Untimed Billing Procedure CPT/HCPCS Codes Master List

Transcription

1 0500F 0501F 1034F 1035F Initial prenatal care visit Prenatal flow sheet Current tobacco smoker Smokeless tobacco user Drainage of skin abscess CPT CODES initial prenatal care visit (report at first prenatal encounter with health care professional providing obstetrical care. Report also date of visit and, in a separate field, the date of the last menstrual period [LMP]) (Prenatal) 12/15/2009 prenatal flow sheet documented in medical record by first prenatal visit (documentation includes at minimum blood pressure, weight, urine protein, uterine size, fetal heart tones, and estimated date of delivery). Report also: date of visit and, in a separate field, the date of the last menstrual period [LMP] (Note: If reporting 0501F Prenatal flow sheet, it is not necessary to report 0500F Initial prenatal care visit) (Prenatal) 12/15/2009 current tobacco smoker (CAD, CAP, COPD, PV) (DM) 12/15/2009 current smokeless tobacco user (eg, chew, snuff) (PV) 12/15/2009 Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple 04/01/2011 Therapeutic injections: Tendons, trigger points single or multiple trigger points; 1 or 2 muscles 02/01/2010 Therapeutic injections: Tendons, trigger points Apply, removal fixation device single or multiple trigger points; 3 or more muscles 02/01/2010 application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure) 05/01/ Application of head brace application of halo, including removal; cranial 05/01/ Application of pelvis brace application of halo, including removal; pelvic 05/01/ Halo brace application application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology (eg, pediatric patients, hydrocephalus, osteogenesis imperfecta), requiring general anesthesia 05/01/2010 Revised 12/2010 Page 1 of 33 All Codes

2 20665 Removal of fixation device removal of tongs or halo applied by another physician 05/01/ Remove cartilage for graft cartilage graft; nasal septum 05/01/ Ablate, bone tumor(s), percutaneous ablation, bone tumor(s) (eg, osteoid osteoma, metastasis) radiofrequency, percutaneous, including computed tomographic guidance 05/01/ Incision of jaw joint arthrotomy, temporomandibular joint 05/01/ Removal of jaw joint Remove jaw joint cartilage condylectomy, temporomandibular joint (separate procedure) 05/01/2010 meniscectomy, partial or complete, temporomandibular joint (separate procedure) 05/01/ Remove coronoid process coronoidectomy (separate procedure) 05/01/ Manip of tmj w/anes Prepare face/oral prosthesis Prepare face/oral prosthesis Prepare face/oral prosthesis Prepare face/oral prosthesis Prepare face/oral prosthesis Prepare face/oral prosthesis Prepare face/oral prosthesis Prepare face/oral prosthesis Prepare face/oral prosthesis Maxillofacial fixation manipulation of temporomandibular joint(s) (TMJ), therapeutic, requiring an anesthesia service (ie, general or monitored anesthesia care) 07/01/2010 impression and custom preparation; surgical obturator prosthesis 07/01/2010 impression and custom preparation; interim obturator prosthesis 07/01/2010 impression and custom preparation; definitive obturator prosthesis 07/01/2010 impression and custom preparation; mandibular resection prosthesis 07/01/2010 impression and custom preparation; palatal augmentation prosthesis 07/01/2010 impression and custom preparation; palatal lift prosthesis 07/01/2010 impression and custom preparation; speech aid prosthesis 07/01/2010 impression and custom preparation; nasal prosthesis 09/01/2010 impression and custom preparation; facial prosthesis 09/01/2010 application of halo type appliance for maxillofacial fixation, includes removal (separate procedure) 09/01/2010 Revised 12/2010 Page 2 of 33 All Codes

3 21120 Reconstruction of chin genioplasty; augmentation (autograft, allograft, prosthetic material) 09/01/ Reconstruction of chin Genioplasty; sliding osteotomy, single piece 09/01/ Reconstruction of chin Reconstruction of chin genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin) 09/01/2010 genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining 09/01/2010 autografts) Reduction of forehead reduction forehead; contouring only 09/01/ Reduction of forehead Reduction of forehead reduction forehead; contouring and application of prosthetic material or bone graft (includes obtaining autograft) 09/01/2010 reduction forehead; contouring and setback of anterior frontal sinus wall 09/01/ Antepartum care only antepartum care only; 4-6 visits 09/01/ Antepartum care only antepartum care only; 7 or more visits 09/01/ Radiation tx management, x5 radiation treatment management, 5 treatments 10/01/2005 Immune admin H1N1 im/nasal H1N1 immunization administration (intramuscular, intranasal), including counseling when performed 10/01/2009 Psychiatric diagnostic interview examination 02/01/2010 Individual outpatient psychotherapy Individual outpatient psychotherapy individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately minutes face to face with patient individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately minutes face to face with patient 02/01/ /01/2010 Revised 12/2010 Page 3 of 33 All Codes

