	Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision	No admit req surg rev
G9414	0010	3	Patient had one dose of meningococcal vaccine (serogroups a, c, w, y) on or between the patient’s 11th and 13th birthdays	1dose menig vac btwn 11 & 13
G9415	0010	3	Patient did not have one dose of meningococcal vaccine on or between the patient’s 11th and 13th birthdays	No 1dose meni vac btwn 11&13
G9416	0010	3	Patient had one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient’s 10th and 13th birthdays	Pt 1 tdap betw 10-13 yrs
G9417	0010	3	Patient did not have one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient’s 10th and 13th birthdays	Pt not 1 tdap betw 10-13 yrs
G9418	0010	3	Primary non-small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation	Lungcx bx rpt docs class
G9419	0010	3	Documentation of medical reason(s) for not including the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of primary non-small cell lung cancer or other documented medical reasons)	Med reas not incl histo type
G9420	0010	3	Specimen site other than anatomic location of lung or is not classified as primary non-small cell lung cancer	Spec site no lung
G9421	0010	3	Primary non-small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation	Lung cx bx rpt no doc class
G9422	0010	3	Primary lung carcinoma resection report documents pt category, pn category and for non-small cell lung cancer, histologic type (squamous cell carcinoma, adenocarcinoma and not nsclc-nos)	Rpt doc class histo type
G9423	0010	3	Documentation of medical reason for not including pt category, pn category and histologic type [for patient with appropriate exclusion criteria (e.g., metastatic disease, benign tumors, malignant tumors other than carcinomas, inadequate surgical specimens)]	Med reas rpt no histo type
G9424	0010	3	Specimen site other than anatomic location of lung, or classified as nsclc-nos	Site no lung or lung cx
G9425	0010	3	Primary lung carcinoma resection report does not document pt category, pn category and for non-small cell lung cancer, histologic type (squamous cell carcinoma, adenocarcinoma)	Spec rpt no doc class histo
G9426	0010	3	Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration performed for ed admitted patients	Impr med time edarr pain med
G9427	0010	3	Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration not performed for ed admitted patients	No impro med time pain med
G9428	0010	3	Pathology report includes the pt category and a statement on thickness, ulceration and mitotic rate	Patho rpt incl pt ctg
G9429	0010	3	Documentation of medical reason(s) for not including pt category and a statement on thickness, ulceration and mitotic rate (e.g., negative skin biopsies in a patient with a history of melanoma or other documented medical reasons)	Doc med rsn no pt cat
G9430	0010	3	Specimen site other than anatomic cutaneous location	Spec site no cutaneous
G9431	0010	3	Pathology report does not include the pt category and a statement on thickness, ulceration and mitotic rate	Patho rpt no pt ctg
G9432	0010	3	Asthma well-controlled based on the act, c-act, acq, or ataq score and results documented	Asth controlled
G9433	0010	3	Death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement period	Death, nhres, hospice
G9434	0010	3	Asthma not well-controlled based on the act, c-act, acq, or ataq score, or specified asthma control tool not used, reason not given	Asth not controlled
G9435	0010	3	Aspirin prescribed at discharge	Asp presc disch
G9436	0010	3	Aspirin not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)	Asp not presc doc reas
G9437	0010	3	Aspirin not prescribed at discharge	Asp not presc disch
G9438	0010	3	P2y inhibitor prescribed at discharge	P2y inhib presc
G9439	0010	3	P2y inhibitor not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)	P2y inhib not presc doc reas
G9440	0010	3	P2y inhibitor not prescribed at discharge	P2y inhib not presc
G9441	0010	3	Statin prescribed at discharge	Statin presc disch
G9442	0010	3	Statin not prescribed for documented reasons (e.g., allergy, medical intolerance)	Statin not presc doc reas
G9443	0010	3	Statin not prescribed at discharge	Statin not presc disch
G9448	0010	3	Patients who were born in the years 1945?1965	Born 1945-1965
G9449	0010	3	History of receiving blood transfusions prior to 1992	Hx bld transf b/f 1992
G9450	0010	3	History of injection drug use	Hx injec drug use
G9451	0010	3	Patient received one-time screening for hcv infection	1x scrn hcv infect
G9452	0010	3	Documentation of medical reason(s) for not receiving one-time screening for hcv infection (e.g., decompensated cirrhosis indicating advanced disease [ie, ascites, esophageal variceal bleeding, hepatic encephalopathy], hepatocellular carcinoma, waitlist for organ transplant, limited life expectancy, other medical reasons)	Doc med reas no scrn hcv
G9453	0010	3	Documentation of patient reason(s) for not receiving one-time screening for hcv infection (e.g., patient declined, other patient reasons)	Pt reas no hcv infect
G9454	0010	3	One-time screening for hcv infection not received within 12-month reporting period and no documentation of prior screening for hcv infection, reason not given	No scr hcv inf 12 mth rp
G9455	0010	3	Patient underwent abdominal imaging with ultrasound, contrast enhanced ct or contrast mri for hcc	Abd imag w/us, ct or mri
G9456	0010	3	Documentation of medical or patient reason(s) for not ordering or performing screening for hcc. medical reason: comorbid medical conditions with expected survival < 5 years, hepatic decompensation and not a candidate for liver transplantation, or other medical reasons; patient reasons: patient declined or other patient reasons (e.g., cost of tests, time related to accessing testing equipment)	Doc med pt reas no hcc scrn
G9457	0010	3	Patient did not undergo abdominal imaging and did not have a documented reason for not undergoing abdominal imaging in the submission period	Pt no abd img no doc rsn
G9458	0010	3	Patient documented as tobacco user and received tobacco cessation intervention (must include at least one of the following: advice given to quit smoking or tobacco use, counseling on the benefits of quitting smoking or tobacco use, assistance with or referral to external smoking or tobacco cessation support programs, or current enrollment in smoking or tobacco use cessation program) if identified as a tobacco user	Tob user recd cess interv
G9459	0010	3	Currently a tobacco non-user	Tob non-user
G9460	0010	3	Tobacco assessment or tobacco cessation intervention not performed, reason not given	No tob assess or cess inter
G9463	0010	3	I intend to report the sinusitis measures group	Sinusitis intent
G9464	0010	3	All quality actions for the applicable measures in the sinusitis measures group have been performed for this patient	Sinusitis comp
G9465	0010	3	I intend to report the acute otitis externa (aoe) measures group	Aoe intent
G9466	0010	3	All quality actions for the applicable measures in the aoe measures group have been performed for this patient	Aoe comp
G9467	0010	3	Patient who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills within the last twelve months	Recd cortico >=10mg/day >60d
G9468	0010	3	Patient not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills	No recd cortico>=10mg/d >60d
G9469	0010	3	Patients who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 90 or greater consecutive days or a single prescription equating to 900 mg prednisone or greater for all fills	Rec cortico>90d or 1rx 900mg
G9470	0010	3	Patients not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills	No rec cortico>60d 1rx 600mg
G9471	0010	3	Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered or documented	W/in 2yr dxa not order
G9472	0010	3	Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered and documented, no review of systems and no medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed	No dxa no med hx no rv sx
G9473	0010	3	Services performed by chaplain in the hospice setting, each 15 minutes	Chap services at hospice
G9474	0010	3	Services performed by dietary counselor in the hospice setting, each 15 minutes	Diet counsel at hospice
G9475	0010	3	Services performed by other counselor in the hospice setting, each 15 minutes	Other counselor at hospice
G9476	0010	3	Services performed by volunteer in the hospice setting, each 15 minutes	Volun service at hospice
G9477	0010	3	Services performed by care coordinator in the hospice setting, each 15 minutes	Care coord at hospice
G9478	0010	3	Services performed by other qualified therapist in the hospice setting, each 15 minutes	Othe therapist at hospice
G9479	0010	3	Services performed by qualified pharmacist in the hospice setting, each 15 minutes	Pharmacist at hospice
G9480	0010	3	Admission to medicare care choice model program (mccm)	Admission to mccm
G9481	0010	3	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m new pt 10mins
G9482	0010	3	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 20 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m new pt 20mins
G9483	0010	3	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m new pt 30mins
G9484	0010	3	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 45 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m new pt 45mins
G9485	0010	3	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 60 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m new pt 60mins
G9486	0010	3	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m est. pt 10mins
G9487	0010	3	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m est. pt 15mins
G9488	0010	3	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m est. pt 25mins
G9489	0010	3	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved coms innovation center demonstration project, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m est. pt 40mins
G9490	0010	3	Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services. (for use only in medicare-approved cms innovation center models); may not be billed for a 30 day period covered by a transitional care management code	Cmmi mod home visit
G9496	0010	3	Documentation of reason for not detecting adenoma(s) or other neoplasm. (e.g., neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma	Doc rsn no adeno/neopl detec
G9497	0010	3	Received instruction from the anesthesiologist or proxy prior to the day of surgery to abstain from smoking on the day of surgery	Rec inst no smoke day surg
G9498	0010	3	Antibiotic regimen prescribed	Abx reg prescribed
G9499	0010	3	Patient did not start or is not receiving antiviral treatment for hepatitis c during the measurement period	No start/rec antvir tx hep c
G9500	0010	3	Radiation exposure indices, or exposure time and number of fluorographic images in final report for procedures using fluoroscopy, documented	Rad expos ind/exp tm doc
G9501	0010	3	Radiation exposure indices, or exposure time and number of fluorographic images not documented in final report for procedure using fluoroscopy, reason not given	Rad expos ind/exp tm no doc
G9502	0010	3	Documentation of medical reason for not performing foot exam (i.e., patients who have had either a bilateral amputation above or below the knee, or both a left and right amputation above or below the knee before or during the measurement period)	Med reas no perf foot exam
G9503	0010	3	Patient taking tamsulosin hydrochloride	Pt tk tams hcl
G9504	0010	3	Documented reason for not assessing hepatitis b virus (hbv) status (e.g., patient not initiating anti-tnf therapy, patient declined) prior to initiating anti-tnf therapy	Doc rsn hep b stat not asses
G9505	0010	3	Antibiotic regimen prescribed within 10 days after onset of symptoms for documented medical reason	Abx pres w/in 10 dys of symp
G9506	0010	3	Biologic immune response modifier prescribed	Bio imm resp mod presc
G9507	0010	3	Documentation that the patient is on a statin medication or has documentation of a valid contraindication or exception to statin medications; contraindications/exceptions that can be defined by diagnosis codes include pregnancy during the measurement period, active liver disease, rhabdomyolysis, end stage renal disease on dialysis and heart failure; provider documented contraindications/exceptions include breastfeeding during the measurement period, woman of child-bearing age not actively taking birth control, allergy to statin, drug interaction (hiv protease inhibitors, nefazodone, cyclosporine, gemfibrozil, and danazol) and intolerance (with supporting documentation of trying a statin at least once within the last 5 years or diagnosis codes for myostitis or toxic myopathy related to drugs)	Doc reas on statin or contra
G9508	0010	3	Documentation that the patient is not on a statin medication	Doc pt not on statin
G9509	0010	3	Adult patients 18 years of age or older with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5	Adit mdd dys rem 12 mnths
G9510	0010	3	Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq- 9 or phq-9m score was not assessed or is greater than or equal to 5	Remis12m not phq-9 score <5
G9511	0010	3	Index event date phq-9 or phq-9m score greater than 9 documented during the twelve month denominator identification period	Idx evt dte phq>9 doc 12 mo
G9512	0010	3	Individual had a pdc of 0.8 or greater	Indiv pdc > 0.8
G9513	0010	3	Individual did not have a pdc of 0.8 or greater	Indiv pdc not > 0.8
G9514	0010	3	Patient required a return to the operating room within 90 days of surgery	Req ret or w/in 90d of surg
G9515	0010	3	Patient did not require a return to the operating room within 90 days of surgery	No reas, no ret or w/in 90d
G9516	0010	3	Patient achieved an improvement in visual acuity, from their preoperative level, within 90 days of surgery	Impr vis acuit w/in 90d
G9517	0010	3	Patient did not achieve an improvement in visual acuity, from their preoperative level, within 90 days of surgery, reason not given	No impr vis acuit w/in 90d
G9518	0010	3	Documentation of active injection drug use	Doc active inj drug use
G9519	0010	3	Patient achieves final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery	Final ref +/- 1.0 w/in 90d
G9520	0010	3	Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery	Refract not +/- 1.0 w/in 90d
G9521	0010	3	Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months	Er and ip hosp <2 in 12 mos
G9522	0010	3	Total number of emergency department visits and inpatient hospitalizations equal to or greater than two in the past 12 months or patient not screened, reason not given	Er/ip hosp =/>2 in 12 mos
G9523	0010	3	Patient discontinued from hemodialysis or peritoneal dialysis	D/c hemo or perit dialysis
G9524	0010	3	Patient was referred to hospice care	Refer to hospice
G9525	0010	3	Documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons)	Doc pt reas no hospice refer
G9526	0010	3	Patient was not referred to hospice care, reason not given	No reason, no refer hospice
G9529	0010	3	Patient with minor blunt head trauma had an appropriate indication(s) for a head ct	Minor blunt trauma w/head ct
G9530	0010	3	Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider	Pt mbht hd ct ord ec prov
G9531	0010	3	Patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticlopidine, ticagrelor, tirofiban, or vorapaxar	Pt doc
G9532	0010	3	Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma	Pt hd ct ord
G9533	0010	3	Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ct	Indic for head ct not valid
G9534	0010	3	Advanced brain imaging (cta, ct, mra or mri) was not ordered	Adv brain image not ordered
G9535	0010	3	Patients with a normal neurological examination	Normal neuro exam
G9536	0010	3	Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms)	Doc med reas adv brain image
G9537	0010	3	Documentation of system reason(s) for obtaining imaging of the head (ct or mri) (i.e., needed as part of a clinical trial; other clinician ordered the study)	Doc sysm rsn img hd
G9538	0010	3	Advanced brain imaging (cta, ct, mra or mri) was ordered	Adv brain image ordered
G9539	0010	3	Intent for potential removal at time of placement	Intent pot remv time placemt
G9540	0010	3	Patient alive 3 months post procedure	Pt alive 3 mos post proc
G9541	0010	3	Filter removed within 3 months of placement	Filter rem 3 mon plmt
G9542	0010	3	Documented re-assessment for the appropriateness of filter removal within 3 months of placement	Doc reass appr remo filt 3ms
G9543	0010	3	Documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement	Doc 2x re-assess filt remov
G9544	0010	3	Patients that do not have the filter removed, documented re-assessment for the appropriateness of filter removal, or documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement	No filt remov w/in 3mos plcm
G9547	0010	3	Cystic renal lesion that is simple appearing (bosniak i or ii) , or adrenal lesion less than or equal to 1.0 cm or adrenal lesion greater than 1.0 cm but less than or equal to 4.0 cm classified as likely benign by unenhanced ct or washout protocol ct, or mri with in- and opposed-phase sequences or other equivalent institutional imaging protocols	Cys ren les or adren
G9548	0010	3	Final reports for imaging studies stating no follow-up imaging is recommended	No f/u rec image study
G9549	0010	3	Documentation of medical reason(s) that follow-up imaging is indicated (e.g., patient has lymphadenopathy, signs of metastasis or an active diagnosis or history of cancer, and other medical reason(s))	Doc med rsn for f/u imag
G9550	0010	3	Final reports for imaging studies with follow-up imaging recommended	Imag rec
G9551	0010	3	Final reports for imaging studies without an incidentally found lesion noted	Imag no les
G9552	0010	3	Incidental thyroid nodule < 1.0 cm noted in report	Inc thyr node <1.0 in rpt
G9553	0010	3	Prior thyroid disease diagnosis	Prior thyroid dise dx
G9554	0010	3	Final reports for ct, cta, mri or mra of the chest or neck or ultrasound of the neck with follow-up imaging recommended	Ct/cta/mri/a chst foll rec
G9555	0010	3	Documentation of medical reason(s) for recommending follow up imaging (e.g., patient has multiple endocrine neoplasia, patient has cervical lymphadenopathy, other medical reason(s))	Doc med rsn for follup image
G9556	0010	3	Final reports for ct, cta, mri or mra of the chest or neck or ultrasound of the neck with follow-up imaging not recommended	Ct/cta/mri/a no follup imag
G9557	0010	3	Final reports for ct, cta, mri or mra studies of the chest or neck or ultrasound of the neck without an incidentally found thyroid nodule < 1.0 cm noted or no nodule found	Ct/cta/mri/a no thyr <1.0cm
G9558	0010	3	Patient treated with a beta-lactam antibiotic as definitive therapy	Tx beta-lactam abx therapy
G9559	0010	3	Documentation of medical reason(s) for not prescribing a beta-lactam antibiotic (e.g., allergy, intolerance to beta-lactam antibiotics)	Doc med reas no abx therapy
G9560	0010	3	Patient not treated with a beta-lactam antibiotic as definitive therapy, reason not given	No beta-lactam abx ther, rng
G9561	0010	3	Patients prescribed opiates for longer than six weeks	Presc opiates >6 wks
G9562	0010	3	Patients who had a follow-up evaluation conducted at least every three months during opioid therapy	Foll-up eval q3mo opiod tx
G9563	0010	3	Patients who did not have a follow-up evaluation conducted at least every three months during opioid therapy	No f/u eval q3mo opiod tx
G9572	0010	3	Index date phq-score greater than 9 documented during the twelve month denominator identification period	Phq-scr >9 doc in 12m time
G9573	0010	3	Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five	Adl pt md or dys rem 6 mon
G9574	0010	3	Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five; either phq-9 or phq-9m score was not assessed or is greater than or equal to five	Adl pt md dys no rem 6 mon
G9577	0010	3	Patients prescribed opiates for longer than six weeks	Presc opiates >6 wks
G9578	0010	3	Documentation of signed opioid treatment agreement at least once during opioid therapy	Doc opioid tx 1x during ther
G9579	0010	3	No documentation of signed an opioid treatment agreement at least once during opioid therapy	No doc opioid tx 1x at ther
G9580	0010	3	Door to puncture time of less than 2 hours	Door to punc time <2hrs
G9581	0010	3	Door to puncture time of greater than 2 hours for reasons documented by clinician (e.g., patients who are transferred from one institution to another with a known diagnosis of cva for endovascular stroke treatment; hospitalized patients with newly diagnosed cva considered for endovascular stroke treatment)	Md doc, door to punc tm >2hr
G9582	0010	3	Door to puncture time of greater than 2 hours, no reason given	Door to punc time >2hr, nrg
G9583	0010	3	Patients prescribed opiates for longer than six weeks	Presc opiates >6 wks
G9584	0010	3	Patient evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient interviewed at least once during opioid therapy	Eval opioid use instr/pt int
G9585	0010	3	Patient not evaluated for risk of misuse of opiates by using a brief validated instrument (e.g., opioid risk tool, soapp-r) or patient not interviewed at least once during opioid therapy	No eval opi use instr/intv
G9593	0010	3	Pediatric patient with minor blunt head trauma classified as low risk according to the pecarn prediction rules	Low pecarn ped head trauma
G9594	0010	3	Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider	Pt mbht hd ct ord ec prov
G9595	0010	3	Patient has documentation of ventricular shunt, brain tumor, or coagulopathy	Doc shnt/tum/coag
G9596	0010	3	Pediatric patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma	Ped pt hd ct ord
G9597	0010	3	Pediatric patient with minor blunt head trauma not classified as low risk according to the pecarn prediction rules	No low pecarn ped head traum
G9598	0010	3	Aortic aneurysm 5.5 - 5.9 cm maximum diameter on centerline formatted ct or minor diameter on axial formatted ct	Aor ane 5.5-5.9 cm max diam
G9599	0010	3	Aortic aneurysm 6.0 cm or greater maximum diameter on centerline formatted ct or minor diameter on axial formatted ct	Aor ane >=6.0 cm max diam
G9600	0010	3	Symptomatic aaas that required urgent/emergent (non-elective) repair	Symp aaa urgent repair
G9601	0010	3	Patient discharge to home no later than post-operative day #7	Pt dchg home post op day 7
G9602	0010	3	Patient not discharged to home by post-operative day #7	Pt no dchg home postop day 7
G9603	0010	3	Patient survey score improved from baseline following treatment	Pt surv improv bsline tx
G9604	0010	3	Patient survey results not available	Pt surv results not avail
G9605	0010	3	Patient survey score did not improve from baseline following treatment	Surv score no improv w/tx
G9606	0010	3	Intraoperative cystoscopy performed to evaluate for lower tract injury	Intraop cyst eval trac inj
G9607	0010	3	Documented medical reasons for not performing intraoperative cystoscopy (e.g., urethral pathology precluding cystoscopy, any patient who has a congenital or acquired absence of the urethra) or in the case of patient death	Doc med rsn not perf cystosc
G9608	0010	3	Intraoperative cystoscopy not performed to evaluate for lower tract injury	Intraop cyst eval not done
G9609	0010	3	Documentation of an order for anti-platelet agents	Doc order anti-plat
G9610	0010	3	Documentation of medical reason(s) in the patient’s record for not ordering anti-platelet agents	Doc md rsn no antipla
G9611	0010	3	Order for anti-platelet agents was not documented in the patient’s record, reason not given	No doc order anti-plat rng
G9612	0010	3	Photodocumentation of two or more cecal landmarks to establish a complete examination	Phodoc 2 mr cec lndmk
G9613	0010	3	Documentation of post-surgical anatomy (e.g., right hemicolectomy, ileocecal resection, etc.)	Doc post surg anatomy
G9614	0010	3	Photodocumentation of less than two cecal landmarks (i.e., no cecal landmarks or only one cecal landmark) to establish a complete examination	Photodoc < 2 cec lndmk
G9615	0010	3	Preoperative assessment documented	Pre-op asst doc
G9616	0010	3	Documentation of reason(s) for not documenting a preoperative assessment (e.g., patient with a gynecologic or other pelvic malignancy noted at the time of surgery)	Doc rsn no preop assmt
G9617	0010	3	Preoperative assessment not documented, reason not given	Pre-op asst not doc, rng
G9618	0010	3	Documentation of screening for uterine malignancy or those that had an ultrasound and/or endometrial sampling of any kind	Doc scr uter mal or us/samp
G9619	0010	3	Documentation of reason(s) for not screening for uterine malignancy (e.g., prior hysterectomy)	Doc rsn no scr uter malig
G9620	0010	3	Patient not screened for uterine malignancy, or those that have not had an ultrasound and/or endometrial sampling of any kind, reason not given	No scr utr malig/us/samp rng
G9621	0010	3	Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling	Scr unheal etoh w/counsel
G9622	0010	3	Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method	No unheal etoh user
G9623	0010	3	Documentation of medical reason(s) for not screening for unhealthy alcohol use (e.g., limited life expectancy, other medical reasons)	Doc med rsn no scr etoh use
G9624	0010	3	Patient not screened for unhealthy alcohol use using a systematic screening method or patient did not receive brief counseling if identified as an unhealthy alcohol user, reason not given	Pt not scrn or no counseling
G9625	0010	3	Patient sustained bladder injury at the time of surgery or discovered subsequently up to 30 days post-surgery	Pt bl srg 30 day pst srg
G9626	0010	3	Documented medical reason for not reporting bladder injury (e.g., gynecologic or other pelvic malignancy documented, concurrent surgery involving bladder pathology, injury that occurs during urinary incontinence procedure, patient death from non-medical causes not related to surgery, patient died during procedure without evidence of bladder injury)	Med rsn no rpt baldder inj
G9627	0010	3	Patient did not sustain bladder injury at the time of surgery nor discovered subsequently up to 30n days post-surgery	Pt no bl srg 30 day pst srg
G9628	0010	3	Patient sustained bowel injury at the time of surgery or discovered subsequently up to 30 days post-surgery	Pt bwli srg 30 day pst srg
G9629	0010	3	Documented medical reasons for not reporting bowel injury (e.g., gynecologic or other pelvic malignancy documented, planned (e.g., not due to an unexpected bowel injury) resection and/or re-anastomosis of bowel, or patient death from non-medical causes not related to surgery, patient died during procedure without evidence of bowel injury)	Med rsn no rpt bowel inj
G9630	0010	3	Patient did not sustain a bowel injury at the time of surgery nor discovered subsequently up to 30 days post-surgery	Pt no bwli srg 30 day srg
G9631	0010	3	Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery	Pt ui srg 30 day pst srg
G9632	0010	3	Documented medical reasons for not reporting ureter injury (e.g., gynecologic or other pelvic malignancy documented, concurrent surgery involving bladder pathology, injury that occurs during a urinary incontinence procedure, patient death from non-medical causes not related to surgery, patient died during procedure without evidence of ureter injury)	Med rsn for no rpt uret inj
G9633	0010	3	Patient did not sustain ureter injury at the time of surgery nor discovered subsequently up to 30 days post-surgery	Pt no ui srg 30 day pst srg
G9634	0010	3	Health-related quality of life assessed with tool during at least two visits and quality of life score remained the same or improved	Qual life tool 2x same/impr
G9635	0010	3	Health-related quality of life not assessed with tool for documented reason(s) (e.g., patient has a cognitive or neuropsychiatric impairment that impairs his/her ability to complete the hrqol survey, patient has the inability to read and/or write in order to complete the hrqol questionnaire)	No doc rsn do qual life assm
G9636	0010	3	Health-related quality of life not assessed with tool during at least two visits or quality of life score declined	No life asst 2x same/decr
G9637	0010	3	Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique)	Doc >1 dose reduc tech
G9638	0010	3	Final reports without documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique)	No doc >1 dose reduc tech
G9639	0010	3	Major amputation or open surgical bypass not required within 48 hours of the index endovascular lower extremity revascularization procedure	Amp no reqd in48h ieler proc
G9640	0010	3	Documentation of planned hybrid or staged procedure	Doc plan hybrid/stage proc
G9641	0010	3	Major amputation or open surgical bypass required within 48 hours of the index endovascular lower extremity revascularization procedure	Amp reqd w/in 48h ieler proc
G9642	0010	3	Current smokers (e.g., cigarette, cigar, pipe, e-cigarette or marijuana)	Current smoker
G9643	0010	3	Elective surgery	Elective surgery
G9644	0010	3	Patients who abstained from smoking prior to anesthesia on the day of surgery or procedure	No smok b/4 anes day of surg
G9645	0010	3	Patients who did not abstain from smoking prior to anesthesia on the day of surgery or procedure	Had smoke b/4 anes day surg
G9646	0010	3	Patients with 90 day mrs score of 0 to 2	Pt w/90d mrs 0-2
G9647	0010	3	Patients in whom mrs score could not be obtained at 90 day follow-up	No mrs score in 90d followup
G9648	0010	3	Patients with 90 day mrs score greater than 2	Pt w/90d mrs >2
G9649	0010	3	Psoriasis assessment tool documented meeting any one of the specified benchmarks (e.g., (pga; 5-point or 6-point scale), body surface area (bsa), psoriasis area and severity index (pasi) and/or dermatology life quality index) (dlqi))	Psor as doc spc bm
G9650	0010	3	Documentation that the patient declined therapy change or has documented contraindications (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi	Doc pt no ther chg or contra
G9651	0010	3	Psoriasis assessment tool documented not meeting any one of the specified benchmarks (e.g., (pga; 5-point or 6-point scale), body surface area (bsa), psoriasis area and severity index (pasi) and/or dermatology life quality index) (dlqi)) or psoriasis assessment tool not documented	Psor as doc no spc bm
G9652	0010	3	Patient has been treated with a systemic or biologic medication for psoriasis for at least six months	Pt tx sys bio med psori 6mth
G9653	0010	3	Patient has not been treated with a systemic or biologic medication for psoriasis for at least six months	Pt no tx sys bio rx 6 mths
G9654	0010	3	Monitored anesthesia care (mac)	Mon anesth care
G9655	0010	3	A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is used	Toc tool incl key elem
G9656	0010	3	Patient transferred directly from anesthetizing location to pacu or other non-icu location	Pt trans from anest to pacu
G9657	0010	3	Transfer of care during an anesthetic or to the intensive care unit	Toc dur aneth to icu
G9658	0010	3	A transfer of care protocol or handoff tool/checklist that includes the required key handoff elements is not used	Toc tool incl elem not used
G9659	0010	3	Patients greater than 85 years of age who did not have a history of colorectal cancer or valid medical reason for the colonoscopy, including: iron deficiency anemia, lower gastrointestinal bleeding, crohn’s disease (i.e., regional enteritis), familial adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease, ulcerative colitis, abnormal finding of gastrointestinal tract, or changes in bowel habits	>85y no hx colo ca/rsn scope
G9660	0010	3	Documentation of medical reason(s) for a colonoscopy performed on a patient greater than 85 years of age (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, iron deficiency anemia, lower gastrointestinal bleeding, crohn’s disease (i.e., regional enteritis), familial history of adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease, ulcerative colitis, abnormal finding of gastrointestinal tract, or changes in bowel habits)	Doc med rsn scope pt >85y
G9661	0010	3	Patients greater than 85 years of age who received a routine colonoscopy for a reason other than the following: an assessment of signs/symptoms of gi tract illness, and/or the patient is considered high risk, and/or to follow-up on previously diagnosed advance lesions	>85y scope othr rsn
G9662	0010	3	Previously diagnosed or have an active diagnosis of clinical ascvd	Prior dx/active clin ascvd
G9663	0010	3	Any fasting or direct ldl-c laboratory test result <= 190 mg/dl	Fast/dir ldl <= 190 mg/dl
G9664	0010	3	Patients who are currently statin therapy users or received an order (prescription) for statin therapy	Taking statin or rec’d order
G9665	0010	3	Patients who are not currently statin therapy users or did not receive an order (prescription) for statin therapy	No statin/no order statin
G9666	0010	3	The highest fasting or direct ldl-c laboratory test result of 70-189 mg/dl in the measurement period or two years prior to the beginning of the measurement period	Fas/dir ldl 70-189mg/dl mst
G9667	0010	3	Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who have an active diagnosis of pregnancy or who are breastfeeding, patients who are receiving palliative care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease (esrd), and patients with diabetes who have a fasting or direct ldl-c laboratory test result < 70 mg/dl and are not taking statin therapy)	Doc med rsn no stat tx/presc
G9669	0010	3	I intend to report the multiple chronic conditions measures group	Intend rpt mult chr msr grp
G9670	0010	3	All quality actions for the applicable measures in the multiple chronic conditions measures group have been performed for this patient	Qty act mcc mg perf
G9671	0010	3	I intend to report the diabetic retinopathy measures group	Intend rpt dia retin msr grp
G9672	0010	3	All quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for this patient	Qty act diab retin mg perf
G9673	0010	3	I intend to report the cardiovascular prevention measures group	Intend rpt card prev msr grp
G9674	0010	3	Patients with clinical ascvd diagnosis	Pt w/clin ascvd dx
G9675	0010	3	Patients who have ever had a fasting or direct laboratory result of ldl-c = 190 mg/dl	Pt w/fast/dir lab ldl-c >190
G9676	0010	3	Patients aged 40 to 75 years at the beginning of the measurement period with type 1 or type 2 diabetes and with an ldl-c result of 70?189 mg/dl recorded as the highest fasting or direct laboratory test result in the measurement year or during the two years prior to the beginning of the measurement period	40-75y w/type 1/2 w/ldl-c rs
G9677	0010	3	All quality actions for the applicable measures in the cardiovascular prevention measures group have been performed for this patient	Qty act card prev mg perf
G9678	0010	3	Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation agreement	Oncology care model service
G9679	0010	3	This code is for onsite acute care treatment of a nursing facility resident with pneumonia; may only be billed once per day per beneficiary	Acute care pneumonia
G9680	0010	3	This code is for onsite acute care treatment of a nursing facility resident with chf; may only be billed once per day per beneficiary	Acute care congestive heart
G9681	0010	3	This code is for onsite acute care treatment of a resident with copd or asthma; may only be billed once per day per beneficiary	Acute care chronic obstruct
G9682	0010	3	This code is for the onsite acute care treatment a nursing facility resident with a skin infection; may only be billed once per day per beneficiary	Acute care skin infection
G9683	0010	3	Facility service(s) for the onsite acute care treatment of a nursing facility resident with fluid or electrolyte disorder. (may only be billed once per day per beneficiary). this service is for a demonstration project	Acute fluid/electro disorder
G9684	0010	3	This code is for the onsite acute care treatment of a nursing facility resident for a uti; may only be billed once per day per beneficiary	Acute care urinary tract inf
G9685	0010	3	Physician service or other qualified health care professional for the evaluation and management of a beneficiary’s acute change in condition in a nursing facility. this service is for a demonstration project	Acute nursing facility care
G9686	0010	3	Onsite nursing facility conference, that is separate and distinct from an evaluation and management visit, including qualified practitioner and at least one member of the nursing facility interdisciplinary care team	Nursing facility conference
G9687	0010	3	Hospice services provided to patient any time during the measurement period	Hospice anytime msmt per
G9688	0010	3	Patients using hospice services any time during the measurement period	Pt w/hosp anytime msmt per
G9689	0010	3	Patient admitted for performance of elective carotid intervention	Inpt elect carotid intervent
G9690	0010	3	Patient receiving hospice services any time during the measurement period	Pt in hos
G9691	0010	3	Patient had hospice services any time during the measurement period	Pt hosp dur msmt period
G9692	0010	3	Hospice services received by patient any time during the measurement period	Hosp recd by pt dur msmt per
G9693	0010	3	Patient use of hospice services any time during the measurement period	Pt use hosp during msmt per
G9694	0010	3	Hospice services utilized by patient any time during the measurement period	Hosp srv used pt in msmt per
G9695	0010	3	Long-acting inhaled bronchodilator prescribed	Long act inhal bronchdil pre
G9696	0010	3	Documentation of medical reason(s) for not prescribing a long-acting inhaled bronchodilator	Med rsn no presc bronchdil
G9697	0010	3	Documentation of patient reason(s) for not prescribing a long-acting inhaled bronchodilator	Pt rsn no presc bronchdil
G9698	0010	3	Documentation of system reason(s) for not prescribing a long-acting inhaled bronchodilator	Sys rsn no presc bronchdil
G9699	0010	3	Long-acting inhaled bronchodilator not prescribed, reason not otherwise specified	Long inhal bronchdil no pres
G9700	0010	3	Patients who use hospice services any time during the measurement period	Pt is w/hosp during msmt per
G9701	0010	3	Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established	Child anbx 30 prior dx estab
G9702	0010	3	Patients who use hospice services any time during the measurement period	Pt use hosp during msmt per
G9703	0010	3	Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis	Child anbx 30 prior dx phary
G9704	0010	3	Ajcc breast cancer stage i: t1 mic or t1a documented	Ajcc br ca stg i: t1 mic/t1a
G9705	0010	3	Ajcc breast cancer stage i: t1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented	Ajcc br ca stg ib
G9706	0010	3	Low (or very low) risk of recurrence, prostate cancer	Low recur prost ca
G9707	0010	3	Patient received hospice services any time during the measurement period	Pt had hosp dur msmt per
G9708	0010	3	Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy	Bilat mast/hx bi /unilat mas
G9709	0010	3	Hospice services used by patient any time during the measurement period	Hosp srv used pt in msmt per
G9710	0010	3	Patient was provided hospice services any time during the measurement period	Pt prov hosp srv msmt per
G9711	0010	3	Patients with a diagnosis or past history of total colectomy or colorectal cancer	Pt hx tot col or colon ca
G9712	0010	3	Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis/ mastoiditis/bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia, gonococcal infections/venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis/uti, acne, hiv disease/asymptomatic hiv, cystic fibrosis, disorders of the immune system, malignancy neoplasms, chronic bronchitis, emphysema, bronchiectasis, extrinsic allergic alveolitis, chronic airway obstruction, chronic obstructive asthma, pneumoconiosis and other lung disease due to external agents, other diseases of the respiratory system, and tuberculosis	Doc med rsn presc anbx
G9713	0010	3	Patients who use hospice services any time during the measurement period	Pt use hosp during msmt per
G9714	0010	3	Patient is using hospice services any time during the measurement period	Pt is w/hosp during msmt per
G9715	0010	3	Patients who use hospice services any time during the measurement period	Pt w/hosp anytime msmt per
G9716	0010	3	Bmi is documented as being outside of normal limits, follow-up plan is not completed for documented reason	Bmi doc onl fup not cmpltd
G9717	0010	3	Documentation stating the patient has an active diagnosis of depression or has a diagnosed bipolar disorder, therefore screening or follow-up not required	Doc pt dx dep/bp f/u nt req
G9718	0010	3	Hospice services for patient provided any time during the measurement period	Hospice anytime msmt per
G9719	0010	3	Patient is not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair	Pt not ambul/immob/wc
G9720	0010	3	Hospice services for patient occurred any time during the measurement period	Hospice anytime msmt per
G9721	0010	3	Patient not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair	Pt not ambul/immob/wc
G9722	0010	3	Documented history of renal failure or baseline serum creatinine = 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure, unless, since transplantation the cr has been or is 4.0 or higher	Doc hx renal fail or cr+ >4
G9723	0010	3	Hospice services for patient received any time during the measurement period	Hosp recd by pt dur msmt per
G9724	0010	3	Patients who had documentation of use of anticoagulant medications overlapping the measurement year	Pt w/doc use anticoag mst yr
G9725	0010	3	Patients who use hospice services any time during the measurement period	Pt w/hosp anytime msmt per
G9726	0010	3	Patient refused to participate	Refused to participate
G9727	0010	3	Patient unable to complete the knee fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available	Pt unable cmplt knee fs prom
G9728	0010	3	Patient refused to participate	Refused to participate
G9729	0010	3	Patient unable to complete the hip fs prom at initial evaluation and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available	Pt unbl cmplt hip fs prom
G9730	0010	3	Patient refused to participate	Refused to participate
G9731	0010	3	Patient unable to complete the ankle/foot fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available	Pt unbl cmplt ft/ank fs prom
G9732	0010	3	Patient refused to participate	Refused to participate
G9733	0010	3	Patient unable to complete the low back fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available	Pt unbl cmplt lb fs prom
G9734	0010	3	Patient refused to participate	Refused to participate
G9735	0010	3	Patient unable to complete the shoulder fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available	Pt unbl cmplt shld fs prom
G9736	0010	3	Patient refused to participate	Refused to participate
G9737	0010	3	Patient unable to complete the elbow/wrist/hand fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available	Pt unbl cmplt ewh fs prom
G9738	0010	3	Patient refused to participate	Refused to participate
G9739	0010	3	Patient unable to complete the general orthopedic fs prom at initial evaluation and/or discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available	Pt unbl cmplt go fs prom
G9740	0010	3	Hospice services given to patient any time during the measurement period	Hosp srv to pt dur msmt per
G9741	0010	3	Patients who use hospice services any time during the measurement period	Pt w/hosp anytime msmt per
G9742	0010	3	Psychiatric symptoms assessed	Psych sympt assessed
G9743	0010	3	Psychiatric symptoms not assessed, reason not otherwise specified	Psych symp not assessed, rns
G9744	0010	3	Patient not eligible due to active diagnosis of hypertension	Pt not eli d/t act dig htn
G9745	0010	3	Documented reason for not screening or recommending a follow-up for high blood pressure	Doc rsn no hbp scrn or f/u
G9746	0010	3	Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery)	Mit sten, valve or trans af
G9747	0010	3	Patient is undergoing palliative dialysis with a catheter	Pall dialysis with catheter
G9748	0010	3	Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant	App transpl lvg kidney donor
G9749	0010	3	Patient is undergoing palliative dialysis with a catheter	Pall dialysis with catheter
G9750	0010	3	Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant	App transpl lvg kidney donor
G9751	0010	3	Patient died at any time during the 24-month measurement period	Pt died w/in 24 mos rpt time
G9752	0010	3	Emergency surgery	Urgent surgery
G9753	0010	3	Documentation of medical reason for not conducting a search for dicom format images for prior patient ct imaging studies completed at non-affiliated external healthcare facilities or entities within the past 12 months that are available through a secure, authorized, media-free, shared archive (e.g., trauma, acute myocardial infarction, stroke, aortic aneurysm where time is of the essence)	Doc no dicom, ct other fac
G9754	0010	3	A finding of an incidental pulmonary nodule	Incid pulm nodule
G9755	0010	3	Documentation of medical reason(s) for not including a recommended interval and modality for follow-up or for no follow-up, and source of recommendations (e.g., patients with unexplained fever, immunocompromised patients who are at risk for infection)	Doc med rsn no fllw up
G9756	0010	3	Surgical procedures that included the use of silicone oil	Surg proc w/silicone oil
G9757	0010	3	Surgical procedures that included the use of silicone oil	Surg proc w/silicone oil
G9758	0010	3	Patient in hospice at any time during the measurement period	Pt in hos
G9759	0010	3	History of preoperative posterior capsule rupture	Hx preop post cap rup
G9760	0010	3	Patients who use hospice services any time during the measurement period	Pt w/hosp anytime msmt per
G9761	0010	3	Patients who use hospice services any time during the measurement period	Pt w/hosp anytime msmt per
G9762	0010	3	Patient had at least two hpv vaccines (with at least 146 days between the two) or three hpv vaccines on or between the patient’s 9th and 13th birthdays	Pt had >= 2-3 hpv vaccines
G9763	0010	3	Patient did not have at least two hpv vaccines (with at least 146 days between the two) or three hpv vaccines on or between the patient’s 9th and 13th birthdays	Pt not have 2-3 hpv vaccines
G9764	0010	3	Patient has been treated with a systemic medication for psoriasis vulgaris	Pt treatd w/oral syst or bio
G9765	0010	3	Documentation that the patient declined change in medication or alternative therapies were unavailable, has documented contraindications, or has not been treated with a systemic medication for at least six consecutive months (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi	Doc pat declined therapy
G9766	0010	3	Patients who are transferred from one institution to another with a known diagnosis of cva for endovascular stroke treatment	Cva stroke dx tx transf fac
G9767	0010	3	Hospitalized patients with newly diagnosed cva considered for endovascular stroke treatment	Hosp new dx cva consid evst
G9768	0010	3	Patients who utilize hospice services any time during the measurement period	Pt w/hosp anytime msmt per
G9769	0010	3	Patient had a bone mineral density test in the past two years or received osteoporosis medication or therapy in the past 12 months	Bn den 2yr/got ost med/ther
G9770	0010	3	Peripheral nerve block (pnb)	Perip nerve block
G9771	0010	3	At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) achieved within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time	Anes end, 1 temp >35.5(95.9)
G9772	0010	3	Documentation of medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time (e.g., emergency cases, intentional hypothermia, etc.)	Doc med rsn no temp >= 35.5
G9773	0010	3	At least 1 body temperature measurement equal to or greater than 35.5 degrees celsius (or 95.9 degrees fahrenheit) not achieved within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time, reason not given	1 bod temp >=35.5
G9774	0010	3	Patients who have had a hysterectomy	Pt had hyst
G9775	0010	3	Patient received at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively	Recd 2 anti-emet pre/intraop
G9776	0010	3	Documentation of medical reason for not receiving at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g., intolerance or other medical reason)	Doc med rsn no proph antiem
G9777	0010	3	Patient did not receive at least 2 prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively	Pt no antiemet pre/intraop
G9778	0010	3	Patients who have a diagnosis of pregnancy	Pts dx w/pregn
G9779	0010	3	Patients who are breastfeeding	Pts breastfeeding
G9780	0010	3	Patients who have a diagnosis of rhabdomyolysis	Pts dx w/rhabdomyolysis
G9781	0010	3	Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who are receiving palliative or hospice care, patients with active liver disease or hepatic disease or insufficiency, and patients with end stage renal disease (esrd))	Doc rsn no statin
G9782	0010	3	History of or active diagnosis of familial or pure hypercholesterolemia	Hx dx fam/pure hypercholes
G9783	0010	3	Documentation of patients with diabetes who have a most recent fasting or direct ldl- c laboratory test result < 70 mg/dl and are not taking statin therapy	Doc dx dm, fast <70, no stat
G9784	0010	3	Pathologists/dermatopathologists providing a second opinion on a biopsy	Path/derm prov 2nd biop opin
G9785	0010	3	Pathology report diagnosing cutaneous basal cell carcinoma, squamous cell carcinoma, or melanoma (to include in situ disease) sent from the pathologist/ dermatopathologist to the biopsying clinician for review within 7 days from the time when the tissue specimen was received by the pathologist	Path report sent
G9786	0010	3	Pathology report diagnosing cutaneous basal cell carcinoma, squamous cell carcinoma, or melanoma (to include in situ disease) was not sent from the pathologist/ dermatopathologist to the biopsying clinician for review within 7 days from the time when the tissue specimen was received by the pathologist	Path report not sent
G9787	0010	3	Patient alive as of the last day of the measurement year	Pt alive
G9788	0010	3	Most recent bp is less than or equal to 140/90 mm hg	Most rct bp </= 140/90
G9789	0010	3	Blood pressure recorded during inpatient stays, emergency room visits, urgent care visits, and patient self-reported bp’s (home and health fair bp results)	Record bp ip, er, urg/self
G9790	0010	3	Most recent bp is greater than 140/90 mm hg, or blood pressure not documented	Most rct bp >/= 140/90
G9791	0010	3	Most recent tobacco status is tobacco free	Most rct tob stat free
G9792	0010	3	Most recent tobacco status is not tobacco free	Most rct tob stat not free
G9793	0010	3	Patient is currently on a daily aspirin or other antiplatelet	Pt on daily asa/antiplat
G9794	0010	3	Documentation of medical reason(s) for not on a daily aspirin or other antiplatelet (e.g., history of gastrointestinal bleed, intra-cranial bleed, idiopathic thrombocytopenic purpura (itp), gastric bypass or documentation of active anticoagulant use during the measurement period)	Doc med rsn no daily aspirin
G9795	0010	3	Patient is not currently on a daily aspirin or other antiplatelet	Pt no daily asa/antiplat
G9796	0010	3	Patient is currently on a statin therapy	Pt not currently on statin
G9797	0010	3	Patient is not on a statin therapy	Pt currently on statin
G9798	0010	3	Discharge(s) for ami between july 1 of the year prior measurement period to june 30 of the measurement period	D/c ami btw 7/1-6/30 meas pd
G9799	0010	3	Patients with a medication dispensing event indicator of a history of asthma any time during the patient’s history through the end of the measure period	Med disp evt indic hx asth
G9800	0010	3	Patients who are identified as having an intolerance or allergy to beta-blocker therapy	Pt id intol/alleg beta-block
G9801	0010	3	Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis	Nonacut transf from inpt
G9802	0010	3	Patients who use hospice services any time during the measurement period	Pt w/hosp anytime msmt per
G9803	0010	3	Patient prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami	Pt presc 135 day trmt
G9804	0010	3	Patient was not prescribed at least a 135 day treatment within the 180-day measurement interval with beta-blockers post-discharge for ami	Pt not presc 135 day trmt
G9805	0010	3	Patients who use hospice services any time during the measurement period	Pt w/hosp anytime msmt per
G9806	0010	3	Patients who received cervical cytology or an hpv test	Pt recd cerv cyto/hpv
G9807	0010	3	Patients who did not receive cervical cytology or an hpv test	Pt no recd cerv cyto/hpv
G9808	0010	3	Any patients who had no asthma controller medications dispensed during the measurement year	Pt no asthm cont med mst per
G9809	0010	3	Patients who use hospice services any time during the measurement period	Pt w/hosp anytime msmt per
G9810	0010	3	Patient achieved a pdc of at least 75% for their asthma controller medication	Pdc 75% w/asth cont med
G9811	0010	3	Patient did not achieve a pdc of at least 75% for their asthma controller medication	No pdc 75% w/asth cont med
G9812	0010	3	Patient died including all deaths occurring during the hospitalization in which the operation was performed, even if after 30 days, and those deaths occurring after discharge from the hospital, but within 30 days of the procedure	Pt died during inpt/30d aft
G9813	0010	3	Patient did not die within 30 days of the procedure or during the index hospitalization	Pt not died w/in 30d of proc
G9814	0010	3	Death occurring during the index acute care hospitalization	Death during index hosp
G9815	0010	3	Death did not occur during the index acute care hospitalization	Death not during index hosp
G9816	0010	3	Death occurring after discharge from the hospital but within 30 days post procedure	Death <30 day post discharge
G9817	0010	3	Death did not occur after discharge from the hospital within 30 days post procedure	No death 30-days post-disch
G9818	0010	3	Documentation of sexual activity	Doc sex activity
G9819	0010	3	Patients who use hospice services any time during the measurement period	Pt w/hosp anytime msmt per
G9820	0010	3	Documentation of a chlamydia screening test with proper follow-up	Doc chlam scr test w/follow
G9821	0010	3	No documentation of a chlamydia screening test with proper follow-up	No doc chlam scr ts w/follow
G9822	0010	3	Women who had an endometrial ablation procedure during the year prior to the index date (exclusive of the index date)	Endo abl proc yr prev ind dt
G9823	0010	3	Endometrial sampling or hysteroscopy with biopsy and results documented	Endo smpl/hyst bx res doc
G9824	0010	3	Endometrial sampling or hysteroscopy with biopsy and results not documented	Endo smpl/hyst bx res no doc
G9825	0010	3	Her-2/neu negative or undocumented/unknown	Her-2 neg,undoc/unkn
G9826	0010	3	Patient transferred to practice after initiation of chemotherapy	Transf pract aft init chemo
G9827	0010	3	Her2-targeted therapies not administered during the initial course of treatment	Her-2 targ ther no init tx
G9828	0010	3	Her2-targeted therapies administered during the initial course of treatment	Her-2 targ ther dur init tx
G9829	0010	3	Breast adjuvant chemotherapy administered	Breast adj chemo admin
G9830	0010	3	Her-2/neu positive	Her-2 pos
G9831	0010	3	Ajcc stage at breast cancer diagnosis = ii or iii	Ajcc stg brt ca dx ii or iii
G9832	0010	3	Ajcc stage at breast cancer diagnosis = i (ia or ib) and t-stage at breast cancer diagnosis does not equal = t1, t1a, t1b	Brt ca dx i, no t1/t1a/t1b
G9833	0010	3	Patient transfer to practice after initiation of chemotherapy	Transf pract aft init chemo
G9834	0010	3	Patient has metastatic disease at diagnosis	Pt met dis at dx
G9835	0010	3	Trastuzumab administered within 12 months of diagnosis	Trastuz given w/in 12 mos dx
G9836	0010	3	Reason for not administering trastuzumab documented (e.g. patient declined, patient died, patient transferred, contraindication or other clinical exclusion, neoadjuvant chemotherapy or radiation not complete)	Rsn no trast given doc
G9837	0010	3	Trastuzumab not administered within 12 months of diagnosis	Trastuz not in 12 mos dx
G9838	0010	3	Patient has metastatic disease at diagnosis	Pt met dis at dx
G9839	0010	3	Anti-egfr monoclonal antibody therapy	Anti-egfr mon anti ther
G9840	0010	3	Ras (kras and nras) gene mutation testing performed before initiation of anti-egfr moab	Gene testing performed
G9841	0010	3	Ras (kras and nras) gene mutation testing not performed before initiation of anti-egfr moab	Gene testing not performed
G9842	0010	3	Patient has metastatic disease at diagnosis	Pt met dis at dx
G9843	0010	3	Ras (kras or nras) gene mutation	Kras or nras gene mutation
G9844	0010	3	Patient did not receive anti-egfr monoclonal antibody therapy	Pt no recd anti-egfr ther
G9845	0010	3	Patient received anti-egfr monoclonal antibody therapy	Pt recd anti-egfr ther
G9846	0010	3	Patients who died from cancer	Pt died from cancer
G9847	0010	3	Patient received chemotherapy in the last 14 days of life	Pt recd chemo last 14d life
G9848	0010	3	Patient did not receive chemotherapy in the last 14 days of life	Pt no chemo last 14d life
G9849	0010	3	Patients who died from cancer	Pt died from cancer
G9850	0010	3	Patient had more than one emergency department visit in the last 30 days of life	1/more ed last 30d life
G9851	0010	3	Patient had one or less emergency department visits in the last 30 days of life	1/no ed visit last 30d life
G9852	0010	3	Patients who died from cancer	Pt died from cancer
G9853	0010	3	Patient admitted to the icu in the last 30 days of life	Icu stay last 30d life
G9854	0010	3	Patient was not admitted to the icu in the last 30 days of life	No icu stay last 30d life
G9855	0010	3	Patients who died from cancer	Pt died from cancer
G9856	0010	3	Patient was not admitted to hospice	Pt no hospice
G9857	0010	3	Patient admitted to hospice	Pt admit hospice
G9858	0010	3	Patient enrolled in hospice	Pt enroll hospice
G9859	0010	3	Patients who died from cancer	Pt died from cancer
G9860	0010	3	Patient spent less than three days in hospice care	Pt less 3d hospice
G9861	0010	3	Patient spent greater than or equal to three days in hospice care	Pt more than 3d hospice
G9862	0010	3	Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is = 66 years old, or life expectancy < 10 years old, other medical reasons)	Doc rsn no 10 yr follow
G9868	0010	3	Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use under the next generation aco model, less than 10 minutes	Next gen aco model <10min
G9869	0010	3	Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use under the next generation aco model, 10-20 minutes	Next gen aco model 10-20min
G9870	0010	3	Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use under the next generation aco model, 20 or more minutes	Next gen aco model >20min
G9873	0010	3	First medicare diabetes prevention program (mdpp) core session was attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions	1 em core session
G9874	0010	3	Four total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions	4 em core sessions
G9875	0010	3	Nine total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an mdpp supplier during months 1 through 6 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for core sessions	9 em core sessions
G9876	0010	3	Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 7-9 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary did not achieve at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9	2 em core ms mo 7-9 no wl
G9877	0010	3	Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 10-12 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary did not achieve at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 10-12	2 em core ms mo 10-12 no wl
G9878	0010	3	Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 7-9 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions.the beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9	2 em core ms mo 7-9 wl
G9879	0010	3	Two medicare diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 10-12 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 7 through 12 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 10-12	2 em core ms mo 10-12 wl
G9880	0010	3	The mdpp beneficiary achieved at least 5% weight loss (wl) from his/her baseline weight in months 1-12 of the mdpp services period under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 5% weight loss from baseline as measured by an in-person weight measurement at a core session or core maintenance session	Em 5 percent wl
G9881	0010	3	The mdpp beneficiary achieved at least 9% weight loss (wl) from his/her baseline weight in months 1-24 under the mdpp expanded model (em). this is a one-time payment available when a beneficiary first achieves at least 9% weight loss from baseline as measured by an in-person weight measurement at a core session, core maintenance session, or ongoing maintenance session	Em 9 percent wl
G9882	0010	3	Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 13-15 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 13-15	2 em ongoing ms mo 13-15 wl
G9883	0010	3	Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 16-18 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 16-18	2 em ongoing ms mo 16-18 wl
G9884	0010	3	Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 19-21 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 19-21	2 em ongoing ms mo 19-21 wl
G9885	0010	3	Two medicare diabetes prevention program (mdpp) ongoing maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 22-24 under the mdpp expanded model (em). an ongoing maintenance session is an mdpp service that: (1) is furnished by an mdpp supplier during months 13 through 24 of the mdpp services period; (2) is approximately 1 hour in length; and (3) adheres to a cdc-approved dpp curriculum for maintenance sessions. the beneficiary maintained at least 5% weight loss (wl) from his/her baseline weight, as measured by at least one in-person weight measurement at an ongoing maintenance session in months 22-24	2 em ongoing ms mo 22-24 wl
G9890	0010	3	Bridge payment: a one-time payment for the first medicare diabetes prevention program (mdpp) core session, core maintenance session, or ongoing maintenance session furnished by an mdpp supplier to an mdpp beneficiary during months 1-24 of the mdpp expanded model (em) who has previously received mdpp services from a different mdpp supplier under the mdpp expanded model. a supplier may only receive one bridge payment per mdpp beneficiary	Em bridge payment
G9891	0010	3	Mdpp session reported as a line-item on a claim for a payable mdpp expanded model (em) hcpcs code for a session furnished by the billing supplier under the mdpp expanded model and counting toward achievement of the attendance performance goal for the payable mdpp expanded model hcpcs code (this code is for reporting purposes only)	Em session reporting
G9892	0010	3	Documentation of patient reason(s) for not performing a dilated macular examination	Doc pt rsn no dil mac exam
G9893	0010	3	Dilated macular exam was not performed, reason not otherwise specified	No mac exam
G9894	0010	3	Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate	Adr dep thrpy prescribed
G9895	0010	3	Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g., salvage therapy)	Doc med rsn no adr dep thrpy
G9896	0010	3	Documentation of patient reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate	Doc pt rsn no adr dep thrpy
G9897	0010	3	Patients who were not prescribed/administered androgen deprivation therapy in combination with external beam radiotherapy to the prostate, reason not given	Pt nt prsc adr dep thrpy rng
G9898	0010	3	Patient age 65 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 days during the measurement period	Pt 66+ snp or ltc pos
G9899	0010	3	Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed	Scrn mam perf rslts doc
G9900	0010	3	Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified	Scrn mam perf rslts not doc
G9901	0010	3	Patient age 65 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 days during the measurement period	Pt 66+ snp or ltc pos
G9902	0010	3	Patient screened for tobacco use and identified as a tobacco user	Pt scrn tbco and id as user
G9903	0010	3	Patient screened for tobacco use and identified as a tobacco non-user	Pt scrn tbco id as non user
G9904	0010	3	Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason)	Doc med rsn no tbco scrn
G9905	0010	3	Patient not screened for tobacco use, reason not given	No pt tbco scrn rng
G9906	0010	3	Patient identified as a tobacco user received tobacco cessation intervention (counseling and/or pharmacotherapy)	Pt recv tbco cess interv
G9907	0010	3	Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g., limited life expectancy, other medical reason)	Doc med rsn no tbco interv
G9908	0010	3	Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy), reason not given	No pt tbco cess interv rng
G9909	0010	3	Documentation of medical reason(s) for not providing tobacco cessation intervention if identified as a tobacco user (eg, limited life expectancy, other medical reason)	Doc med rsn no tbco interv
G9910	0010	3	Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 days during the measurement period	Pt 66+ snp or ltc pos
G9911	0010	3	Clinically node negative (t1n0m0 or t2n0m0) invasive breast cancer before or after neoadjuvant systemic therapy	Node neg pre/post syst ther
G9912	0010	3	Hepatitis b virus (hbv) status assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy	Hbv status assesed and int
G9913	0010	3	Hepatitis b virus (hbv) status not assessed and results interpreted prior to initiating anti-tnf (tumor necrosis factor) therapy, reason not given	No hbv status assesd and int
G9914	0010	3	Patient receiving an anti-tnf agent	Pt receiving anti-tnf agent
G9915	0010	3	No record of hbv results documented	No documntd hbv results rcd
G9916	0010	3	Functional status performed once in the last 12 months	Funct status past 12 months
G9917	0010	3	Documentation of advanced stage dementia and caregiver knowledge is limited	Adv dem crgvr limited
G9918	0010	3	Functional status not performed, reason not otherwise specified	No funct stat perf, rsn nos
G9919	0010	3	Screening performed and positive and provision of recommendations	Scrn nd pos nd prov of rec
G9920	0010	3	Screening performed and negative	Scrning perf and negative
G9921	0010	3	No screening performed, partial screening performed or positive screen without recommendations and reason is not given or otherwise specified	No or part scrn nd rng or os
G9922	0010	3	Safety concerns screen provided and if positive then documented mitigation recommendations	Sfty cncrns scrn nd mit recs
G9923	0010	3	Safety concerns screen provided and negative	Safty cncrns scrn and neg
G9924	0010	3	Documentation of medical reason(s) for not providing safety concerns screen or for not providing recommendations, orders or referrals for positive screen (e.g., patient in palliative care, other medical reason)	Doc med rsn no scrn or recs
G9925	0010	3	Safety concerns screening not provided, reason not otherwise specified	No scrn prov rsn nos
G9926	0010	3	Safety concerns screening positive screen is without provision of mitigation recommendations, including but not limited to referral to other resources	Sfty cncrns scrn but no recs
G9927	0010	3	Documentation of system reason(s) for not prescribing warfarin or another fda-approved anticoagulation due to patient being currently enrolled in a clinical trial related to af/atrial flutter treatment	Doc no warf /fda pt trial
G9928	0010	3	Warfarin or another fda-approved anticoagulant not prescribed, reason not given	No warf or fda drug presc
G9929	0010	3	Patient with transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery)	Trs/rev af
G9930	0010	3	Patients who are receiving comfort care only	Com care
G9931	0010	3	Documentation of cha2ds2-vasc risk score of 0 or 1	No chad or chad scr 0 or 1
G9932	0010	3	Documentation of patient reason(s) for not having records of negative or managed positive tb screen (e.g., patient does not return for mantoux (ppd) skin test evaluation)	Doc pt rsn no tb scrn recrds
G9933	0010	3	Adenoma(s) or colorectal cancer detected during screening colonoscopy	Canc detectd during col scrn
G9934	0010	3	Documentation that neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma	Doc rsn not detecting cancer
G9935	0010	3	Adenoma(s) or colorectal cancer not detected during screening colonoscopy	Canc not detectd during srcn
G9936	0010	3	Surveillance colonoscopy - personal history of colonic polyps, colon cancer, or other malignant neoplasm of rectum, rectosigmoid junction, and anus	Pmh plyp/neo co/rect/jun/ans
G9937	0010	3	Diagnostic colonoscopy	Dig or surv colsco
G9938	0010	3	Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54, or 56 for more than 90 days during the measurement period	Pt 66+ snp or ltc pos
G9939	0010	3	Pathologists/dermatopathologists is the same clinician who performed the biopsy	Same path/derm perf biopsy
G9940	0010	3	Documentation of medical reason(s) for not on a statin (e.g., pregnancy, in vitro fertilization, clomiphene rx, esrd, cirrhosis, muscular pain and disease during the measurement period or prior year)	Doc reas no statin therapy
G9941	0010	3	Back pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 - 20 weeks) postoperatively	Pre and post vas wthn 3 mos
G9942	0010	3	Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy	Adtl spine proc on same date
G9943	0010	3	Back pain was not measured by the visual analog scale (vas) within three months preoperatively and at three months ( 6 - 20 weeks) postoperatively	Bk pn nt msr vas scl pre/pst
G9944	0010	3	Back pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively	Vas 3 mon pre and 1 yr post
G9945	0010	3	Patient had cancer, fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis	Pt w/cancer scoliosis
G9946	0010	3	Back pain was not measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively	Bk pain no vas
G9947	0010	3	Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at three months (6 to 20 weeks) postoperatively	Pre and post vas wthn 3 mos
G9948	0010	3	Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminectomy	Adtl spine proc on same date
G9949	0010	3	Leg pain was not measured by the visual analog scale (vas) at three months (6 ? 20 weeks) postoperatively	Leg pain no vas
G9954	0010	3	Patient exhibits 2 or more risk factors for post-operative vomiting	Pt >2 rsk fac post-op vomit
G9955	0010	3	Cases in which an inhalational anesthetic is used only for induction	Inhlnt anesth only for induc
G9956	0010	3	Patient received combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively	Combo thrpy of >= 2 prophly
G9957	0010	3	Documentation of medical reason for not receiving combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively (e.g., intolerance or other medical reason)	Doc med rsn no combo thrpy
G9958	0010	3	Patient did not receive combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively	No combo prohpyl thrp for pt
G9959	0010	3	Systemic antimicrobials not prescribed	Systemic antimicro not presc
G9960	0010	3	Documentation of medical reason(s) for prescribing systemic antimicrobials	Med rsn sys antimi nt rx
G9961	0010	3	Systemic antimicrobials prescribed	Systemic antimicro presc
G9962	0010	3	Embolization endpoints are documented separately for each embolized vessel and ovarian artery angiography or embolization performed in the presence of variant uterine artery anatomy	Embolization doc separatly
G9963	0010	3	Embolization endpoints are not documented separately for each embolized vessel or ovarian artery angiography or embolization not performed in the presence of variant uterine artery anatomy	Embolization not doc separat
G9964	0010	3	Patient received at least one well-child visit with a pcp during the performance period	Pt recv >=1 well-chld visit
G9965	0010	3	Patient did not receive at least one well-child visit with a pcp during the performance period	No well-chld vist recv by pt
G9966	0010	3	Children who were screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report	Scrn, inter, report child
G9967	0010	3	Children who were not screened for risk of developmental, behavioral and social delays using a standardized tool with interpretation and report	No scrn, inter, reprt child
G9968	0010	3	Patient was referred to another provider or specialist during the performance period	Pt refrd 2 pvdr/spclst in pp
G9969	0010	3	Provider who referred the patient to another provider received a report from the provider to whom the patient was referred	Pvdr rfrd pt rprt rcvd
G9970	0010	3	Provider who referred the patient to another provider did not receive a report from the provider to whom the patient was referred	Pvdr rfrd pt no rprt rcvd
G9974	0010	3	Dilated macular exam performed, including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degeneration severity	Mac exam perf
G9975	0010	3	Documentation of medical reason(s) for not performing a dilated macular examination	Doc med rsn no dil mac exam
G9978	0010	3	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m new pt 10mins
G9979	0010	3	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 20 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m new pt 20mins
G9980	0010	3	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m new pt 30 mins
G9981	0010	3	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 45 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m new pt 45mins
G9982	0010	3	Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 60 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m new pt 60mins
G9983	0010	3	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m est. pt 10mins
G9984	0010	3	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m est. pt 15mins
G9985	0010	3	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m est. pt 25mins
G9986	0010	3	Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology	Remote e/m est. pt 40mins
G9987	0010	3	Bundled payments for care improvement advanced (bpci advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services; for use only for a bpci advanced model episode of care; may not be billed for a 30-day period covered by a transitional care management code	Bpci advanced in home visit

