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An episode of care, also known as an episode, groups all relevant services provided to a patient for a particular condition within a confined time range. An episode of care serves as a unit of accounting as well as a unit of accountability for providers who take on financial risk for the episode. Defining an episode in such a manner helps to identify sources of variation and to standardize care.
An episode of care for Bariatric Surgery, sometimes abbreviated BARI, is a procedural episode. The Bariatric Surgery episode includes services related to the procedure such as a facility stay, anesthesia services, as well as services within the 30-day pre- and 90-day post-operative care time window, such as diagnostic services, (imaging, labs etc.), office visits, and ancillary services.
Episode Components
| Triggers | A Bariatric Surgery episode trigger includes an inpatient facility claim with a procedure trigger code in the principal position and a qualifying diagnosis code in the principal position (Table 1). This episode is also triggered by an outpatient facility or professional claim with a procedure trigger code (in any position) and a qualifying diagnosis code (in any position) on the same claim line. |
| Typical Diagnosis | Typical diagnosis codes (ICD 10 DX codes) indicate typical care. Claims with typical diagnosis codes usually associated with an episode help steer services into this episode. However, a relevant procedure code is required on the same claim/claim line for the indicated diagnosis code to be incorporated into the episode. (Table 2) |
| Actionable adverse events (AAE) | Actionable adverse events (AAE) are events that are recognized by diagnosis codes (ICD 10 DX codes) and their timing to indicate potential complications of care. They require a relevant procedure code (ICD 10 PX codes; CPT/HCPCS codes) on the same claim/claim line to assign the claim to the episode. Additional rules are used to identify AAEs in addition to the presence of AAE diagnosis codes. For example, relevant acute inpatient readmission claims are flagged as actionable adverse events regardless of the presence of AAE codes. (Table 3) |
| Relevant Procedure Codes | All relevant services within the timeframe of an episode are included within an episode. These include office visits, emergency room visits, inpatient professional or facility services, labs, radiology or ancillary services. Relevant diagnosis and procedure codes help identify which services are included. Some procedure codes are sufficient to stand alone, while others require typical or actionable adverse event (AAE) diagnosis codes on the same claim/claim line to steer services into the episode. (Tables 4 and 5) |
| Relevant Pharmacy | All relevant pharmacy services are included within an episode. These are identified by National Drug Codes (NDC) on a pharmacy claim and are grouped using the RxNorm grouping classification for ease of assigning them into episodes. (Table 6) |
| SubTypes | Episode subtypes are used to adjust the target price and/or to subset episode type for reporting purposes. They are specific to the episode and identified from the trigger claim or from claims during the look-back period. Examples of Subtype Groups: Bariatric Surgery: Open Gastric BypassLaparoscopic Gastric BypassIntraluminal DeviceOcclusion/Restriction of Stomach |
Code Tables
Table 1: Trigger Codes
| Trigger Type | Code Value |
| CPT / HCPCS Triggers | 43644, 43645, 43659, 43770, 43771, 43773, 43775, 43810, 43820, 43825, 43842, 43843, 43845, 43846, 43847, 43848 |
| ICD-10-CM (DX) Qualifying Diagnosis | E65, E6601, E6609, E661, E663, E668, E669, E780, E7800, E7801, E781, E782, E783, E784, E785, E881, E8881, G4730, G4731, G4733, G4734, G4736, G4737, G4739, Z6825, Z6826, Z6827, Z6828, Z6829, Z6830, Z6831, Z6832, Z6833, Z6834, Z6835, Z6836, Z6837, Z6838, Z6839, Z6841, Z6842, Z6843, Z6844, Z6845, Z9884 |
| ICD-10-PCS (PX) Triggers | 0D16079, 0D1607A, 0D1607B, 0D1607L, 0D160J9, 0D160JA, 0D160JB, 0D160JL, 0D160K9, 0D160KA, 0D160KB, 0D160KL, 0D160Z9, 0D160ZA, 0D160ZB, 0D160ZL, 0D16479, 0D1647A, 0D1647B, 0D1647L, 0D164J9, 0D164JA, 0D164JB, 0D164JL, 0D164K9, 0D164KA, 0D164KB, 0D164KL, 0D164Z9, 0D164ZA, 0D164ZB, 0D164ZL, 0D16879, 0D1687A, 0D1687B, 0D1687L, 0D168J9, 0D168JA, 0D168JB, 0D168JL, 0D168K9, 0D168KA, 0D168KB, 0D168KL, 0D168Z9, 0D168ZA, 0D168ZB, 0D168ZL, 0D194Z9, 0D194ZB, 0D760DZ, 0D760ZZ, 0D763DZ, 0D763ZZ, 0D764DZ, 0D764ZZ, 0D767DZ, 0D767ZZ, 0D768DZ, 0D768ZZ, 0DB40ZZ, 0DB43ZZ, 0DB44ZZ, 0DB47ZZ, 0DB60Z3, 0DB60ZZ, 0DB63Z3, 0DB63ZZ, 0DB64Z3, 0DB64ZZ, 0DB67Z3, 0DB67ZZ, 0DB68Z3, 0DB68ZZ, 0DM60ZZ, 0DM64ZZ, 0DN60ZZ, 0DN63ZZ, 0DN64ZZ, 0DN67ZZ, 0DN68ZZ, 0DQ60ZZ, 0DQ63ZZ, 0DQ64ZZ, 0DQ67ZZ, 0DQ68ZZ, 0DT40ZZ, 0DT44ZZ, 0DT47ZZ, 0DT48ZZ, 0DT70ZZ, 0DT74ZZ, 0DT77ZZ, 0DT78ZZ, 0DU607Z, 0DU60JZ, 0DU60KZ, 0DU647Z, 0DU64JZ, 0DU64KZ, 0DU677Z, 0DU67JZ, 0DU67KZ, 0DU687Z, 0DU68JZ, 0DU68KZ, 0DV60CZ, 0DV60DZ, 0DV60ZZ, 0DV63CZ, 0DV63DZ, 0DV63ZZ, 0DV64CZ, 0DV64DZ, 0DV64ZZ, 0DV67ZZ, 0DV68ZZ |
Table 2: ICD-10 Typical Diagnosis
| Group ID | Group Name | Code Value |
| DXX01186 | NS – chronic pain – other | G8929, G894 |
| DXX03160 | GI – s/p gi surgery – other | Z48814, Z48815 |
| DXX0495 | Resp – screening | Z1383 |
| DXX05158 | CV – edema | R600, R601, R609 |
| DXX0516 | CV – elevated BP | R030 |
| DXX05183 | CV – vasc cath adjust remove | Z452 |
| DXX05345 | Orthostatic Hypotension / Dizziness | I951, R42 |
| DXX06206 | GI – abdominal pain | R1012, R1032 |
| DXX06214 | GI – abdominal tenderness | R10812, R10822 |
| DXX06232 | GI – s/p bariatric surgery | Z9884 |
| DXX06267 | Nausea, vomiting | R110, R1110, R1111, R1112, R112 |
| DXX06308 | Other disorders of stomach and duodenum | K311, K313, K314, K3183, K3189, K319 |
| DXX06317 | Acute esophagitis, acute gastritis, duodenitis | K2930, K2940, K2950 |
| DXX06350 | Gastroperesis | K3184 |
| DXX06365 | Abdominal pain | R100, R1010, R1011, R1013, R102, R1030, R1031, R1033, R1084, R109 |
| DXX06367 | Abdominal tenderness | R10811, R10813, R10814, R10815, R10816, R10817, R10819, R10821, R10823, R10824, R10825, R10826, R10827, R10829 |
| DXX07114 | Hepatotoxicity | R740, R748, R749, R945 |
| DXX08949 | MS – muscle – nos – muscle weakness | M6281 |
| DXX09185 | Othr – other aftercare | Z428 |
| DXX1007 | Overweight | E663, Z6825, Z6826, Z6827, Z6828, Z6829 |
| DXX10101 | diabetes mellitus with neurologic manifestations | E0843, E0943, E1043, E1143, E1343 |
| DXX10106 | hyperlipidemia | E780, E7800, E7801, E781, E782, E783, E784, E785 |
| DXX10107 | Obesity | E6609, E661, E668, E669, Z6830, Z6831, Z6832, Z6833, Z6834, Z6835, Z6836, Z6837, Z6838, Z6839 |
| DXX10108 | Sleep Apnea | G4730, G4731, G4734, G4735, G4736, G4737, G4739 |
| DXX10112 | Severe Morbid Obesity | Z6845 |
| DXX10113 | Obstructive sleep apnea | G4733 |
| DXX1019 | Morbid Obesity | E6601, Z6841, Z6842, Z6843, Z6844 |
| DXX1069 | Abnormal Weight Gain | R635 |
| DXX1071 | Endo – other | E65, E881, E8881 |
| DXX1094 | Sxs – abnormal findings – lab or exam | E790, R7871, R7879, R7889, R790, R7989, R799 |
| DXX1096 | Prvn – screening – other | Z131, Z1321, Z13220, Z13228, Z1329 |
| DXX1849 | Other bacterial infections | B9681 |
| DXX1963 | Anxiety Disorders | F064 |
| DXX2008 | Tobacco Use | T65212D, T65214D, T65221D, T65222D, T65224D, T65291D, T65292D, T65294D |
| DXX2104 | NS – acute pain – post op | G8918 |
| DXX2328 | Sxs – malaise / fatigue | G933, R530, R531, R5381, R5383 |
| DXX2329 | Sxs – chronic fatique syndrome | R5382 |
| DXX2332 | Sxs – symptoms -other | R419, R4584, R6889 |
| DXX2337 | Prvn – routine medical exam | Z0001 |
| DXX2338 | Prvn – routine exam – other | Z005, Z0070, Z0071 |
| DXX2339 | Prvn – admin exam / visit | Z006, Z020, Z021, Z022, Z023, Z024, Z025, Z026, Z0271, Z0279, Z0282, Z0289, Z029, Z760 |
| DXX2340 | Prvn – pre-op exam | Z0130, Z0131, Z01810, Z01811, Z01812, Z01818, Z0183 |
| DXX2342 | Prvn – encounter for lab test | Z0184 |
| DXX2343 | Prvn – screening – other | Z13810, Z13811, Z13818, Z1384, Z139 |
| DXX2344 | Prvn – counseling | Z322, Z323, Z6981, Z700, Z701, Z702, Z703, Z708, Z709, Z713, Z7181, Z7189, Z719, Z7689 |
| DXX2345 | Othr – fitting – other device | Z451, Z4582, Z4589, Z459, Z4682, Z469 |
| DXX2350 | Othr – post-surgical states nec | Z9621, Z9622, Z974, Z978, Z983, Z9862, Z98891 |
| DXX2352 | Othr – other | Z77110, Z77111, Z77112, Z77118, Z77122, Z77123, Z77128, Z7721, Z7722, Z779, Z9182, Z9284, Z9289 |
| DXX2354 | Othr – aftercare | S3630XD, S3632XD, S3633XD, S3639XD, S36400D, S36408D, S36409D, S36410D, S36418D, S36419D, S36420D, S36428D, S36429D, S36430D, S36438D, S36439D, S36490D, S36498D, S36499D, S36892D, S36893D, S36898D, S36899D |
| DXX2356 | Othr – long-term use other medication | Z793, Z7984, Z79891, Z79899 |
| DXX2357 | Othr – longterm anticoagulation | Z7901 |
| DXX2358 | Othr – post op care | Z4803 |
| DXX2359 | Othr – other aftercare | Z438, Z439, Z4800, Z4801, Z4802, Z481, Z5181, Z7902, Z791, Z792, Z794, Z7951, Z7952, Z7982 |
| DXX2360 | Complication of Implanted device, graft | T836XXD, T85511S, T85521S, T85591S, T8581XD, T8582XD, T8583XD, T85848D, T8584XD, T8585XD, T8586XD, T85898D, T8589XD, T859XXD |
| DXX2361 | complications of surgical procedures | T819XXD, T888XXD |
| DXX2362 | complications of medical care | T8181XD, T880XXD, T887XXD, T889XXD |
| DXX2370 | Fever & Chills | R5081, R509, R6883 |
| DXX2378 | Pain, unspecified | R52 |
| DXX2379 | Observation/Examination | Z0000, Z008, Z0189, Z048, Z049 |
| DXX2380 | Follow up after cancer treatment | Z08 |
| DXX2381 | Aftercare | Z09, Z4689, Z4889, Z5189 |
| DXX2382 | Preventive Screening | Z136, Z13828, Z1389 |
| DXX2384 | Other personal risk factors | Z9189 |
| DXX2387 | Post-surgical states | Z9889, Z98890 |
Table 3: ICD-10 Actionable Adverse Events
| Group ID | Group Name | Code Value |
| DXX01384 | Hemorrhagic Stroke | I60, I600, I6000, I6001, I6002, I601, I6010, I6011, I6012, I602, I6020, I6021, I6022, I603, I6030, I6031, I6032, I604, I605, I6050, I6051, I6052, I606, I607, I608, I609, I610, I611, I612, I613, I614, I615, I616, I618, I619, I6200, I6201, I6202, I6203, I621, I629 |
| DXX01385 | Thromboembolic Stroke | I6300, I63011, I63012, I63013, I63019, I6302, I63031, I63032, I63033, I63039, I6309, I6310, I63111, I63112, I63113, I63119, I6312, I63131, I63132, I63133, I63139, I6319, I6320, I63211, I63212, I63213, I63219, I6322, I63231, I63232, I63233, I63239, I6329, I6330, I63311, I63312, I63313, I63319, I63321, I63322, I63323, I63329, I63331, I63332, I63333, I63339, I63341, I63342, I63343, I63349, I6339, I6340, I63411, I63412, I63413, I63419, I63421, I63422, I63423, I63429, I63431, I63432, I63433, I63439, I63441, I63442, I63443, I63449, I6349, I6350, I63511, I63512, I63513, I63519, I63521, I63522, I63523, I63529, I63531, I63532, I63533, I63539, I63541, I63542, I63543, I63549, I6359, I636, I638, I639 |
| DXX01388 | Transient cerebral ischemia, TIA | G450, G451, G452, G458, G459, G460, G461, G462, I67841, I67848 |
| DXX01392 | Delirium, Encephalopathy | F05, G92, G9340, G9341, G9349, I6783 |
| DXX01395 | Other cerebral complications | G972, I97810, I97811, I97820, I97821 |
| DXX04126 | other lung complications | J90, J940, J941, J942, J949, J954, J955, J95811, J95859, J9588, R091 |
| DXX04127 | empyema, lung abscess | J869 |
