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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 Heart Failure, sometimes abbreviated HF, is a chronic condition episode. There is a 30-day lookback period to capture services rendered prior to the trigger claim, such as diagnostic services, office visits, and ancillary services. The Heart Failure episode does not have an end date regarding the look-forward period, but can be broken into distinct reporting periods for implementations (e.g., 12 months).
Episode Components
| Triggers | A Heart Failure episode can be triggered by an inpatient facility claim with a trigger principal diagnosis code for the condition (See Table 1) or an outpatient facility or professional claim with a trigger diagnosis code (in any position) and an E&M procedure code (in any position) on the same claim line. For professional claim triggers a second trigger signal or confirming claim is required that meets the same criteria as any of the initial trigger claims above. The confirming claim must be at least 30 days after the initial trigger claim. |
| 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, for chronic episodes, relevant acute inpatient admissions 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 diagnoses 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: CardiomyopathyLVEF < 40% or LV systolic dysfunctionHeart Aneurysm and other Sequelae of AMI |
Code Tables
Table 1: Trigger Codes
| Trigger Type | Code Value |
| ICD-10-CM (DX) Triggers | I0981, I110, I130, I501, I5020, I5021, I5022, I5023, I5030, I5031, I5032, I5033, I5040, I5041, I5042, I5043, I50810, I50811, I50812, I50813, I50814, I5082, I5083, I5084, I5089, I509 |
Table 2: ICD-10 Typical Diagnosis
| Group ID | Group Name | Code Value |
| DXX01111 | NS – headache – symptom | G441, R51 |
| DXX01186 | NS – chronic pain – other | G8929, G894 |
| DXX01405 | Personal history of TIA | Z8673 |
| DXX04105 | Resp – hyperventilation | R064 |
| DXX04112 | Resp – abnormal chest sounds | R0989 |
| DXX0497 | Resp – shortness of breath | R0602, R0682 |
| DXX05158 | CV – edema | R600, R601, R609 |
| DXX05159 | CV – abnl ecg | R9431 |
| DXX0516 | CV – elevated BP | R030 |
| DXX05160 | CV – abnl imaging study | R931, R938 |
| DXX05161 | CV – abnl cv test nec nos | R9430, R9439 |
| DXX05164 | CV – s/p cv ds nec nos | Z8679 |
| DXX05166 | CV – s/p major cv surgery | Z48812 |
| DXX05183 | CV – vasc cath adjust remove | Z452 |
| DXX0524 | CV – cardiac murmurs | R008, R009, R010, R011, R012 |
| DXX05259 | Sxs – symptoms -other – other | R231, R232 |
| DXX05285 | Hypertensive Heart Disease w Heart Failure | I110 |
| DXX05287 | Cardiomyopathy | I420, I421, I422, I423, I424, I425, I426, I427, I428, I429, I43, I5181 |
| DXX05288 | Pulmonary heart disease | I272, I2781, I2789, I279 |
| DXX05297 | Hypotension / Syncope | I9589 |
| DXX05299 | Shock / Cardiac Arrest | T882XXA |
| DXX05303 | Acute CHF / pulm edema | J811 |
| DXX05311 | Other Phlebitis, Lymphangitis, varices | Z86718 |
| DXX05313 | Acute pericarditis | A1884, I010, I300, I301, I308, I309, M3212 |
| DXX05314 | Myocarditis | A3952, B3322, B5881, I012, I090, I400, I401, I408, I409, I41, I514 |
| DXX05319 | Artificial Heart, Assist Device | Z95811, Z95812 |
| DXX05321 | Chronic, adhesive, constrictive pericarditis | I092, I310, I311 |
| DXX05323 | Heart Aneurysm and other Sequelae of AMI | I230, I231, I232, I233, I234, I235, I236, I237, I238, I241, I253, I510, I511, I512 |
| DXX05325 | Heart Valve Disorders | I050, I051, I052, I058, I059, I060, I061, I062, I068, I069, I070, I071, I072, I078, I079, I080, I081, I082, I083, I088, I089, I091, I340, I341, I342, I348, I349, I350, I351, I352, I358, I359, I360, I361, I362, I368, I369, I370, I371, I372, I378, I379 |
| DXX05328 | Hypertensive Heart Disease w Heart Failure & CKD | I130 |
| DXX05330 | Other heart disease | A3681, A3950, B3320, B570, B572, I018, I019, I020, I029, I0989, I099, I271 |
| DXX05331 | Other pericarditis | A3953, B3323, I313, I318, I319, I32 |
| DXX05332 | Pacemaker, Defibrillator in place | Z45010, Z45018, Z4502, Z4509, Z950, Z95810, Z95818, Z959 |
| DXX05333 | Previous heart valve replacement | Z952, Z953, Z954 |
| DXX05343 | Heart Failure unspecified as acute or chronic | I501, I5020, I5022, I5030, I5032, I5040, I5042, I509 |
| DXX05344 | Chronic Heart Failure, Degeneration | I0981, I515, I517, I5189 |
| DXX05345 | Orthostatic Hypotension / Dizziness | I950, I951, R42 |
| DXX05346 | Premature Beats | I493, I4949 |
| DXX05351 | Other Cardiovascular Disease | I2541 |
| DXX05359 | Family history of CV disease | Z8249 |
| DXX05373 | Shock during or post-procedure | T8110XA, T8111XA, T8112XA, T8119XA |
| DXX0554 | CV – av block – 1st degree | I440 |
| DXX0559 | CV – right bundle branch block | I450, I4510, I4519 |
| DXX0588 | CV – other heart ds | I00, I513, I519, I52 |
| DXX0590 | CV – hypotension | R031 |
| DXX06203 | GI – anorexia | R630 |
| DXX06365 | Abdominal pain | R100, R1010, R1011, R1013, R102, R1030, R1084, R109 |
| DXX07114 | Hepatotoxicity | R740, R748, R749, R945 |
| DXX08949 | MS – muscle – nos – muscle weakness | M6281 |
| DXX10106 | hyperlipidemia | E780, E7800, E7801, E781, E782, E783, E784, E785 |
| DXX10108 | Sleep Apnea | G4730 |
| DXX10119 | Mild-mod malnutrition | E440, E441, E46, E640 |
| DXX10121 | Vitamin, Mineral & Other Nutrl Deficiency | D81818, D81819, E508, E509, E5111, E5112, E512, E518, E519, E52, E530, E531, E538, E539, E54, E559, E560, E561, E568, E569, E58, E59, E60, E610, E611, E612, E613, E614, E615, E616, E617, E618, E619, E630, E631, E638, E639, E641, E642, E648, E649 |
| DXX1069 | Abnormal Weight Gain | R635 |
| DXX1094 | Sxs – abnormal findings – lab or exam | R7889, R790, R7989, R799 |
| DXX1155 | GU – proteinuria | R800 |
| DXX16257 | Blood – abnormal coagulation test | R791 |
| DXX16271 | Blood – lymphadenitis | R590, R591, R599 |
| DXX16293 | Iron deficiency and other anemias | D530, D532, D538, D539 |
| DXX1931 | NS – insomnia | G4700 |
| DXX1963 | Anxiety Disorders | F064 |
| DXX2008 | Tobacco Use | F17200, F17201, F17210, F17211, F17220, F17221, F17290, F17291, T65211A, T65214A, T65221A, T65224A, T65291A, T65294A, Z87891 |
| DXX2328 | Sxs – malaise / fatigue | R531, R5381, R5383 |
| DXX2329 | Sxs – chronic fatigue syndrome | R5382 |
| DXX2332 | Sxs – symptoms -other | R419, R6889 |
| DXX2335 | Sxs – abnormal findings – lab or exam | R701, R770, R771, R778, R779, R781, R784, R785, R786, R789 |
| DXX2337 | Prvn – routine medical exam | Z0001 |
| DXX2352 | Othr – other | Z7409, Z789 |
| DXX2356 | Othr – long-term use other medication | Z7984, Z79891, Z79899 |
| DXX2357 | Othr – longterm anticoagulation | Z7901 |
| DXX2359 | Othr – other aftercare | Z5181, Z7902, Z792, Z7982 |
| DXX2369 | Abnormal weight loss | R634 |
| DXX2377 | Personal history of blood, endocrine, nutritional disorders | Z8639 |
| DXX2378 | Pain, unspecified | R52 |
| DXX2379 | Observation/Examination | Z0000, Z0389 |
| DXX2381 | Aftercare | Z09, Z5189 |
| DXX2382 | Preventive Screening | Z136 |
| DXX2387 | Post-surgical states | Z9889, Z98890 |
| XX0000 | Ungrouped Codes | I2720, I2721, I2722, I2723, I2724, I2729, I50810, I50812, I50814, I5082, I5083, I5084, I5089 |
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, 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 |
| DXX01390 | Coma, persistent vegetative state | G931, G935, G936, R4020, R402110, R402111, R402112, R402113, R402114, R402120, R402121, R402122, R402123, R402124, R402210, R402211, R402212, R402213, R402214, R402220, R402221, R402222, R402223, R402224, R402310, R402311, R402312, R402313, R402314, R402320, R402321, R402322, R402323, R402324, R402340, R402341, R402342, R402343, R402344, R403 |
| DXX01392 | Delirium, Encephalopathy | F05, G92, G9340, G9341, G9349, I6783 |
| DXX04126 | other lung complications | J90, J940, J941, J942, J949, J954, J955, J95811, J95859, J9588, R091 |
| DXX04127 | empyema, lung abscess | J869 |
| DXX04130 | Aspiration Pneumonia | J690, J698 |
| DXX04142 | Respiratory Failure | J80, J9584, J9600, J9601, J9602, J9620, J9621, J9622, J9690, J9691, J9692, R092 |
| DXX04154 | Respiratory Insufficiency | R0681, R0901, R0902, Y654, Z9981 |
| DXX04157 | Hemoptysis | R042, R0489, R049 |
| DXX04160 | Tracheostomy Complications | J9500, J9501, J9502, J9503, J9504, J9509 |
| DXX04165 | Community Acquired Pneumonia | J13, J14, J153, J154, J157, J181 |
| DXX04170 | Ventilator Associated Pneumonia | J95851 |
| DXX04174 | Other Staph Pneumonia | J15211 |
| DXX04177 | Ventilator Dependence | Z9911, Z9912 |
| DXX04187 | Other lung problems | J182, J918, J9811, J9819, R063 |
| DXX04188 | Other Bacterial Pneumonia | J158, J159, J168, J180, J188, J189 |
| DXX05264 | arterial thromboembolism | 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 |
| 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, T886XXA |
| DXX05303 | Acute CHF / pulm edema | I5021, I5023, I5031, I5033, I5041, I5043, J810, R0601 |
| DXX05308 | Pulmonary Embolism | I2690, I2692, I2699 |
| DXX05309 | IVC & other intra-abd venous thrombosis | I82220, 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 |
| DXX05375 | Dehydration | E860, E861, E869 |
| DXX06160 | Gastroenteritis | A080, A0811, A0819, A082, A0831, A0832, A0839, A084, A088, A09, K5289, K529 |
| DXX06305 | C-Difficile Infection | A047 |