H0001–H2037: Alcohol and Drug Abuse Treatment/Rehabilitative Services

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
H0001	0010	3	Alcohol and/or drug assessment	Alcohol and/or drug assess
H0002	0010	3	Behavioral health screening to determine eligibility for admission to treatment program	Alcohol and/or drug screenin
H0003	0010	3	Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs	Alcohol and/or drug screenin
H0004	0010	3	Behavioral health counseling and therapy, per 15 minutes	Alcohol and/or drug services
H0005	0010	3	Alcohol and/or drug services; group counseling by a clinician	Alcohol and/or drug services
H0006	0010	3	Alcohol and/or drug services; case management	Alcohol and/or drug services
H0007	0010	3	Alcohol and/or drug services; crisis intervention (outpatient)	Alcohol and/or drug services
H0008	0010	3	Alcohol and/or drug services; sub-acute detoxification (hospital inpatient)	Alcohol and/or drug services
H0009	0010	3	Alcohol and/or drug services; acute detoxification (hospital inpatient)	Alcohol and/or drug services
H0010	0010	3	Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient)	Alcohol and/or drug services
H0011	0010	3	Alcohol and/or drug services; acute detoxification (residential addiction program inpatient)	Alcohol and/or drug services
H0012	0010	3	Alcohol and/or drug services; sub-acute detoxification (residential addiction program outpatient)	Alcohol and/or drug services
H0013	0010	3	Alcohol and/or drug services; acute detoxification (residential addiction program outpatient)	Alcohol and/or drug services
H0014	0010	3	Alcohol and/or drug services; ambulatory detoxification	Alcohol and/or drug services
H0015	0010	3	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education	Alcohol and/or drug services
H0016	0010	3	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	Alcohol and/or drug services
H0017	0010	3	Behavioral health; residential (hospital residential treatment program), without room and board, per diem	Alcohol and/or drug services
H0018	0010	3	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	Alcohol and/or drug services
H0019	0010	3	Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	Alcohol and/or drug services
H0020	0010	3	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	Alcohol and/or drug services
H0021	0010	3	Alcohol and/or drug training service (for staff and personnel not employed by providers)	Alcohol and/or drug training
H0022	0010	3	Alcohol and/or drug intervention service (planned facilitation)	Alcohol and/or drug interven
H0023	0010	3	Behavioral health outreach service (planned approach to reach a targeted population)	Alcohol and/or drug outreach
H0024	0010	3	Behavioral health prevention information dissemination service (one-way direct or non-direct contact with service audiences to affect knowledge and attitude)	Alcohol and/or drug preventi
H0025	0010	3	Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)	Alcohol and/or drug preventi
H0026	0010	3	Alcohol and/or drug prevention process service, community-based (delivery of services to develop skills of impactors)	Alcohol and/or drug preventi
H0027	0010	3	Alcohol and/or drug prevention environmental service (broad range of external activities geared toward modifying systems in order to mainstream prevention through policy and law)	Alcohol and/or drug preventi
H0028	0010	3	Alcohol and/or drug prevention problem identification and referral service (e.g., student assistance and employee assistance programs), does not include assessment	Alcohol and/or drug preventi
H0029	0010	3	Alcohol and/or drug prevention alternatives service (services for populations that exclude alcohol and other drug use e.g., alcohol free social events)	Alcohol and/or drug preventi
H0030	0010	3	Behavioral health hotline service	Alcohol and/or drug hotline
H0031	0010	3	Mental health assessment, by non-physician	Mh health assess by non-md
H0032	0010	3	Mental health service plan development by non-physician	Mh svc plan dev by non-md
H0033	0010	3	Oral medication administration, direct observation	Oral med adm direct observe
H0034	0010	3	Medication training and support, per 15 minutes	Med trng & support per 15min
H0035	0010	3	Mental health partial hospitalization, treatment, less than 24 hours	Mh partial hosp tx under 24h
H0036	0010	3	Community psychiatric supportive treatment, face-to-face, per 15 minutes	Comm psy face-face per 15min
H0037	0010	3	Community psychiatric supportive treatment program, per diem	Comm psy sup tx pgm per diem
H0038	0010	3	Self-help/peer services, per 15 minutes	Self-help/peer svc per 15min
H0039	0010	3	Assertive community treatment, face-to-face, per 15 minutes	Asser com tx face-face/15min
H0040	0010	3	Assertive community treatment program, per diem	Assert comm tx pgm per diem
H0041	0010	3	Foster care, child, non-therapeutic, per diem	Fos c chld non-ther per diem
H0042	0010	3	Foster care, child, non-therapeutic, per month	Fos c chld non-ther per mon
H0043	0010	3	Supported housing, per diem	Supported housing, per diem
H0044	0010	3	Supported housing, per month	Supported housing, per month
H0045	0010	3	Respite care services, not in the home, per diem	Respite not-in-home per diem
H0046	0010	3	Mental health services, not otherwise specified	Mental health service, nos
H0047	0010	3	Alcohol and/or other drug abuse services, not otherwise specified	Alcohol/drug abuse svc nos
H0048	0010	3	Alcohol and/or other drug testing: collection and handling only, specimens other than blood	Spec coll non-blood:a/d test
H0049	0010	3	Alcohol and/or drug screening	Alcohol/drug screening
H0050	0010	3	Alcohol and/or drug services, brief intervention, per 15 minutes	Alcohol/drug service 15 min
H1000	0010	3	Prenatal care, at-risk assessment	Prenatal care atrisk assessm
H1001	0010	3	Prenatal care, at-risk enhanced service; antepartum management	Antepartum management
H1002	0010	3	Prenatal care, at risk enhanced service; care coordination	Carecoordination prenatal
H1003	0010	3	Prenatal care, at-risk enhanced service; education	Prenatal at risk education
H1004	0010	3	Prenatal care, at-risk enhanced service; follow-up home visit	Follow up home visit/prental
H1005	0010	3	Prenatal care, at-risk enhanced service package (includes h1001-h1004)	Prenatalcare enhanced srv pk
H1010	0010	3	Non-medical family planning education, per session	Nonmed family planning ed
H1011	0010	3	Family assessment by licensed behavioral health professional for state defined purposes	Family assessment
H2000	0010	3	Comprehensive multidisciplinary evaluation	Comp multidisipln evaluation
H2001	0010	3	Rehabilitation program, per 1/2 day	Rehabilitation program 1/2 d
H2010	0010	3	Comprehensive medication services, per 15 minutes	Comprehensive med svc 15 min
H2011	0010	3	Crisis intervention service, per 15 minutes	Crisis interven svc, 15 min
H2012	0010	3	Behavioral health day treatment, per hour	Behav hlth day treat, per hr
H2013	0010	3	Psychiatric health facility service, per diem	Psych hlth fac svc, per diem
H2014	0010	3	Skills training and development, per 15 minutes	Skills train and dev, 15 min
H2015	0010	3	Comprehensive community support services, per 15 minutes	Comp comm supp svc, 15 min
H2016	0010	3	Comprehensive community support services, per diem	Comp comm supp svc, per diem
H2017	0010	3	Psychosocial rehabilitation services, per 15 minutes	Psysoc rehab svc, per 15 min
H2018	0010	3	Psychosocial rehabilitation services, per diem	Psysoc rehab svc, per diem
H2019	0010	3	Therapeutic behavioral services, per 15 minutes	Ther behav svc, per 15 min
H2020	0010	3	Therapeutic behavioral services, per diem	Ther behav svc, per diem
H2021	0010	3	Community-based wrap-around services, per 15 minutes	Com wrap-around sv, 15 min
H2022	0010	3	Community-based wrap-around services, per diem	Com wrap-around sv, per diem
H2023	0010	3	Supported employment, per 15 minutes	Supported employ, per 15 min
H2024	0010	3	Supported employment, per diem	Supported employ, per diem
H2025	0010	3	Ongoing support to maintain employment, per 15 minutes	Supp maint employ, 15 min
H2026	0010	3	Ongoing support to maintain employment, per diem	Supp maint employ, per diem
H2027	0010	3	Psychoeducational service, per 15 minutes	Psychoed svc, per 15 min
H2028	0010	3	Sexual offender treatment service, per 15 minutes	Sex offend tx svc, 15 min
H2029	0010	3	Sexual offender treatment service, per diem	Sex offend tx svc, per diem
H2030	0010	3	Mental health clubhouse services, per 15 minutes	Mh clubhouse svc, per 15 min
H2031	0010	3	Mental health clubhouse services, per diem	Mh clubhouse svc, per diem
H2032	0010	3	Activity therapy, per 15 minutes	Activity therapy, per 15 min
H2033	0010	3	Multisystemic therapy for juveniles, per 15 minutes	Multisys ther/juvenile 15min
H2034	0010	3	Alcohol and/or drug abuse halfway house services, per diem	A/d halfway house, per diem
H2035	0010	3	Alcohol and/or other drug treatment program, per hour	A/d tx program, per hour
H2036	0010	3	Alcohol and/or other drug treatment program, per diem	A/d tx program, per diem
H2037	0010	3	Developmental delay prevention activities, dependent child of client, per 15 minutes	Dev delay prev dp ch, 15 min