| DXX04130 | Aspiration Pneumonia | J690, J691, J698 |
| DXX04138 | Viral Pneumonia | B012, J120, J122, J123, J1289, J129 |
| DXX04142 | Respiratory Failure | J80, J9584, J9600, J9601, J9602, J9610, J9611, J9612, J9620, J9621, J9622, J9690, J9691, J9692, R092 |
| DXX04154 | Respiratory Insufficiency | R0681, R0901, R0902, Y654, Z9981 |
| DXX04160 | Tracheostomy Complications | J9500, J9501, J9502, J9503, J9504, J9509 |
| DXX04164 | Chronic Fungal and Other Pneumonias | A70, B390, B391, B392, B440, B7781 |
| DXX04170 | Ventilator Associated Pneumonia | J95851 |
| DXX04172 | Gram Negative Pneumonia | J155, J156 |
| DXX04173 | MRSA Pneumonia | J15212 |
| DXX04174 | Other Staph Pneumonia | J1520, J15211, J1529 |
| DXX04176 | Resp Failure following trauma / surgery | J951, J952, J953, J95821, J95822 |
| DXX04177 | Ventilator Dependence | Z9911, Z9912 |
| DXX04187 | Other lung problems | J182, J918, J9811, J9819, R063 |
| DXX04188 | Other Bacterial Pneumonia | J158, J159, J17, J188, J189 |
| DXX04189 | Debilitating Viral Pneumonia | J09X1 |
| DXX04190 | Influenza with Pneumonia | J1000, J1001, J1008, J1100, J1108 |
| DXX05264 | arterial thromboembolism | I7411, I742, I743, I744, I745, I748, I749, I75011, I75012, I75013, I75019, I75021, I75022, I75023, I75029, I7581, I7589 |
| DXX05272 | dic, coagulation, hemorrhagic disorders | D65, D688, D689, D7582 |
| DXX05274 | Transfusion, Infusion related complications | D6951, E8771, R5084, T8029XA, T8030XA, T80310A, T80311A, T80319A, T8039XA, T8040XA, T80410A, T80411A, T80419A, T8049XA, T8051XA, T8059XA, T8061XA, T8069XA, T80818A, T8089XA, T8090XA, T80910A, T80911A, T80919A, T8092XA, T80A0XA, T80A10A, T80A11A, T80A19A, T80A9XA, Y620, Y621, Y623, Y630, Y631, Y640, Y650, Y651 |
| DXX05275 | Phlebitis, Deep vein thrombosis (DVT) | I8000, I8001, I8002, I8003, I8010, I8011, I8012, I8013, I80201, I80202, I80203, I80209, I80211, I80212, I80213, I80219, I80221, I80222, I80223, I80229, I80231, I80232, I80233, I80239, I80291, I80292, I80293, I80299, I803, I809, I821, I82401, I82402, I82403, I82409, I82411, I82412, I82413, I82419, I82421, I82422, I82423, I82429, I82431, I82432, I82433, I82439, I82441, I82442, I82443, I82449, I82491, I82492, I82493, I82499, I824Y1, I824Y2, I824Y3, I824Y9, I824Z1, I824Z2, I824Z3, I824Z9, I82811, I82812, I82813, I82819, I82890, I8290, I87001, I87002, I87003, I87009, I87011, I87012, I87013, I87019, I87021, I87022, I87023, I87029, I87031, I87032, I87033, I87039, I87091, I87092, I87093, I87099 |
| DXX05281 | STEMI | I2101, I2102, I2109, I2111, I2119, I2121, I2129, I213 |
| DXX05289 | Subendocardial infarct | I214 |
| DXX05291 | Recent AMI | I220, I221, I222, I228, I229 |
| DXX05297 | Hypotension / Syncope | I952, I9581, I959, R55 |
| DXX05298 | Fluid Electrolyte Acid Base Problems | E8330, E8339, E8340, E8341, E8342, E8349, E870, E871, E872, E873, E874, E875, E876, E8770, E8779, E878 |
| DXX05299 | Shock / Cardiac Arrest | I462, I468, I469, I4901, I4902, R570, R571, R578, R579, T782XXA, T882XXA, T886XXA |
| DXX05303 | Acute CHF / pulm edema | I5021, I5023, I5031, I5033, I5041, I5043, J810, J811, R0601 |
| DXX05308 | Pulmonary Embolism | I2690, I2692, I2699 |
| DXX05309 | IVC & other intra-abd venous thrombosis | I81, I820, I82220, I82221, I823 |
| DXX05311 | Other Phlebitis, Lymphangitis, varices | I808, I82210, I82290, I82601, I82602, I82603, I82609, I82611, I82612, I82613, I82619, I82621, I82622, I82623, I82629, I82A11, I82A12, I82A13, I82A19, I82B11, I82B12, I82B13, I82B19, I82C11, I82C12, I82C13, I82C19, I891 |
| DXX05342 | Acute cor pulmonale | I2601, I2602, I2609 |
| DXX05367 | Hypertensive Urgency | I160, I161, I169 |
| DXX05372 | Shock during or following cardiac surgery | I97120, I97121, I97710, I97790 |
| DXX05373 | Shock during or post-procedure | I97711, I97791, I9788, T8110XA, T8111XA, T8112XA, T8119XA |
| DXX05375 | Dehydration | E860, E861, E869 |
| DXX06160 | Gastroenteritis | A080, A0811, A0819, A082, A0831, A0832, A0839, A084, A088, A09, K5289, K529 |
| DXX06268 | Complicated Hiatal Hernia | K440, K441 |
| DXX06274 | Intestinal infection | A040, A041, A042, A043, A044, A048 |
| DXX06301 | Marginal Ulcer | K287 |
| DXX06305 | C-Difficile Infection | A047 |
| DXX06306 | GI Bleed | K2901, K2931, K2961, K2971, K2981, K2991, K625, K920, K921, K922 |
| DXX06307 | Intestinal Obstruction | K315, K560, K561, K562, K565, K5660, K5669, K567 |
| DXX06311 | Vascular Insufficiency of intestine | K550, K55011, K55012, K55019, K55021, K55022, K55029, K55031, K55032, K55039, K55041, K55042, K55049, K55051, K55052, K55059, K55061, K55062, K55069, K5530, K5531, K5532, K5533, K558, K559 |
| DXX06314 | Digestive system complications | K913, K9181, K9182, K9183 |
| DXX06315 | Fistula GI tract | K316, N321, N822, N823, N824 |
| DXX06316 | Achalasia, Esophageal Spasm, Stricture, Dysphagia | K222 |
| DXX06317 | Acute esophagitis, acute gastritis, duodenitis | K2900, K2970, K2980, K2990 |
| DXX06335 | Retroperitoneal Abscess | K6812, K6819, K689 |
| DXX06338 | Complications of colostomy, enterostomy | K9400, K9401, K9402, K9403, K9409, K9410, K9411, K9412, K9413, K9419, K9420, K9421, K9422, K9423, K9429 |
| DXX06352 | Hemoperitoneum | K661 |
| DXX06353 | Perforation, Peritonitis, Abd Abscess | K630, K631, K650, K651, K658, K659, N733, R188, R1930, R1931, R1932, R1933, R1934, R1935, R1936, R1937 |
| DXX06369 | Esophageal Reflux and Other Esophagitis | K209 |
| DXX06379 | Abdominal Hernia w Gangrene/Obstruction | K420, K421, K430, K431, K433, K434, K436, K437, K450, K451, K460 |
| DXX06380 | Abdominal Hernia w/out Gangrene/Obstruction | K429, K432, K435, K439, K458, K461, K469 |
| DXX06390 | GERD, Hiatal Hernia, Other Upper GI Disorders | K310 |
| DXX06393 | Marginal Ulcer w hmg / obstr / perf | K280, K281, K282, K283, K284, K285, K286 |
| DXX06395 | Post GI Surgery Syndromes | K911 |
| DXX07110 | Hepatorenal Syndrome | K767 |
| DXX0717 | Acute Pancreatitis, pseudo cyst | K850, K8500, K8501, K8502, K851, K8510, K8511, K8512, K852, K8520, K8521, K8522, K853, K8530, K8531, K8532, K8580, K8581, K8582, K859, K8590, K8591, K8592, K863 |
| DXX0718 | Gall Bladder related complications | K653 |
| DXX09187 | Wound Infections | A4852, K6811, T814XXA, T8183XA |
| DXX09190 | Wound Dehiscence | T8130XA, T8131XA, T8132XA, T8133XA |
| DXX09191 | Decubitus Ulcer | L89000, L89001, L89002, L89009, L89010, L89011, L89012, L89019, L89020, L89021, L89022, L89029, L89100, L89101, L89102, L89109, L89110, L89111, L89112, L89119, L89120, L89121, L89122, L89129, L89130, L89131, L89132, L89139, L89140, L89141, L89142, L89149, L89150, L89151, L89152, L89159, L89200, L89201, L89202, L89209, L89210, L89211, L89212, L89219, L89220, L89221, L89222, L89229, L89300, L89301, L89302, L89309, L89310, L89311, L89312, L89319, L89320, L89321, L89322, L89329, L8940, L8941, L8942, L8945, L89500, L89501, L89502, L89509, L89510, L89511, L89512, L89519, L89520, L89521, L89522, L89529, L89600, L89601, L89602, L89609, L89610, L89611, L89612, L89619, L89620, L89621, L89622, L89629, L89810, L89811, L89812, L89819, L89890, L89891, L89892, L89899, L8990, L8991, L8992, L8995 |
| DXX10102 | diabetes mellitus with ophthalmic manifestations | E11311 |
| DXX1030 | Diabetes, poor control | E0811, E08641, E08649, E0865, E0911, E09641, E0965, E1011, E10641, E1065, E11641, E1165, E1311, E13641, E160, E161, E162 |
| DXX11137 | rhabdomyolysis | M6282 |
| DXX11143 | Urinary Tract Infection | N10, N110, N111, N118, N119, N12, N136, N151, N159, N16, N2884, N2885, N2886, N3000, N3001, N3010, N3011, N3020, N3021, N3030, N3031, N3080, N3081, N3090, N3091, N340, N341, N342, N343, N35111, N35112, N35113, N35114, N35119, N3512, N37, N390, R309 |
| DXX11145 | Urinary Complications | N99520, N99521, N99522, N99523, N99524, N99528, N99530, N99531, N99532, N99533, N99534, N99538, N9981, N9989 |
| DXX11147 | Complication of genitourinary device | T83011A, T83011D, T83021A, T83021D, T83031A, T83031D, T83091A, T83091D, T83510A, T83510D, T83511A, T83511D, T83512A, T83512D, T83518A, T83518D, T8351XA, T8351XD, T83590A, T83590D, T83591A, T83591D, T83592A, T83592D, T83593A, T83593D, T83598A, T83598D, T8359XA, T8359XD, T8361XA, T8362XA, T8369XA, T8369XD, T8381XA, T8381XD, T8382XA, T8382XD, T8383XA, T8383XD, T8384XA, T8384XD, T8385XA, T8385XD, T8386XA, T8386XD, T8389XA, T8389XD, T839XXA, T839XXD |
| DXX11152 | Urinary Frequency & other symptoms | R300, R34 |
| DXX11167 | Acute Kidney Failure | N170, N171, N172, N178, N179, N19, N990 |
| DXX13108 | Postop adhesions | K660, N994 |
| DXX16296 | Hemorrhage | R58, R710 |
| DXX1846 | Opportunistic Infections | B252, B3781, B395, B399, B488 |
| DXX1849 | Other bacterial infections | A35, A482, A484, A488, A4901, A491, A492, A493, A498, A499, B950, B951, B952, B953, B954, B955, B9561, B957, B958, B960, B961, B963, B964, B965, B966, B967, B9682, B9689, I76, J200, J201, J202, R899 |
| DXX1850 | MRSA, Drug Resistant Infections | A4902, B9562, Z1610, Z1611, Z1612, Z1619, Z1620, Z1621, Z1622, Z1623, Z1624, Z1629, Z1630, Z1631, Z1632, Z1633, Z16341, Z16342, Z1635, Z1639 |
| DXX1851 | Sepsis | A392, A394, A400, A401, A403, A408, A409, A4101, A4102, A411, A412, A413, A414, A4150, A4151, A4152, A4153, A4159, A4181, A4189, A419, A5486, B007, B377 |
| DXX1852 | Severe Sepsis | A483, R6511, R6520, R6521 |
| DXX1853 | Bacteremia, SIRS, no organ dysfunction | R6510, R7881 |
| DXX1860 | Other Sexually Transmitted Diseases | A5601 |
| DXX19103 | Altered mental status | F060, F061, F062, R400, R401, R440, R442, R443 |
| DXX19105 | Other Mental Disorders | F068 |
| DXX2161 | Complications from Central Line | T80211D, T80212D, T80218A, T80218D, T80219A, T80219D, T8022XA, T8022XD |
| DXX2164 | Accidental Falls | V00811A, V00811D, V00812A, V00812D, V00818A, V00818D, V00831A, V00831D, W050XXA, W050XXD, W051XXA, W051XXD, W052XXA, W052XXD, W06XXXA, W06XXXD, W07XXXA, W07XXXD, W08XXXA, W08XXXD, W102XXA, W102XXD, W108XXA, W108XXD, W109XXA, W109XXD, W1811XA, W1811XD, W1812XA, W1812XD |