| DXX06306 | GI Bleed | K2901, K2961, K2971, K2981, K2991, K625, K920, K921, K922 |
| DXX06317 | Acute esophagitis, acute gastritis, duodenitis | K2900, K2970, K2980, K2990 |
| DXX07110 | Hepatorenal Syndrome | K767 |
| 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 |
| DXX09192 | Dermatitis, Urticaria | T7841XA |
| DXX1030 | Diabetes, poor control | E160, E161, E162 |
| DXX11137 | rhabdomyolysis | M6282 |
| DXX11143 | Urinary Tract Infection | N10, N136, N3000, N3001, N3030, N3031, N3080, N3081, N3090, N3091, N340, N341, N342, N343, N35111, N35112, N35113, N35114, N35119, N3512, N37, N390, R309 |
| DXX11147 | Complication of genitourinary device | T83510A, T83510D, T83511A, T83511D, T83512A, T83512D, T83518A, T83518D, T8351XA, T8351XD |
| DXX11152 | Urinary Frequency & other symptoms | R300, R34 |
| DXX11167 | Acute Kidney Failure | N170, N171, N172, N178, N179, N19, N990 |
| DXX16296 | Hemorrhage | R58, R710 |
| DXX1849 | Other bacterial infections | I76, 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 | A400, A401, A403, A408, A409, A4101, A4102, A411, A412, A413, A414, A4150, A4151, A4152, A4153, A4159, A4181, A4189, A419 |
| DXX1852 | Severe Sepsis | A483, R6511, R6520, R6521 |
| DXX1853 | Bacteremia, SIRS, no organ dysfunction | R6510, R7881 |
| DXX19103 | Altered mental status | F060, F061, F062, R440, R442, R443 |
| DXX19105 | Other Mental Disorders | F068 |
| DXX2161 | Complications from Central Line | T80218A, T80219A, T8022XA |
| DXX2164 | Accidental Falls | V00811A, V00811D, V00812A, V00812D, V00818A, V00818D, W050XXA, W050XXD, W051XXA, W051XXD, 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, T372X5D, T373X5A, T373X5D, T374X5A, T374X5D, T375X5A, T375X5D, T378X5A, T378X5D, T3795XA, T3795XD, T380X5A, T380X5D, T381X5A, T381X5D, T382X5A, T382X5D, T383X5A, T383X5D, T384X5D, 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, T402X5A, T402X5D, T404X5A, T404X5D, T40605A, T40605D, T40695A, T40695D, T407X5D, T40905D, 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, T433X5D, T434X5A, T434X5D, T43505A, T43505D, T43595D, T43605D, T43615D, T43625D, T43635A, T43635D, T43695D, T438X5D, 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, T451X5D, 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, T480X5D, 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, T494X5D, T495X5A, T495X5D, T496X5A, T496X5D, 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, T50B15D, T50B95A, T50B95D, T50Z15A, T50Z15D, T50Z95A, T50Z95D |
| DXX2175 | Complications of anesthesia | T410X5A, T411X5A, T41205A, T41295A, T413X5A, T4145XA, T883XXA, T8852XA, T8853XA, T8859XA, Y653, Y700, Y701, Y702, Y703, Y708 |
| DXX2361 | complications of surgical procedures | I97410, I97418, I9742, I9751, I9752, I97610, I97618, I9762, I97620, I97621, I97622, I97638, I97640, I97648, I9789, J9562, J9572, J95831, J95861, J95863, J9589, K9162, T8189XA, T819XXA, T888XXA, Y628, Y629, Y652, Y710, Y711, Y712, Y713, Y718 |
| DXX2362 | complications of medical care | R680, T7841XD, T801XXA, T8052XA, T8052XD, T8062XA, T8062XD, T8181XA, T880XXA, Y635, Y636, Y638, Y639, Y641, Y648, Y649 |
| DXX2367 | Malfunction / Complication of Heart Device | T82513A, T82514A, T82518A, T82519A, T82523A, T82524A, T82528A, T82529A, T82533A, T82534A, T82538A, T82539A, T82593A, T82594A, T82598A, T82599A, T826XXA, T827XXA, T82817A, T82818A, T82827A, T82837A, T82847A, T82855A, T82856A, T82857A, T82867A, T82897A, T829XXA |
| 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 | E15 |
| XX0000 | Ungrouped Codes | I2783, I50811, I50813 |
Table 4: ICD-10 Relevant Procedure Codes
| Group ID | Group Name | Code Value |
| PXX01177 | Computerized axial tomography (CT) scan head – 177 | B02000Z, B0200ZZ, B02010Z, B0201ZZ, B020Y0Z, B020YZZ, B020ZZZ, B02700Z, B0270ZZ, B02710Z, B0271ZZ, B027ZZZ, B02800Z, B0280ZZ, B02810Z, B0281ZZ, B028Y0Z, B028YZZ, B028ZZZ, B02900Z, B0290ZZ, B02910Z, B0291ZZ, B029ZZZ, B02B00Z, B02B0ZZ, B02B10Z, B02B1ZZ, B02BY0Z, B02BYZZ, B02BZZZ, B32R0ZZ, B32R1ZZ, B32RYZZ, B32RZZZ, B92000Z, B9200ZZ, B92010Z, B9201ZZ, B920Y0Z, B920YZZ, B920ZZZ, B92200Z, B9220ZZ, B92210Z, B9221ZZ, B922Y0Z, B922YZZ, B922ZZZ, B92600Z, B9260ZZ, B92610Z, B9261ZZ, B926Y0Z, B926YZZ, B926ZZZ, B92900Z, B9290ZZ, B92910Z, B9291ZZ, B929Y0Z, B929YZZ, B929ZZZ, B92D00Z, B92D0ZZ, B92D10Z, B92D1ZZ, B92DY0Z, B92DYZZ, B92DZZZ, B92FZZZ, B92JZZZ, BN200ZZ, BN201ZZ, BN20YZZ, BN20ZZZ, BN230ZZ, BN231ZZ, BN23YZZ, BN23ZZZ, BN250ZZ, BN251ZZ, BN25YZZ, BN25ZZZ, BN260ZZ, BN261ZZ, BN26YZZ, BN26ZZZ, BN290ZZ, BN291ZZ, BN29YZZ, BN29ZZZ, BN2F0ZZ, BN2F1ZZ, BN2FYZZ, BN2FZZZ, BW2800Z, BW280ZZ, BW2810Z, BW281ZZ, BW28Y0Z, BW28YZZ, BW28ZZZ |
| PXX01199 | Electroencephalogram (EEG) – 199 | 4A0004Z, 4A0034Z, 4A00X4Z, 4A0104Z, 4A0134Z, 4A01X4Z, 4A1004Z, 4A1034Z, 4A10X4Z, 4A1104Z, 4A1134Z, 4A11X4Z |
| PXX03215 | Other physical therapy and rehabilitation – 215 | F08Z0EZ, F08Z0FZ, F08Z0UZ, F08Z0YZ, F08Z0ZZ, F08Z1EZ, F08Z1FZ, F08Z1UZ, F08Z1YZ, F08Z1ZZ, F08Z2EZ, F08Z2FZ, F08Z2UZ, F08Z2YZ, F08Z2ZZ, F08Z3CZ, F08Z3DZ, F08Z3EZ, F08Z3FZ, F08Z3UZ, F08Z3YZ, F08Z3ZZ, F08Z4DZ, F08Z4EZ, F08Z4FZ, F08Z4UZ, F08Z4YZ, F08Z4ZZ |
| PXX03231 | Other therapeutic procedures – 231 | 059030Z, 05903ZZ, 059040Z, 05904ZZ, 059130Z, 05913ZZ, 059140Z, 05914ZZ, 059330Z, 05933ZZ, 059340Z, 05934ZZ, 059430Z, 05943ZZ, 059440Z, 05944ZZ, 059530Z, 05953ZZ, 059540Z, 05954ZZ, 059630Z, 05963ZZ, 059640Z, 05964ZZ, 059730Z, 05973ZZ, 059740Z, 05974ZZ, 059830Z, 05983ZZ, 059840Z, 05984ZZ, 059930Z, 05993ZZ, 059940Z, 05994ZZ, 059A30Z, 059A3ZZ, 059A40Z, 059A4ZZ, 059B30Z, 059B3ZZ, 059B40Z, 059B4ZZ, 059C30Z, 059C3ZZ, 059C40Z, 059C4ZZ, 059D30Z, 059D3ZZ, 059D40Z, 059D4ZZ, 059F30Z, 059F3ZZ, 059F40Z, 059F4ZZ, 059G30Z, 059G3ZZ, 059G40Z, 059G4ZZ, 059H30Z, 059H3ZZ, 059H40Z, 059H4ZZ, 059L30Z, 059L3ZZ, 059L40Z, 059L4ZZ, 059M30Z, 059M3ZZ, 059M40Z, 059M4ZZ, 059N30Z, 059N3ZZ, 059N40Z, 059N4ZZ, 059P30Z, 059P3ZZ, 059P40Z, 059P4ZZ, 059Q30Z, 059Q3ZZ, 059Q40Z, 059Q4ZZ, 059R30Z, 059R3ZZ, 059R40Z, 059R4ZZ, 059S30Z, 059S3ZZ, 059S40Z, 059S4ZZ, 059T30Z, 059T3ZZ, 059T40Z, 059T4ZZ, 059V30Z, 059V3ZZ, 059V40Z, 059V4ZZ, 059Y30Z, 059Y3ZZ, 059Y40Z, 059Y4ZZ, 069030Z, 06903ZZ, 069040Z, 06904ZZ, 069130Z, 06913ZZ, 069140Z, 06914ZZ, 069230Z, 06923ZZ, 069240Z, 06924ZZ, 069430Z, 06943ZZ, 069440Z, 06944ZZ, 069530Z, 06953ZZ, 069540Z, 06954ZZ, 069630Z, 06963ZZ, 069640Z, 06964ZZ, 069730Z, 06973ZZ, 069740Z, 06974ZZ, 069830Z, 06983ZZ, 069840Z, 06984ZZ, 069930Z, 06993ZZ, 069940Z, 06994ZZ, 069B30Z, 069B3ZZ, 069B40Z, 069B4ZZ, 069C30Z, 069C3ZZ, 069C40Z, 069C4ZZ, 069D30Z, 069D3ZZ, 069D40Z, 069D4ZZ, 069F30Z, 069F3ZZ, 069F40Z, 069F4ZZ, 069G30Z, 069G3ZZ, 069G40Z, 069G4ZZ, 069H30Z, 069H3ZZ, 069H40Z, 069H4ZZ, 069J30Z, 069J3ZZ, 069J40Z, 069J4ZZ, 069M30Z, 069M3ZZ, 069M40Z, 069M4ZZ, 069N30Z, 069N3ZZ, 069N40Z, 069N4ZZ, 069P30Z, 069P3ZZ, 069P40Z, 069P4ZZ, 069Q30Z, 069Q3ZZ, 069Q40Z, 069Q4ZZ, 069R30Z, 069R3ZZ, 069R40Z, 069R4ZZ, 069S30Z, 069S3ZZ, 069S40Z, 069S4ZZ, 069T30Z, 069T3ZZ, 069T40Z, 069T4ZZ, 069V30Z, 069V3ZZ, 069V40Z, 069V4ZZ, 069Y30Z, 069Y3ZZ, 069Y40Z, 069Y4ZZ, 3E013GC, 3E0234Z, 3E0303Z, 3E030FZ, 3E030HZ, 3E030KZ, 3E030RZ, 3E030WK, 3E030XZ, 3E0333Z, 3E033FZ, 3E033HZ, 3E033KZ, 3E033RZ, 3E033WK, 3E033XZ, 3E0403Z, 3E040FZ, 3E040HZ, 3E040KZ, 3E040RZ, 3E040WK, 3E040XZ, 3E0433Z, 3E043FZ, 3E043HZ, 3E043KZ, 3E043RZ, 3E043WK, 3E043XZ, 3E0503Z, 3E050FZ, 3E050HZ, 3E050KZ, 3E050RZ, 3E050TZ, 3E050WK, 3E050XZ, 3E0533Z, 3E053FZ, 3E053HZ, 3E053KZ, 3E053RZ, 3E053TZ, 3E053WK, 3E053XZ, 3E0603Z, 3E060FZ, 3E060HZ, 3E060RZ, 3E060TZ, 3E060WK, 3E060XZ, 3E0633Z, 3E063FZ, 3E063HZ, 3E063RZ, 3E063TZ, 3E063WK, 3E063XZ, 3E09329, 3E0933Z, 3E0934Z, 3E093BZ, 3E093GC, 3E093HZ, 3E093KZ, 3E093TZ, 3E09729, 3E0973Z, 3E0974Z, 3E097BZ, 3E097GC, 3E097HZ, 3E097KZ, 3E097TZ, 3E09X29, 3E09X3Z, 3E09X4Z, 3E09XBZ, 3E09XHZ, 3E09XKZ, 3E09XTZ, 3E0D329, 3E0D33Z, 3E0D34Z, 3E0D36Z, 3E0D37Z, 3E0D3BZ, 3E0D3GC, 3E0D3HZ, 3E0D3KZ, 3E0D3RZ, 3E0D3TZ, 3E0D729, 3E0D73Z, 3E0D74Z, 3E0D76Z, 3E0D77Z, 3E0D7BZ, 3E0D7GC, 3E0D7HZ, 3E0D7KZ, 3E0D7RZ, 3E0D7TZ, 3E0DX29, 3E0DX3Z, 3E0DX4Z, 3E0DX6Z, 3E0DX7Z, 3E0DXBZ, 3E0DXHZ, 3E0DXKZ, 3E0DXRZ, 3E0DXTZ, 3E0F3SF, 3E0F7SF, 3E0F8SF, 3E0G3BZ, 3E0G3HZ, 3E0G3KZ, 3E0G3SF, 3E0G3TZ, 3E0G7BZ, 3E0G7HZ, 3E0G7KZ, 3E0G7SF, 3E0G7TZ, 3E0G8BZ, 3E0G8HZ, 3E0G8KZ, 3E0G8SF, 3E0G8TZ, 3E0H3BZ, 3E0H3GC, 3E0H3HZ, 3E0H3KZ, 3E0H3SF, 3E0H3TZ, 3E0H7BZ, 3E0H7HZ, 3E0H7KZ, 3E0H7SF, 3E0H7TZ, 3E0H8BZ, 3E0H8HZ, 3E0H8KZ, 3E0H8SF, 3E0H8TZ, 3E0J3SF, 3E0J7SF, 3E0J8SF, 3E0K3BZ, 3E0K3HZ, 3E0K3KZ, 3E0K3SF, 3E0K3TZ, 3E0K7BZ, 3E0K7GC, 3E0K7HZ, 3E0K7KZ, 3E0K7SF, 3E0K7TZ, 3E0K8BZ, 3E0K8GC, 3E0K8HZ, 3E0K8KZ, 3E0K8SF, 3E0K8TZ, 3E0N73Z, 3E0N76Z, 3E0N77Z, 3E0N7BZ, 3E0N7GC, 3E0N7HZ, 3E0N7KZ, 3E0N7SF, 3E0N7TZ, 3E0N83Z, 3E0N86Z, 3E0N87Z, 3E0N8BZ, 3E0N8GC, 3E0N8HZ, 3E0N8KZ, 3E0N8SF, 3E0N8TZ, 3E0P3GC, 3E0P3SF, 3E0P7SF, 3E0P8SF, 3E0W33Z, 3E0W36Z, 3E0W37Z, 3E0W3BZ, 3E0W3GC, 3E0W3HZ, 3E0W3KZ, 3E0W3TZ, XW03331, XW03372, XW04331, XW04372 |
| PXX04178 | CT scan chest – 178 | B22600Z, B2260ZZ, B22610Z, B2261ZZ, B226Y0Z, B226YZZ, B226ZZZ, B32S0ZZ, B32S1ZZ, B32SYZZ, B32SZZZ, B32T0ZZ, B32T1ZZ, B32TYZZ, B32TZZZ, BB2400Z, BB240ZZ, BB2410Z, BB241ZZ, BB24Y0Z, BB24YZZ, BB24ZZZ, BP2W0ZZ, BP2W1ZZ, BP2WYZZ, BW2400Z, BW240ZZ, BW2410Z, BW241ZZ, BW24Y0Z, BW24YZZ, BW24ZZZ |
| PXX04216 | Respiratory intubation and mechanical ventilation – 216 | 0BH17EZ, 0BH18EZ, 5A09357, 5A09457, 5A09557 |
| PXX04217 | Other respiratory therapy – 217 | 3E0F73Z, 3E0F76Z, 3E0F77Z, 3E0F7BZ, 3E0F7GC, 5A09358, 5A09458, 5A09558 |