J0000–J9999: Drugs Administered Other Than Oral Method

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
J0120	0010	3	Injection, tetracycline, up to 250 mg	Tetracyclin injection
J0121	0010	3	Injection, omadacycline, 1 mg	Inj., omadacycline, 1 mg
J0122	0010	3	Injection, eravacycline, 1 mg	Inj., eravacycline, 1 mg
J0129	0010	3	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	Abatacept injection
J0130	0010	3	Injection abciximab, 10 mg	Abciximab injection
J0131	0010	3	Injection, acetaminophen, 10 mg	Acetaminophen injection
J0132	0010	3	Injection, acetylcysteine, 100 mg	Acetylcysteine injection
J0133	0010	3	Injection, acyclovir, 5 mg	Acyclovir injection
J0135	0010	3	Injection, adalimumab, 20 mg	Adalimumab injection
J0150	0010	3	Injection, adenosine for therapeutic use, 6 mg (not to be used to report any adenosine phosphate compounds, instead use a9270)	Injection adenosine 6 mg
J0151	0010	3	Injection, adenosine for diagnostic use, 1 mg (not to be used to report any adenosine phosphate compounds, instead use a9270)	Inj adenosine diag 1mg
J0153	0010	3	Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)	Adenosine inj 1mg
J0171	0010	3	Injection, adrenalin, epinephrine, 0.1 mg	Adrenalin epinephrine inject
J0178	0010	3	Injection, aflibercept, 1 mg	Aflibercept injection
J0179	0010	3	Injection, brolucizumab-dbll, 1 mg	Inj, brolucizumab-dbll, 1 mg
J0180	0010	3	Injection, agalsidase beta, 1 mg	Agalsidase beta injection
J0185	0010	3	Injection, aprepitant, 1 mg	Inj., aprepitant, 1 mg
J0190	0010	3	Injection, biperiden lactate, per 5 mg	Inj biperiden lactate/5 mg
J0200	0010	3	Injection, alatrofloxacin mesylate, 100 mg	Alatrofloxacin mesylate
J0202	0010	3	Injection, alemtuzumab, 1 mg	Injection, alemtuzumab
J0205	0010	3	Injection, alglucerase, per 10 units	Alglucerase injection
J0207	0010	3	Injection, amifostine, 500 mg	Amifostine
J0210	0010	3	Injection, methyldopate hcl, up to 250 mg	Methyldopate hcl injection
J0215	0010	3	Injection, alefacept, 0.5 mg	Alefacept
J0220	0010	3	Injection, alglucosidase alfa, 10 mg, not otherwise specified	Alglucosidase alfa injection
J0221	0010	3	Injection, alglucosidase alfa, (lumizyme), 10 mg	Lumizyme injection
J0222	0010	3	Injection, patisiran, 0.1 mg	Inj., patisiran, 0.1 mg
J0256	0010	3	Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg	Alpha 1 proteinase inhibitor
J0257	0010	3	Injection, alpha 1 proteinase inhibitor (human), (glassia), 10 mg	Glassia injection
J0270	0010	3	Injection, alprostadil, 1.25 mcg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	Alprostadil for injection
J0275	0010	3	Alprostadil urethral suppository (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	Alprostadil urethral suppos
J0278	0010	3	Injection, amikacin sulfate, 100 mg	Amikacin sulfate injection
J0280	0010	3	Injection, aminophyllin, up to 250 mg	Aminophyllin 250 mg inj
J0282	0010	3	Injection, amiodarone hydrochloride, 30 mg	Amiodarone hcl
J0285	0010	3	Injection, amphotericin b, 50 mg	Amphotericin b
J0287	0010	3	Injection, amphotericin b lipid complex, 10 mg	Amphotericin b lipid complex
J0288	0010	3	Injection, amphotericin b cholesteryl sulfate complex, 10 mg	Ampho b cholesteryl sulfate
J0289	0010	3	Injection, amphotericin b liposome, 10 mg	Amphotericin b liposome inj
J0290	0010	3	Injection, ampicillin sodium, 500 mg	Ampicillin 500 mg inj
J0291	0010	3	Injection, plazomicin, 5 mg	Inj., plazomicin, 5 mg
J0295	0010	3	Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm	Ampicillin sulbactam 1.5 gm
J0300	0010	3	Injection, amobarbital, up to 125 mg	Amobarbital 125 mg inj
J0330	0010	3	Injection, succinylcholine chloride, up to 20 mg	Succinycholine chloride inj
J0348	0010	3	Injection, anidulafungin, 1 mg	Anidulafungin injection
J0350	0010	3	Injection, anistreplase, per 30 units	Injection anistreplase 30 u
J0360	0010	3	Injection, hydralazine hcl, up to 20 mg	Hydralazine hcl injection
J0364	0010	3	Injection, apomorphine hydrochloride, 1 mg	Apomorphine hydrochloride
J0365	0010	3	Injection, aprotonin, 10,000 kiu	Aprotonin, 10,000 kiu
J0380	0010	3	Injection, metaraminol bitartrate, per 10 mg	Inj metaraminol bitartrate
J0390	0010	3	Injection, chloroquine hydrochloride, up to 250 mg	Chloroquine injection
J0395	0010	3	Injection, arbutamine hcl, 1 mg	Arbutamine hcl injection
J0400	0010	3	Injection, aripiprazole, intramuscular, 0.25 mg	Aripiprazole injection
J0401	0010	3	Injection, aripiprazole, extended release, 1 mg	Inj aripiprazole ext rel 1mg
J0456	0010	3	Injection, azithromycin, 500 mg	Azithromycin
J0461	0010	3	Injection, atropine sulfate, 0.01 mg	Atropine sulfate injection
J0470	0010	3	Injection, dimercaprol, per 100 mg	Dimecaprol injection
J0475	0010	3	Injection, baclofen, 10 mg	Baclofen 10 mg injection
J0476	0010	3	Injection, baclofen, 50 mcg for intrathecal trial	Baclofen intrathecal trial
J0480	0010	3	Injection, basiliximab, 20 mg	Basiliximab
J0485	0010	3	Injection, belatacept, 1 mg	Belatacept injection
J0490	0010	3	Injection, belimumab, 10 mg	Belimumab injection
J0500	0010	3	Injection, dicyclomine hcl, up to 20 mg	Dicyclomine injection
J0515	0010	3	Injection, benztropine mesylate, per 1 mg	Inj benztropine mesylate
J0517	0010	3	Injection, benralizumab, 1 mg	Inj., benralizumab, 1 mg
J0520	0010	3	Injection, bethanechol chloride, myotonachol or urecholine, up to 5 mg	Bethanechol chloride inject
J0558	0010	3	Injection, penicillin g benzathine and penicillin g procaine, 100,000 units	Peng benzathine/procaine inj
J0561	0010	3	Injection, penicillin g benzathine, 100,000 units	Penicillin g benzathine inj
J0565	0010	3	Injection, bezlotoxumab, 10 mg	Inj, bezlotoxumab, 10 mg
J0567	0010	3	Injection, cerliponase alfa, 1 mg	Inj., cerliponase alfa 1 mg
J0570	0010	3	Buprenorphine implant, 74.2 mg	Buprenorphine implant 74.2mg
J0571	0010	3	Buprenorphine, oral, 1 mg	Buprenorphine oral 1mg
J0572	0010	3	Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine	Bupren/nal up to 3mg bupreno
J0573	0010	3	Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine	Bupren/nal 3.1 to 6mg bupren
J0574	0010	3	Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine	Bupren/nal 6.1 to 10mg bupre
J0575	0010	3	Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine	Bupren/nal over 10mg bupreno
J0583	0010	3	Injection, bivalirudin, 1 mg	Bivalirudin
J0584	0010	3	Injection, burosumab-twza 1 mg	Injection, burosumab-twza 1m
J0585	0010	3	Injection, onabotulinumtoxina, 1 unit	Injection,onabotulinumtoxina
J0586	0010	3	Injection, abobotulinumtoxina, 5 units	Abobotulinumtoxina
J0587	0010	3	Injection, rimabotulinumtoxinb, 100 units	Inj, rimabotulinumtoxinb
J0588	0010	3	Injection, incobotulinumtoxin a, 1 unit	Incobotulinumtoxin a
J0592	0010	3	Injection, buprenorphine hydrochloride, 0.1 mg	Buprenorphine hydrochloride
J0593	0010	3	Injection, lanadelumab-flyo, 1 mg (code may be used for medicare when drug administered under direct supervision of a physician, not for use when drug is self-administered)	Inj., lanadelumab-flyo, 1 mg
J0594	0010	3	injection, busulfan, 1 mg	Busulfan injection
J0595	0010	3	Injection, butorphanol tartrate, 1 mg	Butorphanol tartrate 1 mg
J0596	0010	3	Injection, c1 esterase inhibitor (recombinant), ruconest, 10 units	Injection, ruconest
J0597	0010	3	Injection, c-1 esterase inhibitor (human), berinert, 10 units	C-1 esterase, berinert
J0598	0010	3	Injection, c-1 esterase inhibitor (human), cinryze, 10 units	C-1 esterase, cinryze
J0599	0010	3	Injection, c-1 esterase inhibitor (human), (haegarda), 10 units	Inj., haegarda 10 units
J0600	0010	3	Injection, edetate calcium disodium, up to 1000 mg	Edetate calcium disodium inj
J0604	0010	3	Cinacalcet, oral, 1 mg, (for esrd on dialysis)	Cinacalcet, esrd on dialysis
J0606	0010	3	Injection, etelcalcetide, 0.1 mg	Inj, etelcalcetide, 0.1 mg
J0610	0010	3	Injection, calcium gluconate, per 10 ml	Calcium gluconate injection
J0620	0010	3	Injection, calcium glycerophosphate and calcium lactate, per 10 ml	Calcium glycer & lact/10 ml
J0630	0010	3	Injection, calcitonin salmon, up to 400 units	Calcitonin salmon injection
J0636	0010	3	Injection, calcitriol, 0.1 mcg	Inj calcitriol per 0.1 mcg
J0637	0010	3	Injection, caspofungin acetate, 5 mg	Caspofungin acetate
J0638	0010	3	Injection, canakinumab, 1 mg	Canakinumab injection
J0640	0010	3	Injection, leucovorin calcium, per 50 mg	Leucovorin calcium injection
J0641	0010	3	Injection, levoleucovorin, not otherwise specified, 0.5 mg	Inj levoleucovorin nos 0.5mg
J0642	0010	3	Injection, levoleucovorin (khapzory), 0.5 mg	Injection, khapzory, 0.5 mg
J0670	0010	3	Injection, mepivacaine hydrochloride, per 10 ml	Inj mepivacaine hcl/10 ml
J0690	0010	3	Injection, cefazolin sodium, 500 mg	Cefazolin sodium injection
J0692	0010	3	Injection, cefepime hydrochloride, 500 mg	Cefepime hcl for injection
J0694	0010	3	Injection, cefoxitin sodium, 1 gm	Cefoxitin sodium injection
J0695	0010	3	Injection, ceftolozane 50 mg and tazobactam 25 mg	Inj ceftolozane tazobactam
J0696	0010	3	Injection, ceftriaxone sodium, per 250 mg	Ceftriaxone sodium injection
J0697	0010	3	Injection, sterile cefuroxime sodium, per 750 mg	Sterile cefuroxime injection
J0698	0010	3	Injection, cefotaxime sodium, per gm	Cefotaxime sodium injection
J0702	0010	3	Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	Betamethasone acet&sod phosp
J0706	0010	3	Injection, caffeine citrate, 5 mg	Caffeine citrate injection
J0710	0010	3	Injection, cephapirin sodium, up to 1 gm	Cephapirin sodium injection
J0712	0010	3	Injection, ceftaroline fosamil, 10 mg	Ceftaroline fosamil inj
J0713	0010	3	Injection, ceftazidime, per 500 mg	Inj ceftazidime per 500 mg
J0714	0010	3	Injection, ceftazidime and avibactam, 0.5 g/0.125 g	Ceftazidime and avibactam
J0715	0010	3	Injection, ceftizoxime sodium, per 500 mg	Ceftizoxime sodium / 500 mg
J0716	0010	3	Injection, centruroides immune f(ab)2, up to 120 milligrams	Centruroides immune f(ab)
J0717	0010	3	Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	Certolizumab pegol inj 1mg
J0720	0010	3	Injection, chloramphenicol sodium succinate, up to 1 gm	Chloramphenicol sodium injec
J0725	0010	3	Injection, chorionic gonadotropin, per 1,000 usp units	Chorionic gonadotropin/1000u
J0735	0010	3	Injection, clonidine hydrochloride, 1 mg	Clonidine hydrochloride
J0740	0010	3	Injection, cidofovir, 375 mg	Cidofovir injection
J0743	0010	3	Injection, cilastatin sodium; imipenem, per 250 mg	Cilastatin sodium injection
J0744	0010	3	Injection, ciprofloxacin for intravenous infusion, 200 mg	Ciprofloxacin iv
J0745	0010	3	Injection, codeine phosphate, per 30 mg	Inj codeine phosphate /30 mg
J0760	0010	3	Injection, colchicine, per 1 mg	Colchicine injection
J0770	0010	3	Injection, colistimethate sodium, up to 150 mg	Colistimethate sodium inj
J0775	0010	3	Injection, collagenase, clostridium histolyticum, 0.01 mg	Collagenase, clost hist inj
J0780	0010	3	Injection, prochlorperazine, up to 10 mg	Prochlorperazine injection
J0795	0010	3	Injection, corticorelin ovine triflutate, 1 microgram	Corticorelin ovine triflutal
J0800	0010	3	Injection, corticotropin, up to 40 units	Corticotropin injection
J0833	0010	3	Injection, cosyntropin, not otherwise specified, 0.25 mg	Cosyntropin injection nos
J0834	0010	3	Injection, cosyntropin, 0.25 mg	Inj., cosyntropin, 0.25 mg
J0840	0010	3	Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram	Crotalidae poly immune fab
J0841	0010	3	Injection, crotalidae immune f(ab’)2 (equine), 120 mg	Inj crotalidae im f(ab’)2 eq
J0850	0010	3	Injection, cytomegalovirus immune globulin intravenous (human), per vial	Cytomegalovirus imm iv /vial
J0875	0010	3	Injection, dalbavancin, 5 mg	Injection, dalbavancin
J0878	0010	3	Injection, daptomycin, 1 mg	Daptomycin injection
J0881	0010	3	Injection, darbepoetin alfa, 1 microgram (non-esrd use)	Darbepoetin alfa, non-esrd
J0882	0010	3	Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)	Darbepoetin alfa, esrd use
J0883	0010	3	Injection, argatroban, 1 mg (for non-esrd use)	Argatroban nonesrd use 1mg
J0884	0010	3	Injection, argatroban, 1 mg (for esrd on dialysis)	Argatroban esrd dialysis 1mg
J0885	0010	3	Injection, epoetin alfa, (for non-esrd use), 1000 units	Epoetin alfa, non-esrd
J0886	0010	3	Injection, epoetin alfa, 1000 units (for esrd on dialysis)	Epoetin alfa 1000 units esrd
J0887	0010	3	Injection, epoetin beta, 1 microgram, (for esrd on dialysis)	Epoetin beta esrd use
J0888	0010	3	Injection, epoetin beta, 1 microgram, (for non esrd use)	Epoetin beta non esrd
J0890	0010	3	Injection, peginesatide, 0.1 mg (for esrd on dialysis)	Peginesatide injection
J0894	0010	3	Injection, decitabine, 1 mg	Decitabine injection
J0895	0010	3	Injection, deferoxamine mesylate, 500 mg	Deferoxamine mesylate inj
J0897	0010	3	Injection, denosumab, 1 mg	Denosumab injection
J0900	0010	3	Injection, testosterone enanthate and estradiol valerate, up to 1 cc	Testosterone enanthate inj
J0945	0010	3	Injection, brompheniramine maleate, per 10 mg	Brompheniramine maleate inj
J1000	0010	3	Injection, depo-estradiol cypionate, up to 5 mg	Depo-estradiol cypionate inj
J1020	0010	3	Injection, methylprednisolone acetate, 20 mg	Methylprednisolone 20 mg inj
J1030	0010	3	Injection, methylprednisolone acetate, 40 mg	Methylprednisolone 40 mg inj
J1040	0010	3	Injection, methylprednisolone acetate, 80 mg	Methylprednisolone 80 mg inj
J1050	0010	3	Injection, medroxyprogesterone acetate, 1 mg	Medroxyprogesterone acetate
J1060	0010	3	Injection, testosterone cypionate and estradiol cypionate, up to 1 ml	Testosterone cypionate 1 ml
J1070	0010	3	Injection, testosterone cypionate, up to 100 mg	Testosterone cypionat 100 mg
J1071	0010	3	Injection, testosterone cypionate, 1 mg	Inj testosterone cypionate
J1080	0010	3	Injection, testosterone cypionate, 1 cc, 200 mg	Testosterone cypionat 200 mg
J1094	0010	3	Injection, dexamethasone acetate, 1 mg	Inj dexamethasone acetate
J1095	0010	3	Injection, dexamethasone 9 percent, intraocular, 1 microgram	Injection, dexamethasone 9%
J1096	0010	3	Dexamethasone, lacrimal ophthalmic insert, 0.1 mg	Dexametha opth insert 0.1 mg
J1097	0010	3	Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml	Phenylep ketorolac opth soln
J1100	0010	3	Injection, dexamethasone sodium phosphate, 1 mg	Dexamethasone sodium phos
J1110	0010	3	Injection, dihydroergotamine mesylate, per 1 mg	Inj dihydroergotamine mesylt
J1120	0010	3	Injection, acetazolamide sodium, up to 500 mg	Acetazolamid sodium injectio
J1130	0010	3	Injection, diclofenac sodium, 0.5 mg	Inj diclofenac sodium 0.5mg
J1160	0010	3	Injection, digoxin, up to 0.5 mg	Digoxin injection
J1162	0010	3	Injection, digoxin immune fab (ovine), per vial	Digoxin immune fab (ovine)
J1165	0010	3	Injection, phenytoin sodium, per 50 mg	Phenytoin sodium injection
J1170	0010	3	Injection, hydromorphone, up to 4 mg	Hydromorphone injection
J1180	0010	3	Injection, dyphylline, up to 500 mg	Dyphylline injection
J1190	0010	3	Injection, dexrazoxane hydrochloride, per 250 mg	Dexrazoxane hcl injection
J1200	0010	3	Injection, diphenhydramine hcl, up to 50 mg	Diphenhydramine hcl injectio
J1205	0010	3	Injection, chlorothiazide sodium, per 500 mg	Chlorothiazide sodium inj
J1212	0010	3	Injection, dmso, dimethyl sulfoxide, 50%, 50 ml	Dimethyl sulfoxide 50% 50 ml
J1230	0010	3	Injection, methadone hcl, up to 10 mg	Methadone injection
J1240	0010	3	Injection, dimenhydrinate, up to 50 mg	Dimenhydrinate injection
J1245	0010	3	Injection, dipyridamole, per 10 mg	Dipyridamole injection
J1250	0010	3	Injection, dobutamine hydrochloride, per 250 mg	Inj dobutamine hcl/250 mg
J1260	0010	3	Injection, dolasetron mesylate, 10 mg	Dolasetron mesylate
J1265	0010	3	Injection, dopamine hcl, 40 mg	Dopamine injection
J1267	0010	3	Injection, doripenem, 10 mg	Doripenem injection
J1270	0010	3	Injection, doxercalciferol, 1 mcg	Injection, doxercalciferol
J1290	0010	3	Injection, ecallantide, 1 mg	Ecallantide injection
J1300	0010	3	Injection, eculizumab, 10 mg	Eculizumab injection
J1301	0010	3	Injection, edaravone, 1 mg	Injection, edaravone, 1 mg
J1303	0010	3	Injection, ravulizumab-cwvz, 10 mg	Inj., ravulizumab-cwvz 10 mg
J1320	0010	3	Injection, amitriptyline hcl, up to 20 mg	Amitriptyline injection
J1322	0010	3	Injection, elosulfase alfa, 1 mg	Elosulfase alfa, injection
J1324	0010	3	Injection, enfuvirtide, 1 mg	Enfuvirtide injection
J1325	0010	3	Injection, epoprostenol, 0.5 mg	Epoprostenol injection
J1327	0010	3	Injection, eptifibatide, 5 mg	Eptifibatide injection
J1330	0010	3	Injection, ergonovine maleate, up to 0.2 mg	Ergonovine maleate injection
J1335	0010	3	Injection, ertapenem sodium, 500 mg	Ertapenem injection
J1364	0010	3	Injection, erythromycin lactobionate, per 500 mg	Erythro lactobionate /500 mg
J1380	0010	3	Injection, estradiol valerate, up to 10 mg	Estradiol valerate 10 mg inj
J1410	0010	3	Injection, estrogen conjugated, per 25 mg	Inj estrogen conjugate 25 mg
J1428	0010	3	Injection, eteplirsen, 10 mg	Inj, eteplirsen, 10 mg
J1430	0010	3	Injection, ethanolamine oleate, 100 mg	Ethanolamine oleate 100 mg
J1435	0010	3	Injection, estrone, per 1 mg	Injection estrone per 1 mg
J1436	0010	3	Injection, etidronate disodium, per 300 mg	Etidronate disodium inj
J1438	0010	3	Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	Etanercept injection
J1439	0010	3	Injection, ferric carboxymaltose, 1 mg	Inj ferric carboxymaltos 1mg
J1442	0010	3	Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram	Inj filgrastim excl biosimil
J1443	0010	3	Injection, ferric pyrophosphate citrate solution, 0.1 mg of iron	Inj ferric pyrophosphate cit
J1444	0010	3	Injection, ferric pyrophosphate citrate powder, 0.1 mg of iron	Fe pyro cit pow 0.1 mg iron
J1446	0010	3	Injection, tbo-filgrastim, 5 micrograms	Inj, tbo-filgrastim, 5 mcg
J1447	0010	3	Injection, tbo-filgrastim, 1 microgram	Inj tbo filgrastim 1 microg
J1450	0010	3	Injection fluconazole, 200 mg	Fluconazole
J1451	0010	3	Injection, fomepizole, 15 mg	Fomepizole, 15 mg
J1452	0010	3	Injection, fomivirsen sodium, intraocular, 1.65 mg	Intraocular fomivirsen na
J1453	0010	3	Injection, fosaprepitant, 1 mg	Fosaprepitant injection
J1454	0010	3	Injection, fosnetupitant 235 mg and palonosetron 0.25 mg	Inj fosnetupitant, palonoset
J1455	0010	3	Injection, foscarnet sodium, per 1000 mg	Foscarnet sodium injection
J1457	0010	3	Injection, gallium nitrate, 1 mg	Gallium nitrate injection
J1458	0010	3	Injection, galsulfase, 1 mg	Galsulfase injection
J1459	0010	3	Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg	Inj ivig privigen 500 mg
J1460	0010	3	Injection, gamma globulin, intramuscular, 1 cc	Gamma globulin 1 cc inj
J1555	0010	3	Injection, immune globulin (cuvitru), 100 mg	Inj cuvitru, 100 mg
J1556	0010	3	Injection, immune globulin (bivigam), 500 mg	Inj, imm glob bivigam, 500mg
J1557	0010	3	Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg	Gammaplex injection
J1559	0010	3	Injection, immune globulin (hizentra), 100 mg	Hizentra injection
J1560	0010	3	Injection, gamma globulin, intramuscular, over 10 cc	Gamma globulin > 10 cc inj
J1561	0010	3	Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg	Gamunex-c/gammaked
J1562	0010	3	Injection, immune globulin (vivaglobin), 100 mg	Vivaglobin, inj
J1566	0010	3	Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg	Immune globulin, powder
J1568	0010	3	Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg	Octagam injection
J1569	0010	3	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	Gammagard liquid injection
J1570	0010	3	Injection, ganciclovir sodium, 500 mg	Ganciclovir sodium injection
J1571	0010	3	Injection, hepatitis b immune globulin (hepagam b), intramuscular, 0.5 ml	Hepagam b im injection
J1572	0010	3	Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg	Flebogamma injection
J1573	0010	3	Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml	Hepagam b intravenous, inj
J1575	0010	3	Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin	Hyqvia 100mg immuneglobulin
J1580	0010	3	Injection, garamycin, gentamicin, up to 80 mg	Garamycin gentamicin inj
J1590	0010	3	Injection, gatifloxacin, 10 mg	Gatifloxacin injection
J1595	0010	3	Injection, glatiramer acetate, 20 mg	Injection glatiramer acetate
J1599	0010	3	Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg	Ivig non-lyophilized, nos
J1600	0010	3	Injection, gold sodium thiomalate, up to 50 mg	Gold sodium thiomaleate inj
J1602	0010	3	Injection, golimumab, 1 mg, for intravenous use	Golimumab for iv use 1mg
J1610	0010	3	Injection, glucagon hydrochloride, per 1 mg	Glucagon hydrochloride/1 mg
J1620	0010	3	Injection, gonadorelin hydrochloride, per 100 mcg	Gonadorelin hydroch/ 100 mcg
J1626	0010	3	Injection, granisetron hydrochloride, 100 mcg	Granisetron hcl injection
J1627	0010	3	Injection, granisetron, extended-release, 0.1 mg	Inj, granisetron, xr, 0.1 mg
J1628	0010	3	Injection, guselkumab, 1 mg	Inj., guselkumab, 1 mg
J1630	0010	3	Injection, haloperidol, up to 5 mg	Haloperidol injection
J1631	0010	3	Injection, haloperidol decanoate, per 50 mg	Haloperidol decanoate inj
J1640	0010	3	Injection, hemin, 1 mg	Hemin, 1 mg
J1642	0010	3	Injection, heparin sodium, (heparin lock flush), per 10 units	Inj heparin sodium per 10 u
J1644	0010	3	Injection, heparin sodium, per 1000 units	Inj heparin sodium per 1000u
J1645	0010	3	Injection, dalteparin sodium, per 2500 iu	Dalteparin sodium
J1650	0010	3	Injection, enoxaparin sodium, 10 mg	Inj enoxaparin sodium
J1652	0010	3	Injection, fondaparinux sodium, 0.5 mg	Fondaparinux sodium
J1655	0010	3	Injection, tinzaparin sodium, 1000 iu	Tinzaparin sodium injection
J1670	0010	3	Injection, tetanus immune globulin, human, up to 250 units	Tetanus immune globulin inj
J1675	0010	3	Injection, histrelin acetate, 10 micrograms	Histrelin acetate
J1700	0010	3	Injection, hydrocortisone acetate, up to 25 mg	Hydrocortisone acetate inj
J1710	0010	3	Injection, hydrocortisone sodium phosphate, up to 50 mg	Hydrocortisone sodium ph inj
J1720	0010	3	Injection, hydrocortisone sodium succinate, up to 100 mg	Hydrocortisone sodium succ i
J1725	0010	3	Injection, hydroxyprogesterone caproate, 1 mg	Hydroxyprogesterone caproate
J1726	0010	3	Injection, hydroxyprogesterone caproate, (makena), 10 mg	Makena, 10 mg
J1729	0010	3	Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg	Inj hydroxyprogst capoat nos
J1730	0010	3	Injection, diazoxide, up to 300 mg	Diazoxide injection
J1740	0010	3	Injection, ibandronate sodium, 1 mg	Ibandronate sodium injection
J1741	0010	3	Injection, ibuprofen, 100 mg	Ibuprofen injection
J1742	0010	3	Injection, ibutilide fumarate, 1 mg	Ibutilide fumarate injection
J1743	0010	3	Injection, idursulfase, 1 mg	Idursulfase injection
J1744	0010	3	Injection, icatibant, 1 mg	Icatibant injection
J1745	0010	3	Injection, infliximab, excludes biosimilar, 10 mg	Infliximab not biosimil 10mg
J1746	0010	3	Injection, ibalizumab-uiyk, 10 mg	Inj., ibalizumab-uiyk, 10 mg
J1750	0010	3	Injection, iron dextran, 50 mg	Inj iron dextran
J1756	0010	3	Injection, iron sucrose, 1 mg	Iron sucrose injection
J1786	0010	3	Injection, imiglucerase, 10 units	Imuglucerase injection
J1790	0010	3	Injection, droperidol, up to 5 mg	Droperidol injection
J1800	0010	3	Injection, propranolol hcl, up to 1 mg	Propranolol injection
J1810	0010	3	Injection, droperidol and fentanyl citrate, up to 2 ml ampule	Droperidol/fentanyl inj
J1815	0010	3	Injection, insulin, per 5 units	Insulin injection
J1817	0010	3	Insulin for administration through dme (i.e., insulin pump) per 50 units	Insulin for insulin pump use
J1826	0010	3	Injection, interferon beta-1a, 30 mcg	Interferon beta-1a inj
J1830	0010	3	Injection, interferon beta-1b, 0.25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	Interferon beta-1b / .25 mg
J1833	0010	3	Injection, isavuconazonium, 1 mg	Injection, isavuconazonium
J1835	0010	3	Injection, itraconazole, 50 mg	Itraconazole injection
J1840	0010	3	Injection, kanamycin sulfate, up to 500 mg	Kanamycin sulfate 500 mg inj
J1850	0010	3	Injection, kanamycin sulfate, up to 75 mg	Kanamycin sulfate 75 mg inj
J1885	0010	3	Injection, ketorolac tromethamine, per 15 mg	Ketorolac tromethamine inj
J1890	0010	3	Injection, cephalothin sodium, up to 1 gram	Cephalothin sodium injection
J1930	0010	3	Injection, lanreotide, 1 mg	Lanreotide injection
J1931	0010	3	Injection, laronidase, 0.1 mg	Laronidase injection
J1940	0010	3	Injection, furosemide, up to 20 mg	Furosemide injection
J1942	0010	3	Injection, aripiprazole lauroxil, 1 mg	Aripiprazole lauroxil 1mg
J1943	0010	3	Injection, aripiprazole lauroxil, (aristada initio), 1 mg	Inj., aristada initio, 1 mg
J1944	0010	3	Injection, aripiprazole lauroxil, (aristada), 1 mg	Aripirazole lauroxil 1 mg
J1945	0010	3	Injection, lepirudin, 50 mg	Lepirudin
J1950	0010	3	Injection, leuprolide acetate (for depot suspension), per 3.75 mg	Leuprolide acetate /3.75 mg
J1953	0010	3	Injection, levetiracetam, 10 mg	Levetiracetam injection
J1955	0010	3	Injection, levocarnitine, per 1 gm	Inj levocarnitine per 1 gm
J1956	0010	3	Injection, levofloxacin, 250 mg	Levofloxacin injection
J1960	0010	3	Injection, levorphanol tartrate, up to 2 mg	Levorphanol tartrate inj
J1980	0010	3	Injection, hyoscyamine sulfate, up to 0.25 mg	Hyoscyamine sulfate inj
J1990	0010	3	Injection, chlordiazepoxide hcl, up to 100 mg	Chlordiazepoxide injection
J2001	0010	3	Injection, lidocaine hcl for intravenous infusion, 10 mg	Lidocaine injection
J2010	0010	3	Injection, lincomycin hcl, up to 300 mg	Lincomycin injection
J2020	0010	3	Injection, linezolid, 200 mg	Linezolid injection
J2060	0010	3	Injection, lorazepam, 2 mg	Lorazepam injection
J2062	0010	3	Loxapine for inhalation, 1 mg	Loxapine for inhalation 1 mg
J2150	0010	3	Injection, mannitol, 25% in 50 ml	Mannitol injection
J2170	0010	3	Injection, mecasermin, 1 mg	Mecasermin injection
J2175	0010	3	Injection, meperidine hydrochloride, per 100 mg	Meperidine hydrochl /100 mg
J2180	0010	3	Injection, meperidine and promethazine hcl, up to 50 mg	Meperidine/promethazine inj
J2182	0010	3	Injection, mepolizumab, 1 mg	Injection, mepolizumab, 1mg
J2185	0010	3	Injection, meropenem, 100 mg	Meropenem
J2186	0010	3	Injection, meropenem and vaborbactam, 10mg/10mg (20mg)	Inj., meropenem, vaborbactam
J2210	0010	3	Injection, methylergonovine maleate, up to 0.2 mg	Methylergonovin maleate inj
J2212	0010	3	Injection, methylnaltrexone, 0.1 mg	Methylnaltrexone injection
J2248	0010	3	Injection, micafungin sodium, 1 mg	Micafungin sodium injection
J2250	0010	3	Injection, midazolam hydrochloride, per 1 mg	Inj midazolam hydrochloride
J2260	0010	3	Injection, milrinone lactate, 5 mg	Inj milrinone lactate / 5 mg
J2265	0010	3	Injection, minocycline hydrochloride, 1 mg	Minocycline hydrochloride
J2270	0010	3	Injection, morphine sulfate, up to 10 mg	Morphine sulfate injection
J2271	0010	3	Injection, morphine sulfate, 100mg	Morphine so4 injection 100mg
J2274	0010	3	Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg	Inj morphine pf epid ithc
J2275	0010	3	Injection, morphine sulfate (preservative-free sterile solution), per 10 mg	Morphine sulfate injection
J2278	0010	3	Injection, ziconotide, 1 microgram	Ziconotide injection
J2280	0010	3	Injection, moxifloxacin, 100 mg	Inj, moxifloxacin 100 mg
J2300	0010	3	Injection, nalbuphine hydrochloride, per 10 mg	Inj nalbuphine hydrochloride
J2310	0010	3	Injection, naloxone hydrochloride, per 1 mg	Inj naloxone hydrochloride
J2315	0010	3	Injection, naltrexone, depot form, 1 mg	Naltrexone, depot form
J2320	0010	3	Injection, nandrolone decanoate, up to 50 mg	Nandrolone decanoate 50 mg
J2323	0010	3	Injection, natalizumab, 1 mg	Natalizumab injection
J2325	0010	3	Injection, nesiritide, 0.1 mg	Nesiritide injection
J2326	0010	3	Injection, nusinersen, 0.1 mg	Inj, nusinersen, 0.1mg
J2350	0010	3	Injection, ocrelizumab, 1 mg	Injection, ocrelizumab, 1 mg
J2353	0010	3	Injection, octreotide, depot form for intramuscular injection, 1 mg	Octreotide injection, depot
J2354	0010	3	Injection, octreotide, non-depot form for subcutaneous or intravenous injection, 25 mcg	Octreotide inj, non-depot
J2355	0010	3	Injection, oprelvekin, 5 mg	Oprelvekin injection
J2357	0010	3	Injection, omalizumab, 5 mg	Omalizumab injection
J2358	0010	3	Injection, olanzapine, long-acting, 1 mg	Olanzapine long-acting inj
J2360	0010	3	Injection, orphenadrine citrate, up to 60 mg	Orphenadrine injection
J2370	0010	3	Injection, phenylephrine hcl, up to 1 ml	Phenylephrine hcl injection
J2400	0010	3	Injection, chloroprocaine hydrochloride, per 30 ml	Chloroprocaine hcl injection
J2405	0010	3	Injection, ondansetron hydrochloride, per 1 mg	Ondansetron hcl injection
J2407	0010	3	Injection, oritavancin, 10 mg	Injection, oritavancin
J2410	0010	3	Injection, oxymorphone hcl, up to 1 mg	Oxymorphone hcl injection
J2425	0010	3	Injection, palifermin, 50 micrograms	Palifermin injection
J2426	0010	3	Injection, paliperidone palmitate extended release, 1 mg	Paliperidone palmitate inj
J2430	0010	3	Injection, pamidronate disodium, per 30 mg	Pamidronate disodium /30 mg
J2440	0010	3	Injection, papaverine hcl, up to 60 mg	Papaverin hcl injection
J2460	0010	3	Injection, oxytetracycline hcl, up to 50 mg	Oxytetracycline injection
J2469	0010	3	Injection, palonosetron hcl, 25 mcg	Palonosetron hcl
J2501	0010	3	Injection, paricalcitol, 1 mcg	Paricalcitol
J2502	0010	3	Injection, pasireotide long acting, 1 mg	Inj, pasireotide long acting
J2503	0010	3	Injection, pegaptanib sodium, 0.3 mg	Pegaptanib sodium injection
J2504	0010	3	Injection, pegademase bovine, 25 iu	Pegademase bovine, 25 iu
J2505	0010	3	Injection, pegfilgrastim, 6 mg	Injection, pegfilgrastim 6mg
J2507	0010	3	Injection, pegloticase, 1 mg	Pegloticase injection
J2510	0010	3	Injection, penicillin g procaine, aqueous, up to 600,000 units	Penicillin g procaine inj
J2513	0010	3	Injection, pentastarch, 10% solution, 100 ml	Pentastarch 10% solution
J2515	0010	3	Injection, pentobarbital sodium, per 50 mg	Pentobarbital sodium inj
J2540	0010	3	Injection, penicillin g potassium, up to 600,000 units	Penicillin g potassium inj
J2543	0010	3	Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams)	Piperacillin/tazobactam
J2545	0010	3	Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mg	Pentamidine non-comp unit
J2547	0010	3	Injection, peramivir, 1 mg	Injection, peramivir
J2550	0010	3	Injection, promethazine hcl, up to 50 mg	Promethazine hcl injection
J2560	0010	3	Injection, phenobarbital sodium, up to 120 mg	Phenobarbital sodium inj
J2562	0010	3	Injection, plerixafor, 1 mg	Plerixafor injection
J2590	0010	3	Injection, oxytocin, up to 10 units	Oxytocin injection
J2597	0010	3	Injection, desmopressin acetate, per 1 mcg	Inj desmopressin acetate
J2650	0010	3	Injection, prednisolone acetate, up to 1 ml	Prednisolone acetate inj
J2670	0010	3	Injection, tolazoline hcl, up to 25 mg	Totazoline hcl injection
J2675	0010	3	Injection, progesterone, per 50 mg	Inj progesterone per 50 mg
J2680	0010	3	Injection, fluphenazine decanoate, up to 25 mg	Fluphenazine decanoate 25 mg
J2690	0010	3	Injection, procainamide hcl, up to 1 gm	Procainamide hcl injection
J2700	0010	3	Injection, oxacillin sodium, up to 250 mg	Oxacillin sodium injeciton
J2704	0010	3	Injection, propofol, 10 mg	Inj, propofol, 10 mg
J2710	0010	3	Injection, neostigmine methylsulfate, up to 0.5 mg	Neostigmine methylslfte inj
J2720	0010	3	Injection, protamine sulfate, per 10 mg	Inj protamine sulfate/10 mg
J2724	0010	3	Injection, protein c concentrate, intravenous, human, 10 iu	Protein c concentrate
J2725	0010	3	Injection, protirelin, per 250 mcg	Inj protirelin per 250 mcg
J2730	0010	3	Injection, pralidoxime chloride, up to 1 gm	Pralidoxime chloride inj
J2760	0010	3	Injection, phentolamine mesylate, up to 5 mg	Phentolaine mesylate inj
J2765	0010	3	Injection, metoclopramide hcl, up to 10 mg	Metoclopramide hcl injection
J2770	0010	3	Injection, quinupristin/dalfopristin, 500 mg (150/350)	Quinupristin/dalfopristin
J2778	0010	3	Injection, ranibizumab, 0.1 mg	Ranibizumab injection
J2780	0010	3	Injection, ranitidine hydrochloride, 25 mg	Ranitidine hydrochloride inj
J2783	0010	3	Injection, rasburicase, 0.5 mg	Rasburicase
J2785	0010	3	Injection, regadenoson, 0.1 mg	Regadenoson injection
J2786	0010	3	Injection, reslizumab, 1 mg	Injection, reslizumab, 1mg
J2787	0010	3	Riboflavin 5’-phosphate, ophthalmic solution, up to 3 ml	Riboflavin 5’phos opth<=3ml
J2788	0010	3	Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.)	Rho d immune globulin 50 mcg
J2790	0010	3	Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.)	Rho d immune globulin inj
J2791	0010	3	Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu	Rhophylac injection
J2792	0010	3	Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu	Rho(d) immune globulin h, sd
J2793	0010	3	Injection, rilonacept, 1 mg	Rilonacept injection
J2794	0010	3	Injection, risperidone (risperdal consta), 0.5 mg	Inj risperdal consta, 0.5 mg
J2795	0010	3	Injection, ropivacaine hydrochloride, 1 mg	Ropivacaine hcl injection
J2796	0010	3	Injection, romiplostim, 10 micrograms	Romiplostim injection
J2797	0010	3	Injection, rolapitant, 0.5 mg	Inj., rolapitant, 0.5 mg
J2798	0010	3	Injection, risperidone, (perseris), 0.5 mg	Inj., perseris, 0.5 mg
J2800	0010	3	Injection, methocarbamol, up to 10 ml	Methocarbamol injection
J2805	0010	3	Injection, sincalide, 5 micrograms	Sincalide injection
J2810	0010	3	Injection, theophylline, per 40 mg	Inj theophylline per 40 mg
J2820	0010	3	Injection, sargramostim (gm-csf), 50 mcg	Sargramostim injection
J2840	0010	3	Injection, sebelipase alfa, 1 mg	Inj sebelipase alfa 1 mg
J2850	0010	3	Injection, secretin, synthetic, human, 1 microgram	Inj secretin synthetic human
J2860	0010	3	Injection, siltuximab, 10 mg	Injection, siltuximab
J2910	0010	3	Injection, aurothioglucose, up to 50 mg	Aurothioglucose injeciton
J2916	0010	3	Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg	Na ferric gluconate complex
J2920	0010	3	Injection, methylprednisolone sodium succinate, up to 40 mg	Methylprednisolone injection
J2930	0010	3	Injection, methylprednisolone sodium succinate, up to 125 mg	Methylprednisolone injection
J2940	0010	3	Injection, somatrem, 1 mg	Somatrem injection
J2941	0010	3	Injection, somatropin, 1 mg	Somatropin injection
J2950	0010	3	Injection, promazine hcl, up to 25 mg	Promazine hcl injection
J2993	0010	3	Injection, reteplase, 18.1 mg	Reteplase injection
J2995	0010	3	Injection, streptokinase, per 250,000 iu	Inj streptokinase /250000 iu
J2997	0010	3	Injection, alteplase recombinant, 1 mg	Alteplase recombinant
J3000	0010	3	Injection, streptomycin, up to 1 gm	Streptomycin injection
J3010	0010	3	Injection, fentanyl citrate, 0.1 mg	Fentanyl citrate injection
J3030	0010	3	Injection, sumatriptan succinate, 6 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	Sumatriptan succinate / 6 mg
J3031	0010	3	Injection, fremanezumab-vfrm, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)	Inj., fremanezumab-vfrm 1 mg
J3060	0010	3	Injection, taliglucerase alfa, 10 units	Inj, taliglucerase alfa 10 u
J3070	0010	3	Injection, pentazocine, 30 mg	Pentazocine injection
J3090	0010	3	Injection, tedizolid phosphate, 1 mg	Inj tedizolid phosphate
J3095	0010	3	Injection, telavancin, 10 mg	Telavancin injection
J3101	0010	3	Injection, tenecteplase, 1 mg	Tenecteplase injection
J3105	0010	3	Injection, terbutaline sulfate, up to 1 mg	Terbutaline sulfate inj
J3110	0010	3	Injection, teriparatide, 10 mcg	Teriparatide injection
J3111	0010	3	Injection, romosozumab-aqqg, 1 mg	Inj. romosozumab-aqqg 1 mg
J3120	0010	3	Injection, testosterone enanthate, up to 100 mg	Testosterone enanthate inj
J3121	0010	3	Injection, testosterone enanthate, 1 mg	Inj testostero enanthate 1mg
J3130	0010	3	Injection, testosterone enanthate, up to 200 mg	Testosterone enanthate inj
J3140	0010	3	Injection, testosterone suspension, up to 50 mg	Testosterone suspension inj
J3145	0010	3	Injection, testosterone undecanoate, 1 mg	Testosterone undecanoate 1mg
J3150	0010	3	Injection, testosterone propionate, up to 100 mg	Testosteron propionate inj
J3230	0010	3	Injection, chlorpromazine hcl, up to 50 mg	Chlorpromazine hcl injection
J3240	0010	3	Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial	Thyrotropin injection
J3243	0010	3	Injection, tigecycline, 1 mg	Tigecycline injection
J3245	0010	3	Injection, tildrakizumab, 1 mg	Inj., tildrakizumab, 1 mg
J3246	0010	3	Injection, tirofiban hcl, 0.25 mg	Tirofiban hcl
J3250	0010	3	Injection, trimethobenzamide hcl, up to 200 mg	Trimethobenzamide hcl inj
J3260	0010	3	Injection, tobramycin sulfate, up to 80 mg	Tobramycin sulfate injection
J3262	0010	3	Injection, tocilizumab, 1 mg	Tocilizumab injection
J3265	0010	3	Injection, torsemide, 10 mg/ml	Injection torsemide 10 mg/ml
J3280	0010	3	Injection, thiethylperazine maleate, up to 10 mg	Thiethylperazine maleate inj
J3285	0010	3	Injection, treprostinil, 1 mg	Treprostinil injection
J3300	0010	3	Injection, triamcinolone acetonide, preservative free, 1 mg	Triamcinolone a inj prs-free
J3301	0010	3	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	Triamcinolone acet inj nos
J3302	0010	3	Injection, triamcinolone diacetate, per 5 mg	Triamcinolone diacetate inj
J3303	0010	3	Injection, triamcinolone hexacetonide, per 5 mg	Triamcinolone hexacetonl inj
J3304	0010	3	Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg	Inj triamcinolone ace xr 1mg
J3305	0010	3	Injection, trimetrexate glucuronate, per 25 mg	Inj trimetrexate glucoronate
J3310	0010	3	Injection, perphenazine, up to 5 mg	Perphenazine injeciton
J3315	0010	3	Injection, triptorelin pamoate, 3.75 mg	Triptorelin pamoate
J3316	0010	3	Injection, triptorelin, extended-release, 3.75 mg	Inj., triptorelin xr 3.75 mg
J3320	0010	3	Injection, spectinomycin dihydrochloride, up to 2 gm	Spectinomycn di-hcl inj
J3350	0010	3	Injection, urea, up to 40 gm	Urea injection
J3355	0010	3	Injection, urofollitropin, 75 iu	Urofollitropin, 75 iu
J3357	0010	3	Ustekinumab, for subcutaneous injection, 1 mg	Ustekinumab sub cu inj, 1 mg
J3358	0010	3	Ustekinumab, for intravenous injection, 1 mg	Ustekinumab, iv inject, 1 mg
J3360	0010	3	Injection, diazepam, up to 5 mg	Diazepam injection
J3364	0010	3	Injection, urokinase, 5000 iu vial	Urokinase 5000 iu injection
J3365	0010	3	Injection, iv, urokinase, 250,000 i.u. vial	Urokinase 250,000 iu inj
J3370	0010	3	Injection, vancomycin hcl, 500 mg	Vancomycin hcl injection
J3380	0010	3	Injection, vedolizumab, 1 mg	Injection, vedolizumab
J3385	0010	3	Injection, velaglucerase alfa, 100 units	Velaglucerase alfa
J3396	0010	3	Injection, verteporfin, 0.1 mg	Verteporfin injection
J3397	0010	3	Injection, vestronidase alfa-vjbk, 1 mg	Inj., vestronidase alfa-vjbk
J3398	0010	3	Injection, voretigene neparvovec-rzyl, 1 billion vector genomes	Inj luxturna 1 billion vec g
J3400	0010	3	Injection, triflupromazine hcl, up to 20 mg	Triflupromazine hcl inj
J3410	0010	3	Injection, hydroxyzine hcl, up to 25 mg	Hydroxyzine hcl injection
J3411	0010	3	Injection, thiamine hcl, 100 mg	Thiamine hcl 100 mg
J3415	0010	3	Injection, pyridoxine hcl, 100 mg	Pyridoxine hcl 100 mg
J3420	0010	3	Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	Vitamin b12 injection
J3430	0010	3	Injection, phytonadione (vitamin k), per 1 mg	Vitamin k phytonadione inj
J3465	0010	3	Injection, voriconazole, 10 mg	Injection, voriconazole
J3470	0010	3	Injection, hyaluronidase, up to 150 units	Hyaluronidase injection
J3471	0010	3	Injection, hyaluronidase, ovine, preservative free, per 1 usp unit (up to 999 usp units)	Ovine, up to 999 usp units
J3472	0010	3	Injection, hyaluronidase, ovine, preservative free, per 1000 usp units	Ovine, 1000 usp units
J3473	0010	3	Injection, hyaluronidase, recombinant, 1 usp unit	Hyaluronidase recombinant
J3475	0010	3	Injection, magnesium sulfate, per 500 mg	Inj magnesium sulfate
J3480	0010	3	Injection, potassium chloride, per 2 meq	Inj potassium chloride
J3485	0010	3	Injection, zidovudine, 10 mg	Zidovudine
J3486	0010	3	Injection, ziprasidone mesylate, 10 mg	Ziprasidone mesylate
J3489	0010	3	Injection, zoledronic acid, 1 mg	Zoledronic acid 1mg
J3490	0010	3	Unclassified drugs	Drugs unclassified injection
J3520	0010	3	Edetate disodium, per 150 mg	Edetate disodium per 150 mg
J3530	0010	3	Nasal vaccine inhalation	Nasal vaccine inhalation
J3535	0010	3	Drug administered through a metered dose inhaler	Metered dose inhaler drug
J3570	0010	3	Laetrile, amygdalin, vitamin b17	Laetrile amygdalin vit b17
J3590	0010	3	Unclassified biologics	Unclassified biologics
J3591	0010	3	Unclassified drug or biological used for esrd on dialysis	Esrd on dialysi drug/bio noc
J7030	0010	3	Infusion, normal saline solution , 1000 cc	Normal saline solution infus
J7040	0010	3	Infusion, normal saline solution, sterile (500 ml = 1 unit)	Normal saline solution infus
J7042	0010	3	5% dextrose/normal saline (500 ml = 1 unit)	5% dextrose/normal saline
J7050	0010	3	Infusion, normal saline solution, 250 cc	Normal saline solution infus
J7060	0010	3	5% dextrose/water (500 ml = 1 unit)	5% dextrose/water
J7070	0010	3	Infusion, d5w, 1000 cc	D5w infusion
J7100	0010	3	Infusion, dextran 40, 500 ml	Dextran 40 infusion
J7110	0010	3	Infusion, dextran 75, 500 ml	Dextran 75 infusion
J7120	0010	3	Ringers lactate infusion, up to 1000 cc	Ringers lactate infusion
J7121	0010	3	5% dextrose in lactated ringers infusion, up to 1000 cc	5% dextrose in lac ringers
J7131	0010	3	Hypertonic saline solution, 1 ml	Hypertonic saline sol
J7170	0010	3	Injection, emicizumab-kxwh, 0.5 mg	Inj., emicizumab-kxwh 0.5 mg
J7175	0010	3	Injection, factor x, (human), 1 i.u.	Inj, factor x, (human), 1iu
J7177	0010	3	Injection, human fibrinogen concentrate (fibryga), 1 mg	Inj., fibryga, 1 mg
J7178	0010	3	Injection, human fibrinogen concentrate, not otherwise specified, 1 mg	Inj human fibrinogen con nos
J7179	0010	3	Injection, von willebrand factor (recombinant), (vonvendi), 1 i.u. vwf:rco	Vonvendi inj 1 iu vwf:rco
J7180	0010	3	Injection, factor xiii (antihemophilic factor, human), 1 i.u.	Factor xiii anti-hem factor
J7181	0010	3	Injection, factor xiii a-subunit, (recombinant), per iu	Factor xiii recomb a-subunit
J7182	0010	3	Injection, factor viii, (antihemophilic factor, recombinant), (novoeight), per iu	Factor viii recomb novoeight
J7183	0010	3	Injection, von willebrand factor complex (human), wilate, 1 i.u. vwf:rco	Wilate injection
J7185	0010	3	Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u.	Xyntha inj
J7186	0010	3	Injection, antihemophilic factor viii/von willebrand factor complex (human), per factor viii i.u.	Antihemophilic viii/vwf comp
J7187	0010	3	Injection, von willebrand factor complex (humate-p), per iu vwf:rco	Humate-p, inj
J7188	0010	3	Injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u.	Factor viii recomb obizur
J7189	0010	3	Factor viia (antihemophilic factor, recombinant), per 1 microgram	Factor viia
J7190	0010	3	Factor viii (antihemophilic factor, human) per i.u.	Factor viii
J7191	0010	3	Factor viii (antihemophilic factor (porcine)), per i.u.	Factor viii (porcine)
J7192	0010	3	Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified	Factor viii recombinant nos
J7193	0010	3	Factor ix (antihemophilic factor, purified, non-recombinant) per i.u.	Factor ix non-recombinant
J7194	0010	3	Factor ix, complex, per i.u.	Factor ix complex
J7195	0010	3	Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified	Factor ix recombinant nos
J7196	0010	3	Injection, antithrombin recombinant, 50 i.u.	Antithrombin recombinant
J7197	0010	3	Antithrombin iii (human), per i.u.	Antithrombin iii injection
J7198	0010	3	Anti-inhibitor, per i.u.	Anti-inhibitor
J7199	0010	3	Hemophilia clotting factor, not otherwise classified	Hemophilia clot factor noc
J7200	0010	3	Injection, factor ix, (antihemophilic factor, recombinant), rixubis, per iu	Factor ix recombinan rixubis
J7201	0010	3	Injection, factor ix, fc fusion protein, (recombinant), alprolix, 1 i.u.	Factor ix alprolix recomb
J7202	0010	3	Injection, factor ix, albumin fusion protein, (recombinant), idelvion, 1 i.u.	Factor ix idelvion inj
J7203	0010	3	Injection factor ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 iu	Factor ix recomb gly rebinyn
J7205	0010	3	Injection, factor viii fc fusion protein (recombinant), per iu	Factor viii fc fusion recomb
J7207	0010	3	Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u.	Factor viii pegylated recomb
J7208	0010	3	Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u.	Inj. jivi 1 iu
J7209	0010	3	Injection, factor viii, (antihemophilic factor, recombinant), (nuwiq), 1 i.u.	Factor viii nuwiq recomb 1iu
J7210	0010	3	Injection, factor viii, (antihemophilic factor, recombinant), (afstyla), 1 i.u.	Inj, afstyla, 1 i.u.
J7211	0010	3	Injection, factor viii, (antihemophilic factor, recombinant), (kovaltry), 1 i.u.	Inj, kovaltry, 1 i.u.
J7296	0010	3	Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg	Kyleena, 19.5 mg
J7297	0010	3	Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg	Liletta, 52 mg
J7298	0010	3	Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg	Mirena, 52 mg
J7300	0010	3	Intrauterine copper contraceptive	Intraut copper contraceptive
J7301	0010	3	Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg	Skyla, 13.5 mg
J7302	0010	3	Levonorgestrel-releasing intrauterine contraceptive system, 52 mg	Levonorgestrel iu 52 mg
J7303	0010	3	Contraceptive supply, hormone containing vaginal ring, each	Contraceptive vaginal ring
J7304	0010	3	Contraceptive supply, hormone containing patch, each	Contraceptive hormone patch
J7306	0010	3	Levonorgestrel (contraceptive) implant system, including implants and supplies	Levonorgestrel implant sys
J7307	0010	3	Etonogestrel (contraceptive) implant system, including implant and supplies	Etonogestrel implant system
J7308	0010	3	Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	Aminolevulinic acid hcl top
J7309	0010	3	Methyl aminolevulinate (mal) for topical administration, 16.8%, 1 gram	Methyl aminolevulinate, top
J7310	0010	3	Ganciclovir, 4.5 mg, long-acting implant	Ganciclovir long act implant
J7311	0010	3	Injection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg	Inj., retisert, 0.01 mg
J7312	0010	3	Injection, dexamethasone, intravitreal implant, 0.1 mg	Dexamethasone intra implant
J7313	0010	3	Injection, fluocinolone acetonide, intravitreal implant (iluvien), 0.01 mg	Inj., iluvien, 0.01 mg
J7314	0010	3	Injection, fluocinolone acetonide, intravitreal implant (yutiq), 0.01 mg	Inj., yutiq, 0.01 mg
J7315	0010	3	Mitomycin, ophthalmic, 0.2 mg	Ophthalmic mitomycin
J7316	0010	3	Injection, ocriplasmin, 0.125 mg	Inj, ocriplasmin, 0.125 mg
J7318	0010	3	Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg	Inj, durolane 1 mg
J7320	0010	3	Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg	Genvisc 850, inj, 1mg
J7321	0010	3	Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose	Hyalgan supartz visco-3 dose
J7322	0010	3	Hyaluronan or derivative, hymovis, for intra-articular injection, 1 mg	Hymovis injection 1 mg
J7323	0010	3	Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose	Euflexxa inj per dose
J7324	0010	3	Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose	Orthovisc inj per dose
J7325	0010	3	Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	Synvisc or synvisc-one
J7326	0010	3	Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	Gel-one
J7327	0010	3	Hyaluronan or derivative, monovisc, for intra-articular injection, per dose	Monovisc inj per dose
J7328	0010	3	Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg	Gelsyn-3 injection 0.1 mg
J7329	0010	3	Hyaluronan or derivative, trivisc, for intra-articular injection, 1 mg	Inj, trivisc 1 mg
J7330	0010	3	Autologous cultured chondrocytes, implant	Cultured chondrocytes implnt
J7331	0010	3	Hyaluronan or derivative, synojoynt, for intra-articular injection, 1 mg	Synojoynt, inj., 1 mg
J7332	0010	3	Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg	Inj., triluron, 1 mg
J7335	0010	3	Capsaicin 8% patch, per 10 square centimeters	Capsaicin 8% patch
J7336	0010	3	Capsaicin 8% patch, per square centimeter	Capsaicin 8% patch
J7340	0010	3	Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml	Carbidopa levodopa ent 100ml
J7342	0010	3	Instillation, ciprofloxacin otic suspension, 6 mg	Ciprofloxacin otic susp 6 mg
J7345	0010	3	Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	Aminolevulinic acid, 10% gel
J7401	0010	3	Mometasone furoate sinus implant, 10 micrograms	Mometasone furoate sinus imp
J7500	0010	3	Azathioprine, oral, 50 mg	Azathioprine oral 50mg
J7501	0010	3	Azathioprine, parenteral, 100 mg	Azathioprine parenteral
J7502	0010	3	Cyclosporine, oral, 100 mg	Cyclosporine oral 100 mg
J7503	0010	3	Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg	Tacrol envarsus ex rel oral
J7504	0010	3	Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg	Lymphocyte immune globulin
J7505	0010	3	Muromonab-cd3, parenteral, 5 mg	Monoclonal antibodies
J7506	0010	3	Prednisone, oral, per 5 mg	Prednisone oral
J7507	0010	3	Tacrolimus, immediate release, oral, 1 mg	Tacrolimus imme rel oral 1mg
J7508	0010	3	Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg	Tacrol astagraf ex rel oral
J7509	0010	3	Methylprednisolone oral, per 4 mg	Methylprednisolone oral
J7510	0010	3	Prednisolone oral, per 5 mg	Prednisolone oral per 5 mg
J7511	0010	3	Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg	Antithymocyte globuln rabbit
J7512	0010	3	Prednisone, immediate release or delayed release, oral, 1 mg	Prednisone ir or dr oral 1mg
J7513	0010	3	Daclizumab, parenteral, 25 mg	Daclizumab, parenteral
J7515	0010	3	Cyclosporine, oral, 25 mg	Cyclosporine oral 25 mg
J7516	0010	3	Cyclosporin, parenteral, 250 mg	Cyclosporin parenteral 250mg
J7517	0010	3	Mycophenolate mofetil, oral, 250 mg	Mycophenolate mofetil oral
J7518	0010	3	Mycophenolic acid, oral, 180 mg	Mycophenolic acid
J7520	0010	3	Sirolimus, oral, 1 mg	Sirolimus, oral
J7525	0010	3	Tacrolimus, parenteral, 5 mg	Tacrolimus injection
J7527	0010	3	Everolimus, oral, 0.25 mg	Oral everolimus
J7599	0010	3	Immunosuppressive drug, not otherwise classified	Immunosuppressive drug noc
J7604	0010	3	Acetylcysteine, inhalation solution, compounded product, administered through dme, unit dose form, per gram	Acetylcysteine comp unit
J7605	0010	3	Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms	Arformoterol non-comp unit
J7606	0010	3	Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms	Formoterol fumarate, inh
J7607	0010	3	Levalbuterol, inhalation solution, compounded product, administered through dme, concentrated form, 0.5 mg	Levalbuterol comp con
J7608	0010	3	Acetylcysteine, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per gram	Acetylcysteine non-comp unit
J7609	0010	3	Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg	Albuterol comp unit
J7610	0010	3	Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg	Albuterol comp con
J7611	0010	3	Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg	Albuterol non-comp con
J7612	0010	3	Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 0.5 mg	Levalbuterol non-comp con
J7613	0010	3	Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg	Albuterol non-comp unit
J7614	0010	3	Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg	Levalbuterol non-comp unit
J7615	0010	3	Levalbuterol, inhalation solution, compounded product, administered through dme, unit dose, 0.5 mg	Levalbuterol comp unit
J7620	0010	3	Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme	Albuterol ipratrop non-comp
J7622	0010	3	Beclomethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram	Beclomethasone comp unit
J7624	0010	3	Betamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram	Betamethasone comp unit
J7626	0010	3	Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg	Budesonide non-comp unit
J7627	0010	3	Budesonide, inhalation solution, compounded product, administered through dme, unit dose form, up to 0.5 mg	Budesonide comp unit
J7628	0010	3	Bitolterol mesylate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram	Bitolterol mesylate comp con
J7629	0010	3	Bitolterol mesylate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram	Bitolterol mesylate comp unt
J7631	0010	3	Cromolyn sodium, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams	Cromolyn sodium noncomp unit
J7632	0010	3	Cromolyn sodium, inhalation solution, compounded product, administered through dme, unit dose form, per 10 milligrams	Cromolyn sodium comp unit
J7633	0010	3	Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 0.25 milligram	Budesonide non-comp con
J7634	0010	3	Budesonide, inhalation solution, compounded product, administered through dme, concentrated form, per 0.25 milligram	Budesonide comp con
J7635	0010	3	Atropine, inhalation solution, compounded product, administered through dme, concentrated form, per milligram	Atropine comp con
J7636	0010	3	Atropine, inhalation solution, compounded product, administered through dme, unit dose form, per milligram	Atropine comp unit
J7637	0010	3	Dexamethasone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram	Dexamethasone comp con
J7638	0010	3	Dexamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram	Dexamethasone comp unit
J7639	0010	3	Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram	Dornase alfa non-comp unit
J7640	0010	3	Formoterol, inhalation solution, compounded product, administered through dme, unit dose form, 12 micrograms	Formoterol comp unit
J7641	0010	3	Flunisolide, inhalation solution, compounded product, administered through dme, unit dose, per milligram	Flunisolide comp unit
J7642	0010	3	Glycopyrrolate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram	Glycopyrrolate comp con
J7643	0010	3	Glycopyrrolate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram	Glycopyrrolate comp unit
J7644	0010	3	Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram	Ipratropium bromide non-comp
J7645	0010	3	Ipratropium bromide, inhalation solution, compounded product, administered through dme, unit dose form, per milligram	Ipratropium bromide comp
J7647	0010	3	Isoetharine hcl, inhalation solution, compounded product, administered through dme, concentrated form, per milligram	Isoetharine comp con
J7648	0010	3	Isoetharine hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per milligram	Isoetharine non-comp con
J7649	0010	3	Isoetharine hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram	Isoetharine non-comp unit
J7650	0010	3	Isoetharine hcl, inhalation solution, compounded product, administered through dme, unit dose form, per milligram	Isoetharine comp unit
J7657	0010	3	Isoproterenol hcl, inhalation solution, compounded product, administered through dme, concentrated form, per milligram	Isoproterenol comp con
J7658	0010	3	Isoproterenol hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per milligram	Isoproterenol non-comp con
J7659	0010	3	Isoproterenol hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram	Isoproterenol non-comp unit
J7660	0010	3	Isoproterenol hcl, inhalation solution, compounded product, administered through dme, unit dose form, per milligram	Isoproterenol comp unit
J7665	0010	3	Mannitol, administered through an inhaler, 5 mg	Mannitol for inhaler
J7667	0010	3	Metaproterenol sulfate, inhalation solution, compounded product, concentrated form, per 10 milligrams	Metaproterenol comp con
J7668	0010	3	Metaproterenol sulfate, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 10 milligrams	Metaproterenol non-comp con
J7669	0010	3	Metaproterenol sulfate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams	Metaproterenol non-comp unit
J7670	0010	3	Metaproterenol sulfate, inhalation solution, compounded product, administered through dme, unit dose form, per 10 milligrams	Metaproterenol comp unit
J7674	0010	3	Methacholine chloride administered as inhalation solution through a nebulizer, per 1 mg	Methacholine chloride, neb
J7676	0010	3	Pentamidine isethionate, inhalation solution, compounded product, administered through dme, unit dose form, per 300 mg	Pentamidine comp unit dose
J7677	0010	3	Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram	Revefenacin inh non-com 1mcg
J7680	0010	3	Terbutaline sulfate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram	Terbutaline sulf comp con
J7681	0010	3	Terbutaline sulfate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram	Terbutaline sulf comp unit
J7682	0010	3	Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams	Tobramycin non-comp unit
J7683	0010	3	Triamcinolone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram	Triamcinolone comp con
J7684	0010	3	Triamcinolone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram	Triamcinolone comp unit
J7685	0010	3	Tobramycin, inhalation solution, compounded product, administered through dme, unit dose form, per 300 milligrams	Tobramycin comp unit
J7686	0010	3	Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg	Treprostinil, non-comp unit
J7699	0010	3	Noc drugs, inhalation solution administered through dme	Inhalation solution for dme
J7799	0010	3	Noc drugs, other than inhalation drugs, administered through dme	Non-inhalation drug for dme
J7999	0010	3	Compounded drug, not otherwise classified	Compounded drug, noc
J8498	0010	3	Antiemetic drug, rectal/suppository, not otherwise specified	Antiemetic rectal/supp nos
J8499	0010	3	Prescription drug, oral, non chemotherapeutic, nos	Oral prescrip drug non chemo
J8501	0010	3	Aprepitant, oral, 5 mg	Oral aprepitant
J8510	0010	3	Busulfan; oral, 2 mg	Oral busulfan
J8515	0010	3	Cabergoline, oral, 0.25 mg	Cabergoline, oral 0.25mg
J8520	0010	3	Capecitabine, oral, 150 mg	Capecitabine, oral, 150 mg
J8521	0010	3	Capecitabine, oral, 500 mg	Capecitabine, oral, 500 mg
J8530	0010	3	Cyclophosphamide; oral, 25 mg	Cyclophosphamide oral 25 mg
J8540	0010	3	Dexamethasone, oral, 0.25 mg	Oral dexamethasone
J8560	0010	3	Etoposide; oral, 50 mg	Etoposide oral 50 mg
J8562	0010	3	Fludarabine phosphate, oral, 10 mg	Oral fludarabine phosphate
J8565	0010	3	Gefitinib, oral, 250 mg	Gefitinib oral
J8597	0010	3	Antiemetic drug, oral, not otherwise specified	Antiemetic drug oral nos
J8600	0010	3	Melphalan; oral, 2 mg	Melphalan oral 2 mg
J8610	0010	3	Methotrexate; oral, 2.5 mg	Methotrexate oral 2.5 mg
J8650	0010	3	Nabilone, oral, 1 mg	Nabilone oral
J8655	0010	3	Netupitant 300 mg and palonosetron 0.5 mg, oral	Oral netupitant, palonosetro
J8670	0010	3	Rolapitant, oral, 1 mg	Rolapitant, oral, 1mg
J8700	0010	3	Temozolomide, oral, 5 mg	Temozolomide
J8705	0010	3	Topotecan, oral, 0.25 mg	Topotecan oral
J8999	0010	3	Prescription drug, oral, chemotherapeutic, nos	Oral prescription drug chemo
J9000	0010	3	Injection, doxorubicin hydrochloride, 10 mg	Doxorubicin hcl injection
J9010	0010	3	Injection, alemtuzumab, 10 mg	Alemtuzumab injection
J9015	0010	3	Injection, aldesleukin, per single use vial	Aldesleukin injection
J9017	0010	3	Injection, arsenic trioxide, 1 mg	Arsenic trioxide injection
J9019	0010	3	Injection, asparaginase (erwinaze), 1,000 iu	Erwinaze injection
J9020	0010	3	Injection, asparaginase, not otherwise specified, 10,000 units	Asparaginase, nos
J9022	0010	3	Injection, atezolizumab, 10 mg	Inj, atezolizumab,10 mg
J9023	0010	3	Injection, avelumab, 10 mg	Injection, avelumab, 10 mg
J9025	0010	3	Injection, azacitidine, 1 mg	Azacitidine injection
J9027	0010	3	Injection, clofarabine, 1 mg	Clofarabine injection
J9030	0010	3	Bcg live intravesical instillation, 1 mg	Bcg live intravesical 1mg
J9031	0010	3	Bcg (intravesical) per instillation	Bcg live intravesical vac
J9032	0010	3	Injection, belinostat, 10 mg	Injection, belinostat, 10mg
J9033	0010	3	Injection, bendamustine hcl (treanda), 1 mg	Inj., treanda 1 mg
J9034	0010	3	Injection, bendamustine hcl (bendeka), 1 mg	Inj., bendeka 1 mg
J9035	0010	3	Injection, bevacizumab, 10 mg	Bevacizumab injection
J9036	0010	3	Injection, bendamustine hydrochloride, (belrapzo/bendamustine), 1 mg	Inj. belrapzo/bendamustine
J9039	0010	3	Injection, blinatumomab, 1 microgram	Injection, blinatumomab
J9040	0010	3	Injection, bleomycin sulfate, 15 units	Bleomycin sulfate injection
J9041	0010	3	Injection, bortezomib (velcade), 0.1 mg	Inj., velcade 0.1 mg
J9042	0010	3	Injection, brentuximab vedotin, 1 mg	Brentuximab vedotin inj
J9043	0010	3	Injection, cabazitaxel, 1 mg	Cabazitaxel injection
J9044	0010	3	Injection, bortezomib, not otherwise specified, 0.1 mg	Inj, bortezomib, nos, 0.1 mg
J9045	0010	3	Injection, carboplatin, 50 mg	Carboplatin injection
J9047	0010	3	Injection, carfilzomib, 1 mg	Injection, carfilzomib, 1 mg
J9050	0010	3	Injection, carmustine, 100 mg	Carmustine injection
J9055	0010	3	Injection, cetuximab, 10 mg	Cetuximab injection
J9057	0010	3	Injection, copanlisib, 1 mg	Inj., copanlisib, 1 mg
J9060	0010	3	Injection, cisplatin, powder or solution, 10 mg	Cisplatin 10 mg injection
J9065	0010	3	Injection, cladribine, per 1 mg	Inj cladribine per 1 mg
J9070	0010	3	Cyclophosphamide, 100 mg	Cyclophosphamide 100 mg inj
J9098	0010	3	Injection, cytarabine liposome, 10 mg	Cytarabine liposome inj
J9100	0010	3	Injection, cytarabine, 100 mg	Cytarabine hcl 100 mg inj
J9118	0010	3	Injection, calaspargase pegol-mknl, 10 units	Inj. calaspargase pegol-mknl
J9119	0010	3	Injection, cemiplimab-rwlc, 1 mg	Inj., cemiplimab-rwlc, 1 mg
J9120	0010	3	Injection, dactinomycin, 0.5 mg	Dactinomycin injection
J9130	0010	3	Dacarbazine, 100 mg	Dacarbazine 100 mg inj
J9145	0010	3	Injection, daratumumab, 10 mg	Injection, daratumumab 10 mg
J9150	0010	3	Injection, daunorubicin, 10 mg	Daunorubicin injection
J9151	0010	3	Injection, daunorubicin citrate, liposomal formulation, 10 mg	Daunorubicin citrate inj
J9153	0010	3	Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine	Inj daunorubicin, cytarabine
J9155	0010	3	Injection, degarelix, 1 mg	Degarelix injection
J9160	0010	3	Injection, denileukin diftitox, 300 micrograms	Denileukin diftitox inj
J9165	0010	3	Injection, diethylstilbestrol diphosphate, 250 mg	Diethylstilbestrol injection
J9171	0010	3	Injection, docetaxel, 1 mg	Docetaxel injection
J9173	0010	3	Injection, durvalumab, 10 mg	Inj., durvalumab, 10 mg
J9175	0010	3	Injection, elliotts’ b solution, 1 ml	Elliotts b solution per ml
J9176	0010	3	Injection, elotuzumab, 1 mg	Injection, elotuzumab, 1mg
J9178	0010	3	Injection, epirubicin hcl, 2 mg	Inj, epirubicin hcl, 2 mg
J9179	0010	3	Injection, eribulin mesylate, 0.1 mg	Eribulin mesylate injection
J9181	0010	3	Injection, etoposide, 10 mg	Etoposide injection
J9185	0010	3	Injection, fludarabine phosphate, 50 mg	Fludarabine phosphate inj
J9190	0010	3	Injection, fluorouracil, 500 mg	Fluorouracil injection
J9199	0010	3	Injection, gemcitabine hydrochloride (infugem), 200 mg	Injection, infugem, 200 mg
J9200	0010	3	Injection, floxuridine, 500 mg	Floxuridine injection
J9201	0010	3	Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg	In gemcitabine hcl nos 200mg
J9202	0010	3	Goserelin acetate implant, per 3.6 mg	Goserelin acetate implant
J9203	0010	3	Injection, gemtuzumab ozogamicin, 0.1 mg	Gemtuzumab ozogamicin 0.1 mg
J9204	0010	3	Injection, mogamulizumab-kpkc, 1 mg	Inj mogamulizumab-kpkc, 1 mg
J9205	0010	3	Injection, irinotecan liposome, 1 mg	Inj irinotecan liposome 1 mg
J9206	0010	3	Injection, irinotecan, 20 mg	Irinotecan injection
J9207	0010	3	Injection, ixabepilone, 1 mg	Ixabepilone injection
J9208	0010	3	Injection, ifosfamide, 1 gram	Ifosfamide injection
J9209	0010	3	Injection, mesna, 200 mg	Mesna injection
J9210	0010	3	Injection, emapalumab-lzsg, 1 mg	Inj., emapalumab-lzsg, 1 mg
J9211	0010	3	Injection, idarubicin hydrochloride, 5 mg	Idarubicin hcl injection
J9212	0010	3	Injection, interferon alfacon-1, recombinant, 1 microgram	Interferon alfacon-1 inj
J9213	0010	3	Injection, interferon, alfa-2a, recombinant, 3 million units	Interferon alfa-2a inj
J9214	0010	3	Injection, interferon, alfa-2b, recombinant, 1 million units	Interferon alfa-2b inj
J9215	0010	3	Injection, interferon, alfa-n3, (human leukocyte derived), 250,000 iu	Interferon alfa-n3 inj
J9216	0010	3	Injection, interferon, gamma 1-b, 3 million units	Interferon gamma 1-b inj
J9217	0010	3	Leuprolide acetate (for depot suspension), 7.5 mg	Leuprolide acetate suspnsion
J9218	0010	3	Leuprolide acetate, per 1 mg	Leuprolide acetate injeciton
J9219	0010	3	Leuprolide acetate implant, 65 mg	Leuprolide acetate implant
J9225	0010	3	Histrelin implant (vantas), 50 mg	Vantas implant
J9226	0010	3	Histrelin implant (supprelin la), 50 mg	Supprelin la implant
J9228	0010	3	Injection, ipilimumab, 1 mg	Ipilimumab injection
J9229	0010	3	Injection, inotuzumab ozogamicin, 0.1 mg	Inj inotuzumab ozogam 0.1 mg
J9230	0010	3	Injection, mechlorethamine hydrochloride, (nitrogen mustard), 10 mg	Mechlorethamine hcl inj
J9245	0010	3	Injection, melphalan hydrochloride, 50 mg	Inj melphalan hydrochl 50 mg
J9250	0010	3	Methotrexate sodium, 5 mg	Methotrexate sodium inj
J9260	0010	3	Methotrexate sodium, 50 mg	Methotrexate sodium inj
J9261	0010	3	Injection, nelarabine, 50 mg	Nelarabine injection
J9262	0010	3	Injection, omacetaxine mepesuccinate, 0.01 mg	Inj, omacetaxine mep, 0.01mg
J9263	0010	3	Injection, oxaliplatin, 0.5 mg	Oxaliplatin
J9264	0010	3	Injection, paclitaxel protein-bound particles, 1 mg	Paclitaxel protein bound
J9265	0010	3	Injection, paclitaxel, 30 mg	Paclitaxel injection
J9266	0010	3	Injection, pegaspargase, per single dose vial	Pegaspargase injection
J9267	0010	3	Injection, paclitaxel, 1 mg	Paclitaxel injection
J9268	0010	3	Injection, pentostatin, 10 mg	Pentostatin injection
J9269	0010	3	Injection, tagraxofusp-erzs, 10 micrograms	Inj. tagraxofusp-erzs 10 mcg
J9270	0010	3	Injection, plicamycin, 2.5 mg	Plicamycin (mithramycin) inj
J9271	0010	3	Injection, pembrolizumab, 1 mg	Inj pembrolizumab
J9280	0010	3	Injection, mitomycin, 5 mg	Mitomycin injection
J9285	0010	3	Injection, olaratumab, 10 mg	Inj, olaratumab, 10 mg
J9293	0010	3	Injection, mitoxantrone hydrochloride, per 5 mg	Mitoxantrone hydrochl / 5 mg
J9295	0010	3	Injection, necitumumab, 1 mg	Injection, necitumumab, 1 mg
J9299	0010	3	Injection, nivolumab, 1 mg	Injection, nivolumab
J9300	0010	3	Injection, gemtuzumab ozogamicin, 5 mg	Gemtuzumab ozogamicin inj
J9301	0010	3	Injection, obinutuzumab, 10 mg	Obinutuzumab inj
J9302	0010	3	Injection, ofatumumab, 10 mg	Ofatumumab injection
J9303	0010	3	Injection, panitumumab, 10 mg	Panitumumab injection
J9305	0010	3	Injection, pemetrexed, 10 mg	Pemetrexed injection
J9306	0010	3	Injection, pertuzumab, 1 mg	Injection, pertuzumab, 1 mg
J9307	0010	3	Injection, pralatrexate, 1 mg	Pralatrexate injection
J9308	0010	3	Injection, ramucirumab, 5 mg	Injection, ramucirumab
J9309	0010	3	Injection, polatuzumab vedotin-piiq, 1 mg	Inj, polatuzumab vedotin 1mg
J9310	0010	3	Injection, rituximab, 100 mg	Rituximab injection
J9311	0010	3	Injection, rituximab 10 mg and hyaluronidase	Inj rituximab, hyaluronidase
J9312	0010	3	Injection, rituximab, 10 mg	Inj., rituximab, 10 mg
J9313	0010	3	Injection, moxetumomab pasudotox-tdfk, 0.01 mg	Inj., lumoxiti, 0.01 mg
J9315	0010	3	Injection, romidepsin, 1 mg	Romidepsin injection
J9320	0010	3	Injection, streptozocin, 1 gram	Streptozocin injection
J9325	0010	3	Injection, talimogene laherparepvec, per 1 million plaque forming units	Inj talimogene laherparepvec
J9328	0010	3	Injection, temozolomide, 1 mg	Temozolomide injection
J9330	0010	3	Injection, temsirolimus, 1 mg	Temsirolimus injection
J9340	0010	3	Injection, thiotepa, 15 mg	Thiotepa injection
J9351	0010	3	Injection, topotecan, 0.1 mg	Topotecan injection
J9352	0010	3	Injection, trabectedin, 0.1 mg	Injection trabectedin 0.1mg
J9354	0010	3	Injection, ado-trastuzumab emtansine, 1 mg	Inj, ado-trastuzumab emt 1mg
J9355	0010	3	Injection, trastuzumab, excludes biosimilar, 10 mg	Inj trastuzumab excl biosimi
J9356	0010	3	Injection, trastuzumab, 10 mg and hyaluronidase-oysk	Inj. herceptin hylecta, 10mg
J9357	0010	3	Injection, valrubicin, intravesical, 200 mg	Valrubicin injection
J9360	0010	3	Injection, vinblastine sulfate, 1 mg	Vinblastine sulfate inj
J9370	0010	3	Vincristine sulfate, 1 mg	Vincristine sulfate 1 mg inj
J9371	0010	3	Injection, vincristine sulfate liposome, 1 mg	Inj, vincristine sul lip 1mg
J9390	0010	3	Injection, vinorelbine tartrate, 10 mg	Vinorelbine tartrate inj
J9395	0010	3	Injection, fulvestrant, 25 mg	Injection, fulvestrant
J9400	0010	3	Injection, ziv-aflibercept, 1 mg	Inj, ziv-aflibercept, 1mg
J9600	0010	3	Injection, porfimer sodium, 75 mg	Porfimer sodium injection
J9999	0010	3	Not otherwise classified, antineoplastic drugs	Chemotherapy drug

