|
CODE |
DESCRIPTION |
| 37761 |
Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg |
| 43775 |
Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy) |
| 63661 |
Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed |
| 63662 |
Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed |
| 63663 |
Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed |
| 63664 |
Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed |
| 74261 |
Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material |
| 74262 |
Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed |
| 74263 |
Computed tomographic (CT) colonography, screening, including image postprocessing |
| 75571 |
Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium |
| 75572 |
Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed) |
| 75573 |
Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of LV cardiac function, RV structure and function and evaluation of venous structures, if performed) |
| 75574 |
Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed) |
| 78451 |
Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic) |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection |
| 78453 |
Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic) |
| 78454 |
Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection |
| 89398 |
Unlisted reproductive medicine laboratory procedure |
| 90644 |
Meningococcal conjugate vaccine, serogroups C & Y and Hemophilus influenza B vaccine, tetanus toxoid conjugate (Hib-MenCY-TT), 4-dose schedule, when administered to children 2-15 months of age, for intramuscular use |
| 93750 |
Interrogation of ventricular assist device (VAD), in person, with physician analysis of device parameters (eg, drivelines, alarms, power surges), review of device function (eg, flow and volume status, septum status, recovery), with programming, if performed, and report |
| 95905 |
Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes F-wave study when performed, with interpretation and report |
| C9254 |
Injection, lacosamide, 1 mg |
| E0433 |
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 |
| E1036 |
Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs |
| G0420 |
Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour |
| G0421 |
Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour |
| G0422 |
Intensive cardiac rehabilitation; with or without continuous ECG monitoring with exercise, per session |
| G0423 |
Intensive cardiac rehabilitation; with or without continuous ECG monitoring; without exercise, per session |
| G0424 |
Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day |
| G0425 |
Initial inpatient telehealth consultation, typically 30 minutes communicating with the patient via telehealth |
| G0426 |
Initial inpatient telehealth consultation, typically 50 minutes communicating with the patient via telehealth |
| G0427 |
Initial inpatient telehealth consultation, typically 70 minutes or more communicating with the patient via telehealth |
| G0430 |
Drug screen, qualitative; multiple drug classes other than chromatographic method, each procedure |
| G0431 |
Drug screen, qualitative; single drug class method (e.g., immunoassay, enzyme assay), each drug class |
| J0586 |
Injection, abobotulinumtoxina, 5 units |
| J0598 |
Injection, C1 esterase inhibitor (human), 10 units |
| J0718 |
Injection, certolizumab pegol, 1 mg |
| J2562 |
Injection, plerixafor, 1 mg |
| J2793 |
Injection, rilonacept, 1 mg |
| J2796 |
Injection, romiplostim, 10 micrograms |
| J7325 |
Hyaluronan or derivative, Synvisc or Synvisc-One, for intra-articular injection, 1 mg |
| L2861 |
Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each |
| L3891 |
Addition to upper extremity joint, wrist or elbow, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each |
| L5973 |
Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source |
| L8031 |
Breast prosthesis, silicone or equal, with integral adhesive |
| L8627 |
Cochlear implant, external speech processor, component, replacement |
| L8628 |
Cochlear implant, external controller component, replacement |
| L8629 |
Transmitting coil and cable, integrated, for use with cochlear implant device, replacement |
| L8692 |
Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment |
| Q0138 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-ESRD use) |
| Q0139 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for ESRD on dialysis) |
| Q4074 |
Iloprost, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, up to 20 micrograms |