| DXX2171 | Adverse effects of drugs | G4440, G4441, K1232, R502, T360X5A, T360X5D, T361X5A, T361X5D, T362X5A, T362X5D, T363X5A, T363X5D, T364X5A, T364X5D, T365X5A, T365X5D, T366X5A, T366X5D, T367X5A, T367X5D, T368X5A, T368X5D, T3695XA, T3695XD, T370X5A, T370X5D, T371X5A, T371X5D, T372X5A, T373X5A, T374X5A, T375X5A, T375X5D, T378X5A, T378X5D, T3795XA, T3795XD, T380X5A, T380X5D, T381X5A, T381X5D, T382X5A, T382X5D, T383X5A, T383X5D, T384X5A, T384X5D, T385X5A, T385X5D, T386X5A, T386X5D, T387X5A, T387X5D, T38805A, T38805D, T38815A, T38815D, T38895A, T38895D, T38905A, T38905D, T38995A, T38995D, T39015A, T39015D, T39095A, T39095D, T391X5A, T391X5D, T392X5A, T392X5D, T39315A, T39315D, T39395A, T39395D, T394X5A, T394X5D, T398X5A, T398X5D, T3995XA, T3995XD, T400X5A, T400X5D, T402X5A, T402X5D, T403X5A, T403X5D, T404X5A, T404X5D, T40605A, T40605D, T40695A, T40695D, T407X5A, T407X5D, T40905A, T40905D, T40995A, T40995D, T415X5A, T415X5D, T420X5A, T420X5D, T421X5A, T421X5D, T422X5A, T422X5D, T423X5A, T423X5D, T424X5A, T424X5D, T425X5A, T425X5D, T426X5A, T426X5D, T4275XA, T4275XD, T428X5A, T428X5D, T43015A, T43015D, T43025A, T43025D, T431X5A, T431X5D, T43205A, T43205D, T43215A, T43215D, T43225A, T43225D, T43295A, T43295D, T433X5A, T433X5D, T434X5A, T434X5D, T43505A, T43505D, T43595A, T43595D, T43605A, T43605D, T43615A, T43615D, T43625A, T43625D, T43635A, T43635D, T43695A, T43695D, T438X5A, T438X5D, T4395XA, T4395XD, T440X5A, T440X5D, T441X5A, T441X5D, T442X5A, T442X5D, T443X5A, T443X5D, T444X5A, T444X5D, T445X5A, T445X5D, T446X5A, T446X5D, T447X5A, T447X5D, T448X5A, T448X5D, T44905A, T44905D, T44995A, T44995D, T450X5A, T450X5D, T451X5A, T452X5A, T452X5D, T453X5A, T453X5D, T454X5A, T454X5D, T45515A, T45515D, T45525A, T45525D, T45605A, T45605D, T45615A, T45615D, T45625A, T45625D, T45695A, T45695D, T457X5A, T457X5D, T458X5A, T458X5D, T4595XA, T4595XD, T460X5A, T460X5D, T461X5A, T461X5D, T462X5A, T462X5D, T463X5A, T463X5D, T464X5A, T464X5D, T465X5A, T465X5D, T466X5A, T466X5D, T467X5A, T467X5D, T468X5A, T468X5D, T46905A, T46905D, T46995A, T46995D, T470X5A, T470X5D, T471X5A, T471X5D, T472X5A, T472X5D, T473X5A, T473X5D, T474X5A, T474X5D, T475X5A, T475X5D, T476X5A, T476X5D, T477X5A, T477X5D, T478X5A, T478X5D, T4795XA, T4795XD, T480X5A, T481X5A, T481X5D, T48205A, T48205D, T48295A, T48295D, T483X5A, T483X5D, T484X5A, T484X5D, T485X5A, T485X5D, T486X5A, T486X5D, T48905A, T48905D, T48995A, T48995D, T490X5A, T490X5D, T491X5A, T491X5D, T492X5A, T492X5D, T493X5A, T493X5D, T494X5A, T495X5A, T495X5D, T496X5A, T496X5D, T497X5A, T497X5D, T498X5A, T498X5D, T4995XA, T4995XD, T500X5A, T500X5D, T501X5A, T501X5D, T502X5A, T502X5D, T503X5A, T503X5D, T504X5A, T504X5D, T505X5A, T505X5D, T506X5A, T506X5D, T507X5A, T507X5D, T508X5A, T508X5D, T50905A, T50905D, T50995A, T50995D, T50A15A, T50A25A, T50A95A, T50B15A, T50B95A, T50B95D, T50Z15A, T50Z15D, T50Z95A, T50Z95D |
| DXX2175 | Complications of anesthesia | T410X5A, T411X5A, T41205A, T41295A, T413X5A, T4145XA, T883XXA, T883XXD, T884XXA, T884XXD, T8851XD, T8852XA, T8853XA, T8859XA, Y653, Y700, Y701, Y702, Y703, Y708 |
| DXX2360 | Complication of Implanted device, graft | T85511A, T85518A, T85521A, T85528A, T85591A, T85598A, T85610A, T85612A, T85613A, T85615A, T85618A, T85620A, T85622A, T85623A, T85625A, T85628A, T85630A, T85635A, T85638A, T85690A, T85692A, T85695A, T85698A, T8579XA, T85818A, T8581XA, T85828A, T8582XA, T85838A, T8583XA, T85848A, T8584XA, T85858A, T8585XA, T85868A, T8586XA, T85898A, T8589XA, T859XXA |
| DXX2361 | complications of surgical procedures | D7801, D7802, D7811, D7812, D7821, D7822, D7831, D7832, D7833, D7834, E3601, E3602, E3611, E3612, E89810, E89811, E89820, E89821, E89822, E89823, G9731, G9732, G9748, G9749, G9751, G9752, G9761, G9762, G9763, G9764, G9781, G9782, I97131, I97191, I97410, I97411, I97418, I9742, I9751, I9752, I97610, I97611, I97618, I9762, I97620, I97621, I97622, I97630, I97631, I97638, I97640, I97641, I97648, I9789, J9561, J9562, J9571, J9572, J95830, J95831, J95860, J95861, J95862, J95863, J9589, K910, K912, K9161, K9162, K9171, K9172, K91840, K91841, K91850, K91858, K91870, K91871, K91872, K91873, K9189, L7601, L7602, L7611, L7612, L7621, L7622, L7631, L7632, L7633, L7634, M96810, M96811, M96820, M96821, M96830, M96831, M96840, M96841, M96842, M96843, N9961, N9962, N9971, N9972, N99820, N99821, N99840, N99841, N99842, N99843, R5082, T81710A, T81710D, T81711A, T81718A, T81718D, T81719A, T81719D, T8172XA, T8172XD, T8182XA, T8182XD, T8189XA, T8189XD, T819XXA, T888XXA, Y624, Y625, Y626, Y628, Y629, Y652, Y6551, Y6552, Y710, Y711, Y712, Y713, Y718, Y720, Y721, Y722, Y723, Y728, Y730, Y731, Y732, Y733, Y738, Y740, Y741, Y742, Y743, Y748, Y750, Y751, Y752, Y753, Y758, Y760, Y761, Y762, Y763, Y768, Y770, Y771, Y772, Y773, Y778, Y780, Y781, Y782, Y783, Y788, Y790, Y791, Y792, Y793, Y798, Y800, Y801, Y802, Y803, Y808, Y810, Y811, Y812, Y813, Y818, Y828, Y829, Y848 |
| DXX2362 | complications of medical care | D7881, D7889, E368, E8989, I973, J95850, L7681, L7682, M9689, R680, T801XXA, T801XXD, T8181XA, T880XXA, T881XXA, T887XXA, T889XXA, Y633, Y635, Y636, Y638, Y639, Y641, Y648, Y649, Y658, Y66, Y69, Y844, Y846, Y847 |
| DXX2395 | Foreign body left during procedure | T81500A, T81501A, T81502A, T81503A, T81504A, T81505A, T81506A, T81507A, T81508A, T81509A, T81510A, T81511A, T81512A, T81513A, T81514A, T81515A, T81516A, T81517A, T81518A, T81519A, T81520A, T81521A, T81522A, T81523A, T81524A, T81525A, T81526A, T81527A, T81528A, T81529A, T81530A, T81531A, T81532A, T81533A, T81534A, T81535A, T81536A, T81537A, T81538A, T81539A, T81590A, T81591A, T81592A, T81593A, T81594A, T81595A, T81596A, T81597A, T81598A, T81599A, T8160XA, T8161XA, T8169XA |
| DXX9910 | HAC 02: Air Embolism | T800XXA |
| DXX9912 | HAC 04: Stage III and IV Pressure Ulcers | L89003, L89004, L89013, L89014, L89023, L89024, L89103, L89104, L89113, L89114, L89123, L89124, L89133, L89134, L89143, L89144, L89153, L89154, L89203, L89204, L89213, L89214, L89223, L89224, L89303, L89304, L89313, L89314, L89323, L89324, L8943, L8944, L89503, L89504, L89513, L89514, L89523, L89524, L89603, L89604, L89613, L89614, L89623, L89624, L89813, L89814, L89893, L89894, L8993, L8994 |
| DXX9914 | HAC 09: Manifestations of Poor Glycemic Control | E0800, E0801, E0810, E0900, E0901, E0910, E1010, E1100, E1101, E1300, E1301, E1310, E15 |
Table 4: ICD-10 Relevant Procedure Codes
| Group ID | Group Name | Code Value |
| PXX0108 | Other non-OR or closed therapeutic nervous system procedures – 008 | 3C1ZX8Z |
| PXX03231 | Other therapeutic procedures – 231 | 0WQFXZZ, 3E0G33Z, 3E0G8TZ, 3E0H33Z, 3E0M33Z, 3E0P33Z |
| PXX03235 | Robotic Assisted Procedure | 8E0W0CZ, 8E0W3CZ, 8E0W4CZ, 8E0W7CZ, 8E0W8CZ, 8E0WXCZ |
| PXX04178 | CT scan chest – 178 | BW2400Z, BW240ZZ, BW2410Z, BW241ZZ, BW24Y0Z, BW24YZZ, BW24ZZZ |
| PXX0441 | Other non-OR therapeutic procedures on respiratory system – 041 | 3E0M3SF |
| PXX0442 | Other OR therapeutic procedures on respiratory system – 042 | 0DQW0ZZ, 0DQW3ZZ, 0DQW4ZZ |
| PXX05226 | Other diagnostic radiology and related techniques – 226 | BD14ZZZ |
| PXX05247 | Computer Assisted Procedure | 8E0WXBF, 8E0WXBG, 8E0WXBH, 8E0WXBZ |
| PXX0561 | Other OR procedures on vessels other than head and neck – 061 | 06L33ZZ, 06L43ZZ |
| PXX06179 | CT scan abdomen – 179 | B52F00Z, B52F0ZZ, B52F10Z, B52F1ZZ, B52FY0Z, B52FYZZ, B52FZZZ, B52G00Z, B52G0ZZ, B52G10Z, B52G1ZZ, B52GY0Z, B52GYZZ, B52GZZZ, B52H00Z, B52H0ZZ, B52H10Z, B52H1ZZ, B52HY0Z, B52HYZZ, B52HZZZ, BD2400Z, BD240ZZ, BD2410Z, BD241ZZ, BD24Y0Z, BD24YZZ, BD24ZZZ, BF2500Z, BF250ZZ, BF2510Z, BF251ZZ, BF25Y0Z, BF25YZZ, BF25ZZZ, BF2600Z, BF260ZZ, BF2610Z, BF261ZZ, BF26Y0Z, BF26YZZ, BF26ZZZ, BF2700Z, BF270ZZ, BF2710Z, BF271ZZ, BF27Y0Z, BF27YZZ, BF27ZZZ, BF2C00Z, BF2C0ZZ, BF2C10Z, BF2C1ZZ, BF2CY0Z, BF2CYZZ, BF2CZZZ, BW2000Z, BW200ZZ, BW2010Z, BW201ZZ, BW20Y0Z, BW20YZZ, BW20ZZZ, BW2G00Z, BW2G0ZZ, BW2G10Z, BW2G1ZZ, BW2GY0Z, BW2GYZZ, BW2GZZZ |
| PXX06185 | Upper gastrointestinal X-ray – 185 | BD11YZZ, BD15YZZ, BD15ZZZ |
| PXX06186 | Lower gastrointestinal X-ray – 186 | BD14YZZ |
| PXX06194 | Diagnostic ultrasound of gastrointestinal tract – 194 | BD41ZZZ, BD42ZZZ, BD47ZZZ, BD48ZZZ, BD49ZZZ, BD4CZZZ, BF40ZZZ, BF42ZZZ, BF43ZZZ, BF45ZZZ, BF46ZZZ, BF47ZZZ, BF4CZZZ |
| PXX06196 | Diagnostic ultrasound of abdomen or retroperitoneum – 196 | BW40ZZZ |
| PXX06223 | Enteral and parenteral nutrition – 223 | 3E0G36Z |
| PXX06224 | Bariatric Surgery: Open Gastric Bypass | 0D16079, 0D1607A, 0D1607B, 0D1607L, 0D160J9, 0D160JA, 0D160JB, 0D160JL, 0D160K9, 0D160KA, 0D160KB, 0D160KL, 0D160Z9, 0D160ZA, 0D160ZB, 0D160ZL, 0D168ZA |
| PXX06226 | Laparoscopic Gastric Bypass | 0D16479, 0D1647A, 0D1647B, 0D1647L, 0D164J9, 0D164JA, 0D164JB, 0D164JL, 0D164K9, 0D164KA, 0D164KB, 0D164KL, 0D164Z9, 0D164ZA, 0D164ZB, 0D164ZL, 0D16879, 0D1687A, 0D1687B, 0D1687L, 0D168J9, 0D168JA, 0D168JB, 0D168JL, 0D168K9, 0D168KA, 0D168KB, 0D168KL, 0D168Z9, 0D168ZB, 0D168ZL |
| PXX06230 | Lap Adjustable Gastric Band | 0DV64CZ |
| PXX06231 | Gastroplasty | 0DB60Z3, 0DB60ZZ, 0DB63Z3, 0DB63ZZ, 0DB64ZZ, 0DB67Z3, 0DB67ZZ, 0DB68ZZ, 0DF60ZZ, 0DF63ZZ, 0DF64ZZ, 0DF67ZZ, 0DF68ZZ, 0DM60ZZ, 0DM64ZZ, 0DN60ZZ, 0DN63ZZ, 0DN64ZZ, 0DN67ZZ, 0DN68ZZ, 0DQ60ZZ, 0DQ63ZZ, 0DQ67ZZ, 0DQ68ZZ, 0DU607Z, 0DU60JZ, 0DU60KZ, 0DU647Z, 0DU64JZ, 0DU64KZ, 0DU677Z, 0DU67JZ, 0DU67KZ, 0DU687Z, 0DU68JZ, 0DU68KZ |
| PXX06234 | Laparoscopic Sleeve Gastrectomy | 0DB64Z3, 0DB68Z3, 0DQ64ZZ |
| PXX06236 | Gastrectomy | 0D13079, 0D1307A, 0D1307B, 0DT60ZZ, 0DT64ZZ, 0DT67ZZ, 0DT68ZZ |
| PXX06238 | Adjust / Revise Lap Adjustable Gastric Band | 0DP643Z, 0DP64CZ, 0DW643Z, 0DW64CZ, 3E0G3GC |
| PXX06239 | Bariatric Surgery: Open Other | 0DB40ZZ, 0DB43ZZ, 0DB44ZZ, 0DB47ZZ, 0DT40ZZ, 0DT44ZZ, 0DT47ZZ, 0DT48ZZ, 0DT70ZZ, 0DT74ZZ, 0DT77ZZ, 0DT78ZZ, 0DY60Z0, 0DY60Z1, 0DY60Z2 |
| PXX06242 | Laparoscopic BPD (Biliopancreatic Diversion) | 0DW04UZ, 0DW08UZ |
| PXX06246 | Partial Colectomy | 0D190Z9, 0D190ZA, 0D190ZB, 0D190ZL, 0D194Z9, 0D194ZA, 0D194ZB, 0D194ZL, 0D198Z9, 0D198ZA, 0D198ZB, 0D198ZL, 0D1A0ZA, 0D1A0ZB, 0D1A0ZH, 0D1A0ZK, 0D1A0ZL, 0D1A0ZM, 0D1A0ZN, 0D1A0ZP, 0D1A4ZA, 0D1A4ZB, 0D1A4ZH, 0D1A4ZK, 0D1A4ZL, 0D1A4ZM, 0D1A4ZN, 0D1A4ZP, 0D1A8ZA, 0D1A8ZB, 0D1A8ZH, 0D1A8ZK, 0D1A8ZL, 0D1A8ZM, 0D1A8ZN, 0D1A8ZP, 0D1B0ZB, 0D1B0ZH, 0D1B0ZK, 0D1B0ZL, 0D1B0ZM, 0D1B0ZN, 0D1B0ZP, 0D1B4ZB, 0D1B4ZH, 0D1B4ZK, 0D1B4ZL, 0D1B4ZM, 0D1B4ZN, 0D1B4ZP, 0D1B8ZB, 0D1B8ZH, 0D1B8ZK, 0D1B8ZL, 0D1B8ZM, 0D1B8ZN, 0D1B8ZP, 0D1H0ZH, 0D1H0ZK, 0D1H0ZL, 0D1H0ZM, 0D1H0ZN, 0D1H0ZP, 0D1H4ZH, 0D1H4ZK, 0D1H4ZL, 0D1H4ZM, 0D1H4ZN, 0D1H4ZP, 0D1H8ZH, 0D1H8ZK, 0D1H8ZL, 0D1H8ZM, 0D1H8ZN, 0D1H8ZP, 0D1K0ZK, 0D1K0ZL, 0D1K0ZM, 0D1K0ZN, 0D1K0ZP, 0D1K4ZK, 0D1K4ZL, 0D1K4ZM, 0D1K4ZN, 0D1K4ZP, 0D1K8ZK, 0D1K8ZL, 0D1K8ZM, 0D1K8ZN, 0D1K8ZP, 0D1L0Z4, 0D1L0ZL, 0D1L0ZM, 0D1L0ZN, 0D1L0ZP, 0D1L4Z4, 0D1L4ZL, 0D1L4ZM, 0D1L4ZN, 0D1L4ZP, 0D1L8ZL, 0D1L8ZM, 0D1L8ZN, 0D1L8ZP, 0D1M0Z4, 0D1M0ZM, 0D1M0ZN, 0D1M0ZP, 0D1M4Z4, 0D1M4ZM, 0D1M4ZN, 0D1M4ZP, 0D1M8ZM, 0D1M8ZN, 0D1M8ZP, 0D1N0ZN, 0D1N0ZP, 0D1N4ZN, 0D1N4ZP, 0D1N8ZN, 0D1N8ZP |
| PXX06251 | Colonoscopy w biopsy, polypectomy | 0DBE3ZX, 0DBE4ZX |
| PXX06253 | Intraluminal Device | 0D760DZ, 0D763DZ, 0D764DZ, 0D767DZ, 0D768DZ, 0DH60DZ, 0DH63DZ, 0DH64DZ, 0DH67DZ, 0DH68DZ, 0DL60DZ, 0DL63DZ, 0DL64DZ, 0DL67DZ, 0DL68DZ, 0DL70DZ, 0DL73DZ, 0DL74DZ, 0DL77DZ, 0DL78DZ, 0DV60DZ, 0DV63DZ, 0DV64DZ |
| PXX06255 | Occlusion/Restriction of Stomach | 0D760ZZ, 0D763ZZ, 0D764ZZ, 0D767ZZ, 0D768ZZ, 0DL60CZ, 0DL60ZZ, 0DL63CZ, 0DL63ZZ, 0DL64CZ, 0DL64ZZ, 0DL67ZZ, 0DL68ZZ, 0DL70CZ, 0DL70ZZ, 0DL73CZ, 0DL73ZZ, 0DL74CZ, 0DL74ZZ, 0DL77ZZ, 0DL78ZZ, 0DV60CZ, 0DV60ZZ, 0DV63CZ, 0DV63ZZ, 0DV64ZZ, 0DV67ZZ, 0DV68ZZ |
| PXX0668 | Injection or ligation of esophageal varices – 068 | 06L33CZ, 06L33DZ |
| PXX0669 | Esophageal dilatation – 069 | 0D717DZ, 0D717ZZ, 0D718DZ, 0D718ZZ, 0D727DZ, 0D727ZZ, 0D728DZ, 0D728ZZ, 0D737DZ, 0D737ZZ, 0D738DZ, 0D738ZZ, 0D747DZ, 0D747ZZ, 0D748DZ, 0D748ZZ, 0D757DZ, 0D757ZZ, 0D758DZ, 0D758ZZ |
| PXX0670 | Upper gastrointestinal endoscopy, biopsy – 070 | 0D963ZX, 0D964ZX, 0D967ZX, 0D973ZX, 0D974ZX, 0D977ZX, 0DB63ZX, 0DB64ZX, 0DB67ZX, 0DB73ZX, 0DB74ZX, 0DB77ZX, 0DB83ZX, 0DJ68ZZ |
| PXX0675 | Small bowel resection – 075 | 0DB80ZZ, 0DB83ZZ, 0DB87ZZ, 0DBB0ZZ |
| PXX0686 | Other hernia repair – 086 | 0DQS0ZZ, 0DQS3ZZ, 0DQS4ZZ, 0DQT0ZZ, 0DQT3ZZ, 0DQT4ZZ, 0WQF0ZZ, 0WQF3ZZ, 0WQF4ZZ |
| PXX0692 | Other bowel diagnostic procedures – 092 | 0D960ZX, 0D970ZX, 0D980ZX, 0D990ZX, 0D9A0ZX, 0D9B0ZX, 0D9C0ZX, 0DB60ZX, 0DB70ZX, 0DB80ZX, 0DB90ZX, 0DBA0ZX, 0DBB0ZX, 0DBC0ZX, 0DBE0ZX, 0DJ63ZZ, 0DJ64ZZ, 0DJ67ZZ, 0DJD3ZZ, 0DJD4ZZ |