| PXX0439 | Incision of pleura, thoracentesis, chest drainage – 039 | 0B9N3ZZ, 0B9P3ZZ, 0W9930Z, 0W993ZZ, 0W9B30Z, 0W9B3ZZ |
| PXX0442 | Other OR therapeutic procedures on respiratory system – 042 | 0BHR0MZ, 0BHR3MZ, 0BHR4MZ, 0BHS0MZ, 0BHS3MZ, 0BHS4MZ |
| PXX05189 | Contrast aortogram – 189 | B3000ZZ, B3001ZZ, B300YZZ, B30P0ZZ, B30P1ZZ, B30PYZZ, B3100ZZ, B3101ZZ, B310YZZ, B31P0ZZ, B31P1ZZ, B31PYZZ, B4000ZZ, B4001ZZ, B400YZZ, B40D0ZZ, B40D1ZZ, B40DYZZ, B4100ZZ, B4101ZZ, B410YZZ, B41D0ZZ, B41D1ZZ, B41DYZZ |
| PXX05190 | Contrast arteriogram of femoral and lower extremity arteries – 190 | B40F0ZZ, B40F1ZZ, B40FYZZ, B40G0ZZ, B40G1ZZ, B40GYZZ, B40J0ZZ, B40J1ZZ, B40JYZZ, B41F0ZZ, B41F1ZZ, B41FYZZ, B41G0ZZ, B41G1ZZ, B41GYZZ, B41J0ZZ, B41J1ZZ, B41JYZZ |
| PXX05191 | Arterio- or venogram (not heart and head) – 191 | B2000ZZ, B2001ZZ, B200YZZ, B201YZZ, B202YZZ, B203YZZ, B2060ZZ, B2061ZZ, B206YZZ, B207YZZ, B208YZZ, B20FYZZ, B2100ZZ, B2101ZZ, B210YZZ, B2110ZZ, B2111ZZ, B211YZZ, B2120ZZ, B2121ZZ, B212YZZ, B2130ZZ, B2131ZZ, B213YZZ, B2160ZZ, B2161ZZ, B216YZZ, B2170ZZ, B2171ZZ, B217YZZ, B2180ZZ, B2181ZZ, B218YZZ, B21F0ZZ, B21F1ZZ, B21FYZZ, B5080ZZ, B5081ZZ, B508YZZ, B5090ZZ, B5091ZZ, B509YZZ, B5180ZA, B5180ZZ, B5181ZA, B5181ZZ, B518YZA, B518YZZ, B518ZZA, B5190ZA, B5190ZZ, B5191ZA, B5191ZZ, B519YZA, B519YZZ, B519ZZA |
| PXX05193 | Diagnostic ultrasound of heart (echocardiogram) – 193 | B240YZZ, B240ZZ4, B240ZZZ, B241YZZ, B241ZZ4, B241ZZZ, B244YZZ, B244ZZ4, B244ZZZ, B245YZZ, B245ZZ4, B245ZZZ, B246YZZ, B246ZZ4, B246ZZZ, B24BYZZ, B24BZZ4, B24BZZZ, B24CYZZ, B24CZZ4, B24CZZZ, B24DYZZ, B24DZZ4, B24DZZZ |
| PXX05197 | Other diagnostic ultrasound – 197 | B341ZZZ, B342ZZZ, B343ZZZ, B344ZZZ, B345ZZZ, B346ZZZ, B347ZZZ, B348ZZZ, B34HZZZ, B34JZZZ, B34KZZZ, B34RZZZ, B34SZZZ, B34TZZZ, B34VZZZ, B440ZZZ, B444ZZZ, B445ZZZ, B446ZZZ, B447ZZZ, B448ZZZ, B44BZZZ, B44FZZZ, B44GZZZ, B44HZZZ, B44KZZZ, B44LZZZ, B44NZZZ, B543ZZZ, B544ZZZ, B546ZZZ, B547ZZZ, B548ZZZ, B549ZZZ, B54BZZZ, B54CZZZ, B54DZZZ, B54JZZZ, B54KZZZ, B54LZZZ, B54MZZZ, B54NZZZ, B54PZZZ, B54TZZZ |
| PXX05201 | Cardiac stress tests – 201 | 4A0234Z, 4A02XM4, 4A1234Z, 4A12XM4 |
| PXX05205 | Arterial blood gases – 205 | 4A03XR1, 4A13XR1 |
| PXX05225 | Conversion of cardiac rhythm – 225 | 5A2204Z |
| PXX05226 | Other diagnostic radiology and related techniques – 226 | 4A12XSH, B210010, B210110, B210Y10, B211010, B211110, B211Y10, B212010, B212110, B212Y10, B213010, B213110, B213Y10 |
| PXX05227 | Other diagnostic procedures (interview, evaluation, consultation) – 227 | 3E063KZ, 4B02XSZ, 4B02XTZ |
| PXX05228 | Electrophysiology Studies, Cryoablation | 02JA3ZZ, 02JY3ZZ, 02K80ZZ, 02K83ZZ, 02K84ZZ, 0WJD0ZZ, 0WJD3ZZ, 4A023FZ |
| PXX05236 | Other Surgery of Heart & Valve | 02B73ZZ, 02BK3ZZ, 02QA0ZZ, 02QA3ZZ, 02QA4ZZ |
| PXX05240 | Ventricular Repair, Postinfarct VSD | 02B63ZZ, 02BL3ZZ |
| PXX0547 | Diagnostic cardiac catheterization, coronary arteriography – 047 | 4A020N6, 4A020N7, 4A020N8, 4A023N6, 4A023N7, 4A023N8, B2010ZZ, B2011ZZ, B2020ZZ, B2021ZZ, B2030ZZ, B2031ZZ, B2040ZZ, B2041ZZ, B204YZZ, B2050ZZ, B2051ZZ, B205YZZ, B2070ZZ, B2071ZZ, B2080ZZ, B2081ZZ, B20F0ZZ, B20F1ZZ, B2140ZZ, B2141ZZ, B214YZZ, B2150ZZ, B2151ZZ, B215YZZ |
| PXX0549 | Other OR heart procedures – 049 | 02553ZZ, 02563ZZ, 02573ZZ, 02583ZZ, 02593ZZ, 025F3ZZ, 025G3ZZ, 025H3ZZ, 025J3ZZ, 025K3ZZ, 025L3ZZ, 025M3ZZ, 02B53ZZ, 02B83ZZ, 02B93ZZ, 02BF3ZZ, 02BG3ZZ, 02BH3ZZ, 02BJ3ZZ, 02BM3ZZ, 02HA0QZ, 02HA0RS, 02HA0RZ, 02HA3QZ, 02HA3RS, 02HA3RZ, 02HA4QZ, 02HA4RS, 02HA4RZ, 02PA0QZ, 02PA0RZ, 02PA3QZ, 02PA3RZ, 02PA4QZ, 02PA4RZ, 02T83ZZ, 02WA0QZ, 02WA0RZ, 02WA3QZ, 02WA3RZ, 02WA4QZ, 02WA4RZ, 5A02110, 5A02116, 5A0211D, 5A02210, 5A02216, 5A0221D |
| PXX0550 | Extracorporeal circulation auxiliary to open heart procedures – 050 | 5A1221Z, 5A15223 |
| PXX0554 | Other vascular catheterization, not heart – 054 | 02H633Z, 02HK33Z, 02HP03Z, 02HP33Z, 02HP43Z, 02HQ03Z, 02HQ33Z, 02HQ43Z, 02HR03Z, 02HR33Z, 02HR43Z, 02HS03Z, 02HS33Z, 02HS43Z, 02HT03Z, 02HT33Z, 02HT43Z, 02HV03Z, 02HV33Z, 02HV43Z, 02HW03Z, 02HW33Z, 02HW43Z, 02HX03Z, 02HX33Z, 02HX43Z, 03H003Z, 03H033Z, 03H043Z, 03H103Z, 03H133Z, 03H143Z, 03H203Z, 03H233Z, 03H243Z, 03H303Z, 03H333Z, 03H343Z, 03H403Z, 03H433Z, 03H443Z, 03H503Z, 03H533Z, 03H543Z, 03H603Z, 03H633Z, 03H643Z, 03H703Z, 03H733Z, 03H743Z, 03H803Z, 03H833Z, 03H843Z, 03H903Z, 03H933Z, 03H943Z, 03HA03Z, 03HA33Z, 03HA43Z, 03HB03Z, 03HB33Z, 03HB43Z, 03HC03Z, 03HC33Z, 03HC43Z, 03HD03Z, 03HD33Z, 03HD43Z, 03HF03Z, 03HF33Z, 03HF43Z, 03HG03Z, 03HG33Z, 03HG43Z, 03HH03Z, 03HH33Z, 03HH43Z, 03HJ03Z, 03HJ33Z, 03HJ43Z, 03HK03Z, 03HK33Z, 03HK43Z, 03HL03Z, 03HL33Z, 03HL43Z, 03HM03Z, 03HM33Z, 03HM43Z, 03HN03Z, 03HN33Z, 03HN43Z, 03HP03Z, 03HP33Z, 03HP43Z, 03HQ03Z, 03HQ33Z, 03HQ43Z, 03HR03Z, 03HR33Z, 03HR43Z, 03HS03Z, 03HS33Z, 03HS43Z, 03HT03Z, 03HT33Z, 03HT43Z, 03HU03Z, 03HU33Z, 03HU43Z, 03HV03Z, 03HV33Z, 03HV43Z, 03HY03Z, 03HY32Z, 03HY33Z, 03HY43Z, 04H003Z, 04H033Z, 04H043Z, 04H103Z, 04H133Z, 04H143Z, 04H203Z, 04H233Z, 04H243Z, 04H303Z, 04H333Z, 04H343Z, 04H403Z, 04H433Z, 04H443Z, 04H503Z, 04H533Z, 04H543Z, 04H603Z, 04H633Z, 04H643Z, 04H703Z, 04H733Z, 04H743Z, 04H803Z, 04H833Z, 04H843Z, 04H903Z, 04H933Z, 04H943Z, 04HA03Z, 04HA33Z, 04HA43Z, 04HB03Z, 04HB33Z, 04HB43Z, 04HC03Z, 04HC33Z, 04HC43Z, 04HD03Z, 04HD33Z, 04HD43Z, 04HE03Z, 04HE33Z, 04HE43Z, 04HF03Z, 04HF33Z, 04HF43Z, 04HH03Z, 04HH33Z, 04HH43Z, 04HJ03Z, 04HJ33Z, 04HJ43Z, 04HK03Z, 04HK33Z, 04HK43Z, 04HL03Z, 04HL33Z, 04HL43Z, 04HM03Z, 04HM33Z, 04HM43Z, 04HN03Z, 04HN33Z, 04HN43Z, 04HP03Z, 04HP33Z, 04HP43Z, 04HQ03Z, 04HQ33Z, 04HQ43Z, 04HR03Z, 04HR33Z, 04HR43Z, 04HS03Z, 04HS33Z, 04HS43Z, 04HT03Z, 04HT33Z, 04HT43Z, 04HU03Z, 04HU33Z, 04HU43Z, 04HV03Z, 04HV33Z, 04HV43Z, 04HW03Z, 04HW33Z, 04HW43Z, 04HY03Z, 04HY32Z, 04HY33Z, 04HY43Z, 05H003Z, 05H033Z, 05H043Z, 05H103Z, 05H133Z, 05H143Z, 05H303Z, 05H333Z, 05H343Z, 05H403Z, 05H433Z, 05H443Z, 05H503Z, 05H533Z, 05H543Z, 05H603Z, 05H633Z, 05H643Z, 05H703Z, 05H733Z, 05H743Z, 05H803Z, 05H833Z, 05H843Z, 05H903Z, 05H933Z, 05H943Z, 05HA03Z, 05HA33Z, 05HA43Z, 05HB03Z, 05HB33Z, 05HB43Z, 05HC03Z, 05HC33Z, 05HC43Z, 05HD03Z, 05HD33Z, 05HD43Z, 05HF03Z, 05HF33Z, 05HF43Z, 05HG03Z, 05HG33Z, 05HG43Z, 05HH03Z, 05HH33Z, 05HH43Z, 05HL03Z, 05HL33Z, 05HL43Z, 05HM03Z, 05HM33Z, 05HM43Z, 05HN03Z, 05HN33Z, 05HN43Z, 05HP03Z, 05HP33Z, 05HP43Z, 05HQ03Z, 05HQ33Z, 05HQ43Z, 05HR03Z, 05HR33Z, 05HR43Z, 05HS03Z, 05HS33Z, 05HS43Z, 05HT03Z, 05HT33Z, 05HT43Z, 05HV03Z, 05HV33Z, 05HV43Z, 05HY03Z, 05HY33Z, 05HY43Z, 06H003Z, 06H033Z, 06H043Z, 06H103Z, 06H133Z, 06H143Z, 06H203Z, 06H233Z, 06H243Z, 06H303Z, 06H333Z, 06H343Z, 06H403Z, 06H433Z, 06H443Z, 06H503Z, 06H533Z, 06H543Z, 06H603Z, 06H633Z, 06H643Z, 06H703Z, 06H733Z, 06H743Z, 06H803Z, 06H833Z, 06H843Z, 06H903Z, 06H933Z, 06H943Z, 06HB03Z, 06HB33Z, 06HB43Z, 06HC03Z, 06HC33Z, 06HC43Z, 06HD03Z, 06HD33Z, 06HD43Z, 06HF03Z, 06HF33Z, 06HF43Z, 06HG03Z, 06HG33Z, 06HG43Z, 06HH03Z, 06HH33Z, 06HH43Z, 06HJ03Z, 06HJ33Z, 06HJ43Z, 06HM03Z, 06HM33Z, 06HM43Z, 06HN03Z, 06HN33Z, 06HN43Z, 06HP03Z, 06HP33Z, 06HP43Z, 06HQ03Z, 06HQ33Z, 06HQ43Z, 06HR03Z, 06HR33Z, 06HR43Z, 06HS03Z, 06HS33Z, 06HS43Z, 06HT03Z, 06HT33Z, 06HT43Z, 06HV03Z, 06HV33Z, 06HV43Z, 06HY03Z, 06HY33Z, 06HY43Z, 0JH60XZ, 0JH63XZ, 0JH80XZ, 0JH83XZ, 0JHD0XZ, 0JHD3XZ, 0JHF0XZ, 0JHF3XZ, 0JHG0XZ, 0JHG3XZ, 0JHH0XZ, 0JHH3XZ, 0JHL0XZ, 0JHL3XZ, 0JHM0XZ, 0JHM3XZ, 0JHN0XZ, 0JHN3XZ, 0JHP0XZ, 0JHP3XZ |
| PXX0559 | Other OR procedures on vessels of head and neck – 059 | 037R3D6, 037R3DZ, 037R3E6, 037R3EZ, 037R3F6, 037R3FZ, 037R3G6, 037R3GZ, 037R4D6, 037R4DZ, 037R4E6, 037R4EZ, 037R4F6, 037R4FZ, 037R4G6, 037R4GZ, 037S3D6, 037S3DZ, 037S3E6, 037S3EZ, 037S3F6, 037S3FZ, 037S3G6, 037S3GZ, 037S4D6, 037S4DZ, 037S4E6, 037S4EZ, 037S4F6, 037S4FZ, 037S4G6, 037S4GZ, 037T3D6, 037T3DZ, 037T3E6, 037T3EZ, 037T3F6, 037T3FZ, 037T3G6, 037T3GZ, 037T4D6, 037T4DZ, 037T4E6, 037T4EZ, 037T4F6, 037T4FZ, 037T4G6, 037T4GZ, 057T3DZ, 057T4DZ |
| 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 |
| PXX06196 | Diagnostic ultrasound of abdomen or retroperitoneum – 196 | BW40ZZZ |
| PXX06223 | Enteral and parenteral nutrition – 223 | 3E0306Z, 3E0336Z, 3E0406Z, 3E0436Z, 3E0506Z, 3E0536Z, 3E0606Z, 3E0636Z |
| PXX0688 | Abdominal paracentesis – 088 | 0D9S30Z, 0D9S3ZZ, 0D9S40Z, 0D9S4ZZ, 0D9T30Z, 0D9T3ZZ, 0D9T40Z, 0D9T4ZZ, 0D9V30Z, 0D9V3ZZ, 0D9V40Z, 0D9V4ZZ, 0D9W30Z, 0D9W3ZZ, 0D9W40Z, 0D9W4ZZ, 0W9F30Z, 0W9F3ZZ, 0W9F40Z, 0W9F4ZZ, 0W9G30Z, 0W9G3ZZ, 0W9G40Z, 0W9G4ZZ, 0W9J30Z, 0W9J3ZZ |
| PXX11108 | Indwelling catheter – 108 | 0T9B70Z, 0T9B80Z, 0T9C70Z, 0T9C80Z |
| PXX16222 | Blood transfusion – 222 | 30230J1, 30230K1, 30230L1, 30230M1, 30230N1, 30230P1, 30230R1, 30233J1, 30233K1, 30233L1, 30233M1, 30233N1, 30233P1, 30233R1, 30240J1, 30240K1, 30240L1, 30240M1, 30240N1, 30240P1, 30240R1, 30243J1, 30243K1, 30243L1, 30243M1, 30243N1, 30243P1, 30243R1, 30250J1, 30250K1, 30250L1, 30250M1, 30250N1, 30250P1, 30250R1, 30253J1, 30253K1, 30253L1, 30253M1, 30253N1, 30253P1, 30253R1, 30260J1, 30260K1, 30260L1, 30260M1, 30260N1, 30260P1, 30260R1, 30263J1, 30263K1, 30263L1, 30263M1, 30263N1, 30263P1, 30263R1 |
| PXX23228 | Prophylactic vaccinations and inoculations – 228 | 3E0134Z |
Table 5: Relevant Procedure Codes CPT/HCPCS
| Group ID | Group Name | Code Value |
