Homocysteine Level. Test Code Test Name CPT. HCYS Homocysteine Level 83090

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1 Test Code Test Name CPT HCYS Homocysteine Level 83090

2 Page 1 of 4 Narrative Description ICD9 Acute Coronary Occlusion without Myocardial Infarction Acute Myocardial Infarction of Anterolateral Wall episode of care unspecified Acute Myocardial Infarction of Inferolateral Wall subsequent episode of care Acute Myocardial Infarction of Inferoposterior Wall episode of care unspecified Acute Myocardial Infarction of Inferoposterior Wall subsequent episode of care Acute Myocardial Infarction of Other Inferior Wall episode of care unspecified Acute Myocardial Infarction of Other Inferior Wall subsequent episode of care Acute Myocardial Infarction of Other Lateral Wall episode of care unspecified Acute Myocardial Infarction of Other Lateral Wall subsequent episode of care Acute Myocardial Infarction of other specified sites episode of care unspecified Acute Myocardial Infarction of other specified sites subsequent episode of care Acute Myocardial Infarction of unspecified site episode of care unspecified Acute Myocardial Infarction of unspecified site subsequent episode of care Aneurysm of Heart (Wall) Dissection of Coronary Artery Angina Decubitus Atherosclerosis of Aorta Atherosclerosis of Native Arteries of the extremities unspecified Atherosclerosis of Native Arteries of the extremities with Gangrene Atherosclerosis of other specified arteries Atherosclerosis of Renal Artery Atherosclerosis of unspecified bypass graft of the extremities Atherosclerosis of Nonautologous Biological bypass graft of the extremities Benign Essential Hypertension Benign Hypertensive Heart Disease without Heart Failure Benign Hypertensive Heart Disease with Heart Failure Benign Renovascular Hypertension Budd-Chiari Syndrome Cerebral Artery Occlusion unspecified without Cerebral Infarction Cerebral Artery Occlusion unspecified with Cerebral Infarction Cerebral Atherosclerosis Cerebral Embolism without Cerebral Infarction Cerebral Embolism with Cerebral Infarction Cerebral Thrombosis without Cerebral Infarction Cerebral Thrombosis with Cerebral Infarction Chronic Ischemic Heart Disease Unspecified Coronary Atherosclerosis of Unspecified Type of Vessel Native or Graft Coronary Atherosclerosis of bypass graft (Artery)(Vein) of transplanted Heart Diabetes Mellitus without mention of complication, Type II or Unspecified Type, not stated as uncontrolled Diabetes Mellitus without mention of complication, Type I [Juvenile Type],

3 Page 2 of 4 Diabetes with Hyperosmolarity, Type II or Unspecified Type, not stated uncontrolled Diabetes with Hyperosmolarity, Type I [Juvenile Type], Diabetes with Ketoacidosis, Type II or Unspecified Type, not stated as uncontrolled Diabetes with Ketoacidosis, Type I [Juvenile Type], Diabetes with Neurological Manifestations, Type II or Unspecified Type, not stated uncontrolled Diabetes with Neurological Manifestations, Type I [Juvenile Type], Diabetes with Ophthalmic Manifestations, Type II or Unspecified Type, not stated uncontrolled Diabetes with Ophthalmic Manifestations, Type I [Juvenile Type], Diabetes with Other Coma, Type II or Unspecified Type, not stated uncontrolled Diabetes with Other Coma, Type I [Juvenile Type], Diabetes with Other Specified Manifestations, Type II or Unspecified Type, not stated as Diabetes with Other Specified Manifestations, Type I [Juvenile Type], Diabetes with Peripheral Circulatory Disorders, Type II or Unspecified Type, not stated uncontrolled Diabetes with Peripheral Circulatory Disorders, Type I [Juvenile Type], Diabetes with Renal Manifestations, Type II or Unspecified Type, not stated uncontrolled Diabetes with Renal Manifestations, Type I [Juvenile Type], Diabetes with Unspecified Complication, Type II or Unspecified Type, not stated uncontrolled Diabetes with Unspecified Complication, Type I [Juvenile Type], Embolism and Thrombosis of Renal Vein Embolism and Thrombosis of Vena Cava Folate-Deficiency Anemia Generalized and unspecified Atherosclerosis Hyperchylomicronemia Hypertensive Chronic Kidney Disease, Benign, with Chronic Kidney Disease Stage I through Stage IV, or Unspecified Hypertensive Chronic Kidney Disease, Benign, with Chronic Kidney Disease State V or End Stage Renal Disease Hypertensive Chronic Kidney Disease, Malignant, with Chronic Kidney Disease Stage I through Stage IV, or Unspecified Hypertensive Chronic Kidney Disease, Malignant, with Chronic Kidney Disease State V or End Stage Renal Disease Hypertensive Chronic Kidney Disease, Unspecified, with Chronic Kidney Disease Stage I through Stage IV, or Unspecified Hypertensive Chronic Kidney Disease, Unspecified, with Chronic Kidney Disease State V or End Stage Renal Disease Hypertensive Heart and Chronic Kidney Disease, Benign, without Heart Failure and with Chronic Kidney Disease Stage I through Stage IV, or Unspecified hypertensive Heart and Chronic Kidney Disease, Benign, with Heart Failure and Chronic Kidney Disease Stage V or End Stage Renal Disease Hypertensive Heart and Chronic Kidney Disease, Malignant, without Heart Failure and with Chronic Kidney Disease State I through Stage IV, or unspecified - Hypertensive Heart and Chronic Kidney Disease, Malignant, with Heart Failure and with Chronic Kidney Disease State V or End Stage Renal Disease