| PXX0693 | Other non-OR upper GI therapeutic procedures – 093 | 06L43CZ, 0D20X0Z, 0D20XUZ, 0D20XYZ, 0D514ZZ, 0D518ZZ, 0D524ZZ, 0D528ZZ, 0D534ZZ, 0D538ZZ, 0D544ZZ, 0D548ZZ, 0D554ZZ, 0D558ZZ, 0D564ZZ, 0D568ZZ, 0D574ZZ, 0D578ZZ, 0DB14ZZ, 0DB18ZZ, 0DB24ZZ, 0DB28ZZ, 0DB34ZZ, 0DB38ZZ, 0DB48ZZ, 0DB54ZZ, 0DB58ZZ, 0DB74ZZ, 0DB78ZZ, 0DH50DZ, 0DH50UZ, 0DH53DZ, 0DH53UZ, 0DH54DZ, 0DH54UZ, 0DH57DZ, 0DH57UZ, 0DH58DZ, 0DH58UZ, 0DP67DZ, 0DP68DZ, 0DP6X0Z, 0DP6XUZ, 0DV67DZ, 0DV68DZ, 0WQFXZ2, 3E0G76Z, 3E0G7GC, 3E0G86Z, 3E0G8GC, 3E1G38X, 3E1G38Z, 3E1G78X, 3E1G78Z, 3E1G88X, 3E1G88Z, 3E1H38X, 3E1H38Z, 3E1H88X, 3E1H88Z |
| PXX0695 | Other non-OR lower GI therapeutic procedures – 095 | 0D2DX0Z, 0D2DXUZ, 0D2DXYZ, 0D594ZZ, 0D598ZZ, 0D780DZ, 0D783DZ, 0D784DZ, 0D787DZ, 0D787ZZ, 0D788ZZ, 0D790DZ, 0D793DZ, 0D794DZ, 0D797DZ, 0D797ZZ, 0D798ZZ, 0D7A0DZ, 0D7A3DZ, 0D7A4DZ, 0D7A7DZ, 0D7A7ZZ, 0D7A8ZZ, 0D7B0DZ, 0D7B3DZ, 0D7B4DZ, 0D7B7DZ, 0D7B7ZZ, 0D7B8ZZ, 0D7C0DZ, 0D7C3DZ, 0D7C4DZ, 0D7C7DZ, 0D7C7ZZ, 0D7C8ZZ, 0D7E0DZ, 0D7E3DZ, 0D7E4DZ, 0D7E7DZ, 0D7E7ZZ, 0D7E8ZZ, 0D7F0DZ, 0D7F3DZ, 0D7F4DZ, 0D7F7DZ, 0D7F7ZZ, 0D7F8ZZ, 0D7G0DZ, 0D7G3DZ, 0D7G4DZ, 0D7G7DZ, 0D7G7ZZ, 0D7G8ZZ, 0D7H0DZ, 0D7H3DZ, 0D7H4DZ, 0D7H7DZ, 0D7H7ZZ, 0D7H8ZZ, 0D7K0DZ, 0D7K3DZ, 0D7K4DZ, 0D7K7DZ, 0D7K7ZZ, 0D7K8ZZ, 0D7L0DZ, 0D7L3DZ, 0D7L4DZ, 0D7L7DZ, 0D7L7ZZ, 0D7L8ZZ, 0D7M0DZ, 0D7M3DZ, 0D7M4DZ, 0D7M7DZ, 0D7M7ZZ, 0D7M8ZZ, 0D7N0DZ, 0D7N3DZ, 0D7N4DZ, 0D7N7DZ, 0D7N7ZZ, 0D7N8ZZ, 0DB94ZZ, 0DB98ZZ, 0DH80DZ, 0DH83DZ, 0DH84DZ, 0DH87DZ, 0DH90DZ, 0DH93DZ, 0DH94DZ, 0DH97DZ, 0DHA0DZ, 0DHA3DZ, 0DHA4DZ, 0DHA7DZ, 0DHB0DZ, 0DHB3DZ, 0DHB4DZ, 0DHB7DZ, 0DHE0DZ, 0DHE3DZ, 0DHE4DZ, 0DHE7DZ, 0DHP0DZ, 0DHP3DZ, 0DHP4DZ, 0DHP7DZ, 0DP0X0Z, 0DP0XUZ, 0DS97ZZ, 0DS98ZZ, 0DSA7ZZ, 0DSA8ZZ, 0DSB7ZZ, 0DSB8ZZ, 0DSK7ZZ, 0DSK8ZZ, 0DSL7ZZ, 0DSL8ZZ, 0DSM7ZZ, 0DSM8ZZ, 0DSN7ZZ, 0DSN8ZZ, 0DSPXZZ, 3E0G37Z, 3E0G73Z, 3E0G77Z, 3E0G83Z, 3E0G87Z, 3E0H36Z, 3E0H37Z, 3E0H73Z, 3E0H76Z, 3E0H7GC, 3E0H83Z, 3E0H86Z, 3E0H8GC, 3E1H78Z |
| PXX0696 | Other OR lower GI therapeutic procedures – 096 | 0D19079, 0D1907A, 0D1907B, 0D190J9, 0D190JA, 0D190JB, 0D190K9, 0D190KA, 0D190KB, 0D19479, 0D1947A, 0D1947B, 0D194J9, 0D194JA, 0D194JB, 0D194K9, 0D194KA, 0D194KB, 0D19879, 0D1987A, 0D1987B, 0D198J9, 0D198JA, 0D198JB, 0D198K9, 0D198KA, 0D198KB, 0D1A07A, 0D1A07B, 0D1A0JA, 0D1A0JB, 0D1A0KA, 0D1A0KB, 0D1A47A, 0D1A47B, 0D1A4JA, 0D1A4JB, 0D1A4KA, 0D1A4KB, 0D1A87A, 0D1A87B, 0D1A8JA, 0D1A8JB, 0D1A8KA, 0D1A8KB, 0D1B07B, 0D1B0JB, 0D1B0KB, 0D1B47B, 0D1B4JB, 0D1B4KB, 0D1B87B, 0D1B8JB, 0D1B8KB, 0D9870Z, 0D9880Z, 0D9E70Z, 0D9E80Z, 0DB90ZZ, 0DNP7ZZ, 0DNP8ZZ, 0F190Z3, 0TRB07Z |
| PXX0697 | Other gastrointestinal diagnostic procedures – 097 | 0D910ZX, 0D920ZX, 0D930ZX, 0D940ZX, 0D950ZX, 0D9S0ZX, 0D9S3ZX, 0D9S4ZX, 0D9T0ZX, 0D9T3ZX, 0D9T4ZX, 0D9V0ZX, 0D9V3ZX, 0D9V4ZX, 0D9W0ZX, 0D9W3ZX, 0D9W4ZX, 0DB10ZX, 0DB20ZX, 0DB30ZX, 0DB40ZX, 0DB50ZX, 0DBS0ZX, 0DBS3ZX, 0DBS4ZX, 0DBT0ZX, 0DBT3ZX, 0DBT4ZX, 0DBV0ZX, 0DBV3ZX, 0DBV4ZX, 0DBW0ZX, 0DBW3ZX, 0DBW4ZX, 0DJU3ZZ, 0DJV3ZZ, 0DJW3ZZ, 0FJ40ZZ, 0FJ43ZZ, 0FJB3ZZ, 0FJB7ZZ, 0FJB8ZZ, 0W9F0ZX, 0W9F3ZX, 0W9F4ZX, 0W9G0ZX, 0W9G3ZX, 0W9G4ZX, 0W9H0ZX, 0W9H3ZX, 0W9H4ZX, 0W9J0ZX, 0W9J3ZX, 0W9J4ZX, 0WBF0ZX, 0WBF3ZX, 0WBF4ZX, 0WBFXZX, 0WBH0ZX, 0WBH3ZX, 0WBH4ZX, 0WJF3ZZ, 0WJG3ZZ, 0WJH3ZZ, 0WJH4ZZ, 0WJJ3ZZ, 0WJP3ZZ, 0WJP7ZZ, 0WJP8ZZ, 0WJR3ZZ, 0WJR7ZZ, 0WJR8ZZ, 0Y950ZX, 0Y953ZX, 0Y954ZX, 0Y960ZX, 0Y963ZX, 0Y964ZX, 0YB50ZX, 0YB53ZX, 0YB54ZX, 0YB60ZX, 0YB63ZX, 0YB64ZX, 0YB70ZX, 0YB73ZX, 0YB74ZX, 0YB80ZX, 0YB83ZX, 0YB84ZX, 0YJ53ZZ, 0YJ54ZZ, 0YJ63ZZ, 0YJ64ZZ, 0YJ73ZZ, 0YJ74ZZ, 0YJ83ZZ, 0YJ84ZZ, 0YJA3ZZ, 0YJA4ZZ, 0YJE3ZZ, 0YJE4ZZ, 3E1M38X, 3E1M38Z, 4A0C35Z, 4A0C3BZ, 4A0C45Z, 4A0C4BZ, 4A0C75Z, 4A0C7BZ, 4A0C85Z |
| PXX0698 | Other non-OR gastrointestinal therapeutic procedures – 098 | 07PPX0Z, 07PPX3Z, 0D9970Z, 0D9980Z, 0D9A70Z, 0D9A80Z, 0D9B70Z, 0D9B80Z, 0D9F70Z, 0D9F80Z, 0D9G70Z, 0D9G80Z, 0D9H70Z, 0D9H80Z, 0D9K70Z, 0D9K80Z, 0D9L70Z, 0D9L80Z, 0D9M70Z, 0D9M80Z, 0D9N70Z, 0D9N80Z, 0DN87ZZ, 0DN88ZZ, 0DN97ZZ, 0DN98ZZ, 0DNA7ZZ, 0DNA8ZZ, 0DNB7ZZ, 0DNB8ZZ, 0DNE7ZZ, 0DNE8ZZ, 0DNF7ZZ, 0DNF8ZZ, 0DNG7ZZ, 0DNG8ZZ, 0DNH7ZZ, 0DNH8ZZ, 0DNK7ZZ, 0DNK8ZZ, 0DNL7ZZ, 0DNL8ZZ, 0DNM7ZZ, 0DNM8ZZ, 0DNN7ZZ, 0DNN8ZZ, 0DP0X2Z, 0DP0X3Z, 0DP0XDZ, 0DP571Z, 0DP581Z, 0DP5X1Z, 0DP5X2Z, 0DP5X3Z, 0DP5XUZ, 0DP6X2Z, 0DP6X3Z, 0DP6XDZ, 0DPDX2Z, 0DPDX3Z, 0DPDXDZ, 0DPP71Z, 0DPP81Z, 0DPPX1Z, 0DQV0ZZ, 0DQV3ZZ, 0DQV4ZZ, 0DS6XZZ, 0DS9XZZ, 0DSAXZZ, 0DSBXZZ, 0DSHXZZ, 0DSKXZZ, 0DSLXZZ, 0DSMXZZ, 0DSNXZZ, 0DWU00Z, 0DWU30Z, 0DWU40Z, 0DWV00Z, 0DWV30Z, 0DWV40Z, 0DWW00Z, 0DWW30Z, 0DWW40Z, 0F754ZZ, 0F757DZ, 0F758DZ, 0F758ZZ, 0F764ZZ, 0F767DZ, 0F768DZ, 0F768ZZ, 0F784ZZ, 0F787DZ, 0F788DZ, 0F788ZZ, 0F794ZZ, 0F797DZ, 0F798DZ, 0F798ZZ, 0F7C8DZ, 0F7C8ZZ, 0F7D7DZ, 0F7D8DZ, 0F958ZZ, 0F968ZZ, 0F988ZZ, 0F998ZZ, 0F9C40Z, 0F9C4ZZ, 0F9C80Z, 0F9C8ZZ, 0F9D8ZZ, 0F9F8ZZ, 0FHB7DZ, 0FHB8DZ, 0FP0X2Z, 0FP0X3Z, 0FP4X2Z, 0FP4X3Z, 0FP4XDZ, 0FPB7DZ, 0FPB8DZ, 0FPBX1Z, 0FPBX2Z, 0FPBX3Z, 0FPBXDZ, 0FPD7DZ, 0FPD8DZ, 0FPDX0Z, 0FPDX1Z, 0FPDX2Z, 0FPDX3Z, 0FPDXDZ, 0FPGX0Z, 0FPGX2Z, 0FPGX3Z, 0W1G0J9, 0W1G0JB, 0W1G0JG, 0W1G0JJ, 0W1G4J9, 0W1G4JB, 0W1G4JG, 0W1G4JJ, 0W1J0J4, 0W1J0JY, 0W1J3J4, 0W1J4J4, 0W1J4JY, 0WCP7ZZ, 0WCP8ZZ, 0WFJ0ZZ, 0WFJ3ZZ, 0WFJ4ZZ, 0WFP0ZZ, 0WFP3ZZ, 0WFP4ZZ, 0WFP7ZZ, 0WFP8ZZ, 0WHP0YZ, 0WHP33Z, 0WHP3YZ, 0WHP43Z, 0WHP4YZ, 0WHP73Z, 0WHP7YZ, 0WHP83Z, 0WHP8YZ, 0WPFX0Z, 0WPFX1Z, 0WPFX3Z, 0WPFX7Z, 0WPFXJZ, 0WPFXKZ, 0WPFXYZ, 0WPGX0Z, 0WPGX1Z, 0WPGX3Z, 0WPJ00Z, 0WPJ01Z, 0WPJ03Z, 0WPJ0JZ, 0WPJ0YZ, 0WPJ30Z, 0WPJ31Z, 0WPJ33Z, 0WPJ3JZ, 0WPJ3YZ, 0WPJ40Z, 0WPJ41Z, 0WPJ43Z, 0WPJ4JZ, 0WPJ4YZ, 0WPP31Z, 0WPP33Z, 0WPP3YZ, 0WPP41Z, 0WPP43Z, 0WPP4YZ, 0WPP71Z, 0WPP73Z, 0WPP7YZ, 0WPP81Z, 0WPP83Z, 0WPP8YZ, 0WPPX1Z, 0WPPX3Z, 0WPPXYZ, 0WWP31Z, 0WWP33Z, 0WWP3YZ, 0WWP41Z, 0WWP43Z, 0WWP4YZ, 0WWP71Z, 0WWP73Z, 0WWP7YZ, 0WWP81Z, 0WWP83Z, 0WWP8YZ, 0YQ5XZZ, 0YQ6XZZ, 0YQ7XZZ, 0YQ8XZZ, 0YQAXZZ, 0YQEXZZ, 2W53X0Z, 2W53X4Z, 2W53X5Z, 2W53X6Z, 2W53X7Z, 2W53XYZ, 2Y53X5Z, 3E0J73Z, 3E0J76Z, 3E0J77Z, 3E0J7BZ, 3E0J7GC, 3E0J7HZ, 3E0J7KZ, 3E0J7TZ, 3E0J83Z, 3E0J86Z, 3E0J87Z, 3E0J8BZ, 3E0J8GC, 3E0J8HZ, 3E0J8KZ, 3E0J8TZ, 3E0M36Z, 3E0M37Z, 3E0M3BZ, 3E0M3GC, 3E0M3HZ, 3E0M3KZ, 3E0M3TZ, 3E0M7SF, 3E0P36Z, 3E0P37Z, 3E0P3BZ, 3E0P3HZ, 3E0P3KZ, 3E0P3TZ, 3E0P7BZ, 3E0P7HZ, 3E0P7KZ, 3E0P7TZ, 3E0P8BZ, 3E0P8HZ, 3E0P8KZ, 3E0P8TZ, 3E1H78X, 3E1J78X, 3E1J78Z, 3E1J88X, 3E1J88Z |
Table 5: Relevant Procedure Codes CPT/HCPCS
| Group ID | Group Name | Code Value |
| CT0025 | Preventive Medicine, Care Coordination | 2000F, 2001F, 4000F, 4001F, 4004F, 93790, 98960, 98961, 98962, 98966, 98967, 98968, 99078, 99361, 99362, 99366, 99367, 99368, 99371, 99372, 99373, 99382, 99383, 99384, 99385, 99386, 99387, 99392, 99393, 99394, 99395, 99396, 99397, 99398, 99399, 99400, 99401, 99402, 99403, 99404, 99411, 99412, 99429, 99441, 99442, 99443, 99446, 99447, 99448, 99449, 99499, G0175, G0245, G0246, G0247, G0402, G0406, G0407, G0408, G0425, G0426, G0427, G8402, G8686, G8688, G8690, G8692, H0034, H0039, H0040, S0220, S0221, S0315, S0316, S0317, S0320 |
| CT0026 | Drugs for anesthesia and pain | J0400, J0780, J1630, J1631, J1960, J2270, J2310, J2680, J2794, J3010, J3070, J3230, J3486, S0012, S0092, S0093, S0136 |
| CT0028 | Depression Screening | 1220F, 3085F, 3351F, 3352F, 3353F, 3354F, 3725F, 96127, G0444, G8431, G8432, G8433, G8510, G8511, G8940 |
| CT0071 | Drainage of Abdominal Abscess | 49020, 49021, 49040, 49041, 49060, 49061 |
| CT0072 | Image guided drainage of abdominal abscess | 49406, 49407 |
| CT0079 | Toxicology Screening | G0480, G0481, G0482, G0483 |
| CT0080 | Imaging Abdomen | 74000, 74010, 74020, 74022, 74150, 74160, 74170, 74181, 74182, 74183, 74185, 76700, 76705, 76975, 76999, C8900, C8901, C8902 |
| CT0082 | Opioid Administration / Dispensing (OTP) | 96372, H0033, J0592, J1230, J2315 |
| CT0083 | Blood Type, Coomb’s test | 86077, 86880, 86900, 86901 |
| CT0089 | Metabolic Renal Hepatic Chemistry Panel | 80010, 80047, 80048, 80049, 80050, 80051, 80052, 80053, 80069, 80074, 80076, 82040, 82247, 82248, 82310, 82330, 82374, 82435, 82565, 82575, 82947, 84132, 84155, 84295, 84450, 84460, 84520, 84550 |
| CT0090 | Physical Therapy / Rehab | 97001, 97002, 97003, 97004, 97005, 97006, 97033, 97034, 97035, 97039, 97139, 97150, 97545, 97546, 97750, 97755 |
| CT0091 | Physician Services – Outpatient | 99050, 99051, 99053, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99354, 99355, T1015 |
| CT0092 | Physician Services – Inpatient | 99221, 99222, 99223, 99238, 99239, 99252, 99253, 99254, 99255 |
| CT0093 | Routine Immunizations | 90471 |
| CT0094 | Screen for amino acid disorders | 84030 |
| CT0096 | Subsequent Physician Services Inpatient | 99433 |
| CT0097 | Vitamin K administration | J3430 |
| CT0098 | Colonoscopy/Sigmoidoscopy ColorectalCa Screen | 82270, G0328 |
| CT0112 | Procedure – spinal canal – injection into spinal canal | 62310, 62311, 62318, 62319 |
| CT0114 | Procedure – spinal canal – catheter | C1755, E0785 |
| CT0120 | Procedure – destruction – nerve | 64752, 64755, 64760 |
| CT0126 | Procedure – neuro – other non – or rx | 62273 |
| CT0131 | Procedure – anesthesia | 01991, 01992 |
| CT0132 | Rx – central nervous system – parkinson’s rx | J0190, J0515, J8515 |
| CT0133 | Rx – central nervous system – symnpatholytic rx | J1110 |
| CT0134 | Rx – central nervous system – vascular 5ht1 agonists | J3030 |
| CT0135 | Rx – central nervous system – anticonvulsants | J3475, Q2009, S0078 |
| CT0136 | Rx – central nervous system – antidepressants | J1320, S0106 |
| CT0137 | Rx – central nervous system – tranq/antipsychotics | J1790, J2950, J3310, J3400 |
| CT0138 | Rx – central nervous system – amphetamines | S0160 |
| CT0139 | Rx – central nervous system – non-amphetamine stimulants | J0706 |
| CT01393 | Other OR therapeutic nervous system procedures | 0424T |
| CT01394 | Medications (Injections, infusions and other forms) | J0695, J0714, J0875, J7121 |
| CT01395 | DME and supplies | E1012 |
| CT0140 | Rx – central nervous system – barbiturates | J0300, J2515, J2560 |
| CT0141 | Rx – central nervous system – benzodiazepines | J1990, J2060, J2250, J3360 |
| CT0142 | Rx – central nervous system – anxiolytic/sedative/hypnot nec | J3410 |
| CT0347 | Procedure – skin – removal of foreign body – remove foreign body | 10120, 10121 |
| CT0354 | Rx – eent – topical – eye/ear/nose/throat misc | J3396 |
| CT0378 | Tests – ent – swallowing evaluation | 92611 |
| CT0420 | Procedure – respiratory – other or rx | 39501, 39545, 39560, 39561, 39599 |
| CT0425 | Rx – respiratory – phenylephrine | J2370 |
| CT0426 | Rx – respiratory – mucolytics/cold comb | J0132 |
| CT0427 | Rx – respiratory – methylxanthines | J0280, J1180, J2810 |
| CT04280 | Lung Function Tests | 94010 |
| CT04281 | Blood Gases, Pulse Oximetry | 82800, 82803, 82805, 82810 |
| CT0433 | Other care – respiratory – ventillator management | 94660, 94662, 99504 |
| CT0434 | Other care – respiratory – oxygen / oxygen concentrator | E0424, E0425, E0430, E0431, E0434, E0435, E0439, E0440, E0441, E0442, E0443, E0444, E1390, E1391, E1392, K0738 |
| CT0438 | Other care – respiratory – equipment / supplies – nebulizer | E0555, E1405, E1406 |
| CT0442 | Other care – respiratory – equipment / supplies | E0445, E0455, E0457, E0459, E0605, E0606, E1353, E1355, E1399 |
| CT0443 | Other care – respiratory – other | 94002, 94003, 94004, A4604, A4606, A4614, A4615, A4616, A4617, A4619, A4620 |
| CT0449 | Imaging – nuclear – lung scan | A9536, A9558 |
| CT0463 | Tests – pulmonary – other | 94770 |
| CT05116 | Procedure – artery – extremity – injection of thrombin | 36002 |
