Code Description Plain Language Description - Centers for Medicare ...

Code J0702 J1745 G0102 G0103 G2061

G2062

G2063

G0206 G0204 G0121

G0105 S0285

G0289

G0120

460 470 473 743 1960 1961 1967

Description BETAMETHASONE ACET&SOD PHOSP INFLIXIMAB NOT BIOSIMIL 10MG Prostate cancer screening; digital rectal examination Prostate cancer screening; prostate specific antigen test (psa) Qualified non physician healthcare professional online assessment; 5-10 minutes

Plain Language Description Injection to treat reaction to a drug A biologic medication

Qualified non physician healthcare professional online assessment, for an established patient, for up to seven days, cumulative time during the 7 days; 5-10 minutes

Qualified non physician healthcare professional online assessment service; 11-20 minutes

Qualified non physician qualified healthcare professional assessment service; 21+ minutes

Diagnostic mammography, including computeraided detection (cad) when performed; unilateral Diagnostic mammography, including computeraided detection (cad) when performed; bilateral Colon ca scrn; not hi risk ind

Colorectal ca scrn; hi risk ind Cnslt before screen colonosc

Arthro, loose body + chondro

Colon ca scrn; barium enema

SPINAL FUSION (POSTERIOR) KNEE REPLACEMENT SPINAL FUSION (ANTERIOR) HYSTERECTOMY Anesthesia for vaginal delivery Anesthesia for cesarean delivery Anesthesia for labor during planned vaginal delivery

Qualified non physician healthcare professional online assessment service, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutes Qualified non physician qualified healthcare professional assessment service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk Colorectal cancer screening; colonoscopy on individual at high risk Colonoscopy consultation performed prior to a screening colonoscopy procedure Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema Spinal fusion except cervical Major joint replacement or reattachment of lower extremity Cervical spinal fusion Uterine and adnexa procedures for non-malignancy

Code 1968 10005

10021 10040

10060

10140 10160 11000 11056 11102

11103

11200 11401

11422 11602 11721 11730 11900 12001

12011

17000 17003 17110 17111 17250

Description Anesthesia for cesarean delivery following labor FNA W IMAGE

FNA W/O IMAGE ACNE SURGERY

DRAINAGE OF SKIN ABSCESS

DRAINAGE OF HEMATOMA/FLUID PUNCTURE DRAINAGE OF LESION DEBRIDE INFECTED SKIN TRIM SKIN LESIONS 2 TO 4 BIOPSY SKIN LESION

BIOPSY SKIN ADD-ON

REMOVAL OF SKIN TAGS

DRAIN/INJ JOINT/BURSA W/O US

DRAIN/INJ JOINT/BURSA W/O US

DRAIN/INJ JOINT/BURSA W/O US

ASPIRATE/INJ GANGLION CYST

Revision of knee joint Revision of knee joint Revision of knee joint Revision of knee joint Revision of knee joint

Revision of knee joint CORRECTION HALLUX VALGUS

29826

29848 29880

Subacromial Decompression

WRIST ENDOSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY

29881

29888 30520 31231

31237

31575

36415

36471

36475 36478 42820

KNEE ARTHROSCOPY/SURGERY

KNEE ARTHROSCOPY/SURGERY REPAIR OF NASAL SEPTUM NASAL ENDOSCOPY DX

NASAL/SINUS ENDOSCOPY SURG

DIAGNOSTIC LARYNGOSCOPY

ROUTINE VENIPUNCTURE

NJX SCLRSNT MLT INCMPTNT VN

ENDOVENOUS RF 1ST VEIN ENDOVENOUS LASER 1ST VEIN REMOVE TONSILS AND ADENOIDS

Plain Language Description Micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens

Injection of medication into a tendon or ligament Injection of medication into the tendon/ligament origin Injection of medication into an area that triggers pain Draining or injecting medication into a small joint/bursa without ultrasound Draining or injecting medication into a large joint/bursa without ultrasound Draining or injecting medication into a major joint/bursa without ultrasound Removal of fluid or injection of medication into a ganglion cyst Repair of knee joint Repair of knee joint Repair of knee joint Repair of knee joint Repair of knee joint with hinged prosthesis Repair of knee joint Under Repair, Revision, and/or Reconstruction Procedures on the Foot and Toes Shaving of shoulder bone using an endoscope Carpal tunnel release Surgery to remove of all or part of a torn meniscus in both medial and lateral compartments Surgery to remove of all or part of a torn meniscus in one compartment ACL reconstruction Repair procedures of the nose Nasal endoscopy, diagnostic, unilateral or bilateral Surgical nasal/ sinus endoscopy with biopsy, polypectomy or debridement Flexible, fiberoptic diagnostic laryngoscopy Collection of venous blood by venipuncture Injections to remove spider veins on the limbs or trunk Ablation of incompetent vein Laser removal of incompetent vein Removal of tonsils and adenoid glands patient younger than age 12