K0000–K9999: Durable Medical Equipment for Medicare Administrative Contractors

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
K0001	0010	3	Standard wheelchair	Standard wheelchair
K0002	0010	3	Standard hemi (low seat) wheelchair	Stnd hemi (low seat) whlchr
K0003	0010	3	Lightweight wheelchair	Lightweight wheelchair
K0004	0010	3	High strength, lightweight wheelchair	High strength ltwt whlchr
K0005	0010	3	Ultralightweight wheelchair	Ultralightweight wheelchair
K0006	0010	3	Heavy duty wheelchair	Heavy duty wheelchair
K0007	0010	3	Extra heavy duty wheelchair	Extra heavy duty wheelchair
K0008	0010	3	Custom manual wheelchair/base	Cstm manual wheelchair/base
K0009	0010	3	Other manual wheelchair/base	Other manual wheelchair/base
K0010	0010	3	Standard - weight frame motorized/power wheelchair	Stnd wt frame power whlchr
K0011	0010	3	Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking	Stnd wt pwr whlchr w control
K0012	0010	3	Lightweight portable motorized/power wheelchair	Ltwt portbl power whlchr
K0013	0010	3	Custom motorized/power wheelchair base	Custom power whlchr base
K0014	0010	3	Other motorized/power wheelchair base	Other power whlchr base
K0015	0010	3	Detachable, non-adjustable height armrest, replacement only, each	Detach non-adj ht armrst rep
K0017	0010	3	Detachable, adjustable height armrest, base, replacement only, each	Detach adjust armrest base
K0018	0010	3	Detachable, adjustable height armrest, upper portion, replacement only, each	Detach adjust armrst upper
K0019	0010	3	Arm pad, replacement only, each	Arm pad repl, each
K0020	0010	3	Fixed, adjustable height armrest, pair	Fixed adjust armrest pair
K0037	0010	3	High mount flip-up footrest, each	Hi mount flip-up footrest ea
K0038	0010	3	Leg strap, each	Leg strap each
K0039	0010	3	Leg strap, h style, each	Leg strap h style each
K0040	0010	3	Adjustable angle footplate, each	Adjustable angle footplate
K0041	0010	3	Large size footplate, each	Large size footplate each
K0042	0010	3	Standard size footplate, replacement only, each	Standard size ftplate rep ea
K0043	0010	3	Footrest, lower extension tube, replacement only, each	Ftrst lowr exten tube rep ea
K0044	0010	3	Footrest, upper hanger bracket, replacement only, each	Ftrst upr hanger brac rep ea
K0045	0010	3	Footrest, complete assembly, replacement only, each	Ftrst compl assembly repl ea
K0046	0010	3	Elevating legrest, lower extension tube, replacement only, each	Elev lgrst lwr exten repl ea
K0047	0010	3	Elevating legrest, upper hanger bracket, replacement only, each	Elev legrst upr hangr rep ea
K0050	0010	3	Ratchet assembly, replacement only	Ratchet assembly replacement
K0051	0010	3	Cam release assembly, footrest or legrest, replacement only, each	Cam rel asm ft/legrst rep ea
K0052	0010	3	Swingaway, detachable footrests, replacement only, each	Swingaway detach ftrest repl
K0053	0010	3	Elevating footrests, articulating (telescoping), each	Elevate footrest articulate
K0056	0010	3	Seat height less than 17" or equal to or greater than 21" for a high strength, lightweight, or ultralightweight wheelchair	Seat ht <17 or >=21 ltwt wc
K0065	0010	3	Spoke protectors, each	Spoke protectors
K0069	0010	3	Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each	Rr whl compl sol tire rep ea
K0070	0010	3	Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each	Rr whl compl pne tire rep ea
K0071	0010	3	Front caster assembly, complete, with pneumatic tire, replacement only, each	Fr cstr comp pne tire rep ea
K0072	0010	3	Front caster assembly, complete, with semi-pneumatic tire, replacement only, each	Fr cstr semi-pne tire rep ea
K0073	0010	3	Caster pin lock, each	Caster pin lock each
K0077	0010	3	Front caster assembly, complete, with solid tire, replacement only, each	Fr cstr asmb sol tire rep ea
K0098	0010	3	Drive belt for power wheelchair, replacement only	Drive belt for pwc, repl
K0105	0010	3	Iv hanger, each	Iv hanger
K0108	0010	3	Wheelchair component or accessory, not otherwise specified	W/c component-accessory nos
K0195	0010	3	Elevating leg rests, pair (for use with capped rental wheelchair base)	Elevating whlchair leg rests
K0455	0010	3	Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)	Pump uninterrupted infusion
K0462	0010	3	Temporary replacement for patient owned equipment being repaired, any type	Temporary replacement eqpmnt
K0552	0010	3	Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each	Sup/ext non-ins inf pump syr
K0553	0010	3	Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	Ther cgm supply allowance
K0554	0010	3	Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system	Ther cgm receiver/monitor
K0601	0010	3	Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each	Repl batt silver oxide 1.5 v
K0602	0010	3	Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each	Repl batt silver oxide 3 v
K0603	0010	3	Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each	Repl batt alkaline 1.5 v
K0604	0010	3	Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each	Repl batt lithium 3.6 v
K0605	0010	3	Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each	Repl batt lithium 4.5 v
K0606	0010	3	Automatic external defibrillator, with integrated electrocardiogram analysis, garment type	Aed garment w elec analysis
K0607	0010	3	Replacement battery for automated external defibrillator, garment type only, each	Repl batt for aed
K0608	0010	3	Replacement garment for use with automated external defibrillator, each	Repl garment for aed
K0609	0010	3	Replacement electrodes for use with automated external defibrillator, garment type only, each	Repl electrode for aed
K0669	0010	3	Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from dme pdac	Seat/back cus no dmepdac ver
K0672	0010	3	Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each	Removable soft interface le
K0730	0010	3	Controlled dose inhalation drug delivery system	Ctrl dose inh drug deliv sys
K0733	0010	3	Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)	12-24hr sealed lead acid
K0738	0010	3	Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing	Portable gas oxygen system
K0739	0010	3	Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes	Repair/svc dme non-oxygen eq
K0740	0010	3	Repair or nonroutine service for oxygen equipment requiring the skill of a technician, labor component, per 15 minutes	Repair/svc oxygen equipment
K0743	0010	3	Suction pump, home model, portable, for use on wounds	Portable home suction pump
K0744	0010	3	Absorptive wound dressing for use with suction pump, home model, portable, pad size 16 square inches or less	Absorp drg <= 16 suc pump
K0745	0010	3	Absorptive wound dressing for use with suction pump, home model, portable, pad size more than 16 square inches but less than or equal to 48 square inches	Absorp drg >16<=48 suc pump
K0746	0010	3	Absorptive wound dressing for use with suction pump, home model, portable, pad size greater than 48 square inches	Absorp drg >48 suc pump
K0800	0010	3	Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds	Pov group 1 std up to 300lbs
K0801	0010	3	Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds	Pov group 1 hd 301-450 lbs
K0802	0010	3	Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds	Pov group 1 vhd 451-600 lbs
K0806	0010	3	Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds	Pov group 2 std up to 300lbs
K0807	0010	3	Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds	Pov group 2 hd 301-450 lbs
K0808	0010	3	Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds	Pov group 2 vhd 451-600 lbs
K0812	0010	3	Power operated vehicle, not otherwise classified	Power operated vehicle noc
K0813	0010	3	Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds	Pwc gp 1 std port seat/back
K0814	0010	3	Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds	Pwc gp 1 std port cap chair
K0815	0010	3	Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds	Pwc gp 1 std seat/back
K0816	0010	3	Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds	Pwc gp 1 std cap chair
K0820	0010	3	Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds	Pwc gp 2 std port seat/back
K0821	0010	3	Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds	Pwc gp 2 std port cap chair
K0822	0010	3	Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds	Pwc gp 2 std seat/back
K0823	0010	3	Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds	Pwc gp 2 std cap chair
K0824	0010	3	Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds	Pwc gp 2 hd seat/back
K0825	0010	3	Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds	Pwc gp 2 hd cap chair
K0826	0010	3	Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds	Pwc gp 2 vhd seat/back
K0827	0010	3	Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds	Pwc gp vhd cap chair
K0828	0010	3	Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more	Pwc gp 2 xtra hd seat/back
K0829	0010	3	Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more	Pwc gp 2 xtra hd cap chair
K0830	0010	3	Power wheelchair, group 2 standard, seat elevator, sling/solid seat/back, patient weight capacity up to and including 300 pounds	Pwc gp2 std seat elevate s/b
K0831	0010	3	Power wheelchair, group 2 standard, seat elevator, captains chair, patient weight capacity up to and including 300 pounds	Pwc gp2 std seat elevate cap
K0835	0010	3	Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds	Pwc gp2 std sing pow opt s/b
K0836	0010	3	Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds	Pwc gp2 std sing pow opt cap
K0837	0010	3	Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds	Pwc gp 2 hd sing pow opt s/b
K0838	0010	3	Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds	Pwc gp 2 hd sing pow opt cap
K0839	0010	3	Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds	Pwc gp2 vhd sing pow opt s/b
K0840	0010	3	Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more	Pwc gp2 xhd sing pow opt s/b
K0841	0010	3	Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds	Pwc gp2 std mult pow opt s/b
K0842	0010	3	Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds	Pwc gp2 std mult pow opt cap
K0843	0010	3	Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds	Pwc gp2 hd mult pow opt s/b
K0848	0010	3	Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds	Pwc gp 3 std seat/back
K0849	0010	3	Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds	Pwc gp 3 std cap chair
K0850	0010	3	Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds	Pwc gp 3 hd seat/back
K0851	0010	3	Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds	Pwc gp 3 hd cap chair
K0852	0010	3	Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds	Pwc gp 3 vhd seat/back
K0853	0010	3	Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds	Pwc gp 3 vhd cap chair
K0854	0010	3	Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more	Pwc gp 3 xhd seat/back
K0855	0010	3	Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more	Pwc gp 3 xhd cap chair
K0856	0010	3	Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds	Pwc gp3 std sing pow opt s/b
K0857	0010	3	Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds	Pwc gp3 std sing pow opt cap
K0858	0010	3	Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds	Pwc gp3 hd sing pow opt s/b
K0859	0010	3	Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds	Pwc gp3 hd sing pow opt cap
K0860	0010	3	Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds	Pwc gp3 vhd sing pow opt s/b
K0861	0010	3	Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds	Pwc gp3 std mult pow opt s/b
K0862	0010	3	Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds	Pwc gp3 hd mult pow opt s/b
K0863	0010	3	Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds	Pwc gp3 vhd mult pow opt s/b
K0864	0010	3	Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more	Pwc gp3 xhd mult pow opt s/b
K0868	0010	3	Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds	Pwc gp 4 std seat/back
K0869	0010	3	Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds	Pwc gp 4 std cap chair
K0870	0010	3	Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds	Pwc gp 4 hd seat/back
K0871	0010	3	Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds	Pwc gp 4 vhd seat/back
K0877	0010	3	Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds	Pwc gp4 std sing pow opt s/b
K0878	0010	3	Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds	Pwc gp4 std sing pow opt cap
K0879	0010	3	Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds	Pwc gp4 hd sing pow opt s/b
K0880	0010	3	Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight 451 to 600 pounds	Pwc gp4 vhd sing pow opt s/b
K0884	0010	3	Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds	Pwc gp4 std mult pow opt s/b
K0885	0010	3	Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds	Pwc gp4 std mult pow opt cap
K0886	0010	3	Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds	Pwc gp4 hd mult pow s/b
K0890	0010	3	Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds	Pwc gp5 ped sing pow opt s/b
K0891	0010	3	Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds	Pwc gp5 ped mult pow opt s/b
K0898	0010	3	Power wheelchair, not otherwise classified	Power wheelchair noc
K0899	0010	3	Power mobility device, not coded by dme pdac or does not meet criteria	Pow mobil dev no dmepdac
K0900	0010	3	Customized durable medical equipment, other than wheelchair	Cstm dme other than wheelchr
K0901	0010	3	Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf	Ko single upright pre ots
K0902	0010	3	Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf	Ko double upright pre ots
K0903	0010	3	For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient’s foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each	Mult den insert dir carv/cam
K1001	0010	3	Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type	Electronic posa treatment
K1002	0010	3	Cranial electrotherapy stimulation (ces) system, includes all supplies and accessories, any type	Ces system w/supplies access
K1003	0010	3	Whirlpool tub, walk-in, portable	Whirlpool tub walkin portabl
K1004	0010	3	Low frequency ultrasonic diathermy treatment device for home use, includes all components and accessories	Lo freq us diathermy device
K1005	0010	3	Disposable collection and storage bag for breast milk, any size, any type, each	Disp col sto bag breast milk