4 Individual outpatient psychotherapy Individual outpatient interactive psychotherapy Individual outpatient interactive psychotherapy Individual outpatient interactive psychotherapy Individual inpatient psychotherapy Individual inpatient psychotherapy Individual inpatient psychotherapy individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately minutes face to face with patient 02/01/2010 individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient 02/01/2010 individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 45 to 50 minutes face-to-face with the patient 02/01/2010 individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an office or outpatient facility, approximately 75 to 80 minutes face-to-face with the patient 02/01/2010 individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an inpatient hospital, partial hospital or residential care setting, approximately 20 to 30 minutes face-to-face with the patient individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an inpatient hospital, partial hospital or residential care setting, approximately 45 to 50 minutes face-to-face with the patient individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an inpatient hospital, partial hospital or residential care setting, approximately 75 to 80 minutes face-to-face with the patient 02/01/ /01/ /01/2010 Revised 12/2010 Page 4 of 33 All Codes

5 Inpatient individual psychotherapy: Interactive Inpatient individual psychotherapy: Interactive Inpatient individual psychotherapy: Interactive Speech/hearing evaluation Speech/hearing therapy Speech/hearing therapy Special procedures of the ears/nose/throat Services related to hearing and speech devices individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an inpatient hospital, partial hospital or residential care setting, approximately 20 to 30 minutes face-to-face with the patient 02/01/2010 individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an inpatient hospital, partial hospital or residential care setting, approximately 45 to 50 minutes face-to-face with the patient 02/01/2010 individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal communication, in an inpatient hospital, partial hospital or residential care setting, approximately 75 to 80 minutes face-to-face with the patient 02/01/2010 evaluation of speech, language, voice, communication, and/or auditory processing treatment of speech, language, voice, communication, and/or auditory processing disorder; individual treatment of speech, language, voice, communication, and/or auditory processing disorder; group, 2 or more individuals 10/01/ /01/ /01/2009 treatment of swallowing dysfunction and/or oral function of feeding 02/01/2010 therapeutic services for the use of speechgenerating device, including programming and modification 02/01/2010 Revised 12/2010 Page 5 of 33 All Codes

6 92610 Swallowing evaluations Swallowing evaluations Transmission of ecg Report on transmitted ecg ECG record/review ECG recording ECG/monitoring and analysis ECG/review, interpret only evaluation of oral and pharyngeal swallowing function 02/01/2010 flexible fiberoptic endoscopic evaluation of swallowing by cine or video recording 02/01/2010 telephonic transmission of post-symptom electrocardiogram rhythm strip(s), 24-hour attended monitoring, per 30 day period of time; tracing only telephonic transmission of post-symptom electrocardiogram rhythm strip(s), 24-hour attended monitoring, per 30 day period of time; physician review with interpretation and report only 02/01/ /15/2008 wearable patient activated electrocardiographic rhythm derived event recording with presymptom memory loop, 24-hour attended monitoring, per 30 day period of time; includes transmission, physician review and interpretation 05/15/2008 wearable patient activated electrocardiographic rhythm derived event recording with presymptom memory loop, 24-hour attended monitoring, per 30 day period of time; recording (includes connection, recording, and disconnection) 05/15/2008 wearable patient activated electrocardiographic rhythm derived event recording with presymptom memory loop, 24-hour attended monitoring, per 30 day period of time; monitoring, receipt of transmissions, and analysis 05/15/2008 wearable patient activated electrocardiographic rhythm derived event recording with presymptom memory loop, 24-hour attended monitoring, per 30 day period of time; physician review and interpretation 05/15/2008 Revised 12/2010 Page 6 of 33 All Codes