Code 42826 42830 43235

43239

43846

44388

44389

44394 45378 45379 45380 45381 45382 45384 45385 45386 45388 45390 45391 45392

45398 47562 47563 49505

Description REMOVAL OF TONSILS REMOVAL OF ADENOIDS EGD DIAGNOSTIC BRUSH WASH

EGD BIOPSY SINGLE/MULTIPLE

Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption Colonoscopy thru stoma spx

Colonoscopy with biopsy

Colonoscopy w/snare DIAGNOSTIC COLONOSCOPY Colonoscopy w/fb removal COLONOSCOPY AND BIOPSY Colonoscopy submucous njx Colonoscopy w/control bleed Colonoscopy w/lesion removal COLONOSCOPY W/LESION REMOVAL Colonoscopy w/balloon dilat Colonoscopy w/ablation Colonoscopy w/resection Colonoscopy w/endoscope us Colonoscopy w/endoscopic fnb

Colonoscopy w/band ligation LAPAROSCOPIC CHOLECYSTECTOMY LAPARO CHOLECYSTECTOMY/GRAPH PRP I/HERN INIT REDUC >5 YR

Plain Language Description Primary or secondary removal of tonsils Primary removal of the adenoids Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope Surgical procedure used for weight loss resulting in a partial removal of stomach Diagnostic examination of large bowel using an endoscope which is inserted through abdominal opening Biopsies of large bowel using an endoscope which is inserted through abdominal opening Removal of large bowel polyps or growths using an endoscope Diagnostic examination of large bowel using an endoscope Removal of foreign bodies in large bowel using an endoscope Biopsy of large bowel using an endoscope Injections of large bowel using an endoscope Control of bleeding in large bowel using an endoscope Removal of polyps or growths in large bowel using an endoscope Removal of polyps or growths of large bowel using an endoscope Balloon dilation of large bowel using an endoscope Destruction of large bowel growths using an endoscope Removal of large bowel tissue using an endoscope Ultrasound examination of lower large bowel using an endoscope Ultrasound guided needle aspiration or biopsy of lower large bowel using an endoscope Tying of large bowel using an endoscope Removal of gallbladder using an endoscope Gallbladder removal with use of an xray exam of the bile ducts Repair of groin hernia patient age 5 years or older

Code 49585 49650 50590 51741 51798 52000 52310 52332

55250 55700 55866

57022 57288 57454 58100 58558 58563

58565 58571 58661

58662 58671

59000 59025 59400 59409

Description RPR UMBIL HERN REDUC > 5 YR LAP ING HERNIA REPAIR INIT FRAGMENTING OF KIDNEY STONE ELECTRO-UROFLOWMETRY FIRST US URINE CAPACITY MEASURE CYSTOSCOPY CYSTOSCOPY AND TREATMENT CYSTOSCOPY AND TREATMENT

EXCISION PROCEDURES ON THE VAS DEFERENS Prostate biopsy Surgical Procedures on the Prostate

Incision and drainage of vaginal blood accumulation following delivery REPAIR BLADDER DEFECT BX/CURETT OF CERVIX W/SCOPE EXCISION PROCEDURES ON THE CORPUS UTERI HYSTEROSCOPY BIOPSY HYSTEROSCOPY ABLATION

HYSTEROSCOPY STERILIZATION TLH W/T/O 250 G OR LESS LAPAROSCOPY REMOVE ADNEXA

LAPAROSCOPY EXCISE LESIONS LAPAROSCOPY TUBAL BLOCK

AMNIOCENTESIS DIAGNOSTIC FETAL NON-STRESS TEST OBSTETRICAL CARE Vaginal delivery

Plain Language Description Repair of umbilical hernia in patients over 5 years old Inguinal hernia repair done by laparoscope Surgical procedures on the kidney to break up and remove kidney stones A diagnostic test used to measure the flow of urine Ultrasound of bladder to measure urine capacity Procedure on the bladder Removing an indwelling ureteral stent by cystoscopy Ureteral stents inserted internally between the bladder and the kidney and will remain within the patient for a defined period of time Removal of sperm duct(s)

Biopsy of prostate gland Surgical removal of prostate and surrounding lymph nodes using an endoscope

Replacement of sling to support the bladder Biopsy of cervix or uterus Biopsy of the lining of the uterus