L0000–L9999: Orthotic and Prosthetic Procedures, Devices

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
L0112	0010	3	Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated	Cranial cervical orthosis
L0113	0010	3	Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment	Cranial cervical torticollis
L0120	0010	3	Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)	Cerv flex n/adj foam pre ots
L0130	0010	3	Cervical, flexible, thermoplastic collar, molded to patient	Flex thermoplastic collar mo
L0140	0010	3	Cervical, semi-rigid, adjustable (plastic collar)	Cervical semi-rigid adjustab
L0150	0010	3	Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)	Cerv semi-rig adj molded chn
L0160	0010	3	Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf	Cerv sr wire occ/man pre ots
L0170	0010	3	Cervical, collar, molded to patient model	Cervical collar molded to pt
L0172	0010	3	Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf	Cerv col sr foam 2pc pre ots
L0174	0010	3	Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf	Cerv sr 2pc thor ext pre ots
L0180	0010	3	Cervical, multiple post collar, occipital/mandibular supports, adjustable	Cer post col occ/man sup adj
L0190	0010	3	Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)	Cerv collar supp adj cerv ba
L0200	0010	3	Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension	Cerv col supp adj bar & thor
L0220	0010	3	Thoracic, rib belt, custom fabricated	Thor rib belt custom fabrica
L0450	0010	3	Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf	Tlso flex trunk/thor pre ots
L0452	0010	3	Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated	Tlso flex custom fab thoraci
L0454	0010	3	Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Tlso trnk sj-t9 pre cst
L0455	0010	3	Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf	Tlso flex trnk sj-t9 pre ots
L0456	0010	3	Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Tlso flex trnk sj-ss pre cst
L0457	0010	3	Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated, off-the-shelf	Tlso flex trnk sj-ss pre ots
L0458	0010	3	Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment	Tlso 2mod symphis-xipho pre
L0460	0010	3	Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Tlso 2 shl symphys-stern cst
L0462	0010	3	Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment	Tlso 3mod sacro-scap pre
L0464	0010	3	Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment	Tlso 4mod sacro-scap pre
L0466	0010	3	Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Tlso r fram soft ant pre cst
L0467	0010	3	Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf	Tlso r fram soft pre ots
L0468	0010	3	Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Tlso rig fram pelvic pre cst
L0469	0010	3	Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf	Tlso rig fram pelvic pre ots
L0470	0010	3	Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restricts gross trunk motion in sagittal, coronal, and transverse planes, provides intracavitary pressure to reduce load on the intervertebral disks, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment	Tlso rigid frame pre subclav
L0472	0010	3	Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment	Tlso rigid frame hyperex pre
L0480	0010	3	Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated	Tlso rigid plastic custom fa
L0482	0010	3	Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated	Tlso rigid lined custom fab
L0484	0010	3	Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated	Tlso rigid plastic cust fab
L0486	0010	3	Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated	Tlso rigidlined cust fab two
L0488	0010	3	Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, prefabricated, includes fitting and adjustment	Tlso rigid lined pre one pie
L0490	0010	3	Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated, includes fitting and adjustment	Tlso rigid plastic pre one
L0491	0010	3	Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment	Tlso 2 piece rigid shell
L0492	0010	3	Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment	Tlso 3 piece rigid shell
L0621	0010	3	Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf	Sio flex pelvic/sacr pre ots
L0622	0010	3	Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated	Sio flex pelvisacral custom
L0623	0010	3	Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf	Sio rig pnl pelv/sac pre ots
L0624	0010	3	Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated	Sio panel custom
L0625	0010	3	Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf	Lo flex l1-below l5 pre ots
L0626	0010	3	Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Lo sag rig pnl stays pre cst
L0627	0010	3	Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Lo sag ri an/pos pnl pre cst
L0628	0010	3	Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf	Lso flex no ri stays pre ots
L0629	0010	3	Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom fabricated	Lso flex w/rigid stays cust
L0630	0010	3	Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Lso r post pnl sj-t9 pre cst
L0631	0010	3	Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Lso sag r an/pos pnl pre cst
L0632	0010	3	Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated	Lso sag rigid frame cust
L0633	0010	3	Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Lso sc r pos/lat pnl pre cst
L0634	0010	3	Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, custom fabricated	Lso flexion control custom
L0635	0010	3	Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, prefabricated, includes fitting and adjustment	Lso sagit rigid panel prefab
L0636	0010	3	Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, custom fabricated	Lso sagittal rigid panel cus
L0637	0010	3	Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Lso sc r ant/pos pnl pre cst
L0638	0010	3	Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated	Lso sag-coronal panel custom
L0639	0010	3	Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Lso s/c shell/panel prefab
L0640	0010	3	Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, custom fabricated	Lso s/c shell/panel custom
L0641	0010	3	Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf	Lo rig pos pnl l1-l5 pre ots
L0642	0010	3	Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf	Lo sag ri an/pos pnl pre ots
L0643	0010	3	Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf	Lso sag ctr rigi pos pre ots
L0648	0010	3	Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf	Lso sag r an/pos pnl pre ots
L0649	0010	3	Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf	Lso sc r pos/lat pnl pre ots
L0650	0010	3	Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf	Lso sc r ant/pos pnl pre ots
L0651	0010	3	Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, off-the-shelf	Lso sag-co shell pnl pre ots
L0700	0010	3	Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)	Ctlso a-p-l control molded
L0710	0010	3	Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)	Ctlso a-p-l control w/ inter
L0810	0010	3	Halo procedure, cervical halo incorporated into jacket vest	Halo cervical into jckt vest
L0820	0010	3	Halo procedure, cervical halo incorporated into plaster body jacket	Halo cervical into body jack
L0830	0010	3	Halo procedure, cervical halo incorporated into milwaukee type orthosis	Halo cerv into milwaukee typ
L0859	0010	3	Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material	Mri compatible system
L0861	0010	3	Addition to halo procedure, replacement liner/interface material	Halo repl liner/interface
L0970	0010	3	Tlso, corset front	Tlso corset front
L0972	0010	3	Lso, corset front	Lso corset front
L0974	0010	3	Tlso, full corset	Tlso full corset
L0976	0010	3	Lso, full corset	Lso full corset
L0978	0010	3	Axillary crutch extension	Axillary crutch extension
L0980	0010	3	Peroneal straps, prefabricated, off-the-shelf, pair	Peroneal straps pair pre ots
L0982	0010	3	Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)	Stocking sup grips 4 pre ots
L0984	0010	3	Protective body sock, prefabricated, off-the-shelf, each	Protect body sock ea pre ots
L0999	0010	3	Addition to spinal orthosis, not otherwise specified	Add to spinal orthosis nos
L1000	0010	3	Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model	Ctlso milwauke initial model
L1001	0010	3	Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment	Ctlso infant immobilizer
L1005	0010	3	Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment	Tension based scoliosis orth
L1010	0010	3	Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling	Ctlso axilla sling
L1020	0010	3	Addition to ctlso or scoliosis orthosis, kyphosis pad	Kyphosis pad
L1025	0010	3	Addition to ctlso or scoliosis orthosis, kyphosis pad, floating	Kyphosis pad floating
L1030	0010	3	Addition to ctlso or scoliosis orthosis, lumbar bolster pad	Lumbar bolster pad
L1040	0010	3	Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad	Lumbar or lumbar rib pad
L1050	0010	3	Addition to ctlso or scoliosis orthosis, sternal pad	Sternal pad
L1060	0010	3	Addition to ctlso or scoliosis orthosis, thoracic pad	Thoracic pad
L1070	0010	3	Addition to ctlso or scoliosis orthosis, trapezius sling	Trapezius sling
L1080	0010	3	Addition to ctlso or scoliosis orthosis, outrigger	Outrigger
L1085	0010	3	Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions	Outrigger bil w/ vert extens
L1090	0010	3	Addition to ctlso or scoliosis orthosis, lumbar sling	Lumbar sling
L1100	0010	3	Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather	Ring flange plastic/leather
L1110	0010	3	Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model	Ring flange plas/leather mol
L1120	0010	3	Addition to ctlso, scoliosis orthosis, cover for upright, each	Covers for upright each
L1200	0010	3	Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only	Furnsh initial orthosis only
L1210	0010	3	Addition to tlso, (low profile), lateral thoracic extension	Lateral thoracic extension
L1220	0010	3	Addition to tlso, (low profile), anterior thoracic extension	Anterior thoracic extension
L1230	0010	3	Addition to tlso, (low profile), milwaukee type superstructure	Milwaukee type superstructur
L1240	0010	3	Addition to tlso, (low profile), lumbar derotation pad	Lumbar derotation pad
L1250	0010	3	Addition to tlso, (low profile), anterior asis pad	Anterior asis pad
L1260	0010	3	Addition to tlso, (low profile), anterior thoracic derotation pad	Anterior thoracic derotation
L1270	0010	3	Addition to tlso, (low profile), abdominal pad	Abdominal pad
L1280	0010	3	Addition to tlso, (low profile), rib gusset (elastic), each	Rib gusset (elastic) each
L1290	0010	3	Addition to tlso, (low profile), lateral trochanteric pad	Lateral trochanteric pad
L1300	0010	3	Other scoliosis procedure, body jacket molded to patient model	Body jacket mold to patient
L1310	0010	3	Other scoliosis procedure, post-operative body jacket	Post-operative body jacket
L1499	0010	3	Spinal orthosis, not otherwise specified	Spinal orthosis nos
L1600	0010	3	Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise	Ho flex frejka w/cov pre cst
L1610	0010	3	Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Ho frejka cov only pre cst
L1620	0010	3	Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Ho flex pavlik harns pre cst
L1630	0010	3	Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated	Abduct control hip semi-flex
L1640	0010	3	Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated	Pelv band/spread bar thigh c
L1650	0010	3	Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment	Ho abduction hip adjustable
L1652	0010	3	Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, any type	Ho bi thighcuffs w sprdr bar
L1660	0010	3	Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment	Ho abduction static plastic
L1680	0010	3	Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated	Pelvic & hip control thigh c
L1685	0010	3	Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated	Post-op hip abduct custom fa
L1686	0010	3	Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment	Ho post-op hip abduction
L1690	0010	3	Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment	Combination bilateral ho
L1700	0010	3	Legg perthes orthosis, (toronto type), custom fabricated	Leg perthes orth toronto typ
L1710	0010	3	Legg perthes orthosis, (newington type), custom fabricated	Legg perthes orth newington
L1720	0010	3	Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated	Legg perthes orthosis trilat
L1730	0010	3	Legg perthes orthosis, (scottish rite type), custom fabricated	Legg perthes orth scottish r
L1755	0010	3	Legg perthes orthosis, (patten bottom type), custom fabricated	Legg perthes patten bottom t
L1810	0010	3	Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Ko elastic with joints
L1812	0010	3	Knee orthosis, elastic with joints, prefabricated, off-the-shelf	Ko elastic w/joints pre ots
L1820	0010	3	Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment	Ko elas w/ condyle pads & jo
L1830	0010	3	Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf	Ko immob canvas long pre ots
L1831	0010	3	Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment	Knee orth pos locking joint
L1832	0010	3	Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Ko adj jnt pos r sup pre cst
L1833	0010	3	Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf	Ko adj jnt pos r sup pre ots
L1834	0010	3	Knee orthosis, without knee joint, rigid, custom fabricated	Ko w/0 joint rigid molded to
L1836	0010	3	Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf	Ko rigid w/o joints pre ots
L1840	0010	3	Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated	Ko derot ant cruciate custom
L1843	0010	3	Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Ko single upright pre cst
L1844	0010	3	Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated	Ko w/adj jt rot cntrl molded
L1845	0010	3	Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Ko double upright pre cst
L1846	0010	3	Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated	Ko w adj flex/ext rotat mold
L1847	0010	3	Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Ko dbl upright w/air pre cst
L1848	0010	3	Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf	Ko dbl upright w/air pre ots
L1850	0010	3	Knee orthosis, swedish type, prefabricated, off-the-shelf	Ko swedish type pre ots
L1851	0010	3	Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf	Ko single upright prefab ots
L1852	0010	3	Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf	Ko double upright prefab ots
L1860	0010	3	Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)	Ko supracondylar socket mold
L1900	0010	3	Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated	Afo sprng wir drsflx calf bd
L1902	0010	3	Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf	Afo ankle gauntlet pre ots
L1904	0010	3	Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated	Afo molded ankle gauntlet
L1906	0010	3	Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf	Afo multilig ank sup pre ots
L1907	0010	3	Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated	Afo supramalleolar custom
L1910	0010	3	Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment	Afo sing bar clasp attach sh
L1920	0010	3	Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated	Afo sing upright w/ adjust s
L1930	0010	3	Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment	Afo plastic
L1932	0010	3	Afo, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, includes fitting and adjustment	Afo rig ant tib prefab tcf/=
L1940	0010	3	Ankle foot orthosis, plastic or other material, custom fabricated	Afo molded to patient plasti
L1945	0010	3	Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated	Afo molded plas rig ant tib
L1950	0010	3	Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated	Afo spiral molded to pt plas
L1951	0010	3	Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, includes fitting and adjustment	Afo spiral prefabricated
L1960	0010	3	Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated	Afo pos solid ank plastic mo
L1970	0010	3	Ankle foot orthosis, plastic with ankle joint, custom fabricated	Afo plastic molded w/ankle j
L1971	0010	3	Ankle foot orthosis, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment	Afo w/ankle joint, prefab
L1980	0010	3	Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar ‘bk’ orthosis), custom fabricated	Afo sing solid stirrup calf
L1990	0010	3	Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar ‘bk’ orthosis), custom fabricated	Afo doub solid stirrup calf
L2000	0010	3	Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ‘ak’ orthosis), custom fabricated	Kafo sing fre stirr thi/calf
L2005	0010	3	Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated	Kafo sng/dbl mechanical act
L2006	0010	3	Knee ankle foot device, any material, single or double upright, swing and/or stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated	Kaf sng/dbl swg/stn mcpr cus
L2010	0010	3	Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ‘ak’ orthosis), without knee joint, custom fabricated	Kafo sng solid stirrup w/o j
L2020	0010	3	Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ‘ak’ orthosis), custom fabricated	Kafo dbl solid stirrup band/
L2030	0010	3	Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ‘ak’ orthosis), without knee joint, custom fabricated	Kafo dbl solid stirrup w/o j
L2034	0010	3	Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated	Kafo pla sin up w/wo k/a cus
L2035	0010	3	Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment	Kafo plastic pediatric size
L2036	0010	3	Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated	Kafo plas doub free knee mol
L2037	0010	3	Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated	Kafo plas sing free knee mol
L2038	0010	3	Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated	Kafo w/o joint multi-axis an
L2040	0010	3	Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated	Hkafo torsion bil rot straps
L2050	0010	3	Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated	Hkafo torsion cable hip pelv
L2060	0010	3	Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated	Hkafo torsion ball bearing j
L2070	0010	3	Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated	Hkafo torsion unilat rot str
L2080	0010	3	Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated	Hkafo unilat torsion cable
L2090	0010	3	Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated	Hkafo unilat torsion ball br
L2106	0010	3	Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated	Afo tib fx cast plaster mold
L2108	0010	3	Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated	Afo tib fx cast molded to pt
L2112	0010	3	Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment	Afo tibial fracture soft
L2114	0010	3	Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment	Afo tib fx semi-rigid
L2116	0010	3	Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment	Afo tibial fracture rigid
L2126	0010	3	Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated	Kafo fem fx cast thermoplas
L2128	0010	3	Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated	Kafo fem fx cast molded to p
L2132	0010	3	Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment	Kafo femoral fx cast soft
L2134	0010	3	Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment	Kafo fem fx cast semi-rigid
L2136	0010	3	Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment	Kafo femoral fx cast rigid
L2180	0010	3	Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints	Plas shoe insert w ank joint
L2182	0010	3	Addition to lower extremity fracture orthosis, drop lock knee joint	Drop lock knee
L2184	0010	3	Addition to lower extremity fracture orthosis, limited motion knee joint	Limited motion knee joint
L2186	0010	3	Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type	Adj motion knee jnt lerman t
L2188	0010	3	Addition to lower extremity fracture orthosis, quadrilateral brim	Quadrilateral brim
L2190	0010	3	Addition to lower extremity fracture orthosis, waist belt	Waist belt
L2192	0010	3	Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt	Pelvic band & belt thigh fla
L2200	0010	3	Addition to lower extremity, limited ankle motion, each joint	Limited ankle motion ea jnt
L2210	0010	3	Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint	Dorsiflexion assist each joi
L2220	0010	3	Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint	Dorsi & plantar flex ass/res
L2230	0010	3	Addition to lower extremity, split flat caliper stirrups and plate attachment	Split flat caliper stirr & p
L2232	0010	3	Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only	Rocker bottom, contact afo
L2240	0010	3	Addition to lower extremity, round caliper and plate attachment	Round caliper and plate atta
L2250	0010	3	Addition to lower extremity, foot plate, molded to patient model, stirrup attachment	Foot plate molded stirrup at
L2260	0010	3	Addition to lower extremity, reinforced solid stirrup (scott-craig type)	Reinforced solid stirrup
L2265	0010	3	Addition to lower extremity, long tongue stirrup	Long tongue stirrup
L2270	0010	3	Addition to lower extremity, varus/valgus correction (‘t’) strap, padded/lined or malleolus pad	Varus/valgus strap padded/li
L2275	0010	3	Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined	Plastic mod low ext pad/line
L2280	0010	3	Addition to lower extremity, molded inner boot	Molded inner boot
L2300	0010	3	Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable	Abduction bar jointed adjust
L2310	0010	3	Addition to lower extremity, abduction bar-straight	Abduction bar-straight
L2320	0010	3	Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only	Non-molded lacer
L2330	0010	3	Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only	Lacer molded to patient mode
L2335	0010	3	Addition to lower extremity, anterior swing band	Anterior swing band
L2340	0010	3	Addition to lower extremity, pre-tibial shell, molded to patient model	Pre-tibial shell molded to p
L2350	0010	3	Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ‘ptb’ ‘afo’ orthoses)	Prosthetic type socket molde
L2360	0010	3	Addition to lower extremity, extended steel shank	Extended steel shank
L2370	0010	3	Addition to lower extremity, patten bottom	Patten bottom
L2375	0010	3	Addition to lower extremity, torsion control, ankle joint and half solid stirrup	Torsion ank & half solid sti
L2380	0010	3	Addition to lower extremity, torsion control, straight knee joint, each joint	Torsion straight knee joint
L2385	0010	3	Addition to lower extremity, straight knee joint, heavy duty, each joint	Straight knee joint heavy du
L2387	0010	3	Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint	Add le poly knee custom kafo
L2390	0010	3	Addition to lower extremity, offset knee joint, each joint	Offset knee joint each
L2395	0010	3	Addition to lower extremity, offset knee joint, heavy duty, each joint	Offset knee joint heavy duty
L2397	0010	3	Addition to lower extremity orthosis, suspension sleeve	Suspension sleeve lower ext
L2405	0010	3	Addition to knee joint, drop lock, each	Knee joint drop lock ea jnt
L2415	0010	3	Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint	Knee joint cam lock each joi
L2425	0010	3	Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint	Knee disc/dial lock/adj flex
L2430	0010	3	Addition to knee joint, ratchet lock for active and progressive knee extension, each joint	Knee jnt ratchet lock ea jnt
L2492	0010	3	Addition to knee joint, lift loop for drop lock ring	Knee lift loop drop lock rin
L2500	0010	3	Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring	Thi/glut/ischia wgt bearing
L2510	0010	3	Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model	Th/wght bear quad-lat brim m
L2520	0010	3	Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted	Th/wght bear quad-lat brim c
L2525	0010	3	Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model	Th/wght bear nar m-l brim mo
L2526	0010	3	Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted	Th/wght bear nar m-l brim cu
L2530	0010	3	Addition to lower extremity, thigh-weight bearing, lacer, non-molded	Thigh/wght bear lacer non-mo
L2540	0010	3	Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model	Thigh/wght bear lacer molded
L2550	0010	3	Addition to lower extremity, thigh/weight bearing, high roll cuff	Thigh/wght bear high roll cu
L2570	0010	3	Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each	Hip clevis type 2 posit jnt
L2580	0010	3	Addition to lower extremity, pelvic control, pelvic sling	Pelvic control pelvic sling
L2600	0010	3	Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each	Hip clevis/thrust bearing fr
L2610	0010	3	Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each	Hip clevis/thrust bearing lo
L2620	0010	3	Addition to lower extremity, pelvic control, hip joint, heavy duty, each	Pelvic control hip heavy dut
L2622	0010	3	Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each	Hip joint adjustable flexion
L2624	0010	3	Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each	Hip adj flex ext abduct cont
L2627	0010	3	Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables	Plastic mold recipro hip & c
L2628	0010	3	Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables	Metal frame recipro hip & ca
L2630	0010	3	Addition to lower extremity, pelvic control, band and belt, unilateral	Pelvic control band & belt u
L2640	0010	3	Addition to lower extremity, pelvic control, band and belt, bilateral	Pelvic control band & belt b
L2650	0010	3	Addition to lower extremity, pelvic and thoracic control, gluteal pad, each	Pelv & thor control gluteal
L2660	0010	3	Addition to lower extremity, thoracic control, thoracic band	Thoracic control thoracic ba
L2670	0010	3	Addition to lower extremity, thoracic control, paraspinal uprights	Thorac cont paraspinal uprig
L2680	0010	3	Addition to lower extremity, thoracic control, lateral support uprights	Thorac cont lat support upri
L2750	0010	3	Addition to lower extremity orthosis, plating chrome or nickel, per bar	Plating chrome/nickel pr bar
L2755	0010	3	Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only	Carbon graphite lamination
L2760	0010	3	Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)	Extension per extension per
L2768	0010	3	Orthotic side bar disconnect device, per bar	Ortho sidebar disconnect
L2780	0010	3	Addition to lower extremity orthosis, non-corrosive finish, per bar	Non-corrosive finish
L2785	0010	3	Addition to lower extremity orthosis, drop lock retainer, each	Drop lock retainer each
L2795	0010	3	Addition to lower extremity orthosis, knee control, full kneecap	Knee control full kneecap
L2800	0010	3	Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only	Knee cap medial or lateral p
L2810	0010	3	Addition to lower extremity orthosis, knee control, condylar pad	Knee control condylar pad
L2820	0010	3	Addition to lower extremity orthosis, soft interface for molded plastic, below knee section	Soft interface below knee se
L2830	0010	3	Addition to lower extremity orthosis, soft interface for molded plastic, above knee section	Soft interface above knee se
L2840	0010	3	Addition to lower extremity orthosis, tibial length sock, fracture or equal, each	Tibial length sock fx or equ
L2850	0010	3	Addition to lower extremity orthosis, femoral length sock, fracture or equal, each	Femoral lgth sock fx or equa
L2861	0010	3	Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each	Torsion mechanism knee/ankle
L2999	0010	3	Lower extremity orthoses, not otherwise specified	Lower extremity orthosis nos
L3000	0010	3	Foot, insert, removable, molded to patient model, ‘ucb’ type, berkeley shell, each	Ft insert ucb berkeley shell
L3001	0010	3	Foot, insert, removable, molded to patient model, spenco, each	Foot insert remov molded spe
L3002	0010	3	Foot, insert, removable, molded to patient model, plastazote or equal, each	Foot insert plastazote or eq
L3003	0010	3	Foot, insert, removable, molded to patient model, silicone gel, each	Foot insert silicone gel eac
L3010	0010	3	Foot, insert, removable, molded to patient model, longitudinal arch support, each	Foot longitudinal arch suppo
L3020	0010	3	Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each	Foot longitud/metatarsal sup
L3030	0010	3	Foot, insert, removable, formed to patient foot, each	Foot arch support remov prem
L3031	0010	3	Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each	Foot lamin/prepreg composite
L3040	0010	3	Foot, arch support, removable, premolded, longitudinal, each	Ft arch suprt premold longit
L3050	0010	3	Foot, arch support, removable, premolded, metatarsal, each	Foot arch supp premold metat
L3060	0010	3	Foot, arch support, removable, premolded, longitudinal/ metatarsal, each	Foot arch supp longitud/meta
L3070	0010	3	Foot, arch support, non-removable attached to shoe, longitudinal, each	Arch suprt att to sho longit
L3080	0010	3	Foot, arch support, non-removable attached to shoe, metatarsal, each	Arch supp att to shoe metata
L3090	0010	3	Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each	Arch supp att to shoe long/m
L3100	0010	3	Hallus-valgus night dynamic splint, prefabricated, off-the-shelf	Hallus-valgus nt dyn pre ots
L3140	0010	3	Foot, abduction rotation bar, including shoes	Abduction rotation bar shoe
L3150	0010	3	Foot, abduction rotation bar, without shoes	Abduct rotation bar w/o shoe
L3160	0010	3	Foot, adjustable shoe-styled positioning device	Shoe styled positioning dev
L3170	0010	3	Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each	Foot plas heel stabi pre ots
L3201	0010	3	Orthopedic shoe, oxford with supinator or pronator, infant	Oxford w supinat/pronat inf
L3202	0010	3	Orthopedic shoe, oxford with supinator or pronator, child	Oxford w/ supinat/pronator c
L3203	0010	3	Orthopedic shoe, oxford with supinator or pronator, junior	Oxford w/ supinator/pronator
L3204	0010	3	Orthopedic shoe, hightop with supinator or pronator, infant	Hightop w/ supp/pronator inf
L3206	0010	3	Orthopedic shoe, hightop with supinator or pronator, child	Hightop w/ supp/pronator chi
L3207	0010	3	Orthopedic shoe, hightop with supinator or pronator, junior	Hightop w/ supp/pronator jun
L3208	0010	3	Surgical boot, each, infant	Surgical boot each infant
L3209	0010	3	Surgical boot, each, child	Surgical boot each child
L3211	0010	3	Surgical boot, each, junior	Surgical boot each junior
L3212	0010	3	Benesch boot, pair, infant	Benesch boot pair infant
L3213	0010	3	Benesch boot, pair, child	Benesch boot pair child
L3214	0010	3	Benesch boot, pair, junior	Benesch boot pair junior
L3215	0010	3	Orthopedic footwear, ladies shoe, oxford, each	Orthopedic ftwear ladies oxf
L3216	0010	3	Orthopedic footwear, ladies shoe, depth inlay, each	Orthoped ladies shoes dpth i
L3217	0010	3	Orthopedic footwear, ladies shoe, hightop, depth inlay, each	Ladies shoes hightop depth i
L3219	0010	3	Orthopedic footwear, mens shoe, oxford, each	Orthopedic mens shoes oxford
L3221	0010	3	Orthopedic footwear, mens shoe, depth inlay, each	Orthopedic mens shoes dpth i
L3222	0010	3	Orthopedic footwear, mens shoe, hightop, depth inlay, each	Mens shoes hightop depth inl
L3224	0010	3	Orthopedic footwear, woman’s shoe, oxford, used as an integral part of a brace (orthosis)	Woman’s shoe oxford brace
L3225	0010	3	Orthopedic footwear, man’s shoe, oxford, used as an integral part of a brace (orthosis)	Man’s shoe oxford brace
L3230	0010	3	Orthopedic footwear, custom shoe, depth inlay, each	Custom shoes depth inlay
L3250	0010	3	Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each	Custom mold shoe remov prost
L3251	0010	3	Foot, shoe molded to patient model, silicone shoe, each	Shoe molded to pt silicone s
L3252	0010	3	Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each	Shoe molded plastazote cust
L3253	0010	3	Foot, molded shoe plastazote (or similar) custom fitted, each	Shoe molded plastazote cust
L3254	0010	3	Non-standard size or width	Orth foot non-stndard size/w
L3255	0010	3	Non-standard size or length	Orth foot non-standard size/
L3257	0010	3	Orthopedic footwear, additional charge for split size	Orth foot add charge split s
L3260	0010	3	Surgical boot/shoe, each	Ambulatory surgical boot eac
L3265	0010	3	Plastazote sandal, each	Plastazote sandal each
L3300	0010	3	Lift, elevation, heel, tapered to metatarsals, per inch	Sho lift taper to metatarsal
L3310	0010	3	Lift, elevation, heel and sole, neoprene, per inch	Shoe lift elev heel/sole neo
L3320	0010	3	Lift, elevation, heel and sole, cork, per inch	Shoe lift elev heel/sole cor
L3330	0010	3	Lift, elevation, metal extension (skate)	Lifts elevation metal extens
L3332	0010	3	Lift, elevation, inside shoe, tapered, up to one-half inch	Shoe lifts tapered to one-ha
L3334	0010	3	Lift, elevation, heel, per inch	Shoe lifts elevation heel /i
L3340	0010	3	Heel wedge, sach	Shoe wedge sach
L3350	0010	3	Heel wedge	Shoe heel wedge
L3360	0010	3	Sole wedge, outside sole	Shoe sole wedge outside sole
L3370	0010	3	Sole wedge, between sole	Shoe sole wedge between sole
L3380	0010	3	Clubfoot wedge	Shoe clubfoot wedge
L3390	0010	3	Outflare wedge	Shoe outflare wedge
L3400	0010	3	Metatarsal bar wedge, rocker	Shoe metatarsal bar wedge ro
L3410	0010	3	Metatarsal bar wedge, between sole	Shoe metatarsal bar between
L3420	0010	3	Full sole and heel wedge, between sole	Full sole/heel wedge btween
L3430	0010	3	Heel, counter, plastic reinforced	Sho heel count plast reinfor
L3440	0010	3	Heel, counter, leather reinforced	Heel leather reinforced
L3450	0010	3	Heel, sach cushion type	Shoe heel sach cushion type
L3455	0010	3	Heel, new leather, standard	Shoe heel new leather standa
L3460	0010	3	Heel, new rubber, standard	Shoe heel new rubber standar
L3465	0010	3	Heel, thomas with wedge	Shoe heel thomas with wedge
L3470	0010	3	Heel, thomas extended to ball	Shoe heel thomas extend to b
L3480	0010	3	Heel, pad and depression for spur	Shoe heel pad & depress for
L3485	0010	3	Heel, pad, removable for spur	Shoe heel pad removable for
L3500	0010	3	Orthopedic shoe addition, insole, leather	Ortho shoe add leather insol
L3510	0010	3	Orthopedic shoe addition, insole, rubber	Orthopedic shoe add rub insl
L3520	0010	3	Orthopedic shoe addition, insole, felt covered with leather	O shoe add felt w leath insl
L3530	0010	3	Orthopedic shoe addition, sole, half	Ortho shoe add half sole
L3540	0010	3	Orthopedic shoe addition, sole, full	Ortho shoe add full sole
L3550	0010	3	Orthopedic shoe addition, toe tap standard	O shoe add standard toe tap
L3560	0010	3	Orthopedic shoe addition, toe tap, horseshoe	O shoe add horseshoe toe tap
L3570	0010	3	Orthopedic shoe addition, special extension to instep (leather with eyelets)	O shoe add instep extension
L3580	0010	3	Orthopedic shoe addition, convert instep to velcro closure	O shoe add instep velcro clo
L3590	0010	3	Orthopedic shoe addition, convert firm shoe counter to soft counter	O shoe convert to sof counte
L3595	0010	3	Orthopedic shoe addition, march bar	Ortho shoe add march bar
L3600	0010	3	Transfer of an orthosis from one shoe to another, caliper plate, existing	Trans shoe calip plate exist
L3610	0010	3	Transfer of an orthosis from one shoe to another, caliper plate, new	Trans shoe caliper plate new
L3620	0010	3	Transfer of an orthosis from one shoe to another, solid stirrup, existing	Trans shoe solid stirrup exi
L3630	0010	3	Transfer of an orthosis from one shoe to another, solid stirrup, new	Trans shoe solid stirrup new
L3640	0010	3	Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes	Shoe dennis browne splint bo
L3649	0010	3	Orthopedic shoe, modification, addition or transfer, not otherwise specified	Orthopedic shoe modifica nos
L3650	0010	3	Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf	So 8 abd restraint pre ots
L3660	0010	3	Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf	So 8 ab rstr can/web pre ots
L3670	0010	3	Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf	So acro/clav can web pre ots
L3671	0010	3	Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment	So cap design w/o jnts cf
L3674	0010	3	Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment	So airplane w/wo joint cf
L3675	0010	3	Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf	So vest canvas/web pre ots
L3677	0010	3	Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	So hard plas stabili pre cst
L3678	0010	3	Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated, off-the-shelf	So hard plas stabili pre ots
L3702	0010	3	Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Eo w/o joints cf
L3710	0010	3	Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf	Eo elas w/metal jnts pre ots
L3720	0010	3	Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated	Forearm/arm cuffs free motio
L3730	0010	3	Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated	Forearm/arm cuffs ext/flex a
L3740	0010	3	Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated	Cuffs adj lock w/ active con
L3760	0010	3	Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Eo adj jt prefab custom fit
L3761	0010	3	Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf	Eo, adj lock joint prefab ot
L3762	0010	3	Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf	Eo rigid w/o joints pre ots
L3763	0010	3	Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Ewho rigid w/o jnts cf
L3764	0010	3	Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Ewho w/joint(s) cf
L3765	0010	3	Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Ewhfo rigid w/o jnts cf
L3766	0010	3	Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Ewhfo w/joint(s) cf
L3806	0010	3	Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment	Whfo w/joint(s) custom fab
L3807	0010	3	Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Whfo w/o joints pre cst
L3808	0010	3	Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment	Whfo, rigid w/o joints
L3809	0010	3	Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type	Whfo w/o joints pre ots
L3891	0010	3	Addition to upper extremity joint, wrist or elbow, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each	Torsion mechanism wrist/elbo
L3900	0010	3	Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated	Hinge extension/flex wrist/f
L3901	0010	3	Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated	Hinge ext/flex wrist finger
L3904	0010	3	Wrist hand finger orthosis, external powered, electric, custom fabricated	Whfo electric custom fitted
L3905	0010	3	Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Who w/nontorsion jnt(s) cf
L3906	0010	3	Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Who w/o joints cf
L3908	0010	3	Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf	Who cock-up nonmolde pre ots
L3912	0010	3	Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf	Hfo flexion glove pre ots
L3913	0010	3	Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Hfo w/o joints cf
L3915	0010	3	Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Who nontorsion jnts pre cst
L3916	0010	3	Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf	Who nontorsion jnts pre ots
L3917	0010	3	Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Metacarp fx orthosis pre cst
L3918	0010	3	Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf	Metacarp fx orthosis pre ots
L3919	0010	3	Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Ho w/o joints cf
L3921	0010	3	Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Hfo w/joint(s) cf
L3923	0010	3	Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Hfo without joints pre cst
L3924	0010	3	Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf	Hfo without joints pre ots
L3925	0010	3	Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf	Fo pip dip jnt/sprng pre ots
L3927	0010	3	Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf	Fo pip dip no jt spr pre ots
L3929	0010	3	Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Hfo nontorsion jnts pre cst
L3930	0010	3	Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf	Hfo nontorsion jnts pre ots
L3931	0010	3	Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment	Whfo nontorsion joint prefab
L3933	0010	3	Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment	Fo w/o joints cf
L3935	0010	3	Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment	Fo nontorsion joint cf
L3956	0010	3	Addition of joint to upper extremity orthosis, any material; per joint	Add joint upper ext orthosis
L3960	0010	3	Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment	Sewho airplan desig abdu pos
L3961	0010	3	Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Sewho cap design w/o jnts cf
L3962	0010	3	Shoulder elbow wrist hand orthosis, abduction positioning, erb’s palsey design, prefabricated, includes fitting and adjustment	Sewho erbs palsey design abd
L3967	0010	3	Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Sewho airplane w/o jnts cf
L3971	0010	3	Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Sewho cap design w/jnt(s) cf
L3973	0010	3	Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Sewho airplane w/jnt(s) cf
L3975	0010	3	Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Sewhfo cap design w/o jnt cf
L3976	0010	3	Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Sewhfo airplane w/o jnts cf
L3977	0010	3	Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Sewhfo cap desgn w/jnt(s) cf
L3978	0010	3	Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment	Sewhfo airplane w/jnt(s) cf
L3980	0010	3	Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment	Up ext fx orthos humeral nos
L3981	0010	3	Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments	Ue fx orth shoul cap forearm
L3982	0010	3	Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment	Upper ext fx orthosis rad/ul
L3984	0010	3	Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment	Upper ext fx orthosis wrist
L3995	0010	3	Addition to upper extremity orthosis, sock, fracture or equal, each	Sock fracture or equal each
L3999	0010	3	Upper limb orthosis, not otherwise specified	Upper limb orthosis nos
L4000	0010	3	Replace girdle for spinal orthosis (ctlso or so)	Repl girdle milwaukee orth
L4002	0010	3	Replacement strap, any orthosis, includes all components, any length, any type	Replace strap, any orthosis
L4010	0010	3	Replace trilateral socket brim	Replace trilateral socket br
L4020	0010	3	Replace quadrilateral socket brim, molded to patient model	Replace quadlat socket brim
L4030	0010	3	Replace quadrilateral socket brim, custom fitted	Replace socket brim cust fit
L4040	0010	3	Replace molded thigh lacer, for custom fabricated orthosis only	Replace molded thigh lacer
L4045	0010	3	Replace non-molded thigh lacer, for custom fabricated orthosis only	Replace non-molded thigh lac
L4050	0010	3	Replace molded calf lacer, for custom fabricated orthosis only	Replace molded calf lacer
L4055	0010	3	Replace non-molded calf lacer, for custom fabricated orthosis only	Replace non-molded calf lace
L4060	0010	3	Replace high roll cuff	Replace high roll cuff
L4070	0010	3	Replace proximal and distal upright for kafo	Replace prox & dist upright
L4080	0010	3	Replace metal bands kafo, proximal thigh	Repl met band kafo-afo prox
L4090	0010	3	Replace metal bands kafo-afo, calf or distal thigh	Repl met band kafo-afo calf/
L4100	0010	3	Replace leather cuff kafo, proximal thigh	Repl leath cuff kafo prox th
L4110	0010	3	Replace leather cuff kafo-afo, calf or distal thigh	Repl leath cuff kafo-afo cal
L4130	0010	3	Replace pretibial shell	Replace pretibial shell
L4205	0010	3	Repair of orthotic device, labor component, per 15 minutes	Ortho dvc repair per 15 min
L4210	0010	3	Repair of orthotic device, repair or replace minor parts	Orth dev repair/repl minor p
L4350	0010	3	Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf	Ankle control ortho pre ots
L4360	0010	3	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Pneumat walking boot pre cst
L4361	0010	3	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	Pneuma/vac walk boot pre ots
L4370	0010	3	Pneumatic full leg splint, prefabricated, off-the-shelf	Pneum full leg splnt pre ots
L4386	0010	3	Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Non-pneum walk boot pre cst
L4387	0010	3	Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf	Non-pneum walk boot pre ots
L4392	0010	3	Replacement, soft interface material, static afo	Replace afo soft interface
L4394	0010	3	Replace soft interface material, foot drop splint	Replace foot drop spint
L4396	0010	3	Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	Static or dynami afo pre cst
L4397	0010	3	Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf	Static or dynami afo pre ots
L4398	0010	3	Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf	Foot drop splint pre ots
L4631	0010	3	Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated	Afo, walk boot type, cus fab
L5000	0010	3	Partial foot, shoe insert with longitudinal arch, toe filler	Sho insert w arch toe filler
L5010	0010	3	Partial foot, molded socket, ankle height, with toe filler	Mold socket ank hgt w/ toe f
L5020	0010	3	Partial foot, molded socket, tibial tubercle height, with toe filler	Tibial tubercle hgt w/ toe f
L5050	0010	3	Ankle, symes, molded socket, sach foot	Ank symes mold sckt sach ft
L5060	0010	3	Ankle, symes, metal frame, molded leather socket, articulated ankle/foot	Symes met fr leath socket ar
L5100	0010	3	Below knee, molded socket, shin, sach foot	Molded socket shin sach foot
L5105	0010	3	Below knee, plastic socket, joints and thigh lacer, sach foot	Plast socket jts/thgh lacer
L5150	0010	3	Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot	Mold sckt ext knee shin sach
L5160	0010	3	Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot	Mold socket bent knee shin s
L5200	0010	3	Above knee, molded socket, single axis constant friction knee, shin, sach foot	Kne sing axis fric shin sach
L5210	0010	3	Above knee, short prosthesis, no knee joint (‘stubbies’), with foot blocks, no ankle joints, each	No knee/ankle joints w/ ft b
L5220	0010	3	Above knee, short prosthesis, no knee joint (‘stubbies’), with articulated ankle/foot, dynamically aligned, each	No knee joint with artic ali
L5230	0010	3	Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot	Fem focal defic constant fri
L5250	0010	3	Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot	Hip canad sing axi cons fric
L5270	0010	3	Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot	Tilt table locking hip sing
L5280	0010	3	Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot	Hemipelvect canad sing axis
L5301	0010	3	Below knee, molded socket, shin, sach foot, endoskeletal system	Bk mold socket sach ft endo
L5312	0010	3	Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system	Knee disart, sach ft, endo
L5321	0010	3	Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee	Ak open end sach
L5331	0010	3	Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot	Hip disart canadian sach ft
L5341	0010	3	Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot	Hemipelvectomy canadian sach
L5400	0010	3	Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee	Postop dress & 1 cast chg bk
L5410	0010	3	Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment	Postop dsg bk ea add cast ch
L5420	0010	3	Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ‘ak’ or knee disarticulation	Postop dsg & 1 cast chg ak/d
L5430	0010	3	Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ‘ak’ or knee disarticulation, each additional cast change and realignment	Postop dsg ak ea add cast ch
L5450	0010	3	Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee	Postop app non-wgt bear dsg
L5460	0010	3	Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee	Postop app non-wgt bear dsg
L5500	0010	3	Initial, below knee ‘ptb’ type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed	Init bk ptb plaster direct
L5505	0010	3	Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed	Init ak ischal plstr direct
L5510	0010	3	Preparatory, below knee ‘ptb’ type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model	Prep bk ptb plaster molded
L5520	0010	3	Preparatory, below knee ‘ptb’ type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed	Perp bk ptb thermopls direct
L5530	0010	3	Preparatory, below knee ‘ptb’ type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model	Prep bk ptb thermopls molded
L5535	0010	3	Preparatory, below knee ‘ptb’ type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket	Prep bk ptb open end socket
L5540	0010	3	Preparatory, below knee ‘ptb’ type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model	Prep bk ptb laminated socket
L5560	0010	3	Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model	Prep ak ischial plast molded
L5570	0010	3	Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed	Prep ak ischial direct form
L5580	0010	3	Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model	Prep ak ischial thermo mold
L5585	0010	3	Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket	Prep ak ischial open end
L5590	0010	3	Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model	Prep ak ischial laminated
L5595	0010	3	Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model	Hip disartic sach thermopls
L5600	0010	3	Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model	Hip disart sach laminat mold
L5610	0010	3	Addition to lower extremity, endoskeletal system, above knee, hydracadence system	Above knee hydracadence
L5611	0010	3	Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control	Ak 4 bar link w/fric swing
L5613	0010	3	Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control	Ak 4 bar ling w/hydraul swig
L5614	0010	3	Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control	4-bar link above knee w/swng
L5616	0010	3	Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control	Ak univ multiplex sys frict
L5617	0010	3	Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each	Ak/bk self-aligning unit ea
L5618	0010	3	Addition to lower extremity, test socket, symes	Test socket symes
L5620	0010	3	Addition to lower extremity, test socket, below knee	Test socket below knee
L5622	0010	3	Addition to lower extremity, test socket, knee disarticulation	Test socket knee disarticula
L5624	0010	3	Addition to lower extremity, test socket, above knee	Test socket above knee
L5626	0010	3	Addition to lower extremity, test socket, hip disarticulation	Test socket hip disarticulat
L5628	0010	3	Addition to lower extremity, test socket, hemipelvectomy	Test socket hemipelvectomy
L5629	0010	3	Addition to lower extremity, below knee, acrylic socket	Below knee acrylic socket
L5630	0010	3	Addition to lower extremity, symes type, expandable wall socket	Syme typ expandabl wall sckt
L5631	0010	3	Addition to lower extremity, above knee or knee disarticulation, acrylic socket	Ak/knee disartic acrylic soc
L5632	0010	3	Addition to lower extremity, symes type, ‘ptb’ brim design socket	Symes type ptb brim design s
L5634	0010	3	Addition to lower extremity, symes type, posterior opening (canadian) socket	Symes type poster opening so
L5636	0010	3	Addition to lower extremity, symes type, medial opening socket	Symes type medial opening so
L5637	0010	3	Addition to lower extremity, below knee, total contact	Below knee total contact
L5638	0010	3	Addition to lower extremity, below knee, leather socket	Below knee leather socket
L5639	0010	3	Addition to lower extremity, below knee, wood socket	Below knee wood socket
L5640	0010	3	Addition to lower extremity, knee disarticulation, leather socket	Knee disarticulat leather so
L5642	0010	3	Addition to lower extremity, above knee, leather socket	Above knee leather socket
L5643	0010	3	Addition to lower extremity, hip disarticulation, flexible inner socket, external frame	Hip flex inner socket ext fr
L5644	0010	3	Addition to lower extremity, above knee, wood socket	Above knee wood socket
L5645	0010	3	Addition to lower extremity, below knee, flexible inner socket, external frame	Bk flex inner socket ext fra
L5646	0010	3	Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket	Below knee cushion socket
L5647	0010	3	Addition to lower extremity, below knee suction socket	Below knee suction socket
L5648	0010	3	Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket	Above knee cushion socket
L5649	0010	3	Addition to lower extremity, ischial containment/narrow m-l socket	Isch containmt/narrow m-l so
L5650	0010	3	Additions to lower extremity, total contact, above knee or knee disarticulation socket	Tot contact ak/knee disart s
L5651	0010	3	Addition to lower extremity, above knee, flexible inner socket, external frame	Ak flex inner socket ext fra
L5652	0010	3	Addition to lower extremity, suction suspension, above knee or knee disarticulation socket	Suction susp ak/knee disart
L5653	0010	3	Addition to lower extremity, knee disarticulation, expandable wall socket	Knee disart expand wall sock
L5654	0010	3	Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)	Socket insert symes
L5655	0010	3	Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)	Socket insert below knee
L5656	0010	3	Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)	Socket insert knee articulat
L5658	0010	3	Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)	Socket insert above knee
L5661	0010	3	Addition to lower extremity, socket insert, multi-durometer symes	Multi-durometer symes
L5665	0010	3	Addition to lower extremity, socket insert, multi-durometer, below knee	Multi-durometer below knee
L5666	0010	3	Addition to lower extremity, below knee, cuff suspension	Below knee cuff suspension
L5668	0010	3	Addition to lower extremity, below knee, molded distal cushion	Bk molded distal cushion
L5670	0010	3	Addition to lower extremity, below knee, molded supracondylar suspension (‘pts’ or similar)	Bk molded supracondylar susp
L5671	0010	3	Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert	Bk/ak locking mechanism
L5672	0010	3	Addition to lower extremity, below knee, removable medial brim suspension	Bk removable medial brim sus
L5673	0010	3	Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism	Socket insert w lock mech
L5676	0010	3	Additions to lower extremity, below knee, knee joints, single axis, pair	Bk knee joints single axis p
L5677	0010	3	Additions to lower extremity, below knee, knee joints, polycentric, pair	Bk knee joints polycentric p
L5678	0010	3	Additions to lower extremity, below knee, joint covers, pair	Bk joint covers pair
L5679	0010	3	Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism	Socket insert w/o lock mech
L5680	0010	3	Addition to lower extremity, below knee, thigh lacer, nonmolded	Bk thigh lacer non-molded
L5681	0010	3	Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)	Intl custm cong/latyp insert
L5682	0010	3	Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded	Bk thigh lacer glut/ischia m
L5683	0010	3	Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)	Initial custom socket insert
L5684	0010	3	Addition to lower extremity, below knee, fork strap	Bk fork strap
L5685	0010	3	Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each	Below knee sus/seal sleeve
L5686	0010	3	Addition to lower extremity, below knee, back check (extension control)	Bk back check
L5688	0010	3	Addition to lower extremity, below knee, waist belt, webbing	Bk waist belt webbing
L5690	0010	3	Addition to lower extremity, below knee, waist belt, padded and lined	Bk waist belt padded and lin
L5692	0010	3	Addition to lower extremity, above knee, pelvic control belt, light	Ak pelvic control belt light
L5694	0010	3	Addition to lower extremity, above knee, pelvic control belt, padded and lined	Ak pelvic control belt pad/l
L5695	0010	3	Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each	Ak sleeve susp neoprene/equa
L5696	0010	3	Addition to lower extremity, above knee or knee disarticulation, pelvic joint	Ak/knee disartic pelvic join
L5697	0010	3	Addition to lower extremity, above knee or knee disarticulation, pelvic band	Ak/knee disartic pelvic band
L5698	0010	3	Addition to lower extremity, above knee or knee disarticulation, silesian bandage	Ak/knee disartic silesian ba
L5699	0010	3	All lower extremity prostheses, shoulder harness	Shoulder harness
L5700	0010	3	Replacement, socket, below knee, molded to patient model	Replace socket below knee
L5701	0010	3	Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model	Replace socket above knee
L5702	0010	3	Replacement, socket, hip disarticulation, including hip joint, molded to patient model	Replace socket hip
L5703	0010	3	Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only	Symes ankle w/o (sach) foot
L5704	0010	3	Custom shaped protective cover, below knee	Custom shape cover bk
L5705	0010	3	Custom shaped protective cover, above knee	Custom shape cover ak
L5706	0010	3	Custom shaped protective cover, knee disarticulation	Custom shape cvr knee disart
L5707	0010	3	Custom shaped protective cover, hip disarticulation	Custom shape cvr hip disart
L5710	0010	3	Addition, exoskeletal knee-shin system, single axis, manual lock	Kne-shin exo sng axi mnl loc
L5711	0010	3	Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material	Knee-shin exo mnl lock ultra
L5712	0010	3	Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)	Knee-shin exo frict swg & st
L5714	0010	3	Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control	Knee-shin exo variable frict
L5716	0010	3	Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock	Knee-shin exo mech stance ph
L5718	0010	3	Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control	Knee-shin exo frct swg & sta
L5722	0010	3	Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control	Knee-shin pneum swg frct exo
L5724	0010	3	Addition, exoskeletal knee-shin system, single axis, fluid swing phase control	Knee-shin exo fluid swing ph
L5726	0010	3	Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control	Knee-shin ext jnts fld swg e
L5728	0010	3	Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control	Knee-shin fluid swg & stance
L5780	0010	3	Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control	Knee-shin pneum/hydra pneum
L5781	0010	3	Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system	Lower limb pros vacuum pump
L5782	0010	3	Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty	Hd low limb pros vacuum pump
L5785	0010	3	Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)	Exoskeletal bk ultralt mater
L5790	0010	3	Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)	Exoskeletal ak ultra-light m
L5795	0010	3	Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)	Exoskel hip ultra-light mate
L5810	0010	3	Addition, endoskeletal knee-shin system, single axis, manual lock	Endoskel knee-shin mnl lock
L5811	0010	3	Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material	Endo knee-shin mnl lck ultra
L5812	0010	3	Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)	Endo knee-shin frct swg & st
L5814	0010	3	Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock	Endo knee-shin hydral swg ph
L5816	0010	3	Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock	Endo knee-shin polyc mch sta
L5818	0010	3	Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control	Endo knee-shin frct swg & st
L5822	0010	3	Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control	Endo knee-shin pneum swg frc
L5824	0010	3	Addition, endoskeletal knee-shin system, single axis, fluid swing phase control	Endo knee-shin fluid swing p
L5826	0010	3	Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame	Miniature knee joint
L5828	0010	3	Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control	Endo knee-shin fluid swg/sta
L5830	0010	3	Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control	Endo knee-shin pneum/swg pha
L5840	0010	3	Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control	Multi-axial knee/shin system
L5845	0010	3	Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable	Knee-shin sys stance flexion
L5848	0010	3	Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability	Knee-shin sys hydraul stance
L5850	0010	3	Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist	Endo ak/hip knee extens assi
L5855	0010	3	Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist	Mech hip extension assist
L5856	0010	3	Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type	Elec knee-shin swing/stance
L5857	0010	3	Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type	Elec knee-shin swing only
L5858	0010	3	Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type	Stance phase only
L5859	0010	3	Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)	Knee-shin pro flex/ext cont
L5910	0010	3	Addition, endoskeletal system, below knee, alignable system	Endo below knee alignable sy
L5920	0010	3	Addition, endoskeletal system, above knee or hip disarticulation, alignable system	Endo ak/hip alignable system
L5925	0010	3	Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock	Above knee manual lock
L5930	0010	3	Addition, endoskeletal system, high activity knee control frame	High activity knee frame
L5940	0010	3	Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)	Endo bk ultra-light material
L5950	0010	3	Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)	Endo ak ultra-light material
L5960	0010	3	Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)	Endo hip ultra-light materia
L5961	0010	3	Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control	Endo poly hip, pneu/hyd/rot
L5962	0010	3	Addition, endoskeletal system, below knee, flexible protective outer surface covering system	Below knee flex cover system
L5964	0010	3	Addition, endoskeletal system, above knee, flexible protective outer surface covering system	Above knee flex cover system
L5966	0010	3	Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system	Hip flexible cover system
L5968	0010	3	Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature	Multiaxial ankle w dorsiflex
L5969	0010	3	Addition, endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s)	Ak/ft power asst incl motors
L5970	0010	3	All lower extremity prostheses, foot, external keel, sach foot	Foot external keel sach foot
L5971	0010	3	All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only	Sach foot, replacement
L5972	0010	3	All lower extremity prostheses, foot, flexible keel	Flexible keel foot
L5973	0010	3	Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source	Ank-foot sys dors-plant flex
L5974	0010	3	All lower extremity prostheses, foot, single axis ankle/foot	Foot single axis ankle/foot
L5975	0010	3	All lower extremity prosthesis, combination single axis ankle and flexible keel foot	Combo ankle/foot prosthesis
L5976	0010	3	All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)	Energy storing foot
L5978	0010	3	All lower extremity prostheses, foot, multiaxial ankle/foot	Ft prosth multiaxial ankl/ft
L5979	0010	3	All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system	Multi-axial ankle/ft prosth
L5980	0010	3	All lower extremity prostheses, flex foot system	Flex foot system
L5981	0010	3	All lower extremity prostheses, flex-walk system or equal	Flex-walk sys low ext prosth
L5982	0010	3	All exoskeletal lower extremity prostheses, axial rotation unit	Exoskeletal axial rotation u
L5984	0010	3	All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability	Endoskeletal axial rotation
L5985	0010	3	All endoskeletal lower extremity prostheses, dynamic prosthetic pylon	Lwr ext dynamic prosth pylon
L5986	0010	3	All lower extremity prostheses, multi-axial rotation unit (‘mcp’ or equal)	Multi-axial rotation unit
L5987	0010	3	All lower extremity prosthesis, shank foot system with vertical loading pylon	Shank ft w vert load pylon
L5988	0010	3	Addition to lower limb prosthesis, vertical shock reducing pylon feature	Vertical shock reducing pylo
L5990	0010	3	Addition to lower extremity prosthesis, user adjustable heel height	User adjustable heel height
L5999	0010	3	Lower extremity prosthesis, not otherwise specified	Lowr extremity prosthes nos
L6000	0010	3	Partial hand, thumb remaining	Part hand thumb rem
L6010	0010	3	Partial hand, little and/or ring finger remaining	Part hand little/ring
L6020	0010	3	Partial hand, no finger remaining	Part hand no fingers
L6025	0010	3	Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device	Part hand disart myoelectric
L6026	0010	3	Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)	Part hand myo exclu term dev
L6050	0010	3	Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad	Wrst mld sck flx hng tri pad
L6055	0010	3	Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad	Wrst mold sock w/exp interfa
L6100	0010	3	Below elbow, molded socket, flexible elbow hinge, triceps pad	Elb mold sock flex hinge pad
L6110	0010	3	Below elbow, molded socket, (muenster or northwestern suspension types)	Elbow mold sock suspension t
L6120	0010	3	Below elbow, molded double wall split socket, step-up hinges, half cuff	Elbow mold doub splt soc ste
L6130	0010	3	Below elbow, molded double wall split socket, stump activated locking hinge, half cuff	Elbow stump activated lock h
L6200	0010	3	Elbow disarticulation, molded socket, outside locking hinge, forearm	Elbow mold outsid lock hinge
L6205	0010	3	Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm	Elbow molded w/ expand inter
L6250	0010	3	Above elbow, molded double wall socket, internal locking elbow, forearm	Elbow inter loc elbow forarm
L6300	0010	3	Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm	Shlder disart int lock elbow
L6310	0010	3	Shoulder disarticulation, passive restoration (complete prosthesis)	Shoulder passive restor comp
L6320	0010	3	Shoulder disarticulation, passive restoration (shoulder cap only)	Shoulder passive restor cap
L6350	0010	3	Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm	Thoracic intern lock elbow
L6360	0010	3	Interscapular thoracic, passive restoration (complete prosthesis)	Thoracic passive restor comp
L6370	0010	3	Interscapular thoracic, passive restoration (shoulder cap only)	Thoracic passive restor cap
L6380	0010	3	Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow	Postop dsg cast chg wrst/elb
L6382	0010	3	Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow	Postop dsg cast chg elb dis/
L6384	0010	3	Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic	Postop dsg cast chg shlder/t
L6386	0010	3	Immediate post surgical or early fitting, each additional cast change and realignment	Postop ea cast chg & realign
L6388	0010	3	Immediate post surgical or early fitting, application of rigid dressing only	Postop applicat rigid dsg on
L6400	0010	3	Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping	Below elbow prosth tiss shap
L6450	0010	3	Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping	Elb disart prosth tiss shap
L6500	0010	3	Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping	Above elbow prosth tiss shap
L6550	0010	3	Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping	Shldr disar prosth tiss shap
L6570	0010	3	Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping	Scap thorac prosth tiss shap
L6580	0010	3	Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model	Wrist/elbow bowden cable mol
L6582	0010	3	Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed	Wrist/elbow bowden cbl dir f
L6584	0010	3	Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model	Elbow fair lead cable molded
L6586	0010	3	Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed	Elbow fair lead cable dir fo
L6588	0010	3	Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model	Shdr fair lead cable molded
L6590	0010	3	Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed	Shdr fair lead cable direct
L6600	0010	3	Upper extremity additions, polycentric hinge, pair	Polycentric hinge pair
L6605	0010	3	Upper extremity additions, single pivot hinge, pair	Single pivot hinge pair
L6610	0010	3	Upper extremity additions, flexible metal hinge, pair	Flexible metal hinge pair
L6611	0010	3	Addition to upper extremity prosthesis, external powered, additional switch, any type	Additional switch, ext power
L6615	0010	3	Upper extremity addition, disconnect locking wrist unit	Disconnect locking wrist uni
L6616	0010	3	Upper extremity addition, additional disconnect insert for locking wrist unit, each	Disconnect insert locking wr
L6620	0010	3	Upper extremity addition, flexion/extension wrist unit, with or without friction	Flexion/extension wrist unit
L6621	0010	3	Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device	Flex/ext wrist w/wo friction
L6623	0010	3	Upper extremity addition, spring assisted rotational wrist unit with latch release	Spring-ass rot wrst w/ latch
L6624	0010	3	Upper extremity addition, flexion/extension and rotation wrist unit	Flex/ext/rotation wrist unit
L6625	0010	3	Upper extremity addition, rotation wrist unit with cable lock	Rotation wrst w/ cable lock
L6628	0010	3	Upper extremity addition, quick disconnect hook adapter, otto bock or equal	Quick disconn hook adapter o
L6629	0010	3	Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal	Lamination collar w/ couplin
L6630	0010	3	Upper extremity addition, stainless steel, any wrist	Stainless steel any wrist
L6632	0010	3	Upper extremity addition, latex suspension sleeve, each	Latex suspension sleeve each
L6635	0010	3	Upper extremity addition, lift assist for elbow	Lift assist for elbow
L6637	0010	3	Upper extremity addition, nudge control elbow lock	Nudge control elbow lock
L6638	0010	3	Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow	Elec lock on manual pw elbow
L6640	0010	3	Upper extremity additions, shoulder abduction joint, pair	Shoulder abduction joint pai
L6641	0010	3	Upper extremity addition, excursion amplifier, pulley type	Excursion amplifier pulley t
L6642	0010	3	Upper extremity addition, excursion amplifier, lever type	Excursion amplifier lever ty
L6645	0010	3	Upper extremity addition, shoulder flexion-abduction joint, each	Shoulder flexion-abduction j
L6646	0010	3	Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system	Multipo locking shoulder jnt
L6647	0010	3	Upper extremity addition, shoulder lock mechanism, body powered actuator	Shoulder lock actuator
L6648	0010	3	Upper extremity addition, shoulder lock mechanism, external powered actuator	Ext pwrd shlder lock/unlock
L6650	0010	3	Upper extremity addition, shoulder universal joint, each	Shoulder universal joint
L6655	0010	3	Upper extremity addition, standard control cable, extra	Standard control cable extra
L6660	0010	3	Upper extremity addition, heavy duty control cable	Heavy duty control cable
L6665	0010	3	Upper extremity addition, teflon, or equal, cable lining	Teflon or equal cable lining
L6670	0010	3	Upper extremity addition, hook to hand, cable adapter	Hook to hand cable adapter
L6672	0010	3	Upper extremity addition, harness, chest or shoulder, saddle type	Harness chest/shlder saddle
L6675	0010	3	Upper extremity addition, harness, (e.g., figure of eight type), single cable design	Harness figure of 8 sing con
L6676	0010	3	Upper extremity addition, harness, (e.g., figure of eight type), dual cable design	Harness figure of 8 dual con
L6677	0010	3	Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow	Ue triple control harness
L6680	0010	3	Upper extremity addition, test socket, wrist disarticulation or below elbow	Test sock wrist disart/bel e
L6682	0010	3	Upper extremity addition, test socket, elbow disarticulation or above elbow	Test sock elbw disart/above
L6684	0010	3	Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic	Test socket shldr disart/tho
L6686	0010	3	Upper extremity addition, suction socket	Suction socket
L6687	0010	3	Upper extremity addition, frame type socket, below elbow or wrist disarticulation	Frame typ socket bel elbow/w
L6688	0010	3	Upper extremity addition, frame type socket, above elbow or elbow disarticulation	Frame typ sock above elb/dis
L6689	0010	3	Upper extremity addition, frame type socket, shoulder disarticulation	Frame typ socket shoulder di
L6690	0010	3	Upper extremity addition, frame type socket, interscapular-thoracic	Frame typ sock interscap-tho
L6691	0010	3	Upper extremity addition, removable insert, each	Removable insert each
L6692	0010	3	Upper extremity addition, silicone gel insert or equal, each	Silicone gel insert or equal
L6693	0010	3	Upper extremity addition, locking elbow, forearm counterbalance	Lockingelbow forearm cntrbal
L6694	0010	3	Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism	Elbow socket ins use w/lock
L6695	0010	3	Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism	Elbow socket ins use w/o lck
L6696	0010	3	Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)	Cus elbo skt in for con/atyp
L6697	0010	3	Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)	Cus elbo skt in not con/atyp
L6698	0010	3	Addition to upper extremity prosthesis, below elbow/above elbow, lock mechanism, excludes socket insert	Below/above elbow lock mech
L6703	0010	3	Terminal device, passive hand/mitt, any material, any size	Term dev, passive hand mitt
L6704	0010	3	Terminal device, sport/recreational/work attachment, any material, any size	Term dev, sport/rec/work att
L6706	0010	3	Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined	Term dev mech hook vol open
L6707	0010	3	Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined	Term dev mech hook vol close
L6708	0010	3	Terminal device, hand, mechanical, voluntary opening, any material, any size	Term dev mech hand vol open
L6709	0010	3	Terminal device, hand, mechanical, voluntary closing, any material, any size	Term dev mech hand vol close
L6711	0010	3	Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric	Ped term dev, hook, vol open
L6712	0010	3	Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric	Ped term dev, hook, vol clos
L6713	0010	3	Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric	Ped term dev, hand, vol open
L6714	0010	3	Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric	Ped term dev, hand, vol clos
L6715	0010	3	Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement	Term device, multi art digit
L6721	0010	3	Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined	Hook/hand, hvy dty, vol open
L6722	0010	3	Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined	Hook/hand, hvy dty, vol clos
L6805	0010	3	Addition to terminal device, modifier wrist unit	Term dev modifier wrist unit
L6810	0010	3	Addition to terminal device, precision pinch device	Term dev precision pinch dev
L6880	0010	3	Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)	Elec hand ind art digits
L6881	0010	3	Automatic grasp feature, addition to upper limb electric prosthetic terminal device	Term dev auto grasp feature
L6882	0010	3	Microprocessor control feature, addition to upper limb prosthetic terminal device	Microprocessor control uplmb
L6883	0010	3	Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power	Replc sockt below e/w disa
L6884	0010	3	Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power	Replc sockt above elbow disa
L6885	0010	3	Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power	Replc sockt shldr dis/interc
L6890	0010	3	Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment	Prefab glove for term device
L6895	0010	3	Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated	Custom glove for term device
L6900	0010	3	Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining	Hand restorat thumb/1 finger
L6905	0010	3	Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining	Hand restoration multiple fi
L6910	0010	3	Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining	Hand restoration no fingers
L6915	0010	3	Hand restoration (shading, and measurements included), replacement glove for above	Hand restoration replacmnt g
L6920	0010	3	Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device	Wrist disarticul switch ctrl
L6925	0010	3	Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device	Wrist disart myoelectronic c
L6930	0010	3	Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device	Below elbow switch control
L6935	0010	3	Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device	Below elbow myoelectronic ct
L6940	0010	3	Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device	Elbow disarticulation switch
L6945	0010	3	Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device	Elbow disart myoelectronic c
L6950	0010	3	Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device	Above elbow switch control
L6955	0010	3	Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device	Above elbow myoelectronic ct
L6960	0010	3	Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device	Shldr disartic switch contro
L6965	0010	3	Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device	Shldr disartic myoelectronic
L6970	0010	3	Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device	Interscapular-thor switch ct
L6975	0010	3	Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device	Interscap-thor myoelectronic
L7007	0010	3	Electric hand, switch or myoelectric controlled, adult	Adult electric hand
L7008	0010	3	Electric hand, switch or myoelectric, controlled, pediatric	Pediatric electric hand
L7009	0010	3	Electric hook, switch or myoelectric controlled, adult	Adult electric hook
L7040	0010	3	Prehensile actuator, switch controlled	Prehensile actuator
L7045	0010	3	Electric hook, switch or myoelectric controlled, pediatric	Pediatric electric hook
L7170	0010	3	Electronic elbow, hosmer or equal, switch controlled	Electronic elbow hosmer swit
L7180	0010	3	Electronic elbow, microprocessor sequential control of elbow and terminal device	Electronic elbow sequential
L7181	0010	3	Electronic elbow, microprocessor simultaneous control of elbow and terminal device	Electronic elbo simultaneous
L7185	0010	3	Electronic elbow, adolescent, variety village or equal, switch controlled	Electron elbow adolescent sw
L7186	0010	3	Electronic elbow, child, variety village or equal, switch controlled	Electron elbow child switch
L7190	0010	3	Electronic elbow, adolescent, variety village or equal, myoelectronically controlled	Elbow adolescent myoelectron
L7191	0010	3	Electronic elbow, child, variety village or equal, myoelectronically controlled	Elbow child myoelectronic ct
L7259	0010	3	Electronic wrist rotator, any type	Electronic wrist rotator any
L7260	0010	3	Electronic wrist rotator, otto bock or equal	Electron wrist rotator otto
L7261	0010	3	Electronic wrist rotator, for utah arm	Electron wrist rotator utah
L7360	0010	3	Six volt battery, each	Six volt bat otto bock/eq ea
L7362	0010	3	Battery charger, six volt, each	Battery chrgr six volt otto
L7364	0010	3	Twelve volt battery, each	Twelve volt battery utah/equ
L7366	0010	3	Battery charger, twelve volt, each	Battery chrgr 12 volt utah/e
L7367	0010	3	Lithium ion battery, rechargeable, replacement	Replacemnt lithium ionbatter
L7368	0010	3	Lithium ion battery charger, replacement only	Lithium ion battery charger
L7400	0010	3	Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)	Add ue prost be/wd, ultlite
L7401	0010	3	Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)	Add ue prost a/e ultlite mat
L7402	0010	3	Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)	Add ue prost s/d ultlite mat
L7403	0010	3	Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material	Add ue prost b/e acrylic
L7404	0010	3	Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material	Add ue prost a/e acrylic
L7405	0010	3	Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material	Add ue prost s/d acrylic
L7499	0010	3	Upper extremity prosthesis, not otherwise specified	Upper extremity prosthes nos
L7510	0010	3	Repair of prosthetic device, repair or replace minor parts	Prosthetic device repair rep
L7520	0010	3	Repair prosthetic device, labor component, per 15 minutes	Repair prosthesis per 15 min
L7600	0010	3	Prosthetic donning sleeve, any material, each	Prosthetic donning sleeve
L7700	0010	3	Gasket or seal, for use with prosthetic socket insert, any type, each	Pros soc insert gasket/seal
L7900	0010	3	Male vacuum erection system	Male vacuum erection system
L7902	0010	3	Tension ring, for vacuum erection device, any type, replacement only, each	Tension ring, vac erect dev
L8000	0010	3	Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type	Mastectomy bra
L8001	0010	3	Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type	Breast prosthesis bra & form
L8002	0010	3	Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type	Brst prsth bra & bilat form
L8010	0010	3	Breast prosthesis, mastectomy sleeve	Mastectomy sleeve
L8015	0010	3	External breast prosthesis garment, with mastectomy form, post mastectomy	Ext breastprosthesis garment
L8020	0010	3	Breast prosthesis, mastectomy form	Mastectomy form
L8030	0010	3	Breast prosthesis, silicone or equal, without integral adhesive	Breast prosthes w/o adhesive
L8031	0010	3	Breast prosthesis, silicone or equal, with integral adhesive	Breast prosthesis w adhesive
L8032	0010	3	Nipple prosthesis, prefabricated, reusable, any type, each	Reusable nipple prosthesis
L8033	0010	3	Nipple prosthesis, custom fabricated, reusable, any material, any type, each	Nipple prosthesis custom, ea
L8035	0010	3	Custom breast prosthesis, post mastectomy, molded to patient model	Custom breast prosthesis
L8039	0010	3	Breast prosthesis, not otherwise specified	Breast prosthesis nos
L8040	0010	3	Nasal prosthesis, provided by a non-physician	Nasal prosthesis
L8041	0010	3	Midfacial prosthesis, provided by a non-physician	Midfacial prosthesis
L8042	0010	3	Orbital prosthesis, provided by a non-physician	Orbital prosthesis
L8043	0010	3	Upper facial prosthesis, provided by a non-physician	Upper facial prosthesis
L8044	0010	3	Hemi-facial prosthesis, provided by a non-physician	Hemi-facial prosthesis
L8045	0010	3	Auricular prosthesis, provided by a non-physician	Auricular prosthesis
L8046	0010	3	Partial facial prosthesis, provided by a non-physician	Partial facial prosthesis
L8047	0010	3	Nasal septal prosthesis, provided by a non-physician	Nasal septal prosthesis
L8048	0010	3	Unspecified maxillofacial prosthesis, by report, provided by a non-physician	Unspec maxillofacial prosth
L8049	0010	3	Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician	Repair maxillofacial prosth
L8300	0010	3	Truss, single with standard pad	Truss single w/ standard pad
L8310	0010	3	Truss, double with standard pads	Truss double w/ standard pad
L8320	0010	3	Truss, addition to standard pad, water pad	Truss addition to std pad wa
L8330	0010	3	Truss, addition to standard pad, scrotal pad	Truss add to std pad scrotal
L8400	0010	3	Prosthetic sheath, below knee, each	Sheath below knee
L8410	0010	3	Prosthetic sheath, above knee, each	Sheath above knee
L8415	0010	3	Prosthetic sheath, upper limb, each	Sheath upper limb
L8417	0010	3	Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each	Pros sheath/sock w gel cushn
L8420	0010	3	Prosthetic sock, multiple ply, below knee, each	Prosthetic sock multi ply bk
L8430	0010	3	Prosthetic sock, multiple ply, above knee, each	Prosthetic sock multi ply ak
L8435	0010	3	Prosthetic sock, multiple ply, upper limb, each	Pros sock multi ply upper lm
L8440	0010	3	Prosthetic shrinker, below knee, each	Shrinker below knee
L8460	0010	3	Prosthetic shrinker, above knee, each	Shrinker above knee
L8465	0010	3	Prosthetic shrinker, upper limb, each	Shrinker upper limb
L8470	0010	3	Prosthetic sock, single ply, fitting, below knee, each	Pros sock single ply bk
L8480	0010	3	Prosthetic sock, single ply, fitting, above knee, each	Pros sock single ply ak
L8485	0010	3	Prosthetic sock, single ply, fitting, upper limb, each	Pros sock single ply upper l
L8499	0010	3	Unlisted procedure for miscellaneous prosthetic services	Unlisted misc prosthetic ser
L8500	0010	3	Artificial larynx, any type	Artificial larynx
L8501	0010	3	Tracheostomy speaking valve	Tracheostomy speaking valve
L8505	0010	3	Artificial larynx replacement battery / accessory, any type	Artificial larynx, accessory
L8507	0010	3	Tracheo-esophageal voice prosthesis, patient inserted, any type, each	Trach-esoph voice pros pt in
L8509	0010	3	Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type	Trach-esoph voice pros md in
L8510	0010	3	Voice amplifier	Voice amplifier
L8511	0010	3	Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each	Indwelling trach insert
L8512	0010	3	Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10	Gel cap for trach voice pros
L8513	0010	3	Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each	Trach pros cleaning device
L8514	0010	3	Tracheoesophageal puncture dilator, replacement only, each	Repl trach puncture dilator
L8515	0010	3	Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each	Gel cap app device for trach
L8600	0010	3	Implantable breast prosthesis, silicone or equal	Implant breast silicone/eq
L8603	0010	3	Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies	Collagen imp urinary 2.5 ml
L8604	0010	3	Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies	Dextranomer/hyaluronic acid
L8605	0010	3	Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies	Inj bulking agent anal canal
L8606	0010	3	Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies	Synthetic implnt urinary 1ml
L8607	0010	3	Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies	Inj vocal cord bulking agent
L8608	0010	3	Miscellaneous external component, supply or accessory for use with the argus ii retinal prosthesis system	Arg ii ext com/sup/acc misc
L8609	0010	3	Artificial cornea	Artificial cornea
L8610	0010	3	Ocular implant	Ocular implant
L8612	0010	3	Aqueous shunt	Aqueous shunt prosthesis
L8613	0010	3	Ossicula implant	Ossicular implant
L8614	0010	3	Cochlear device, includes all internal and external components	Cochlear device
L8615	0010	3	Headset/headpiece for use with cochlear implant device, replacement	Coch implant headset replace
L8616	0010	3	Microphone for use with cochlear implant device, replacement	Coch implant microphone repl
L8617	0010	3	Transmitting coil for use with cochlear implant device, replacement	Coch implant trans coil repl
L8618	0010	3	Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement	Coch implant tran cable repl
L8619	0010	3	Cochlear implant, external speech processor and controller, integrated system, replacement	Coch imp ext proc/contr rplc
L8621	0010	3	Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each	Repl zinc air battery
L8622	0010	3	Alkaline battery for use with cochlear implant device, any size, replacement, each	Repl alkaline battery
L8623	0010	3	Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each	Lith ion batt cid,non-earlvl
L8624	0010	3	Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each	Lith ion batt cid, ear level
L8625	0010	3	External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each	Charger coch impl/aoi battry
L8627	0010	3	Cochlear implant, external speech processor, component, replacement	Cid ext speech process repl
L8628	0010	3	Cochlear implant, external controller component, replacement	Cid ext controller repl
L8629	0010	3	Transmitting coil and cable, integrated, for use with cochlear implant device, replacement	Cid transmit coil and cable
L8630	0010	3	Metacarpophalangeal joint implant	Metacarpophalangeal implant
L8631	0010	3	Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)	Mcp joint repl 2 pc or more
L8641	0010	3	Metatarsal joint implant	Metatarsal joint implant
L8642	0010	3	Hallux implant	Hallux implant
L8658	0010	3	Interphalangeal joint spacer, silicone or equal, each	Interphalangeal joint spacer
L8659	0010	3	Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size	Interphalangeal joint repl
L8670	0010	3	Vascular graft material, synthetic, implant	Vascular graft, synthetic
L8679	0010	3	Implantable neurostimulator, pulse generator, any type	Imp neurosti pls gn any type
L8680	0010	3	Implantable neurostimulator electrode, each	Implt neurostim elctr each
L8681	0010	3	Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only	Pt prgrm for implt neurostim
L8682	0010	3	Implantable neurostimulator radiofrequency receiver	Implt neurostim radiofq rec
L8683	0010	3	Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver	Radiofq trsmtr for implt neu
L8684	0010	3	Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement	Radiof trsmtr implt scrl neu
L8685	0010	3	Implantable neurostimulator pulse generator, single array, rechargeable, includes extension	Implt nrostm pls gen sng rec
L8686	0010	3	Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension	Implt nrostm pls gen sng non
L8687	0010	3	Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension	Implt nrostm pls gen dua rec
L8688	0010	3	Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension	Implt nrostm pls gen dua non
L8689	0010	3	External recharging system for battery (internal) for use with implantable neurostimulator, replacement only	External recharg sys intern
L8690	0010	3	Auditory osseointegrated device, includes all internal and external components	Aud osseo dev, int/ext comp
L8691	0010	3	Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each	Aoi snd proc repl excl actua
L8692	0010	3	Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment	Non-osseointegrated snd proc
L8693	0010	3	Auditory osseointegrated device abutment, any length, replacement only	Aud osseo dev, abutment
L8694	0010	3	Auditory osseointegrated device, transducer/actuator, replacement only, each	Aoi transducer/actuator repl
L8695	0010	3	External recharging system for battery (external) for use with implantable neurostimulator, replacement only	External recharg sys extern
L8696	0010	3	Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each	Ext antenna phren nerve stim
L8698	0010	3	Miscellaneous component, supply or accessory for use with total artificial heart system	Misc used with tot art heart
L8699	0010	3	Prosthetic implant, not otherwise specified	Prosthetic implant nos
L8701	0010	3	Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated	Pow ue rom dev ewh uprt cust
L8702	0010	3	Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated	Pow ue rom dev ewhf uprt cus
L9900	0010	3	Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs “l” code	O&p supply/accessory/service