7 Patient recorded spirometry Patient recorded spirometry Review patient spirometry Ped home apnea rec, compl Ped home apnea rec, hkup Ped home apnea rec, downld Ped home apnea rec, report patient-initiated spirometric recording per 30- day period of time; includes reinforced education, transmission of spirometric tracing, data capture, analysis of transmitted data, periodic recalibration and physician review and interpretation 05/15/2008 patient-initiated spirometric recording per 30- day period of time; recording (includes hookup, reinforced education, data transmission, data capture, trend analysis, and periodic recalibration) patient-initiated spirometric recording per 30- day period of time; physician review and interpretation only 05/15/ /15/2008 pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; includes monitor attachment, download of data, physician review, interpretation, and preparation of a report 05/15/2008 pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; monitor attachment only (includes hook-up, initiation of recording and disconnection) 05/15/2008 pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; monitoring, download of information, receipt of transmission(s) and analyses by computer only 05/15/2008 pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; physician review, interpretation and preparation of report only 05/15/2008 Revised 12/2010 Page 7 of 33 All Codes

8 95117 Allergy immunotherapy 2 or more injections 02/01/ Immunotherapy, one injection Immunotherapy, many antigens Polysomnography, Polysomnography, 4 or more Polysomnography w/cpap Cognitive capability assessments Cognitive capability assessments professional services for allergen immunotherapy in prescribing physicians office or institution, including provision of allergenic extract; single injection professional services for allergen immunotherapy in prescribing physicians office or institution, including provision of allergenic extract; 2 or more injections polysomnography; sleep staging with 1-3 additional parameters of sleep, attended by a technologist polysomnography; sleep staging with 4 or more additional parameters of sleep, attended by a technologist polysomnography; sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist developmental testing; limited (eg. Developmental Screening Test II, Early Language Milestone Screen), with interpretation and report extended (includes assessment of motor, language, social, adaptive and/or cognitive functioning by standardized developmental instruments) with interpretation and report 04/01/ /01/ /01/ /01/ /01/ /01/ /15/ /01/ /15/ Physical medicine assessments physical therapy evaluation 02/01/2010 Physical medicine assessments occupational therapy evaluation 02/01/2010 Revised 12/2010 Page 8 of 33 All Codes

9 99201 Outpatient and other visits Outpatient and other visits office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Physicians typically spend 10 minutes face-to-face with the patient and/or family. 02/01/2010 office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; Straightforward medical decision making. consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Physicians typically spend 20 minutes face-to-face with the patient and/or family. 02/01/2010 Revised 12/2010 Page 9 of 33 All Codes

10 99203 Outpatient and other visits Outpatient and other visits office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Physicians typically spend 30 minutes face-to-face with the patient and/or family. 02/01/2010 office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 45 minutes face-toface with the patient and/or family. 02/01/2010 Revised 12/2010 Page 10 of 33 All Codes

11 99205 Outpatient and other visits Outpatient and other visits Outpatient and other visits office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 60 minutes face-to-face with the patient and/or family. 02/01/2010 office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these services. 02/01/2010 office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; a problem focused examination; Straightforward medical decision making. consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Physicians typically spend 10 minutes face-to-face with the patient and/or family. 02/01/2010 Revised 12/2010 Page 11 of 33 All Codes

12 99213 Outpatient and other visits Outpatient and other visits office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; an expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Physicians typically spend 15 minutes face-to-face with the patient and/or family. 02/01/2010 office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; a detailed examination; Medical decision making of moderate complexity. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 25 minutes face-toface with the patient and/or family. 02/01/2010 Revised 12/2010 Page 12 of 33 All Codes

13 99215 Outpatient and other visits Inpatient hospital discharge services office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; a comprehensive examination; Medical decision making of high complexity. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 40 minutes face-toface with the patient and/or family. 02/01/2010 hospital discharge day management: 30 minutes or less 02/01/ Inpatient hospital discharge services more than 30 minutes 02/01/ Consultations office consultation for a new or established patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Physicians typically spend 15 minutes face-to-face with the patient and/or family. 02/01/2010 Revised 12/2010 Page 13 of 33 All Codes

14 99242 Consultations Consultations Consultations office consultation for a new or established patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Straightforward medical decision making. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the presenting problem(s) are of low severity. Physicians typically spend 30 minutes face-to-face with the patient and/or family. 02/01/2010 office consultation for a new or established patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of low complexity. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Physicians typically spend 40 minutes face-toface with the patient and/or family. 02/01/2010 office consultation for a new or established patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 60 minutes face-to-face with the patient and/or family. 02/01/2010 Revised 12/2010 Page 14 of 33 All Codes