| CT0025 | Preventive Medicine, Care Coordination | 2000F, 2001F, 4000F, 4001F, 4004F, 93790, 93797, 93798, 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, G0422, G0423, G0424, G0425, G0426, G0427, G8402, G8453, G8686, G8688, G8690, G8692, G9458, H0034, H0039, H0040, S0220, S0221, S0315, S0316, S0317, S0320, S0340, S0341, S0342 |
| CT0026 | Anesthesia and pain meds | J0400, J0780, J1630, J1631, J1960, J2270, J2310, J2358, J2426, J2680, J2794, J3010, J3070, J3230, J3486, S0012, S0092, S0093, S0136, S0166 |
| CT0028 | Depression Screening | 1220F, 3085F, 3351F, 3352F, 3353F, 3354F, 3725F, 96127, G0444, G8431, G8432, G8433, G8510, G8511, G8940 |
| CT0043 | Counseling Services | G0396, G0397 |
| CT0059 | LVEF < 40% or LV systolic dysfunction | 3021F, 3055F, G8027, G8028, G8030, G8031, G8450, G8451, G8452, G8468, G8469, G8472, G8694, G8738, G8923, G8934 |
| CT0076 | Coronary Thrombolysis | 92977 |
| CT0079 | Toxicology Screening | G0480, G0481, G0482, G0483 |
| CT0080 | Imaging Abdomen | 74000, 74020, 74022, 74150, 74160, 74170, 74175, 74181, 74182, 74183, 74185, 76700, 76705, 76999 |
| CT0082 | Medications for pain | 96372, H0033, J0592, J1230, J2315 |
| CT0083 | Blood Type, Coomb’s test | 86077, 86880, 86900, 86901 |
| CT0087 | Hearing Test | 92588 |
| CT0088 | Hepatitis B vaccine | 90744, G0010 |
| 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 | 92610, 97001, 97002, 97003, 97004, 97005, 97006, 97016, 97032, 97033, 97034, 97035, 97036, 97039, 97110, 97112, 97113, 97116, 97124, 97139, 97140, 97150, 97530, 97545, 97546, 97750, 97755, G0129, S9129, S9131 |
| CT0091 | Physician Services – Outpatient | 99050, 99051, 99053, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99271, 99272, 99273, 99274, 99275, 99354, 99355, 99381, 99391, 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 | 99478, 99479, 99480 |
| CT0097 | Vitamin K administration | J3430 |
| CT0098 | Occult Blood | 82270 |
| CT0114 | Procedure – spinal canal – catheter | C1755, E0785 |
| CT0119 | Procedure – block – nerve | 64472 |
| CT0122 | Procedure – peripheral nerve repair / graft – graft / guide | C9355 |
| CT0131 | Procedure – anesthesia | 1992 |
| CT0132 | Rx – central nervous system – Parkinson’s rx | J0190, J0515, J8515 |
| CT0133 | Rx – central nervous system – sympatholytic rx | J1110 |
| CT0134 | Rx – central nervous system – vascular 5ht1 agonists | J3030 |
| CT0135 | Rx – central nervous system – anticonvulsants | C9254, J1165, J1953, 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 |
| CT01392 | Other diagnostic nervous system procedures | 0434T, 0435T, 0436T |
| CT01393 | Other OR therapeutic nervous system procedures | 0424T, 0425T, 0426T, 0427T, 0428T, 0429T, 0430T, 0431T, 0432T, 0433T |
| CT01394 | Medications (Injections, infusions and other forms) | C9270, C9272, C9275, C9276, C9277, C9279, C9281, C9282, C9283, C9285, J0171, J0558, J0561, J0597, J0638, J0695, J0714, J0775, J0875, J1290, J1559, J1599, J1680, J1786, J1826, J2793, J3095, J3357, J3385, J7121, J7184, J7309, J7312, J7328, J7335, J7611, J7612, J7613, J7614, J7686, J8562, Q2026, Q2027, Q2040, Q2041, Q2042, Q2044, S0148, S0169 |
| CT01395 | DME and supplies | A4466, A9273, C9362, C9365, C9367, C9406, C9800, E0433, E0446, E0465, E0466, E1012, E1036, E2622, E2623, E2624, E2625, K0740, K0741, K0742, K0743, K0744, K0745, K0746, Q0478, Q0479, Q4117, Q4118, Q4119, Q4120, Q4121, Q4161, Q4162, Q4163, Q4164, Q4165, Q9950, T1505 |
| 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 |
| CT0144 | Imaging – ct – head / brain | 70450, 70470 |
| CT0148 | Imaging – cta – head / neck | 70496 |
| CT0149 | Imaging – mri – brain | 70551, 70553 |
| CT0152 | Imaging – nuclear – csf – scan | 78630, 78635, 78645, 78647, 78650 |
| CT0159 | Tests – vascular – cerebrovascular | 93880, 93882, 93892, 93893 |
| CT0160 | Tests – neuro – eeg | 95816, 95954, 95955 |
| CT0161 | Tests – neuro – muscle testing | 95833, 95834 |
| CT0162 | Tests – neuro – ncv / emg | 95870, 95872 |
| CT0163 | Tests – neuro – evoked potentials | 95925, 95926, 95927, 95930, 95933, 95934, 95936, 95937 |
| CT0165 | Tests – neuro – other | 95921, 95922, 95923, 95990, 96004 |
| CT0238 | Imaging – us – eye | 76511, 76512, 76513, 76516, 76519 |
| CT0251 | Tests – eye – dx – other | 92136, 92240 |
| CT03396 | Other OR therapeutic procedures on nose, mouth and pharynx | 3056F, 3115F, 3117F, 3118F, 3119F |
| CT0351 | Therapy – habilitation | T2012 |
| CT0354 | Rx – eent – topical – eye/ear/nose/throat misc | J3396 |
| CT0361 | Imaging – mra – head | 70544 |
| CT0380 | Tests – ent – other dx | 92504 |
| CT0415 | Procedure – chest tube / thoracentesis – thoracentesis | 32421 |
| CT0416 | Procedure – chest tube / thoracentesis – insertion of chest tube | 32422 |
| CT0421 | Procedure – respiratory – other non – or rx | 94610 |
| CT0424 | Rx – respiratory – beta agonists | J7606 |
| CT0425 | Rx – respiratory – phenylephrine | J2370 |
| CT0426 | Rx – respiratory – mucolytics/cold comb | J0132 |
| CT0427 | Rx – respiratory – methylxanthines | J0280, J1180, J2810 |
| CT04280 | Lung Function Tests | 94010, 94014, 94015, 94016, 94060, 94070, 94150, 94200, 94240, 94250, 94260, 94350, 94360, 94370, 94375, 94400, 94620, 94621 |
| CT04281 | Blood Gases, Pulse Oximetry | 82800, 82803, 82805, 82810, 94760, 94761, 94762 |
| CT04282 | Chest X-Ray | 71010, 71015, 71020, 71021, 71022, 71023, 71030, 71034, 71035 |
| CT0429 | Other care – respiratory therapy | A7025, A7026, S5180, S5181 |
| CT0430 | Other care – respiratory – tracheostomy care | A4623, A4624, A4625, A4626, A4627, A4628, A4629, A7501, A7502, A7503, A7504, A7505, A7506, A7507, A7508, A7509 |
| CT0433 | Other care – respiratory – ventilator 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 |
| CT0435 | Other care – respiratory – equipment / supplies – ventilator | E0450, E0460, E0461, E0463, E0464 |
| CT04356 | Other diagnostic ultrasound | 37252, 37253 |
| CT0436 | Other care – respiratory – equipment / supplies – cpap | A7027, A7030, A7034, A7035, A7036, A7037, A7038, A7039, A7044, A7045, A7046, E0601 |
| CT0437 | Other care – respiratory – equipment / supplies – ippb | E0500 |
| CT0438 | Other care – respiratory – equipment / supplies – nebulizer | A7003, A7004, A7005, A7006, A7007, A7008, A7009, A7010, A7011, A7012, A7013, A7014, A7015, A7016, A7017, A7018, A7020, E0550, E0555, E0560, E0561, E0562, E0565, E0570, E0571, E0572, E0574, E0575, E0580, E0585, E1372, E1405, E1406 |
| CT0439 | Other care – respiratory – equipment / supplies – peak flow meter | S8096 |
| CT0440 | Other care – respiratory – equipment / supplies – spirometer | A9284 |
| CT0441 | Other care – respiratory – equipment / supplies – apnea monitor | A4556, A4557 |
| CT0442 | Other care – respiratory – equipment / supplies | A7028, A7029, A7031, A7032, A7033, A7040, A7041, A7042, A7043, E0445, E0455, E0457, E0459, E0470, E0471, E0472, E0480, E0481, E0482, E0483, E0484, E0485, E0486, E0487, E0600, E0605, E0606, E1353, E1354, E1355, E1356, E1357, E1358, E1399, K0195 |
| CT0443 | Other care – respiratory – other | 94002, 94003, 94004, 94453, 95012, A4604, A4606, A4611, A4612, A4613, A4614, A4615, A4616, A4617, A4619, A4620 |
| CT0444 | Other care – prevention – smoking cessation | S9453 |
| CT0445 | Imaging – ct – chest | 71250, 71260, 71270 |
| CT0446 | Imaging – cta – chest | 71275 |
| CT0447 | Imaging – mri – chest | 71550, 71551, 71552 |
| CT0448 | Imaging – mra – chest | 71555, C8909, C8910, C8911 |
| CT0449 | Imaging – nuclear – lung scan | 78580, 78584, 78585, 78586, 78587, 78588, 78591, 78593, 78594, 78596, 78599, A9536, A9558 |
| CT0453 | Tests – pulmonary – peak flow | S8110 |
| CT0458 | Tests – pulmonary – co diffusing capacity | 94720 |
| CT0461 | Tests – pulmonary – exhaled air analysis | 94680, 94681, 94690 |
| CT0463 | Tests – pulmonary – other | 94450, 94452, 94725, 94750, 94770 |
| CT05112 | Procedure – artery – extremity – angioplasty – transluminal / percutaneous | 75962, 75964 |
| CT05113 | Procedure – artery – extremity – atherectomy – transluminal / percutaneous | 75992, 75993 |
| CT05118 | Procedure – artery – nos – angioplasty / stenting | 37205, 75960 |
| CT05119 | Procedure – artery – nos – atherectomy – catheter | C1714, C1724 |
| CT05124 | Procedure – artery – nos – thrombolysis | 75896 |
| CT0513 | Procedure – pacemaker / defibrillator – transcutaneous pacing | 92953 |
| CT05133 | Procedure – artery / vein – nos – closure / closure device | C1760, G0269 |
| CT05134 | Procedure – artery / vein – nos – thrombectomy catheter | C1757 |
| CT05135 | Procedure – artery / vein – nos – other | 75961 |
| CT05141 | Procedure – graft | L8670 |
| CT05150 | Procedure – vein – vena cava – filter | 75940, C1880 |
| CT05159 | Procedure – vein – nos – angioplasty | 75978 |
| CT05163 | Procedure – vascular – occlusion / embolization – transcatheter | 75894 |
| CT05164 | Procedure – vascular – related supplies – angioplasty | C1885 |
| CT05165 | Procedure – vascular – related supplies – atherectomy | C1725 |
| CT05166 | Procedure – vascular – related supplies – graft material | C1768 |
| CT05167 | Procedure – vascular – related supplies – occlusion catheter | C2628 |
| CT05168 | Procedure – vascular – related supplies – embolization protective system | C1884 |
| CT05171 | Procedure – central venous catheter – insertion | 36556, 36561, S5522, S5523 |
| CT05172 | Procedure – central venous catheter – fluoroscopy – guidance | 77001 |
| CT05174 | Procedure – central venous catheter – repair / maintenance | 75901, 75902 |