M0000–M9999: Medical Services

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
M0064	0010	3	Brief office visit for the sole purpose of monitoring or changing drug prescriptions used in the treatment of mental psychoneurotic and personality disorders	Visit for drug monitoring
M0075	0010	3	Cellular therapy	Cellular therapy
M0076	0010	3	Prolotherapy	Prolotherapy
M0100	0010	3	Intragastric hypothermia using gastric freezing	Intragastric hypothermia
M0300	0010	3	Iv chelation therapy (chemical endarterectomy)	Iv chelationtherapy
M0301	0010	3	Fabric wrapping of abdominal aneurysm	Fabric wrapping of aneurysm
M1000	0010	3	Pain screened as moderate to severe	Pain scr as mod to sevr
M1001	0010	3	Plan of care to address moderate to severe pain documented on or before the date of the second visit with a clinician	Pln to adrs pain doc
M1002	0010	3	Plan of care for moderate to severe pain not documented on or before the date of the second visit with a clinician, reason not given	Pln to adrs pain not doc
M1003	0010	3	Tb screening performed and results interpreted within twelve months prior to initiation of first-time biologic disease modifying anti-rheumatic drug therapy for ra	Tb scr 12 mo pri fst bio dz
M1004	0010	3	Documentation of medical reason for not screening for tb or interpreting results (i.e., patient positive for tb and documentation of past treatment; patient who has recently completed a course of anti-tb therapy)	Doc med rsn no srn tb
M1005	0010	3	Tb screening not performed or results not interpreted, reason not given	Tb scr no perf
M1006	0010	3	Disease activity not assessed, reason not given	Dz not ases, no rsn
M1007	0010	3	>=50% of total number of a patient’s outpatient ra encounters assessed	>=50% total pt outpt ra enct
M1008	0010	3	<50% of total number of a patient’s outpatient ra encounters assessed	<50% total pt outpt ra encts
M1009	0010	3	Discharge/discontinuation of the episode of care documented in the medical record	Dc eoc doc med rec
M1010	0010	3	Discharge/discontinuation of the episode of care documented in the medical record	Dc eoc doc med rec
M1011	0010	3	Discharge/discontinuation of the episode of care documented in the medical record	Dc eoc doc med rec
M1012	0010	3	Discharge/discontinuation of the episode of care documented in the medical record	Dc eoc doc med rec
M1013	0010	3	Discharge/discontinuation of the episode of care documented in the medical record	Dc eoc doc med rec
M1014	0010	3	Discharge/discontinuation of the episode of care documented in the medical record	Dc epi care doc medrec
M1015	0010	3	Discharge/discontinuation of the episode of care documented in the medical record	Dc eoc doc med rec
M1016	0010	3	Female patients unable to bear children	Pt dx meop or sur steri
M1017	0010	3	Patient admitted to palliative care services	Pt admt to palitve serv
M1018	0010	3	Patients with an active diagnosis or history of cancer (except basal cell and squamous cell skin carcinoma), patients who are heavy tobacco smokers, lung cancer screening patients	Pt dx hst cr pt sk lg cr scr
M1019	0010	3	Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5	Adl pt mj dep ds rs 12 phq<5
M1020	0010	3	Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq-9 or phq-9m score was not assessed or is greater than or equal to 5	Adl pt mj dep ds no rs 12 mo
M1021	0010	3	Patient had only urgent care visits during the performance period	Pt uc in pp
M1022	0010	3	Patients who were in hospice at any time during the performance period	Pt hospice during perf pd
M1023	0010	3	Adolescent patients 12 to 17 years of age with major depression or dysthymia who reached remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five	Adl pt mj dep ds rs 6 phq<5
M1024	0010	3	Adolescent patients 12 to 17 years of age with major depression or dysthymia who did not reach remission at six months as demonstrated by a six month (+/-60 days) phq-9 or phq-9m score of less than five. either phq-9 or phq-9m score was not assessed or is greater than or equal to five	Adl pt mj dep ds no rs 6 mo
M1025	0010	3	Patients who were in hospice at any time during the performance period	Pt hospice during perf pd
M1026	0010	3	Patients who were in hospice at any time during the performance period	Pt hospice during perf pd
M1027	0010	3	Imaging of the head (ct or mri) was obtained	Img head (ct or mri) obtnd
M1028	0010	3	Documentation of patients with primary headache diagnosis and imaging other than ct or mri obtained	Doc of pt prm hda dx and otr
M1029	0010	3	Imaging of the head (ct or mri) was not obtained, reason not given	Doc sysm rsn img hd
M1030	0010	3	Patients with clinical indications for imaging of the head	Pt clin ind img hd
M1031	0010	3	Patients with no clinical indications for imaging of the head	Pt clin ind img hd
M1032	0010	3	Adults currently taking pharmacotherapy for oud	Adt tkng pharmthry for oud
M1033	0010	3	Pharmacotherapy for oud initiated after june 30th of performance period	Pharmthry for oud afr 6.30
M1034	0010	3	Adults who have at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven days	Adt 180 dys pharmthry oud
M1035	0010	3	Adults who are deliberately phased out of medication assisted treatment (mat) prior to 180 days of continuous treatment	Adt pd out mat pr 180 dys tx
M1036	0010	3	Adults who have not had at least 180 days of continuous pharmacotherapy with a medication prescribed for oud without a gap of more than seven days	Adt no 180 dys pharmthry oud
M1037	0010	3	Patients with a diagnosis of lumbar spine region cancer at the time of the procedure	Pt dx lum sp reg cacr
M1038	0010	3	Patients with a diagnosis of lumbar spine region fracture at the time of the procedure	Pt dx lum sp reg fract
M1039	0010	3	Patients with a diagnosis of lumbar spine region infection at the time of the procedure	Pt dx lum sp reg inf
M1040	0010	3	Patients with a diagnosis of lumbar idiopathic or congenital scoliosis	Pt dx lum idi or cong scol
M1041	0010	3	Patient had cancer, fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis	Pt cr ft inf lm or pt id sl
M1042	0010	3	Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively	Ftl st mea sco ot odi 3 mo
M1043	0010	3	Functional status was not measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively	Fs no odi 9-15mo
M1044	0010	3	Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively	Ftl st mea odi 3 mo
M1045	0010	3	Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was greater than or equal to 37	Fs oks 9-15mo = 37
M1046	0010	3	Functional status measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively was less than 37	Fs oks 9-15mo = 37
M1047	0010	3	Functional status was measured by the oxford knee score (oks) patient reported outcome tool within three months preoperatively and at one year (9 to 15 months) postoperatively	Fs msrd oks pre and post
M1048	0010	3	Functional status measurement with score was obtained utilizing the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at three months (6 to 20 weeks) postoperatively	Fsm wth scr odi pre and post
M1049	0010	3	Functional status was not measured by the oswestry disability index (odi version 2.1a) at three months (6 - 20 weeks) postoperatively	Fs wth scr no odi pre and p
M1050	0010	3	Functional status was measured by the oswestry disability index (odi version 2.1a) patient reported outcome tool within three months preoperatively and at three months (6 to 20 weeks) postoperatively	Fs msrd odi pre and post
M1051	0010	3	Patient had cancer, fracture or infection related to the lumbar spine or patient had idiopathic or congenital scoliosis	Pt w/cancer scoliosis
M1052	0010	3	Leg pain was not measured by the visual analog scale (vas) at one year (9 to 15 months) postoperatively	Lg pn not meas w/ vas 1yr po
M1053	0010	3	Leg pain was measured by the visual analog scale (vas) within three months preoperatively and at one year (9 to 15 months) postoperatively	Pre and post vas wthn 3 mos
M1054	0010	3	Patient had only urgent care visits during the performance period	Pt uc in pp
M1055	0010	3	Aspirin or another antiplatelet therapy used	Aspirin used
M1056	0010	3	Prescribed anticoagulant medication during the performance period, history of gi bleeding, history of intracranial bleeding, bleeding disorder and specific provider documented reasons: allergy to aspirin or anti-platelets, use of non-steroidal anti-inflammatory agents, drug-drug interaction, uncontrolled hypertension > 180/110 mmhg or gastroesophageal reflux disease	Presc antico med in pp
M1057	0010	3	Aspirin or another antiplatelet therapy not used, reason not given	Aspirin not used, no rsn
M1058	0010	3	Patient was a permanent nursing home resident at any time during the performance period	Pt prm nurs hm res in pp
M1059	0010	3	Patient was in hospice or receiving palliative care at any time during the performance period	Pt no prm nurs hm res in pp
M1060	0010	3	Patient died prior to the end of the performance period	Pt died in pp
M1061	0010	3	Patient pregnancy	Pt preg
M1062	0010	3	Patient immunocompromised	Pt imcomprmd
M1063	0010	3	Patients receiving high doses of immunosuppressive therapy	Pt rec hg dos imsup thpy
M1064	0010	3	Shingrix vaccine documented as administered or previously received	Shing vac doc adm or pv rec
M1065	0010	3	Shingrix vaccine was not administered for reasons documented by clinician (e.g. patient administered vaccine other than shingrix, patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)	Shing vac no adm clinc rsn
M1066	0010	3	Shingrix vaccine not documented as administered, reason not given	Shing vac no doc no rsn
M1067	0010	3	Hospice services for patient provided any time during the measurement period	Hspc pt prv time meam per
M1068	0010	3	Adults who are not ambulatory	Pt not ambulatory
M1069	0010	3	Patient screened for future fall risk	Pt scr ft fall rsk
M1070	0010	3	Patient not screened for future fall risk, reason not given	Pt not scrn fut fall no rsn
M1071	0010	3	Patient had any additional spine procedures performed on the same date as the lumbar discectomy/laminotomy	Pt had add’l sp pcr perf
M1106	0010	3	The start of an episode of care documented in the medical record	Start eoc doc med rec
M1107	0010	3	Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson’s diagnosed at any time before or during the episode of care	Docu dx degen neuro
M1108	0010	3	Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)	Oc ni pt 1-2 vis
M1109	0010	3	Ongoing care not indicated, patient discharged after only 1-2 visits due to specific medical events, documented in the medical record that make the treatment episode impossible such as the patient becomes hospitalized or scheduled for surgery or hospitalized	Oc ni pt dc 1-2 vis
M1110	0010	3	Ongoing care not indicated, patient self-discharged early and seen only 1-2 visits (e.g., financial or insurance reasons, transportation problems, or reason unknown)	Oc ni pt selfdc 1-2 vis
M1111	0010	3	The start of an episode of care documented in the medical record	Start eoc doc med rec
M1112	0010	3	Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson’s diagnosed at any time before or during the episode of care	Docu dx degen neuro
M1113	0010	3	Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)	Oc ni pt 1-2 vis
M1114	0010	3	Ongoing care not indicated, patient discharged after only 1-2 visits due to specific medical events, documented in the medical record that make the treatment episode impossible such as the patient becomes hospitalized or scheduled for surgery or hospitalized	Oc ni pt dc 1-2 vis
M1115	0010	3	Ongoing care not indicated, patient self-discharged early and seen only 1-2 visits (e.g., financial or insurance reasons, transportation problems, or reason unknown)	Oc ni pt selfdc 1-2 vis
M1116	0010	3	The start of an episode of care documented in the medical record	Start eoc doc med rec
M1117	0010	3	Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson’s diagnosed at any time before or during the episode of care	Docu dx degen neuro
M1118	0010	3	Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)	Oc ni pt 1-2 vis
M1119	0010	3	Ongoing care not indicated, patient discharged after only 1-2 visits due to specific medical events, documented in the medical record that make the treatment episode impossible such as the patient becomes hospitalized or scheduled for surgery or hospitalized	Oc ni pt dc 1-2 vis
M1120	0010	3	Ongoing care not indicated, patient self-discharged early and seen only 1-2 visits (e.g., financial or insurance reasons, transportation problems, or reason unknown)	Oc ni pt selfdc 1-2 vis
M1121	0010	3	The start of an episode of care documented in the medical record	Start eoc doc med rec
M1122	0010	3	Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson’s diagnosed at any time before or during the episode of care	Docu dx degen neuro
M1123	0010	3	Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)	Oc ni pt 1-2 vis
M1124	0010	3	Ongoing care not indicated, patient discharged after only 1-2 visits due to specific medical events, documented in the medical record that make the treatment episode impossible such as the patient becomes hospitalized or scheduled for surgery	Oc ni pt dc 1-2 vis
M1125	0010	3	Ongoing care not indicated, patient self-discharged early and seen only 1-2 visits (e.g., financial or insurance reasons, transportation problems, or reason unknown)	Oc ni pt selfdc 1-2 vis
M1126	0010	3	The start of an episode of care documented in the medical record	Start eoc doc med rec
M1127	0010	3	Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson’s diagnosed at any time before or during the episode of care	Docu dx degen neuro
M1128	0010	3	Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)	Oc ni pt 1-2 vis
M1129	0010	3	Ongoing care not indicated, patient discharged after only 1-2 visits due to specific medical events, documented in the medical record that make the treatment episode impossible such as the patient becomes hospitalized or scheduled for surgery	Oc ni pt dc 1-2 vis
M1130	0010	3	Ongoing care not indicated, patient self-discharged early and seen only 1-2 visits (e.g., financial or insurance reasons, transportation problems, or reason unknown)	Oc ni pt self dc 1-2 vis
M1131	0010	3	Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson’s diagnosed at any time before or during the episode of care	Docu dx degen neuro
M1132	0010	3	Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)	Oc ni pt 1-2 vis
M1133	0010	3	Ongoing care not indicated, patient discharged after only 1-2 visits due to specific medical events, documented in the medical record that make the treatment episode impossible such as the patient becomes hospitalized or scheduled for surgery	Oc ni pt dc 1-2 vis
M1134	0010	3	Ongoing care not indicated, patient self-discharged early and seen only 1-2 visits (e.g., financial or insurance reasons, transportation problems, or reason unknown	Oc ni pt self dc 1-2 vis
M1135	0010	3	The start of an episode of care documented in the medical record	Start eoc doc med rec
M1136	0010	3	The start of an episode of care documented in the medical record	Start eoc doc med rec
M1137	0010	3	Documentation stating patient has a diagnosis of a degenerative neurological condition such as als, ms, or parkinson’s diagnosed at any time before or during the episode of care	Docu dx degen neuro
M1138	0010	3	Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only)	Oc ni pt 1-2 vis
M1139	0010	3	Ongoing care not indicated, patient self-discharged early and seen only 1-2 visits (e.g., financial or insurance reasons, transportation problems, or reason unknown)	Oc ni pt self dc 1-2 vis
M1140	0010	3	Ongoing care not indicated, patient discharged after only 1-2 visits due to specific medical events, documented in the medical record that make the treatment episode impossible such as the patient becomes hospitalized or scheduled for surgery for surgery or hospitalized	Oc ni pt dc 1-2 vis
M1141	0010	3	Functional status was not measured by the oxford knee score (oks) at one year (9 to 15 months) postoperatively	Fs no oks
M1142	0010	3	Emergent cases	Emerge cases
M1143	0010	3	Initiated episode of rehabilitation therapy, medical, or chiropractic care for neck impairment	Ni rehab med chiro
M1144	0010	3	Ongoing care not indicated, patient seen only 1-2 visits (e.g., home program only, referred to another provider or facility, consultation only	Oc no ind pt 1-2 vis

P0000–P9999: Pathology and Laboratory Services

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
P2028	0010	3	Cephalin floculation, blood	Cephalin floculation test
P2029	0010	3	Congo red, blood	Congo red blood test
P2031	0010	3	Hair analysis (excluding arsenic)	Hair analysis
P2033	0010	3	Thymol turbidity, blood	Blood thymol turbidity
P2038	0010	3	Mucoprotein, blood (seromucoid) (medical necessity procedure)	Blood mucoprotein
P3000	0010	3	Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision	Screen pap by tech w md supv
P3001	0010	3	Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician	Screening pap smear by phys
P7001	0010	3	Culture, bacterial, urine; quantitative, sensitivity study	Culture bacterial urine
P9010	0010	3	Blood (whole), for transfusion, per unit	Whole blood for transfusion
P9011	0010	3	Blood, split unit	Blood split unit
P9012	0010	3	Cryoprecipitate, each unit	Cryoprecipitate each unit
P9016	0010	3	Red blood cells, leukocytes reduced, each unit	Rbc leukocytes reduced
P9017	0010	3	Fresh frozen plasma (single donor), frozen within 8 hours of collection, each unit	Plasma 1 donor frz w/in 8 hr
P9019	0010	3	Platelets, each unit	Platelets, each unit
P9020	0010	3	Platelet rich plasma, each unit	Plaelet rich plasma unit
P9021	0010	3	Red blood cells, each unit	Red blood cells unit
P9022	0010	3	Red blood cells, washed, each unit	Washed red blood cells unit
P9023	0010	3	Plasma, pooled multiple donor, solvent/detergent treated, frozen, each unit	Frozen plasma, pooled, sd
P9031	0010	3	Platelets, leukocytes reduced, each unit	Platelets leukocytes reduced
P9032	0010	3	Platelets, irradiated, each unit	Platelets, irradiated
P9033	0010	3	Platelets, leukocytes reduced, irradiated, each unit	Platelets leukoreduced irrad
P9034	0010	3	Platelets, pheresis, each unit	Platelets, pheresis
P9035	0010	3	Platelets, pheresis, leukocytes reduced, each unit	Platelet pheres leukoreduced
P9036	0010	3	Platelets, pheresis, irradiated, each unit	Platelet pheresis irradiated
P9037	0010	3	Platelets, pheresis, leukocytes reduced, irradiated, each unit	Plate pheres leukoredu irrad
P9038	0010	3	Red blood cells, irradiated, each unit	Rbc irradiated
P9039	0010	3	Red blood cells, deglycerolized, each unit	Rbc deglycerolized
P9040	0010	3	Red blood cells, leukocytes reduced, irradiated, each unit	Rbc leukoreduced irradiated
P9041	0010	3	Infusion, albumin (human), 5%, 50 ml	Albumin (human),5%, 50ml
P9043	0010	3	Infusion, plasma protein fraction (human), 5%, 50 ml	Plasma protein fract,5%,50ml
P9044	0010	3	Plasma, cryoprecipitate reduced, each unit	Cryoprecipitatereducedplasma
P9045	0010	3	Infusion, albumin (human), 5%, 250 ml	Albumin (human), 5%, 250 ml
P9046	0010	3	Infusion, albumin (human), 25%, 20 ml	Albumin (human), 25%, 20 ml
P9047	0010	3	Infusion, albumin (human), 25%, 50 ml	Albumin (human), 25%, 50ml
P9048	0010	3	Infusion, plasma protein fraction (human), 5%, 250 ml	Plasmaprotein fract,5%,250ml
P9050	0010	3	Granulocytes, pheresis, each unit	Granulocytes, pheresis unit
P9051	0010	3	Whole blood or red blood cells, leukocytes reduced, cmv-negative, each unit	Blood, l/r, cmv-neg
P9052	0010	3	Platelets, hla-matched leukocytes reduced, apheresis/pheresis, each unit	Platelets, hla-m, l/r, unit
P9053	0010	3	Platelets, pheresis, leukocytes reduced, cmv-negative, irradiated, each unit	Plt, pher, l/r cmv-neg, irr
P9054	0010	3	Whole blood or red blood cells, leukocytes reduced, frozen, deglycerol, washed, each unit	Blood, l/r, froz/degly/wash
P9055	0010	3	Platelets, leukocytes reduced, cmv-negative, apheresis/pheresis, each unit	Plt, aph/pher, l/r, cmv-neg
P9056	0010	3	Whole blood, leukocytes reduced, irradiated, each unit	Blood, l/r, irradiated
P9057	0010	3	Red blood cells, frozen/deglycerolized/washed, leukocytes reduced, irradiated, each unit	Rbc, frz/deg/wsh, l/r, irrad
P9058	0010	3	Red blood cells, leukocytes reduced, cmv-negative, irradiated, each unit	Rbc, l/r, cmv-neg, irrad
P9059	0010	3	Fresh frozen plasma between 8-24 hours of collection, each unit	Plasma, frz between 8-24hour
P9060	0010	3	Fresh frozen plasma, donor retested, each unit	Fr frz plasma donor retested
P9070	0010	3	Plasma, pooled multiple donor, pathogen reduced, frozen, each unit	Pathogen reduced plasma pool
P9071	0010	3	Plasma (single donor), pathogen reduced, frozen, each unit	Pathogen reduced plasma sing
P9072	0010	3	Platelets, pheresis, pathogen reduced or rapid bacterial tested, each unit	Plate path red/rapid bac tes
P9073	0010	3	Platelets, pheresis, pathogen-reduced, each unit	Platelets pheresis path redu
P9099	0010	3	Blood component or product not otherwise classified	Blood component/product noc
P9100	0010	3	Pathogen(s) test for platelets	Pathogen test for platelets
P9603	0010	3	Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled	One-way allow prorated miles
P9604	0010	3	Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge	One-way allow prorated trip
P9612	0010	3	Catheterization for collection of specimen, single patient, all places of service	Catheterize for urine spec
P9615	0010	3	Catheterization for collection of specimen(s) (multiple patients)	Urine specimen collect mult

Q0000–Q9999: Miscellaneous Services

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
Q0035	0010	3	Cardiokymography	Cardiokymography
Q0081	0010	3	Infusion therapy, using other than chemotherapeutic drugs, per visit	Infusion ther other than che
Q0083	0010	3	Chemotherapy administration by other than infusion technique only (e.g., subcutaneous, intramuscular, push), per visit	Chemo by other than infusion
Q0084	0010	3	Chemotherapy administration by infusion technique only, per visit	Chemotherapy by infusion
Q0085	0010	3	Chemotherapy administration by both infusion technique and other technique(s) (e.g., subcutaneous, intramuscular, push), per visit	Chemo by both infusion and o
Q0091	0010	3	Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory	Obtaining screen pap smear
Q0092	0010	3	Set-up portable x-ray equipment	Set up port xray equipment
Q0111	0010	3	Wet mounts, including preparations of vaginal, cervical or skin specimens	Wet mounts/ w preparations
Q0112	0010	3	All potassium hydroxide (koh) preparations	Potassium hydroxide preps
Q0113	0010	3	Pinworm examinations	Pinworm examinations
Q0114	0010	3	Fern test	Fern test
Q0115	0010	3	Post-coital direct, qualitative examinations of vaginal or cervical mucous	Post-coital mucous exam
Q0138	0010	3	Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)	Ferumoxytol, non-esrd
Q0139	0010	3	Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for esrd on dialysis)	Ferumoxytol, esrd use
Q0144	0010	3	Azithromycin dihydrate, oral, capsules/powder, 1 gram	Azithromycin dihydrate, oral
Q0161	0010	3	Chlorpromazine hydrochloride, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen	Chlorpromazine hcl 5mg oral
Q0162	0010	3	Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen	Ondansetron oral
Q0163	0010	3	Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen	Diphenhydramine hcl 50mg
Q0164	0010	3	Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen	Prochlorperazine maleate 5mg
Q0166	0010	3	Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen	Granisetron hcl 1 mg oral
Q0167	0010	3	Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen	Dronabinol 2.5mg oral
Q0169	0010	3	Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen	Promethazine hcl 12.5mg oral
Q0173	0010	3	Trimethobenzamide hydrochloride, 250 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen	Trimethobenzamide hcl 250mg
Q0174	0010	3	Thiethylperazine maleate, 10 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen	Thiethylperazine maleate10mg
Q0175	0010	3	Perphenazine, 4 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen	Perphenazine 4mg oral
Q0177	0010	3	Hydroxyzine pamoate, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen	Hydroxyzine pamoate 25mg
Q0180	0010	3	Dolasetron mesylate, 100 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen	Dolasetron mesylate oral
Q0181	0010	3	Unspecified oral dosage form, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for a iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen	Unspecified oral anti-emetic
Q0477	0010	3	Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only	Pwr module pt cable lvad rpl
Q0478	0010	3	Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type	Power adapter, combo vad
Q0479	0010	3	Power module for use with electric or electric/pneumatic ventricular assist device, replacement only	Power module combo vad, rep
Q0480	0010	3	Driver for use with pneumatic ventricular assist device, replacement only	Driver pneumatic vad, rep
Q0481	0010	3	Microprocessor control unit for use with electric ventricular assist device, replacement only	Microprcsr cu elec vad, rep
Q0482	0010	3	Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only	Microprcsr cu combo vad, rep
Q0483	0010	3	Monitor/display module for use with electric ventricular assist device, replacement only	Monitor elec vad, rep
Q0484	0010	3	Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only	Monitor elec or comb vad rep
Q0485	0010	3	Monitor control cable for use with electric ventricular assist device, replacement only	Monitor cable elec vad, rep
Q0486	0010	3	Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only	Mon cable elec/pneum vad rep
Q0487	0010	3	Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only	Leads any type vad, rep only
Q0488	0010	3	Power pack base for use with electric ventricular assist device, replacement only	Pwr pack base elec vad, rep
Q0489	0010	3	Power pack base for use with electric/pneumatic ventricular assist device, replacement only	Pwr pck base combo vad, rep
Q0490	0010	3	Emergency power source for use with electric ventricular assist device, replacement only	Emr pwr source elec vad, rep
Q0491	0010	3	Emergency power source for use with electric/pneumatic ventricular assist device, replacement only	Emr pwr source combo vad rep
Q0492	0010	3	Emergency power supply cable for use with electric ventricular assist device, replacement only	Emr pwr cbl elec vad, rep
Q0493	0010	3	Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only	Emr pwr cbl combo vad, rep
Q0494	0010	3	Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only	Emr hd pmp elec/combo, rep
Q0495	0010	3	Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only	Charger elec/combo vad, rep
Q0496	0010	3	Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only	Battery elec/combo vad, rep
Q0497	0010	3	Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only	Bat clps elec/comb vad, rep
Q0498	0010	3	Holster for use with electric or electric/pneumatic ventricular assist device, replacement only	Holster elec/combo vad, rep
Q0499	0010	3	Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only	Belt/vest elec/combo vad rep
Q0500	0010	3	Filters for use with electric or electric/pneumatic ventricular assist device, replacement only	Filters elec/combo vad, rep
Q0501	0010	3	Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only	Shwr cov elec/combo vad, rep
Q0502	0010	3	Mobility cart for pneumatic ventricular assist device, replacement only	Mobility cart pneum vad, rep
Q0503	0010	3	Battery for pneumatic ventricular assist device, replacement only, each	Battery pneum vad replacemnt
Q0504	0010	3	Power adapter for pneumatic ventricular assist device, replacement only, vehicle type	Pwr adpt pneum vad, rep veh
Q0506	0010	3	Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only	Lith-ion batt elec/pneum vad
Q0507	0010	3	Miscellaneous supply or accessory for use with an external ventricular assist device	Misc sup/acc ext vad
Q0508	0010	3	Miscellaneous supply or accessory for use with an implanted ventricular assist device	Mis sup/acc imp vad
Q0509	0010	3	Miscellaneous supply or accessory for use with any implanted ventricular assist device for which payment was not made under medicare part a	Mis sup/ac imp vad nopay med
Q0510	0010	3	Pharmacy supply fee for initial immunosuppressive drug(s), first month following transplant	Dispens fee immunosupressive
Q0511	0010	3	Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period	Sup fee antiem,antica,immuno
Q0512	0010	3	Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period	Px sup fee anti-can sub pres
Q0513	0010	3	Pharmacy dispensing fee for inhalation drug(s); per 30 days	Disp fee inhal drugs/30 days
Q0514	0010	3	Pharmacy dispensing fee for inhalation drug(s); per 90 days	Disp fee inhal drugs/90 days
Q0515	0010	3	Injection, sermorelin acetate, 1 microgram	Sermorelin acetate injection
Q1004	0010	3	New technology intraocular lens category 4 as defined in federal register notice	Ntiol category 4
Q1005	0010	3	New technology intraocular lens category 5 as defined in federal register notice	Ntiol category 5
Q2004	0010	3	Irrigation solution for treatment of bladder calculi, for example renacidin, per 500 ml	Bladder calculi irrig sol
Q2009	0010	3	Injection, fosphenytoin, 50 mg phenytoin equivalent	Fosphenytoin inj pe
Q2017	0010	3	Injection, teniposide, 50 mg	Teniposide, 50 mg
Q2026	0010	3	Injection, radiesse, 0.1 ml	Radiesse injection
Q2028	0010	3	Injection, sculptra, 0.5 mg	Inj, sculptra, 0.5mg
Q2034	0010	3	Influenza virus vaccine, split virus, for intramuscular use (agriflu)	Agriflu vaccine
Q2035	0010	3	Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria)	Afluria vacc, 3 yrs & >, im
Q2036	0010	3	Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval)	Flulaval vacc, 3 yrs & >, im
Q2037	0010	3	Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)	Fluvirin vacc, 3 yrs & >, im
Q2038	0010	3	Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)	Fluzone vacc, 3 yrs & >, im
Q2039	0010	3	Influenza virus vaccine, not otherwise specified	Influenza virus vaccine, nos
Q2040	0010	3	Tisagenlecleucel, up to 250 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion	Tisagenlecleucel car-pos t
Q2041	0010	3	Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose	Axicabtagene ciloleucel car+
Q2042	0010	3	Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose	Tisagenlecleucel car-pos t
Q2043	0010	3	Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion	Sipuleucel-t auto cd54+
Q2049	0010	3	Injection, doxorubicin hydrochloride, liposomal, imported lipodox, 10 mg	Imported lipodox inj
Q2050	0010	3	Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg	Doxorubicin inj 10mg
Q2052	0010	3	Services, supplies and accessories used in the home under the medicare intravenous immune globulin (ivig) demonstration	Ivig demo, services/supplies
Q3001	0010	3	Radioelements for brachytherapy, any type, each	Brachytherapy radioelements
Q3014	0010	3	Telehealth originating site facility fee	Telehealth facility fee
Q3027	0010	3	Injection, interferon beta-1a, 1 mcg for intramuscular use	Inj beta interferon im 1 mcg
Q3028	0010	3	Injection, interferon beta-1a, 1 mcg for subcutaneous use	Inj beta interferon sq 1 mcg
Q3031	0010	3	Collagen skin test	Collagen skin test
Q4001	0010	3	Casting supplies, body cast adult, with or without head, plaster	Cast sup body cast plaster
Q4002	0010	3	Cast supplies, body cast adult, with or without head, fiberglass	Cast sup body cast fiberglas
Q4003	0010	3	Cast supplies, shoulder cast, adult (11 years +), plaster	Cast sup shoulder cast plstr
Q4004	0010	3	Cast supplies, shoulder cast, adult (11 years +), fiberglass	Cast sup shoulder cast fbrgl
Q4005	0010	3	Cast supplies, long arm cast, adult (11 years +), plaster	Cast sup long arm adult plst
Q4006	0010	3	Cast supplies, long arm cast, adult (11 years +), fiberglass	Cast sup long arm adult fbrg
Q4007	0010	3	Cast supplies, long arm cast, pediatric (0-10 years), plaster	Cast sup long arm ped plster
Q4008	0010	3	Cast supplies, long arm cast, pediatric (0-10 years), fiberglass	Cast sup long arm ped fbrgls
Q4009	0010	3	Cast supplies, short arm cast, adult (11 years +), plaster	Cast sup sht arm adult plstr
Q4010	0010	3	Cast supplies, short arm cast, adult (11 years +), fiberglass	Cast sup sht arm adult fbrgl
Q4011	0010	3	Cast supplies, short arm cast, pediatric (0-10 years), plaster	Cast sup sht arm ped plaster
Q4012	0010	3	Cast supplies, short arm cast, pediatric (0-10 years), fiberglass	Cast sup sht arm ped fbrglas
Q4013	0010	3	Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster	Cast sup gauntlet plaster
Q4014	0010	3	Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass	Cast sup gauntlet fiberglass
Q4015	0010	3	Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster	Cast sup gauntlet ped plster
Q4016	0010	3	Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass	Cast sup gauntlet ped fbrgls
Q4017	0010	3	Cast supplies, long arm splint, adult (11 years +), plaster	Cast sup lng arm splint plst
Q4018	0010	3	Cast supplies, long arm splint, adult (11 years +), fiberglass	Cast sup lng arm splint fbrg
Q4019	0010	3	Cast supplies, long arm splint, pediatric (0-10 years), plaster	Cast sup lng arm splnt ped p
Q4020	0010	3	Cast supplies, long arm splint, pediatric (0-10 years), fiberglass	Cast sup lng arm splnt ped f
Q4021	0010	3	Cast supplies, short arm splint, adult (11 years +), plaster	Cast sup sht arm splint plst
Q4022	0010	3	Cast supplies, short arm splint, adult (11 years +), fiberglass	Cast sup sht arm splint fbrg
Q4023	0010	3	Cast supplies, short arm splint, pediatric (0-10 years), plaster	Cast sup sht arm splnt ped p
Q4024	0010	3	Cast supplies, short arm splint, pediatric (0-10 years), fiberglass	Cast sup sht arm splnt ped f
Q4025	0010	3	Cast supplies, hip spica (one or both legs), adult (11 years +), plaster	Cast sup hip spica plaster
Q4026	0010	3	Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass	Cast sup hip spica fiberglas
Q4027	0010	3	Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster	Cast sup hip spica ped plstr
Q4028	0010	3	Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass	Cast sup hip spica ped fbrgl
Q4029	0010	3	Cast supplies, long leg cast, adult (11 years +), plaster	Cast sup long leg plaster
Q4030	0010	3	Cast supplies, long leg cast, adult (11 years +), fiberglass	Cast sup long leg fiberglass
Q4031	0010	3	Cast supplies, long leg cast, pediatric (0-10 years), plaster	Cast sup lng leg ped plaster
Q4032	0010	3	Cast supplies, long leg cast, pediatric (0-10 years), fiberglass	Cast sup lng leg ped fbrgls
Q4033	0010	3	Cast supplies, long leg cylinder cast, adult (11 years +), plaster	Cast sup lng leg cylinder pl
Q4034	0010	3	Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass	Cast sup lng leg cylinder fb
Q4035	0010	3	Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster	Cast sup lngleg cylndr ped p
Q4036	0010	3	Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass	Cast sup lngleg cylndr ped f
Q4037	0010	3	Cast supplies, short leg cast, adult (11 years +), plaster	Cast sup shrt leg plaster
Q4038	0010	3	Cast supplies, short leg cast, adult (11 years +), fiberglass	Cast sup shrt leg fiberglass
Q4039	0010	3	Cast supplies, short leg cast, pediatric (0-10 years), plaster	Cast sup shrt leg ped plster
Q4040	0010	3	Cast supplies, short leg cast, pediatric (0-10 years), fiberglass	Cast sup shrt leg ped fbrgls
Q4041	0010	3	Cast supplies, long leg splint, adult (11 years +), plaster	Cast sup lng leg splnt plstr
Q4042	0010	3	Cast supplies, long leg splint, adult (11 years +), fiberglass	Cast sup lng leg splnt fbrgl
Q4043	0010	3	Cast supplies, long leg splint, pediatric (0-10 years), plaster	Cast sup lng leg splnt ped p
Q4044	0010	3	Cast supplies, long leg splint, pediatric (0-10 years), fiberglass	Cast sup lng leg splnt ped f
Q4045	0010	3	Cast supplies, short leg splint, adult (11 years +), plaster	Cast sup sht leg splnt plstr
Q4046	0010	3	Cast supplies, short leg splint, adult (11 years +), fiberglass	Cast sup sht leg splnt fbrgl
Q4047	0010	3	Cast supplies, short leg splint, pediatric (0-10 years), plaster	Cast sup sht leg splnt ped p
Q4048	0010	3	Cast supplies, short leg splint, pediatric (0-10 years), fiberglass	Cast sup sht leg splnt ped f
Q4049	0010	3	Finger splint, static	Finger splint, static
Q4050	0010	3	Cast supplies, for unlisted types and materials of casts	Cast supplies unlisted
Q4051	0010	3	Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies)	Splint supplies misc
Q4074	0010	3	Iloprost, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 20 micrograms	Iloprost non-comp unit dose
Q4081	0010	3	Injection, epoetin alfa, 100 units (for esrd on dialysis)	Epoetin alfa, 100 units esrd
Q4082	0010	3	Drug or biological, not otherwise classified, part b drug competitive acquisition program (cap)	Drug/bio noc part b drug cap
Q4100	0010	3	Skin substitute, not otherwise specified	Skin substitute, nos
Q4101	0010	3	Apligraf, per square centimeter	Apligraf
Q4102	0010	3	Oasis wound matrix, per square centimeter	Oasis wound matrix
Q4103	0010	3	Oasis burn matrix, per square centimeter	Oasis burn matrix
Q4104	0010	3	Integra bilayer matrix wound dressing (bmwd), per square centimeter	Integra bmwd
Q4105	0010	3	Integra dermal regeneration template (drt) or integra omnigraft dermal regeneration matrix, per square centimeter	Integra drt or omnigraft
Q4106	0010	3	Dermagraft, per square centimeter	Dermagraft
Q4107	0010	3	Graftjacket, per square centimeter	Graftjacket
Q4108	0010	3	Integra matrix, per square centimeter	Integra matrix
Q4110	0010	3	Primatrix, per square centimeter	Primatrix
Q4111	0010	3	Gammagraft, per square centimeter	Gammagraft
Q4112	0010	3	Cymetra, injectable, 1 cc	Cymetra injectable
Q4113	0010	3	Graftjacket xpress, injectable, 1 cc	Graftjacket xpress
Q4114	0010	3	Integra flowable wound matrix, injectable, 1 cc	Integra flowable wound matri
Q4115	0010	3	Alloskin, per square centimeter	Alloskin
Q4116	0010	3	Alloderm, per square centimeter	Alloderm
Q4117	0010	3	Hyalomatrix, per square centimeter	Hyalomatrix
Q4118	0010	3	Matristem micromatrix, 1 mg	Matristem micromatrix
Q4119	0010	3	Matristem wound matrix, per square centimeter	Matristem wound matrix
Q4120	0010	3	Matristem burn matrix, per square centimeter	Matristem burn matrix
Q4121	0010	3	Theraskin, per square centimeter	Theraskin
Q4122	0010	3	Dermacell, dermacell awm or dermacell awm porous, per square centimeter	Dermacell, awm, porous sq cm
Q4123	0010	3	Alloskin rt, per square centimeter	Alloskin
Q4124	0010	3	Oasis ultra tri-layer wound matrix, per square centimeter	Oasis tri-layer wound matrix
Q4125	0010	3	Arthroflex, per square centimeter	Arthroflex
Q4126	0010	3	Memoderm, dermaspan, tranzgraft or integuply, per square centimeter	Memoderm/derma/tranz/integup
Q4127	0010	3	Talymed, per square centimeter	Talymed
Q4128	0010	3	Flex hd, allopatch hd, or matrix hd, per square centimeter	Flexhd/allopatchhd/matrixhd
Q4129	0010	3	Unite biomatrix, per square centimeter	Unite biomatrix
Q4130	0010	3	Strattice tm, per square centimeter	Strattice tm
Q4131	0010	3	Epifix or epicord, per square centimeter	Epifix or epicord
Q4132	0010	3	Grafix core and grafixpl core, per square centimeter	Grafix core, grafixpl core
Q4133	0010	3	Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter	Grafix stravix prime pl sqcm
Q4134	0010	3	Hmatrix, per square centimeter	Hmatrix
Q4135	0010	3	Mediskin, per square centimeter	Mediskin
Q4136	0010	3	Ez-derm, per square centimeter	Ezderm
Q4137	0010	3	Amnioexcel, amnioexcel plus or biodexcel, per square centimeter	Amnioexcel biodexcel 1sq cm
Q4138	0010	3	Biodfence dryflex, per square centimeter	Biodfence dryflex, 1cm
Q4139	0010	3	Amniomatrix or biodmatrix, injectable, 1 cc	Amnio or biodmatrix, inj 1cc
Q4140	0010	3	Biodfence, per square centimeter	Biodfence 1cm
Q4141	0010	3	Alloskin ac, per square centimeter	Alloskin ac, 1 cm
Q4142	0010	3	Xcm biologic tissue matrix, per square centimeter	Xcm biologic tiss matrix 1cm
Q4143	0010	3	Repriza, per square centimeter	Repriza, 1cm
Q4145	0010	3	Epifix, injectable, 1 mg	Epifix, inj, 1mg
Q4146	0010	3	Tensix, per square centimeter	Tensix, 1cm
Q4147	0010	3	Architect, architect px, or architect fx, extracellular matrix, per square centimeter	Architect ecm px fx 1 sq cm
Q4148	0010	3	Neox cord 1k, neox cord rt, or clarix cord 1k, per square centimeter	Neox neox rt or clarix cord
Q4149	0010	3	Excellagen, 0.1 cc	Excellagen, 0.1 cc
Q4150	0010	3	Allowrap ds or dry, per square centimeter	Allowrap ds or dry 1 sq cm
Q4151	0010	3	Amnioband or guardian, per square centimeter	Amnioband, guardian 1 sq cm
Q4152	0010	3	Dermapure, per square centimeter	Dermapure 1 square cm
Q4153	0010	3	Dermavest and plurivest, per square centimeter	Dermavest, plurivest sq cm
Q4154	0010	3	Biovance, per square centimeter	Biovance 1 square cm
Q4155	0010	3	Neoxflo or clarixflo, 1 mg	Neoxflo or clarixflo 1 mg
Q4156	0010	3	Neox 100 or clarix 100, per square centimeter	Neox 100 or clarix 100
Q4157	0010	3	Revitalon, per square centimeter	Revitalon 1 square cm
Q4158	0010	3	Kerecis omega3, per square centimeter	Kerecis omega3, per sq cm
Q4159	0010	3	Affinity, per square centimeter	Affinity1 square cm
Q4160	0010	3	Nushield, per square centimeter	Nushield 1 square cm
Q4161	0010	3	Bio-connekt wound matrix, per square centimeter	Bio-connekt per square cm
Q4162	0010	3	Woundex flow, bioskin flow, 0.5 cc	Wndex flw, bioskn flw, 0.5cc
Q4163	0010	3	Woundex, bioskin, per square centimeter	Woundex, bioskin, per sq cm
Q4164	0010	3	Helicoll, per square centimeter	Helicoll, per square cm
Q4165	0010	3	Keramatrix or kerasorb, per square centimeter	Keramatrix, kerasorb sq cm
Q4166	0010	3	Cytal, per square centimeter	Cytal, per square centimeter
Q4167	0010	3	Truskin, per square centimeter	Truskin, per sq centimeter
Q4168	0010	3	Amnioband, 1 mg	Amnioband, 1 mg
Q4169	0010	3	Artacent wound, per square centimeter	Artacent wound, per sq cm
Q4170	0010	3	Cygnus, per square centimeter	Cygnus, per sq cm
Q4171	0010	3	Interfyl, 1 mg	Interfyl, 1 mg
Q4172	0010	3	Puraply or puraply am, per square centimeter	Puraply or puraply am
Q4173	0010	3	Palingen or palingen xplus, per square centimeter	Palingen or palingen xplus
Q4174	0010	3	Palingen or promatrx, 0.36 mg per 0.25 cc	Palingen or promatrx
Q4175	0010	3	Miroderm, per square centimeter	Miroderm
Q4176	0010	3	Neopatch, per square centimeter	Neopatch, per sq centimeter
Q4177	0010	3	Floweramnioflo, 0.1 cc	Floweramnioflo, 0.1 cc
Q4178	0010	3	Floweramniopatch, per square centimeter	Floweramniopatch, per sq cm
Q4179	0010	3	Flowerderm, per square centimeter	Flowerderm, per sq cm
Q4180	0010	3	Revita, per square centimeter	Revita, per sq cm
Q4181	0010	3	Amnio wound, per square centimeter	Amnio wound, per square cm
Q4182	0010	3	Transcyte, per square centimeter	Transcyte, per sq centimeter
Q4183	0010	3	Surgigraft, per square centimeter	Surgigraft, 1 sq cm
Q4184	0010	3	Cellesta or cellesta duo, per square centimeter	Cellesta or duo per sq cm
Q4185	0010	3	Cellesta flowable amnion (25 mg per cc); per 0.5 cc	Cellesta flowab amnion 0.5cc
Q4186	0010	3	Epifix, per square centimeter	Epifix 1 sq cm
Q4187	0010	3	Epicord, per square centimeter	Epicord 1 sq cm
Q4188	0010	3	Amnioarmor, per square centimeter	Amnioarmor 1 sq cm
Q4189	0010	3	Artacent ac, 1 mg	Artacent ac, 1 mg
Q4190	0010	3	Artacent ac, per square centimeter	Artacent ac 1 sq cm
Q4191	0010	3	Restorigin, per square centimeter	Restorigin 1 sq cm
Q4192	0010	3	Restorigin, 1 cc	Restorigin, 1 cc
Q4193	0010	3	Coll-e-derm, per square centimeter	Coll-e-derm 1 sq cm
Q4194	0010	3	Novachor, per square centimeter	Novachor 1 sq cm
Q4195	0010	3	Puraply, per square centimeter	Puraply 1 sq cm
Q4196	0010	3	Puraply am, per square centimeter	Puraply am 1 sq cm
Q4197	0010	3	Puraply xt, per square centimeter	Puraply xt 1 sq cm
Q4198	0010	3	Genesis amniotic membrane, per square centimeter	Genesis amnio membrane 1sqcm
Q4200	0010	3	Skin te, per square centimeter	Skin te 1 sq cm
Q4201	0010	3	Matrion, per square centimeter	Matrion 1 sq cm
Q4202	0010	3	Keroxx (2.5g/cc), 1cc	Keroxx (2.5g/cc), 1cc
Q4203	0010	3	Derma-gide, per square centimeter	Derma-gide, 1 sq cm
Q4204	0010	3	Xwrap, per square centimeter	Xwrap 1 sq cm
Q4205	0010	3	Membrane graft or membrane wrap, per square centimeter	Membrane graft or wrap sq cm
Q4206	0010	3	Fluid flow or fluid gf, 1 cc	Fluid flow or fluid gf 1 cc
Q4208	0010	3	Novafix, per square cenitmeter	Novafix per sq cm
Q4209	0010	3	Surgraft, per square centimeter	Surgraft per sq cm
Q4210	0010	3	Axolotl graft or axolotl dualgraft, per square centimeter	Axolotl graf dualgraf sq cm
Q4211	0010	3	Amnion bio or axobiomembrane, per square centimeter	Amnion bio or axobio sq cm
Q4212	0010	3	Allogen, per cc	Allogen, per cc
Q4213	0010	3	Ascent, 0.5 mg	Ascent, 0.5 mg
Q4214	0010	3	Cellesta cord, per square centimeter	Cellesta cord per sq cm
Q4215	0010	3	Axolotl ambient or axolotl cryo, 0.1 mg	Axolotl ambient, cryo 0.1 mg
Q4216	0010	3	Artacent cord, per square centimeter	Artacent cord per sq cm
Q4217	0010	3	Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter	Woundfix biowound plus xplus
Q4218	0010	3	Surgicord, per square centimeter	Surgicord per sq cm
Q4219	0010	3	Surgigraft-dual, per square centimeter	Surgigraft dual per sq cm
Q4220	0010	3	Bellacell hd or surederm, per square centimeter	Bellacell hd, surederm sq cm
Q4221	0010	3	Amniowrap2, per square centimeter	Amniowrap2 per sq cm
Q4222	0010	3	Progenamatrix, per square centimeter	Progenamatrix, per sq cm
Q4226	0010	3	Myown skin, includes harvesting and preparation procedures, per square centimeter	Myown harv prep proc sq cm
Q5001	0010	3	Hospice or home health care provided in patient’s home/residence	Hospice or home hlth in home
Q5002	0010	3	Hospice or home health care provided in assisted living facility	Hospice/home hlth in asst lv
Q5003	0010	3	Hospice care provided in nursing long term care facility (ltc) or non-skilled nursing facility (nf)	Hospice in lt/non-skilled nf
Q5004	0010	3	Hospice care provided in skilled nursing facility (snf)	Hospice in snf
Q5005	0010	3	Hospice care provided in inpatient hospital	Hospice, inpatient hospital
Q5006	0010	3	Hospice care provided in inpatient hospice facility	Hospice in hospice facility
Q5007	0010	3	Hospice care provided in long term care facility	Hospice in ltch
Q5008	0010	3	Hospice care provided in inpatient psychiatric facility	Hospice in inpatient psych
Q5009	0010	3	Hospice or home health care provided in place not otherwise specified (nos)	Hospice/home hlth, place nos
Q5010	0010	3	Hospice home care provided in a hospice facility	Hospice home care in hospice
Q5101	0010	3	Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram	Injection, zarxio
Q5102	0010	3	Injection, infliximab, biosimilar, 10 mg	Inj., infliximab biosimilar
Q5103	0010	3	Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg	Injection, inflectra
Q5104	0010	3	Injection, infliximab-abda, biosimilar, (renflexis), 10 mg	Injection, renflexis
Q5105	0010	3	Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units	Inj retacrit esrd on dialysi
Q5106	0010	3	Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units	Inj retacrit non-esrd use
Q5107	0010	3	Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg	Inj mvasi 10 mg
Q5108	0010	3	Injection, pegfilgrastim-jmdb, biosimilar, (fulphila), 0.5 mg	Injection, fulphila
Q5109	0010	3	Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mg	Injection, ixifi, 10 mg
Q5110	0010	3	Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram	Nivestym
Q5111	0010	3	Injection, pegfilgrastim-cbqv, biosimilar, (udenyca), 0.5 mg	Injection, udenyca 0.5 mg
Q5112	0010	3	Injection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mg	Inj ontruzant 10 mg
Q5113	0010	3	Injection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mg	Inj herzuma 10 mg
Q5114	0010	3	Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg	Inj ogivri 10 mg
Q5115	0010	3	Injection, rituximab-abbs, biosimilar, (truxima), 10 mg	Inj truxima 10 mg
Q5116	0010	3	Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg	Inj., trazimera, 10 mg
Q5117	0010	3	Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg	Inj., kanjinti, 10 mg
Q5118	0010	3	Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg	Inj., zirabev, 10 mg
Q9950	0010	3	Injection, sulfur hexafluoride lipid microspheres, per ml	Inj sulf hexa lipid microsph
Q9951	0010	3	Low osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml	Locm >= 400 mg/ml iodine,1ml
Q9953	0010	3	Injection, iron-based magnetic resonance contrast agent, per ml	Inj fe-based mr contrast,1ml
Q9954	0010	3	Oral magnetic resonance contrast agent, per 100 ml	Oral mr contrast, 100 ml
Q9955	0010	3	Injection, perflexane lipid microspheres, per ml	Inj perflexane lip micros,ml
Q9956	0010	3	Injection, octafluoropropane microspheres, per ml	Inj octafluoropropane mic,ml
Q9957	0010	3	Injection, perflutren lipid microspheres, per ml	Inj perflutren lip micros,ml
Q9958	0010	3	High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml	Hocm <=149 mg/ml iodine, 1ml
Q9959	0010	3	High osmolar contrast material, 150-199 mg/ml iodine concentration, per ml	Hocm 150-199mg/ml iodine,1ml
Q9960	0010	3	High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml	Hocm 200-249mg/ml iodine,1ml
Q9961	0010	3	High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml	Hocm 250-299mg/ml iodine,1ml
Q9962	0010	3	High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml	Hocm 300-349mg/ml iodine,1ml
Q9963	0010	3	High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml	Hocm 350-399mg/ml iodine,1ml
Q9964	0010	3	High osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml	Hocm>= 400mg/ml iodine, 1ml
Q9965	0010	3	Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml	Locm 100-199mg/ml iodine,1ml
Q9966	0010	3	Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml	Locm 200-299mg/ml iodine,1ml
Q9967	0010	3	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	Locm 300-399mg/ml iodine,1ml
Q9968	0010	3	Injection, non-radioactive, non-contrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg	Visualization adjunct
Q9969	0010	3	Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose	Non-heu tc-99m add-on/dose
Q9970	0010	3	Injection, ferric carboxymaltose, 1mg	Inj ferric carboxymaltos 1mg
Q9972	0010	3	Injection, epoetin beta, 1 microgram, (for esrd on dialysis)	Epoetin beta esrd use
Q9973	0010	3	Injection, epoetin beta, 1 microgram, (non-esrd use)	Epoetin beta non esrd
Q9974	0010	3	Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg	Morphine epidural/intratheca
Q9975	0010	3	Injection, factor viii fc fusion protein (recombinant), per iu	Factor viii fc fusion recomb
Q9976	0010	3	Injection, ferric pyrophosphate citrate solution, 0.1 mg of iron	Inj ferric pyrophosphate cit
Q9977	0010	3	Compounded drug, not otherwise classified	Compounded drug noc
Q9978	0010	3	Netupitant 300 mg and palonosetron 0.5 mg	Netupitant palonosetron oral
Q9979	0010	3	Injection, alemtuzumab, 1 mg	Injection, alemtuzumab
Q9980	0010	3	Hyaluronan or derivative, genvisc 850, for intra-articular injection, 1 mg	Genvisc, inj, 1mg
Q9981	0010	3	Rolapitant, oral, 1 mg	Rolapitant, oral, 1mg
Q9982	0010	3	Flutemetamol f18, diagnostic, per study dose, up to 5 millicuries	Flutemetamol f18 diagnostic
Q9983	0010	3	Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries	Florbetaben f18 diagnostic
Q9984	0010	3	Levonorgestrel-releasing intrauterine contraceptive system (kyleena), 19.5 mg	Kyleena, 19.5 mg
Q9985	0010	3	Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg	Inj hydroxyprogst capoat nos
Q9986	0010	3	Injection, hydroxyprogesterone caproate, (makena), 10 mg	Makena, 10 mg
Q9987	0010	3	Pathogen(s) test for platelets	Pathogen test for platelets
Q9988	0010	3	Platelets, pheresis, pathogen-reduced, each unit	Platelets, pathogen reduced
Q9989	0010	3	Ustekinumab, for intravenous injection, 1 mg	Ustekinumab, iv inject,1 mg
Q9991	0010	3	Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg	Buprenorph xr 100 mg or less
Q9992	0010	3	Injection, buprenorphine extended-release (sublocade), greater than 100 mg	Buprenorphine xr over 100 mg
Q9993	0010	3	Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg	Inj., triamcinolone ext rel
Q9994	0010	3	In-line cartridge containing digestive enzyme(s) for enteral feeding, each	Enzyme cartridge enteral nut
Q9995	0010	3	Injection, emicizumab-kxwh, 0.5 mg	Inj., emicizumab-kxwh 0.5 mg