Surgical hysteroscopy with biopsy Surgical procedure used to treat premenopausal abnormal uterine bleeding Laparoscopic/Hysteroscopic Procedures on the uterus Laparoscopic hysterectomy Removal of either benign or malignant tissue from the uterus, ovaries, fallopian tubes, or any of the surrounding tissues using a laparoscope Removal of lesions of the ovary, pelvic viscera, or peritoneal surface Laparoscopic tubal sterilization is surgery to block the fallopian tubes to prevent pregnancy Removal of amniotic fluid from the uterus for diagnostic purposes A common prenatal test used to check on a baby's health. Obstetrical pre- and postpartum care and vaginal delivery

Code 59410 59414 59425 59426 59510

59514 59515 59610

59612 59614

62322

62323

63030

64483

64493

64721

66821

66984

67028

69210

69436

70450 70486

70491 70551 70553

71045 71046 71047 71048 71101

71250 71260 71275

Description Vaginal delivery with post-delivery care Vaginal delivery of placenta Pre-delivery care 4-6 visits Pre-delivery care 7 or more visits CESAREAN DELIVERY

Cesarean delivery Cesarean delivery with post-delivery care VBAC DELIVERY

Vaginal delivery after prior cesarean delivery Vaginal delivery after prior cesarean delivery with post-delivery care SPINAL INJECTION FOR PAIN MANAGEMENT

Injection of substance into spinal canal of lower back or sacrum using imaging guidance LOW BACK DISK SURGERY

Transforaminal Epidural Injection

INJ PARAVERT F JNT L/S 1 LEV

CARPAL TUNNEL SURGERY

YAG capusulotomy surgery

CATARACT SURG W/IOL 1 STAGE

INJECTION EYE DRUG

REMOVE IMPACTED EAR WAX

CREATE EARDRUM OPENING

CT HEAD/BRAIN W/O DYE CT MAXILLOFACIAL W/O DYE

CT SOFT TISSUE NECK W/DYE MRI BRAIN STEM W/O DYE MRI BRAIN STEM W/O & W/DYE

CHEST X-RAY CHEST X-RAY CHEST X-RAY CHEST X-RAY X-RAY EXAM UNILAT RIBS/CHEST

CT THORAX W/O DYE CT THORAX W/DYE CT ANGIOGRAPHY CHEST

Plain Language Description

Cesarean delivery with pre- and postdelivery care

Vaginal delivery after prior cesarean delivery

Injection of substance into spinal canal of lower back or sacrum using imaging guidance

Surgical procedure to decompress a herniated vertebra Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance Injection into lower back of nerve block using imaging guidance Release of the transverse carpal ligament Removal of recurring cataract in lens capsule using laser Removal of cataract with insertion of lens Injection of a pharmaceutical agent into the eye Removal of ear wax from one or both ears Insertion of tubes into one or both ears CT scan head or brain without dye CT Scan of the face and jaw without dye CT scan of neck with dye MRI of brain stem without dye MRI scan of brain before and after contrast Single view 2 views, front and back 3 views 4 or more views Radiologic examination of one side of the chest/ribs CT scan of the thorax without dye CT scan of the thorax with dye Diagnostic Radiology (Diagnostic Imaging) Procedures of the Chest

Code 72040

72050

72070

72072

72100 72110

72131 72141 72146 72148 72156

72157

72158

72170 72192 72193 72195 72197 73000

73030

73070

73080

73090

73100 73110 73120 73130

73140

73221 73560

73562

73564

73565 73590

Description X-RAY EXAM NECK SPINE 2-3 VW

X-RAY EXAM NECK SPINE 4/5VWS

X-RAY EXAM THORAC SPINE 2VWS

X-RAY EXAM THORAC SPINE 3VWS

X-RAY EXAM L-S SPINE 2/3 VWS X-RAY EXAM L-2 SPINE 4/>VWS

CT LUMBAR SPINE W/O DYE MRI NECK SPINE W/O DYE MRI CHEST SPINE W/O DYE MRI LUMBAR SPINE W/O DYE MRI NECK SPINE W/O & W/DYE

MRI CHEST SPINE W/O & W/DYE

MRI LUMBAR SPINE W/O & W/DYE

X-RAY EXAM OF PELVIS CT PELVIS W/O DYE CT PELVIS W/DYE MRI PELVIS W/O DYE MRI PELVIS W/O & W/DYE X-RAY EXAM OF COLLAR BONE