| CT05176 | Procedure – peripheral venous catheter | 36000 |
| CT05184 | Procedure – vascular access – port / pump – insertion | C1772, C2626, E0782, E0783, E0786 |
| CT05190 | Procedure – anesthesia | 00530, 00534, 00537, 00560 |
| CT05192 | Therapy – cardiac rehab | S9472 |
| CT05193 | Rx – cardiovascular system – cardiac drugs | J1742, J2260 |
| CT05194 | Rx – cardiovascular system – cardiac glycosides | J1160 |
| 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 |
| CT05198 | Rx – cardiovascular system – vasodilating agents, nec | S9347 |
| 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, S0171, S9361 |
| CT05203 | Rx – diuretics, osmotic | J2150, J3350 |
| CT05204 | Rx – diuretics, thiazides / related | J1205 |
| CT05205 | Rx – diuretics – diuretic, carb anhydrase inhib | J1120 |
| CT05208 | Other care – other – pacemaker – monitor | E0610, E0615 |
| CT05209 | Other care – other – external defibrillator | E0617, K0606, K0607, K0608, K0609 |
| CT0521 | Procedure – pericardiocentesis | 76930 |
| CT05210 | Other care – other – pvd – compressor | E0675 |
| CT05211 | Other care – other – external counter pulsation | G0166 |
| CT05212 | Imaging – ct – aorta | G0288 |
| CT05213 | Imaging – ct – cardiac | 75571, 75572, 75573, S8092 |
| CT05214 | Imaging – cta – coronary | 75574 |
| CT05215 | Imaging – cta – aorta | 75635 |
| CT05216 | Imaging – us – intravascular | 75945, 75946, C1753 |
| CT05217 | Imaging – nuclear – venous thrombosis – scan | 78456, 78457, 78458 |
| CT05218 | Imaging – nuclear – venous thrombosis – radiopharmaceutical | A9504 |
| CT0522 | Procedure – biopsy – endocardium | 76932, 93505 |
| CT05220 | Imaging – arteriography – other | 75774, 75791 |
| CT0523 | Procedure – cardioversion | 92960, 92961 |
| CT05230 | Tests – cardiac stress tests – cardiac stress tests – other | 78459, 78491, 78492, 78499, S3904 |
| CT05231 | Tests – other cardiac scans – infarct scan | 78466, 78468, 78469 |
| CT05232 | Tests – other cardiac scans | 78414, 78428, 78445 |
| CT05233 | Tests – cardiac – ecg – ecg – 12 lead | R0076 |
| CT05234 | Tests – cardiac – ecg – other | 93025, 93278, S9025 |
| CT05236 | Tests – cardiac – ecg monitoring – event recorder | C1764, E0616 |
| CT05239 | Tests – cardiac – echo – intracardiac | C1759 |
| CT05240 | Tests – cardiac – echo – contrast agent | A9700, Q9955, Q9956 |
| CT05241 | Tests – cardiac – doppler | 93320, 93321, 93325 |
| CT05249 | Tests – cardiac – electrophysiology – tilt table evaluation | 93660 |
| CT0525 | Procedure – cardiac assist device – intra – aortic balloon | 33967, 33968, 33970, 33971, 33973, 33974 |
| CT05250 | Tests – cardiac – electrophysiology – other | 93615, 93616, 93662 |
| CT05251 | Tests – cardiac – electrophysiology – supplies – other | C1766, C1892, C1893, C2629, C2630 |
| CT05252 | Tests – cardiac – swan ganz | 93503 |
| CT05253 | Tests – cardiac – analysis – pace / defib | 93727 |
| CT05254 | Tests – cardiac – monitoring – chf | S9109 |
| CT05255 | Tests – cardiac – other | 93799, Q0035, S3902 |
| CT05256 | Tests – cardiac – radiopharmaceuticals | A9500, A9501, A9502, A9505, A9526, A9555 |
| CT05257 | Tests – vascular – arterial – extremity | 93922, 93923, 93924, 93925, 93926 |
| CT05258 | Tests – vascular – venous | 93965, 93970, 93971 |
| CT05259 | Tests – vascular – other | 93720, 93721, 93722, 93975, 93976, 93978, 93979, 93982 |
| CT0526 | Procedure – cardiac assist device – lvad | 33975, 33976, 33977, 33978, 33979, 33980, 33983, 93750, Q0480, Q0481, Q0482, Q0483, Q0484, Q0485, Q0486, Q0487, Q0488, Q0489, Q0490, Q0491, Q0492, Q0493, Q0494, Q0495, Q0496, Q0497, Q0498, Q0499, Q0500, Q0501, Q0502, Q0503, Q0504, Q0505, Q0506 |
| CT05260 | Tests – cardiovascular – other | 93701, 93740, 93760, 93762, 93770, 93784, 93786, 93788 |
| CT05262 | Electrophysiology Studies, Cryoablation | 93600, 93602, 93603, 93609, 93610, 93612, 93613, 93618, 93619, 93620, 93621, 93622, 93623, 93624, 93631, 93650, 93651, 93652 |
| CT0527 | Procedure – extracorporeal circulation | 33960, 33961, 36822, 92970, 92971 |
| CT05271 | Shock / Cardiac Arrest | 92950 |
| CT05305 | Pacemaker Defibrillator Check | 93279, 93281, 93282, 93283, 93284, 93285, 93286, 93287, 93288, 93289, 93290, 93291, 93292, 93293, 93294, 93295, 93296, 93297, 93298, 93299, 93640, 93641, 93642, 93724, 93731, 93732, 93733, 93734, 93735, 93736, 93741, 93742, 93743, 93744 |
| CT05306 | Heart Echo / Ultrasound | 93303, 93304, 93305, 93306, 93307, 93308, 93312, 93313, 93314, 93315, 93316, 93317, 93318, C8923, C8924, C8925, C8927, C8928, C8929, C8930, G8395 |
| CT05307 | Electrocardiogram – EKG monitoring | 0178T, 0179T, 0180T, 93000, 93005, 93010, 93012, 93014, 93040, 93041, 93042, 93224, 93225, 93226, 93227, 93228, 93229, 93230, 93231, 93232, 93233, 93235, 93236, 93237, 93268, 93270, 93271, 93272, G0403, G0404, G0405, S0345, S0346, S0347 |
| CT05308 | Cardiac Stress Test | 78451, 78452, 78453, 78454, 78460, 78461, 78464, 78465, 78472, 78473, 78478, 78480, 78481, 78483, 78494, 78496, 93015, 93016, 93017, 93018, 93350, 93351, 93352 |
| CT05309 | Cardiac cath & Angiogram | 75756, 92978, 92979, 93451, 93452, 93453, 93454, 93455, 93456, 93457, 93458, 93459, 93460, 93461, 93462, 93501, 93508, 93510, 93511, 93514, 93524, 93526, 93527, 93528, 93529, 93530, 93531, 93532, 93533, 93539, 93540, 93541, 93542, 93543, 93544, 93545, 93555, 93556, 93561, 93562, 93571, 93572 |
| CT05379 | Diagnostic ultrasound of heart (echocardiogram) | 0399T |
| CT05381 | Electrographic cardiac monitoring | 0417T, 0418T |
| CT05385 | Other diagnostic cardiovascular procedures | 93050 |
| CT0574 | Procedure – artery – abdomen – angioplasty – transluminal / percutaneous | 75968 |
| CT0576 | Procedure – artery – abdomen – atherectomy – transluminal / percutaneous | 75995, 75996 |
| CT0583 | Procedure – aorta – repair – aneurysm / dissection – endovascular | 75952 |
| CT0594 | Procedure – artery – iliac – repair / graft – endovascular | 75954 |
| CT06105 | Imaging – nuclear – shilling test – radiopharmaceutical | A9546, A9559 |
| CT06112 | Imaging – x-ray – upper gi – small bowel – contrast | 74355 |
| CT06114 | Imaging – x-ray – upper gi – other | 74340 |
| CT0612 | Procedure – esophageal / gastric intubation | 91000 |
| CT06120 | Tests – gi – duodeneal motility study | 91022 |
| CT06121 | Tests – gi – other dx | 82930 |
| CT06122 | Lab – gi – fat absorption | S3708 |
| CT0619 | Procedure – gastrostomy | 74350 |
| CT0667 | Procedure – other anal / rectal procedures – other procedures – rectum / anus | 91123 |
| CT0693 | Rx – gi – antichol/antispasmodics | J0500, J1980 |
| CT0694 | Rx – gi – antiemetics | J1240, J1626, J2405, J2469, J2550, J2765, J3250, J3280, J8501, S0091, S0174, S0181, S0183, S9351, S9370 |
| CT0695 | Rx – gi – h2 antagonists | J2780, S0023, S0028 |
| CT0696 | Rx – gi drug misc,nec | S0191 |
| CT0697 | Rx – gi – ppis | C9113, S0164 |
| CT0698 | Rx – diagnostic rx – gastric function | J2805, J2850 |
| CT0732 | Imaging – nuclear – hepatobiliary ductal scan – radiopharmaceutical | A9510, A9537 |
| CT08106 | Imaging – x-ray – other – joint survey | R0070 |
| CT08108 | Imaging – arteriography – extremities | 75710, G0278 |
| 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 |
| CT08122 | Orthotics – upper extremity | L3964, L3965, L3966, L3968, L3969, L3970, L3972, L3974 |
| CT0847 | Procedure – related supplies – graft – tendon repair | C9356 |
| CT0848 | Procedure – ortho – related supplies – other | C1754 |
| CT0851 | Therapy – chiropractic / osteopathic manipulation | 98940, 98941, 98942 |
| CT0857 | Rx – muscle relaxants – muscle relax, skeletal central | J0475, J0476, J2800, S9363 |
| CT0858 | Rx – muscle relaxants – muscle relax, skeletal, misc | J2360 |
| CT0859 | Rx – muscle relaxants – muscle relax, neuromusc block | J0330 |
| CT0872 | Imaging – mri – lower extremity | 73718 |
| CT0877 | Imaging – us – extremity | 76880 |
| CT0878 | Imaging – nuclear – other musculoskeletal | 78399 |
| CT0880 | Imaging – x-ray – ribs | 71100, 71101 |
| CT0942 | Procedure – suture – skin – repair of superficial wound | G0168 |
| CT0950 | Procedure – graft – skin – graft material | 1450F, 1451F, C9358, Q4100, Q4101, Q4102, Q4103, Q4104, Q4105, Q4106, Q4107, Q4108, Q4110, Q4111 |
| CT0952 | Procedure – debridement of nails | G0127 |
| CT0959 | Procedure – other non – or rx – other non – or skin procedures | 96999, 97602, S0630 |
| 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 | 97597, 97598, 97605, 97606, E0181, E0182, E0184, E0185, E0186, E0187, E0188, E0189, E0190, E0191, E0193, E0194, E0196, E0197, E0198, E0199, E0769, G0281, G0282, S9097 |
| CT0966 | Other care – wound care – hyperbaric oxygen | A4575 |
| CT0967 | Other care – wound care – electromagnetic therapy | G0295, G0329 |
| CT0968 | Other care – wound care – growth factor | S9055 |
| CT0969 | Other care – chronic edema – surgical stockings | A4490, A4495, A4500, A4510 |
| CT0970 | Other care – chronic edema – appliance – limb compression | A4600 |
| CT0971 | Other care – chronic edema – appliance – non – segmental | E0655, E0665, E0666 |
| CT0972 | Other care – chronic edema – appliance – segmental | E0656, E0657, E0660, E0667, E0668, E0669, E0671, E0672, E0673 |
| CT0973 | Other care – chronic edema – compression stocking | A6530, A6531, A6532, A6533, A6534, A6535, A6536, A6537, A6538, A6539, A6540, A6541, A6544, A6549 |