R0000–R9999: Diagnostic Radiology Services

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
R0070	0010	3	Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen	Transport portable x-ray
R0075	0010	3	Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen	Transport port x-ray multipl
R0076	0010	3	Transportation of portable ekg to facility or location, per patient	Transport portable ekg

S0000-S9999: Commercial Payers

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
S0012	0010	3	Butorphanol tartrate, nasal spray, 25 mg	Butorphanol tartrate, nasal
S0014	0010	3	Tacrine hydrochloride, 10 mg	Tacrine hydrochloride, 10 mg
S0017	0010	3	Injection, aminocaproic acid, 5 grams	Injection, aminocaproic acid
S0020	0010	3	Injection, bupivicaine hydrochloride, 30 ml	Injection, bupivicaine hydro
S0021	0010	3	Injection, cefoperazone sodium, 1 gram	Injection, cefoperazone sod
S0023	0010	3	Injection, cimetidine hydrochloride, 300 mg	Injection, cimetidine hydroc
S0028	0010	3	Injection, famotidine, 20 mg	Injection, famotidine, 20 mg
S0030	0010	3	Injection, metronidazole, 500 mg	Injection, metronidazole
S0032	0010	3	Injection, nafcillin sodium, 2 grams	Injection, nafcillin sodium
S0034	0010	3	Injection, ofloxacin, 400 mg	Injection, ofloxacin, 400 mg
S0039	0010	3	Injection, sulfamethoxazole and trimethoprim, 10 ml	Injection, sulfamethoxazole
S0040	0010	3	Injection, ticarcillin disodium and clavulanate potassium, 3.1 grams	Injection, ticarcillin disod
S0073	0010	3	Injection, aztreonam, 500 mg	Injection, aztreonam, 500 mg
S0074	0010	3	Injection, cefotetan disodium, 500 mg	Injection, cefotetan disodiu
S0077	0010	3	Injection, clindamycin phosphate, 300 mg	Injection, clindamycin phosp
S0078	0010	3	Injection, fosphenytoin sodium, 750 mg	Injection, fosphenytoin sodi
S0080	0010	3	Injection, pentamidine isethionate, 300 mg	Injection, pentamidine iseth
S0081	0010	3	Injection, piperacillin sodium, 500 mg	Injection, piperacillin sodi
S0088	0010	3	Imatinib, 100 mg	Imatinib 100 mg
S0090	0010	3	Sildenafil citrate, 25 mg	Sildenafil citrate, 25 mg
S0091	0010	3	Granisetron hydrochloride, 1 mg (for circumstances falling under the medicare statute, use q0166)	Granisetron 1mg
S0092	0010	3	Injection, hydromorphone hydrochloride, 250 mg (loading dose for infusion pump)	Hydromorphone 250 mg
S0093	0010	3	Injection, morphine sulfate, 500 mg (loading dose for infusion pump)	Morphine 500 mg
S0104	0010	3	Zidovudine, oral, 100 mg	Zidovudine, oral, 100 mg
S0106	0010	3	Bupropion hcl sustained release tablet, 150 mg, per bottle of 60 tablets	Bupropion hcl sr 60 tablets
S0108	0010	3	Mercaptopurine, oral, 50 mg	Mercaptopurine 50 mg
S0109	0010	3	Methadone, oral, 5 mg	Methadone oral 5mg
S0117	0010	3	Tretinoin, topical, 5 grams	Tretinoin topical 5 g
S0119	0010	3	Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code)	Ondansetron 4 mg
S0122	0010	3	Injection, menotropins, 75 iu	Inj menotropins 75 iu
S0126	0010	3	Injection, follitropin alfa, 75 iu	Inj follitropin alfa 75 iu
S0128	0010	3	Injection, follitropin beta, 75 iu	Inj follitropin beta 75 iu
S0132	0010	3	Injection, ganirelix acetate, 250 mcg	Inj ganirelix acetat 250 mcg
S0136	0010	3	Clozapine, 25 mg	Clozapine, 25 mg
S0137	0010	3	Didanosine (ddi), 25 mg	Didanosine, 25 mg
S0138	0010	3	Finasteride, 5 mg	Finasteride, 5 mg
S0139	0010	3	Minoxidil, 10 mg	Minoxidil, 10 mg
S0140	0010	3	Saquinavir, 200 mg	Saquinavir, 200 mg
S0142	0010	3	Colistimethate sodium, inhalation solution administered through dme, concentrated form, per mg	Colistimethate inh sol mg
S0144	0010	3	Injection, propofol, 10 mg	Inj, propofol, 10 mg
S0145	0010	3	Injection, pegylated interferon alfa-2a, 180 mcg per ml	Peg interferon alfa-2a/180
S0148	0010	3	Injection, pegylated interferon alfa-2b, 10 mcg	Peg interferon alfa-2b/10
S0155	0010	3	Sterile dilutant for epoprostenol, 50 ml	Epoprostenol dilutant
S0156	0010	3	Exemestane, 25 mg	Exemestane, 25 mg
S0157	0010	3	Becaplermin gel 0.01%, 0.5 gm	Becaplermin gel 1%, 0.5 gm
S0160	0010	3	Dextroamphetamine sulfate, 5 mg	Dextroamphetamine
S0164	0010	3	Injection, pantoprazole sodium, 40 mg	Injection pantroprazole
S0166	0010	3	Injection, olanzapine, 2.5 mg	Inj olanzapine 2.5mg
S0169	0010	3	Calcitrol, 0.25 microgram	Calcitrol
S0170	0010	3	Anastrozole, oral, 1 mg	Anastrozole 1 mg
S0171	0010	3	Injection, bumetanide, 0.5 mg	Bumetanide 0.5 mg
S0172	0010	3	Chlorambucil, oral, 2 mg	Chlorambucil 2 mg
S0174	0010	3	Dolasetron mesylate, oral 50 mg (for circumstances falling under the medicare statute, use q0180)	Dolasetron 50 mg
S0175	0010	3	Flutamide, oral, 125 mg	Flutamide 125 mg
S0176	0010	3	Hydroxyurea, oral, 500 mg	Hydroxyurea 500 mg
S0177	0010	3	Levamisole hydrochloride, oral, 50 mg	Levamisole 50 mg
S0178	0010	3	Lomustine, oral, 10 mg	Lomustine 10 mg
S0179	0010	3	Megestrol acetate, oral, 20 mg	Megestrol 20 mg
S0182	0010	3	Procarbazine hydrochloride, oral, 50 mg	Procarbazine, oral
S0183	0010	3	Prochlorperazine maleate, oral, 5 mg (for circumstances falling under the medicare statute, use q0164)	Prochlorperazine 5 mg
S0187	0010	3	Tamoxifen citrate, oral, 10 mg	Tamoxifen 10 mg
S0189	0010	3	Testosterone pellet, 75 mg	Testosterone pellet 75 mg
S0190	0010	3	Mifepristone, oral, 200 mg	Mifepristone, oral, 200 mg
S0191	0010	3	Misoprostol, oral, 200 mcg	Misoprostol, oral, 200 mcg
S0194	0010	3	Dialysis/stress vitamin supplement, oral, 100 capsules	Vitamin suppl 100 caps
S0195	0010	3	Pneumococcal conjugate vaccine, polyvalent, intramuscular, for children from five years to nine years of age who have not previously received the vaccine	Pneumo vaccine 5-9 yrs
S0197	0010	3	Prenatal vitamins, 30-day supply	Prenatal vitamins 30 day
S0199	0010	3	Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs	Med abortion inc all ex drug
S0201	0010	3	Partial hospitalization services, less than 24 hours, per diem	Partial hospitalization serv
S0207	0010	3	Paramedic intercept, non-hospital-based als service (non-voluntary), non-transport	Paramedicintercep nonhospals
S0208	0010	3	Paramedic intercept, hospital-based als service (non-voluntary), non-transport	Paramed intrcept nonvol
S0209	0010	3	Wheelchair van, mileage, per mile	Wc van mileage per mi
S0215	0010	3	Non-emergency transportation; mileage, per mile	Nonemerg transp mileage
S0220	0010	3	Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 30 minutes	Medical conference by physic
S0221	0010	3	Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 60 minutes	Medical conference, 60 min
S0250	0010	3	Comprehensive geriatric assessment and treatment planning performed by assessment team	Comp geriatr assmt team
S0255	0010	3	Hospice referral visit (advising patient and family of care options) performed by nurse, social worker, or other designated staff	Hospice refer visit nonmd
S0257	0010	3	Counseling and discussion regarding advance directives or end of life care planning and decisions, with patient and/or surrogate (list separately in addition to code for appropriate evaluation and management service)	End of life counseling
S0260	0010	3	History and physical (outpatient or office) related to surgical procedure (list separately in addition to code for appropriate evaluation and management service)	H&p for surgery
S0265	0010	3	Genetic counseling, under physician supervision, each 15 minutes	Genetic counsel 15 mins
S0270	0010	3	Physician management of patient home care, standard monthly case rate (per 30 days)	Home std case rate 30 days
S0271	0010	3	Physician management of patient home care, hospice monthly case rate (per 30 days)	Home hospice case 30 days
S0272	0010	3	Physician management of patient home care, episodic care monthly case rate (per 30 days)	Home episodic case 30 days
S0273	0010	3	Physician visit at member’s home, outside of a capitation arrangement	Md home visit outside cap
S0274	0010	3	Nurse practitioner visit at member’s home, outside of a capitation arrangement	Nurse practr visit outs cap
S0280	0010	3	Medical home program, comprehensive care coordination and planning, initial plan	Medical home, initial plan
S0281	0010	3	Medical home program, comprehensive care coordination and planning, maintenance of plan	Medical home, maintenance
S0285	0010	3	Colonoscopy consultation performed prior to a screening colonoscopy procedure	Cnslt before screen colonosc
S0302	0010	3	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	Completed epsdt
S0310	0010	3	Hospitalist services (list separately in addition to code for appropriate evaluation and management service)	Hospitalist visit
S0311	0010	3	Comprehensive management and care coordination for advanced illness, per calendar month	Comp mgmt care coord adv ill
S0315	0010	3	Disease management program; initial assessment and initiation of the program	Disease management program
S0316	0010	3	Disease management program, follow-up/reassessment	Follow-up/reassessment
S0317	0010	3	Disease management program; per diem	Disease mgmt per diem
S0320	0010	3	Telephone calls by a registered nurse to a disease management program member for monitoring purposes; per month	Rn telephone calls to dmp
S0340	0010	3	Lifestyle modification program for management of coronary artery disease, including all supportive services; first quarter / stage	Lifestyle mod 1st stage
S0341	0010	3	Lifestyle modification program for management of coronary artery disease, including all supportive services; second or third quarter / stage	Lifestyle mod 2 or 3 stage
S0342	0010	3	Lifestyle modification program for management of coronary artery disease, including all supportive services; fourth quarter / stage	Lifestyle mod 4th stage
S0353	0010	3	Treatment planning and care coordination management for cancer, initial treatment	Cancer treatmentplan initial
S0354	0010	3	Treatment planning and care coordination management for cancer, established patient with a change of regimen	Cancer treatment plan change
S0390	0010	3	Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit	Rout foot care per visit
S0395	0010	3	Impression casting of a foot performed by a practitioner other than the manufacturer of the orthotic	Impression casting ft
S0400	0010	3	Global fee for extracorporeal shock wave lithotripsy treatment of kidney stone(s)	Global eswl kidney
S0500	0010	3	Disposable contact lens, per lens	Dispos cont lens
S0504	0010	3	Single vision prescription lens (safety, athletic, or sunglass), per lens	Singl prscrp lens
S0506	0010	3	Bifocal vision prescription lens (safety, athletic, or sunglass), per lens	Bifoc prscp lens
S0508	0010	3	Trifocal vision prescription lens (safety, athletic, or sunglass), per lens	Trifoc prscrp lens
S0510	0010	3	Non-prescription lens (safety, athletic, or sunglass), per lens	Non-prscrp lens
S0512	0010	3	Daily wear specialty contact lens, per lens	Daily cont lens
S0514	0010	3	Color contact lens, per lens	Color cont lens
S0515	0010	3	Scleral lens, liquid bandage device, per lens	Scleral lens liquid bandage
S0516	0010	3	Safety eyeglass frames	Safety frames
S0518	0010	3	Sunglasses frames	Sunglass frames
S0580	0010	3	Polycarbonate lens (list this code in addition to the basic code for the lens)	Polycarb lens
S0581	0010	3	Nonstandard lens (list this code in addition to the basic code for the lens)	Nonstnd lens
S0590	0010	3	Integral lens service, miscellaneous services reported separately	Misc integral lens serv
S0592	0010	3	Comprehensive contact lens evaluation	Comp cont lens eval
S0595	0010	3	Dispensing new spectacle lenses for patient supplied frame	New lenses in pts old frame
S0596	0010	3	Phakic intraocular lens for correction of refractive error	Phakic iol refractive error
S0601	0010	3	Screening proctoscopy	Screening proctoscopy
S0610	0010	3	Annual gynecological examination, new patient	Annual gynecological examina
S0612	0010	3	Annual gynecological examination, established patient	Annual gynecological examina
S0613	0010	3	Annual gynecological examination; clinical breast examination without pelvic evaluation	Ann breast exam
S0618	0010	3	Audiometry for hearing aid evaluation to determine the level and degree of hearing loss	Audiometry for hearing aid
S0620	0010	3	Routine ophthalmological examination including refraction; new patient	Routine ophthalmological exa
S0621	0010	3	Routine ophthalmological examination including refraction; established patient	Routine ophthalmological exa
S0622	0010	3	Physical exam for college, new or established patient (list separately in addition to appropriate evaluation and management code)	Phys exam for college
S0630	0010	3	Removal of sutures; by a physician other than the physician who originally closed the wound	Removal of sutures
S0800	0010	3	Laser in situ keratomileusis (lasik)	Laser in situ keratomileusis
S0810	0010	3	Photorefractive keratectomy (prk)	Photorefractive keratectomy
S0812	0010	3	Phototherapeutic keratectomy (ptk)	Phototherap keratect
S1001	0010	3	Deluxe item, patient aware (list in addition to code for basic item)	Deluxe item
S1002	0010	3	Customized item (list in addition to code for basic item)	Custom item
S1015	0010	3	Iv tubing extension set	Iv tubing extension set
S1016	0010	3	Non-pvc (polyvinyl chloride) intravenous administration set, for use with drugs that are not stable in pvc e.g., paclitaxel	Non-pvc intravenous administ
S1030	0010	3	Continuous noninvasive glucose monitoring device, purchase (for physician interpretation of data, use cpt code)	Gluc monitor purchase
S1031	0010	3	Continuous noninvasive glucose monitoring device, rental, including sensor, sensor replacement, and download to monitor (for physician interpretation of data, use cpt code)	Gluc monitor rental
S1034	0010	3	Artificial pancreas device system (e.g., low glucose suspend (lgs) feature) including continuous glucose monitor, blood glucose device, insulin pump and computer algorithm that communicates with all of the devices	Art pancreas system
S1035	0010	3	Sensor; invasive (e.g., subcutaneous), disposable, for use with artificial pancreas device system	Art pancreas inv disp sensor
S1036	0010	3	Transmitter; external, for use with artificial pancreas device system	Art pancreas ext transmitter
S1037	0010	3	Receiver (monitor); external, for use with artificial pancreas device system	Art pancreas ext receiver
S1040	0010	3	Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)	Cranial remolding orthosis
S1090	0010	3	Mometasone furoate sinus implant, 370 micrograms	Mometasone sinus implant
S2053	0010	3	Transplantation of small intestine and liver allografts	Transplantation of small int
S2054	0010	3	Transplantation of multivisceral organs	Transplantation of multivisc
S2055	0010	3	Harvesting of donor multivisceral organs, with preparation and maintenance of allografts; from cadaver donor	Harvesting of donor multivis
S2060	0010	3	Lobar lung transplantation	Lobar lung transplantation
S2061	0010	3	Donor lobectomy (lung) for transplantation, living donor	Donor lobectomy (lung)
S2065	0010	3	Simultaneous pancreas kidney transplantation	Simult panc kidn trans
S2066	0010	3	Breast reconstruction with gluteal artery perforator (gap) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral	Breast gap flap reconst
S2067	0010	3	Breast reconstruction of a single breast with “stacked” deep inferior epigastric perforator (diep) flap(s) and/or gluteal artery perforator (gap) flap(s), including harvesting of the flap(s), microvascular transfer, closure of donor site(s) and shaping the flap into a breast, unilateral	Breast “stacked” diep/gap
S2068	0010	3	Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral	Breast diep or siea flap
S2070	0010	3	Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with endoscopic laser treatment of ureteral calculi (includes ureteral catheterization)	Cysto laser tx ureteral calc
S2079	0010	3	Laparoscopic esophagomyotomy (heller type)	Lap esophagomyotomy
S2080	0010	3	Laser-assisted uvulopalatoplasty (laup)	Laup
S2083	0010	3	Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline	Adjustment gastric band
S2095	0010	3	Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres	Transcath emboliz microspher
S2102	0010	3	Islet cell tissue transplant from pancreas; allogeneic	Islet cell tissue transplant
S2103	0010	3	Adrenal tissue transplant to brain	Adrenal tissue transplant
S2107	0010	3	Adoptive immunotherapy i.e. development of specific anti-tumor reactivity (e.g., tumor-infiltrating lymphocyte therapy) per course of treatment	Adoptive immunotherapy
S2112	0010	3	Arthroscopy, knee, surgical for harvesting of cartilage (chondrocyte cells)	Knee arthroscp harv
S2115	0010	3	Osteotomy, periacetabular, with internal fixation	Periacetabular osteotomy
S2117	0010	3	Arthroereisis, subtalar	Arthroereisis, subtalar
S2118	0010	3	Metal-on-metal total hip resurfacing, including acetabular and femoral components	Total hip resurfacing
S2120	0010	3	Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation	Low density lipoprotein(ldl)
S2140	0010	3	Cord blood harvesting for transplantation, allogeneic	Cord blood harvesting
S2142	0010	3	Cord blood-derived stem-cell transplantation, allogeneic	Cord blood-derived stem-cell
S2150	0010	3	Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; marrow ablative therapy; drugs, supplies, hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services; and the number of days of pre-and post-transplant care in the global definition	Bmt harv/transpl 28d pkg
S2152	0010	3	Solid organ(s), complete or segmental, single organ or combination of organs; deceased or living donor(s), procurement, transplantation, and related complications; including: drugs; supplies; hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services, and the number of days of pre- and post-transplant care in the global definition	Solid organ transpl pkg
S2202	0010	3	Echosclerotherapy	Echosclerotherapy
S2205	0010	3	Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), single coronary arterial graft	Minimally invasive direct co
S2206	0010	3	Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), two coronary arterial grafts	Minimally invasive direct co
S2207	0010	3	Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using venous graft only, single coronary venous graft	Minimally invasive direct co
S2208	0010	3	Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and venous graft(s), single venous graft	Minimally invasive direct co
S2209	0010	3	Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using two arterial grafts and single venous graft	Minimally invasive direct co
S2225	0010	3	Myringotomy, laser-assisted	Myringotomy laser-assist
S2230	0010	3	Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear	Implant semi-imp hear
S2235	0010	3	Implantation of auditory brain stem implant	Implant auditory brain imp
S2260	0010	3	Induced abortion, 17 to 24 weeks	Induced abortion 17-24 weeks
S2265	0010	3	Induced abortion, 25 to 28 weeks	Induced abortion 25-28 wks
S2266	0010	3	Induced abortion, 29 to 31 weeks	Induced abortion 29-31 wks
S2267	0010	3	Induced abortion, 32 weeks or greater	Induced abortion 32 or more
S2300	0010	3	Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy	Arthroscopy, shoulder, surgi
S2325	0010	3	Hip core decompression	Hip core decompression
S2340	0010	3	Chemodenervation of abductor muscle(s) of vocal cord	Chemodenervation of abductor
S2341	0010	3	Chemodenervation of adductor muscle(s) of vocal cord	Chemodenerv adduct vocal
S2342	0010	3	Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(s), unilateral or bilateral	Nasal endoscop po debrid
S2348	0010	3	Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar	Decompress disc rf lumbar
S2350	0010	3	Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace	Diskectomy, anterior, with d
S2351	0010	3	Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure)	Diskectomy, anterior, with d
S2360	0010	3	Percutaneous vertebroplasty, one vertebral body, unilateral or bilateral injection; cervical	Vertebroplast cerv 1st
S2361	0010	3	Each additional cervical vertebral body (list separately in addition to code for primary procedure)	Vertebroplast cerv addl
S2400	0010	3	Repair, congenital diaphragmatic hernia in the fetus using temporary tracheal occlusion, procedure performed in utero	Fetal surg congen hernia
S2401	0010	3	Repair, urinary tract obstruction in the fetus, procedure performed in utero	Fetal surg urin trac obstr
S2402	0010	3	Repair, congenital cystic adenomatoid malformation in the fetus, procedure performed in utero	Fetal surg cong cyst malf
S2403	0010	3	Repair, extralobar pulmonary sequestration in the fetus, procedure performed in utero	Fetal surg pulmon sequest
S2404	0010	3	Repair, myelomeningocele in the fetus, procedure performed in utero	Fetal surg myelomeningo
S2405	0010	3	Repair of sacrococcygeal teratoma in the fetus, procedure performed in utero	Fetal surg sacrococ teratoma
S2409	0010	3	Repair, congenital malformation of fetus, procedure performed in utero, not otherwise classified	Fetal surg noc
S2411	0010	3	Fetoscopic laser therapy for treatment of twin-to-twin transfusion syndrome	Fetoscop laser ther ttts
S2900	0010	3	Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure)	Robotic surgical system
S3000	0010	3	Diabetic indicator; retinal eye exam, dilated, bilateral	Bilat dil retinal exam
S3005	0010	3	Performance measurement, evaluation of patient self assessment, depression	Eval self-assess depression
S3600	0010	3	Stat laboratory request (situations other than s3601)	Stat lab
S3601	0010	3	Emergency stat laboratory charge for patient who is homebound or residing in a nursing facility	Stat lab home/nf
S3620	0010	3	Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total)	Newborn metabolic screening
S3630	0010	3	Eosinophil count, blood, direct	Eosinophil blood count
S3645	0010	3	Hiv-1 antibody testing of oral mucosal transudate	Hiv-1 antibody testing of or
S3650	0010	3	Saliva test, hormone level; during menopause	Saliva test, hormone level;
S3652	0010	3	Saliva test, hormone level; to assess preterm labor risk	Saliva test, hormone level;
S3655	0010	3	Antisperm antibodies test (immunobead)	Antisperm antibodies test
S3708	0010	3	Gastrointestinal fat absorption study	Gastrointestinal fat absorpt
S3721	0010	3	Prostate cancer antigen 3 (pca3) testing	Pca3 testing
S3722	0010	3	Dose optimization by area under the curve (auc) analysis, for infusional 5-fluorouracil	Dose optimization auc - 5fu
S3800	0010	3	Genetic testing for amyotrophic lateral sclerosis (als)	Genetic testing als
S3840	0010	3	Dna analysis for germline mutations of the ret proto-oncogene for susceptibility to multiple endocrine neoplasia type 2	Dna analysis ret-oncogene
S3841	0010	3	Genetic testing for retinoblastoma	Gene test retinoblastoma
S3842	0010	3	Genetic testing for von hippel-lindau disease	Gene test hippel-lindau
S3844	0010	3	Dna analysis of the connexin 26 gene (gjb2) for susceptibility to congenital, profound deafness	Dna analysis deafness
S3845	0010	3	Genetic testing for alpha-thalassemia	Gene test alpha-thalassemia
S3846	0010	3	Genetic testing for hemoglobin e beta-thalassemia	Gene test beta-thalassemia
S3849	0010	3	Genetic testing for niemann-pick disease	Gene test niemann-pick
S3850	0010	3	Genetic testing for sickle cell anemia	Gene test sickle cell
S3852	0010	3	Dna analysis for apoe epsilon 4 allele for susceptibility to alzheimer’s disease	Dna analysis apoe alzheimer
S3853	0010	3	Genetic testing for myotonic muscular dystrophy	Gene test myo musclr dyst
S3854	0010	3	Gene expression profiling panel for use in the management of breast cancer treatment	Gene profile panel breast
S3855	0010	3	Genetic testing for detection of mutations in the presenilin - 1 gene	Gene test presenilin-1 gene
S3861	0010	3	Genetic testing, sodium channel, voltage-gated, type v, alpha subunit (scn5a) and variants for suspected brugada syndrome	Genetic test brugada
S3865	0010	3	Comprehensive gene sequence analysis for hypertrophic cardiomyopathy	Comp genet test hyp cardiomy
S3866	0010	3	Genetic analysis for a specific gene mutation for hypertrophic cardiomyopathy (hcm) in an individual with a known hcm mutation in the family	Spec gene test hyp cardiomy
S3870	0010	3	Comparative genomic hybridization (cgh) microarray testing for developmental delay, autism spectrum disorder and/or intellectual disability	Cgh test developmental delay
S3890	0010	3	Dna analysis, fecal, for colorectal cancer screening	Fecal dna analysis
S3900	0010	3	Surface electromyography (emg)	Surface emg
S3902	0010	3	Ballistocardiogram	Ballistocardiogram
S3904	0010	3	Masters two step	Masters two step
S4005	0010	3	Interim labor facility global (labor occurring but not resulting in delivery)	Interim labor facility globa
S4011	0010	3	In vitro fertilization; including but not limited to identification and incubation of mature oocytes, fertilization with sperm, incubation of embryo(s), and subsequent visualization for determination of development	Ivf package
S4013	0010	3	Complete cycle, gamete intrafallopian transfer (gift), case rate	Compl gift case rate
S4014	0010	3	Complete cycle, zygote intrafallopian transfer (zift), case rate	Compl zift case rate
S4015	0010	3	Complete in vitro fertilization cycle, not otherwise specified, case rate	Complete ivf nos case rate
S4016	0010	3	Frozen in vitro fertilization cycle, case rate	Frozen ivf case rate
S4017	0010	3	Incomplete cycle, treatment cancelled prior to stimulation, case rate	Ivf canc a stim case rate
S4018	0010	3	Frozen embryo transfer procedure cancelled before transfer, case rate	F emb trns canc case rate
S4020	0010	3	In vitro fertilization procedure cancelled before aspiration, case rate	Ivf canc a aspir case rate
S4021	0010	3	In vitro fertilization procedure cancelled after aspiration, case rate	Ivf canc p aspir case rate
S4022	0010	3	Assisted oocyte fertilization, case rate	Asst oocyte fert case rate
S4023	0010	3	Donor egg cycle, incomplete, case rate	Incompl donor egg case rate
S4025	0010	3	Donor services for in vitro fertilization (sperm or embryo), case rate	Donor serv ivf case rate
S4026	0010	3	Procurement of donor sperm from sperm bank	Procure donor sperm
S4027	0010	3	Storage of previously frozen embryos	Store prev froz embryos
S4028	0010	3	Microsurgical epididymal sperm aspiration (mesa)	Microsurg epi sperm asp
S4030	0010	3	Sperm procurement and cryopreservation services; initial visit	Sperm procure init visit
S4031	0010	3	Sperm procurement and cryopreservation services; subsequent visit	Sperm procure subs visit
S4035	0010	3	Stimulated intrauterine insemination (iui), case rate	Stimulated iui case rate
S4037	0010	3	Cryopreserved embryo transfer, case rate	Cryo embryo transf case rate
S4040	0010	3	Monitoring and storage of cryopreserved embryos, per 30 days	Monit store cryo embryo 30 d
S4042	0010	3	Management of ovulation induction (interpretation of diagnostic tests and studies, non-face-to-face medical management of the patient), per cycle	Ovulation mgmt per cycle
S4981	0010	3	Insertion of levonorgestrel-releasing intrauterine system	Insert levonorgestrel ius
S4989	0010	3	Contraceptive intrauterine device (e.g., progestacert iud), including implants and supplies	Contracept iud
S4990	0010	3	Nicotine patches, legend	Nicotine patch legend
S4991	0010	3	Nicotine patches, non-legend	Nicotine patch nonlegend
S4993	0010	3	Contraceptive pills for birth control	Contraceptive pills for bc
S4995	0010	3	Smoking cessation gum	Smoking cessation gum
S5000	0010	3	Prescription drug, generic	Prescription drug, generic
S5001	0010	3	Prescription drug, brand name	Prescription drug,brand name
S5010	0010	3	5% dextrose and 0.45% normal saline, 1000 ml	5% dextrose and 0.45% saline
S5011	0010	3	5% dextrose in lactated ringer’s, 1000 ml	5% dextrose in lactated ring
S5012	0010	3	5% dextrose with potassium chloride, 1000 ml	5% dextrose with potassium
S5013	0010	3	5% dextrose/0.45% normal saline with potassium chloride and magnesium sulfate, 1000 ml	5%dextrose/0.45%saline1000ml
S5014	0010	3	5% dextrose/0.45% normal saline with potassium chloride and magnesium sulfate, 1500 ml	D5w/0.45ns w kcl and mgs04
S5035	0010	3	Home infusion therapy, routine service of infusion device (e.g., pump maintenance)	Hit routine device maint
S5036	0010	3	Home infusion therapy, repair of infusion device (e.g., pump repair)	Hit device repair
S5100	0010	3	Day care services, adult; per 15 minutes	Adult daycare services 15min
S5101	0010	3	Day care services, adult; per half day	Adult day care per half day
S5102	0010	3	Day care services, adult; per diem	Adult day care per diem
S5105	0010	3	Day care services, center-based; services not included in program fee, per diem	Centerbased day care perdiem
S5108	0010	3	Home care training to home care client, per 15 minutes	Homecare train pt 15 min
S5109	0010	3	Home care training to home care client, per session	Homecare train pt session
S5110	0010	3	Home care training, family; per 15 minutes	Family homecare training 15m
S5111	0010	3	Home care training, family; per session	Family homecare train/sessio
S5115	0010	3	Home care training, non-family; per 15 minutes	Nonfamily homecare train/15m
S5116	0010	3	Home care training, non-family; per session	Nonfamily hc train/session
S5120	0010	3	Chore services; per 15 minutes	Chore services per 15 min
S5121	0010	3	Chore services; per diem	Chore services per diem
S5125	0010	3	Attendant care services; per 15 minutes	Attendant care service /15m
S5126	0010	3	Attendant care services; per diem	Attendant care service /diem
S5130	0010	3	Homemaker service, nos; per 15 minutes	Homaker service nos per 15m
S5131	0010	3	Homemaker service, nos; per diem	Homemaker service nos /diem
S5135	0010	3	Companion care, adult (e.g., iadl/adl); per 15 minutes	Adult companioncare per 15m
S5136	0010	3	Companion care, adult (e.g., iadl/adl); per diem	Adult companioncare per diem
S5140	0010	3	Foster care, adult; per diem	Adult foster care per diem
S5141	0010	3	Foster care, adult; per month	Adult foster care per month
S5145	0010	3	Foster care, therapeutic, child; per diem	Child fostercare th per diem
S5146	0010	3	Foster care, therapeutic, child; per month	Ther fostercare child /month
S5150	0010	3	Unskilled respite care, not hospice; per 15 minutes	Unskilled respite care /15m
S5151	0010	3	Unskilled respite care, not hospice; per diem	Unskilled respitecare /diem
S5160	0010	3	Emergency response system; installation and testing	Emer response sys instal&tst
S5161	0010	3	Emergency response system; service fee, per month (excludes installation and testing)	Emer rspns sys serv permonth
S5162	0010	3	Emergency response system; purchase only	Emer rspns system purchase
S5165	0010	3	Home modifications; per service	Home modifications per serv
S5170	0010	3	Home delivered meals, including preparation; per meal	Homedelivered prepared meal
S5175	0010	3	Laundry service, external, professional; per order	Laundry serv,ext,prof,/order
S5180	0010	3	Home health respiratory therapy, initial evaluation	Hh respiratory thrpy in eval
S5181	0010	3	Home health respiratory therapy, nos, per diem	Hh respiratory thrpy nos/day
S5185	0010	3	Medication reminder service, non-face-to-face; per month	Med reminder serv per month
S5190	0010	3	Wellness assessment, performed by non-physician	Wellness assessment by nonph
S5199	0010	3	Personal care item, nos, each	Personal care item nos each
S5497	0010	3	Home infusion therapy, catheter care / maintenance, not otherwise classified; includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit cath care noc
S5498	0010	3	Home infusion therapy, catheter care / maintenance, simple (single lumen), includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem	Hit simple cath care
S5501	0010	3	Home infusion therapy, catheter care / maintenance, complex (more than one lumen), includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit complex cath care
S5502	0010	3	Home infusion therapy, catheter care / maintenance, implanted access device, includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem (use this code for interim maintenance of vascular access not currently in use)	Hit interim cath care
S5517	0010	3	Home infusion therapy, all supplies necessary for restoration of catheter patency or declotting	Hit declotting kit
S5518	0010	3	Home infusion therapy, all supplies necessary for catheter repair	Hit cath repair kit
S5520	0010	3	Home infusion therapy, all supplies (including catheter) necessary for a peripherally inserted central venous catheter (picc) line insertion	Hit picc insert kit
S5521	0010	3	Home infusion therapy, all supplies (including catheter) necessary for a midline catheter insertion	Hit midline cath insert kit
S5522	0010	3	Home infusion therapy, insertion of peripherally inserted central venous catheter (picc), nursing services only (no supplies or catheter included)	Hit picc insert no supp
S5523	0010	3	Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included)	Hip midline cath insert kit
S5550	0010	3	Insulin, rapid onset, 5 units	Insulin rapid 5 u
S5551	0010	3	Insulin, most rapid onset (lispro or aspart); 5 units	Insulin most rapid 5 u
S5552	0010	3	Insulin, intermediate acting (nph or lente); 5 units	Insulin intermed 5 u
S5553	0010	3	Insulin, long acting; 5 units	Insulin long acting 5 u
S5560	0010	3	Insulin delivery device, reusable pen; 1.5 ml size	Insulin reuse pen 1.5 ml
S5561	0010	3	Insulin delivery device, reusable pen; 3 ml size	Insulin reuse pen 3 ml
S5565	0010	3	Insulin cartridge for use in insulin delivery device other than pump; 150 units	Insulin cartridge 150 u
S5566	0010	3	Insulin cartridge for use in insulin delivery device other than pump; 300 units	Insulin cartridge 300 u
S5570	0010	3	Insulin delivery device, disposable pen (including insulin); 1.5 ml size	Insulin dispos pen 1.5 ml
S5571	0010	3	Insulin delivery device, disposable pen (including insulin); 3 ml size	Insulin dispos pen 3 ml
S8030	0010	3	Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy	Tantalum ring application
S8032	0010	3	Low-dose computed tomography for lung cancer screening	Low dose ct lung screening
S8035	0010	3	Magnetic source imaging	Magnetic source imaging
S8037	0010	3	Magnetic resonance cholangiopancreatography (mrcp)	Mrcp
S8040	0010	3	Topographic brain mapping	Topographic brain mapping
S8042	0010	3	Magnetic resonance imaging (mri), low-field	Mri low field
S8055	0010	3	Ultrasound guidance for multifetal pregnancy reduction(s), technical component (only to be used when the physician doing the reduction procedure does not perform the ultrasound, guidance is included in the cpt code for multifetal pregnancy reduction - 59866)	Us guidance fetal reduct
S8080	0010	3	Scintimammography (radioimmunoscintigraphy of the breast), unilateral, including supply of radiopharmaceutical	Scintimammography
S8085	0010	3	Fluorine-18 fluorodeoxyglucose (f-18 fdg) imaging using dual-head coincidence detection system (non-dedicated pet scan)	Fluorine-18 fluorodeoxygluco
S8092	0010	3	Electron beam computed tomography (also known as ultrafast ct, cine ct)	Electron beam computed tomog
S8096	0010	3	Portable peak flow meter	Portable peak flow meter
S8097	0010	3	Asthma kit (including but not limited to portable peak expiratory flow meter, instructional video, brochure, and/or spacer)	Asthma kit
S8100	0010	3	Holding chamber or spacer for use with an inhaler or nebulizer; without mask	Spacer without mask
S8101	0010	3	Holding chamber or spacer for use with an inhaler or nebulizer; with mask	Spacer with mask
S8110	0010	3	Peak expiratory flow rate (physician services)	Peak expiratory flow rate (p
S8120	0010	3	Oxygen contents, gaseous, 1 unit equals 1 cubic foot	O2 contents gas cubic ft
S8121	0010	3	Oxygen contents, liquid, 1 unit equals 1 pound	O2 contents liquid lb
S8130	0010	3	Interferential current stimulator, 2 channel	Interferential stim 2 chan
S8131	0010	3	Interferential current stimulator, 4 channel	Interferential stim 4 chan
S8185	0010	3	Flutter device	Flutter device
S8186	0010	3	Swivel adapter	Swivel adaptor
S8189	0010	3	Tracheostomy supply, not otherwise classified	Trach supply noc
S8210	0010	3	Mucus trap	Mucus trap
S8262	0010	3	Mandibular orthopedic repositioning device, each	Mandib ortho repos device
S8265	0010	3	Haberman feeder for cleft lip/palate	Haberman feeder
S8270	0010	3	Enuresis alarm, using auditory buzzer and/or vibration device	Enuresis alarm
S8301	0010	3	Infection control supplies, not otherwise specified	Infect control supplies nos
S8415	0010	3	Supplies for home delivery of infant	Supplies for home delivery
S8420	0010	3	Gradient pressure aid (sleeve and glove combination), custom made	Custom gradient sleev/glov
S8421	0010	3	Gradient pressure aid (sleeve and glove combination), ready made	Ready gradient sleev/glov
S8422	0010	3	Gradient pressure aid (sleeve), custom made, medium weight	Custom grad sleeve med
S8423	0010	3	Gradient pressure aid (sleeve), custom made, heavy weight	Custom grad sleeve heavy
S8424	0010	3	Gradient pressure aid (sleeve), ready made	Ready gradient sleeve
S8425	0010	3	Gradient pressure aid (glove), custom made, medium weight	Custom grad glove med
S8426	0010	3	Gradient pressure aid (glove), custom made, heavy weight	Custom grad glove heavy
S8427	0010	3	Gradient pressure aid (glove), ready made	Ready gradient glove
S8428	0010	3	Gradient pressure aid (gauntlet), ready made	Ready gradient gauntlet
S8429	0010	3	Gradient pressure exterior wrap	Gradient pressure wrap
S8430	0010	3	Padding for compression bandage, roll	Padding for comprssn bdg
S8431	0010	3	Compression bandage, roll	Compression bandage
S8450	0010	3	Splint, prefabricated, digit (specify digit by use of modifier)	Splint digit
S8451	0010	3	Splint, prefabricated, wrist or ankle	Splint wrist or ankle
S8452	0010	3	Splint, prefabricated, elbow	Splint elbow
S8460	0010	3	Camisole, post-mastectomy	Camisole post-mast
S8490	0010	3	Insulin syringes (100 syringes, any size)	100 insulin syringes
S8930	0010	3	Electrical stimulation of auricular acupuncture points; each 15 minutes of personal one-on-one contact with the patient	Auricular electrostimulation
S8940	0010	3	Equestrian/hippotherapy, per session	Hippotherapy per session
S8948	0010	3	Application of a modality (requiring constant provider attendance) to one or more areas; low-level laser; each 15 minutes	Low-level laser trmt 15 min
S8950	0010	3	Complex lymphedema therapy, each 15 minutes	Complex lymphedema therapy,
S8990	0010	3	Physical or manipulative therapy performed for maintenance rather than restoration	Pt or manip for maint
S8999	0010	3	Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event)	Resuscitation bag
S9001	0010	3	Home uterine monitor with or without associated nursing services	Home uterine monitor with or
S9007	0010	3	Ultrafiltration monitor	Ultrafiltration monitor
S9015	0010	3	Automated eeg monitoring	Automated eeg monitoring
S9024	0010	3	Paranasal sinus ultrasound	Paranasal sinus ultrasound
S9025	0010	3	Omnicardiogram/cardiointegram	Omnicardiogram/cardiointegra
S9034	0010	3	Extracorporeal shockwave lithotripsy for gall stones (if performed with ercp, use 43265)	Eswl for gallstones
S9055	0010	3	Procuren or other growth factor preparation to promote wound healing	Procuren or other growth fac
S9056	0010	3	Coma stimulation per diem	Coma stimulation per diem
S9061	0010	3	Home administration of aerosolized drug therapy (e.g., pentamidine); administrative services, professional pharmacy services, care coordination, all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Medical supplies and equipme
S9083	0010	3	Global fee urgent care centers	Urgent care center global
S9088	0010	3	Services provided in an urgent care center (list in addition to code for service)	Services provided in urgent
S9090	0010	3	Vertebral axial decompression, per session	Vertebral axial decompressio
S9097	0010	3	Home visit for wound care	Home visit wound care
S9098	0010	3	Home visit, phototherapy services (e.g., bili-lite), including equipment rental, nursing services, blood draw, supplies, and other services, per diem	Home phototherapy visit
S9110	0010	3	Telemonitoring of patient in their home, including all necessary equipment; computer system, connections, and software; maintenance; patient education and support; per month	Telemonitoring/home per mnth
S9117	0010	3	Back school, per visit	Back school visit
S9122	0010	3	Home health aide or certified nurse assistant, providing care in the home; per hour	Home health aide or certifie
S9123	0010	3	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	Nursing care in home rn
S9124	0010	3	Nursing care, in the home; by licensed practical nurse, per hour	Nursing care, in the home; b
S9125	0010	3	Respite care, in the home, per diem	Respite care, in the home, p
S9126	0010	3	Hospice care, in the home, per diem	Hospice care, in the home, p
S9127	0010	3	Social work visit, in the home, per diem	Social work visit, in the ho
S9128	0010	3	Speech therapy, in the home, per diem	Speech therapy, in the home,
S9129	0010	3	Occupational therapy, in the home, per diem	Occupational therapy, in the
S9131	0010	3	Physical therapy; in the home, per diem	Pt in the home per diem
S9140	0010	3	Diabetic management program, follow-up visit to non-md provider	Diabetic management program,
S9141	0010	3	Diabetic management program, follow-up visit to md provider	Diabetic management program,
S9145	0010	3	Insulin pump initiation, instruction in initial use of pump (pump not included)	Insulin pump initiation
S9150	0010	3	Evaluation by ocularist	Evaluation by ocularist
S9152	0010	3	Speech therapy, re-evaluation	Speech therapy, re-eval
S9208	0010	3	Home management of preterm labor, including administrative services, professional pharmacy services, care coordination, and all necessary supplies or equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code)	Home mgmt preterm labor
S9209	0010	3	Home management of preterm premature rupture of membranes (pprom), including administrative services, professional pharmacy services, care coordination, and all necessary supplies or equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code)	Home mgmt pprom
S9211	0010	3	Home management of gestational hypertension, includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code)	Home mgmt gest hypertension
S9212	0010	3	Home management of postpartum hypertension, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code)	Hm postpar hyper per diem
S9213	0010	3	Home management of preeclampsia, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing services coded separately); per diem (do not use this code with any home infusion per diem code)	Hm preeclamp per diem
S9214	0010	3	Home management of gestational diabetes, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code)	Hm gest dm per diem
S9325	0010	3	Home infusion therapy, pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem (do not use this code with s9326, s9327 or s9328)	Hit pain mgmt per diem
S9326	0010	3	Home infusion therapy, continuous (twenty-four hours or more) pain management infusion; administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit cont pain per diem
S9327	0010	3	Home infusion therapy, intermittent (less than twenty-four hours) pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit int pain per diem
S9328	0010	3	Home infusion therapy, implanted pump pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit pain imp pump diem
S9329	0010	3	Home infusion therapy, chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with s9330 or s9331)	Hit chemo per diem
S9330	0010	3	Home infusion therapy, continuous (twenty-four hours or more) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit cont chem diem
S9331	0010	3	Home infusion therapy, intermittent (less than twenty-four hours) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit intermit chemo diem
S9335	0010	3	Home therapy, hemodialysis; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing services coded separately), per diem	Ht hemodialysis diem
S9336	0010	3	Home infusion therapy, continuous anticoagulant infusion therapy (e.g., heparin), administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit cont anticoag diem
S9338	0010	3	Home infusion therapy, immunotherapy, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit immunotherapy diem
S9339	0010	3	Home therapy; peritoneal dialysis, administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit periton dialysis diem
S9340	0010	3	Home therapy; enteral nutrition; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem	Hit enteral per diem
S9341	0010	3	Home therapy; enteral nutrition via gravity; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem	Hit enteral grav diem
S9342	0010	3	Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem	Hit enteral pump diem
S9343	0010	3	Home therapy; enteral nutrition via bolus; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem	Hit enteral bolus nurs
S9345	0010	3	Home infusion therapy, anti-hemophilic agent infusion therapy (e.g., factor viii); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit anti-hemophil diem
S9346	0010	3	Home infusion therapy, alpha-1-proteinase inhibitor (e.g., prolastin); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit alpha-1-proteinas diem
S9347	0010	3	Home infusion therapy, uninterrupted, long-term, controlled rate intravenous or subcutaneous infusion therapy (e.g., epoprostenol); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit longterm infusion diem
S9348	0010	3	Home infusion therapy, sympathomimetic/inotropic agent infusion therapy (e.g., dobutamine); administrative services, professional pharmacy services, care coordination, all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit sympathomim diem
S9349	0010	3	Home infusion therapy, tocolytic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit tocolysis diem
S9351	0010	3	Home infusion therapy, continuous or intermittent anti-emetic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and visits coded separately), per diem	Hit cont antiemetic diem
S9353	0010	3	Home infusion therapy, continuous insulin infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit cont insulin diem
S9355	0010	3	Home infusion therapy, chelation therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit chelation diem
S9357	0010	3	Home infusion therapy, enzyme replacement intravenous therapy; (e.g., imiglucerase); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit enzyme replace diem
S9359	0010	3	Home infusion therapy, anti-tumor necrosis factor intravenous therapy; (e.g., infliximab); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit anti-tnf per diem
S9361	0010	3	Home infusion therapy, diuretic intravenous therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit diuretic infus diem
S9363	0010	3	Home infusion therapy, anti-spasmotic therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit anti-spasmotic diem
S9364	0010	3	Home infusion therapy, total parenteral nutrition (tpn); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem (do not use with home infusion codes s9365-s9368 using daily volume scales)	Hit tpn total diem
S9365	0010	3	Home infusion therapy, total parenteral nutrition (tpn); one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem	Hit tpn 1 liter diem
S9366	0010	3	Home infusion therapy, total parenteral nutrition (tpn); more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem	Hit tpn 2 liter diem
S9367	0010	3	Home infusion therapy, total parenteral nutrition (tpn); more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem	Hit tpn 3 liter diem
S9368	0010	3	Home infusion therapy, total parenteral nutrition (tpn); more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem	Hit tpn over 3l diem
S9370	0010	3	Home therapy, intermittent anti-emetic injection therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Ht inj antiemetic diem
S9372	0010	3	Home therapy; intermittent anticoagulant injection therapy (e.g., heparin); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code for flushing of infusion devices with heparin to maintain patency)	Ht inj anticoag diem
S9373	0010	3	Home infusion therapy, hydration therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use with hydration therapy codes s9374-s9377 using daily volume scales)	Hit hydra total diem
S9374	0010	3	Home infusion therapy, hydration therapy; one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit hydra 1 liter diem
S9375	0010	3	Home infusion therapy, hydration therapy; more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit hydra 2 liter diem
S9376	0010	3	Home infusion therapy, hydration therapy; more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit hydra 3 liter diem
S9377	0010	3	Home infusion therapy, hydration therapy; more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies (drugs and nursing visits coded separately), per diem	Hit hydra over 3l diem
S9379	0010	3	Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit noc per diem
S9381	0010	3	Delivery or service to high risk areas requiring escort or extra protection, per visit	Hit high risk/escort
S9401	0010	3	Anticoagulation clinic, inclusive of all services except laboratory tests, per session	Anticoag clinic per session
S9430	0010	3	Pharmacy compounding and dispensing services	Pharmacy comp/disp serv
S9433	0010	3	Medical food nutritionally complete, administered orally, providing 100% of nutritional intake	Medical food oral 100% nutr
S9434	0010	3	Modified solid food supplements for inborn errors of metabolism	Mod solid food suppl
S9435	0010	3	Medical foods for inborn errors of metabolism	Medical foods for inborn err
S9436	0010	3	Childbirth preparation/lamaze classes, non-physician provider, per session	Lamaze class
S9437	0010	3	Childbirth refresher classes, non-physician provider, per session	Childbirth refresher class
S9438	0010	3	Cesarean birth classes, non-physician provider, per session	Cesarean birth class
S9439	0010	3	Vbac (vaginal birth after cesarean) classes, non-physician provider, per session	Vbac class
S9441	0010	3	Asthma education, non-physician provider, per session	Asthma education
S9442	0010	3	Birthing classes, non-physician provider, per session	Birthing class
S9443	0010	3	Lactation classes, non-physician provider, per session	Lactation class
S9444	0010	3	Parenting classes, non-physician provider, per session	Parenting class
S9445	0010	3	Patient education, not otherwise classified, non-physician provider, individual, per session	Pt education noc individ
S9446	0010	3	Patient education, not otherwise classified, non-physician provider, group, per session	Pt education noc group
S9447	0010	3	Infant safety (including cpr) classes, non-physician provider, per session	Infant safety class
S9449	0010	3	Weight management classes, non-physician provider, per session	Weight mgmt class
S9451	0010	3	Exercise classes, non-physician provider, per session	Exercise class
S9452	0010	3	Nutrition classes, non-physician provider, per session	Nutrition class
S9453	0010	3	Smoking cessation classes, non-physician provider, per session	Smoking cessation class
S9454	0010	3	Stress management classes, non-physician provider, per session	Stress mgmt class
S9455	0010	3	Diabetic management program, group session	Diabetic management program,
S9460	0010	3	Diabetic management program, nurse visit	Diabetic management program,
S9465	0010	3	Diabetic management program, dietitian visit	Diabetic management program,
S9470	0010	3	Nutritional counseling, dietitian visit	Nutritional counseling, diet
S9472	0010	3	Cardiac rehabilitation program, non-physician provider, per diem	Cardiac rehabilitation progr
S9473	0010	3	Pulmonary rehabilitation program, non-physician provider, per diem	Pulmonary rehabilitation pro
S9474	0010	3	Enterostomal therapy by a registered nurse certified in enterostomal therapy, per diem	Enterostomal therapy by a re
S9475	0010	3	Ambulatory setting substance abuse treatment or detoxification services, per diem	Ambulatory setting substance
S9476	0010	3	Vestibular rehabilitation program, non-physician provider, per diem	Vestibular rehab per diem
S9480	0010	3	Intensive outpatient psychiatric services, per diem	Intensive outpatient psychia
S9482	0010	3	Family stabilization services, per 15 minutes	Family stabilization 15 min
S9484	0010	3	Crisis intervention mental health services, per hour	Crisis intervention per hour
S9485	0010	3	Crisis intervention mental health services, per diem	Crisis intervention mental h
S9490	0010	3	Home infusion therapy, corticosteroid infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit corticosteroid/diem
S9494	0010	3	Home infusion therapy, antibiotic, antiviral, or antifungal therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with home infusion codes for hourly dosing schedules s9497-s9504)	Hit antibiotic total diem
S9497	0010	3	Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 3 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit antibiotic q3h diem
S9500	0010	3	Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit antibiotic q24h diem
S9501	0010	3	Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 12 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit antibiotic q12h diem
S9502	0010	3	Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 8 hours, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit antibiotic q8h diem
S9503	0010	3	Home infusion therapy, antibiotic, antiviral, or antifungal; once every 6 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit antibiotic q6h diem
S9504	0010	3	Home infusion therapy, antibiotic, antiviral, or antifungal; once every 4 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit antibiotic q4h diem
S9529	0010	3	Routine venipuncture for collection of specimen(s), single home bound, nursing home, or skilled nursing facility patient	Venipuncture home/snf
S9537	0010	3	Home therapy; hematopoietic hormone injection therapy (e.g., erythropoietin, g-csf, gm-csf); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Ht hem horm inj diem
S9538	0010	3	Home transfusion of blood product(s); administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (blood products, drugs, and nursing visits coded separately), per diem	Hit blood products diem
S9542	0010	3	Home injectable therapy, not otherwise classified, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Ht inj noc per diem
S9558	0010	3	Home injectable therapy; growth hormone, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Ht inj growth horm diem
S9559	0010	3	Home injectable therapy, interferon, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Hit inj interferon diem
S9560	0010	3	Home injectable therapy; hormonal therapy (e.g.; leuprolide, goserelin), including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Ht inj hormone diem
S9562	0010	3	Home injectable therapy, palivizumab, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Ht inj palivizumab diem
S9590	0010	3	Home therapy, irrigation therapy (e.g., sterile irrigation of an organ or anatomical cavity); including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	Ht irrigation diem
S9810	0010	3	Home therapy; professional pharmacy services for provision of infusion, specialty drug administration, and/or disease state management, not otherwise classified, per hour (do not use this code with any per diem code)	Ht pharm per hour
S9900	0010	3	Services by a journal-listed christian science practitioner for the purpose of healing, per diem	Christian sci pract visit
S9901	0010	3	Services by a journal-listed christian science nurse, per hour	Christian sci nurse visit
S9960	0010	3	Ambulance service, conventional air service, nonemergency transport, one way (fixed wing)	Air ambulanc nonemerg fixed
S9961	0010	3	Ambulance service, conventional air service, nonemergency transport, one way (rotary wing)	Air ambulan nonemerg rotary
S9970	0010	3	Health club membership, annual	Health club membership yr
S9975	0010	3	Transplant related lodging, meals and transportation, per diem	Transplant related per diem
S9976	0010	3	Lodging, per diem, not otherwise classified	Lodging per diem
S9977	0010	3	Meals, per diem, not otherwise specified	Meals per diem
S9981	0010	3	Medical records copying fee, administrative	Med record copy admin
S9982	0010	3	Medical records copying fee, per page	Med record copy per page
S9986	0010	3	Not medically necessary service (patient is aware that service not medically necessary)	Not medically necessary svc
S9988	0010	3	Services provided as part of a phase i clinical trial	Serv part of phase i trial
S9989	0010	3	Services provided outside of the united states of america (list in addition to code(s) for service(s))	Services outside us
S9990	0010	3	Services provided as part of a phase ii clinical trial	Services provided as part of
S9991	0010	3	Services provided as part of a phase iii clinical trial	Services provided as part of
S9992	0010	3	Transportation costs to and from trial location and local transportation costs (e.g., fares for taxicab or bus) for clinical trial participant and one caregiver/companion	Transportation costs to and
S9994	0010	3	Lodging costs (e.g., hotel charges) for clinical trial participant and one caregiver/companion	Lodging costs (e.g. hotel ch
S9996	0010	3	Meals for clinical trial participant and one caregiver/companion	Meals for clinical trial par
S9999	0010	3	Sales tax	Sales tax

