HCPCS Index 2017

Occipitalmandibular support, cervical,   L0160
Ocriplasmin,   J7316
Octafluoropropane,   Q9956
Octagam,   J1568
Octreotide acetate,   J2353, J2354
Ocular prosthetic implant,   L8610
Ofatumumab,   J9302
Olanzapine,   J2358
Omacetaxine Mepesuccinate,   J9262
Omalizumab,   J2357
OnabotulinumtoxinA,   J0585
Ondansetron HCl,   J2405
Ondansetron oral,   Q0162
One arm, drive attachment,   K010
Oprelvekin,   J2355
O P supplyaccessoryservice,   L9900
Oral deviceappliance,   E0485 - E0486
Oral deviceappliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment   E0485
Oral deviceappliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment   E0486
Oral interface,   A7047
Oralnasal mask,   A7027
nasal pillows,   A7029
oral cushion,   A7028
Oropharyngeal suction catheter,   A4628
Orphenadrine,   J2360
arch support,   L3040 - L3100
Foot, arch support, non-removable attached to shoe, longitudinal, each   L3070
Foot, arch support, removable, premolded, longitudinal, each   L3040
Foot, arch support, non-removable attached to shoe, metatarsal, each   L3080
Foot, arch support, removable, premolded, metatarsal, each   L3050
Foot, arch support, removable, premolded, longitudinal metatarsal, each   L3060
Foot, arch support, non-removable attached to shoe, longitudinalmetatarsal, each   L3090
Hallus-valgus night dynamic splint   L3100
footwear,   L3201 - L3265
Orthopedic shoe, oxford with supinator or pronator, infant   L3201
Orthopedic shoe, oxford with supinator or pronator, child   L3202
Orthopedic shoe, oxford with supinator or pronator, junior   L3203
Orthopedic shoe, hightop with supinator or pronator, infant   L3204
Orthopedic shoe, hightop with supinator or pronator, child   L3206
Orthopedic shoe, hightop with supinator or pronator, junior   L3207
Surgical boot, each, infant   L3208
Surgical boot, each, child   L3209
Surgical boot, each, junior   L3211
Benesch boot, pair, infant   L3212
Benesch boot, pair, child   L3213
Benesch boot, pair, junior   L3214
Orthopedic footwear, ladies shoe, oxford, each   L3215
Orthopedic footwear, ladies shoe, depth inlay, each   L3216
Orthopedic footwear, ladies shoe, hightop, depth inlay, each   L3217
Orthopedic footwear, mens shoe, oxford, each   L3219
Orthopedic footwear, mens shoe, depth inlay, each   L3221
Orthopedic footwear, mens shoe, hightop, depth inlay, each   L3222
Orthopedic footwear, woman's shoe, oxford, used as an integral part of a brace (orthosis)   L3224
Orthopedic footwear, man's shoe, oxford, used as an integral part of a brace (orthosis)   L3225
Orthopedic footwear, custom shoe, depth inlay, each   L3230
Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each   L3250
Foot, shoe molded to patient model, silicone shoe, each   L3251
Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each   L3252
Foot, molded shoe plastazote (or similar) custom fitted, each   L3253
Non-standard size or width   L3254
Non-standard size or length   L3255
Orthopedic footwear, additional charge for split size   L3257
Surgical bootshoe, each   L3260
Plastazote sandal, each   L3265
insert,   L3000 - L3030
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each   L3000
Foot, insert, removable, molded to patient model, spenco, each   L3001
Foot, insert, removable, molded to patient model, plastazote or equal, each   L3002
Foot, insert, removable, molded to patient model, silicone gel, each   L3003
Foot, insert, removable, molded to patient model, longitudinal arch support, each   L3010
Foot, insert, removable, molded to patient model, longitudinal metatarsal support, each   L3020
Foot, insert, removable, formed to patient foot, each   L3030
lift,   L3300 - L3334
Lift, elevation, heel, tapered to metatarsals, per inch   L3300
Lift, elevation, heel and sole, neoprene, per inch   L3310
Lift, elevation, heel and sole, cork, per inch   L3320
Lift, elevation, metal extension (skate)   L3330
Lift, elevation, inside shoe, tapered, up to one-half inch   L3332
Lift, elevation, heel, per inch   L3334
miscellaneous additions,   L3500 - L3595
Orthopedic shoe addition, insole, leather   L3500
Orthopedic shoe addition, insole, rubber   L3510
Orthopedic shoe addition, insole, felt covered with leather   L3520
Orthopedic shoe addition, sole, half   L3530
Orthopedic shoe addition, sole, full   L3540
Orthopedic shoe addition, toe tap standard   L3550
Orthopedic shoe addition, toe tap, horseshoe   L3560
Orthopedic shoe addition, special extension to instep (leather with eyelets)   L3570
Orthopedic shoe addition, convert instep to velcro closure   L3580
Orthopedic shoe addition, convert firm shoe counter to soft counter   L3590
Orthopedic shoe addition, march bar   L3595
positioning device,   L3140 - L3170
Foot, abduction rotation bar, including shoes   L3140
Foot, abduction rotatation bar, without shoes   L3150
Foot, adjustable shoe-styled positioning device   L3160
Foot, plastic, silicone or equal, heel stabilizer, each   L3170
transfer,   L3600 - L3649
Transfer of an orthosis from one shoe to another, caliper plate, existing   L3600
Transfer of an orthosis from one shoe to another, caliper plate, new   L3610
Transfer of an orthosis from one shoe to another, solid stirrup, existing   L3620
Transfer of an orthosis from one shoe to another, solid stirrup, new   L3630
Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes   L3640
Orthopedic shoe, modification, addition or transfer, not otherwise specified   L3649
wedge,   L3420
Diabetes outpatient self-management training services, individual, per 30 minutes   G0108
Linear accelerator based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, maximum five sessions per course of treatment   G0251
Injection, tetracycline, up to 250 mg   J0120
Standard wheelchair   K0001
Orthopedic shoe, oxford with supinator or pronator, infant   L3201
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist   G0117
Pharmacy dispensing fee for inhalation drug(s) initial 30-day supply as a beneficiary   G0333
Trapeze bars, aka patient helper, attached to bed, with grab bar   E0910
Patient documented as being treated with antidepressant medication during the entire 12 week acute treatment phase   G8126
Medical nutrition therapy reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes   G0270
Ambulance service, outside state per mile, transport (medicaid only)   A0021
Platform attachment, forearm crutch, each   E0153
Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips   E0110
Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing   G0268
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each   L3000
Enteral nutrition infusion pump - without alarm   B9000
Electromagnetic therapy, to one or more areas, for wound care other than described in g0329 or for other uses   G0295
Skin barrier, wipes or swabs, each   A5120
Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each   L2570
Rollabout chair, any and all types with castors 5 or greater   E1031
Alcohol andor drug assessment   H0001
External urethral clamp or compression device (not to be used for catheter clamp), each   A4356
Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only   L1200
Screening mammography, producing direct digital image, bilateral, all views   G0202
Traction frame, attached to headboard, cervical traction   E0840
Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility   G0257
Injection procedure for sacroiliac joint arthrograpy   G0259
Ambulatory traction device, all types, each   E0830
Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)   L0700
Heat lamp, without stand (table model), includes bulb, or infrared element   E0200
Helmet, protective, soft, prefabricated, includes all components and accessories   A8000
Scheduled interdisciplinary team conference (minimum of three exclusive of patient care nursing staff) with patient present   G0175
Addition to lower extremity, limited ankle motion, each joint   L2200
Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery   E0550
Traction frame, attached to footboard, pelvic traction   E0890
Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated   L0112
Foot, arch support, removable, premolded, longitudinal, each   L3040
Iv pole   E0776
Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time   E2500
Gait trainer, pediatric size, posterior support, includes all accessories and components   E8000
Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes   G0151
Wheelchair specially sized or constructed, (indicate brand name, model number, if any) and justification   E1220
Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest   E1240
Pre-operative pulmonary surgery services for preparation for lvrs, complete course of services, to include a minimum of 16 days of services   G0302
Foot, arch support, non-removable attached to shoe, longitudinal, each   L3070
Sling or seat, patient lift, canvas or nylon   E0621
Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)   G0176
Pneumatic compressor, non-segmental home model   E0650
Foot, abduction rotation bar, including shoes   L3140
Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)   E0610
Stationary compressed gaseous oxygen system, rental includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing   E0424
Home blood glucose monitor   E0607
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches   E2201
Tracheostomylaryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each   A7520
Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bandscuffs (single bar 'ak' orthosis), custom-fabricated   L2000
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, includes fitting and adjustment   L0621
Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval   C1300
Respiratory suction pump, home model, portable or stationary, electric   E0600
Ippb machine, all types, with built-in nebulization manual or automatic valves internal or external power source   E0500
Non-prescription drugs   A9150
Walker, rigid (pickup), adjustable or fixed height   E0130
Battery, heavy duty replacement for patient owned ventilator   A4611
Social work and psychological services, directly relating to andor furthering the patient's rehabilitation goals, each 15 minutes, face-to-face individual (services provided by a corf-qualified social worker or psychologist in a corf)   G0409
Technetium tc-99m sestamibi, diagnostic, per study dose   A9500
Direct (face-to-face with patient) skilled nursing services of a registered nurse provided in a comprehensive outpatient rehabilitation facility, each 10 minutes beyond the first 5 minutes   G0128
Collagen meniscus implant procedure for filling meniscal defects (eg cmi, collagen scaffold, menaflex)   G0428
Negative pressure wound therapy electrical pump, stationary or portable   E2402
Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth   G0406
Administration of influenza virus vaccine   G0008
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision   G0123
Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model   L1000
General use wheelchair seat cushion, width less than 22 inches, any depth   E2601
Canister, disposable, used with suction pump, each   A7000
Centrifuge, for dialysis   E1500
Electrocardiogram, routine ecg with 12 leads performed as a screening for the initial preventive physical examination with interpretation and report   G0403
Initial preventive physical examination face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment   G0402
Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service   G0364
Sitz type bath or equipment, portable, used with or without commode   E0160
Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)   G0365
Halo procedure, cervical halo incorporated into jacket vest   L0810
Trauma response team associated with hospital critical care service   G0390
Bedside drainage bottle with or without tubing, rigid or expandable, each   A5102
Ostomy pouch, closed with barrier attached (1 piece), each   A5051
Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic bandbelt, custom fabricated   L2040
Dynamic adjustable elbow extensionflexion device, includes soft interface material   E1800
Iliac andor femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization andor coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure)   G0278
Jaw motion rehabilitation system   E1700
Legg perthes orthosis, (toronto type), custom-fabricated   L1700
Complete (cbc), automated (hgb, hct, rbc, wbc without platelet count)   G0307
Face-to-face educational services related to the care of chronic kidney disease individual, per session, per one hour   G0420
Addition to knee joint, drop lock, each   L2405
Intensive cardiac rehabilitation with or without continuous ecg monitoring with exercise, per session   G0422
Syringe with needle, sterile, 1 cc or less, each   A4206
Ostomy faceplate, each   A4361
Enteral feeding supply kit syringe fed, per day, includes but not limited to feedingflushing syringe, administration set tubing, dressings, tape   B4034
Insertion tray without drainage bag and without catheter (accessories only)   A4310
Hospice evaluation and counseling services, pre-election   G0337
Destruction of localized lesion of choroid (for example, choroidal neovascularization) photocoagulation, feeder vessel technique (one or more sessions)   G0186
Hospital observation service, per hour   G0378
Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i E Superficial to muscle and fascia) and at least the following if present (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails   G0247
Pet imaging whole body melanoma for non-covered indications   G0219
Noncovered surgical procedure(s) using conscious sedation, regional, general or spinal anesthesia in a medicare qualifying clinical trial, per day   G0293
Surgical pathology, gross and microscopic examinations for prostate needle saturation biopsy sampling, 10-20 specimens   G0416
Frontier extended stay clinic demonstration for a patient stay in a clinic approved for the cms demonstration project the following measures should be present the stay must be equal to or greater than 4 hours weather or other conditions must prevent transfer or the case falls into a category of monitoring and observation cases that are permitted by the rules of the demonstration there is a maximum frontier extended stay clinic (fesc) visit of 48 hours, except in the case when weather or other conditions prevent transfer payment is made on each period up to 4 hours, after the first 4 hours   G9140
Hospital bed, fixed height, with any type side rails, with mattress   E0250
Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care   G0329
Whirlpool, portable (overtub type)   E1300
Tissue marker, implantable, any type, each   A4648
Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (eg angioseal plug, vascular plug)   G0269
Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer andor surgical planning for breast cancer (eg initial staging of axillary lymph nodes)   G0252
Ultrasound b-scan andor real time with image documentation for abdominal aortic aneurysm (aaa) screening   G0389
Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom-fabricated   L1900
Implantable access catheter, (e,g , venous, arterial, epidural subarachnoid, or peritoneal, etc ) external access   A4300
Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed   G0412
Traction frame, attached to footboard, extremity traction, (eg buck's)   E0870
Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care that meets patient's needs, per re-certification period   G0179
Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests   E1280
Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests   E1100
Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count   G0306
Heel wedge, sach   L3340
Gradient compression stocking, below knee, 18-30 mmhg, each   A6530
Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)   G0237
Trimming of dystrophic nails, any number   G0127
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe   A5500
Addition to lower extremity, thighweight bearing, gluteal ischial weight bearing, ring   L2500
Addition to lower extremity orthosis, plating chrome or nickel, per bar   L2750
Wound closure utilizing tissue adhesive(s) only   G0168
Linear accelerator based stereotactic radiosurgery, complete course of therapy in one session   G0173
Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated, includes fitting and adjustment   L1600
Bathshower chair, with or without wheels, any size   E0240
Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests   E1170
Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient   A4630
Thoracic, rib belt, custom fabricated   L0220
Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician   G0141
Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b)evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education   G0245
Standard wheelchair, fixed full length arms, fixed or swing away detachable footrests   E1130
Wheelchair accessory, tray, each   E0950
Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation   E0720
Current perception thresholdsensory nerve conduction test, (snct) per limb, any nerve   G0255
Tape, non-waterproof, per 18 square inches   A4450
Miscellaneous dme supply, accessory, andor service component of another hcpcs code   A9900
Cervical, multiple post collar, occipitalmandibular supports, adjustable   L0180
Lift, elevation, heel, tapered to metatarsals, per inch   L3300
Traction equipment, overdoor, cervical   E0860
Powered pressure reducing mattress overlaypad, alternating, with pump, includes heavy duty   E0181
Other scoliosis procedure, body jacket molded to patient model   L1300
Restraints, any type (body, chest, wrist or ankle)   E0710
Safety equipment, device or accessory, any type   E0700
Home sleep study test (hst) with type ii portable monitor, unattended minimum of 7 channels eeg, eog, emg, ecgheart rate, airflow, respiratory effort and oxygen saturation   G0398
Single energy x-ray absorptiometry (sexa) bone density study, one or more sites appendicular skeleton (peripheral) (eg, radius, wrist, heel)   G0130
Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician includes face-to-face demonstration of use and care of the inr monitor, obtaining at least one blood sample, provision of instructions for reporting home inr test results, and documentation of patient's ability to perform testing and report results   G0248
Cane, includes canes of all materials, adjustable or fixed, with tip   E0100
Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery   G0288
Colorectal cancer screening alternative to g0105, screening colonoscopy, barium enema   G0120
Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth   G0425
Percutaneous islet cell transplant, includes portal vein catheterization and infusion   G0341
Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment   L1810
Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests   E1050
Semen analysis presence andor motility of sperm excluding huhner   G0027
Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment   G0339
Parenteral nutrition solution carbohydrates (dextrose), 50 or less (500 ml 1 unit) - homemix   B4164
Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, includes fitting and adjustment   L0450
Regulator   E1353
Cervical or vaginal cancer screening pelvic and clinical breast examination   G0101
Non-contact wound warming wound cover for use with the non-contact wound warming device and warming card   A6000
Radiopharmaceutical, diagnostic, not otherwise classified   A4641
Peritoneal dialysis catheter anchoring device, belt, each   A4653
Tlso, corset front   L0970
Prostate cancer screening digital rectal examination   G0102
Colorectal cancer screening flexible sigmoidoscopy   G0104
Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints   L2180
Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous statsis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care   G0281
Halo procedure, cervical halo incorporated into plaster body jacket   L0820
Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment   L1001
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips   E0105
Technetium tc-99m teboroxime, diagnostic, per study dose   A9501
Sitz type bath or equipment, portable, used with or without commode, with faucet attachments   E0161
Ostomy pouch, closed without barrier attached (1 piece), each   A5052
Dme delivery, set up, andor dispensing service component of another hcpcs code   A9901
Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint   L2210
Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)   J0129
Legg perthes orthosis, (newington type), custom fabricated   L1710
Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment   L1902
Static progressive stretch elbow device, extension andor flexion, with or without range of motion adjustment, includes all components and accessories   E1801
Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following (1) a patient history, (2) a physical examination that includes (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education   G0246
Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria includes provision of materials for use in the home and reporting of test results to physician testing not occurring more frequently than once a week testing materials, billing units of service include 4 tests   G0249
Noncovered procedure(s) using either no anesthesia or local anesthesia only, in a medicare qualifying clinical trial, per day   G0294
Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated, includes fitting and adjustment   L1610
Parenteral nutrition infusion pump, portable   B9004
Lift, elevation, heel and sole, neoprene, per inch   L3310
Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated   L2005
Skin barrier solid, 6 x 6 or equivalent, each   A5121
Addition to lower extremity, thighweight bearing, quadri- lateral brim, molded to patient model   L2510
Behavioral health screening to determine eligibility for admission to treatment program   H0002
Other scoliosis procedure, post-operative body jacket   L1310
Physician service required to establish and document the need for a power mobility device   G0372
Direct admission of patient for hospital observation care   G0379
Stationary compressed gas system, purchase includes regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing   E0425
Face-to-face educational services related to the care of chronic kidney disease group, per session, per one hour   G0421
Intensive cardiac rehabilitation with or without continuous ecg monitoring without exercise, per session   G0423
Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes   G0271
Replacement cushions for jaw motion rehabilitation system, pkg Of 6   E1701
Alcohol andor substance (other than tobacco) abuse structured assessment (e G , audit, dast), and brief intervention 15 to 30 minutes   G0396
Percutaneous skeletal fixation of posterior pelvic bone fracture andor dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint andor sacrum)   G0413
Standard hemi (low seat) wheelchair   K0002
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision   G0143
Cervical, multiple post collar, occipitalmandibular supports, adjustable cervical bars (somi, guilford, taylor types)   L0190
Patient not documented as being treated with antidepressant medication during the entire 12 weeks acute treatment phase   G8127
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation   E0730
Administration of pneumococcal vaccine   G0009
Pump for alternating pressure pad, for replacement only   E0182
Bath tub wall rail, each   E0241
Heel wedge   L3350
Hospital bed, fixed height, with any type side rails, without mattress   E0251
Replacement bulblamp for ultraviolet light therapy system, each   A4633
Syringe, with or without needle, each   A4657
Orthopedic shoe, oxford with supinator or pronator, child   L3202
Skin barrier solid, 4 x 4 or equivalent each   A4362
Electrical stimulation, (unattended), to one or more areas, for wound care other than described in g0281   G0282
Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf   L0455
Injection procedure for sacroiliac joint provision of anesthetic, steroid andor other therapeutic agent, with or without arthrography   G0260
Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar   E0911
Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (eg as a result of highly active antiretroviral therapy)   G0429
Urinary suspensory with leg bag, with or without tube, each   A5105
Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest   E1110
Oxygen accessory, wheeled cart for portable cylinder or portable concentrator, any type, replacement only, each   E1354
For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe   A5501
Electrocardiogram, routine ecg with 12 leads tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination   G0404
Phototherapy (bilirubin) light with photometer   E0202
Foot, abduction rotatation bar, without shoes   L3150
Heel loopholder, any type, with or without ankle strap, each   E0951
Tracheostomylaryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each   A7521
Anchorscrew for opposing bone-to-bone or soft tissue-to-bone (implantable)   C1713
Walker, folding (pickup), adjustable or fixed height   E0135
Continuous airway pressure (cpap) device   E0601
Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes   G0152
Foot, arch support, non-removable attached to shoe, metatarsal, each   L3080
Patient lift, bathroom or toilet, not otherwise classified   E0625
Foot, arch support, removable, premolded, metatarsal, each   L3050
Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter   E0555
Helmet, protective, hard, prefabricated, includes all components and accessories   A8001
Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more)   G0177
Gait trainer, pediatric size, upright support, includes all accessories and components   E8001
Diagnostic mammography, producing direct digital image, bilateral, all views   G0204
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each   A4357
Collagen based wound filler, dry form, sterile, per gram of collagen   A6010
Enteral nutrition infusion pump - with alarm   B9002
Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes   G0109
Foot, insert, removable, molded to patient model, spenco, each   L3001
Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion   G0342
Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalomologist   G0118
Colorectal cancer screening colonoscopy on individual at high risk   G0105
Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)   L0710
Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater   E0779
Prostate cancer screening prostate specific antigen test (psa)   G0103
Home sleep test (hst) with type iii portable monitor, unattended minimum of 4 channels 2 respiratory movementairflow, 1 ecgheart rate and 1 oxygen saturation   G0399
Colorectal cancer screening colonoscopy on individual not meeting criteria for high risk   G0121
Whirlpool, non-portable (built-in type)   E1310
Wheelchair with fixed arm, footrests   E1221
Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care that meets patient's needs, per certification period   G0180
Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest   A0080
Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips   E0111
Transfer device, any type, each   E0705
Wheelchair, detachable arms, desk or full length, swing away detachable footrests   E1140
Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)   G0238
Canister, non-disposable, used with suction pump, each   A7001
Amputee wheelchair, fixed full length arms, without footrests or legrest   E1171
Enteral feeding supply kit pump fed, per day, includes but not limited to feedingflushing syringe, administration set tubing, dressings, tape   B4035
Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs   E1035
Pet imaging, any site, not otherwise specified   G0235
Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment   G0340
Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth   G0426
Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests   E1060
Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization treatment program, per session (45 minutes or more)   G0129
Addition to knee lock with integrated release mechanism ( bail, cable, or equal), any material, each joint   L2415
Gradient compression stocking, below knee, 30-40 mmhg, each   A6531
Heavy duty wheelchair, fixed full length arms, swing away detachable footrest   E1285
Surgical supply miscellaneous   A4649
Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridementshaving of articular cartilage (chrondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee   G0289
Single vitaminmineraltrace element, oral, per dose, not otherwise specified   A9152
Battery cables replacement for patient-owned ventilator   A4612
Implantable access total catheter, portreservoir (eg venous, arterial, epidural, subarachnoid, peritoneal, etc )   A4301
Syringe with needle, sterile 2cc, each   A4207
Platform attachment, walker, each   E0154
Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries   A4642
Pre-operative pulmonary surgery services for preparation for lvrs, 10 to 15 days of services   G0303
Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth   G0407
Group psychotherapy other than of a multiple-family group, in a partial hospitalization setting, approximately 45 to 50 minutes   G0410
Traction stand, free standing, extremity traction, (eg buck's)   E0880
Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches   E2202
Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digitalvisible check systems   E0615
Traction stand, free standing, pelvic traction, (eg buck's)   E0900
Pneumatic compressor, segmental home model without calibrated gradient pressure   E0651
Addition to lower extremity fracture orthosis, drop lock knee joint   L2182
Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time   E2502
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician   G0124
Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment   L0113
Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated   L0452
Addition to lower extremity, pelvic control, pelvic sling   L2580
Addition to lower extremity orthosis, high strength, lightweight material, all hybrid laminationprepreg composite, per segment, for custom fabricated orthosis only   L2755
Kidney, dialysate delivery syst Kidney machine, pump recirculat- ing, air removal syst, flowrate meter, power off, heater and temperature control with alarm, i V Poles, pressure gauge, concentrate container   E1510
Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic bandbelt, custom-fabricated   L2050
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment   L1820
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated   L0622
Lightweight wheelchair, fixed full length arms, swing away detachable footrest   E1250
Parenteral nutrition solution amino acid, 35, (500 ml 1 unit) - homemix   B4168
Tape, waterproof, per 18 square inches   A4452
Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc )   A4311
Addition to tlso, (low profile), lateral thoracic extension   L1210
Lso, corset front   L0972
General use wheelchair seat cushion, width 22 inches or greater, any depth   E2602
Traction equipment, cervical, free-standing standframe, pneumatic, applying traction force to other than mandible   E0849
Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 21-40 specimens   G0417
Addition to tlso, (low profile), anterior thoracic extension   L1220
Hospital bed, variable height, hi-lo, with any type side rails, with mattress   E0255
Tracheostomylaryngectomy tube, stainless steel or equal (sterilizable and reusable), each   A7522
Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, includes fitting and adjustment   L0454
Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)   G0239
Lift, elevation, heel and sole, cork, per inch   L3320
Addition to lower extremity fracture orthosis, limited motion knee joint   L2184
Spinal orthosis, not otherwise specified   L1499
Sphygmomanometerblood pressure apparatus with cuff and stethoscope   A4660
Tlso, full corset   L0974
Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs   E1036
Walker, with trunk support, adjustable or fixed height, any type   E0140
Wheelchair with fixed arm, elevating legrests   E1222
Sole wedge, outside sole   L3360
Legg perthes orthosis, trilateral, (tachdijan type), custom-fabricated   L1720
Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest   E1070
Miscellaneous dme supply or accessory, not otherwise specified   A9999
Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated, includes fitting and adjustment   L1620
Clinician documented that patient was not an eligible candidate for antidepressant medication during the entire 12 week acute treatment phase measure   G8128
Gradient compression stocking, below knee, 40-50 mmhg, each   A6532
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest   A0090
Lso, full corset   L0976
Alcohol andor substance (other than tobacco) abuse structured assessment (e G , audit, dast), and intervention, greater than 30 minutes   G0397
Heavy duty wheelchair, detachable arms (desk or full length) swing away detachable footrest   E1290
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each   A4358
Electrocardiogram, routine ecg with 12 leads interpretation and report only, performed as a screening for the initial preventive physical examination   G0405
Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development andor revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient's care, integration of new information into the medical treatment plan andor adjustment of medical therapy, within a calendar month, 30 minutes or more   G0181
Halo procedure, cervical halo incorporated into milwaukee type orthosis   L0830
Heparin infusion pump for hemodialysis   E1520
Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria testing not occurring more frequently than once a week billing units of service include 4 tests   G0250
Replacement measuring scales for jaw motion rehabilitation system, pkg Of 200   E1702
Replacement bulb for therapeutic light box, tabletop model   A4634
Enteral feeding supply kit gravity fed, per day, includes but not limited to feedingflushing syringe, administration set tubing, dressings, tape   B4036
Open treatment of anterior pelvic bone fracture andor dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis andor superiorinferior rami)   G0414
Disposable drug delivery system, flow rate of 50 ml or greater per hour   A4305
Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth   G0427
Syringe with needle, sterile 3cc, each   A4208
Injection abciximab, 10 mg   J0130
Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth   G0408
Ostomy clamp, any type, replacement only, each   A4363
Dynamic adjustable forearm pronationsupination device, includes soft interface material   E1802
Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone   A4312
Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated, off-the-shelf   L0457
Implantable radiation dosimeter, each   A4650
Multiple vitamins, with or without minerals and trace elements, oral, per dose, not otherwise specified   A9153
Alcohol andor drug screening laboratory analysis of specimens for presence of alcohol andor drugs   H0003
Foot, arch support, non-removable attached to shoe, longitudinalmetatarsal, each   L3090
Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band belt, custom-fabricated   L2060
Tubing, used with suction pump, each   A7002
Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, includes fitting and adjustment   L0623
Addition to lower extremity, dorsiflexion and plantar flexion assistresist, each joint   L2220
Lightweight wheelchair, detachable arms (desk or full length) swing away detachable footrest   E1260
Colorectal cancer screening fecal occult blood test, immunoassay, 1-3 simultaneous   G0328
Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint   L2425
Interactive group psychotherapy, in a partial hospitalization setting, approximately 45 to 50 minutes   G0411
Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment   L1005
Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches   E2203
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce   A4455
Lightweight wheelchair   K0003
Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes   G0153
Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips   E0112
Breast pump, manual, any type   E0602
Pneumatic compressor, segmental home model with calibrated gradient pressure   E0652
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision   G0144
Implantable cardiac event recorder with memory, activator and programmer   E0616
Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bandscuffs (single bar 'ak' orthosis), without knee joint, custom-fabricated   L2010
Sitz bath chair   E0162
Ostomy pouch, closed for use on faceplate, each   A5053
Therapeutic lightbox, minimum 10,000 lux, table top model   E0203
Technetium tc-99m tetrofosmin, diagnostic, per study dose   A9502
Foot, arch support, removable, premolded, longitudinal metatarsal, each   L3060
Home sleep test (hst) with type iv portable monitor, unattended minimum of 3 channels   G0400
Colorectal cancer screening alternative to g0104, screening sigmoidoscopy, barium enema   G0106
Seat lift mechanism incorporated into a combination lift-chair mechanism   E0627
Foot, adjustable shoe-styled positioning device   L3160
Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time   E2504
Ankle foot orthosis, molded ankle gauntlet, custom-fabricated   L1904
Collagen based wound filler, gelpaste, per gram of collagen   A6011
Helmet, protective, soft, custom fabricated, includes all components and accessories   A8002
Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 41-60 specimens   G0418
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care   G0283
Gait trainer, pediatric size, anterior support, includes all accessories and components   E8002
Administration of hepatitis b vaccine   G0010
Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar   E0912
Pre-operative pulmonary surgery services for preparation for lvrs, 1 to 9 days of services   G0304
Addition to lower extremity, thighweight bearing, quadri- lateral brim, custom fitted   L2520
Foot, insert, removable, molded to patient model, plastazote or equal, each   L3002
For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe   A5503
Level 1 hospital emergency department visit provided in a type b emergency department (the ed must meet at least one of the following requirements (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 48924 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)   G0380
Cervical, flexible, non-adjustable (foam collar)   L0120
Wheel attachment, rigid pick-up walker, per pair   E0155
Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each   A5112
Battery charger replacement for patient-owned ventilator   A4613
Skin barrier solid, 8 x 8 or equivalent, each   A5122
Laparotomy for islet cell transplant, includes portal vein catheterization and infusion   G0343
Drug screen, qualitative multiple drug classes by high complexity test method (eg immunoassay, enzyme assay), per patient encounter   G0431
Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours   E0780
Portable gaseous oxygen system, purchase includes regulator, flowmeter, humidifier, cannula or mask, and tubing   E0430
Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)   L2760
Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery   E0560
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, includes fitting and adjustment   L1830
Orthopedic shoe, oxford with supinator or pronator, junior   L3203
Diagnostic mammography, producing direct digital image, unilateral, all views   G0206
Dry pressure mattress   E0184
Colorectal cancer screening barium enema   G0122
Cervical, multiple post collar, occipitalmandibular supports, adjustable cervical bars, and thoracic extension   L0200
Bath tub rail, floor base   E0242
Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each   L2600
Traction stand, free standing, cervical traction   E0850
Parenteral nutrition solution amino acid, 55 through 7, (500 ml 1 unit) NAME   B4172
Skin protection wheelchair seat cushion, width less than 22 inches, any depth   E2603
Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day   G0424
Catheter, transluminal atherectomy, directional   C1714
Toe loopholder, any type, each   E0952
Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient's skin by layers of fabric)   E0731
Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest   E1172
Standrack   E1355
Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests   E1150
Fracture frame, attached to bed, includes weights   E0920
Addition to tlso, (low profile), milwaukee type superstructure   L1230
Orthotic side bar disconnect device, per bar   L2768
Heat lamp, with stand, includes bulb, or infrared element   E0205
Addition to knee joint, ratchet lock for active and progressive knee extension, each joint   L2430
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each   E0955
Adhesive remover, wipes, any type, each   A4456
Breast pump, electric (ac andor dc), any type   E0603
Orthopedic shoe, hightop with supinator or pronator, infant   L3204
Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation   A4313
Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material   L0859
Toilet rail, each   E0243
Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches   E2204
Dynamic adjustable wrist extension flexion device, includes soft interface material   E1805
Left ventricular ejection fraction (lvef) 40 or documentation as normal or mildly depressed left ventricular systolic function   G8395
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient   E0781
Cervical traction equipment not requiring additional stand or frame   E0855
Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development andor revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient's care, integration of new information into the medical treatment plan andor adjustment of medical therapy, within a calendar month, 30 minutes or more   G0182
Underarm pad, crutch, replacement, each   A4635
Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 andor hiv-2, screening   G0432
Syringe with needle, sterile 5cc or greater, each   A4209
Adhesive, liquid or equal, any type, per oz   A4364
Commode chair, mobile or stationary, with fixed arms   E0163
Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic bandbelt, custom fabricated   L2070
Disposable external urethral clamp or compression device, with pad andor pouch, each   A4360
Skin protection wheelchair seat cushion, width 22 inches or greater, any depth   E2604
Portable gaseous oxygen system, rental includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing   E0431
Artificial saliva, 30 ml   A9155
Addition to lower extremity, thighweight bearing, ischial containmentnarrow m-l brim molded to patient model   L2525
Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment   L1831
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries   A9503
Parenteral nutrition infusion pump, stationary   B9006
Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm first 25 sq cm or less wound surface area   C5271
Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated, includes fitting and adjustment   L0456
Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests   E1270
Behavioral health counseling and therapy, per 15 minutes   H0004
Wheelchair, fixed full length arms, swing away detachable elevating legrests   E1160
Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling   L1010
Leg strap latex, replacement only, per set   A5113
Tracheostomy shower protector, each   A7523
Level 2 hospital emergency department visit provided in a type b emergency department (the ed must meet at least one of the following requirements (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 48924 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)   G0381
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable   A7003
High strength, lightweight wheelchair   K0004
Humidifier, non-heated, used with positive airway pressure device   E0561
Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests   E1180
Calibrated microcapillary tube, each   A4651
Post-discharge pulmonary surgery services after lvrs, minimum of 6 days of services   G0305
Addition to lower extremity, split flat caliper stirrups and plate attachment   L2230
Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type   L2186
Nasogastric tubing with stylet   B4081
Adhesive or non-adhesive disk or foam pad   A5126
Oxygen accessory, battery packcartridge for portable concentrator, any type, replacement only, each   E1356
Lift, elevation, metal extension (skate)   L3330
Transport chair, pediatric size   E1037
Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom-fabricated   L1630
Blood pressure cuff only   A4663
Separate seat lift mechanism for use with patient owned furniture-electric   E0628
Legg perthes orthosis, (scottish rite type), custom-fabricated   L1730
Incontinence treatment system, pelvic floor stimulator, monitor, sensor andor trainer   E0740
For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe   A5504
Cervical, flexible, thermoplastic collar, molded to patient   L0130
Foot, plastic, silicone or equal, heel stabilizer, each   L3170
Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest   E1083
Collagen dressing, sterile, size 16 sq in Or less, each   A6021
Wheelchair with detachable arms, footrests   E1223
Peak expiratory flow rate meter, hand held   A4614
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision   G0145
Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf   L0467
Injection, acetaminophen, 10 mg   J0131
Hallus-valgus night dynamic splint   L3100
Non-emergency transportation taxi   A0100
Parenteral nutrition solution amino acid, 7 through 85, (500 ml 1 unit) NAME   B4176
Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, greater than 60 specimens   G0419
Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time   E2506
Sole wedge, between sole   L3370
Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated   L0624
Heavy duty wheelchair, fixed full length arms, elevating legrest   E1295
Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip   E0113
Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bandscuffs (double bar 'ak' orthosis), custom-fabricated   L2020
Helmet, protective, hard, custom fabricated, includes all components and accessories   A8003
Gradient compression stocking, thigh length, 18-30 mmhg, each   A6533
Non-segmental pneumatic appliance for use with pneumatic compressor, half arm   E0655
Walker, rigid, wheeled, adjustable or fixed height   E0141
Hospital bed, variable height, hi-lo, with any type side rails, without mattress   E0256
Air bubble detector for hemodialysis, each, replacement   E1530
Direct skilled nursing services of a licensed nurse (lpn or rn) in the home health or hospice setting, each 15 minutes   G0154
Ankle foot orthosis, multiligamentus ankle support, prefabricated, includes fitting and adjustment   L1906
Brachytherapy needle   C1715
Open treatment of posterior pelvic bone fracture andor dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint andor sacrum)   G0415
Ostomy pouch, closed for use on barrier with flange (2 piece), each   A5054
Seat attachment, walker   E0156
External defibrillator with integrated electrocardiogram analysis   E0617
Foot, insert, removable, molded to patient model, silicone gel, each   L3003
Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each   L2610
Disposable drug delivery system, flow rate of less than 50 ml per hour   A4306
Gel or gel-like pressure pad for mattress, standard mattress length and width   E0185
Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries   A9504
Clubfoot wedge   L3380
Non-emergency transportation and bus, intra or inter state carrier   A0110
Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision   G0147
Alcohol andor drug services group counseling by a clinician   H0005
Positioning wheelchair seat cushion, width less than 22 inches, any depth   E2605
Neuromuscular stimulator for scoliosis   E0744
Collagen dressing, sterile, size more than 16 sq in But less than or equal to 48 sq in, each   A6022
Portable liquid oxygen system, rental home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge   E0433
Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and tranverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment   L0458
Static progressive stretch wrist device, flexion andor extension, with or without range of motion adjustment, includes all components and accessories   E1806
Parenteral nutrition solution amino acid, greater than 85 (500 ml 1 unit) NAME   B4178
Services of clinical social worker in home health or hospice settings, each 15 minutes   G0155
Ultralightweight wheelchair   K0005
Commode chair, mobile or stationary, with detachable arms   E0165
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc )   A4314
Cervical traction device, cervical collar with inflatable air bladder   E0856
Enema bag with tubing, reusable   A4458
Cervical, semi-rigid, adjustable (plastic collar)   L0140
Nasogastric tubing without stylet   B4082
Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf   L0469
Walker, folding, wheeled, adjustable or fixed height   E0143
Oxygen accessory, battery charger for portable concentrator, any type, replacement only, each   E1357
Crutch attachment, walker, each   E0157
Small volume nonfiltered pneumatic nebulizer, disposable   A7004
Level 3 hospital emergency department visit provided in a type b emergency department (the ed must meet at least one of the following requirements (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 48924 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)   G0382
Appliance cleaner, incontinence and ostomy appliances, per 16 oz   A5131
For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe   A5505
Leg strap foam or fabric, replacement only, per set   A5114
Stoma cap   A5055
Fracture frame, free standing, includes weights   E0930
Brachytherapy source, non-stranded, gold-198, per source   C1716
Segmental pneumatic appliance for use with pneumatic compressor, trunk   E0656
Apnea monitor, without recording feature   E0618
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips   E0114
Humidifier, heated, used with positive airway pressure device   E0562
Soft interface for helmet, replacement only   A8004
Tracheostoma stentstudbutton, each   A7524
Noc for enteral supplies   B9998
Electric heat pad, standard   E0210
Infusion pump, implantable, non-programmable (includes all components, eg pump, catheter, connectors, etc )   E0782
Automatic blood pressure monitor   A4670
Left ventricular ejection fraction (lvef) not performed or documented   G8396
Separate seat lift mechanism for use with patient owned furniture-non-electric   E0629
Manual adult size wheelchair, includes tilt in space   E1161
Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests   E1190
Transport chair, adult size, patient weight capacity up to and including 300 pounds   E1038
Ostomy vent, any type, each   A4366
Raised toilet seat   E0244
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress   E0260
Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests   E1084
Gradient compression stocking, thigh length, 30-40 mmhg, each   A6534
Pressure alarm for hemodialysis, each, replacement   E1540
Breast pump, hospital grade, electric (ac and or dc), any type   E0604
Replacement, handgrip, cane, crutch, or walker, each   A4636
Cannula, nasal   A4615
Axillary crutch extension   L0978
Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device   E2508
Microcapillary tube sealant   A4652
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each   E0956
Wheelchair with detachable arms, elevating legrests   E1224
Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment   L0625
Addition to ctlso or scoliosis orthosis, kyphosis pad   L1020
Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom-fabricated   L1640
Addition to tlso, (low profile), lumbar derotation pad   L1240
Needle-free injection device, each   A4210
Legg perthes orthosis, (patten bottom type), custom-fabricated   L1755
Afo, supramalleolar with straps, with or without interfacepads, custom fabricated   L1907
Special wheelchair seat height from floor   E1296
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, includes fitting and adjustment   L1832
Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)   C5272
Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bandscuffs, (double bar 'ak' orthosis), without knee joint, custom fabricated   L2030
Pediculosis (lice infestation) treatment, topical, for administration by patientcaretaker   A9180
Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only   L2232
Addition to halo procedure, replacement linerinterface material   L0861
Addition to lower extremity fracture orthosis, quadrilateral brim   L2188
Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each   E2205
Addition to knee joint, lift loop for drop lock ring   L2492
Addition to lower extremity, thighweight bearing, ischial containmentnarrow m-l brim, custom fitted   L2526
Addition to lower extremity, pelvic control, hip joint, heavy duty, each   L2620
Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic bandbelt, custom-fabricated   L2080
Addition to lower extremity orthosis, non-corrosive finish, per bar   L2780
Foot, insert, removable, molded to patient model, longitudinal arch support, each   L3010
Orthopedic shoe, hightop with supinator or pronator, child   L3206
Injection, acetylcysteine, 100 mg   J0132
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 andor hiv-2, screening   G0433
Air pressure mattress   E0186
Lift, elevation, inside shoe, tapered, up to one-half inch   L3332
Water pressure mattress   E0187
Addition to lower extremity orthosis, drop lock retainer, each   L2785
Non-emergency transportation mini-bus, mountain area transports, or other transportation systems   A0120
Addition to lower extremity, thigh-weight bearing, lacer, non-molded   L2530
Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated   L2034
Ostomy belt, each   A4367
Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment   L0460
Peroneal straps, pair   L0980
Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access   E2510
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)   E0630
Outflare wedge   L3390
Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each   L2622
Mouth piece   A4617
Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf   L0641
Surgical dressing holder, non-reusable, each   A4461
Disposable cycler set used with cycler dialysis machine, each   A4671
Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band belt, custom-fabricated   L2090
Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibularoccipital piece)   L0150
Dynamic adjustable knee extension flexion device, includes soft interface material   E1810
Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment   L0626
Vaporizer, room type   E0605
Noc for parenteral supplies   B9999
Positioning wheelchair seat cushion, width 22 inches or greater, any depth   E2606
Bath conductivity meter for hemodialysis, each   E1550
Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each   E0957
Gradient compression stocking, thigh length, 40-50 mmhg, each   A6535
Special wheelchair seat depth, by upholstery   E1297
Percutaneous cathetertube anchoring device, adhesive skin attachment   A5200
Supplies for self-administered injections   A4211
Hemi-wheelchair, fixed full length arms, swing away detachable foot rests   E1085
Lift, elevation, heel, per inch   L3334
Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds   E1039
For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe   A5506
Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests   E1195