| CT0974 | Other care – chronic edema – compressor – non – segmental | E0650 |
| CT0975 | Other care – chronic edema – compressor – segmental | E0651, E0652 |
| CT0976 | Other care – chronic edema – compressor | E0676 |
| CT0993 | DME – wound therapy | E2402 |
| CT1011 | Rx – antidiabetic rx – insulins | J1815 |
| CT1013 | Rx – endocrine – other – parathyroid hormones | J0630 |
| CT1014 | Rx – endocrine – other – pituitary hormones | J0800, J0833, J0834, J2353, J2354, J2597, J2940, J2941, Q0139, Q0515, S9558 |
| CT1015 | Rx – endocrine – other – antigout rx | J0760 |
| 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, S0194 |
| 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, J3300, J3301, J3302, J3303, J7506, J7509, J7510, J8540, S9490 |
| CT10297 | High dose steroids | J1030, J1040, J2920, J2930, Q0138 |
| CT10298 | Anti-TNF agents | J1745 |
| CT1036 | Other care – nutrition – assessment | 97802, 97803, G0270, G0271 |
| CT1037 | Other care – nutrition – enteral – administration | S9340, S9341, S9342, S9343 |
| CT1038 | Other care – nutrition – enteral | B4034, B4035, B4036, B4081, B4100, B4104, B9998 |
| CT1039 | Other care – nutrition – enteral – tubing | B4082, B4083, B4087 |
| 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 |
| CT1045 | Other care – nutrition – parenteral – all – inclusive | S9364, S9365, S9366, S9367, S9368 |
| CT1046 | Other care – nutrition – education | S9452 |
| CT1047 | Other care – nutrition – medical food | S9433, S9434, S9435 |
| CT1048 | Other care – nutrition – counseling – dietician | S9470 |
| CT1049 | Other care – other – weight management | S9449 |
| 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 |
| CT1062 | Lab – endocrine | S3650, S3652 |
| CT1122 | Procedure – gu – other non – or rx | 74475, 74480, 74485 |
| CT1146 | Therapy – dialysis – supplies | A4932 |
| CT1147 | Therapy – neurostimulator – incontinence | E0740 |
| CT1148 | Rx – gu – other – bladder rx | J0520 |
| CT1150 | Imaging – nuclear – kidney – scan | 78700, 78701, 78707, 78708, 78709, 78710, 78725 |
| CT1151 | Imaging – nuclear – bladder / ureter | 78730, 78740 |
| CT1155 | Imaging – x-ray – urinary tract – cystography / voiding cystourethrogram | 74430, 74455 |
| CT1156 | Imaging – x-ray – urinary tract – other | 74450, 74470 |
| CT1157 | Imaging – arteriography – renal | G0275 |
| CT1159 | Tests – gu – post void residual / bladder capacity | 51798 |
| CT1164 | Tests – gu – urodynamics – voiding pressure | 51795 |
| CT1166 | Lab – urinalysis | 81007, 81015, 81020, 81050, 81099 |
| CT1167 | Lab – specimen collection – urine | P9612, P9615 |
| CT1168 | Prosthetics – implant | L8604 |
| CT14388 | Magnetic resonance imaging | 75558, 75560, 75562, 75564 |
| CT1615 | Therapy – transfusion – administration | 36430 |
| CT1616 | Therapy – transfusion – blood | P9010, P9011, P9016, P9021, P9022, P9038, P9039, P9040, P9051, P9054, P9056, P9057, P9058, S9538 |
| 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 |
| CT1621 | Therapy – apheresis | S2120 |
| CT1622 | Rx – immune system – interferons | J1830, Q3025, Q3026, S0145, S9559 |
| CT1625 | Rx – immune system – dmard / related | J0718, 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, J2796, J2820, Q4081, S9537 |
| 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 |
| CT16298 | Finger stick | 36416, 82948, 88720 |
| CT16299 | Bleeding Status | 3555F, 85002, 85345, 85347, 85348, 85598, 85610, 85611, 85670, 85675, 85705, 85730, 85732, 99363, 99364, G0248, G0250, S9401 |
| CT1630 | Rx – coagulation system – anticoagulants | C9121, J0583, J1644, J1645, J1650, J1652, J1655, J1945, J7197, S9336, S9372 |
| CT1631 | Rx – coagulation system – antiheparin agnt | J2720 |
| CT1632 | Rx – coagulation system – hemostatics | J0365, J7185, J7186, J7189, J7190, J7191, J7192, J7193, J7194, J7195, J7196, J7198, J7199, P9012, S0017 |
| CT1633 | Rx – coagulation system – thrombolytic rx | J0350, J2993, J2995, J2997, J3101, 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, J1162, J1459, J1460, J1560, J1561, J1562, J1566, J1568, J1569, J1571, J1572, J1573, J1670, J2788, J2790, J2791, J2792, J7504 |
| CT1636 | Rx – serums, toxoids, vaccines – toxins | J0585, J0586, 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, 96523, 99601, 99602, A4220, A4221, A4222, A4223, A4305, A4306, E0776, E0779, E0780, E0781, K0552, K0601, K0602, K0603, K0604, K0605, S1015, S1016, S5035, S5036, S5497, S5498, S5501, S5502, S5517, S5518, S5520, S5521, S9379, S9542, S9810 |
| CT1640 | Imaging – nuclear – red cell survival | 78130, 78135 |
| CT1642 | Imaging – nuclear – platelet kinetics | 78190, 78191 |
| CT1643 | Imaging – nuclear – other blood / related | 78140, 78199 |
| 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, G0249 |
| CT1647 | Lab – hematology – blood count | 85055 |
| CT1648 | Lab – hematology – blood count – eosinophil count | S3630 |
| CT1649 | Lab – other hematology | 85097, 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 |
| CT17101 | IMMUNOTHERAPY | S9338 |
| CT1805 | Rx – antibiotics / antivirals / antifungals – infusion | S9345, S9494, S9497, S9500, S9501, S9502, S9503, S9504 |
| 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, S9562 |
| CT1818 | Rx – antifungals | J0285, J0287, J0288, J0289, J0637, J1450, J1835 |
| CT1820 | Other care – other – infection control | S8301 |
| 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, S3645 |
| 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 |
| 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 |
| CT1903 | Therapy – behavior – medication management | M0064 |
| CT1905 | Therapy – behavior – partial hospitalization | S0201 |
| CT1907 | Tests – neuro – sleep studies | 95803, 95805, 95806, 95807, 95808, 95810, 95811, G0398, G0399, G0400 |
| 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, S9454, S9482, T2034 |
| CT19378 | Laboratory – Chemistry and Hematology | 83987, G0435 |
| CT19381 | Smoking / Tobacco Cessation | 99406, 99407 |
| CT19382 | High Risk Behavior Screening | 4293F |
| CT19383 | Sexual Behavior Counseling | G0445 |
| CT19384 | Peer Services | H0038 |
| CT2004 | Lab – chemistry | 82055 |
| 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, G0432, G0433, G0442, G0443, G9621, G9622, H0001, H0003, H0049, H0050, T1006 |
| CT20376 | Other Laboratory | G9143, S3713, S3865, S3866, S3870 |
| 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 |
| CT2301 | Therapy – allergy treatment | 95115, 95117, 95120, 95125, 95130, 95131, 95132, 95133, 95134, 95144, 95145, 95146, 95147, 95148, 95149, 95165, 95170, 95180, 95199 |
| CT2302 | Therapy – behavior – other | H2000, H2033, T2036, T2037 |
| CT2304 | Therapy – pt – exercises / activities | 97537, 97542 |
| CT2305 | Therapy – pt – modalities | G0283, S8948 |
| CT2308 | Therapy – biofeedback | 90901, E0746 |
| CT2309 | Therapy – activity therapy | H2032 |
| CT2311 | Therapy – vaccination – mmr / related | 90704, 90705, 90706, 90707, 90708, 90710 |
| CT2312 | Therapy – vaccination – dtp / related | 90696, 90698, 90700, 90701, 90702, 90703, 90718, 90719, 90720, 90721, 90723, 90749 |
| CT2313 | Therapy – vaccination – hib vaccine | 90645, 90646, 90647, 90648 |
| CT2314 | Therapy – vaccination – hepatitis a vaccine | 90632, 90633, 90634, 90636 |
| CT2315 | Therapy – vaccination – hepatitis b | 90740, 90743, 90746, 90747, 90748 |
| CT2316 | Therapy – vaccination – poliovirus vaccine | 90712, 90713 |
| CT2317 | Therapy – vaccination – chicken pox | 90716 |
| CT2319 | Therapy – vaccination – other vaccine | 90476, 90477, 90581, 90585, 90665, 90675, 90676, 90680, 90690, 90691, 90692, 90693, 90714, 90715, 90717, 90725, 90727, 90733, 90734, 90735, 90736 |
| CT2320 | Therapy – vaccination – vaccine administration | 90465, 90466, 90467, 90468, 90472, 90473, 90474 |
| CT2326 | Other care – bladder / bowel care – other supplies | A4310, A4320, A4321, A4322, A4330, A4331, A4332, A4333, A4334, A4335, A4336, 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 | A4360, A4520, A4554, T4521, T4522, T4523, T4524, T4525, T4526, T4527, T4528, T4529, T4530, T4531, T4532, T4533, T4534, T4535, T4536, T4537, T4538, T4539, T4540, T4541, T4542, T4543 |
| CT2330 | Other care – bladder / bowel care – other supplies – skin barrier | A5120, A5121, A5122, A5126, A5131, A5200 |
| CT23307 | Vaccine for flu or Pneumonia | 90654, 90655, 90656, 90657, 90658, 90660, 90661, 90662, 90663, 90664, 90666, 90667, 90668, 90669, 90670, 90732, G0008, G0009, G9141, G9142, Q2035, Q2036, Q2037, Q2038, Q2039, S0195 |
| CT23309 | Markers for Inflammation | 85651, 85652, 86140, 86141 |
| CT2331 | Other care – observation | G0379 |
| CT23311 | Current Tobacco / Cigarette Smoker | G8455 |
| CT2338 | Other care – other – education | S9445, S9446 |
| CT23393 | Prophylactic vaccinations and inoculations | 90284, 90681, 90697, 90738 |
| CT23398 | Ancillary Services | 99415, 99416, G9473, G9474, G9475, G9476, G9477, G9478, G9479 |
| CT23400 | HPV VACCINE | 90649, 90650 |
| CT2341 | Other care – other – exercise classes | S9451 |
| CT2342 | Tests – allergy tests – percutaneous | 95004, 95010 |
| CT2343 | Tests – allergy tests – intradermal | 95015, 95024, 95027, 95028 |
| CT2344 | Tests – allergy tests – patch | 95044 |
| CT2345 | Tests – allergy tests – other | 95052, 95056, 95070, 95071, 95075 |