| CT05133 | Procedure – artery / vein – nos – closure / closure device | G0269 |
| CT05134 | Procedure – artery / vein – nos – thrombectomy catheter | C1757 |
| CT05150 | Procedure – vein – vena cava – filter | C1880 |
| CT05166 | Procedure – vascular – related supplies – graft material | C1768 |
| CT05167 | Procedure – vascular – related supplies – occlusion catheter | C2628 |
| CT05172 | Procedure – central venous catheter – fluoroscopy – guidance | 77001 |
| CT05176 | Procedure – peripheral venous catheter | 36000 |
| CT05177 | Procedure – catheter – venous – other – vena cava or selective branch catheter | 36010, 36011, 36012 |
| CT05178 | Procedure – catheter – venous – other – other | 36481, 36500, 36510 |
| CT05179 | Procedure – catheter – arterial – arterial line for monitoring | 36620, 36625 |
| CT05181 | Procedure – catheter – arterial – selective branch catheter | 36215, 36216, 36217, 36218 |
| CT05182 | Procedure – catheter – arterial – pulmonary artery catheter | 36014, 36015 |
| CT05183 | Procedure – catheter – arterial – other | 36100, 36120, 36140, 36640, 36660 |
| CT05184 | Procedure – vascular access – port / pump – insertion | 36260, C1772, C2626, E0782, E0783, E0786 |
| CT05185 | Procedure – vascular access – port / pump – revision | 36261 |
| CT05186 | Procedure – vascular access – port / pump – removal | 36262 |
| CT05193 | Rx – cardiovascular system – cardiac drugs | J1742, J2260 |
| CT05195 | Rx – cardiovascular system – antiarrhythmic rx | J0150, J0152, J0282, J2690 |
| CT05196 | Rx – cardiovascular system – beta blockers | J1800 |
| CT05197 | Rx – cardiovascular system – hypotensive rx | J0210, J0360, J0735, J1730, J2760, S0139 |
| CT05199 | Rx – cardiovascular system – vasodilating rx | J1325, J2440, J2670, J3285, K0455, S0155 |
| CT05201 | Rx – cardiovascular system – natriuretic peptides | J2325 |
| CT05202 | Rx – diuretics, loop diuretics | J1940, J3265 |
| CT05203 | Rx – diuretics, osmotic | J2150, J3350 |
| CT05204 | Rx – diuretics, thiazides / related | J1205 |
| CT05205 | Rx – diuretics – diuretic, carb anhydrase inhib | J1120 |
| CT05215 | Imaging – cta – aorta | 75635 |
| CT05216 | Imaging – us – intravascular | C1753 |
| CT05217 | Imaging – nuclear – venous thrombosis – scan | 78456, 78457, 78458 |
| CT05218 | Imaging – nuclear – venous thrombosis – radiopharmaceutical | A9504 |
| CT05220 | Imaging – arteriography – other | 75774 |
| CT05221 | Imaging – venography – extremities | 36005 |
| CT05230 | Tests – cardiac stress tests – cardiac stress tests – other | 78491, 78492 |
| CT05232 | Tests – other cardiac scans | 78445 |
| CT05233 | Tests – cardiac – ecg – ecg – 12 lead | R0076 |
| CT05240 | Tests – cardiac – echo – contrast agent | Q9955, Q9956 |
| CT05251 | Tests – cardiac – electrophysiology – supplies – other | C1766 |
| CT05256 | Tests – cardiac – radiopharmaceuticals | A9500, A9501, A9502, A9505, A9526, A9555 |
| CT05258 | Tests – vascular – venous | 93970, 93971 |
| CT05259 | Tests – vascular – other | 93975, 93976 |
| CT05260 | Tests – cardiovascular – other | 93740, 93760, 93762, 93770, 93784, 93786, 93788 |
| CT05308 | Cardiac Stress Test | 78451, 78452, 78453, 78454, 78460, 78461, 78464, 78465, 78472, 78473, 78481, 78483, 93015, 93016, 93017, 93018 |
| CT05309 | Cardiac cath & Angiogram | 36013 |
| CT05385 | Other diagnostic cardiovascular procedures | 93050 |
| CT0581 | Procedure – aorta – repair – aneurysm / dissection – open | M0301 |
| CT0608 | Procedure – ugi endoscopy – small bowel endoscopy | 44360, 44361, 44363, 44364, 44365, 44366, 44369, 44370, 44372, 44376, 44377, 44378, 44379, 44380, 44382 |
| CT0609 | Procedure – ugi endoscopy – other | 43600, 44383, 44385, 44386 |
| CT0610 | Procedure – dilation – esophagus | 43510, 74360 |
| CT06104 | Imaging – nuclear – shilling test | 78270, 78271, 78272 |
| CT06105 | Imaging – nuclear – shilling test – radiopharmaceutical | A9546, A9559 |
| CT06106 | Imaging – nuclear – gi blood loss | 78278 |
| CT06107 | Imaging – nuclear – other gi | 78261, 78264, 78267, 78268, 78282, 78290, 78291, 78299 |
| CT06109 | Imaging – x-ray – abdomen | 74190 |
| CT06110 | Imaging – x-ray – upper gi – esophagus – contrast | 74220, 74230 |
| CT06112 | Imaging – x-ray – upper gi – small bowel – contrast | 74250, 74251, 74355 |
| CT06113 | Imaging – x-ray – upper gi – duodenogram | 74260 |
| CT06114 | Imaging – x-ray – upper gi – other | 74340 |
| CT06118 | Tests – gi – esophageal balloon distension test | 91040 |
| CT06119 | Tests – gi – gastric motility study | 91020 |
| CT0612 | Procedure – esophageal / gastric intubation | 91000, 91105 |
| CT06120 | Tests – gi – duodeneal motility study | 91022 |
| CT06121 | Tests – gi – other dx | 82930, 91052, 91055, 91065, 91110, 91111, 91132, 91133, 91299 |
| CT06124 | Bariatric Surgery: Open Gastric Bypass | 43846, 43847 |
| CT06125 | Bariatric Surgery: Open Other | 43810, 43820, 43825 |
| CT06126 | Bariatric Surgery: Open REVISION | 43848 |
| CT06130 | Gastroplasty | 43842, 43843 |
| CT06131 | Gastroplasty (BPD: Biliopancreatic diversion) | 43845 |
| CT06132 | Lap Adjustable Gastric Band | 43770, 43771, 43773, S2083 |
| CT06133 | Laparoscopic BPD (Biliopancreatic Diversion) | 43659 |
| CT06135 | Laparoscopic Gastric Bypass | 43644, 43645 |
| CT06137 | Laparoscopic Sleeve Gastrectomy | 43775 |
| CT0617 | Procedure – other procedures – esophagus | 43320 |
| CT0618 | Procedure – gastrectomy | 43620, 43621, 43622, 43631, 43632, 43633, 43634 |
| CT0619 | Procedure – gastrostomy | 43653, 43750, 43760, 43830, 43831, 43832, 44373, 74350 |
| CT0620 | Procedure – gastric neurostimulator – implantation | 43647 |
| CT0621 | Procedure – gastric neurostimulator – revision | 43648 |
| CT0623 | Procedure – obesity procedure – restriction | C9724 |
| CT0626 | Procedure – obesity procedure – removal | 43772, 43774, 43887, 43888 |
| CT0627 | Procedure – other procedures – stomach | 43500, 43501, 43610, 43611, 43635, 43640, 43641, 43651, 43652, 43761, 43800, 43840, 43850, 43855, 43860, 43865, 43870, 43880, 43999 |
| CT06304 | Esophageal Motility and Diagnostic Workup | 74240, 74241, 74245, 74246, 74247, 74249, 78262, 91010, 91011, 91012, 91030, 91034, 91035, 91037, 91038 |
| CT06370 | Radioisotope scan and function studies | 78265, 78266 |
| CT06372 | Upper gastrointestinal endoscopy, biopsy | 0133T |
| CT06373 | Endoscopic retrograde cannulation of pancreas (ERCP) | 0397T |
| CT0643 | Procedure – ileostomy / other enterostomy | 44015 |
| CT0649 | Procedure – laparotomy / related | 43605, 49000, 49002, 49010 |
| CT0651 | Procedure – laparoscopy – abdomen – dx | 49320 |
| CT0652 | Procedure – laparoscopy – abdomen – biopsy | 49321 |
| CT0653 | Procedure – laparoscopy – gi – other | 49326, 49329 |
| CT0654 | Procedure – lysis of adhesions | 44005 |
| CT0655 | Procedure – paracentesis | 49080, 49081 |
| CT0657 | Procedure – other lower gi procedures – other bowel dx | 44010, 44020, 44025, 44100 |
| CT0658 | Procedure – other lower gi procedures – other or rx | 44021, 44055, 44110, 44111, 44500, 44700, 44701, 44799, 44800, 44820, 44850, 44899 |
| CT0659 | Procedure – other lower gi procedures – other non – or rx | 91100, 99175 |
| CT0667 | Procedure – other anal / rectal procedures – other procedures – rectum / anus | 91123 |
| CT0684 | Procedure – hernia repair – other | 39502, 39520, 39530, 39531, 39540, 39541 |
| CT0687 | Procedure – other or gi rx – other procedure – abdomen | 49250, 49255, 49423, 49425, 49999 |
| CT0688 | Procedure – other gi dx | 49180, 49400, 49424 |
| CT0690 | Procedure – anesthesia | 00700, 00702, 00730, 00740, 00750, 00752, 00754, 00756, 00770, 00790, 00792, 00794, 00796, 00797, 00800, 00802, 00810, 00820, 00830, 00832, 00834, 00836, 00840, 00842 |
| CT0691 | Therapy – nasogastric tube | 43752 |
| CT0692 | Therapy – neurostimulator – nausea / vomiting | E0765 |
| CT0693 | Rx – gi – antichol/antispasmodics | J0500, J1980 |
| CT0694 | Rx – gi – antiemetics | J1240, J1626, J2405, J2469, J2550, J2765, J3250, J3280, J8501, S0091 |
| CT0695 | Rx – gi – h2 antagonists | J2780, S0023, S0028 |
| CT0697 | Rx – gi – ppis | C9113, S0164 |
| CT0698 | Rx – diagnostic rx – gastric function | J2805, J2850 |
| CT0728 | Procedure – other procedures – pancreas | 48400 |
| CT0732 | Imaging – nuclear – hepatobiliary ductal scan – radiopharmaceutical | A9510, A9537 |
| CT0733 | Imaging – x-ray – biliary tract – cholangiogram – intraoperative | 74301 |
| CT08106 | Imaging – x-ray – other – joint survey | R0070 |
| CT08113 | DME – heat/cold application | E0200, E0205, E0210, E0215, E0217, E0218, E0221, E0225, E0231, E0232, E0235, E0236, E0239 |
| CT08114 | DME – traction | E0830, E0840, E0849, E0850, E0870, E0880, E0890, E0900 |
| CT08115 | DME – trapeze / other orthopedic device | E0910, E0911, E0912, E0920, E0930, E0940, E0941, E0945, E0946, E0947, E0948 |
| CT08116 | DME – rehabilitation | E2000 |
| CT0823 | Procedure – condrocyte transplantation | J7330 |
| CT0841 | Procedure – other rx on muscles and tendons | 23930, 23931, 25028, 25031 |
| CT0844 | Procedure – other or rx on musculoskeletal system | 20005 |
| CT0848 | Procedure – ortho – related supplies – other | C1754 |
| CT0856 | Rx – osteoporosis rx | J2430 |
| CT0857 | Rx – muscle relaxants – muscle relax, skeletal central | J0475, J0476, J2800 |
| CT0858 | Rx – muscle relaxants – muscle relax, skeletal, misc | J2360 |
| CT0859 | Rx – muscle relaxants – muscle relax, neuromusc block | J0330 |
| CT0922 | Procedure – i&d – skin – drainage of abscess | 20000 |
| CT0923 | Procedure – i&d – skin – drainage of hematoma | 10140, 10160 |
| CT0924 | Procedure – i&d – skin – drainage – post – op infection | 10180 |
| CT0942 | Procedure – suture – skin – repair of superficial wound | G0168 |
| CT0959 | Procedure – other non – or rx – other non – or skin procedures | 96999 |
| CT0963 | Rx – skin / mucous membrane – antiinflam s/mm agnts / comb nec | J7311 |
| CT0964 | Rx – skin / mucous membrane – s/mm miscellaneous | J7308, S0157 |
| CT0965 | Other care – wound care | E0181, E0182, E0184, E0185, E0186, E0187, E0188, E0189, E0190, E0191, E0193, E0194, E0196, E0197, E0198, E0199, E0769, G0281, G0282 |
| CT0966 | Other care – wound care – hyperbaric oxygen | A4575 |
| CT0967 | Other care – wound care – electromagnetic therapy | G0295, G0329 |
| CT0969 | Other care – chronic edema – surgical stockings | A4490, A4495, A4500, A4510 |
| CT0993 | DME – wound therapy | E2402 |
| CT1003 | Procedure – thyroid ablation – radionucleotide | A9527, A9530 |
| CT1011 | Rx – antidiabetic rx – insulins | J1815 |
| CT1012 | Rx – antidiabetic rx, misc | J1610 |
| CT1013 | Rx – endocrine – other – parathyroid hormones | J0630 |
| CT1014 | Rx – endocrine – other – pituitary hormones | J0800, J2353, J2354, J2597, J2940, J2941, Q0515 |
| CT1017 | Rx – vitamins – vitamin b / b complex | J3411, J3415, J3420 |
| CT1019 | Rx – vitamins – vitamin d | J0636, J1270, J2501 |
| CT1021 | Rx – vitamins – multivit prep | A9152, A9153 |
| CT1022 | Rx – diagnostic rx – thyroid function | J2725, J3240 |
| CT1023 | Rx – diagnostic rx, misc | J7674 |
| CT1025 | Other care – diabetes care – glucose monitoring – other supplies | A4250, A4256, A4257 |
| CT1026 | Other care – diabetes care – glucose monitoring – lancet | A4258, A4259, E0620 |