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable   A7005
Tracheostomy mask, each   A7525
Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy   G8397
Infusion pump system, implantable, programmable (includes all components, eg , pump, catheter, connectors, etc )   E0783
Non-covered item or service   A9270
Services of home healthhospice aide in home health or hospice settings, each 15 minutes   G0156
Continuous passive motion exercise device for use on knee only   E0935
Portable liquid oxygen system, rental includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing   E0434
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each   A5056
Parenteral nutrition solution carbohydrates (dextrose), greater than 50 (500 ml1 unit) - homemix   B4180
Foot, insert, removable, molded to patient model, longitudinal metatarsal support, each   L3020
Compressor, air power source for equipment which is not self- contained or cylinder driven   E0565
Addition to ctlso or scoliosis orthosis, kyphosis pad, floating   L1025
Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each   E0116
Neuromuscular stimulator, electronic shock unit   E0745
Thallium tl-201 thallous chloride, diagnostic, per millicurie   A9505
Apnea monitor, with recording feature   E0619
Segmental pneumatic appliance for use with pneumatic compressor, chest   E0657
Brachytherapy source, non-stranded, high dose rate iridium-192, per source   C1717
Electric heat pad, moist   E0215
Collagen dressing, sterile, size more than 48 sq in, each   A6023
Alcohol andor drug services case management   H0006
Stomach tube - levine type   B4083
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress   E0261
Replacement, tip, cane, crutch, walker, each   A4637
Tub stool or bench   E0245
Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening   G0148
Addition to lower extremity fracture orthosis, waist belt   L2190
Tubing (oxygen), per foot   A4616
Heavy duty wheelchair   K0006
Level 4 hospital emergency department visit provided in a type b emergency department (the ed must meet at least one of the following requirements (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 48924 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)   G0383
Leg extensions for walker, per set of four (4)   E0158
Pail or pan for use with commode chair, replacement only   E0167
Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone   A4315
Addition to lower extremity, round caliper and plate attachment   L2240
Orthopedic shoe, hightop with supinator or pronator, junior   L3207
Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm first 100 sq cm wound surface area, or 1 of body area of infants and children   C5273
Knee orthosis, without knee joint, rigid, custom-fabricated   L1834
Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment   L1910
Addition to tlso, (low profile), anterior asis pad   L1250
Injection, acyclovir, 5 mg   J0133
Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment   L1650
Oxygen accessory, dc power adapter for portable concentrator, any type, replacement only, each   E1358
Drug screen, other than chromatographic any number of drug classes, by clia waived test or moderate complexity test, per patient encounter   G0434
Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat   E0144
Manual wheelchair accessory, wheel lock assembly, complete, each   E2206
Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each   E1225
Drainage extension line, sterile, for dialysis, each   A4672
Cervical, semi-rigid, wire frame occipitalmandibular support   L0160
Non-segmental pneumatic appliance for use with pneumatic compressor, full leg   E0660
Brachytherapy source, non-stranded, non-high dose rate iridium-192, per source   C1719
Hemi-wheelchair detachable arms desk or full length, swing away detachable footrests   E1086
Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation   A4316
Surgical dressing holder, reusable, each   A4463
Extra heavy duty wheelchair   K0007
Commode chair, extra wide andor heavy duty, stationary or mobile, with or without arms, any type, each   E0168
Transfer tub rail attachment   E0246
Replacement battery for patient-owned ear pulse generator, each   A4638
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress   E0265
Collagen dressing wound filler, sterile, per 6 inches   A6024
Water circulating heat pad with pump   E0217
Skin piercing device for collection of capillary blood, laser, each   E0620
Synthetic sheepskin pad   E0188
Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries   A9507
Portable liquid oxygen system, purchase includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor   E0435
Nebulizer, with compressor   E0570
Continuous passive motion exercise device for use other than knee   E0936
Postural drainage board   E0606
Administration set, with small volume filtered pneumatic nebulizer   A7006
Non-coring needle or stylet with or without catheter   A4212
Special wheelchair seat depth andor width, by construction   E1298
Stocking supporter grips, set of four (4)   L0982
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each   A5057
Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm each additional 100 sq cm wound surface area, or part thereof, or each additional 1 of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)   C5274
Addition to lower extremity orthosis, knee control, full kneecap   L2795
Speech generating software program, for personal computer or personal digital assistant   E2511
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment   L0627
Walker, heavy duty, multiple braking system, variable wheel resistance   E0147
Addition to ctlso or scoliosis orthosis, lumbar bolster pad   L1030
Addition to tlso, (low profile), anterior thoracic derotation pad   L1260
Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, any type   L1652
Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom-fabricated   L1920
Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, includes fitting and adjustment   L1836
Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt   L2192
Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment   L2035
Addition to lower extremity, foot plate, molded to patient model, stirrup attachment   L2250
Addition to lower extremity, thighweight bearing, lacer, molded to patient model   L2540
Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each   L2624
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth   E2607
Foot, insert, removable, formed to patient foot, each   L3030
Surgical boot, each, infant   L3208
Injection, adalimumab, 20 mg   J0135
Infectious agent antibody detection by rapid antibody test, hiv-1 andor hiv-2, screening   G0435
Metatarsal bar wedge, rocker   L3400
Non-emergency transportation wheel-chair van   A0130
Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom-fabricated   L2106
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each   E1226
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf   L0642
Blood leak detector for hemodialysis, each, replacement   E1560
External ambulatory infusion pump, insulin   E0784
Ostomy filter, any type, each   A4368
Brake attachment for wheeled walker, replacement, each   E0159
Gradient compression stocking, full lengthchap style, 18-30 mmhg, each   A6536
For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe   A5507
Patient lift, electric with seat or sling   E0635
Amputee wheelchair, fixed full length arms, swing away detachable footrest   E1200
Dilated macular or fundus exam not performed   G8398
Mechanical wound suction, disposable, includes dressing, all accessories and components, each   A9272
Tracheostomy tube collarholder, each   A7526
Alcohol andor drug services crisis intervention (outpatient)   H0007
Parenteral nutrition solution, per 10 grams lipids   B4185
Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes   G0157
Crutch, underarm, articulating, spring assisted, each   E0117
Wheelchair accessory, crutch and cane holder, each   E2207
Gastrostomyjejunostomy tube, standard, any material, any type, each   B4087
Manual wheelchair accessory, one-arm drive attachment, each   E0958
Level 5 hospital emergency department visit provided in a type b emergency department (the ed must meet at least one of the following requirements (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 48924 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)   G0384
Static progressive stretch knee device, extension andor flexion, with or without range of motion adjustment, includes all components and accessories   E1811
Immersion external heater for nebulizer   E1372
Electromyography (emg), biofeedback device   E0746
Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment   L0462
Metatarsal bar wedge, between sole   L3410
Replacement pad for infrared heating pad system, each   A4639
Protective body sock, each   L0984
Hot water bottle, ice cap or collar, heat andor cold wrap, any type   A9273
Crutch substitute, lower leg platform, with or without wheels, each   E0118
Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated   L1840
Water circulating cold pad with pump   E0218
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate   E1390
Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated   L2036
Transfer bench for tub or toilet with or without commode opening   E0247
Breathing circuits   A4618
Large volume nebulizer, disposable, unfilled, used with aerosol compressor   A7007
Trapeze bar, free standing, complete with grab bar   E0940
Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment   L0628
Iodine i-131 iobenguane sulfate, diagnostic, per 05 millicurie   A9508
Ostomy skin barrier, liquid (spray, brush, etc), per oz   A4369
Osteogenesis stimulator, electrical, non-invasive, other than spinal applications   E0747
Lambswool sheepskin pad, any size   E0189
Special height arms for wheelchair   E1227
Walker, heavy duty, without wheels, rigid or folding, any type, each   E0148
Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment   L1660
Multipositional patient support system, with integrated lift, patient accessible controls   E0636
Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad   L1040
Wheelchair accessory, cylinder tank carrier, each   E2208
Addition to tlso, (low profile), abdominal pad   L1270
Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment   L1930
Injection, adenosine for therapeutic use, 6 mg (not to be used to report any adenosine phosphate compounds, instead use a9270)   J0150
Commode chair with integrated seat lift mechanism, electric, any type   E0170
Stationary liquid oxygen system, rental includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, tubing   E0439
For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe   A5508
Cardioverter-defibrillator, dual chamber (implantable)   C1721
Gastrostomyjejunostomy tube, low-profile, any material, any type, each   B4088
Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only   L2800
Surgical boot, each, child   L3209
Cervical, collar, molded to patient model   L0170
Adjustable chair, for esrd patients   E1570
Gradient compression stocking, full lengthchap style, 30-40 mmhg, each   A6537
Aerosol compressor, adjustable pressure, light duty for intermittent use   E0572
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress   E0266
Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf   L0643
Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix   B4189
Syringe, sterile, 20 cc or greater, each   A4213
Foot, insertplate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid laminationprepreg composite, each   L3031
Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth   E2608
Extension line with easy lock connectors, used with dialysis   A4673
Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, andor multiple digits, total wound surface area up to 100 sq cm first 25 sq cm or less wound surface area   C5275
Patient with central dual-energy x-ray absorptiometry (dxa) results documented or ordered or pharmacologic therapy (other than mineralsvitamins) for osteoporosis prescribed)   G8399
Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom-fabricated   L2108
Alcohol andor drug services sub-acute detoxification (hospital inpatient)   H0008
Implantable intraspinal (epiduralintrathecal) catheter used with implantable infusion pump, replacement   E0785
Custom manual wheelchairbase   K0008
Addition to lower extremity, thighweight bearing, high roll cuff   L2550
Irrigation tray with bulb or piston syringe, any purpose   A4320
Non-elastic binder for extremity   A4465
Tracheostomylaryngectomy tube plugstop, each   A7527
High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests   E1087
Manual wheelchair accessory, adapter for amputee, each   E0959
Dynamic knee, extensionflexion device with active resistance control   E1812
Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables   L2627
Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes   G0158
Gel sheet for dermal or epidermal application, (eg silicone, hydrogel, other), each   A6025
Smoking and tobacco cessation counseling visit for the asymptomatic patient intermediate, greater than 3 minutes, up to 10 minutes   G0436
Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment   L0464
Addition to lower extremity, reinforced solid stirrup (scott-craig type)   L2260
Accessory for speech generating device, mounting system   E2512
Ostomy pouch, drainable with barrier attached, (1 piece), each   A5061
Non-emergency transportation and air travel (private or commercial) intra or inter state   A0140
Non-segmental pneumatic appliance for use with pneumatic compressor, full arm   E0665
Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated   L1680
Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes   G0159
Ostomy pouch, drainable without barrier attached (1 piece), each   A5062
Injection, adenosine for diagnostic use, 1 mg (not to be used to report any adenosine phosphate compounds, instead use a9270)   J0151
Iodine i-123 sodium iodide, diagnostic, per millicurie   A9509
Gradient compression stocking, full lengthchap style, 40-50 mmhg, each   A6538
Stationary liquid oxygen system, purchase includes use of reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing   E0440
Ultrasonicelectronic aerosol generator with small volume nebulizer   E0574
Large volume nebulizer, disposable, prefilled, used with aerosol compressor   A7008
Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix   B4193
Surgical boot, each, junior   L3211
Accessory, arm trough, with or without hand support, each   E2209
Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables   L2628
Smoking and tobacco cessation counseling visit for the asymptomatic patient intensive, greater than 10 minutes   G0437
Cardioverter-defibrillator, single chamber (implantable)   C1722
Addition to lower extremity, long tongue stirrup   L2265
Afo, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, includes fitting and adjustment   L1932
Full sole and heel wedge, between sole   L3420
Osteogenesis stimulator, electrical, non-invasive, spinal applications   E0748
Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom fabricated   L0629
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf   L0648
External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories   A9274
Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, andor multiple digits, total wound surface area up to 100 sq cm each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)   C5276
High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests   E1088
Wound pouch, each   A6154
Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each   E1391
For diabetics only, direct formed, compression molded to patient's foot without external heat source, multiple-density insert(s) prefabricated, per shoe   A5510
Addition to tlso, (low profile), rib gusset (elastic), each   L1280
Wheelchair accessory, shoulder harnessstraps or chest strap, including any type mounting hardware   E0960
Addition to ctlso or scoliosis orthosis, sternal pad   L1050
Walker, heavy duty, wheeled, rigid or folding, any type   E0149
Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varusvalgus adjustment, prefabricated, includes fitting and adjustment   L1843
Non-segmental pneumatic appliance for use with pneumatic compressor, half leg   E0666
Infrared heating pad system   E0221
Addition to spinal orthosis, not otherwise specified   L0999
Accessory for speech generating device, not otherwise classified   E2599
Cervical, collar, semi-rigid thermoplastic foam, two piece   L0172
Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated   L2037
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment   L2112
Alcohol andor drug services acute detoxification (hospital inpatient)   H0009
Ostomy skin barrier, powder, per oz   A4371
Commode chair with integrated seat lift mechanism, non-electric, any type   E0171
Therapeutic agent for urinary catheter irrigation   A4321
Dynamic adjustable ankle extensionflexion device, includes soft interface material   E1815
Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, each   A4466
Needle, sterile, any size, each   A4215
Other manual wheelchairbase   K0009
Transducer protectorsfluid barriers, for hemodialysis, any size, per 10   E1575
Transfer bench, heavy duty, for tub or toilet with or without commode opening   E0248
Face tent   A4619
Special back height for wheelchair   E1228
Non-emergency transportation per mile - case worker or social worker   A0160
Food thickener, administered orally, per ounce   B4100
Replacement pad for use with medically necessary alternating pressure pad owned by patient   A4640
Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)   E0786
Hospital bed, institutional type includes oscillating, circulating and stryker frame, with mattress   E0270
Patient with central dual-energy x-ray absorptiometry (dxa) results not documented or not ordered or pharmacologic therapy (other than mineralsvitamins) for osteoporosis not prescribed, reason not given   G8400
Chemicalsantiseptics solution used to cleansterilize dialysis equipment, per 8 oz   A4674
Gravity assisted traction device, any type   E0941
Combination sit to stand frametable system, any size including pediatric, with seat lift feature, with or without wheels   E0637
Custom fabricated wheelchair seat cushion, any size   E2609
Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment   L0466
Positioning cushionpillowwedge, any shape or size, includes all components and accessories   E0190
Addition to lower extremity orthosis, knee control, condylar pad   L2810
Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment   L0468
Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment   L0630
Ostomy pouch, drainable for use on barrier with flange (2 piece system), each   A5063
Wheelchair seat cushion, powered   E2610
Transportation ancillary parking fees, tolls, other   A0170
Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer   A7009
Heel or elbow protector, each   E0191
Manual wheelchair accessory, wheel lock brake extension (handle), each   E0961
Pad for water circulating heat unit, for replacement only   E0249
Standard - weight frame motorizedpower wheelchair   K0010
Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes   G0160
Osteogenesis stimulator, electrical, surgically implanted   E0749
Enteral formula, for adults, used to replace fluids and electrolytes (eg clear liquids), 500 ml 1 unit   B4102
Wheelchair accessory, bearings, any type, replacement only, each   E2210
Segmental pneumatic appliance for use with pneumatic compressor, full leg   E0667
Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varusvalgus adjustment, custom fabricated   L1844
Seat lift mechanism placed over or on top of toilet, any type   E0172
Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated   L2038
Stationary oxygen contents, gaseous, 1 month's supply 1 unit   E0441
Irrigation syringe, bulb or piston, each   A4322
Gravlee jet washer   A4470
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq in or less, each dressing   A6196
Gradient compression stocking, waist length, 18-30 mmhg, each   A6539
Mattress, innerspring   E0271
Nebulizer, ultrasonic, large volume   E0575
Addition to lower extremity, varusvalgus correction ('t') strap, paddedlined or malleolus pad   L2270
Unipuncture control system for hemodialysis   E1580
Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix   B4197
Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior framepanel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf   L0649
High strength lightweight wheelchair, fixed length arms, swing away detachable footrest   E1089
Sterile water, saline andor dextrose, diluentflush, 10 ml   A4216
Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries   A9510
Cervical head harnesshalter   E0942
Wheelchair, pediatric size, not otherwise specified   E1229
Standing frametable system, one position (eg upright, supine or prone stander), any size including pediatric, with or without wheels   E0638
Clinician documented that patient was not an eligible candidate for screening or therapy for osteoporosis for women measure   G8401
Portable oxygen concentrator, rental   E1392
Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension   L0174
Benesch boot, pair, infant   L3212
Activated carbon filter for hemodialysis, each   A4680
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 14 inch material of shore a 35 durometer or 316 inch material of shore a 40 durometer (or higher), prefabricated, each   A5512
Ostomy skin barrier, solid 4x4 or equivalent, standard wear, with built-in convexity, each   A4372
Hydrocollator unit, includes pads   E0225
Parenteral infusion pump, stationary, single or multi-channel   E0791
Annual wellness visit includes a personalized prevention plan of service (pps), initial visit   G0438
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section   L2820
Addition to tlso, (low profile), lateral trochanteric pad   L1290
Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, andor multiple digits, total wound surface area greater than or equal to 100 sq cm first 100 sq cm wound surface area, or 1 of body area of infants and children   C5277
Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated   L1685
Variable concentration mask   A4620
Home glucose disposable monitor, includes test strips   A9275
Static progressive stretch ankle device, flexion andor extension, with or without range of motion adjustment, includes all components and accessories   E1816
Alcohol andor drug services sub-acute detoxification (residential addiction program inpatient)   H0010
Addition to lower extremity, pelvic control, band and belt, unilateral   L2630
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment   L2114
Ankle foot orthosis, plastic or other material, custom-fabricated   L1940
Injection, adrenalin, epinephrine, 01 mg   J0171
Addition to ctlso or scoliosis orthosis, thoracic pad   L1060
Catheter, transluminal atherectomy, rotational   C1724
Foot rest, for use with commode chair, each   E0175
Standard - weight frame motorizedpower wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking   K0011
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit   G0439
Electronic salivary reflex stimulator (intra-oralnon-invasive)   E0755
Segmental pneumatic appliance for use with pneumatic compressor, full arm   E0668
Manual wheelchair accessory, headrest extension, each   E0966
Lower extremity neurological exam performed and documented   G8404
Vabra aspirator   A4480
Addition to lower extremity orthosis, soft interface for molded plastic, above knee section   L2830
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment   L2116
Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restricts gross trunk motion in sagittal, coronal, and transverse planes, provides intracavitary pressure to reduce load on the intervertebral disks, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment   L0470
Addition to lower extremity, varusvalgus correction, plastic modification, paddedlined   L2275
Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each   A4690
Ostomy skin barrier, with flange (solid, flexible or accordian), with built-in convexity, any size, each   A4373
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment   L0631
Mattress, foam rubber   E0272
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, each dressing   A6197
Pelvic beltharnessboot   E0944
Addition to lower extremity, pelvic control, band and belt, bilateral   L2640
Catheter, transluminal angioplasty, non-laser (may include guidance, infusionperfusion capability)   C1725
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware   E2611
Alcohol andor drug services acute detoxification (residential addiction program inpatient)   H0011
Gradient compression stocking, waist length, 30-40 mmhg, each   A6540
Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes   G0161
Stationary oxygen contents, liquid, 1 month's supply 1 unit   E0442
Manual wheelchair accessory, pneumatic propulsion tire, any size, each   E2211
Non-contact wound warming device (temperature control unit, ac adapter and power cord) for use with warming card and wound cover   E0231
Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix   B4199
Hemodialysis machine   E1590
Durable medical equipment, miscellaneous   E1399
Male external catheter with integral collection chamber, any type, each   A4326
High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable foot rests   E1090
Tracheostoma filter, any type, any size, each   A4481
Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, andor multiple digits, total wound surface area greater than or equal to 100 sq cm each additional 100 sq cm wound surface area, or part thereof, or each additional 1 of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)   C5278
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 316 inch material of shore a 35 durometer or higher), includes arch filler and other shaping material, custom fabricated, each   A5513
Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter   E0580
Power operated vehicle (three or four wheel nonhighway) specify brand name and model number   E1230
Patient lift, moveable from room to room with disassembly and reassembly, includes all componentsaccessories   E0639
Technetium tc-99m pertechnetate, diagnostic, per millicurie   A9512
Sterile watersaline, 500 ml   A4217
Enteral formula, for pediatrics, used to replace fluids and electrolytes (eg clear liquids), 500 ml 1 unit   B4103
Non-emergency transportation ancillary lodging-recipient   A0180
Injection, aflibercept, 1 mg   J0178
Powered air flotation bed (low air loss therapy)   E0193
Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom-fabricated   L1945
Ostomy pouch, urinary with barrier attached (1 piece), each   A5071
Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment   L1686
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior framepanel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf   L0650
Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varusvalgus adjustment, prefabricated, includes fitting and adjustment   L1845
Sensor invasive (eg subcutaneous), disposable, for use with interstitial continuous glucose monitoring system, one unit 1 day supply   A9276
Benesch boot, pair, child   L3213
Addition to ctlso or scoliosis orthosis, trapezius sling   L1070
Tracheostomy, inner cannula   A4623
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet   A7010
Static progressive stretch forearm pronation supination device, with or without range of motion adjustment, includes all components and accessories   E1818
Prothrombin complex concentrate (human), kcentra, per iu of factor ix activity   C9132
Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries   A9516
Replacement soft interface material, dynamic adjustable extensionflexion device   E1820
Sterile saline or water, metered dose dispenser, 10 ml   A4218
Annual alcohol misuse screening, 15 minutes   G0442