| 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, E0955, E0956, E0957, E0958, E0959, E0960, E0961, E0966, E0967, E0968, E0969, E0970, E0971, E0973, E0974, E0978, E0980, E0981, E0982, E0983, E0984, E0985, E0986, E0990, E0992, E0994, E0995, E1002, E1003, E1004, E1005, E1006, E1007, E1008, E1009, E1010, E1011, E1014, E1015, E1016, E1017, E1018, E1020, E1028, E1029, E1030, E1031, E1035, E1037, E1038, E1039, E1050, E1060, E1070, E1083, E1084, E1085, E1086, E1087, E1088, E1089, E1090, E1092, E1093, E1100, E1110, E1130, E1140, E1150, E1160, E1161, E1170, E1171, E1172, E1180, E1190, E1195, E1200, E1220, E1221, E1222, E1223, E1224, E1225, E1226, E1227, E1228, E1229, E1230, E1231, E1232, E1233, E1234, E1235, E1236, E1237, E1238, E1239, E1240, E1250, E1260, E1270, E1280, E1285, E1290, E1295, E1296, E1297, E1298, E2201, E2202, E2203, E2204, E2205, E2206, E2207, E2208, E2209, E2210, E2211, E2212, E2213, E2214, E2215, E2216, E2217, E2218, E2219, E2220, E2221, E2222, E2224, E2225, E2226, E2227, E2228, E2230, E2231, E2291, E2292, E2293, E2294, E2295, E2300, E2301, E2310, E2311, E2312, E2313, E2321, E2322, E2323, E2324, E2325, E2326, E2327, E2328, E2329, E2330, E2331, E2340, E2341, E2342, E2343, E2351, E2360, E2361, E2362, E2363, E2364, E2365, E2366, E2367, E2368, E2369, E2370, E2371, E2372, E2373, E2374, E2375, E2376, E2377, E2381, E2382, E2383, E2384, E2385, E2386, E2387, E2388, E2389, E2390, E2391, E2392, E2394, E2395, E2396, E2397, E2601, E2602, E2603, E2604, E2605, E2606, E2607, E2608, E2609, E2610, E2611, E2612, E2613, E2614, E2615, E2616, E2617, E2619, E2620, E2621, K0001, K0002, K0003, K0004, K0005, K0006, K0007, K0009, K0010, K0011, K0012, K0014, K0015, K0017, K0018, K0019, K0020, K0037, K0038, K0039, K0040, K0041, K0042, K0043, K0044, K0045, K0046, K0047, K0050, K0051, K0052, K0053, K0056, K0065, K0069, K0070, K0071, K0072, K0073, K0077, K0098, K0105, K0108, K0669, K0733, K0800, K0801, K0802, K0806, K0807, K0808, K0812, K0813, K0814, K0815, K0816, K0820, K0821, K0822, K0823, K0824, K0825, K0826, K0827, K0828, K0829, K0830, K0831, K0835, K0836, K0837, K0838, K0839, K0840, K0841, K0842, K0843, K0848, K0849, K0850, K0851, K0852, K0853, K0854, K0855, K0856, K0857, K0858, K0859, K0860, K0861, K0862, K0863, K0864, K0868, K0869, K0870, K0871, K0877, K0878, K0879, K0880, K0884, K0885, K0886, K0890, K0891, K0898, K0899 |
| CT2353 | DME – patient lifts | E0621, E0625, E0627, E0628, E0629, E0630, E0635, E0636, E0637, E0638, E0639, E0640, E0641, E0642 |
| CT9902 | E & M – consultation | Q3014, T1014 |
| CT9903 | E & M – hospital | 99217, 99218, 99219, 99220, 99231, 99232, 99233, 99234, 99235, 99236, 99291, 99292, 99293, 99294, 99466, 99471, 99472, 99481, 99482, G0378, G0390, S0310 |
| CT9904 | E & M – emergency care | 99058, 99281, 99282, 99283, 99284, 99285, G0380, G0381, G0382, G0383, G0384, S9083, S9088 |
| CT9905 | E & M – home visit | 99224, 99225, 99226, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, S0273 |
| 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, S0302 |
| CT9908 | E & M – other | 96040, 99026, 99027, 99056, 99060, 99150, 99288, 99289, 99290, 99360, 99450, 99455, 99456, 99485, 99486, 99488, S0260, S0265 |
| CT9909 | Procedure – maintenance – cns / spinal pump / port | 95991 |
| CT9910 | Procedure – anesthesia | 00300, 01996, 99100, 99116, 99135, 99140 |
| CT99101 | Other care – other – lead assessment | T1029 |
| CT99102 | Other care – other | H0043, H0044, S1001, S1002, S9988, S9989, S9990, S9991, S9999, T2025, T2035, T2038, T2040, T2041 |
| CT99103 | Imaging – ct – follow – up | 76380 |
| CT99104 | Imaging – ct – other | 76497 |
| CT99105 | Imaging – ct – guidance | 77012 |
| CT99107 | Imaging – mri – other | 75552, 75553, 75554, 75555, 75556, 75557, 75559, 75561, 75563, 75565, 76498, C1770, S8042 |
| CT99108 | Imaging – mri – guidance | 77021 |
| CT99109 | Imaging – mri – contrast agent | A9576, A9577, A9578, A9579, A9581, A9583, Q9953, Q9954 |
| CT9911 | Procedure – sedation | 99143, 99144, 99145, 99148, 99149 |
| CT99110 | Imaging – us – head / neck | 76506 |
| CT99111 | Imaging – us – retroperitoneum | 76770, 76775, G0389 |
| CT99113 | Imaging – us – guide – biopsy | 76942 |
| CT99114 | Imaging – us – guide – other | 76936, 76937, 76940, 76998 |
| CT99115 | Imaging – us – other | 76604, 76970 |
| CT99117 | Imaging – nuclear – bone scan – radiopharmaceutical | A9503, A9561 |
| CT99118 | Imaging – nuclear – blood / plasma volume – scan | 78110, 78111, 78120, 78121, 78122 |
| CT99119 | Imaging – nuclear – blood / plasma volume – radiopharmaceutical | A9508, A9524, A9532 |
| CT9912 | Procedure – anesthesia – related supplies | A4618 |
| CT99120 | Imaging – nuclear – lymphatics | 78195 |
| CT99121 | Imaging – nuclear – brain – radiopharmaceutical | A9557 |
| CT99122 | Imaging – nuclear – csf – radiopharmaceutical | A9548 |
| CT99123 | Imaging – nuclear – kidney – radiopharmaceutical | A9539, A9551, A9554, A9562, A9567 |
| CT99125 | Imaging – nuclear – localization of inflammation | 78805, 78806, 78807 |
| CT99127 | Imaging – nuclear – other – automated data add – on | 78890, 78891 |
| CT99128 | Imaging – nuclear – other | 78660, 78699, 78799, 78808, 78999 |
| 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, A9582 |
| CT99130 | Imaging – pet – other | A9552, A9580, G0235, S8085 |
| CT99131 | Imaging – venography – other | 75893 |
| CT99133 | Imaging – other imaging – fluoroscopy | 76000, 76001, 76496, 93280 |
| CT99134 | Imaging – other imaging – fluoroscopy – guidance | 77002, 77003 |
| CT99136 | Imaging – other imaging | 75809, 75900, 76100, 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 | 75898, 75970, 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 |
| CT99141 | Imaging – supplies – ultrasound related | A4559 |
| CT99142 | Lab – pathology consultation | 80500, 80502 |
| CT99143 | Lab – chemistry | 82000, 82003, 82013, 82016, 82017, 82024, 82030, 82045, 82085, 82088, 82101, 82103, 82104, 82105, 82106, 82107, 82108, 82120, 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, 82273, 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, 82731, 82735, 82742, 82746, 82747, 82757, 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, 83001, 83002, 83003, 83008, 83009, 83010, 83012, 83013, 83014, 83015, 83018, 83020, 83021, 83026, 83030, 83033, 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, 83661, 83662, 83663, 83664, 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, 84163, 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, 84702, 84703, 84704, 84830, 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, 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, 89125, 89160, 89190, 89220, 89225, 89230, 89235, 89240 |
| CT99166 | Lab – genetic testing – cardiac ion channel syndrome | S3860, S3862 |
| CT99167 | Lab – genetic testing – brugada syndrome | S3861 |
| CT99168 | Lab – chemistry and toxicology tests | P2028, P2029, P2031, P2033, P2038 |
| CT99169 | Lab – specimen collection – blood – venous – venipuncture | 36410, 36415, S9529 |
| CT9917 | Procedure – related supplies – access catheter | A4300, A4301 |
| CT99171 | Lab – specimen collection – blood – venous – venous port | 36591 |
| CT99172 | Lab – specimen collection – blood – arterial – arterial puncture | 36600 |
| CT99173 | Lab – specimen collection – specimen handling | 99000 |
| CT99174 | Lab – microscopic – wet mount | Q0111 |
| CT99175 | Lab – microscopic – koh prep | Q0112 |
| CT99176 | Lab – stat request | S3600, S3601 |
| CT9918 | Procedure – related supplies – ablation – catheter | Q4116 |
| CT99182 | Transportation – paramedic | S0207, S0208 |
| 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, S0209, S0215, S9992, T2001, T2002, T2003, T2004, T2005, T2007, T2049 |
| CT99184 | DME – other | A4639, A4640, A9281, A9283, A9300, A9900, A9901, A9999, S9381, T1999, T2029, T2039, T5999 |
| 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 |
| CT99190 | DME – repair / maintenance | K0739 |
| CT99191 | Supplies | A4206, A4207, A4208, A4209, A4210, A4211, A4212, A4213, A4215, A4216, A4217, A4218, A4244, A4245, A4246, A4247, A4265, A4450, A4452, A4455, A4456, 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, C1894, C9898, J1642, T2028 |
| CT99195 | Prosthetics – other | K0462 |
| CT99197 | Other – non – covered | A9270, G0293, G0294, S9986 |
| CT99198 | PQRI | G8396, G8417, G8418, G8419, G8420, G8421, G8422, G8427, G8428, G8430, G8440, G8441, G8442, G8447, G8448, G8470, G8471, G8473, G8474, G8475, G8476, G8477, G8478, G8506, G8508, G8509, G8524, G8525, G8526, G8530, G8531, G8532, G8534, G8535, G8536, G8537, G8538, G8539, G8540, G8541, G8542, G8543, G9016, G9019, G9020, G9033, G9035, G9036, G9140 |
| CT9920 | Procedure – related supplies – catheter | C1758, C1887, C2627 |
| CT9921 | Procedure – related supplies – dilation / stenting | C1876, C1877 |
| CT9922 | Procedure – related supplies – drainage | C1729 |
| CT9923 | Procedure – related supplies – graft / repair | C1762, C1763, C1771, C1817, C9354, Q4112, Q4113, Q4114, Q4115 |
| CT9924 | Procedure – related supplies – implant | C9899 |
| CT9925 | Procedure – related supplies – resection – morcellator | C1782 |
| CT9926 | Procedure – related supplies – retrieval – device | C1773 |
| CT9927 | Procedure – related supplies – other | C1765, C9250, C9359, C9360, C9361, C9363, C9364, Q9968 |
| CT9928 | Therapy – acupuncture | 97810, 97811, 97813, 97814 |