| CT1027 | Other care – diabetes care – glucose monitoring | A9279, A9280 |
| CT10295 | Thyroid Function Tests | 84432, 84436, 84437, 84439, 84442, 84443, 84445, 84479, 84480, 84481, 84482 |
| CT10296 | Low dose steroids | J0702, J1020, J1094, J1100, J1700, J1710, J1720, J2650, J3301, J3302, J3303, J7506, J7509, J7510, J8540 |
| CT10297 | High dose steroids | J1030, J1040, J2920, J2930 |
| CT10298 | Anti-TNF agents | J1745 |
| CT1030 | Other care – diabetes care – insulin pump | E0784 |
| CT1036 | Other care – nutrition – assessment | 97802, 97803, G0270, G0271 |
| CT1038 | Other care – nutrition – enteral | B4034, B4035, B4036, B4081, B4100, B4104, B9998 |
| CT1039 | Other care – nutrition – enteral – tubing | B4082, B4083, B4087, B4088 |
| CT1040 | Other care – nutrition – enteral – formula | B4102, B4103, B4149, B4150, B4152, B4153, B4154, B4155, B4157, B4158, B4159, B4160, B4161, B4162, B9000 |
| CT1041 | Other care – nutrition – enteral – pump | B9002 |
| CT1042 | Other care – nutrition – parenteral – nutrition solution | B4164, B4168, B4172, B4176, B4178, B4180, B4185, B4189, B4193, B4197, B4199, B5000, B5100, B5200 |
| CT1043 | Other care – nutrition – parenteral | B4216, B4220, B4222, B4224, B9999 |
| CT1044 | Other care – nutrition – parenteral – pump | B9004, B9006, E0791 |
| CT1052 | Imaging – nuclear – thyroid – radiopharmaceutical | A9509, A9516, A9528, A9529, A9531 |
| CT1061 | Lab – endocrine response test | 80400, 80402, 80406, 80408, 80410, 80412, 80414, 80415, 80416, 80417, 80418, 80420, 80422, 80424, 80426, 80428, 80430, 80432, 80434, 80435, 80436, 80438, 80439, 80440 |
| CT1137 | Procedure – anesthesia | 860 |
| CT1142 | Therapy – dialysis – home | 99512 |
| CT1146 | Therapy – dialysis – supplies | A4932 |
| CT1147 | Therapy – neurostimulator – incontinence | E0740 |
| CT1148 | Rx – gu – other – bladder rx | J0520 |
| CT1151 | Imaging – nuclear – bladder / ureter | 78730, 78740 |
| CT1166 | Lab – urinalysis | 81007, 81015, 81020, 81050, 81099 |
| CT1167 | Lab – specimen collection – urine | P9612, P9615 |
| CT1219 | Rx – reproductive system – impotence rx | J0270, J0275, S0090 |
| CT1220 | Rx – gu – other – bph rx | S0138 |
| CT1326 | Rx – reproductive system – androgens / comb | J0900, J1060, J1070, J1080, J2320 |
| CT1327 | Rx – reproductive system – estrogens / comb | J1000, J1056, J1380, J1410, J1435 |
| CT1328 | Rx – reproductive system – gonadotropins | J0725, J1620, J3355, S0122, S0126, S0128 |
| CT1329 | Rx – reproductive system – progestins | J1051, J2675 |
| CT1330 | Rx – reproductive system – gonadotropin rel horm agnsts | J1675, S0132 |
| CT1331 | Rx – reproductive system – oxytocics | J1330, J2210, J2590 |
| CT1412 | Procedure – other rx obstetrical | 36460 |
| CT1452 | Imaging – us – guide – cvs / amnio | 76945 |
| CT1454 | Lab – microscopic – amniotic fluid – fern test | Q0114 |
| CT1502 | Other care – newborn – jaundice – phototherapy | E0202 |
| CT1613 | Procedure – heme / lymph – other rx | 36680, 38300, 38305, 38308, 49062, 49323 |
| CT1615 | Therapy – transfusion – administration | 36430, 36440, 36450, 36455 |
| CT1616 | Therapy – transfusion – blood | P9010, P9011, P9016, P9021, P9022, P9038, P9039, P9040, P9051, P9054, P9056, P9057, P9058 |
| CT1617 | Therapy – transfusion – plasma | P9017, P9023, P9043, P9044, P9048, P9059, P9060 |
| CT1618 | Therapy – transfusion – granulocytes | P9050 |
| CT1619 | Therapy – transfusion – platelets | P9019, P9020, P9031, P9032, P9033, P9034, P9035, P9036, P9037, P9052, P9053, P9055 |
| CT1620 | Therapy – phlebotomy | 99195 |
| CT1622 | Rx – immune system – interferons | J1830, Q3025, Q3026, S0145 |
| CT1623 | Rx – immune system – gold compounds | J2910 |
| CT1624 | Rx – immune system – immunosuppressants | J0215, J2357, J7507, J7517, J7518, J7520, J7525 |
| CT1625 | Rx – immune system – dmard / related | J1438 |
| CT1626 | Rx – blood derivatives | P9041, P9045, P9046, P9047 |
| CT1627 | Rx – hematopoietic system – other | J1640 |
| CT1628 | Rx – hematopoietic system – iron / related | J1750, J1756, J2916 |
| CT1629 | Rx – hematopoietic system – hematopoietic growth factors | J0881, J0885, J2355, J2820, Q4081 |
| CT16293 | Azathioprine / Mercaptopurine | J7500, J7501, S0108 |
| CT16295 | Cyclosporin | J7502, J7515, J7516 |
| CT16296 | Lipid Level Monitoring | 80061, 82465, 83695, 83698, 83700, 83701, 83704, 83718, 83719, 83721, 84478 |
| CT16297 | Blood Count | 82728, 83540, 83550, 85004, 85007, 85008, 85009, 85013, 85014, 85018, 85025, 85027, 85032, 85041, 85044, 85045, 85046, 85048, 85049, 85060, G0306, G0307 |
| CT16299 | Bleeding Status | 85002, 85345, 85347, 85348, 85610, 85611, 85670, 85675, 85705, 85730, 85732, 99363, 99364 |
| CT1630 | Rx – coagulation system – anticoagulants | C9121, J0583, J1644, J1645, J1650, J1652, J1655, J1945, J7197 |
| CT1631 | Rx – coagulation system – antiheparin agnt | J2720 |
| CT16316 | Blood transfusion | P9070, P9071, P9072 |
| CT1632 | Rx – coagulation system – hemostatics | J0365, J7189, J7190, J7191, J7192, J7193, J7194, J7195, J7198, J7199, P9012, S0017 |
| CT1633 | Rx – coagulation system – thrombolytic rx | J0350, J2993, J2995, J2997, J3364, J3365 |
| CT1634 | Rx – coagulation system – antiplatelet rx | J0130, J1245, J1327, J3246 |
| CT1635 | Rx – serums, toxoids, vaccines – serums | 90281, 90283, 90291, 90296, 90371, 90375, 90376, 90384, 90385, 90386, 90389, 90396, 90399, J0850, J1460, J1560, J1561, J1562, J1566, J1568, J1569, J1571, J1572, J1573, J1670, J2788, J2790, J2791, J2792, J7504 |
| CT1636 | Rx – serums, toxoids, vaccines – toxins | J0585, J0587 |
| CT1638 | Rx – administration – injection | 90772, 90773, 90774, 90775, 96373, 96374, 96375, 96376, 99506 |
| CT1639 | Rx – administration – infusion | 90765, 90766, 90767, 90768, 90779, 96361, 96365, 96366, 96367, 96368, 96369, 96370, 96371, 96379, 99601, 99602, A4220, A4221, A4222, A4223, A4305, A4306, C8957, E0776, E0779, E0780, E0781, K0552, K0601, K0602, K0603, K0604, K0605 |
| CT1645 | Lab – blood gases | 82820 |
| CT1646 | Lab – hematology – coagulation | 85170, 85175, 85210, 85220, 85230, 85240, 85244, 85245, 85246, 85247, 85250, 85260, 85270, 85280, 85290, 85291, 85292, 85293, 85300, 85301, 85302, 85303, 85305, 85306, 85307, 85335, 85337, 85360, 85362, 85366, 85370, 85378, 85379, 85380, 85384, 85385, 85390, 85396, 85397, 85400, 85410, 85415, 85420, 85421, 85612, 85613, 85635 |
| CT1647 | Lab – hematology – blood count | 85055 |
| CT1649 | Lab – other hematology | 85130, 85441, 85445, 85460, 85461, 85475, 85520, 85525, 85530, 85536, 85540, 85547, 85549, 85555, 85557, 85576, 85597, 85660, 85810, 85999, 88738, 88740, 88741 |
| CT1651 | Lab – immunology | 86000, 86001, 86003, 86005, 86021, 86022, 86023, 86038, 86039, 86060, 86063, 86078, 86079, 86146, 86147, 86148, 86155, 86156, 86157, 86160, 86161, 86162, 86171, 86185, 86200, 86215, 86225, 86226, 86235, 86243, 86255, 86256, 86277, 86280, 86294, 86300, 86301, 86304, 86305, 86308, 86309, 86310, 86316, 86320, 86325, 86327, 86329, 86331, 86332, 86334, 86335, 86336, 86337, 86340, 86341, 86343, 86344, 86352, 86353, 86355, 86356, 86357, 86359, 86360, 86361, 86367, 86376, 86378, 86382, 86384, 86403, 86406, 86430, 86431, 86480, 86485, 86486, 86490, 86510, 86580, 86586, 86590, 86592, 86593 |
| CT1652 | Lab – transfusion medicine | 86850, 86860, 86870, 86885, 86886, 86890, 86891, 86903, 86904, 86905, 86906, 86910, 86911, 86920, 86921, 86922, 86923, 86927, 86930, 86931, 86932, 86940, 86941, 86945, 86950, 86960, 86965, 86970, 86971, 86972, 86975, 86976, 86977, 86978, 86985, 86999 |
| CT1806 | Rx – antibiotics – aminoglycosides | J0278, J1580, J1840, J1850, J3000, J3260 |
| CT1807 | Rx – antibiotics – cephalosporins | J0690, J0692, J0694, J0696, J0697, J0698, J0710, J0713, J0715, J1890 |
| CT1808 | Rx – b-lactam antibiotics | J0743, J1335, J2185, S0073 |
| CT1809 | Rx – antibiotics – chloramphenicol / comb | J0720 |
| CT1810 | Rx – antibiotics – macrolides | J0456, J1364, Q0144 |
| CT1811 | Rx – antibiotics – penicillins | J0290, J0295, J2510, J2540, J2543, J2700, S0032, S0040, S0081 |
| CT1812 | Rx – antibiotics – tetracyclines | J0120, J2460 |
| CT1813 | Rx – antibiotics, misc | J0770, J2010, J2020, J2770, J3320, J3370, S0021, S0074, S0077, S0142 |
| CT1814 | Rx – antibiotics – quinolones | J0744, J1590, J1956, J2280, S0034 |
| CT1815 | Rx – antibiotics – sulfonamides / comb | S0039 |
| CT1816 | Rx – antibiotics – anti-infectives, misc | J3305, S0030, S0080 |
| CT1817 | Rx – antivirals | 90378, 90379, G9034, J0133, J1324, J1452, J1455, J1570, J3465, J3485, J7310, S0104, S0137, S0140 |
| CT1818 | Rx – antifungals | J0285, J0287, J0288, J0289, J0637, J1450, J1835 |
| CT1819 | Rx – other anti-infectives – antimalarials | J0200, J0390 |
| CT1821 | Lab – infectious agent antigen | 87260, 87265, 87267, 87269, 87271, 87272, 87273, 87274, 87275, 87276, 87277, 87278, 87279, 87280, 87281, 87283, 87285, 87290, 87299, 87300, 87301, 87305, 87324, 87327, 87328, 87329, 87332, 87335, 87336, 87337, 87338, 87339, 87340, 87341, 87350, 87380, 87385, 87390, 87391, 87400, 87420, 87425, 87427, 87430, 87449, 87450, 87451 |
| CT1822 | Lab – infectious agent antibody | 86317, 86318, 86602, 86603, 86606, 86609, 86611, 86612, 86615, 86617, 86618, 86619, 86622, 86625, 86628, 86635, 86638, 86641, 86644, 86645, 86648, 86651, 86652, 86653, 86654, 86658, 86663, 86664, 86665, 86666, 86668, 86671, 86674, 86677, 86682, 86684, 86687, 86688, 86689, 86692, 86694, 86695, 86696, 86698, 86701, 86702, 86703, 86704, 86705, 86706, 86707, 86708, 86709, 86710, 86713, 86717, 86720, 86723, 86727, 86729, 86732, 86735, 86738, 86741, 86744, 86747, 86750, 86753, 86756, 86757, 86759, 86762, 86765, 86768, 86771, 86774, 86777, 86778, 86780, 86781, 86784, 86787, 86788, 86789, 86790, 86793, 86800, 86803, 86804 |
| CT1823 | Lab – infectious agent dna | 87470, 87471, 87472, 87475, 87476, 87477, 87480, 87481, 87482, 87493, 87495, 87496, 87497, 87498, 87500, 87510, 87511, 87512, 87515, 87516, 87517, 87520, 87521, 87522, 87525, 87526, 87527, 87528, 87529, 87530, 87531, 87532, 87533, 87534, 87535, 87536, 87537, 87538, 87539, 87540, 87541, 87542, 87550, 87551, 87552, 87555, 87556, 87557, 87560, 87561, 87562, 87580, 87581, 87582, 87590, 87591, 87592, 87620, 87621, 87622, 87640, 87641, 87650, 87651, 87652, 87653, 87660, 87797, 87798, 87799, 87800, 87801, 87802, 87803, 87804, 87807, 87808, 87809, 87850, 87880, 87899, 87900, 87901, 87902, 87903, 87904 |
| CT1824 | Lab – microbiology – other | 87015, 87164, 87166, 87168, 87169, 87172, 87176, 87177, 87230, 87905, 87999 |
| CT1825 | Lab – microbiology – c & s | 87040, 87045, 87046, 87070, 87071, 87073, 87075, 87076, 87077, 87081, 87084, 87086, 87088, 87101, 87102, 87103, 87106, 87107, 87109, 87116, 87118, 87140, 87143, 87147, 87149, 87150, 87152, 87153, 87158, 87181, 87184, 87185, 87186, 87187, 87188, 87190, 87197 |
| CT1826 | Lab – microbiology – microscopic exam | 87205, 87206, 87207, 87209, 87210, 87220 |
| CT1827 | Lab – microbiology – viral culture | 87250, 87252, 87253, 87254, 87255 |
| CT1828 | Lab – microbiology | P7001 |
| CT1829 | Lab – microscopic – pinworm | Q0113 |
| CT18302 | CHLAMYDIA SCREENING | 86631, 86632, 87110, 87270, 87320, 87485, 87486, 87487, 87490, 87491, 87492, 87810 |
| CT1901 | Therapy – behavior – evaluation and therapy | 96150, 96151, 96152, 96153, 96154, 96155 |