Benesch boot, pair, junior   L3214
Lightweight portable motorizedpower wheelchair   K0012
Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom-fabricated   L2126
Gradient compression stocking, waist length, 40-50 mmhg, each   A6541
Segmental pneumatic appliance for use with pneumatic compressor, half leg   E0669
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated   L0632
Corrugated tubing, non-disposable, used with large volume nebulizer, 10 feet   A7011
Addition to lower extremity, pelvic and thoracic control, gluteal pad, each   L2650
Tracheal suction catheter, any type other than closed system, each   A4624
Injection, agalsidase beta, 1 mg   J0180
Portable oxygen contents, gaseous, 1 month's supply 1 unit   E0443
Alcohol andor drug services sub-acute detoxification (residential addiction program outpatient)   H0012
Transmitter external, for use with interstitial continuous glucose monitoring system   A9277
Female external urinary collection device meatal cup, each   A4327
Catheter, balloon dilatation, non-vascular   C1726
Ostomy pouch, drainable, with faceplate attached, plastic, each   A4375
Additive for enteral formula (eg fiber)   B4104
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, off-the-shelf   L0651
Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom-fabricated   L1950
Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment   L1690
Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each   E2212
Ostomy pouch, urinary without barrier attached (1 piece), each   A5072
Skilled services by a registered nurse (rn) for management and evaluation of the plan of care each 15 minutes (the patient's underlying condition or complication requires an rn to ensure that essential non-skilled care achieves its purpose in the home health or hospice setting)   G0162
Bicarbonate concentrate, solution, for hemodialysis, per gallon   A4706
Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests   E1092
Addition to ctlso or scoliosis orthosis, outrigger   L1080
Air fluidized bed   E0194
Oxygen and water vapor enriching system with heated delivery   E1405
General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware   E2612
Osteogenesis stimulator, low intensity ultrasound, non-invasive   E0760
Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system   E1231
Addition to lower extremity, molded inner boot   L2280
Bed board   E0273
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq in, each dressing   A6198
Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varusvalgus adjustment, custom fabricated   L1846
Non-emergency transportation ancillary meals-recipient   A0190
Warming card for use with the non contact wound warming device and non contact wound warming wound cover   E0232
Automatic intermittent peritioneal dialysis system   E1592
Lower extremity neurological exam not performed   G8405
Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment   L0472
Parenteral nutrition additives (vitamins, trace elements, heparin, electrolytes) homemix per day   B4216
Manual wheelchair accessory, hand rim with projections, any type, each   E0967
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each   L2840
Nebulizer, with compressor and heater   E0585
Extremity beltharness   E0945
Patient lift, fixed system, includes all componentsaccessories   E0640
Gradient compression stocking, garter belt   A6544
Alcohol andor drug services acute detoxification (residential addiction program outpatient)   H0013
Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests   E1093
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches   A6199
Addition to lower extremity orthosis, femoral length sock, fracture or equal, each   L2850
Injection, biperiden lactate, per 5 mg   J0190
Non-emergency transportation ancillary lodging escort   A0200
Addition to lower extremity, thoracic control, thoracic band   L2660
Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, includes fitting and adjustment   L1951
Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, includes fitting and adjustment   L1847
Receiver (monitor) external, for use with interstitial continuous glucose monitoring system   A9278
Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom-fabricated   L2128
Factor ix (antihemophilic factor, recombinant), rixibus, per iu   C9133
Catheter, balloon tissue dissector, non-vascular (insertable)   C1727
Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes   G0443
Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable   L2300
Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated   L0480
Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior framepanel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment   L0633
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each   E2213
Replacement soft interface materialcuffs for bi-directional static progressive stretch device   E1821
Ostomy pouch, urinary for use on barrier with flange (2 piece), each   A5073
Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system   E1232
Oxygen and water vapor enriching system without heated delivery   E1406
Ostomy pouch, drainable, with faceplate attached, rubber, each   A4376
Water collection device, used with large volume nebulizer   A7012
Commode seat, wheelchair   E0968
Refill kit for implantable infusion pump   A4220
Bicarbonate concentrate, powder, for hemodialysis, per packet   A4707
Standing frametable system, multi-position (eg three-way stander), any size including pediatric, with or without wheels   E0641
Fracture, frame, dual with cross bars, attached to bed, (eg balken, 4 poster)   E0946
Orthopedic footwear, ladies shoe, oxford, each   L3215
Non-thermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device   E0761
Knee orthosis, elastic with joints, prefabricated, off-the-shelf   L1812
Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk   E0670
Surgical stockings below knee length, each   A4500
Portable oxygen contents, liquid, 1 month's supply 1 unit   E0444
Gel pressure mattress   E0196
Over-bed table   E0274
Cycler dialysis machine for peritoneal dialysis   E1594
Paraffin bath unit, portable (see medical supply code a4265 for paraffin)   E0235
Moisture exchanger, disposable, for use with invasive mechanical ventilation   A4483
Skilled services of a licensed nurse (lpn or rn) for the observation and assessment of the patient's condition, each 15 minutes (the change in the patient's condition requires skilled nursing personnel to identify and evaluate the patient's need for possible modification of treatment in the home health or hospice setting)   G0163
Custom motorizedpower wheelchair base   K0013
Female external urinary collection device pouch, each   A4328
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories 1 unit   B4149
Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure   G8406
Iodine i-131 sodium iodide capsule(s), therapeutic, per millicurie   A9517
Tracheostomy care kit for new tracheostomy   A4625
Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions   L1085
Parenteral nutrition supply kit premix, per day   B4220
Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware   E2613
Oximeter device for measuring blood oxygen levels non-invasively   E0445
Surgical stockings above knee length, each   A4490
Composite dressing, sterile, pad size 16 sq in Or less, with any size adhesive border, each dressing   A6203
Alcohol andor drug services ambulatory detoxification   H0014
Catheter, brachytherapy seed administration   C1728
Other motorizedpower wheelchair base   K0014
Ankle foot orthosis, posterior solid ankle, plastic, custom-fabricated   L1960
Manual wheelchair accessory, pneumatic caster tire, any size, each   E2214
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories 1 unit   B4150
Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment   L2132
Gradient compression wrap, non-elastic, below knee, 30-50 mm hg, each   A6545
Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system   E1233
Monitoring featuredevice, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified   A9279
Ostomy pouch, drainable, for use on faceplate, plastic, each   A4377
Injection, alatrofloxacin mesylate, 100 mg   J0200
Addition to lower extremity, abduction bar-straight   L2310
Addition to ctlso or scoliosis orthosis, lumbar sling   L1090
Skilled services of a licensed nurse (lpn or rn), in the training andor education of a patient or family member, in the home health or hospice setting, each 15 minutes   G0164
Continent device plug for continent stoma   A5081
Dynamic adjustable finger extensionflexion device, includes soft interface material   E1825
Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware   E2614
Perianal fecal collection pouch with adhesive, each   A4330
Tracheostomy cleaning brush, each   A4626
Blood pump for hemodialysis, replacement   E1620
Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated   L0482
Annual depression screening, 15 minutes   G0444
Air pressure pad for mattress, standard mattress length and width   E0197
Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior framepanel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, custom fabricated   L0634
Non-emergency transportation ancillary meals-escort   A0210
Standing frametable system, mobile (dynamic stander), any size including pediatric   E0642
Parenteral nutrition supply kit home mix, per day   B4222
Transcutaneous electrical joint stimulation device system, includes all accessories   E0762
Pump for water circulating pad   E0236
Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each   L2861
Supplies for maintenance of drug infusion catheter, per week (list drug separately)   A4221
Fracture frame, attachments for complex pelvic traction   E0947
Segmental gradient pressure pneumatic appliance, full leg   E0671
Technetium tc-99m, tilmanocept, diagnostic, up to 05 millicuries   A9520
Knee orthosis, swedish type, prefabricated, includes fitting and adjustment   L1850
Bed pan, standard, metal or plastic   E0275
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf   L1833
Addition to lower extremity, thoracic control, paraspinal uprights   L2670
Narrowing device, wheelchair   E0969
Acetate concentrate solution, for hemodialysis, per gallon   A4708
Orthopedic footwear, ladies shoe, depth inlay, each   L3216
Filter, disposable, used with aerosol compressor or ultrasonic generator   A7013
Footwear evaluation performed and documented   G8410
Delivery andor installation charges for hemodialysis equipment   E1600
Continent device catheter for continent stoma   A5082
Water pressure pad for mattress, standard mattress length and width   E0198
Fracture frame, attachments for complex cervical traction   E0948
Acid concentrate, solution, for hemodialysis, per gallon   A4709
No 2 footplates, except for elevating leg rest   E0970
Alert or alarm device, not otherwise classified   A9280
Hydrocollator unit, portable   E0239
Filter, nondisposable, used with aerosol compressor or ultrasonic generator   A7014
Lower extremity orthoses, not otherwise specified   L2999
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)   A4222
Ostomy pouch, drainable, for use on faceplate, rubber, each   A4378
Composite dressing, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, with any size adhesive border, each dressing   A6204
Injection, alglucerase, per 10 units   J0205
Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories   E0446
Ankle foot orthosis, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment   L1971
High intensity behavioral counseling to prevent sexually transmitted infection face-to-face, individual, includes education, skills training and guidance on how to change sexual behavior performed semi-annually, 30 minutes   G0445
Surgical stockings thigh length, each   A4495
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 15 kcalml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories 1 unit   B4152
Orthopedic footwear, ladies shoe, hightop, depth inlay, each   L3217
Alcohol andor drug services intensive outpatient (treatment program that operates at least 3 hoursday and at least 3 daysweek and is based on an individualized treatment plan), including assessment, counseling crisis intervention, and activity therapies or education   H0015
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler   A4627
Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system   E1234
Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware   E2615
Extension drainage tubing, any type, any length, with connectoradaptor, for use with urinary leg bag or urostomy pouch, each   A4331
Dynamic adjustable toe extensionflexion device, includes soft interface material   E1830
Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf   L1848
Manual wheelchair accessory, tube for pneumatic caster tire, any size, each   E2215
Footwear evaluation was not performed   G8415
Knee orthosis, modification of supracondylar prosthetic socket, custom-fabricated (sk)   L1860
Segmental gradient pressure pneumatic appliance, full arm   E0672
Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only   L2320
Ambulance service, neonatal transport, base rate, emergency transport, one way   A0225
Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather   L1100
Reverse osmosis water purification system, for hemodialysis   E1610
Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program   E0764
Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment   L2134
Addition to lower extremity, thoracic control, lateral support uprights   L2680
Ankle foot orthosis, plastic with ankle joint, custom-fabricated   L1970
Detachable, non-adjustable height armrest, each   K0015
Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated   L0484
Catheter, drainage   C1729
Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior framepanel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, prefabricated, includes fitting and adjustment   L0635
Gradient compression stockingsleeve, not otherwise specified   A6549
Parenteral nutrition administration kit, per day   B4224
Bed pan, fracture, metal or plastic   E0276
Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries   A9521
External counterpulsation, per treatment session   G0166
Manual wheelchair accessory, anti-tipping device, each   E0971
Dry pressure pad for mattress, standard mattress length and width   E0199
Iodine i-131 iodinated serum albumin, diagnostic, per 5 microcuries   A9524
Segmental gradient pressure pneumatic appliance, half leg   E0673
Catheter, electrophysiology, diagnostic, other than 3d mapping (19 or fewer electrodes)   C1730
Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon   A4714
Deionizer water purification system, for hemodialysis   E1615
Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware   E2616
Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated   L0486
Orthopedic footwear, mens shoe, oxford, each   L3219
Alcohol andor drug services medicalsomatic (medical intervention in ambulatory setting)   H0016
Fda approved nerve stimulator, with replaceable batteries, for treatment of nausea and vomiting   E0765
Lubricant, individual sterile packet, each   A4332
Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only   L2330
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)   A4223
Wheelchair, pediatric size, rigid, adjustable, with seating system   E1235
Immunohistochemistry or immunocytochemistry, per specimen first single or multiplex antibody stain   G0461
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories 1 unit   B4153
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes   G0446
Oropharyngeal suction catheter, each   A4628
Clinician documented that patient was not an eligible candidate for footwear evaluation measure   G8416
Ostomy pouch, urinary, with faceplate attached, plastic, each   A4379
Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model   L1110
Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, renal - amirosyn rf, nephramine, renamine - premix   B5000
Static progressive stretch toe device, extension andor flexion, with or without range of motion adjustment, includes all components and accessories   E1831
Continent device, stoma absorptive cover for continent stoma   A5083
Volume control ventilator, without pressure support mode, may include pressure control mode, used with invasive interface (eg tracheostomy tube)   E0450
Reachinggrabbing device, any type, any length, each   A9281
Composite dressing, sterile, pad size more than 48 sq in, with any size adhesive border, each dressing   A6205
Bls mileage (per mile)   A0380
Manual wheelchair accessory, foam filled propulsion tire, any size, each   E2216
Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior framepanels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, custom fabricated   L0636
Injection, amifostine, 500 mg   J0207
Detachable, adjustable height armrest, base, each   K0017
Aerosol mask, used with dme nebulizer   A7015
Powered pressure-reducing air mattress   E0277
Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment   L2136
Dome and mouthpiece, used with small volume ultrasonic nebulizer   A7016
Surgical stockings full length, each   A4510
Pneumatic compression device, high pressure, rapid inflationdeflation cycle, for arterial insufficiency (unilateral or bilateral system)   E0675
Electrical stimulation device used for cancer treatment, includes all accessories, any type   E0766
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each   E0973
Bls routine disposable supplies   A0382
Oxygen tent, excluding croup or pediatric tents   E0455
Bed cradle, any type   E0280
Addition to ctlso, scoliosis orthosis, cover for upright, each   L1120
Injection, methyldopate hcl, up to 250 mg   J0210
Calculated bmi above normal parameters and a follow-up plan was documented   G8417
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior framepanels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment   L0637
Infusion set for external insulin pump, non needle cannula type   A4230
Face-to-face behavioral counseling for obesity, 15 minutes   G0447
Behavioral health residential (hospital residential treatment program), without room and board, per diem   H0017
Wig, any type, each   A9282
y set tubing for peritoneal dialysis   A4719
Ostomy accessory convex insert   A5093
Orthopedic footwear, mens shoe, depth inlay, each   L3221
Catheter, electrophysiology, diagnostic, other than 3d mapping (20 or more electrodes)   C1731
Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf bandcuff (single bar 'bk' orthosis), custom-fabricated   L1980
Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, prefabricated, includes fitting and adjustment   L0488
Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries   A9526
Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, hepatic - freamine hbc, hepatamine - premix   B5100
Contact layer, sterile, 16 sq in Or less, each dressing   A6206
Wheelchair, pediatric size, folding, adjustable, with seating system   E1236
Urinary catheter anchoring device, adhesive skin attachment, each   A4333
Addition to lower extremity, anterior swing band   L2335
Ostomy pouch, urinary, with faceplate attached, rubber, each   A4380
Tracheostomy care kit for established tracheostomy   A4629
Custom fabricated wheelchair back cushion, any size, including any type mounting hardware   E2617
Dynamic adjustable shoulder flexion abduction rotation device, includes soft interface material   E1840
Detachable, adjustable height armrest, upper portion, each   K0018
Manual wheelchair accessory, foam filled caster tire, any size, each   E2217
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins andor minerals, may include fiber, administered through an enteral feeding tube, 100 calories 1 unit   B4154
Immunohistochemistry or immunocytochemistry, per specimen each additional single or multiplex antibody stain (list separately in addition to code for primary procedure)   G0462
Hospital bed, fixed height, without side rails, with mattress   E0290
Ostomy pouch, urinary, for use on faceplate, plastic, each   A4381
Incontinence garment, any type, (eg brief, diaper), each   A4520
Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen   A7017
Urinary catheter anchoring device, leg strap, each   A4334
Iodine i-125, sodium iodide solution, therapeutic, per millicurie   A9527
Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, stress - branch chain amino acids - premix   B5200
Contact layer, sterile, more than 16 sq in but less than or equal to 48 sq in, each dressing   A6207
Chest shell (cuirass)   E0457
Dialysate solution, any concentration of dextrose, fluid volume greater than 249cc, but less than or equal to 999cc, for peritoneal dialysis   A4720
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior framepanels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated   L0638
Addition to lower extremity, pre-tibial shell, molded to patient model   L2340
Orthopedic footwear, mens shoe, hightop, depth inlay, each   L3222
Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated, includes fitting and adjustment   L0490
Hospital outpatient clinic visit for assessment and management of a patient   G0463
Behavioral health short-term residential (non-hospital residential treatment program), without room and board, per diem   H0018
Intermittent limb compression device (includes all accessories), not otherwise specified   E0676
Bls specialized service disposable supplies defibrillation (used by als ambulances and bls ambulances in jurisdictions where defibrillation is permitted in bls ambulances)   A0384
Calculated bmi below normal parameters and a follow-up plan was documented   G8418
Manual wheelchair accessory, anti-rollback device, each   E0974
Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf bandcuff (double bar 'bk' orthosis), custom-fabricated   L1990
Injection, alefacept, 05 mg   J0215
Replacement cover for wheelchair seat cushion or back cushion, each   E2619
Arm pad, each   K0019
Infusion set for external insulin pump, needle type   A4231
Static progressive stretch shoulder device, with or without range of motion adjustment, includes all components and accessories   E1841
Manual wheelchair accessory, foam propulsion tire, any size, each   E2218
Foot pressure off loadingsupportive device, any type, each   A9283
Catheter, electrophysiology, diagnosticablation, 3d or vector mapping   C1732
Wheelchair, pediatric size, rigid, adjustable, without seating system   E1237
Water softening system, for hemodialysis   E1625
Electrical stimulation or electromagnetic wound treatment device, not otherwise classified   E0769
Enteral formula, nutritionally incompletemodular nutrients, includes specific nutrients, carbohydrates (eg glucose polymers), proteinsamino acids (eg glutamine, arginine), fat (eg medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories 1 unit   B4155
Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ventricular pacing   G0448
Enteral formula, nutritionally complete, for special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories 1 unit   B4157
Fixed, adjustable height armrest, pair   K0020
Als mileage (per mile)   A0390
Reciprocating peritoneal dialysis system   E1630
Dialysate solution, any concentration of dextrose, fluid volume greater than 999cc but less than or equal to 1999cc, for peritoneal dialysis   A4721
Calculated bmi outside normal parameters, no follow-up plan documented   G8419
Functional electrical stimulator, transcutaneous stimulation of nerve andor muscle groups, any type, complete system, not otherwise specified   E0770
Catheter, electrophysiology, diagnosticablation, other than 3d or vector mapping, other than cool-tip   C1733
Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliationmanagement, patient compliance with ordersplan of care, performance of activities of daily living, appropriateness of care setting (for use only in the meidcare-approved bundled payments for care improvement initiative) may not be billed for a 30-day period covered by a transitional care management code   G9187
Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment   L0491
Contact layer, sterile, more than 48 sq in, each dressing   A6208
Communication board, non-electronic augmentative or alternative communication device   E1902
Behavioral health long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem   H0019
Ultraviolet light therapy system, includes bulbslamps, timer and eye protection treatment area 2 square feet or less   E0691
Manual wheelchair accessory, foam caster tire, any size, each   E2219
Wheelchair, pediatric size, folding, adjustable, without seating system   E1238
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, includes fitting and adjustment   L0639
Chest wrap   E0459
Injection, alglucosidase alfa, 10 mg, not otherwise specified   J0220
Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie   A9528
Hospital bed, fixed height, without side rails, without mattress   E0291
Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for 'ptb' 'afo' orthoses)   L2350
Orthopedic footwear, woman's shoe, oxford, used as an integral part of a brace (orthosis)   L3224
Wheelchair accessory, positioning beltsafety beltpelvic strap, each   E0978
Incontinence supply miscellaneous   A4335
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware   E2620
Screening for sexually transmitted infections, including laboratory tests for chlamydia, gonorrhea, syphilis and Hepatitis B   G0450
Surgical trays   A4550
Water, distilled, used with large volume nebulizer, 1000 ml   A7018
Syringe with needle for external insulin pump, sterile, 3cc   A4232
Ostomy pouch, urinary, for use on faceplate, heavy plastic, each   A4382
Spirometer, non-electronic, includes all accessories   A9284
Beta-blocker therapy not prescribed, reason not given   G9188
Gastric suction pump, home model, portable or stationary, electric   E2000
Iodine i-131 sodium iodide solution, diagnostic, per millicurie   A9529
Manual wheelchair accessory, solid (rubberplastic) propulsion tire, any size, each   E2220
Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment   L0492
Addition to lower extremity, extended steel shank   L2360
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, custom fabricated   L0640
High mount flip-up footrest, each   K0037
Endoscope, retrograde imagingillumination colonoscope device (implantable)   C1749
Ostomy pouch, urinary, for use on faceplate, rubber, each   A4383
Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware   E2621
Wearable artificial kidney, each   E1632
Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each   A4233
Safety vest, wheelchair   E0980
Als specialized service disposable supplies defibrillation (to be used only in jurisdictions where defibrillation cannot be performed in bls ambulances)   A0392
Dialysate solution, any concentration of dextrose, fluid volume greater than 1999cc but less than or equal to 2999cc, for peritoneal dialysis   A4722
Calculated bmi within normal parameters and documented   G8420
Exercise equipment   A9300
Foam dressing, wound cover, sterile, pad size 16 sq in Or less, without adhesive border, each dressing   A6209
Negative pressure ventilator portable or stationary   E0460
Power wheelchair, pediatric size, not otherwise specified   E1239
Alcohol andor drug services methadone administration andor service (provision of the drug by a licensed program)   H0020
Injection, alglucosidase alfa, (lumizyme), 10 mg   J0221
Ultraviolet light therapy system panel, includes bulbslamps, timer and eye protection, 4 foot panel   E0692
Incontinence supply, urethral insert, any type, each   A4336
Orthopedic footwear, man's shoe, oxford, used as an integral part of a brace (orthosis)   L3225
Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber andor iron, administered through an enteral feeding tube, 100 calories 1 unit   B4158
Hospital bed, variable height, hi-lo, without side rails, with mattress   E0292
Interface for cough stimulating device, includes all components, replacement only   A7020