4 Page 3 of 4 Hypertensive Heart and Chronic Kidney Disease, Unspecified, without Heart Failure and with Chronic Kidney Disease Stage I through Stage IV, or Unspecified Hypertensive Heart and Chronic Kidney Disease, Unspecified, with Heart Failure and Chronic Kidney Disease Stage V or End Stage Renal Disease Intermediate Coronary Syndrome Malignant Essential Hypertension Malignant Hypertensive Heart Disease without Heart Failure Malignant Hypertensive Heart Disease with Heart Failure Malignant Renovascular Hypertension Mixed Hyperlipidemia Nopyogenic Thrombosis of Intracranial Venous Sinus Occlusion and Stenosis of Basilar Artery without Cerebral Infarction Occlusion and Stenosis of Basilar Artery with Cerebral Infarction Occlusion and Stenosis of Carotid Artery without Cerebral Infarction Occlusion and Stenosis of Carotid Artery with Cerebral Infarction Occlusion and Stenosis of Multiple and Bilateral Precerebral Arteries without Cerebral Infarction Occlusion and Stenosis of Other Specified Precerebral Artery with Cerebral Infarction Occlusion and Stenosis of Other Specified Precerebral Artery without Cerebral Infarction Occlusion and Stenosis of Unspecified Precerebral Artery with Cerebral Infarction Occlusion and Stenosis of Unspecified Precerebral Artery without Cerebral Infarction Occlusion and Stenosis of Unspecified Precerebral Artery with Cerebral Infarction Occlusion and Stenosis of Vertebral Artery without Cerebral Infarction Occlusion and Stenosis of Vertebral Artery with Cerebral Infarction Old Myocardial Infarction 412 Other Acute and Subacute forms of Ischemic Heart Disease Other Other and Unspecified Angina Pectoris Other and Unspecified Hyperlipidemia Other Aneurysm of Heart Other Atherosclerosis of Native Arteries of the extremities Other Benign Secondary Hypertension Other Malignant Secondary Hypertension Other specified forms of chronic Ischemic Heart Disease Other Specified Megaloblastic Anemias not elsewhere classified Other Unspecified Secondary Hypertension Other Vitamin B12 Deficiency Anemia Pernicious Anemia 281.0

5 Page 4 of 4 Postmyocardial Infarction Syndrome Prinzmetal Angia Pure Hypercholesterolemia Pure Hyperglyceridemia Subendocardial Infarction Episode of care unspecified Subendocardial Infarction Episode of care Thrombophlebitis Migrans True Posterior Wall Infarction episode of care unspecified True Posterior Wall Infarction subsequent episode of care Unspecified Essential Hypertension Unspecified Hypertensive Heart Disease without Heart Failure - Unspecified Hypertensive Heart Disease with Heart Failure Unspecified Renovascular Hypertension Venous Embolism and Thrombosis of unspecified deep vessels of lower extremity Venous Embolism and Thrombosis of deep vessels of Distal lower extremity

6 MEDICARE POLICY # L25650 Page 1 of

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