| CT1902 | Therapy – behavior – electroconvulsive therapy | 90870 |
| CT1907 | Tests – neuro – sleep studies | 95806, 95807, 95808, 95810, 95811 |
| CT19303 | Psychiatry Evaluations | 90785, 90791, 90792, 90801, 90802, 96118, 96119, 96120, 96125, T1023 |
| CT19304 | Psychiatry Services | 97532, 97535, H0004, H0031, H2010, H2015, H2016, H2021, H2022, S3005 |
| CT19378 | Laboratory – Chemistry and Hematology | 83987 |
| CT19381 | Smoking / Tobacco Cessation | 99406, 99407 |
| CT19382 | High Risk Behavior Screening | 4293F |
| CT19383 | Sexual Behavior Counseling | G0445 |
| CT19384 | Peer Services | H0038 |
| CT2006 | Alcohol / Drug Use Management | H0045, H0048 |
| CT2009 | Alcohol / Drug Use Screening | 3016F, 4158F, 4290F, 4320F, 80100, 80101, 80102, 80103, 80300, 80301, 80302, 80303, 80304, 80320, 80321, 80322, 80375, 80376, 80377, 82009, 82010, 82075, 99408, 99409, G0430, G0431, G0442, G0443, G9621, G9622, H0001, H0003, H0049, H0050, T1006 |
| CT2101 | Lab – therapeutic drug assay | 80150, 80152, 80154, 80156, 80157, 80158, 80160, 80162, 80164, 80166, 80168, 80170, 80172, 80173, 80174, 80176, 80178, 80182, 80184, 80185, 80186, 80188, 80190, 80192, 80194, 80195, 80196, 80197, 80198, 80200, 80201, 80202, 80299 |
| CT2302 | Therapy – behavior – other | H2000, H2033 |
| CT2304 | Therapy – pt – exercises / activities | 97537, 97542 |
| CT2305 | Therapy – pt – modalities | G0283 |
| CT2308 | Therapy – biofeedback | 90901, 90911, E0746 |
| CT2309 | Therapy – activity therapy | H2032 |
| CT2319 | Therapy – vaccination – other vaccine | 90476, 90477, 90581 |
| CT2320 | Therapy – vaccination – vaccine administration | 90465, 90466, 90467, 90468, 90472, 90473, 90474 |
| CT2324 | Other care – ostomy – nursing care | 99505 |
| CT2325 | Other care – ostomy – supplies | A4361, A4362, A4363, A4364, A4366, A4367, A4368, A4369, A4371, A4372, A4373, A4375, A4376, A4377, A4378, A4379, A4380, A4381, A4382, A4383, A4384, A4385, A4387, A4388, A4389, A4390, A4391, A4392, A4393, A4394, A4395, A4396, A4397, A4398, A4399, A4400, A4402, A4404, A4405, A4406, A4407, A4408, A4409, A4410, A4411, A4412, A4413, A4414, A4415, A4416, A4417, A4418, A4419, A4420, A4421, A4422, A4423, A4424, A4425, A4426, A4427, A5051, A5052, A5053, A5054, A5055, A5061, A5062, A5063, A5093 |
| CT2326 | Other care – bladder / bowel care – other supplies | A4310, A4320, A4321, A4322, A4330, A4331, A4332, A4333, A4334, A4335, A4354, A4355, A4356, A5113, A5114 |
| CT2327 | Other care – bladder / bowel care – catheter | A4311, A4312, A4313, A4314, A4315, A4316, A4326, A4327, A4328, A4338, A4340, A4344, A4346, A4349, A4351, A4352, A4353 |
| CT2328 | Other care – bladder / bowel care – drainage bag | A4357, A4358, A5102, A5105, A5112 |
| CT2329 | Other care – bladder / bowel care – other supplies – diaper / related | A4520, A4554, T4521, T4522, T4523, T4524, T4525, T4526, T4527, T4528, T4529, T4530, T4531, T4532, T4533, T4534, T4535, T4536, T4537, T4538, T4539, T4540, T4543 |
| CT2330 | Other care – bladder / bowel care – other supplies – skin barrier | A5120, A5121, A5122, A5126, A5131, A5200 |
| CT23309 | Markers for Inflammation | 85651, 85652, 86140, 86141 |
| CT2331 | Other care – observation | G0379 |
| CT23393 | Prophylactic vaccinations and inoculations | 90284 |
| CT23398 | Ancillary Services | 99415, 99416, G9474, G9475, G9476, G9477, G9478, G9479 |
| CT2352 | DME – mobility aids | A4635, A4636, A4637, E0100, E0105, E0110, E0111, E0112, E0113, E0114, E0116, E0117, E0118, E0130, E0135, E0140, E0141, E0143, E0144, E0147, E0148, E0149, E0153, E0154, E0155, E0156, E0157, E0158, E0159 |
| CT2353 | DME – patient lifts | E0621, E0625, E0627, E0628, E0629, E0630, E0635, E0636, E0637, E0638, E0639, E0640, E0641, E0642 |
| CT9902 | E & M – consultation | Q3014 |
| CT9903 | E & M – hospital | 99217, 99218, 99219, 99220, 99231, 99232, 99233, 99234, 99235, 99236, 99291, 99292, 99481, 99482, G0378, G0390 |
| CT9904 | E & M – emergency care | 99058, 99281, 99282, 99283, 99284, 99285, G0380, G0381, G0382, G0383, G0384 |
| CT9905 | E & M – home visit | 99224, 99225, 99226, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350 |
| CT9906 | E & M – nursing home | 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337 |
| CT9907 | E & M – prevention | 99420 |
| CT9908 | E & M – other | 96040, 99026, 99027, 99056, 99060, 99150, 99288, 99360, 99450, 99455, 99456, 99485, 99486, 99488 |
| CT9910 | Procedure – anesthesia | 01990, 01996, 01999, 99100, 99116, 99135, 99140 |
| CT99102 | Other care – other | H0043, H0044 |
| CT99103 | Imaging – ct – follow – up | 76380 |
| CT99104 | Imaging – ct – other | 76497 |
| CT99105 | Imaging – ct – guidance | 77012 |
| CT99107 | Imaging – mri – other | 75559, 75563, 76498, C1770 |
| CT99108 | Imaging – mri – guidance | 77021 |
| CT99109 | Imaging – mri – contrast agent | A9576, A9577, A9578, A9579, Q9953, Q9954 |
| CT9911 | Procedure – sedation | 99143, 99144, 99145, 99148, 99149 |
| CT99111 | Imaging – us – retroperitoneum | 76770, 76775, G0389 |
| CT99113 | Imaging – us – guide – biopsy | 76942 |
| CT99114 | Imaging – us – guide – other | 76937, 76940, 76941, 76998 |
| CT99115 | Imaging – us – other | 76970 |
| CT99117 | Imaging – nuclear – bone scan – radiopharmaceutical | A9503, A9561 |
| CT99118 | Imaging – nuclear – blood / plasma volume – scan | 78110, 78111 |
| CT99119 | Imaging – nuclear – blood / plasma volume – radiopharmaceutical | A9508, A9524, A9532 |
| CT99121 | Imaging – nuclear – brain – radiopharmaceutical | A9557 |
| CT99122 | Imaging – nuclear – csf – radiopharmaceutical | A9548 |
| CT99123 | Imaging – nuclear – kidney – radiopharmaceutical | A9539, A9551, A9554, A9562, A9567 |
| CT99124 | Imaging – nuclear – tumor localization | 78800, 78801, 78802, 78803, 78804 |
| CT99125 | Imaging – nuclear – localization of inflammation | 78805, 78806, 78807 |
| CT99126 | Imaging – nuclear – lymphoma – radiolabeled antibody | A9542, A9544 |
| CT99128 | Imaging – nuclear – other | 78799, 78808 |
| CT99129 | Imaging – nuclear – radiopharmaceutical – radiopharmaceutical – other | A4641, A4642, A9507, A9512, A9521, A9538, A9540, A9541, A9547, A9550, A9553, A9556, A9560, A9566, A9568, A9569, A9570, A9571, A9572 |
| CT99130 | Imaging – pet – other | A9552, G0235 |
| CT99133 | Imaging – other imaging – fluoroscopy | 76496 |
| CT99134 | Imaging – other imaging – fluoroscopy – guidance | 77002, 77003 |
| CT99136 | Imaging – other imaging | 76010, 76080, 76101, 76102, 76120, 76125, 76140, 76150, 76350, 76376, 76377, 76390, 76499, Q0092, R0075 |
| CT99137 | Imaging – therapeutic procedure – abscess drainage | 75989 |
| CT99138 | Imaging – therapeutic procedure – other therapeutic procedure | 75984 |
| CT99139 | Imaging – supplies – contrast agent – low osmolar | Q9951, Q9965, Q9966, Q9967 |
| CT99140 | Imaging – supplies – contrast agent – high osmolar | A9698, Q9958, Q9959, Q9960, Q9961, Q9962, Q9963, Q9964 |
| CT99142 | Lab – pathology consultation | 80500, 80502 |
| CT99143 | Lab – chemistry | 82000, 82003, 82013, 82016, 82017, 82024, 82030, 82045, 82085, 82088, 82101, 82103, 82104, 82108, 82127, 82128, 82131, 82135, 82136, 82139, 82140, 82143, 82145, 82150, 82154, 82157, 82160, 82163, 82164, 82172, 82175, 82180, 82190, 82205, 82232, 82239, 82240, 82252, 82261, 82271, 82272, 82274, 82286, 82300, 82306, 82307, 82308, 82331, 82340, 82355, 82360, 82365, 82370, 82373, 82375, 82376, 82378, 82379, 82380, 82382, 82383, 82384, 82387, 82390, 82397, 82415, 82436, 82438, 82441, 82480, 82482, 82485, 82486, 82487, 82488, 82489, 82491, 82492, 82495, 82507, 82520, 82523, 82525, 82528, 82530, 82533, 82540, 82541, 82542, 82543, 82544, 82550, 82552, 82553, 82554, 82570, 82585, 82595, 82600, 82607, 82608, 82610, 82615, 82626, 82627, 82633, 82634, 82638, 82646, 82649, 82651, 82652, 82654, 82656, 82657, 82658, 82664, 82666, 82668, 82670, 82671, 82672, 82677, 82679, 82690, 82693, 82696, 82705, 82710, 82715, 82725, 82726, 82735, 82742, 82746, 82747, 82759, 82760, 82775, 82776, 82784, 82785, 82787, 82926, 82928, 82938, 82941, 82943, 82945, 82946, 82950, 82951, 82952, 82953, 82955, 82960, 82962, 82963, 82965, 82975, 82977, 82978, 82979, 82980, 82985, 83003, 83008, 83009, 83010, 83012, 83013, 83014, 83015, 83018, 83020, 83021, 83026, 83045, 83050, 83051, 83055, 83060, 83065, 83068, 83069, 83070, 83071, 83080, 83088, 83090, 83150, 83491, 83497, 83498, 83499, 83500, 83505, 83516, 83518, 83519, 83520, 83525, 83527, 83528, 83570, 83582, 83586, 83593, 83605, 83615, 83625, 83630, 83631, 83632, 83633, 83634, 83670, 83690, 83727, 83735, 83775, 83785, 83788, 83789, 83805, 83825, 83835, 83840, 83857, 83858, 83864, 83866, 83872, 83873, 83874, 83876, 83880, 83883, 83885, 83887, 83890, 83891, 83892, 83893, 83894, 83896, 83897, 83898, 83900, 83901, 83902, 83903, 83904, 83905, 83906, 83907, 83908, 83909, 83912, 83913, 83914, 83915, 83916, 83918, 83919, 83921, 83925, 83930, 83935, 83937, 83945, 83950, 83951, 83970, 83986, 83992, 83993, 84022, 84035, 84060, 84061, 84066, 84075, 84078, 84080, 84081, 84085, 84087, 84100, 84105, 84106, 84110, 84119, 84120, 84126, 84127, 84133, 84134, 84135, 84138, 84140, 84143, 84144, 84145, 84146, 84150, 84152, 84153, 84154, 84156, 84157, 84160, 84165, 84166, 84181, 84182, 84202, 84203, 84206, 84207, 84210, 84220, 84228, 84233, 84234, 84235, 84238, 84244, 84252, 84255, 84260, 84270, 84275, 84285, 84300, 84302, 84305, 84307, 84311, 84315, 84375, 84376, 84377, 84378, 84379, 84392, 84402, 84403, 84425, 84430, 84431, 84446, 84449, 84466, 84484, 84485, 84488, 84490, 84510, 84512, 84525, 84540, 84545, 84560, 84577, 84578, 84580, 84583, 84585, 84586, 84588, 84590, 84591, 84597, 84600, 84620, 84630, 84681, 84999 |
| CT99144 | Lab – tissue typing | 86805, 86806, 86807, 86808, 86812, 86813, 86816, 86817, 86821, 86822, 86825, 86826, 86849 |
| CT99146 | Lab – cytology | 88104, 88106, 88107, 88108, 88112, 88160, 88161, 88162, 88172, 88173, 88182, 88184, 88185, 88187, 88188, 88189, 88199 |
| CT99147 | Lab – cytogenetics | 88230, 88233, 88237, 88239, 88240, 88241, 88245, 88248, 88249, 88261, 88262, 88263, 88264, 88267, 88269, 88271, 88272, 88273, 88274, 88275, 88280, 88283, 88285, 88289, 88291, 88299 |
| CT99148 | Lab – surgical pathology | 88300, 88302, 88304, 88305, 88307, 88309, 88312, 88313, 88314, 88318, 88319, 88321, 88323, 88325, 88329, 88331, 88332, 88333, 88334, 88342, 88346, 88347, 88348, 88349, 88355, 88356, 88358, 88360, 88361, 88362, 88365, 88367, 88368, 88371, 88372, 88380, 88381, 88384, 88385, 88386, 88387, 88388, 88399 |
| CT99149 | Lab – other clinical lab | 88400, 89050, 89051, 89055, 89060, 89100, 89105, 89125, 89130, 89132, 89135, 89136, 89140, 89141, 89160, 89190, 89220, 89225, 89230, 89235, 89240 |
| CT99168 | Lab – chemistry and toxicology tests | P2028, P2029, P2031, P2033, P2038 |
| CT9917 | Procedure – related supplies – access catheter | A4300, A4301 |
| CT99173 | Lab – specimen collection – specimen handling | 99000 |
| CT99174 | Lab – microscopic – wet mount | Q0111 |
| CT99175 | Lab – microscopic – koh prep | Q0112 |
| CT99183 | Transportation – other transportation | A0021, A0080, A0090, A0100, A0110, A0120, A0130, A0140, A0160, A0170, A0180, A0190, A0200, A0210, A0225, A0380, A0382, A0384, A0390, A0392, A0394, A0396, A0398, A0420, A0422, A0424, A0425, A0426, A0427, A0428, A0429, A0430, A0431, A0432, A0433, A0434, A0435, A0436, A0888, A0998, A0999, P9603, P9604 |