Disposable underpads, all sizes   A4554
Development testing, with interpretation and report, per standardized instrument form   G0451
Iodine i-131 sodium iodide solution, therapeutic, per millicurie   A9530
Beta-blocker therapy prescribed or currently being taken   G9189
Addition to lower extremity, patten bottom   L2370
Enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber andor iron, administered through an enteral feeding tube, 100 calories 1 unit   B4159
Hospital bed, variable height, hi-lo, without side rails, without mattress   E0293
Foam dressing, wound cover, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, without adhesive border, each dressing   A6210
Orthopedic footwear, custom shoe, depth inlay, each   L3230
Dialysate solution, any concentration of dextrose, fluid volume greater than 2999cc but less than or equal to 3999cc, for peritoneal dialysis   A4723
Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each   A4234
Alcohol andor drug training service (for staff and personnel not employed by providers)   H0021
Indwelling catheter foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc ), each   A4338
Ultraviolet light therapy system panel, includes bulbslamps, timer and eye protection, 6 foot panel   E0693
Bmi not calculated   G8421
Blood glucose monitor with integrated voice synthesizer   E2100
Volume control ventilator, without pressure support mode, may include pressure control mode, used with non-invasive interface (eg mask)   E0461
Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg   J0256
Als specialized service disposable supplies iv drug therapy   A0394
Leg strap, each   K0038
Electrodetransducer for use with electrical stimulation device used for cancer treatment, replacement only   A4555
Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth   E2622
High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each   A7025
Peritoneal dialysis clamps, each   E1634
Molecular pathology procedure physician interpretation and report   G0452
Manual wheelchair accessory, solid (rubberplastic) caster tire (removable), any size, each   E2221
Ostomy faceplate equivalent, silicone ring, each   A4384
Catheter, hemodialysisperitoneal, long-term   C1750
Wheelchair accessory, seat upholstery, replacement only, each   E0981
Electrodes, (eg apnea monitor), per pair   A4556
Dialysate solution, any concentration of dextrose, fluid volume greater than 3999cc but less than or equal to 4999cc, for peritoneal dialysis   A4724
Als specialized service disposable supplies esophageal intubation   A0396
High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each   A7026
Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis)   C1751
Foam dressing, wound cover, sterile, pad size more than 48 sq in, without adhesive border, each dressing   A6211
Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each   A4235
Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth   E2623
Iodine i-131 sodium iodide, diagnostic, per microcurie (up to 100 microcuries)   A9531
Compact (portable) travel hemodialyzer system   E1635
Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each   L3250
Manual wheelchair accessory, solid (rubberplastic) caster tire with integrated wheel, any size, each   E2222
Wheelchair accessory, back upholstery, replacement only, each   E0982
Blood glucose monitor with integrated lancingblood sample   E2101
Rocking bed with or without side rails   E0462
Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbslamps, timer and eye protection   E0694
Addition to lower extremity, torsion control, ankle joint and half solid stirrup   L2375
Patient not eligible for bmi calculation   G8422
Documentation of medical reason(s) for not prescribing beta-blocker therapy (eg, allergy, intolerance, other medical reasons)   G9190
Alcohol andor drug intervention service (planned facilitation)   H0022
Ostomy skin barrier, solid 4x4 or equivalent, extended wear, without built-in convexity, each   A4385
Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress   E0294
Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)   G0453
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 07 kcalml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories 1 unit   B4160
Indwelling catheter specialty type, eg coude, mushroom, wing, etc ), each   A4340
Injection, alpha 1 proteinase inhibitor (human), (glassia), 10 mg   J0257
Leg strap, h style, each   K0039
Enteral formula, for pediatrics, hydrolyzedamino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories 1 unit   B4161
Indwelling catheter, foley type, two-way, all silicone, each   A4344
Lead wires, (eg apnea monitor), per pair   A4557
Documentation of patient reason(s) for not prescribing beta-blocker therapy (eg, patient declined, other patient reasons)   G9191
Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth   E2624
Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each   A4236
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress   E0295
Als routine disposable supplies   A0398
Pulse generator system for tympanic treatment of inner ear endolymphatic fluid   E2120
Iodine i-125 serum albumin, diagnostic, per 5 microcuries   A9532
Injection, alprostadil, 125 mcg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)   J0270
Behavioral health outreach service (planned approach to reach a targeted population)   H0023
Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each   A4387
Adjustable angle footplate, each   K0040
Combination oralnasal mask, used with continuous positive airway pressure device, each   A7027
Eligible professional attests to documenting the patient's current medications to the best of hisher knowledge and ability   G8427
Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control   E0983
Foam dressing, wound cover, sterile, pad size 16 sq in Or less, with any size adhesive border, each dressing   A6212
Sorbent cartridges, for hemodialysis, per 10   E1636
Dialysate solution, any concentration of dextrose, fluid volume greater than 4999cc but less than or equal to 5999cc, for peritoneal dialysis   A4725
Foot, shoe molded to patient model, silicone shoe, each   L3251
Catheter, hemodialysisperitoneal, short-term   C1752
Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist   G0454
Pressure support ventilator with volume control mode, may include pressure control mode, used with invasive interface (eg tracheostomy tube)   E0463
Addition to lower extremity, torsion control, straight knee joint, each joint   L2380
Manual wheelchair accessory, propulsion wheel excludes tire, any size, each   E2224
Indwelling catheter foley type, three way for continuous irrigation, each   A4346
Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen   G0455
Oral cushion for combination oralnasal mask, replacement only, each   A7028
Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each   A4388
Dialysate solution, any concentration of dextrose, fluid volume greater than 5999cc, for peritoneal dialysis   A4726
Alprostadil urethral suppository (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)   J0275
Pressure support ventilator with volume control mode, may include pressure control mode, used with non-invasive interface (eg mask)   E0464
Catheter, intravascular ultrasound   C1753
Addition to lower extremity, straight knee joint, heavy duty, each joint   L2385
Foam dressing, wound cover, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, with any size adhesive border, each dressing   A6213
Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories 1 unit   B4162
Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth   E2625
Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each   E2225
Large size footplate, each   K0041
Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the health care system)   G9192
Hospital bed, total electric (head, foot and height adjustments) Without side rails, with mattress   E0296
Current medications not documented by the eligible professional, reason not given   G8428
Ambulance waiting time (als or bls), one half (12) hour increments   A0420
Conductive gel or paste, for use with electrical device (eg tens, nmes), per oz   A4558
Hemostats, each   E1637
Behavioral health prevention information dissemination service (one-way direct or non-direct contact with service audiences to affect knowledge and attitude)   H0024
Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each   L3252
Alcohol or peroxide, per pint   A4244
Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries   A9536
Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control   E0984
Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable   E2626
Male external catheter, with or without adhesive, disposable, each   A4349
Alcohol wipes, per box   A4245
Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint   L2387
Manual wheelchair accessory, caster fork, any size, replacement only, each   E2226
Standard size footplate, each   K0042
Catheter, intradiscal   C1754
Foot, molded shoe plastazote (or similar) custom fitted, each   L3253
Clinician documented that patient with a diagnosis of major depression was not an eligible candidate for antidepressant medication treatment or patient did not have a diagnosis of major depression   G9193
Injection, amikacin sulfate, 100 mg   J0278
Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress   E0297
Negative pressure wound therapy, (eg vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session total wounds(s) surface area less than or equal to 50 square centimeters   G0456
Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each   A4389
Scale, each   E1639
Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining   E2628
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, eg nasal or facial mask (intermittent assist device with continuous positive airway pressure device)   E0470
Coupling gel or paste, for use with ultrasound device, per oz   A4559
Nasal pillows for combination oralnasal mask, replacement only, pair   A7029
Eligible professional attests the patient is not eligible for medication documentation   G8430
Dialysate solution, non-dextrose containing, 500 ml   A4728
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation   A0422
Foam dressing, wound cover, sterile, pad size more than 48 sq in, with any size adhesive border, each dressing   A6214
Wheelchair accessory, seat lift mechanism   E0985
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries   A9537
Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude andor behavior)   H0025
Alcohol andor drug prevention process service, community-based (delivery of services to develop skills of impactors)   H0026
Dialysis equipment, not otherwise specified   E1699
Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged) (requires medical review)   A0424
Addition to lower extremity, offset knee joint, each joint   L2390
Positive screen for clinical depression with a documented follow-up plan   G8431
Non-standard size or width   L3254
Full face mask used with positive airway pressure device, each   A7030
Negative pressure wound therapy, (eg vacuum assisted drainage collection) using a mechanically-powered device, not durable medical equipment, including provision of cartridge and dressing(s), topical application(s), wound assessment, and instructions for ongoing care, per session total wounds(s) surface area greater than 50 square centimeters   G0457
Injection, aminophyllin, up to 250 mg   J0280
Footrest, lower extension tube, each   K0043
Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries   A9538
Pessary, rubber, any type   A4561
Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 180 day (6 month) continuation treatment phase   G9194
Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each   A4390
Catheter, intraspinal   C1755
Foam dressing, wound filler, sterile, per gram   A6215
Betadine or phisohex solution, per pint   A4246
Manual wheelchair accessory, push activated power assist, each   E0986
Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type   E2627
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, eg nasal or facial mask (intermittent assist device with continuous positive airway pressure device)   E0471
Manual wheelchair accessory, gear reduction drive wheel, each   E2227
Fistula cannulation set for hemodialysis, each   A4730
Pediatric crib, hospital grade, fully enclosed, with or without top enclosure   E0300
Intermittent urinary catheter straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc ), each   A4351
Low dose rate (ldr) prostate brachytherapy services, composite rate   G0458
Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries   A9539
Alcohol andor drug prevention environmental service (broad range of external activities geared toward modifying systems in order to mainstream prevention through policy and law)   H0027
Gauze, non-impregnated, non-sterile, pad size 16 sq in Or less, without adhesive border, each dressing   A6216
Clinical depression screening not documented, reason not given   G8432
Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, eg tracheostomy tube (intermittent assist device with continuous positive airway pressure device)   E0472
Injection, amiodarone hydrochloride, 30 mg   J0282
Pessary, non rubber, any type   A4562
Intermittent urinary catheter coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc ), each   A4352
Betadine or iodine swabswipes, per box   A4247
Non-standard size or length   L3255
Manual wheelchair accessory, wheel braking system and lock, complete, each   E2228
Topical anesthetic, for dialysis, per gram   A4736
Face mask interface, replacement for full face mask, each   A7031
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress   E0301
Ground mileage, per statute mile   A0425
Manual wheelchair accessory, lever-activated, wheel drive, pair   E0988
Addition to lower extremity, offset knee joint, heavy duty, each joint   L2395
Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 180 day (6 months) continuation treatment phase   G9195
Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each   A4391
Catheter, pacing, transesophageal   C1756
Footrest, upper hanger bracket, each   K0044
Addition to lower extremity orthosis, suspension sleeve   L2397
Chlorhexidine containing antiseptic, 1 ml   A4248
Wheelchair accessory, elevating leg rest, complete assembly, each   E0990
Percussor, electric or pneumatic, home model   E0480
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)   A0426
Injection, amphotericin b, 50 mg   J0285
Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each   A4392
Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries   A9540
Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress   E0302
Catheter, thrombectomyembolectomy   C1757
Orthopedic footwear, additional charge for split size   L3257
Documentation of medical reason(s) for not ordering first or second generation cephalosporin for antimicrobial prophylaxis   G9196
Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy   G0459
Injectable anesthetic, for dialysis, per 10 ml   A4737
Manual wheelchair accessory, manual standing system   E2230
Intermittent urinary catheter, with insertion supplies   A4353
Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)   E2629
Screening for clinical depression not documented, patient not eligibleappropriate   G8433
Slings   A4565
Cushion for use on nasal mask interface, replacement only, each   A7032
Footrest, complete assembly   K0045
Gauze, non-impregnated, non-sterile, pad size more than 16 sq in but less than or equal to 48 sq in, without adhesive border, each dressing   A6217
Injection, ampicillin sodium, 500 mg   J0290
Alcohol andor drug prevention problem identification and referral service (e G Student assistance and employee assistance programs), does not include assessment   H0028
Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support   E2630
Alcohol andor drug prevention alternatives service (services for populations that exclude alcohol and other drug use eg alcohol free social events)   H0029
Catheter, ureteral   C1758
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries   A9541
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each   A4393
Urine test or reagent strips or tablets (100 tablets or strips)   A4250
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware   E2231
Injection, amphotericin b lipid complex, 10 mg   J0287
Intrapulmonary percussive ventilation system and related accessories   E0481
Shunt accessory, for hemodialysis, any type, each   A4740
Ambulance service, advanced life support, emergency transport, level 1 (als1-emergency)   A0427
Surgical bootshoe, each   L3260
Pillow for use on nasal cannula type interface, replacement only, pair   A7033
Documentation that patient is not eligible for pain assessment   G8442
Gauze, non-impregnated, non-sterile, pad size more than 48 sq in, without adhesive border, each dressing   A6218
Insertion tray with drainage bag but without catheter   A4354
Shoulder sling or vest design, abduction restrainer, with or without swathe control, prefabricated, includes fitting and adjustment   A4566
Elevating legrest, lower extension tube, each   K0046
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress   E0303
Manual wheelchair accessory, solid seat insert   E0992
Documentation of order for first or second generation cephalosporin for antimicrobial prophylaxis   G9197
A medically-necessary, face to face encounter( one- on- one) between a new patient and a FQHC practitioner during which time one or more FQHC services are rendered and includes a typical bundle of Medicare-covered services that would be furnished per diem to a patient receiving a FQHC visit   G0466
Arm rest, each   E0994
Order for first or second generation cephalosporin for antimicrobial prophylaxis was not documented, reason not given   G9198
Blood ketone test or reagent strip, each   A4252
Catheter, intracardiac echocardiography   C1759
Wheelchair accessory, addition to mobile arm support, elevating proximal arm   E2631
Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each   A4355
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce   A4394
Gauze, non-impregnated, sterile, pad size 16 sq in Or less, with any size adhesive border, each dressing   A6219
Back, planar, for pediatric size wheelchair including fixed attaching hardware   E2291
Blood tubing, arterial or venous, for hemodialysis, each   A4750
Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries   A9542
Cough stimulating device, alternating positive and negative airway pressure   E0482
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap   A7034
Beta-blocker therapy prescribed   G8450
Behavioral health hotline service   H0030
Plastazote sandal, each   L3265
Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress   E0304
Elevating legrest, upper hanger bracket, each   K0047
Splint   A4570
Injection, amphotericin b cholesteryl sulfate complex, 10 mg   J0288
A medically-necessary, face to face encounter( one- on- one) between an established patient and a FQHC practitioner during which time one or more FQHC services are rendered and includes a typical bundle of Medicare-covered services that would be furnished per diem to a patient receiving a FQHC visit   G0467
Ambulance service, basic life support, non-emergency transport, (bls)   A0428
Ostomy deodorant for use in ostomy pouch, solid, per tablet   A4395
Bed side rails, half length   E0305
Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control   E2632
Ambulance service, basic life support, emergency transport (bls-emergency)   A0429
Wheelchair accessory, calf restpad, each   E0995
Closure device, vascular (implantableinsertable)   C1760
Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries   A9543
Gauze, non-impregnated, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, with any size adhesive border, each dressing   A6220
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips   A4253
Seat, planar, for pediatric size wheelchair including fixed attaching hardware   E2292
High frequency chest wall oscillation air-pulse generator system, (includes hoses and vest), each   E0483
A FQHC visit that includes an Initial Preventive Physical Examination (IPPE) or Annual Wellness Visit (AWV) and includes a typical bundle of Medicare-covered services that would be furnished per diem to a patient receiving an IPPE or AWV   G0468
Ratchet assembly   K0050
Clinician documented patient with left ventricular ejection fraction (lvef) 40 or documentation as moderately or severely depressed left ventricular systolic function was not eligible candidate for beta-blocker therapy   G8451
Topical hyperbaric oxygen chamber, disposable   A4575
Injection, amphotericin b liposome, 10 mg   J0289
Headgear used with positive airway pressure device   A7035
Venous thromboembolism (vte) prophylaxis not administered the day of or the day after hospital admission for documented reasons (eg, patient is ambulatory, patient expired during inpatient stay, patient already on warfarin or another anticoagulant, other medical reason(s) or eg, patient left against medical advice, other patient reason(s))   G9199
Blood tubing, arterial and venous combined, for hemodialysis, each   A4755
Mental health assessment, by non-physician   H0031
Back, contoured, for pediatric size wheelchair including fixed attaching hardware   E2293
Mental health service plan development by non-physician   H0032
Chinstrap used with positive airway pressure device   A7036
Platforms for home blood glucose monitor, 50 per box   A4255
Bed side rails, full length   E0310
Ostomy belt with peristomal hernia support   A4396
Wheelchair accessory, addition to mobile arm support, supinator   E2633
Ambulance service, conventional air services, transport, one way (fixed wing)   A0430
Cam release assembly, footrest or legrest, each   K0051
Wheelchair accessory, power seating system, tilt only   E1002
Beta-blocker therapy not prescribed   G8452
Connective tissue, human (includes fascia lata)   C1762
Venous thromboembolism (vte) prophylaxis was not administered the day of or the day after hospital admission, reason not given   G9200
A medically-necessary, face-to-face mental health encounter(one-on-one) between a new patient and a FQHC practitioner during which time one or more FQHC services are rendered and includes a typical bundle of Medicare covered services that would be furnished per diem to a patient receiving a mental health visit   G0469
Gauze, non-impregnated, sterile, pad size more than 48 sq in, with any size adhesive border, each dressing   A6221
Oscillatory positive expiratory pressure device, non-electric, any type, each   E0484
Iodine i-131 tositumomab, diagnostic, per study dose   A9544
Cast supplies (eg plaster)   A4580
Dialysate solution test kit, for peritoneal dialysis, any type, each   A4760
Venous thromboembolism (vte) prophylaxis administered the day of or the day after hospital admission   G9201
Normal, low and high calibrator solution chips   A4256
Swingaway, detachable footrests, each   K0052
Seat, contoured, for pediatric size wheelchair including fixed attaching hardware   E2294
Oral deviceappliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment   E0485
Irrigation supply sleeve, each   A4397
Clinician documented that patient is not an eligible candidate for genotype testing patient not receiving antiviral treatment for hepatitis c   G8458
Connective tissue, non-human (includes synthetic)   C1763
Dialysate concentrate, powder, additive for peritoneal dialysis, per packet   A4765
Ambulance service, conventional air services, transport, one way (rotary wing)   A0431
Wheelchair accessory, power seating system, recline only, without shear reduction   E1003
Special casting material (eg fiberglass)   A4590
Injection, ampicillin sodiumsulbactam sodium, per 15 gm   J0295
Bed accessory board, table, or support device, any type   E0315
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq in Or less, without adhesive border, each dressing   A6222
Tubing used with positive airway pressure device   A7037
A medically-necessary, face-to-face mental health encounter(one-on-one) between an established patient and a FQHC practitioner during which time one or more FQHC services are rendered and includes a typical bundle of Medicare covered services that would be furnished per diem to a patient receiving a mental health visit   G0470
Oral medication administration, direct observation   H0033
Iodine i-131 tositumomab, therapeutic, per treatment dose   A9545
Cobalt co-5758, cyanocobalamin, diagnostic, per study dose, up to 1 microcurie   A9546
Oral deviceappliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment   E0486
Electrical stimulator supplies, 2 lead, per month, (eg tens, nmes)   A4595
Clinician documented that patient is not an eligible candidate for quantitative rna testing at week 12 patient not receiving antiviral treatment for hepatitis c   G8460
Elevating footrests, articulating (telescoping), each   K0053
Safety enclosure framecanopy for use with hospital bed, any type   E0316
Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml   A4766
Filter, disposable, used with positive airway pressure device   A7038
Wheelchair accessory, power seating system, recline only, with mechanical shear reduction   E1004
Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (SNF) or by a laboratory on behalf of a home health agency (HHA)   G0471
Ostomy irrigation supply bag, each   A4398
Replacement lens shield cartridge for use with laser skin piercing device, each   A4257
Patients with a positive hepatitis c antibody test   G9202
Manual wheelchair accessory, for pediatric size wheelchair, dynamic seating frame, allows coordinated movement of multiple positioning features   E2295
Event recorder, cardiac (implantable)   C1764
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq in, but less than or equal to 48 sq in, without adhesive border, each dressing   A6223
Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers   A0432
Medication training and support, per 15 minutes   H0034
Injection, amobarbital, up to 125 mg   J0300
Urinal male, jug-type, any material   E0325
Filter, non disposable, used with positive airway pressure device   A7039
Spring-powered device for lancet, each   A4258
Sleeve for intermittent limb compression device, replacement only, each   A4600
Injection, succinylcholine chloride, up to 20 mg   J0330
Wheelchair accessory, power seatng system, recline only, with power shear reduction   E1005
Indium in-111 oxyquinoline, diagnostic, per 05 millicurie   A9547
Ostomy irrigation supply conecatheter, with or without brush   A4399
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq in, without adhesive border, each dressing   A6224
Power wheelchair accessory, power seat elevation system   E2300
Rna testing for hepatitis c documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c   G9203
Most recent hemoglobin (hgb) level 120 gdl   G0908
Blood collection tube, vacuum, for dialysis, per 50   A4770
Mental health partial hospitalization, treatment, less than 24 hours   H0035
Advanced life support, level 2 (als 2)   A0433
Spirometer, electronic, includes all accessories   E0487
Adhesion barrier   C1765
Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair   K0056
Patient receiving antiviral treatment for hepatitis c   G8461
Rna testing for hepatitis c was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given   G9204
Spoke protectors, each   K0065
Gauze, impregnated, water or normal saline, sterile, pad size 16 sq in Or less, without adhesive border, each dressing   A6228
Urinal female, jug-type, any material   E0326
Specialty care transport (sct)   A0434
Indium in-111 pentetate, diagnostic, per 05 millicurie   A9548
Ostomy irrigation set   A4400
Lancets, per box of 100   A4259
Power wheelchair accessory, power standing system   E2301
Serum clotting time tube, for dialysis, per 50   A4771
Community psychiatric supportive treatment, face-to-face, per 15 minutes   H0036