X-RAY EXAM OF SHOULDER

X-RAY EXAM OF ELBOW

X-RAY EXAM OF ELBOW

X-RAY EXAM OF FOREARM

X-RAY EXAM OF WRIST X-RAY EXAM OF WRIST X-RAY EXAM OF HAND X-RAY EXAM OF HAND

X-RAY EXAM OF FINGER(S)

MRI JOINT UPR EXTREM W/O DYE X-RAY EXAM OF KNEE 1 OR 2

X-RAY EXAM OF KNEE 3

X-RAY EXAM KNEE 4 OR MORE

X-RAY EXAM OF KNEES X-RAY EXAM OF LOWER LEG

Plain Language Description Radiologic examination of the neck/spine, 2-3 views Radiologic examination of the neck/spine, 4-5 views Radiologic examination of the middle spine, 2 views Radiologic examination of the middle spine, 3 views X-ray of the lower spine 2-3 views X-ray of lower and sacral spine, minimum of 4 views CT scan of lower spine without dye MRI of the neck or spine without dye MRI of chest and spine without dye MRI scan of lower spinal canal MRI of neck/spine with and without dye MRI of chest and spine with and without dye MRI of lower back with and without dye Radiologic examination of the pelvis CT of pelvis without dye CT scan, pelvis, with contrast MRI of pelvis without dye MRI of pelvis before and after dye Radiologic examination of the collar bone Radiologic examination of the shoulder Radiologic examination, elbow; 2 views Radiologic examination, elbow; 3 or more views Radiologic examination of the forearm 3 or more views Up to 3 views X-ray of the hand with 2 views X-ray of the hand with 3 or more views Radiologic examination of the finger(s) MRI of upper extremity without dye Radiologic examination of the knee with 1 or 2 views Radiologic examination of the knee with 3 views Radiologic examination of the knee with 4 or more views Radiologic examination of both knees Radiologic examination of the lower leg

Code 73600

73610

73620 73630

73650 73660 73700 73718 73721

73722

73723

74022

74150 74160 74170 74176

74177

74178

Description X-RAY EXAM OF ANKLE

X-RAY EXAM OF ANKLE

X-RAY EXAM OF FOOT X-RAY EXAM OF FOOT

X-RAY EXAM OF HEEL X-RAY EXAM OF TOE(S) CT LOWER EXTREMITY W/O DYE MRI LOWER EXTREMITY W/O DYE MRI JNT OF LWR EXTRE W/O DYE

MRI JOINT OF LWR EXTR W/DYE

MRI JOINT LWR EXTR W/O&W/DYE

X-RAY EXAM SERIES ABDOMEN

CT ABDOMEN W/O DYE CT ABDOMEN W/DYE CT ABDOMEN W/O & W/DYE CT ABD & PELVIS W/O CONTRAST

CT ABD & PELV W/CONTRAST

CT ABD & PELV 1/> REGNS

74181 74183

76000

76001

76512 76514

MRI ABDOMEN W/O DYE MRI ABDOMEN W/O & W/DYE

CHEST X-RAY

CHEST X-RAY

OPHTH US B W/NON-QUANT A ECHO EXAM OF EYE THICKNESS

76536 76642 76700

76705

US EXAM OF HEAD AND NECK ULTRASOUND BREAST LIMITED US EXAM ABDOM COMPLETE

ECHO EXAM OF ABDOMEN

76770 76775

US EXAM ABDO BACK WALL COMP US EXAM ABDO BACK WALL LIM

Plain Language Description Radiologic examination of the ankle with 2 views Radiologic examination of the ankle with 3 views Radiologic examination, foot; 2 views Radiologic examination of the foot with 3 or more views Radiologic examination of the heel Radiologic examination of the toe(s) CT scan of leg without dye MRI of leg without dye MRI of lower extremity joint (knee/ankle) without dye MRI of lower extremity joint (knee/ankle) with dye MRI of lower extremity joint (knee/ankle) with and without dye Serial radiologic examination of the abdomen CT of abdomen without dye CT of abdomen with dye CT of abdomen with and without dye CT of abdomen and pelvis without dye CT scan of abdomen and pelvis with contrast Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions MRI of abdomen without dye MRI of abdomen without and with dye Flouroscopy, or x-ray "movie" that takes less than an hour Flouroscopy, or x-ray "movie" that takes more than an hour Ultrasound of the eye A diagnostic procedure that allows a provider to see the organs and other structures in the abdomen Ultrasound of head and neck Limited ultrasound of the breast Ultrasound of abdomen with all areas scanned A diagnostic procedure that allows a provider to see the organs and other structures in the abdomen Ultrasound of back wall of the abdomen with all areas viewed Ultrasound of back wall of the abdomen with limited areas viewed

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