| CT99184 | DME – other | A4639, A4640, A9281, A9283, A9300, A9900, A9901, A9999 |
| CT99185 | DME – bath / toilet aids | E0160, E0161, E0162, E0163, E0165, E0167, E0168, E0170, E0171, E0172, E0175, E0240, E0241, E0242, E0243, E0244, E0245, E0246, E0247, E0248, E0249 |
| CT99186 | DME – beds / accessories | E0250, E0251, E0255, E0256, E0260, E0261, E0265, E0266, E0270, E0271, E0272, E0273, E0274, E0275, E0276, E0277, E0280, E0290, E0291, E0292, E0293, E0294, E0295, E0296, E0297, E0300, E0301, E0302, E0303, E0304, E0305, E0310, E0315, E0316, E0325, E0326, E0328, E0329, E0350, E0352, E0370, E0371, E0372, E0373, E0462 |
| CT99187 | DME – safety equipment | E0700, E0705 |
| CT99188 | DME – restraints | E0710 |
| CT99189 | DME – whirlpool – equipment | E1300, E1310 |
| CT99191 | Supplies | A4206, A4207, A4208, A4209, A4210, A4211, A4212, A4213, A4215, A4216, A4217, A4218, A4244, A4245, A4246, A4247, A4265, A4270, A4450, A4452, A4455, A4458, A4461, A4463, A4465, A4470, A4480, A4550, A4601, A4649, A6000, A6010, A6011, A6021, A6022, A6023, A6024, A6025, A6154, A6196, A6197, A6198, A6199, A6203, A6204, A6205, A6206, A6207, A6208, A6209, A6210, A6211, A6212, A6213, A6214, A6215, A6216, A6217, A6218, A6219, A6220, A6221, A6222, A6223, A6224, A6228, A6229, A6230, A6231, A6232, A6233, A6234, A6235, A6236, A6237, A6238, A6239, A6240, A6241, A6242, A6243, A6244, A6245, A6246, A6247, A6248, A6250, A6251, A6252, A6253, A6254, A6255, A6256, A6257, A6258, A6259, A6260, A6261, A6262, A6266, A6402, A6403, A6404, A6407, A6413, A6441, A6442, A6443, A6444, A6445, A6446, A6447, A6448, A6449, A6450, A6451, A6452, A6453, A6454, A6455, A6456, A6457, A6550, A7000, A7001, A7002, A9155, C1751, C1769, J1642 |
| CT99195 | Prosthetics – other | K0462 |
| CT99197 | Other – non – covered | A9270, G0293, G0294 |
| CT99198 | PQRI | G8427, G8428, G8430, G8440, G8441, G8442, G8447, G8448, G9019, G9020, G9033, G9035, G9036, G9140 |
| CT9920 | Procedure – related supplies – catheter | C1758, C2627 |
| CT9921 | Procedure – related supplies – dilation / stenting | C1726 |
| CT9922 | Procedure – related supplies – drainage | C1729 |
| CT9923 | Procedure – related supplies – graft / repair | C1762, C1763, C1771, C1781 |
| CT9925 | Procedure – related supplies – resection – morcellator | C1782 |
| CT9926 | Procedure – related supplies – retrieval – device | C1773 |
| CT9927 | Procedure – related supplies – other | C1727, C1765 |
| CT9928 | Therapy – accupuncture | 97810, 97811, 97813, 97814 |
| CT9929 | Therapy – rehabilitation | H2001 |
| CT99309 | Physician Services | 99251 |
| CT9931 | Therapy – rehabilitation – other | 92526 |
| CT99311 | Urine Protein | 81000, 81001, 81002, 81003, 81005, 82042, 82043, 82044 |
| CT99312 | HbA1C | 83036, 83037 |
| CT99314 | Robotic Surgery | S2900 |
| CT99316 | Physician Services – Inpatient | 99356, 99357 |
| CT9933 | Therapy – phototherapy | 96570, 96571 |
| CT9934 | Therapy – ultraviolet light therapy | A4633, A4634, E0691, E0692, E0693, E0694 |
| CT9935 | Therapy – hyperbaric oxygen | 99183, C1300 |
| CT9936 | Therapy – neurostimulator – tens – device | E0720, E0730, E0731 |
| CT9937 | Therapy – neurostimulator – tens – leads | A4595 |
| CT9939 | Therapy – neurostimulator – other | A4630, E0745 |
| CT99392 | Other diagnostic procedures (interview, evaluation, consultation) | G0438, G0439 |
| CT9940 | Therapy – other | 36299, 99024, E0761, M0075, M0100, M0300 |
| CT99400 | Advance care planning | 1123F, 1124F, 1157F, 1158F, 4553F, 99497, 99498, S0255, S0257, S0311 |
| CT99401 | Bundled Payment / Medical Home | G9187, S0280, S0281 |
| CT99402 | Care Plan Oversight | 94005, 99339, 99340, 99374, 99375, 99377, 99378, 99379, 99380 |
| CT99403 | Case Management Services | 5050F, G0162, G0463, G9012, S0250, T1001, T1016, T1017, T2022, T2023, T2024 |
| CT99404 | Case Management Services – Behavioral | 96116, G0503, G0507, H0023, H1011 |
| CT99405 | Case Management Services – Educational | T1018 |
| CT99406 | Case Management Services – Maternity | H1000 |
| CT99408 | Chronic Care Management | 99487, 99489, 99490, G0506 |
| CT99409 | Home Health / Hospice | G0179, G0180, G0181, G0182 |
| CT9941 | Rx – allergy – antihistamines / comb | J0945, J1200 |
| CT99410 | Coordinated Care Fees/Services | G9001, G9002, G9003, G9004, G9005, G9006, G9007, G9008, G9009, G9010, G9011 |
| CT99411 | Medication Therapy Management Services | 99605, 99606, 99607 |
| CT99412 | Online Management | 98969, 99444 |
| CT99413 | Personal Care Services | T1019, T1020 |
| CT99414 | Physical therapy / Rehab | 97164, 97168, 97172 |
| CT99415 | Physician Services – Outpatient | 99358, 99359 |
| CT99416 | Procedures and Reporting | 99080, 99090, 99091 |
| CT99417 | Risk Assessment | G9316 |
| CT99418 | Transitional Care Management | 99495, 99496 |
| CT99420 | LEAD SCREENING | 83655 |
| CT9943 | Rx – autonomic rx – parasympathomimetics | J2710, S0014 |
| CT9944 | Rx – autonomic rx – sympathomimetic rx | J0380, J0395, J1250, J1265, J3105 |
| CT9946 | Rx – analg/antipy/nsaids – nsaids | J1885 |
| CT9947 | Rx – analg/antipy/nsaids – narcotics | J0364, J0595, J0745, J1170, J1810, J2175, J2180, J2271, J2275, J2300, J2410, S0109 |
| CT9949 | Rx – electrolytic, caloric, water – calcium supplements | J0610, J0620 |
| CT9950 | Rx – electrolytic, caloric, water – potassium supp | J3480 |
| CT9951 | Rx – electrolytic, caloric, water – multi-mineral prep | J7120 |
| CT9952 | Rx – electrolytic, caloric, water – sodium chlor preps | J7030, J7040, J7050, J7130 |
| CT9953 | Rx – electrolytic, caloric, water – replacement preparations, misc | J7100, J7110 |
| CT9954 | Rx – electrolytic, caloric, water – caloric rx, amino acid prep | J1955 |
| CT9955 | Rx – electrolytic, caloric, water – caloric rx dextrose / rel | J7042, J7060, J7070 |
| CT9956 | Rx – electrolytic, caloric, water – hydration – unspecfied | 90760, 90761, Q0081 |
| CT9957 | Rx – miscellaneous rx | 90287, 90288, 90393, A9150, C9399, J0348, J0795, J0878, J0894, J1212, J1436, J1457, J1458, J1595, J1740, J1743, J2248, J2278, J2323, J2425, J2503, J2513, J2724, J2730, J2778, J3110, J3243, J3490, J3530, J3535, J3570, J3590, J7187, J7321, J7323, J7324, J7505, J7599, J7799, J8499, J8650, Q2004, Q4082 |
| CT9958 | Rx – miscellaneous rx – enzymes | J0180, J0205, J0220, J1931, J2504, J3470, J3471, J3472, J3473 |
| CT9959 | Rx – miscellaneous rx – heavy metal antagonists | J0470, J0600, J0895, J1190, J3520 |
| CT9960 | Rx – miscellaneous rx – anesthetics, local | J0670, J2001, J2400, J2795, S0020 |
| CT9961 | Rx – diagnostic rx – roentgenography | Q9957 |
| CT9963 | Rx – pharmacy fee | Q0513, Q0514 |
| CT9964 | Other care – home care – specialized visit | 99507, 99509, 99510, 99511, 99600 |
| CT9965 | Other care – home care – physician supervision | G0372 |
| CT9966 | Other care – home care – nursing care | G0128 |
| CT9967 | Other care – home care – nursing care – rn | G0154 |
| CT9970 | Other care – home care – rehabilitation – physical therapy | G0151 |
| CT9971 | Other care – home care – rehabilitation – occupational therapy | G0152 |
| CT9973 | Other care – home care – social worker | G0155 |
| CT9974 | Other care – home care – home health aide | G0156 |
| CT9986 | Other care – hospice | G0337, Q5001, Q5002, Q5003, Q5004, Q5005, Q5006, Q5007, Q5008, Q5009 |
| CT9990 | Other care – other – ancillary services | 97804, 99001, 99002, 99070, 99071, 99075, 99082, 99199 |
| CT9991 | Other care – other – lightbox | E0203 |
| XX0000 | Ungrouped Codes | 33952, 33954, 33958, 33962, 33966, 33984, 37191, 37192, 37193, 37619, 6030F, 7010F, 90769, 90770, 90771, 90776, 96360, 97610, A4459, A5056, A5057, C9443, C9444, C9446, G0299, G0300, G0472, G0473, G6045, G6046, G8152, G8153, G8154, G8155, G8156, G8157, G8193, G8196, G8204, G8209, G8214, G8217, G8219, G8220, G8221, G8696, G8697, G8698, G8702, G8703, G8704, G8705, G8706, G8707, G8916, G8917, G8918, G8961, G8962, G8967, G8968, G8969, G8970, G8971, G8972, G9199, G9200, G9201, G9235, G9237, G9298, G9299, G9307, G9308, G9309, G9310, G9311, G9312, G9362, G9363, G9497, G9500, G9501, G9539, G9540, G9541, G9542, G9543, G9544, G9558, G9559, G9560, G9637, G9638, G9642, G9643, G9644, G9645, G9654, G9655, G9656, G9657, G9658, J2274, J2704, Q9974, S0144 |
Table 6: Relevant Typical Drug Groups
| Group ID | Group Name |
| RX001 | contrast media |
| RX002 | diagnostic agents |
| RX0111 | parasympathomimetics |
| RX017 | hypnotics and sedatives |
| RX0320 | cough and cold preparations |
| RX0321 | decongestants and other nasal preparations for topical use |
| RX0324 | throat preparations |
| RX0425 | antihistamines for systemic use |
| RX0426 | Bronchodilators: adrenergics for systemic use |
| RX0427 | drugs for obstructive airway diseases – inhalants |
| RX0429 | other systemic drugs for obstructive airway diseases |
| RX0530 | agents acting on the renin-angiotensin system |
| RX0531 | Agents for hypertensive emergencies |
| RX0534 | Other Anticoagulants |
| RX0535 | beta blocking agents |
| RX0536 | calcium channel blockers |
| RX0538 | diuretics |
| RX0539 | i.v. solutions & additives |
| RX0540 | Nitrates and other antianginals |
| RX0541 | other antihypertensives |
| RX0544 | statins and lipid modifying agents |
| RX0546 | Antiplatelet agents, thrombin inhibitors |
| RX0547 | Heparin group |
| RX0645 | antacids |
| RX0646 | antidiarrheals intestinal adsorbents |
| RX0647 | antiemetics and antinauseants |
| RX0648 | digestives incl. enzymes |
| RX0649 | drugs for constipation |
| RX0650 | drugs for functional gastrointestinal disorders |
| RX0651 | drugs for peptic ulcer and gerd |
| RX0652 | intestinal antiinfectives |
| RX0653 | intestinal antiinflammatory agents |
| RX0654 | stomatological preparations |
| RX0857 | antiinflammatory and antirheumatic products |
| RX0860 | muscle relaxants |
| RX0861 | opioids |
| RX0862 | other analgesics and antipyretics |
| RX0864 | topical products for joint and muscular pain |
| RX0968 | antibiotics and chemotherapeutics for dermatological use |
| RX0969 | antifungals for dermatological use |
| RX0970 | antipruritics incl. antihistamines anesthetics etc. |
| RX0971 | antiseptics and disinfectants |
| RX0973 | corticosteroids dermatological preparations |
| RX0976 | irrigating solutions |
| RX0977 | medicated dressings |
| RX0978 | other dermatological preparations |
| RX0979 | preparations for treatment of wounds and ulcers |
| RX0980 | Moisturizers and skin protective agents |
| RX1082 | antiobesity preparations excl. diet products |
| RX1086 | corticosteroids for systemic use |
| RX1087 | drugs affecting bone structure and mineralization |
| RX1088 | drugs for inborn errors of metabolism |
| RX1089 | drugs used in diabetes |
| RX1091 | drugs to treat hypoglycemia |
| RX1092 | thyroid preparations |
| RX1093 | insulin |
| RX13104 | GYNECOLOGICAL ANTIINFECTIVES AND ANTISEPTICS |
| RX16106 | iron preparations |
| RX16109 | vitamin b12 and folic acid |
| RX18117 | antibacterials for systemic use |
| RX18119 | antiinfectives |
| RX19123 | antidepressants |
| RX19125 | anxiolytics |
| RX19126 | drugs used in addictive disorders |
| RX23131 | mineral supplements |
| RX23133 | other nutrients |
| RX23135 | vitamins |
| RX99136 | anesthetics general |
| RX99137 | anesthetics local |
| RX99138 | medical gas |