Injection, anidulafungin, 1 mg   J0348
Lithium ion battery for non-prosthetic use, replacement   A4601
Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction   E1006
Clinician documented that prostate cancer patient is not an eligible candidate for adjuvant hormonal therapy low or intermediate risk of recurrence or risk of recurrence not determined   G8464
One way chest drain valve   A7040
Hemoglobin level measurement not documented, reason not given   G0909
Introducersheath, guiding, intracardiac electrophysiological, steerable, other than peel-away   C1766
Cervical cap for contraceptive use   A4261
Injection, anistreplase, per 30 units   J0350
Rear wheel assembly, complete, with solid tire, spokes or molded, each   K0069
Hospital bed, pediatric, manual, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress   E0328
Tubing with integrated heating element for use with positive airway pressure device   A4604
Fixed wing air mileage, per statute mile   A0435
Blood glucose test strips, for dialysis, per 50   A4772
Lubricant, per ounce   A4402
Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware   E2310
Most recent hemoglobin level 120 gdl   G0910
Community psychiatric supportive treatment program, per diem   H0037
Patient starting antiviral treatmentfor hepatitis c during the measurement period   G9205
Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, without adhesive border, each dressing   A6229
Technetium tc-99m sodium gluceptate, diagnostic, per study dose, up to 25 millicurie   A9550
High risk of recurrence of prostate cancer   G8465
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction   E1007
Water seal drainage container and tubing for use with implanted chest tube   A7041
Generator, neurostimulator (implantable), non-rechargeable   C1767
Graft, vascular   C1768
Improvement in visual function achieved within 90 days following cataract surgery   G0913
Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq in, without adhesive border, each dressing   A6230
Occult blood test strips, for dialysis, per 50   A4773
Ostomy ring, each   A4404
Rear wheel assembly, complete, with pneumatic tire, spokes or molded, each   K0070
Implanted pleural catheter, each   A7042
Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy prescribed   G8473
Patient starting antiviral treatment for hepatitis c during the measurement period   G9206
Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction   E1008
Tracheal suction catheter, closed system, each   A4605
Oxygen accessory, flow regulator capable of positive inspiratory pressure   E1352
Self-helppeer services, per 15 minutes   H0038
Hospital bed, pediatric, electric or semi-electric, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress   E0329
Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware   E2311
Injection, hydralazine hcl, up to 20 mg   J0360
Technetium tc-99m succimer, diagnostic, per study dose, up to 10 millicuries   A9551
Rotary wing air mileage, per statute mile   A0436
Temporary, absorbable lacrimal duct implant, each   A4262
Guide wire   C1769
Control unit for electronic bowel irrigationevacuation system   E0350
Drive belt for power wheelchair   K0098
Permanent, long term, non-dissolvable lacrimal duct implant, each   A4263
Hepatitis c genotype testing documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c   G9207
Ostomy skin barrier, non-pectin based, paste, per ounce   A4405
Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed for reasons documented by the clinician   G8474
Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq in Or less, each dressing   A6231
Injection, apomorphine hydrochloride, 1 mg   J0364
Ammonia test strips, for dialysis, per 50   A4774
Vacuum drainage bottle and tubing for use with implanted catheter   A7043
Patient care survey was not completed by patient   G0914
Front caster assembly, complete, with pneumatic tire, each   K0071
Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each   E1009
Noncovered ambulance mileage, per mile (eg for miles traveled beyond closest appropriate facility)   A0888
Oxygen probe for use with oximeter device, replacement   A4606
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries   A9552
Assertive community treatment, face-to-face, per 15 minutes   H0039
Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware   E2312
Ostomy skin barrier, pectin-based, paste, per ounce   A4406
Front caster assembly, complete, with semi-pneumatic tire, each   K0072
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each   E2313
Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq in, but less than or equal to 48 sq in, each dressing   A6232
Protamine sulfate, for hemodialysis, per 50 mg   A4802
Permanent implantable contraceptive intratubal occlusion device(s) and delivery system   A4264
Assertive community treatment program, per diem   H0040
Disposable pack (water reservoir bag, speculum, valving mechanism and collection bagbox) for use with the electronic bowel irrigationevacuation system   E0352
Oral interface used with positive airway pressure device, each   A7044
Injection, aprotonin, 10,000 kiu   J0365
Transtracheal oxygen catheter, each   A4608
Angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy not prescribed, reason not given   G8475
Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair   E1010
Hepatitis c genotype testing was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given   G9208
Chromium cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuries   A9553
Imaging coil, magnetic resonance (insertable)   C1770
Improvement in visual function not achieved within 90 days following cataract surgery   G0915
Ambulance response and treatment, no transport   A0998
Most recent blood pressure has a systolic measurement of 130 mmhg and a diastolic measurement of 80 mmhg   G8476
Foster care, child, non-therapeutic, per diem   H0041
Caster pin lock,each   K0073
Hepatitis c quantitative rna testing documented as performed between 4-12 weeks after the initiation of antiviral treatment   G9209
Exhalation port with or without swivel used with accessories for positive airway devices, replacement only   A7045
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each   A4407
Repair device, urinary, incontinence, with sling graft   C1771
Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)   E1011
Iodine i-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries   A9554
Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware   E2321
Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq in, each dressing   A6233
Paraffin, per pound   A4265
Unlisted ambulance service   A0999
Injection, metaraminol bitartrate, per 10 mg   J0380
Disposable catheter tips for peritoneal dialysis, per 10   A4860
Satisfaction with care achieved within 90 days following cataract surgery   G0916
Air pressure elevator for heel   E0370
Ostomy skin barrier, wtih flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each   A4408
Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware   E2322
Foster care, child, non-therapeutic, per month   H0042
Infusion pump, programmable (implantable)   C1772
Injection, chloroquine hydrochloride, up to 250 mg   J0390
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq in Or less, without adhesive border, each dressing   A6234
Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries   A9555
Water chamber for humidifier, used with positive airway pressure device, replacement, each   A7046
Hepatitis c quantitative rna testing not performed between 4-12 weeks after the initiation of antiviral treatment for reasons documented by clinician (eg, patients whose treatment was discontinued during the testing period prior to testing, other medical reasons, patient declined, other patient reasons)   G9210
Patient satisfaction survey was not completed by patient   G0917
Front caster assembly, complete, with solid tire, each   K0077
Diaphragm for contraceptive use   A4266
Plumbing andor electrical work for home hemodialysis equipment   A4870
Most recent blood pressure has a systolic measurement of 130 mmhg andor a diastolic measurement of 80 mmhg   G8477
Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width   E0371
Reclining back, addition to pediatric size wheelchair   E1014
Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, without adhesive border, each dressing   A6235
Gallium ga-67 citrate, diagnostic, per millicurie   A9556
Retrieval device, insertable (used to retrieve fractured medical devices)   C1773
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each   A4409
Blood pressure measurement not performed or documented, reason not given   G8478
Shock absorber for manual wheelchair, each   E1015
Injection, arbutamine hcl, 1 mg   J0395
Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated   E2323
Contracts, repair and maintenance, for hemodialysis equipment   A4890
Oral interface used with respiratory suction pump, each   A7047
Contraceptive supply, condom, male, each   A4267
Supported housing, per diem   H0043
Hepatitis c quantitative rna testing was not documented as performed between 4-12 weeks after the initiation of antiviral treatment, reason not given   G9211
Powered air overlay for mattress, standard mattress length and width   E0372
Satisfaction with care not achieved within 90 days following cataract surgery   G0918
Drain bagbottle, for dialysis, each   A4911
Shock absorber for power wheelchair, each   E1016
Technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries   A9557
Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq in, without adhesive border, each dressing   A6236
Iv hanger, each   K0105
Dsm-ivtm criteria for major depressive disorder documented at the initial evaluation   G9212
Power wheelchair accessory, chin cup for chin control interface   E2324
Contraceptive supply, condom, female, each   A4268
Nonpowered advanced pressure reducing mattress   E0373
Joint device (implantable)   C1776
Influenza immunization ordered or recommended (to be given at alternate location or alternate provider) vaccine not available at time of visit   G0919
Tracheostoma valve, including diaphragm, each   A7501
Supported housing, per month   H0044
Influenza immunization administered or previously received   G8482
Injection, aripiprazole, intramuscular, 025 mg   J0400
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each   A4410
Miscellaneous dialysis supplies, not otherwise specified   A4913
Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware   E2325
Contraceptive supply, spermicide (eg foam, gel), each   A4269
Influenza immunization was not ordered or administered for reasons documented by clinician (eg patient allergy or other medical reason, patient declined or other patient reasons, or other system reasons)   G8483
Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each   E1017
Lead, cardioverter-defibrillator, endocardial single coil (implantable)   C1777
Ostomy skin barrier, solid 4x4 or equivalent, extended wear, with built-in convexity, each   A4411
Type, anatomic location, and activity all documented   G0920
Dsm-iv-tr criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified   G9213
Replacement diaphragmfaceplate for tracheostoma valve, each   A7502
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq in Or less, with any size adhesive border, each dressing   A6237
Wheelchair component or accessory, not otherwise specified   K0108
Xenon xe-133 gas, diagnostic, per 10 millicuries   A9558
Respite care services, not in the home, per diem   H0045
Injection, azithromycin, 500 mg   J0456
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each   A4412
Documentation of patient reason(s) for not being able to assess (eg patient refuses endoscopic andor radiologic assessment)   G0921
Influenza immunization was not ordered or administered, reason not given   G8484
Mental health services, not otherwise specified   H0046
Venous pressure clamp, for hemodialysis, each   A4918
Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each   A7503
Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurie   A9559
Lead, neurostimulator (implantable)   C1778
Disposable endoscope sheath, each   A4270
Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each   E1018
Injection, atropine sulfate, 001 mg   J0461
Cd4 cell count or cd4 cell percentage results documented   G9214
Elevating leg rests, pair (for use with capped rental wheelchair base)   K0195
Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, with any size adhesive border, each dressing   A6238
Power wheelchair accessory, breath tube kit for sip and puff interface   E2326
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each   A4413
Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries   A9560
Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq in, with any size adhesive border, each dressing   A6239
No documentation of disease type, anatomic location, and activity, reason not given   G0922
Lead, pacemaker, transvenous vdd single pass   C1779
Filter for use in a tracheostoma heat and moisture exchange system, each   A7504
Infusion pump used for uninterrupted parenteral administration of medication, (eg epoprostenol or treprostinol)   K0455
Gloves, non-sterile, per 100   A4927
Alcohol andor other drug abuse services, not otherwise specified   H0047
Residual limb support system for wheelchair, any type   E1020
I intend to report the diabetes mellitus (dm) measures group   G8485
Cd4 cell count or percentage not documented as performed, reason not given   G9215
Injection, dimercaprol, per 100 mg   J0470
Adhesive skin support attachment for use with external breast prosthesis, each   A4280
Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware   E2327
Surgical mask, per 20   A4928
Administration and supply of tositumomab, 450 mg   G3001
I intend to report the preventive care measures group   G8486
Lens, intraocular (new technology)   C1780
Tubing for breast pump, replacement   A4281
Pcp prophylaxis was not prescribed at time of diagnosis of hiv, reason not given   G9216
Hydrocolloid dressing, wound filler, paste, sterile, per ounce   A6240
Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries   A9561
Alcohol andor other drug testing collection and handling only, specimens other than blood   H0048
Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware   E2328
Temporary replacement for patient owned equipment being repaired, any type   K0462
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each   A4414
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory   E1028
Injection, baclofen, 10 mg   J0475
Housing, reusable without adhesive, for use in a heat and moisture exchange system andor with a tracheostoma valve, each   A7505
Injection, baclofen, 50 mcg for intrathecal trial   J0476
Adhesive disc for use in a heat and moisture exchange system andor with tracheostoma valve, any type each   A7506
Tourniquet for dialysis, each   A4929
Supplies for external drug infusion pump, syringe type cartridge, sterile, each   K0552
Left ventricular ejection fraction (lvef) 40 or documentation of moderately or severely depressed left ventricular systolic function   G8923
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4x4 inches, each   A4415
Adapter for breast pump, replacement   A4282
Hydrocolloid dressing, wound filler, dry form, sterile, per gram   A6241
Wheelchair accessory, ventilator tray, fixed   E1029
Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries   A9562
I intend to report the chronic kidney disease (ckd) measures group   G8487
Alcohol andor drug screening   H0049
Pcp prophylaxis was not prescribed within 3 months of low cd4 cell count below 200 cellsmm3, reason not given   G9217
Mesh (implantable)   C1781
Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware   E2329
Sodium phosphate p-32, therapeutic, per millicurie   A9563
Hydrogel dressing, wound cover, sterile, pad size 16 sq in Or less, without adhesive border, each dressing   A6242
Replacement battery for external infusion pump owned by patient, silver oxide, 15 volt, each   K0601
Alcohol andor drug services, brief intervention, per 15 minutes   H0050
Cap for breast pump bottle, replacement   A4283
Injection, basiliximab, 20 mg   J0480
Gloves, sterile, per pair   A4930
Pcp prophylaxis was not prescribed within 3 months oflow cd4 cell count below 500 cellsmm3 or a cd4 percentage below 15, reason not given   G9218
Spirometry test results demonstrate fev1fvc 60 with copd symptoms (eg dyspnea, coughsputum, wheezing)   G8924
Ostomy pouch, closed, with barrier attached, with filter (1 piece), each   A4416
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each   A7507
I intend to report the coronary artery disease (cad) measures group   G8489
Wheelchair accessory, ventilator tray, gimbaled   E1030
Morcellator   C1782
Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware   E2330
I intend to report the rheumatoid arthritis (ra) measures group   G8490
Injection, belatacept, 1 mg   J0485
Oral thermometer, reusable, any type, each   A4931
Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system andor with a tracheostoma valve, each   A7508
Prenatal care, at-risk assessment   H1000
Power wheelchair accessory, attendant control, proportional, including all related electronics and fixed mounting hardware   E2331
Breast shield and splash protector for use with breast pump, replacement   A4284
Chromic phosphate p-32 suspension, therapeutic, per millicurie   A9564
Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4 cell count below 200 cellsmm3 for medical reason (ie, patient''s cd4 cell count above threshold within 3 months after cd4 cell count below threshold, indicating that the patient''s cd4 levels are within an acceptable range and the patient does not require pcp prophylaxis)   G9219
Ocular implant, aqueous drainage assist device   C1783
Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each   K0602
Spirometry test results demonstrate fev1fvc 60 or patient does not have copd symptoms   G8925
Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each   A4417
Hydrogel dressing, wound cover, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, without adhesive border, each dressing   A6243
Ocular device, intraoperative, detached retina   C1784
Polycarbonate bottle for use with breast pump, replacement   A4285
Ostomy pouch, closed without barrier attached, with filter (1 piece), each   A4418
Rectal thermometer, reusable, any type, each   A4932
I intend to report the hivaids measures group   G8491
Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4 cell count below 500 cellsmm3 or a cd4 percentage below 15 for medical reason (ie, patient''s cd4 cell count above threshold within 3 months after cd4 cell count below threshold, indicating that the patient''s cd4 levels are within an acceptable range and the patient does not require pcp prophylaxis)   G9220
Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each   A7509
Replacement battery for external infusion pump owned by patient, alkaline, 15 volt, each   K0603
Spirometry test not performed or documented, reason not given   G8926
Prenatal care, at-risk enhanced service antepartum management   H1001
Technetium tc-99m fanolesomab, diagnostic, per study dose, up to 25 millicuries   A9566
Power wheelchair accessory, nonstandard seat frame width, 20-23 inches   E2340
Injection, belimumab, 10 mg   J0490
Hydrogel dressing, wound cover, sterile, pad size more than 48 sq in, without adhesive border, each dressing   A6244
Pacemaker, dual chamber, rate-responsive (implantable)   C1785
Adjuvant chemotherapy referred, prescribed or previously received for ajcc stage iii, colon cancer   G8927
Ostomy pouch, closed for use on barrier with non-locking flange, with filter (2 piece), each   A4419
Injection, dicyclomine hcl, up to 20 mg   J0500
Power wheelchair accessory, nonstandard seat frame width, 24-27 inches   E2341
I intend to report the perioperative care measures group   G8492
Hydrogel dressing, wound cover, sterile, pad size 16 sq in Or less, with any size adhesive border, each dressing   A6245
Replacement battery for external infusion pump owned by patient, lithium, 36 volt, each   K0604
Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries   A9567
Prenatal care, at risk enhanced service care coordination   H1002
Pneumocystis jiroveci pneumonia prophlaxis prescribed   G9221
Locking ring for breast pump, replacement   A4286
Prenatal care, at-risk enhanced service education   H1003
Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches   E2342
Adjuvant chemotherapy not prescribed or previously received, reason given   G8928
Replacement battery for external infusion pump owned by patient, lithium, 45 volt, each   K0605
Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries   A9568
Injection, benztropine mesylate, per 1 mg   J0515
Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin 3 months of low cd4 cell count below 200 cellsmm3   G9222
Sacral nerve stimulation test lead, each   A4290
I intend to report the back pain measures group   G8493
Pacemaker, single chamber, rate-responsive (implantable)   C1786
Ostomy pouch, closed for use on barrier with locking flange (2 piece), each   A4420
Hydrogel dressing, wound cover, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, with any size adhesive border, each dressing   A6246
Injection, bethanechol chloride, myotonachol or urecholine, up to 5 mg   J0520
All quality actions for the applicable measures in the diabetes mellitus (dm) measures group have been performed for this patient   G8494
Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4 cell count below 500 cellsmm3 or a cd4 percentage below 15   G9223
Hydrogel dressing, wound cover, sterile, pad size more than 48 sq in, with any size adhesive border, each dressing   A6247
Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose   A9569
Prenatal care, at-risk enhanced service follow-up home visit   H1004
Adjuvant chemotherapy not prescribed or previously received, reason not given   G8929
Patient programmer, neurostimulator   C1787
Ostomy supply miscellaneous   A4421
Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches   E2343
Automatic external defibrillator, with integrated electrocardiogram analysis, garment type   K0606
Port, indwelling (implantable)   C1788
Indium in-111 labeled autologous white blood cells, diagnostic, per study dose   A9570
Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface   E2351
Assessment of depression severity not documented, reason not given   G8930
Hydrogel dressing, wound filler, gel, per fluid ounce   A6248
Ostomy absorbent material (sheetpadcrystal packet) for use in ostomy pouch to thicken liquid stomal output, each   A4422
Prenatal care, at-risk enhanced service package (includes h1001-h1004)   H1005
Documentation of medical reason for not performing foot exam (eg, patient with bilateral footleg amputation)   G9224
Injection, penicillin g benzathine and penicillin g procaine, 100,000 units   J0558
Replacement battery for automated external defibrillator, garment type only, each   K0607
All quality actions for the applicable measures in the chronic kidney disease (ckd) measures group have been performed for this patient   G8495
Indium in-111 labeled autologous platelets, diagnostic, per study dose   A9571
Skin sealants, protectants, moisturizers, ointments, any type, any size   A6250
Prosthesis, breast (implantable)   C1789
Replacement garment for use with automated external defibrillator, each   K0608
Ostomy pouch, closed for use on barrier with locking flange, with filter (2 piece), each   A4423
Power wheelchair accessory, group 34 non-sealed lead acid battery, each   E2358
Foot exam was not performed, reason not given   G9225
All quality actions for the applicable measures in the preventive care measures group have been performed for this patient   G8496
Injection, penicillin g benzathine, 100,000 units   J0561
Non-medical family planning education, per session   H1010
Assessment of depression severity not documented, reason not given   G8931
Suicide risk assessed at the initial evaluation   G8932
Prosthesis, penile, inflatable   C1813
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each   A4424
Injection, bivalirudin, 1 mg   J0583
Foot examination performed (includes examination through visual inspection, sensory exam with monofilament, and pulse exam - report when all of the 3 components are completed)   G9226
Replacement electrodes for use with automated external defibrillator, garment type only, each   K0609
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq in Or less, without adhesive border, each dressing   A6251
All quality actions for the applicable measures in the coronary artery bypass graft (cabg) measures group have been performed for this patient   G8497
Family assessment by licensed behavioral health professional for state defined purposes   H1011
Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries   A9572
Power wheelchair accessory, group 34 sealed lead acid battery, each (eg gel cell, absorbed glassmat)   E2359
All quality actions for the applicable measures in the coronary artery disease (cad) measures group have been performed for this patient   G8498
Injection, onabotulinumtoxina, 1 unit   J0585
Injection, gadoterate meglumine, 01 ml   A9575
Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan   G9227
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, without adhesive border, each dressing   A6252
Retinal tamponade device, silicone oil   C1814
Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from dme pdac   K0669
Power wheelchair accessory, 22 nf non-sealed lead acid battery, each   E2360
Suicide risk not assessed at the initial evaluation, reason not given   G8933
Ostomy pouch, drainable for use on barrier with non-locking flange, with filter (2 piece system), each   A4425
Comprehensive multidisciplinary evaluation   H2000
Injection, abobotulinumtoxina, 5 units   J0586
Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings)   G9228
Rehabilitation program, per 12 day   H2001
Injection, gadoteridol, (prohance multipack), per ml   A9576
Prosthesis, urinary sphincter (implantable)   C1815
Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each   K0672
Left ventricular ejection fraction (lvef) 40 or documentation of moderately or severely depressed left ventricular systolic function   G8934
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq in, without adhesive border, each dressing   A6253
Power wheelchair accessory, 22nf sealed lead acid battery, each, (eg gel cell, absorbed glassmat)   E2361
All quality actions for the applicable measures in the rheumatoid arthritis (ra) measures group have been performed for this patient   G8499
Ostomy pouch, drainable for use on barrier with locking flange (2 piece system), each   A4426
Comprehensive medication services, per 15 minutes   H2010
Power wheelchair accessory, group 24 non-sealed lead acid battery, each   E2362
Injection, gadobenate dimeglumine (multihance), per ml   A9577
Controlled dose inhalation drug delivery system   K0730
Receiver andor transmitter, neurostimulator (implantable)   C1816
All quality actions for the applicable measures in the hivaids measures group have been performed for this patient   G8500
Chlamydia, gonorrhea, and syphilis not screened, due to documented reason (patient refusal is the only allowed exclusion)   G9229
Clinician prescribed angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy   G8935
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq in Or less, with any size adhesive border, each dressing   A6254
Injection, rimabotulinumtoxinb, 100 units   J0587
Ostomy pouch, drainable for use on barrier with locking flange, with filter (2 piece system), each   A4427
Injection, incobotulinumtoxin a, 1 unit   J0588
Chlamydia, gonorrhea, and syphilis not screened, reason not given   G9230
Septal defect implant system, intracardiac   C1817
Injection, gadobenate dimeglumine (multihance multipack), per ml   A9578