| CT9929 | Therapy – rehabilitation | H2001 |
| CT9930 | Therapy – habilitation | T2013, T2014, T2015, T2016, T2017, T2018, T2019, T2020, T2021 |
| CT99309 | Physician Services | 99251 |
| CT9931 | Therapy – rehabilitation – other | G0409 |
| CT99311 | Urine Protein | 81000, 81001, 81002, 81003, 81005, 82042, 82043, 82044 |
| CT99312 | HbA1C | 83036, 83037 |
| CT99316 | Physician Services – Inpatient | 99356, 99357 |
| 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 |
| CT9938 | Therapy – neurostimulator – tens – supplies | A4558 |
| CT9939 | Therapy – neurostimulator – other | A4630, E0745 |
| CT99392 | Other diagnostic procedures (interview, evaluation, consultation) | 0074T, 0144T, 0145T, 0146T, 0147T, 0148T, 0149T, 0150T, 0188T, 0189T, 0203T, 0204T, G0436, G0437, G0438, G0439, G0446, G0447, G0454, G9156, Q5010, S9110 |
| CT9940 | Therapy – other | 99024, E0761, M0075, M0300, S9355 |
| 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 | 0513F, 0518F, 0557F, 4050F, 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 |
| CT99407 | Case Management Services – Oncology | S0353, S0354 |
| 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 |
| CT99415 | Physician Services – Outpatient | 99358, 99359 |
| CT99416 | Procedures and Reporting | 99080, 99090, 99091 |
| CT99417 | Risk Assessment | G9316 |
| CT99418 | Transitional Care Management | 99495, 99496 |
| CT99419 | Wellness Assessment | S5190 |
| CT9942 | Rx – gi – antichol/antispasmodics | J0461 |
| CT99420 | LEAD SCREENING | 83655 |
| CT9943 | Rx – autonomic rx – parasympathomimetics | J2710, S0014 |
| CT9944 | Rx – autonomic rx – sympathomimetic rx | J0170, J0380, J0395, J1250, J1265, J3105, S9348 |
| CT9945 | Rx – autonomic rx – nicotine preps | S4990, S4991, S4995 |
| 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, S5012 |
| CT9951 | Rx – electrolytic, caloric, water – multi-mineral prep | J7120, S5014 |
| 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, S5010, S5011, S5013 |
| CT9956 | Rx – electrolytic, caloric, water – hydration – unspecified | 90760, 90761, S9373, S9374, S9375, S9376, S9377 |
| CT9957 | Rx – miscellaneous rx | 90287, 90288, 90393, A9150, C9248, C9399, J0348, J0795, J0878, J0894, J1212, J1267, J1436, J1453, J1457, J1458, J1595, J1740, J1743, J1930, J2248, J2278, J2323, J2425, J2503, J2513, J2724, J2730, J2778, J2785, J3110, J3243, J3490, J3530, J3535, J3570, J3590, J7187, J7321, J7323, J7324, J7325, J7505, J7599, J7799, J8499, J8650, Q2004, Q4074, Q4082, S0190, S5000, S5001, T1502 |
| CT9958 | Rx – miscellaneous rx – enzymes | J0180, J0205, J0220, J1931, J2504, J3470, J3471, J3472, J3473, S9357 |
| 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 |
| CT9962 | Rx – other | J0598, S9346, T1503 |
| CT9963 | Rx – pharmacy fee | Q0513, Q0514, S9430 |
| CT9964 | Other care – home care – specialized visit | 99507, 99509, 99510, 99511, 99600 |
| CT9965 | Other care – home care – physician supervision | G0372, S0270, S0272 |
| CT9966 | Other care – home care – nursing care | G0128, T1000, T1002, T1003, T1004 |
| CT9967 | Other care – home care – nursing care – rn | G0154, S9123, T1030 |
| CT9968 | Other care – home care – nursing care – lpn | S9124, T1031 |
| CT9969 | Other care – home care – nursing care – np | S0274 |
| CT9970 | Other care – home care – rehabilitation – physical therapy | G0151, G0157, G0158 |
| CT9971 | Other care – home care – rehabilitation – occupational therapy | G0152 |
| CT9972 | Other care – home care – rehabilitation – speech therapy | S9128 |
| CT9973 | Other care – home care – social worker | G0155, S9127 |
| CT9974 | Other care – home care – home health aide | G0156, S9122, T1021 |
| CT9975 | Other care – home care – other care – day care | S5100, S5101, S5102, S5105 |
| CT9976 | Other care – home care – other care – chore care | S5120, S5121 |
| CT9977 | Other care – home care – other care – attendant care | S5125, S5126 |
| CT9978 | Other care – home care – other care – homemaker | S5130, S5131 |
| CT9979 | Other care – home care – other care – companion care | S5135, S5136 |
| CT9980 | Other care – home care – other care – respite care | S5150, S5151, S9125, T1005 |
| CT9981 | Other care – home care – other care | S5165, S5175, S5185, S5199, T1022 |
| CT9982 | Other care – home care – training | S5108, S5109, S5110, S5111, S5115, S5116 |
| CT9983 | Other care – home care – emergency response system | S5160, S5161, S5162 |
| CT9984 | Other care – home care – meals | S5170 |
| CT9985 | Other care – pain management – pca / related | S9325, S9326, S9327, S9328 |
| CT9986 | Other care – hospice | G0337, Q5001, Q5002, Q5003, Q5004, Q5005, Q5006, Q5007, Q5008, Q5009, S0271, S9126, T2042, T2043, T2044, T2045, T2046 |
| CT9987 | Other care – long term care – residential care | T2010, T2011, T2032, T2033 |
| CT9988 | Other care – long term care – assisted living | T2030, T2031 |
| CT9990 | Other care – other – ancillary services | 97804, 99001, 99002, 99070, 99071, 99075, 99082, 99199 |
| CT9995 | Other care – other – irrigation | S9590 |
| CT9996 | Other care – other – lodging | S9976, S9994 |
| CT9997 | Other care – other – meals | S9977, S9996 |
| CT9998 | Other care – other – medical records | S9981, S9982 |
| XX0000 | Ungrouped Codes | 0001F, 0002M, 0003M, 0151T, 0408T, 0409T, 0410T, 0411T, 0412T, 0413T, 0414T, 0415T, 0416T, 0555F, 1000F, 1002F, 3019F, 3130F, 33952, 33954, 33958, 33962, 33966, 33981, 33982, 33984, 37191, 37192, 37193, 37619, 4002F, 4008F, 4010F, 4019F, 4450F, 4470F, 4480F, 4481F, 6030F, 7010F, 80104, 80163, 81410, 81411, 83861, 84112, 84515, 86244, 86481, 86699, 86700, 86902, 90769, 90770, 90771, 90776, 93260, 93355, 93463, 93464, 93563, 93564, 93565, 93566, 93567, 93568, 94011, 94012, 94013, 96360, 99052, 99054, 99151, C9443, C9444, C9446, C9741, C9801, C9802, E1352, G0299, G0300, G0344, G0434, G0449, G0459, G0466, G0467, G0468, G0469, G0470, G0472, G0473, G8029, G8032, G8033, G8034, G8035, G8036, G8037, G8038, G8039, G8040, G8041, G8155, G8156, G8157, G8182, G8183, G8184, G8214, G8217, G8219, G8220, G8221, G8223, G8548, G8569, G8570, G8571, G8572, G8573, G8574, G8575, G8576, G8577, G8578, G8579, G8580, G8581, G8582, G8583, G8584, G8585, G8586, G8587, G8588, G8589, G8590, G8591, G8592, G8593, G8594, G8595, G8596, G8597, G8598, G8599, G8600, G8601, G8602, G8603, G8604, G8605, G8606, G8607, G8608, G8609, G8610, G8611, G8612, G8613, G8614, G8615, G8616, G8617, G8618, G8619, G8620, G8621, G8622, G8623, G8624, G8625, G8626, G8627, G8628, G8629, G8630, G8631, G8632, G8633, G8634, G8635, G8636, G8637, G8638, G8639, G8640, G8641, G8642, G8643, G8644, G8675, G8676, G8677, G8678, G8679, G8680, G8681, G8682, G8683, G8684, G8685, G8687, G8689, G8691, G8693, G8695, G8696, G8697, G8698, G8739, G8740, G8790, G8791, G8792, G8793, G8794, G8795, G8800, G8801, G8935, G8936, G8937, G8943, G8955, G8958, G8967, G8968, G8969, G8970, G8971, G8972, G9157, G9199, G9200, G9201, G9410, G9411, G9412, G9413, G9459, G9460, G9500, G9501, G9507, G9508, G9539, G9541, G9542, G9543, G9544, G9558, G9559, G9560, G9642, G9662, G9663, G9664, G9665, G9666, G9667, G9668, G9669, G9670, G9673, G9674, G9675, G9677, J0153, Q0507, Q0508, Q0509, S9901 |
Table 6: Relevant Typical Drug Groups
| Group ID | Group Name |
| RX001 | contrast media |
| RX002 | diagnostic agents |
| RX016 | antimigraine preparations |
| RX017 | hypnotics and sedatives |
| RX0320 | cough and cold preparations |
| RX0321 | decongestants and other nasal preparations for topical use |
| 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 |
| RX0532 | antiarrhythmics class i and iii |
| RX0533 | antiarrhythmics class 1c |
| RX0534 | Other Anticoagulants |
| RX0535 | beta blocking agents |
| RX0536 | calcium channel blockers |
| RX0537 | cardiac glycosides and cardiac stimulants |
| RX0538 | diuretics |
| RX0539 | i.v. solutions & additives |
| RX0540 | Nitrates and other antianginals |
| RX0541 | other antihypertensives |
| RX0542 | other cardiac preparations |
| RX0543 | peripheral vasodilators |
| RX0544 | statins and lipid modifying agents |
| RX0545 | Pulm hypertension drugs |
| 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 |
| RX0857 | antiinflammatory and antirheumatic products |
| 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 |
| RX1083 | antithyroid preparations |
| RX1086 | corticosteroids for systemic use |
| RX1089 | drugs used in diabetes |
| RX1091 | drugs to treat hypoglycemia |
| RX1092 | thyroid preparations |
| RX1093 | insulin |
| RX1194 | urinary antiinfectives and antiseptics |
| RX1196 | Phosphorus and potassium binding agents |
| RX13104 | Gynecological antiinfectives and antiseptics |
| RX16106 | iron preparations |
| RX16108 | other hematological agents |
| RX16109 | vitamin b12 and folic acid |
| RX16110 | vitamin k and other hemostatics |
| RX16111 | Agents to stop bleeding |
| RX16112 | Blood stimulating agents Erythropoietin |
| RX18117 | antibacterials for systemic use |
| RX18118 | antifungals for systemic use |
| RX18119 | antiinfectives |
| RX18122 | antivirals for systemic use |
| RX19123 | antidepressants |
| RX19125 | anxiolytics |
| RX19126 | drugs used in addictive disorders |
| RX23131 | mineral supplements |
| RX23133 | other nutrients |
| RX23135 | vitamins |
| RX23136 | Smoking Cessation Agents |
| RX99137 | anesthetics local |