T0000–T9999: Established for State Medical Agencies

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
T1000	0010	3	Private duty / independent nursing service(s) - licensed, up to 15 minutes	Private duty/independent nsg
T1001	0010	3	Nursing assessment / evaluation	Nursing assessment/evaluatn
T1002	0010	3	Rn services, up to 15 minutes	Rn services up to 15 minutes
T1003	0010	3	Lpn/lvn services, up to 15 minutes	Lpn/lvn services up to 15min
T1004	0010	3	Services of a qualified nursing aide, up to 15 minutes	Nsg aide service up to 15min
T1005	0010	3	Respite care services, up to 15 minutes	Respite care service 15 min
T1006	0010	3	Alcohol and/or substance abuse services, family/couple counseling	Family/couple counseling
T1007	0010	3	Alcohol and/or substance abuse services, treatment plan development and/or modification	Treatment plan development
T1009	0010	3	Child sitting services for children of the individual receiving alcohol and/or substance abuse services	Child sitting services
T1010	0010	3	Meals for individuals receiving alcohol and/or substance abuse services (when meals not included in the program)	Meals when receive services
T1012	0010	3	Alcohol and/or substance abuse services, skills development	Alcohol/substance abuse skil
T1013	0010	3	Sign language or oral interpretive services, per 15 minutes	Sign lang/oral interpreter
T1014	0010	3	Telehealth transmission, per minute, professional services bill separately	Telehealth transmit, per min
T1015	0010	3	Clinic visit/encounter, all-inclusive	Clinic service
T1016	0010	3	Case management, each 15 minutes	Case management
T1017	0010	3	Targeted case management, each 15 minutes	Targeted case management
T1018	0010	3	School-based individualized education program (iep) services, bundled	School-based iep ser bundled
T1019	0010	3	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)	Personal care ser per 15 min
T1020	0010	3	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)	Personal care ser per diem
T1021	0010	3	Home health aide or certified nurse assistant, per visit	Hh aide or cn aide per visit
T1022	0010	3	Contracted home health agency services, all services provided under contract, per day	Contracted services per day
T1023	0010	3	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	Program intake assessment
T1024	0010	3	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	Team evaluation & management
T1025	0010	3	Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per diem	Ped compr care pkg, per diem
T1026	0010	3	Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, medical and psychosocial impairments, per hour	Ped compr care pkg, per hour
T1027	0010	3	Family training and counseling for child development, per 15 minutes	Family training & counseling
T1028	0010	3	Assessment of home, physical and family environment, to determine suitability to meet patient’s medical needs	Home environment assessment
T1029	0010	3	Comprehensive environmental lead investigation, not including laboratory analysis, per dwelling	Dwelling lead investigation
T1030	0010	3	Nursing care, in the home, by registered nurse, per diem	Rn home care per diem
T1031	0010	3	Nursing care, in the home, by licensed practical nurse, per diem	Lpn home care per diem
T1040	0010	3	Medicaid certified community behavioral health clinic services, per diem	Comm bh clinic svc per diem
T1041	0010	3	Medicaid certified community behavioral health clinic services, per month	Comm bh clinic svc per month
T1502	0010	3	Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit	Medication admin visit
T1503	0010	3	Administration of medication, other than oral and/or injectable, by a health care agency/professional, per visit	Med admin, not oral/inject
T1505	0010	3	Electronic medication compliance management device, includes all components and accessories, not otherwise classified	Elec med comp dev, noc
T1999	0010	3	Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in “remarks”	Noc retail items andsupplies
T2001	0010	3	Non-emergency transportation; patient attendant/escort	N-et; patient attend/escort
T2002	0010	3	Non-emergency transportation; per diem	N-et; per diem
T2003	0010	3	Non-emergency transportation; encounter/trip	N-et; encounter/trip
T2004	0010	3	Non-emergency transport; commercial carrier, multi-pass	N-et; commerc carrier pass
T2005	0010	3	Non-emergency transportation; stretcher van	N-et; stretcher van
T2007	0010	3	Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments	Non-emer transport wait time
T2010	0010	3	Preadmission screening and resident review (pasrr) level i identification screening, per screen	Pasrr level i
T2011	0010	3	Preadmission screening and resident review (pasrr) level ii evaluation, per evaluation	Pasrr level ii
T2012	0010	3	Habilitation, educational; waiver, per diem	Habil ed waiver, per diem
T2013	0010	3	Habilitation, educational, waiver; per hour	Habil ed waiver per hour
T2014	0010	3	Habilitation, prevocational, waiver; per diem	Habil prevoc waiver, per d
T2015	0010	3	Habilitation, prevocational, waiver; per hour	Habil prevoc waiver per hr
T2016	0010	3	Habilitation, residential, waiver; per diem	Habil res waiver per diem
T2017	0010	3	Habilitation, residential, waiver; 15 minutes	Habil res waiver 15 min
T2018	0010	3	Habilitation, supported employment, waiver; per diem	Habil sup empl waiver/diem
T2019	0010	3	Habilitation, supported employment, waiver; per 15 minutes	Habil sup empl waiver 15min
T2020	0010	3	Day habilitation, waiver; per diem	Day habil waiver per diem
T2021	0010	3	Day habilitation, waiver; per 15 minutes	Day habil waiver per 15 min
T2022	0010	3	Case management, per month	Case management, per month
T2023	0010	3	Targeted case management; per month	Targeted case mgmt per month
T2024	0010	3	Service assessment/plan of care development, waiver	Serv asmnt/care plan waiver
T2025	0010	3	Waiver services; not otherwise specified (nos)	Waiver service, nos
T2026	0010	3	Specialized childcare, waiver; per diem	Special childcare waiver/d
T2027	0010	3	Specialized childcare, waiver; per 15 minutes	Spec childcare waiver 15 min
T2028	0010	3	Specialized supply, not otherwise specified, waiver	Special supply, nos waiver
T2029	0010	3	Specialized medical equipment, not otherwise specified, waiver	Special med equip, noswaiver
T2030	0010	3	Assisted living, waiver; per month	Assist living waiver/month
T2031	0010	3	Assisted living; waiver, per diem	Assist living waiver/diem
T2032	0010	3	Residential care, not otherwise specified (nos), waiver; per month	Res care, nos waiver/month
T2033	0010	3	Residential care, not otherwise specified (nos), waiver; per diem	Res, nos waiver per diem
T2034	0010	3	Crisis intervention, waiver; per diem	Crisis interven waiver/diem
T2035	0010	3	Utility services to support medical equipment and assistive technology/devices, waiver	Utility services waiver
T2036	0010	3	Therapeutic camping, overnight, waiver; each session	Camp overnite waiver/session
T2037	0010	3	Therapeutic camping, day, waiver; each session	Camp day waiver/session
T2038	0010	3	Community transition, waiver; per service	Comm trans waiver/service
T2039	0010	3	Vehicle modifications, waiver; per service	Vehicle mod waiver/service
T2040	0010	3	Financial management, self-directed, waiver; per 15 minutes	Financial mgt waiver/15min
T2041	0010	3	Supports brokerage, self-directed, waiver; per 15 minutes	Support broker waiver/15 min
T2042	0010	3	Hospice routine home care; per diem	Hospice routine home care
T2043	0010	3	Hospice continuous home care; per hour	Hospice continuous home care
T2044	0010	3	Hospice inpatient respite care; per diem	Hospice respite care
T2045	0010	3	Hospice general inpatient care; per diem	Hospice general care
T2046	0010	3	Hospice long term care, room and board only; per diem	Hospice long term care, r&b
T2048	0010	3	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	Bh ltc res r&b, per diem
T2049	0010	3	Non-emergency transportation; stretcher van, mileage; per mile	N-et; stretcher van, mileage
T2101	0010	3	Human breast milk processing, storage and distribution only	Breast milk proc/store/dist
T4521	0010	3	Adult sized disposable incontinence product, brief/diaper, small, each	Adult size brief/diaper sm
T4522	0010	3	Adult sized disposable incontinence product, brief/diaper, medium, each	Adult size brief/diaper med
T4523	0010	3	Adult sized disposable incontinence product, brief/diaper, large, each	Adult size brief/diaper lg
T4524	0010	3	Adult sized disposable incontinence product, brief/diaper, extra large, each	Adult size brief/diaper xl
T4525	0010	3	Adult sized disposable incontinence product, protective underwear/pull-on, small size, each	Adult size pull-on sm
T4526	0010	3	Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each	Adult size pull-on med
T4527	0010	3	Adult sized disposable incontinence product, protective underwear/pull-on, large size, each	Adult size pull-on lg
T4528	0010	3	Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each	Adult size pull-on xl
T4529	0010	3	Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each	Ped size brief/diaper sm/med
T4530	0010	3	Pediatric sized disposable incontinence product, brief/diaper, large size, each	Ped size brief/diaper lg
T4531	0010	3	Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each	Ped size pull-on sm/med
T4532	0010	3	Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each	Ped size pull-on lg
T4533	0010	3	Youth sized disposable incontinence product, brief/diaper, each	Youth size brief/diaper
T4534	0010	3	Youth sized disposable incontinence product, protective underwear/pull-on, each	Youth size pull-on
T4535	0010	3	Disposable liner/shield/guard/pad/undergarment, for incontinence, each	Disposable liner/shield/pad
T4536	0010	3	Incontinence product, protective underwear/pull-on, reusable, any size, each	Reusable pull-on any size
T4537	0010	3	Incontinence product, protective underpad, reusable, bed size, each	Reusable underpad bed size
T4538	0010	3	Diaper service, reusable diaper, each diaper	Diaper serv reusable diaper
T4539	0010	3	Incontinence product, diaper/brief, reusable, any size, each	Reuse diaper/brief any size
T4540	0010	3	Incontinence product, protective underpad, reusable, chair size, each	Reusable underpad chair size
T4541	0010	3	Incontinence product, disposable underpad, large, each	Large disposable underpad
T4542	0010	3	Incontinence product, disposable underpad, small size, each	Small disposable underpad
T4543	0010	3	Adult sized disposable incontinence product, protective brief/diaper, above extra large, each	Adult disp brief/diap abv xl
T4544	0010	3	Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each	Adlt disp und/pull on abv xl
T4545	0010	3	Incontinence product, disposable, penile wrap, each	Incon disposable penile wrap
T5001	0010	3	Positioning seat for persons with special orthopedic needs	Position seat spec orth need
T5999	0010	3	Supply, not otherwise specified	Supply, nos

V0000–V9999: Vision, Hearing and Speech-Language Pathology Services

HCPC	SEQNUM	RECID	LONG DESCRIPTION	SHORT DESCRIPTION
V2020	0010	3	Frames, purchases	Vision svcs frames purchases
V2025	0010	3	Deluxe frame	Eyeglasses delux frames
V2100	0010	3	Sphere, single vision, plano to plus or minus 4.00, per lens	Lens spher single plano 4.00
V2101	0010	3	Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens	Single visn sphere 4.12-7.00
V2102	0010	3	Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens	Singl visn sphere 7.12-20.00
V2103	0010	3	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	Spherocylindr 4.00d/12-2.00d
V2104	0010	3	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens	Spherocylindr 4.00d/2.12-4d
V2105	0010	3	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens	Spherocylinder 4.00d/4.25-6d
V2106	0010	3	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens	Spherocylinder 4.00d/>6.00d
V2107	0010	3	Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens	Spherocylinder 4.25d/12-2d
V2108	0010	3	Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens	Spherocylinder 4.25d/2.12-4d
V2109	0010	3	Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens	Spherocylinder 4.25d/4.25-6d
V2110	0010	3	Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens	Spherocylinder 4.25d/over 6d
V2111	0010	3	Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens	Spherocylindr 7.25d/.25-2.25
V2112	0010	3	Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens	Spherocylindr 7.25d/2.25-4d
V2113	0010	3	Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens	Spherocylindr 7.25d/4.25-6d
V2114	0010	3	Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens	Spherocylinder over 12.00d
V2115	0010	3	Lenticular, (myodisc), per lens, single vision	Lens lenticular bifocal
V2118	0010	3	Aniseikonic lens, single vision	Lens aniseikonic single
V2121	0010	3	Lenticular lens, per lens, single	Lenticular lens, single
V2199	0010	3	Not otherwise classified, single vision lens	Lens single vision not oth c
V2200	0010	3	Sphere, bifocal, plano to plus or minus 4.00d, per lens	Lens spher bifoc plano 4.00d
V2201	0010	3	Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens	Lens sphere bifocal 4.12-7.0
V2202	0010	3	Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens	Lens sphere bifocal 7.12-20.
V2203	0010	3	Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	Lens sphcyl bifocal 4.00d/.1
V2204	0010	3	Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens	Lens sphcy bifocal 4.00d/2.1
V2205	0010	3	Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens	Lens sphcy bifocal 4.00d/4.2
V2206	0010	3	Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens	Lens sphcy bifocal 4.00d/ove
V2207	0010	3	Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens	Lens sphcy bifocal 4.25-7d/.
V2208	0010	3	Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens	Lens sphcy bifocal 4.25-7/2.
V2209	0010	3	Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens	Lens sphcy bifocal 4.25-7/4.
V2210	0010	3	Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens	Lens sphcy bifocal 4.25-7/ov
V2211	0010	3	Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens	Lens sphcy bifo 7.25-12/.25-
V2212	0010	3	Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens	Lens sphcyl bifo 7.25-12/2.2
V2213	0010	3	Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens	Lens sphcyl bifo 7.25-12/4.2
V2214	0010	3	Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens	Lens sphcyl bifocal over 12.
V2215	0010	3	Lenticular (myodisc), per lens, bifocal	Lens lenticular bifocal
V2218	0010	3	Aniseikonic, per lens, bifocal	Lens aniseikonic bifocal
V2219	0010	3	Bifocal seg width over 28 mm	Lens bifocal seg width over
V2220	0010	3	Bifocal add over 3.25d	Lens bifocal add over 3.25d
V2221	0010	3	Lenticular lens, per lens, bifocal	Lenticular lens, bifocal
V2299	0010	3	Specialty bifocal (by report)	Lens bifocal speciality
V2300	0010	3	Sphere, trifocal, plano to plus or minus 4.00d, per lens	Lens sphere trifocal 4.00d
V2301	0010	3	Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens	Lens sphere trifocal 4.12-7.
V2302	0010	3	Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens	Lens sphere trifocal 7.12-20
V2303	0010	3	Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens	Lens sphcy trifocal 4.0/.12-
V2304	0010	3	Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens	Lens sphcy trifocal 4.0/2.25
V2305	0010	3	Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens	Lens sphcy trifocal 4.0/4.25
V2306	0010	3	Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens	Lens sphcyl trifocal 4.00/>6
V2307	0010	3	Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens	Lens sphcy trifocal 4.25-7/.
V2308	0010	3	Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens	Lens sphc trifocal 4.25-7/2.
V2309	0010	3	Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens	Lens sphc trifocal 4.25-7/4.
V2310	0010	3	Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens	Lens sphc trifocal 4.25-7/>6
V2311	0010	3	Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens	Lens sphc trifo 7.25-12/.25-
V2312	0010	3	Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens	Lens sphc trifo 7.25-12/2.25
V2313	0010	3	Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens	Lens sphc trifo 7.25-12/4.25
V2314	0010	3	Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens	Lens sphcyl trifocal over 12
V2315	0010	3	Lenticular, (myodisc), per lens, trifocal	Lens lenticular trifocal
V2318	0010	3	Aniseikonic lens, trifocal	Lens aniseikonic trifocal
V2319	0010	3	Trifocal seg width over 28 mm	Lens trifocal seg width > 28
V2320	0010	3	Trifocal add over 3.25d	Lens trifocal add over 3.25d
V2321	0010	3	Lenticular lens, per lens, trifocal	Lenticular lens, trifocal
V2399	0010	3	Specialty trifocal (by report)	Lens trifocal speciality
V2410	0010	3	Variable asphericity lens, single vision, full field, glass or plastic, per lens	Lens variab asphericity sing
V2430	0010	3	Variable asphericity lens, bifocal, full field, glass or plastic, per lens	Lens variable asphericity bi
V2499	0010	3	Variable sphericity lens, other type	Variable asphericity lens
V2500	0010	3	Contact lens, pmma, spherical, per lens	Contact lens pmma spherical
V2501	0010	3	Contact lens, pmma, toric or prism ballast, per lens	Cntct lens pmma-toric/prism
V2502	0010	3	Contact lens, pmma, bifocal, per lens	Contact lens pmma bifocal
V2503	0010	3	Contact lens, pmma, color vision deficiency, per lens	Cntct lens pmma color vision
V2510	0010	3	Contact lens, gas permeable, spherical, per lens	Cntct gas permeable sphericl
V2511	0010	3	Contact lens, gas permeable, toric, prism ballast, per lens	Cntct toric prism ballast
V2512	0010	3	Contact lens, gas permeable, bifocal, per lens	Cntct lens gas permbl bifocl
V2513	0010	3	Contact lens, gas permeable, extended wear, per lens	Contact lens extended wear
V2520	0010	3	Contact lens, hydrophilic, spherical, per lens	Contact lens hydrophilic
V2521	0010	3	Contact lens, hydrophilic, toric, or prism ballast, per lens	Cntct lens hydrophilic toric
V2522	0010	3	Contact lens, hydrophilic, bifocal, per lens	Cntct lens hydrophil bifocl
V2523	0010	3	Contact lens, hydrophilic, extended wear, per lens	Cntct lens hydrophil extend
V2530	0010	3	Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)	Contact lens gas impermeable
V2531	0010	3	Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)	Contact lens gas permeable
V2599	0010	3	Contact lens, other type	Contact lens/es other type
V2600	0010	3	Hand held low vision aids and other nonspectacle mounted aids	Hand held low vision aids
V2610	0010	3	Single lens spectacle mounted low vision aids	Single lens spectacle mount
V2615	0010	3	Telescopic and other compound lens system, including distance vision telescopic, near vision telescopes and compound microscopic lens system	Telescop/othr compound lens
V2623	0010	3	Prosthetic eye, plastic, custom	Plastic eye prosth custom
V2624	0010	3	Polishing/resurfacing of ocular prosthesis	Polishing artifical eye
V2625	0010	3	Enlargement of ocular prosthesis	Enlargemnt of eye prosthesis
V2626	0010	3	Reduction of ocular prosthesis	Reduction of eye prosthesis
V2627	0010	3	Scleral cover shell	Scleral cover shell
V2628	0010	3	Fabrication and fitting of ocular conformer	Fabrication & fitting
V2629	0010	3	Prosthetic eye, other type	Prosthetic eye other type
V2630	0010	3	Anterior chamber intraocular lens	Anter chamber intraocul lens
V2631	0010	3	Iris supported intraocular lens	Iris support intraoclr lens
V2632	0010	3	Posterior chamber intraocular lens	Post chmbr intraocular lens
V2700	0010	3	Balance lens, per lens	Balance lens
V2702	0010	3	Deluxe lens feature	Deluxe lens feature
V2710	0010	3	Slab off prism, glass or plastic, per lens	Glass/plastic slab off prism
V2715	0010	3	Prism, per lens	Prism lens/es
V2718	0010	3	Press-on lens, fresnell prism, per lens	Fresnell prism press-on lens
V2730	0010	3	Special base curve, glass or plastic, per lens	Special base curve
V2744	0010	3	Tint, photochromatic, per lens	Tint photochromatic lens/es
V2745	0010	3	Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens	Tint, any color/solid/grad
V2750	0010	3	Anti-reflective coating, per lens	Anti-reflective coating
V2755	0010	3	U-v lens, per lens	Uv lens/es
V2756	0010	3	Eye glass case	Eye glass case
V2760	0010	3	Scratch resistant coating, per lens	Scratch resistant coating
V2761	0010	3	Mirror coating, any type, solid, gradient or equal, any lens material, per lens	Mirror coating
V2762	0010	3	Polarization, any lens material, per lens	Polarization, any lens
V2770	0010	3	Occluder lens, per lens	Occluder lens/es
V2780	0010	3	Oversize lens, per lens	Oversize lens/es
V2781	0010	3	Progressive lens, per lens	Progressive lens per lens
V2782	0010	3	Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens	Lens, 1.54-1.65 p/1.60-1.79g
V2783	0010	3	Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens	Lens, >= 1.66 p/>=1.80 g
V2784	0010	3	Lens, polycarbonate or equal, any index, per lens	Lens polycarb or equal
V2785	0010	3	Processing, preserving and transporting corneal tissue	Corneal tissue processing
V2786	0010	3	Specialty occupational multifocal lens, per lens	Occupational multifocal lens
V2787	0010	3	Astigmatism correcting function of intraocular lens	Astigmatism-correct function
V2788	0010	3	Presbyopia correcting function of intraocular lens	Presbyopia-correct function
V2790	0010	3	Amniotic membrane for surgical reconstruction, per procedure	Amniotic membrane
V2797	0010	3	Vision supply, accessory and/or service component of another hcpcs vision code	Vis item/svc in other code
V2799	0010	3	Vision item or service, miscellaneous	Misc vision item or service
V5008	0010	3	Hearing screening	Hearing screening
V5010	0010	3	Assessment for hearing aid	Assessment for hearing aid
V5011	0010	3	Fitting/orientation/checking of hearing aid	Hearing aid fitting/checking
V5014	0010	3	Repair/modification of a hearing aid	Hearing aid repair/modifying
V5020	0010	3	Conformity evaluation	Conformity evaluation
V5030	0010	3	Hearing aid, monaural, body worn, air conduction	Body-worn hearing aid air
V5040	0010	3	Hearing aid, monaural, body worn, bone conduction	Body-worn hearing aid bone
V5050	0010	3	Hearing aid, monaural, in the ear	Hearing aid monaural in ear
V5060	0010	3	Hearing aid, monaural, behind the ear	Behind ear hearing aid
V5070	0010	3	Glasses, air conduction	Glasses air conduction
V5080	0010	3	Glasses, bone conduction	Glasses bone conduction
V5090	0010	3	Dispensing fee, unspecified hearing aid	Hearing aid dispensing fee
V5095	0010	3	Semi-implantable middle ear hearing prosthesis	Implant mid ear hearing pros
V5100	0010	3	Hearing aid, bilateral, body worn	Body-worn bilat hearing aid
V5110	0010	3	Dispensing fee, bilateral	Hearing aid dispensing fee
V5120	0010	3	Binaural, body	Body-worn binaur hearing aid
V5130	0010	3	Binaural, in the ear	In ear binaural hearing aid
V5140	0010	3	Binaural, behind the ear	Behind ear binaur hearing ai
V5150	0010	3	Binaural, glasses	Glasses binaural hearing aid
V5160	0010	3	Dispensing fee, binaural	Dispensing fee binaural
V5170	0010	3	Hearing aid, cros, in the ear	Within ear cros hearing aid
V5171	0010	3	Hearing aid, contralateral routing device, monaural, in the ear (ite)	Hearing aid monaural ite
V5172	0010	3	Hearing aid, contralateral routing device, monaural, in the canal (itc)	Hearing aid monaural itc
V5180	0010	3	Hearing aid, cros, behind the ear	Behind ear cros hearing aid
V5181	0010	3	Hearing aid, contralateral routing device, monaural, behind the ear (bte)	Hearing aid monaural bte
V5190	0010	3	Hearing aid, contralateral routing, monaural, glasses	Hearing aid monaural glasses
V5200	0010	3	Dispensing fee, contralateral, monaural	Disp fee contralateral monau
V5210	0010	3	Hearing aid, bicros, in the ear	In ear bicros hearing aid
V5211	0010	3	Hearing aid, contralateral routing system, binaural, ite/ite	Hearing aid binaural ite/ite
V5212	0010	3	Hearing aid, contralateral routing system, binaural, ite/itc	Hearing aid binaural ite/itc
V5213	0010	3	Hearing aid, contralateral routing system, binaural, ite/bte	Hearing aid binaural ite/bte
V5214	0010	3	Hearing aid, contralateral routing system, binaural, itc/itc	Hearing aid binaural itc/itc
V5215	0010	3	Hearing aid, contralateral routing system, binaural, itc/bte	Hearing aid binaural itc/bte
V5220	0010	3	Hearing aid, bicros, behind the ear	Behind ear bicros hearing ai
V5221	0010	3	Hearing aid, contralateral routing system, binaural, bte/bte	Hearing aid binaural bte/bte
V5230	0010	3	Hearing aid, contralateral routing system, binaural, glasses	Hearing aid binaural glasses
V5240	0010	3	Dispensing fee, contralateral routing system, binaural	Disp fee contralateral binau
V5241	0010	3	Dispensing fee, monaural hearing aid, any type	Dispensing fee, monaural
V5242	0010	3	Hearing aid, analog, monaural, cic (completely in the ear canal)	Hearing aid, monaural, cic
V5243	0010	3	Hearing aid, analog, monaural, itc (in the canal)	Hearing aid, monaural, itc
V5244	0010	3	Hearing aid, digitally programmable analog, monaural, cic	Hearing aid, prog, mon, cic
V5245	0010	3	Hearing aid, digitally programmable, analog, monaural, itc	Hearing aid, prog, mon, itc
V5246	0010	3	Hearing aid, digitally programmable analog, monaural, ite (in the ear)	Hearing aid, prog, mon, ite
V5247	0010	3	Hearing aid, digitally programmable analog, monaural, bte (behind the ear)	Hearing aid, prog, mon, bte
V5248	0010	3	Hearing aid, analog, binaural, cic	Hearing aid, binaural, cic
V5249	0010	3	Hearing aid, analog, binaural, itc	Hearing aid, binaural, itc
V5250	0010	3	Hearing aid, digitally programmable analog, binaural, cic	Hearing aid, prog, bin, cic
V5251	0010	3	Hearing aid, digitally programmable analog, binaural, itc	Hearing aid, prog, bin, itc
V5252	0010	3	Hearing aid, digitally programmable, binaural, ite	Hearing aid, prog, bin, ite
V5253	0010	3	Hearing aid, digitally programmable, binaural, bte	Hearing aid, prog, bin, bte
V5254	0010	3	Hearing aid, digital, monaural, cic	Hearing id, digit, mon, cic
V5255	0010	3	Hearing aid, digital, monaural, itc	Hearing aid, digit, mon, itc
V5256	0010	3	Hearing aid, digital, monaural, ite	Hearing aid, digit, mon, ite
V5257	0010	3	Hearing aid, digital, monaural, bte	Hearing aid, digit, mon, bte
V5258	0010	3	Hearing aid, digital, binaural, cic	Hearing aid, digit, bin, cic
V5259	0010	3	Hearing aid, digital, binaural, itc	Hearing aid, digit, bin, itc
V5260	0010	3	Hearing aid, digital, binaural, ite	Hearing aid, digit, bin, ite
V5261	0010	3	Hearing aid, digital, binaural, bte	Hearing aid, digit, bin, bte
V5262	0010	3	Hearing aid, disposable, any type, monaural	Hearing aid, disp, monaural
V5263	0010	3	Hearing aid, disposable, any type, binaural	Hearing aid, disp, binaural
V5264	0010	3	Ear mold/insert, not disposable, any type	Ear mold/insert
V5265	0010	3	Ear mold/insert, disposable, any type	Ear mold/insert, disp
V5266	0010	3	Battery for use in hearing device	Battery for hearing device
V5267	0010	3	Hearing aid or assistive listening device/supplies/accessories, not otherwise specified	Hearing aid sup/access/dev
V5268	0010	3	Assistive listening device, telephone amplifier, any type	Ald telephone amplifier
V5269	0010	3	Assistive listening device, alerting, any type	Alerting device, any type
V5270	0010	3	Assistive listening device, television amplifier, any type	Ald, tv amplifier, any type
V5271	0010	3	Assistive listening device, television caption decoder	Ald, tv caption decoder
V5272	0010	3	Assistive listening device, tdd	Tdd
V5273	0010	3	Assistive listening device, for use with cochlear implant	Ald for cochlear implant
V5274	0010	3	Assistive listening device, not otherwise specified	Ald unspecified
V5275	0010	3	Ear impression, each	Ear impression
V5281	0010	3	Assistive listening device, personal fm/dm system, monaural, (1 receiver, transmitter, microphone), any type	Ald fm/dm system, monaural
V5282	0010	3	Assistive listening device, personal fm/dm system, binaural, (2 receivers, transmitter, microphone), any type	Ald fm/dm system binaural
V5283	0010	3	Assistive listening device, personal fm/dm neck, loop induction receiver	Ald neck, loop ind receiver
V5284	0010	3	Assistive listening device, personal fm/dm, ear level receiver	Ald fm/dm ear level receiver
V5285	0010	3	Assistive listening device, personal fm/dm, direct audio input receiver	Ald fm/dm aud input receiver
V5286	0010	3	Assistive listening device, personal blue tooth fm/dm receiver	Ald blu tooth fm/dm receiver
V5287	0010	3	Assistive listening device, personal fm/dm receiver, not otherwise specified	Ald fm/dm receiver, nos
V5288	0010	3	Assistive listening device, personal fm/dm transmitter assistive listening device	Ald fm/dm transmitter ald
V5289	0010	3	Assistive listening device, personal fm/dm adapter/boot coupling device for receiver, any type	Ald fm/dm adapt/boot couplin
V5290	0010	3	Assistive listening device, transmitter microphone, any type	Ald transmitter microphone
V5298	0010	3	Hearing aid, not otherwise classified	Hearing aid noc
V5299	0010	3	Hearing service, miscellaneous	Hearing service
V5336	0010	3	Repair/modification of augmentative communicative system or device (excludes adaptive hearing aid)	Repair communication device
V5362	0010	3	Speech screening	Speech screening
V5363	0010	3	Language screening	Language screening
V5364	0010	3	Dysphagia screening	Dysphagia screening