All quality actions for the applicable measures in the perioperative care measures group have been performed for this patient   G8501
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, with any size adhesive border, each dressing   A6255
Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (eg gel cell, absorbed glassmat)   K0733
Clinician documented that patient was not an eligible candidate for angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy   G8936
Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each   A4428
Crisis intervention service, per 15 minutes   H2011
Power wheelchair accessory, group 24 sealed lead acid battery, each (eg gel cell, absorbed glassmat)   E2363
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq in, with any size adhesive border, each dressing   A6256
Injection, buprenorphine hydrochloride, 01 mg   J0592
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml   A9579
Clinician did not prescribe angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy, reason not given   G8937
Integrated keratoprosthesis   C1818
Behavioral health day treatment, per hour   H2012
Power wheelchair accessory, u-1 non-sealed lead acid battery, each   E2364
Documentation of end stage renal disease (esrd), dialysis, renal transplant or pregnancy   G9231
Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each   A4429
All quality actions for the applicable measures in the back pain measures group have been performed for this patient   G8502
Portable gaseous oxygen system, rental home compressor used to fill portable oxygen cylinders includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing   K0738
Injection, busulfan, 1 mg   J0594
Surgical tissue localization and excision device (implantable)   C1819
Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition for specified patient reason   G9232
Transparent film, sterile, 16 sq in Or less, each dressing   A6257
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each   A4430
Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries   A9580
Power wheelchair accessory, u-1 sealed lead acid battery, each (eg gel cell, absorbed glassmat)   E2365
Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy   G8506
Psychiatric health facility service, per diem   H2013
Bmi is calculated, but patient not eligible for follow-up plan   G8938
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes   K0739
Transparent film, sterile, more than 16 sq in but less than or equal to 48 sq in, each dressing   A6258
Skills training and development, per 15 minutes   H2014
Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each   E2366
Repair or nonroutine service for oxygen equipment requiring the skill of a technician, labor component, per 15 minutes   K0740
Injection, butorphanol tartrate, 1 mg   J0595
Injection, gadoxetate disodium, 1 ml   A9581
Ostomy pouch, urinary with barrier attached, with faucet-type tap with valve (1 piece), each   A4431
Documentation of positive pain assessment no documentation of a follow-up plan, reason not given   G8509
All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient   G9233
Generator, neurostimulator (implantable), with rechargeable battery and charging system   C1820
Pain assessment documented, follow-up plan not documented, patient not eligibleappropriate   G8939
I intend to report the total knee replacement measures group   G9234
Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries   A9582
Injection, c-1 esterase inhibitor (human), berinert, 10 units   J0597
Suction pump, home model, portable, for use on wounds   K0743
Screening for clinical depression documented, follow-up plan not documented, patient not eligibleappropriate   G8940
Transparent film, sterile, more than 48 sq in, each dressing   A6259
Negative screen for clinical depression, follow-up not required   G8510
Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each   E2367
Ostomy pouch, urinary for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each   A4432
Interspinous process distraction device (implantable)   C1821
Comprehensive community support services, per 15 minutes   H2015
Injection, gadofosveset trisodium, 1 ml   A9583
Wound cleansers, any type, any size   A6260
Comprehensive community support services, per diem   H2016
Injection, c-1 esterase inhibitor (human), cinryze, 10 units   J0598
Absorptive wound dressing for use with suction pump, home model, portable, pad size 16 square inches or less   K0744
Powered bone marrow biopsy needle   C1830
Positive screen for clinical depression documented, follow up plan not documented, reason not given   G8511
All quality actions for the applicable measures in the general surgery measures group have been performed for this patient   G9235
Power wheelchair component, drive wheel motor, replacement only   E2368
Elder maltreatment screen documented, patient not eligible for follow-up   G8941
Ostomy pouch, urinary for use on barrier with locking flange (2 piece), each   A4433
Power wheelchair component, drive wheel gear box, replacement only   E2369
Ostomy pouch, urinary for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each   A4434
Injection, edetate calcium disodium, up to 1000 mg   J0600
Autogenous av fistula received   G8530
Absorptive wound dressing for use with suction pump, home model, portable, pad size more than 16 square inches but less than or equal to 48 square inches   K0745
Lens, intraocular (telescopic)   C1840
Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries   A9584
Psychosocial rehabilitation services, per 15 minutes   H2017
All quality actions for the applicable measures in the optimizing patient exposure to ionizing radiation measures group have been performed for this patient   G9236
Wound filler, gelpaste, per fluid ounce, not otherwise specified   A6261
Documented functional outcomes assessment and care plan within the previous 30 days   G8942
Wound filler, dry form, per gram, not otherwise specified   A6262
Injection, gadobutrol, 01 ml   A9585
Absorptive wound dressing for use with suction pump, home model, portable, pad size greater than 48 square inches   K0746
Ldl-c result not present or not within 12 months prior   G8943
Clinician documented that patient was not an eligible candidate for autogenous av fistula   G8531
I intend to report the general surgery measures group   G9237
Psychosocial rehabilitation services, per diem   H2018
Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only   E2370
Injection, calcium gluconate, per 10 ml   J0610
Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each   A4435
Retinal prosthesis, includes all internal and external components   C1841
Power wheelchair accessory, group 27 sealed lead acid battery, (eg gel cell, absorbed glassmat), each   E2371
Ajcc melanoma cancer stage 0 through iic melanoma   G8944
Therapeutic behavioral services, per 15 minutes   H2019
Clinician documented that patient recevied vascular access other than autogenous av fistula, reason not given   G8532
Florbetapir f18, diagnostic, per study dose, up to 10 millicuries   A9586
Injection, calcium glycerophosphate and calcium lactate, per 10 ml   J0620
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard   A6266
Stent, coatedcovered, with delivery system   C1874
Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds   K0800
I intend to report the optimizing patient exposure to ionizing radiation measures group   G9238
Minimally invasive biopsy method attempted but not diagnostic of breast cancer (eg high risk lesion of breast such as atypical ductal hyperplasia, lobular neoplasia, atypical lobular carcinoma in situ, atypical columnar hyperplasica, flat epithelial atypia, radial scar, complex sclerosing lesion, papillary lesion, or any lesion with spindle cells)   G8946
Therapeutic behavioral services, per diem   H2020
Stent, coatedcovered, without delivery system   C1875
Documentation of reasons for patient initiaiting maintenance hemodialysis with a catheter as the mode of vascular access (eg, patient has a maturing avfavg, time-limited trial of hemodialysis, patients undergoing palliative dialysis, other medical reasons, patient declined avfavg, other patient reasons, patient followed by reporting nephrologist for fewer than 90 days, other system reasons)   G9239
Radiopharmaceutical, diagnostic, for beta-amyloid positron emission tomography (pet) imaging, per study dose   A9599
No documentation of an elder maltreatment screen, patient not eligible   G8535
Power wheelchair accessory, group 27 non-sealed lead acid battery, each   E2372
Injection, calcitonin salmon, up to 400 units   J0630
Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds   K0801
Gauze, non-impregnated, sterile, pad size 16 sq in Or less, without adhesive border, each dressing   A6402
Strontium sr-89 chloride, therapeutic, per millicurie   A9600
Community-based wrap-around services, per 15 minutes   H2021
No documentation of an elder maltreatment screen, reason not given   G8536
One or more neuropsychiatric symptoms   G8947
Patient whose mode of vascular access is a catheter at the time maintenance hemodialysis is initiated   G9240
Injection, calcitriol, 01 mcg   J0636
Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware   E2373
Gauze, non-impregnated, sterile, pad size more than 16 sq in less than or equal to 48 sq in, without adhesive border, each dressing   A6403
Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds   K0802
Stent, non-coatednon-covered, with delivery system   C1876
Stent, non-coatednon-covered, without delivery system   C1877
Injection, caspofungin acetate, 5 mg   J0637
Gauze, non-impregnated, sterile, pad size more than 48 sq in, without adhesive border, each dressing   A6404
Community-based wrap-around services, per diem   H2022
Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds   K0806
Documentation of a functional outcome assessment using a standardized tool and documentation of a care plan based on identified deficiencies on the date of functional outcome assessment   G8539
No neuropsychiatric symptoms   G8948
Patient whose mode of vascular access is not a catheter at the time maintenance hemodialysis is initiated   G9241
Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries   A9604
Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only   E2374
Documentation that the patient is not eligible for a functional outcome assessment using a standardized tool   G8540
Material for vocal cord medialization, synthetic (implantable)   C1878
Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only   E2375
Injection, canakinumab, 1 mg   J0638
Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard   A6407
Documentation of viral load equal to or greater than 200 copiesml   G9242
Documentation of patient reason(s) for patient not receiving counseling for diet and physical activity (eg patient is not willing to discuss diet or exercise interventions to help control blood pressure, or the patient said heshe refused to make these changes)   G8949
Non-radioactive contrast imaging material, not otherwise classified, per study   A9698
Supported employment, per 15 minutes   H2023
Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds   K0807
Injection, leucovorin calcium, per 50 mg   J0640
Eye pad, sterile, each   A6410
Radiopharmaceutical, therapeutic, not otherwise classified   A9699
Functional outcome assessment using a standardized tool not documented, reason not given   G8541
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only   E2376
Vena cava filter   C1880
Documentation of viral load less than 200 copiesml   G9243
Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up documented   G8950
Supported employment, per diem   H2024
Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds   K0808
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue   E2377
Dialysis access system (implantable)   C1881
Injection, levoleucovorin calcium, 05 mg   J0641
Documentation of a functional outcome assessment using a standardized tool no functional deficiencies identified, care plan not required   G8542
Antiretroviral thereapy not prescribed   G9244
Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, patient not eligiblenot appropriate   G8951
Power operated vehicle, not otherwise classified   K0812
Ongoing support to maintain employment, per 15 minutes   H2025
Eye pad, non-sterile, each   A6411
Supply of injectable contrast material for use in echocardiography, per study   A9700
Injection, mepivacaine hydrochloride, per 10 ml   J0670
Documentation of a functional outcome assessment using a standardized tool care plan not documented, reason not given   G8543
Ongoing support to maintain employment, per diem   H2026
Power wheelchair, group 1 standard, portable, slingsolid seat and back, patient weight capacity up to and including 300 pounds   K0813
Power wheelchair component, actuator, replacement only   E2378
Cardioverter-defibrillator, other than single or dual chamber (implantable)   C1882
Antiretroviral therapy prescribed   G9245
Pre-hypertensive or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given   G8952
Eye patch, occlusive, each   A6412
Adhesive bandage, first-aid type, any size, each   A6413
Injection, cefazolin sodium, 500 mg   J0690
I intend to report the coronary artery bypass graft (cabg) measures group   G8544
Psychoeducational service, per 15 minutes   H2027
Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds   K0814
Adaptorextension, pacing lead or neurostimulator lead (implantable)   C1883
Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each   E2381
All quality actions for the applicable measures in the oncology measures group have been performed for this patient   G8953
Patient did not have at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits   G9246
I intend to report the hepatitis c measures group   G8545
Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each   E2382
Padding bandage, non-elastic, non-wovennon-knitted, width greater than or equal to three inches and less than five inches, per yard   A6441
Most recent assessment of adequacy of volume management   G8955
Power wheelchair, group 1 standard, slingsolid seat and back, patient weight capacity up to and including 300 pounds   K0815
Embolization protective system   C1884
Sexual offender treatment service, per 15 minutes   H2028
Patient had at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits   G9247
Injection, cefepime hydrochloride, 500 mg   J0692
Conforming bandage, non-elastic, knittedwoven, non-sterile, width less than three inches, per yard   A6442
Injection, cefoxitin sodium, 1 gm   J0694
Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each   E2383
Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds   K0816
Patient did not have a medical visit in the last 6 months   G9248
Catheter, transluminal angioplasty, laser   C1885
Patient receiving maintenance hemodialysis in an outpatient dialysis facility   G8956
Sexual offender treatment service, per diem   H2029
I intend to report the ischemic vascular disease (ivd) measures group   G8547
Patient not receiving maintenance hemodialysis in an outpatient dialysis facility   G8957
Mental health clubhouse services, per 15 minutes   H2030
Injection, ceftriaxone sodium, per 250 mg   J0696
No risk factors or one moderate risk factor for thromboembolism   G8970
Conforming bandage, non-elastic, knittedwoven, non-sterile, width greater than or equal to three inches and less than five inches, per yard   A6443
Patient had a medical visit in the last 6 months   G9249
I intend to report the heart failure (hf) measures group   G8548
Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each   E2384
Power wheelchair, group 2 standard, portable, slingsolid seatback, patient weight capacity up to and including 300 pounds   K0820
Catheter, extravascular tissue ablation, any modality (insertable)   C1886
Documentation of patient pain brought to a comfortable level within 48 hours from initial assessment   G9250
Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each   E2385
Mental health clubhouse services, per diem   H2031
Catheter, guiding (may include infusionperfusion capability)   C1887
Conforming bandage, non-elastic, knittedwoven, non-sterile, width greater than or equal to 5 inches, per yard   A6444
Assessment of adequacy of volume management not documented, reason not given   G8958
All quality actions for the applicable measures in the hepatitis c measures group have been performed for this patient   G8549
Injection, sterile cefuroxime sodium, per 750 mg   J0697
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds   K0821
Conforming bandage, non-elastic, knittedwoven, sterile, width less than three inches, per yard   A6445
Activity therapy, per 15 minutes   H2032
Injection, cefotaxime sodium, per gm   J0698
All quality actions for the applicable measures in the heart failure (hf) measures group have been performed for this patient   G8551
Catheter, ablation, non-cardiac, endovascular (implantable)   C1888
Power wheelchair, group 2 standard, slingsolid seatback, patient weight capacity up to and including 300 pounds   K0822
Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each   E2386
Clinician treating major depressive disorder communicates to clinician treating comorbid condition   G8959
Documentation of patient with pain not brought to a comfortable level within 48 hours from initial assessment   G9251
Conforming bandage, non-elastic, knittedwoven, sterile, width greater than or equal to three inches and less than five inches, per yard   A6446
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds   K0823
Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition, reason not given   G8960
Adenoma(s) or other neoplasm detected during screening colonoscopy   G9252
Multisystemic therapy for juveniles, per 15 minutes   H2033
Injection, betamethasone acetate 3mg and betamethasone sodium phosphate 3mg   J0702
All quality actions for the applicable measures in the ischemic vascular disease (ivd) measures group have been performed for this patient   G8552
Infusion pump, non-programmable, permanent (implantable)   C1891
Power wheelchair accessory, foam filled caster tire, any size, replacement only, each   E2387
Patient referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation   G8559
Conforming bandage, non-elastic, knittedwoven, sterile, width greater than or equal to five inches, per yard   A6447
Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each   E2388
Alcohol andor drug abuse halfway house services, per diem   H2034
Injection, caffeine citrate, 5mg   J0706
Adenoma(s) or other neoplasm not detected during screening colonoscopy   G9253
Cardiac stress imaging test primarily performed on low-risk surgery patient for preoperative evaluation within 30 days preceding this surgery   G8961
Power wheelchair, group 2 heavy duty, slingsolid seatback, patient weight capacity 301 to 450 pounds   K0824
Introducersheath, guiding, intracardiac electrophysiological, fixed-curve, peel-away   C1892
Injection, cephapirin sodium, up to 1 gm   J0710
Patient has a history of active drainage from the ear within the previous 90 days   G8560
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds   K0825
Cardiac stress imaging test performed on patient for any reason including those who did not have low risk surgery or test that was performed more than 30 days preceding low risk surgery   G8962
Light compression bandage, elastic, knittedwoven, width less than three inches, per yard   A6448
Power wheelchair accessory, foam caster tire, any size, replacement only, each   E2389
Introducersheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away   C1893
Documentation of patient discharged to home later than post-operative day 2 following cas   G9254
Alcohol andor other drug treatment program, per hour   H2035
Injection, ceftaroline fosamil, 10 mg   J0712
Alcohol andor other drug treatment program, per diem   H2036
Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure   G8561
Power wheelchair, group 2 very heavy duty, slingsolid seatback, patient weight capacity 451 to 600 pounds   K0826
Light compression bandage, elastic, knittedwoven, width greater than or equal to three inches and less than five inches, per yard   A6449
Introducersheath, other than guiding, other than intracardiac electrophysiological, non-laser   C1894
Power wheelchair accessory, solid (rubberplastic) drive wheel tire, any size, replacement only, each   E2390
Documentation of patient discharged to home no later than post operative day 2 following cas   G9255
Cardiac stress imaging performed primarily for monitoring of asymptomatic patient who had pci within 2 years   G8963
Developmental delay prevention activities, dependent child of client, per 15 minutes   H2037
Lead, cardioverter-defibrillator, endocardial dual coil (implantable)   C1895
Patient does not have a history of active drainage from the ear within the previous 90 days   G8562
Power wheelchair accessory, solid (rubberplastic) caster tire (removable), any size, replacement only, each   E2391
Injection, ceftazidime, per 500 mg   J0713
Cardiac stress imaging test performed primarily for any other reason than monitoring of asymptomatic patient who had pci within 2 years (eG , symptomatic patient, patient greater than 2 years since pci, initial evaluation, etc)   G8964
Light compression bandage, elastic, knittedwoven, width greater than or equal to five inches, per yard   A6450
Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds   K0827
Documentation of patient death following cas   G9256
Documentation of patient stroke following cas   G9257
Power wheelchair, group 2 extra heavy duty, slingsolid seatback, patient weight capacity 601 pounds or more   K0828
Lead, cardioverter-defibrillator, other than endocardial single or dual coil (implantable)   C1896
Patient not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given   G8563
Cardiac stress imaging test primarily performed on low chd risk patient for initial detection and risk assessment   G8965
Moderate compression bandage, elastic, knittedwoven, load resistance of 125 to 134 foot pounds at 50 maximum stretch, width greater than or equal to three inches and less than five inches, per yard   A6451
Injection, ceftizoxime sodium, per 500 mg   J0715
Power wheelchair accessory, solid (rubberplastic) caster tire with integrated wheel, any size, replacement only, each   E2392
High compression bandage, elastic, knittedwoven, load resistance greater than or equal to 135 foot pounds at 50 maximum stretch, width greater than or equal to three inches and less than five inches, per yard   A6452
Documentation of patient stroke following cea   G9258
Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each   E2394
Injection, centruroides immune f(ab)2, up to 120 milligrams   J0716
Patient was referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not specified)   G8564
Cardiac stress imaging test performed on symptomatic or higher than low chd risk patient or for any reason other than initial detection and risk assessment   G8966
Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more   K0829
Lead, neurostimulator test kit (implantable)   C1897
Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each   E2395
Injection, chloramphenicol sodium succinate, up to 1 gm   J0720
Power wheelchair, group 2 standard, seat elevator, slingsolid seatback, patient weight capacity up to and including 300 pounds   K0830
Lead, pacemaker, other than transvenous vdd single pass   C1898
Documentation of patient survival and absence of stroke following cas   G9259
Self-adherent bandage, elastic, non-knittednon-woven, width less than three inches, per yard   A6453
Warfarin or another oral anticoagulant that is fda approved prescribed   G8967
Verification and documentation of sudden or rapidly progressive hearing loss   G8565
Power wheelchair, group 2 standard, seat elevator, captains chair, patient weight capacity up to and including 300 pounds   K0831
Self-adherent bandage, elastic, non-knittednon-woven, width greater than or equal to three inches and less than five inches, per yard   A6454
Patient is not eligible for the referral for otologic evaluation for sudden or rapidly progressive hearing loss measure   G8566
Documentation of patient death following cea   G9260
Injection, chorionic gonadotropin, per 1,000 usp units   J0725
Lead, pacemakercardioverter-defibrillator combination (implantable)   C1899
Power wheelchair accessory, caster fork, any size, replacement only, each   E2396
Documentation of medical reason(s) for not prescribing warfarin or another oral anticoagulant that is fda approved not prescribed (eg allergy, risk of bleeding, transient or reversible causes of atrial fibrillation, other medical reasons including, but not limited to pregnancy, mitral stenosis, prosthetic heart valve or patient is in the postoperative period)   G8968
Patient does not have verification and documentation of sudden or rapidly progressive hearing loss   G8567
Power wheelchair, group 2 standard, single power option, slingsolid seatback, patient weight capacity up to and including 300 pounds   K0835
Injection, clonidine hydrochloride, 1 mg   J0735
Power wheelchair accessory, lithium-based battery, each   E2397
Documentation of patient survival and absence of stroke following cea   G9261
Self-adherent bandage, elastic, non-knittednon-woven, width greater than or equal to five inches, per yard   A6455
Documentation of patient reason(s) for not prescribing warfarin or another oral anticoagulant that is fda approved (eg economic, social, andor religious impediments, noncompliance or patient refusal, other patient reasons)   G8969
Lead, left ventricular coronary venous system   C1900
Probe, percutaneous lumbar discectomy   C2614
Documentation of patient death in the hospital following endovascular aaa repair   G9262
Zinc paste impregnated bandage, non-elastic, knittedwoven, width greater than or equal to three inches and less than five inches, per yard   A6456
Patient was not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given   G8568
Injection, cidofovir, 375 mg   J0740
Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds   K0836
Prolonged intubation (24 hrs) required   G8569
Sealant, pulmonary, liquid   C2615
Power wheelchair, group 2 heavy duty, single power option, slingsolid seatback, patient weight capacity 301 to 450 pounds   K0837
Tubular dressing with or without elastic, any width, per linear yard   A6457
Documentation of patient survival in the hospital following endovascular aaa repair   G9263
Injection, cilastatin sodium imipenem, per 250 mg   J0743
Warfarin or another oral anticoagulant that is fda approved not prescribed, reason not given   G8971
Documentation of patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter for documented reasons (eg, patient is undergoing palliative dialysis with a catheter, patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant, other medical reasons, patient declined avfavg, other patient reasons)   G9264
Injection, ciprofloxacin for intravenous infusion, 200 mg   J0744
Prolonged intubation (24 hrs) not required   G8570
Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds   K0838
Brachytherapy source, non-stranded, yttrium-90, per source   C2616
Compression burn garment, bodysuit (head to foot), custom fabricated   A6501
One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism   G8972
Development of deep sternal wound infection within 30 days postoperatively   G8571
Compression burn garment, chin strap, custom fabricated   A6502
Patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter as the mode of vascular access   G9265
Stent, non-coronary, temporary, without delivery system   C2617
Power wheelchair, group 2 very heavy duty, single power option slingsolid seatback, patient weight capacity 451 to 600 pounds   K0839
Most recent hemoglobin (hgb) level 10 gdl   G8973
Injection, codeine phosphate, per 30 mg   J0745
Hemoglobin level measurement not documented, reason not given   G8974
Probe, cryoablation   C2618
Compression burn garment, facial hood, custom fabricated   A6503
No deep sternal wound infection   G8572
Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular access   G9266
Injection, colchicine, per 1mg   J0760
Power wheelchair, group 2 extra heavy duty, single power option, slingsolid seatback, patient weight capacity 601 pounds or more   K0840
Documentation of patient with one or more complications or mortality within 30 days   G9267
Pacemaker, dual chamber, non rate-responsive (implantable)   C2619
Documentation of medical reason(s) for patient having a hemoglobin level 10 gdl (eg patients who have non-renal etiologies of anemia eg sickle cell anemia or other hemoglobinopathies, hypersplenism, primary bone marrow disease, anemia related to chemotherapy for diagnosis of malignancy, postoperative bleeding, active bloodstream or peritoneal infection, other medical reasons)   G8975
Injection, colistimethate sodium, up to 150 mg   J0770
Compression burn garment, glove to wrist, custom fabricated   A6504
Power wheelchair, group 2 standard, multiple power option, slingsolid seatback, patient weight capacity up to and including 300 pounds   K0841
Stroke following isolated cabg surgery   G8573
Compression burn garment, glove to elbow, custom fabricated   A6505
Injection, collagenase, clostridium histolyticum, 001 mg   J0775
Pacemaker, single chamber, non rate-responsive (implantable)   C2620
No stroke following isolated cabg surgery   G8574
Most recent hemoglobin (hgb) level 10 gdl   G8976
Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds   K0842
Documentation of patient with one or more complications within 90 days   G9268
Power wheelchair, group 2 heavy duty, multiple power option, slingsolid seatback, patient weight capacity 301 to 450 pounds   K0843
I intend to report the oncology measures group   G8977
Injection, prochlorperazine, up to 10 mg   J0780
Developed postoperative renal failure or required dialysis   G8575
Pacemaker, other than single or dual chamber (implantable)   C2621
Compression burn garment, glove to axilla, custom fabricated   A6506
Documentation of patient without one or more complications and without mortality within 30 days   G9269
Mobility walking moving around functional limitation, current status, at therapy episode outset and at reporting intervals   G8978
Prosthesis, penile, non-inflatable   C2622
Power wheelchair, group 3 standard, slingsolid seatback, patient weight capacity up to and including 300 pounds   K0848
Injection, corticorelin ovine triflutate, 1 microgram   J0795
Documentation of patient without one or more complications within 90 days   G9270
Compression burn garment, foot to knee length, custom fabricated   A6507
No postoperative renal failuredialysis not required   G8576
Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds   K0849
Compression burn garment, foot to thigh length, custom fabricated   A6508
Ldl value 100   G9271
Re-exploration required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason   G8577
Injection, corticotropin, up to 40 units   J0800
Mobility walking moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting   G8979
Stent, non-coronary, temporary, with delivery system   C2625
Power wheelchair, group 3 heavy duty, slingsolid seatback, patient weight capacity 301 to 450 pounds   K0850
Injection, cosyntropin, not otherwise specified, 025 mg   J0833
Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated   A6509
Infusion pump, non-programmable, temporary (implantable)   C2626
Ldl value 100   G9272
Mobility walking moving around functional limitation, discharge status, at discharge from therapy or to end reporting   G8980
Re-exploration not required due to mediastinal bleeding with or without tamponade, graft occlusion, valve dysfunction or other cardiac reason   G8578
Changing maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals   G8981
Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated   A6510
Catheter, suprapubiccystoscopic   C2627
Blood pressure has a systolic value of 140 and a diastolic value of 90   G9273
Injection, cosyntropin (cortrosyn), 025 mg   J0834
Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds   K0851
Antiplatelet medication at discharge   G8579
Catheter, occlusion   C2628
Compression burn garment, lower trunk including leg openings (panty), custom fabricated   A6511
Blood pressure has a systolic value of 140 and a diastolic value of 90 or systolic value 140 and diastolic value 90 or systolic value 140 and diastolic value 90   G9274
Changing maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting   G8982
Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram   J0840
Power wheelchair, group 3 very heavy duty, slingsolid seatback, patient weight capacity 451 to 600 pounds   K0852
Antiplatelet medication contraindicated   G8580
Changing maintaining body position functional limitation, discharge status, at discharge from therapy or to end reporting   G8983
Injection, cytomegalovirus immune globulin intravenous (human), per vial   J0850
Introducersheath, other than guiding, intracardiac electrophysiological, laser   C2629
Documentation that patient is a current non-tobacco user   G9275
Compression burn garment, not otherwise classified   A6512
Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds   K0853
No antiplatelet medication at discharge   G8581
Injection, daptomycin, 1 mg   J0878
Beta-blocker at discharge   G8582
Documentation that patient is a current tobacco user   G9276
Power wheelchair, group 3 extra heavy duty, slingsolid seatback, patient weight capacity 601 pounds or more   K0854
Carrying, moving handling objects functional limitation, current status, at therapy episode outset and at reporting intervals   G8984
Catheter, electrophysiology, diagnosticablation, other than 3d or vector mapping, cool-tip   C2630
Compression burn mask, face andor neck, plastic or equal, custom fabricated   A6513
Beta-blocker contraindicated   G8583
Injection, darbepoetin alfa, 1 microgram (non-esrd use)   J0881
Repair device, urinary, incontinence, without sling graft   C2631
Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more   K0855
Documentation that the patient is on daily aspirin or has documentation of a valid contraindication to aspirin automatic contraindications include anti-coagulant use, allergy, and history of gastrointestinal bleed additionally, any reason documented by the physician as a reason for not taking daily aspirin is acceptable (examples include non-steroidal anti-inflammatory agents, risk for drug interaction, or uncontrolled hypertension defined as 180 systolic or 110 diastolic)   G9277
Carrying, moving handling objects functional limitation, current status, at therapy episode outset and at reporting intervals   G8985
Power wheelchair, group 3 standard, single power option, slingsolid seatback, patient weight capacity up to and including 300 pounds   K0856
No beta-blocker at discharge   G8584
Carrying, moving handling objects functional limitation, discharge status, at discharge from therapy or to end reporting   G8986
Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)   J0882
Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories   A6550
Brachytherapy source, non-stranded, high activity, iodine-125, greater than 1 01 mci (nist), per source   C2634
Documentation that the patient is not on daily aspirin regimen   G9278
Pneumococcal screening performed and documentation of vaccination received prior to discharge   G9279
Injection, epoetin alfa, (for non-esrd use), 1000 units   J0885
Self care functional limitation, current status, at therapy episode outset and at reporting intervals   G8987
Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds   K0857
Brachytherapy source, non-stranded, high activity, paladium-103, greater than 22 mci (nist), per source   C2635
Anti-lipid treatment at discharge   G8585
Brachytherapy linear source, non-stranded, paladium-103, per 1 mm   C2636
Power wheelchair, group 3 heavy duty, single power option, slingsolid seatback, patient weight 301 to 450 pounds   K0858
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting   G8988
Anti-lipid treatment contraindicated   G8586
Pneumococcal vaccination not administered prior to discharge, reason not specified   G9280
Injection, epoetin alfa, 1000 units (for esrd on dialysis)   J0886
Brachytherapy source, non-stranded, ytterbium-169, per source   C2637
No anti-lipid treatment at discharge   G8587
Screening performed and documentation that vaccination not indicatedpatient refusal   G9281
Self care functional limitation, discharge status, at discharge from therapy or to end reporting   G8989
Injection, peginesatide, 01 mg (for esrd on dialysis)   J0890
Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds   K0859
Other physical or occupational primary functional limitation, current status, at therapy episode outset and at reporting intervals   G8990
Lipid profile results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)   G8593
Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (eg, biopsy taken for other purposes in a patient with a history of non-small cell lung cancer or other documented medical reasons)   G9282
Brachytherapy source, stranded, iodine-125, per source   C2638
Injection, decitabine, 1 mg   J0894
Power wheelchair, group 3 very heavy duty, single power option, slingsolid seatback, patient weight capacity 451 to 600 pounds   K0860
Lipid profile not performed, reason not given   G8594
Injection, deferoxamine mesylate, 500 mg   J0895
Other physical or occupational primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting   G8991
Brachytherapy source, non-stranded, iodine-125, per source   C2639
Power wheelchair, group 3 standard, multiple power option, slingsolid seatback, patient weight capacity up to and including 300 pounds   K0861
Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation   G9283
Injection, denosumab, 1 mg   J0897
Brachytherapy source, stranded, palladium-103, per source   C2640
Most recent ldl-c 100 mgdl   G8595
Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation   G9284
Other physical or occupational primary functional limitation, discharge status, at discharge from therapy or to end reporting   G8992
Power wheelchair, group 3 heavy duty, multiple power option, slingsolid seatback, patient weight capacity 301 to 450 pounds   K0862
Specimen site other than anatomic location of lung or is not classified as non small cell lung cancer   G9285
Power wheelchair, group 3 very heavy duty, multiple power option, slingsolid seatback, patient weight capacity 451 to 600 pounds   K0863
Brachytherapy source, non-stranded, palladium-103, per source   C2641
Injection, testosterone enanthate and estradiol valerate, up to 1 cc   J0900
Injection, bevacizumab, 025 mg   C9257
Other physical or occupational subsequent functional limitation, current status, at therapy episode outset and at reporting intervals   G8993
Most recent ldl-c 100 mgdl   G8597
Brachytherapy source, stranded, cesium-131, per source   C2642
Documentation of antibiotic regimen prescribed within 7 days of diagnosis or within 10 days after onset of symptoms   G9286
Aspirin or another antithrombotic therapy used   G8598
Power wheelchair, group 3 extra heavy duty, multiple power option, slingsolid seatback, patient weight capacity 601 pounds or more   K0864
Other physical or occupational subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting   G8994
Injection, brompheniramine maleate, per 10 mg   J0945
Other physical or occupational subsequent functional limitation, discharge status, at discharge from therapy or to end reporting   G8995
Brachytherapy source, non-stranded, cesium-131, per source   C2643
Injection, depo-estradiol cypionate, up to 5 mg   J1000
Aspirin or another antithrombotic therapy not used, reason not given   G8599
Power wheelchair, group 4 standard, slingsolid seatback, patient weight capacity up to and including 300 pounds   K0868
No antibiotic regimen prescribed within 7 days of diagnosis or within 10 days after onset of symptoms   G9287
Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (eg, a solitary fibrous tumor in a person with a history of non-small cell carcinoma or other documented medical reasons )   G9288
Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds   K0869
Iv t-pa initiated within three hours ( 180 minutes) of time last known well   G8600
Injection, methylprednisolone acetate, 20 mg   J1020
Brachytherapy source, cesium-131 chloride solution, per millicurie   C2644
Swallowing functional limitation, current status at time of initial therapy treatmentepisode outset and reporting intervals   G8996
Injection, methylprednisolone acetate, 40 mg   J1030
Iv t-pa not initiated within three hours ( 180 minutes) of time last known well for reasons documented by clinician   G8601
Brachytherapy source, stranded, not otherwise specified, per source   C2698
Power wheelchair, group 4 heavy duty, slingsolid seatback, patient weight capacity 301 to 450 pounds   K0870
Swallowing functional limitation, projected goal status, at initial therapy treatmentoutset and at discharge from therapy   G8997
Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation   G9289
Iv t-pa not initiated within three hours ( 180 minutes) of time last known well, reason not given   G8602
Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation   G9290
Injection, methylprednisolone acetate, 80 mg   J1040
Swallowing functional limitation, discharge status, at discharge from therapyend of reporting on limitation   G8998
Power wheelchair, group 4 very heavy duty, slingsolid seatback, patient weight capacity 451 to 600 pounds   K0871
Brachytherapy source, non-stranded, not otherwise specified, per source   C2699
Injection, testosterone cypionate and estradiol cypionate, up to 1 ml   J1060
Magnetic resonance angiography with contrast, abdomen   C8900
Surgical procedure performed within 30 days following cataract surgery for major complications (eg retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence)   G8627
Specimen site other than anatomic location of lung, is not classified as non small cell lung cancer or classified as nsclc-nos   G9291
Power wheelchair, group 4 standard, single power option, slingsolid seatback, patient weight capacity up to and including 300 pounds   K0877
Motor speech functional limitation, current status at time of initial therapy treatmentepisode outset and reporting intervals   G8999
Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds   K0878
Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s)   G9143
Documentation of medical reason(s) for not reporting pt category and a statement on thickness and ulceration and for pt1, mitotic rate (eg, negative skin biopsies in a patient with a history of melanoma or other documented medical reasons)   G9292
Surgical procedure not performed within 30 days following cataract surgery for major complications (eg retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence)   G8628
Injection, testosterone cypionate, up to 100 mg   J1070
Magnetic resonance angiography without contrast, abdomen   C8901
Magnetic resonance angiography without contrast followed by with contrast, abdomen   C8902
Documentation of order for prophylactic parenteral antibiotic to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required)   G8629
Power wheelchair, group 4 heavy duty, single power option, slingsolid seatback, patient weight capacity 301 to 450 pounds   K0879
Injection, testosterone cypionate, 1 cc, 200 mg   J1080
Pathology report does not include the pt category and a statement on thickness and ulceration and for pt1, mitotic rate   G9293
Outpatient intravenous insulin treatment (oivit) either pulsatile or continuous, by any means, guided by the results of measurements for respiratory quotient andor, urine urea nitrogen (uun) andor, arterial, venous or capillary glucose andor potassium concentration   G9147
Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate   G9294
Injection, dexamethasone acetate, 1 mg   J1094
Documentation that administration of prophylactic parenteral antibiotics was initiated within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required), as ordered   G8630
Power wheelchair, group 4 very heavy duty, single power option, slingsolid seatback, patient weight 451 to 600 pounds   K0880
Magnetic resonance imaging with contrast, breast unilateral   C8903
National committee for quality assurance - level i medical home   G9148
Power wheelchair, group 4 standard, multiple power option, slingsolid seatback, patient weight capacity up to and including 300 pounds   K0884
Magnetic resonance imaging without contrast, breast unilateral   C8904
Specimen site other than anatomic cutaneous location   G9295
Clinician documented that patient was not an eligible candidate for ordering prophylactic parenteral antibiotics to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required)   G8631
National committee for quality assurance - level 2 medical home   G9149
Injection, dexamethasone sodium phosphate, 1mg   J1100
Injection, dihydroergotamine mesylate, per 1 mg   J1110
National committee for quality assurance - level 3 medical home   G9150
Patients with documented shared decision-making including discussion of conservative (non-surgical) therapy prior to the procedure   G9296
Prophylactic parenteral antibiotics were not ordered to be given or given within one hour (if fluoroquinolone or vancomycin, two hours) prior to the surgical incision (or start of procedure when no incision is required), reason not given   G8632
Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds   K0885
Magnetic resonance imaging without contrast followed by with contrast, breast unilateral   C8905
Injection, acetazolamide sodium, up to 500 mg   J1120
Magnetic resonance imaging with contrast, breast bilateral   C8906
Mapcp demonstration - state provided services   G9151
Power wheelchair, group 4 heavy duty, multiple power option, slingsolid seatback, patient weight capacity 301 to 450 pounds   K0886
Shared decision-making including discussion of conservative (non-surgical) therapy prior to the procedure not documented, reason not given   G9297
Pharmacologic therapy (other than minieralsvitamins) for osteoporosis prescribed   G8633
Patients who are evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure including history of dvt, pe, mi, arrhythmia and stroke   G9298
Mapcp demonstration - community health teams   G9152
Power wheelchair, group 5 pediatric, single power option, slingsolid seatback, patient weight capacity up to and including 125 pounds   K0890
Clinician documented patient not an eligible candidate to receive pharmacologic therapy for osteoporosis   G8634
Injection, digoxin, up to 05 mg   J1160
Magnetic resonance imaging without contrast, breast bilateral   C8907
Pharmacologic therapy for osteoporosis was not prescribed, reason not given   G8635
Injection, digoxin immune fab (ovine), per vial   J1162
Mapcp demonstration - physician incentive pool   G9153
Patients who are not evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure including history of dvt, pe, mi, arrhythmia and stroke, reason not given   G9299
Power wheelchair, group 5 pediatric, multiple power option, slingsolid seatback, patient weight capacity up to and including 125 pounds   K0891
Magnetic resonance imaging without contrast followed by with contrast, breast bilateral   C8908
I intend to report the asthma measures group   G8645
Injection, phenytoin sodium, per 50 mg   J1165
Evaluation for wheelchair requiring face to face visit with physician   G9156
Documentation of medical reason(s) for not completely infusing the prophylactic antibiotic prior to the inflation of the proximal tourniquet (eg, a tourniquet was not used)   G9300
Power wheelchair, not otherwise classified   K0898
Magnetic resonance angiography with contrast, chest (excluding myocardium)   C8909
Transesophageal doppler use for cardiac monitoring   G9157
Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquet   G9301
Injection, hydromorphone, up to 4 mg   J1170
All quality actions for the applicable measures in the asthma measures group have been performed for this patient   G8646
Power mobility device, not coded by dme pdac or does not meet criteria   K0899
Magnetic resonance angiography without contrast, chest (excluding myocardium)   C8910
Prophylactic antibiotic not completely infused prior to the inflation of the proximal tourniquet, reason not given   G9302
Injection, dyphylline, up to 500 mg   J1180
Risk-adjusted functional status change residual score for the knee successfully calculated and the score was equal to zero (0) or greater than zero (0)   G8647
Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)   C8911
Customized durable medical equipment, other than wheelchair   K0900
Motor speech functional limitation, discharge status at discharge from therapyend of reporting on limitation   G9158
Injection, dexrazoxane hydrochloride, per 250 mg   J1190
Spoken language comprehension functional limitation, current status at time of initial therapy treatmentepisode outset and reporting intervals   G9159
Magnetic resonance angiography with contrast, lower extremity   C8912
Injection, iron sucrose, 1 mg   J1756
Knee orthosis (KO), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varusvalgus adjustment, prefabricated, off-the-shelf   K0901
Operative report does not identify the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of the prosthetic implant, reason not given   G9303
Risk-adjusted functional status change residual score for the knee successfully calculated and the score was less than zero (0)   G8648
Risk-adjusted functional status change residual scores for the knee not measured because the patient did not complete foto's functional intake on admission andor follow up status survey near discharge, patient not eligiblenot appropriate   G8649
Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of the prosthetic implant   G9304
Injection, diphenhydramine hcl, up to 50 mg   J1200
Magnetic resonance angiography without contrast, lower extremity   C8913
Spoken language comprehension functional limitation, projected goal status at initial therapy treatmentoutset and at discharge from therapy   G9160
Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varusvalgus adjustment, prefabricated, off-the-shelf   K0902
Risk-adjusted functional status change residual scores for the knee not measured because the patient did not complete foto's functional intake on admission andor follow up status survey near discharge, reason not given   G8650
Intervention for presence of leak of endoluminal contents through an anastomosis not required   G9305
Spoken language comprehension functional limitation, discharge status at discharge from therapyend of reporting on limitation   G9161
Injection, chlorothiazide sodium, per 500 mg   J1205
Magnetic resonance angiography without contrast followed by with contrast, lower extremity   C8914
Magnetic resonance angiography with contrast, pelvis   C8918
Spoken language expression functional limitation, current status at time of initial therapy treatmentepisode outset and reporting intervals   G9162
Injection, dmso, dimethyl sulfoxide, 50, 50 ml   J1212
Risk-adjusted functional status change residual score for the hip successfully calculated and the score was equal to zero (0) or greater than zero (0)   G8651
Intervention for presence of leak of endoluminal contents through an anastomosis required   G9306
No return to the operating room for a surgical procedure, for any reason, within 30 days of the principal operative procedure   G9307
Magnetic resonance angiography without contrast, pelvis   C8919
Injection, methadone hcl, up to 10 mg   J1230
Risk-adjusted functional status change residual score for the hip successfully calculated and the score was less than zero (0)   G8652
Spoken language expression functional limitation, projected goal status at initial therapy treatmentoutset and at discharge from therapy   G9163
Magnetic resonance angiography without contrast followed by with contrast, pelvis   C8920
Spoken language expression functional limitation, discharge status at discharge from therapyend of reporting on limitation   G9164
Unplanned return to the operating room for a surgical procedure, for any reason, within 30 days of the principal operative procedure   G9308
Injection, dimenhydrinate, up to 50 mg   J1240
Risk-adjusted functional status change residual scores for the hip not measured because the patient did not complete foto's functional intake on admission andor follow up status survey near discharge, patient not eligiblenot appropriate   G8653
Attention functional limitation, current status at time of initial therapy treatmentepisode outset and reporting intervals   G9165
Risk-adjusted functional status change residual scores for the hip not measured because the patient did not complete foto's functional intake on admission andor follow up status survey near discharge, reason not given   G8654
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies complete   C8921
No unplanned hospital readmission within 30 days of principal procedure   G9309
Injection, dipyridamole, per 10 mg   J1245
Risk-adjusted functional status change residual score for the lower leg, foot or ankle successfully calculated and the score was equal to zero (0) or greater than zero(0)   G8655
Unplanned hospital readmission within 30 days of principal procedure   G9310
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies follow-up or limited study   C8922
Injection, dobutamine hydrochloride, per 250 mg   J1250
Attention functional limitation, projected goal status at initial therapy treatmentoutset and at discharge from therapy   G9166
No surgical site infection   G9311
Attention functional limitation, discharge status at discharge from therapyend of reporting on limitation   G9167
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography   C8923
Risk-adjusted functional status change residual score for the lower leg, foot or ankle successfully calculated and the score was less than zero (0)   G8656
Injection, dolasetron mesylate, 10 mg   J1260
Injection, dopamine hcl, 40 mg   J1265
Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study   C8924
Memory functional limitation, current status at time of initial therapy treatmentepisode outset and reporting intervals   G9168
Surgical site infection   G9312
Risk-adjusted functional status change residual scores for the lower leg, foot or ankle not measured because the patient did not complete foto's functional intake on admission andor follow up status survey near discharge, patient not eligiblenot appropriate   G8657
Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason (eg, cystic fibrosis, immotile cilia disorders, ciliary dyskinesia, immune deficiency, prior history of sinus surgery within the past 12 months, and anatomic abnormalities, such as deviated nasal septum, resistant organisms, allergy to medication, recurrent sinusitis, chronic sinusitis, or other reasons)   G9313
Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording) including probe placement, image acquisition, interpretation and report   C8925
Risk-adjusted functional status change residual scores for the lower leg, foot or ankle not measured because the patient did not complete foto's functional intake on admission andor follow up status survey near discharge, reason not given   G8658
Memory functional limitation, projected goal status at initial therapy treatmentoutset and at discharge from therapy   G9169
Injection, doripenem, 10 mg   J1267
Memory functional limitation, discharge status at discharge from therapyend of reporting on limitation   G9170
Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies including probe placement, image acquisition, interpretation and report   C8926
Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis, reason not given   G9314