15 99245 Consultations Consultations Consultations office consultation for a new or established patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 80 minutes face-to-face with the patient and/or family. 02/01/2010 inpatient consultation for a new or established patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Physicians typically spend 20 minutes at the bedside and on the patient's hospital floor or unit. 02/01/2010 inpatient consultation for a new or established patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Straightforward medical decision making. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the presenting problem(s) are of low severity. Physicians typically spend 40 minutes at the bedside and on the patient's hospital floor or unit. 02/01/2010 Revised 12/2010 Page 15 of 33 All Codes

16 99253 Consultations Consultations Consultations inpatient consultation for a new or established patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of low complexity. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Physicians typically spend 55 minutes at the bedside and on the patient's hospital floor or unit. 02/01/2010 inpatient consultation for a new or established patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 80 minutes at the bedside and on the patient's hospital floor or unit. 02/01/2010 inpatient consultation for a new or established patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 110 minutes at the bedside and on the patient's hospital floor or unit. 02/01/2010 Revised 12/2010 Page 16 of 33 All Codes

17 99291 Critical care visits: Patients 25 months of age and older Nursing facility visits Nursing facility visits Critical care, evaluation and management of the critically ill or critically injured patient: first minutes initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or of low complexity. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the problem(s) requiring admission are of low severity. Physicians typically spend 25 minutes with the patient and/or family or caregiver. 02/01/2010 initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the problem(s) requiring admission are of moderate severity. Physicians typically spend 35 minutes with the patient and/or family or caregiver. 02/01/ /01/ /19/2010 Revised 12/2010 Page 17 of 33 All Codes

18 99306 Nursing facility visits Nursing facility visits initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the problem(s) requiring admission are of high severity. Physicians typically spend 45 minutes with the patient and/or family or caregiver. 02/01/2010 subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Straightforward medical decision. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is stable, recovering, or improving. Physicians typically spend 10 minutes with the patient and/or family or caregiver. 02/01/2010 Revised 12/2010 Page 18 of 33 All Codes

19 99308 Nursing facility visits Nursing facility visits subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Physicians typically spend 15 minutes with the patient and/or family or caregiver. 02/01/2010 subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the patient has developed a significant complication or a significant new problem. Physicians typically spend 25 minutes with the patient and/or family or caregiver. 02/01/2010 Revised 12/2010 Page 19 of 33 All Codes

20 99310 Nursing facility visits Domiciliary care, rest home, assisted living visits subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components. A comprehensive interval history; A comprehensive examination; Medical decision making of high complexity. consistent with the nature of the problem(s) and the patient's and/or family's needs. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Physicians typically spend 35 minutes with the patient and/or family or caregiver. 02/01/2010 domiciliary or rest home visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the presenting problem(s) are of low severity. Physicians typically spend 20 minutes with the patient and/or family or caregiver. 02/01/2010 Revised 12/2010 Page 20 of 33 All Codes

21 Domiciliary care, rest home, assisted living visits Domiciliary care, rest home, assisted living visits Domiciliary care, rest home, assisted living visits domiciliary or rest home visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Physicians typically spend 30 minutes with the patient and/or family or caregiver. 02/01/2010 domiciliary or rest home visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 45 minutes with the patient and/or family or caregiver. 02/01/2010 domiciliary or rest home visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the presenting problem(s) are of high severity. Physicians typically spend 60 minutes with the patient and/or family or caregiver. 02/01/2010 Revised 12/2010 Page 21 of 33 All Codes

22 Domiciliary care, rest home, assisted living visits Domiciliary care, rest home, assisted living visits domiciliary or rest home visit for the evaluation and management of a new patient, which requires these 3 key components: : A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the patient is unstable or has developed a significant new problem requiring immediate physican attention. Physicians typically spend 75 minutes with the patient and/or family or caregiver. 02/01/2010 domiciliary or rest home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused internal history; A problem focused examination; Straightforward medical decision making. consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Physicians typically spend 15 minutes with the patient and/or family or caregiver. 02/01/2010 Revised 12/2010 Page 22 of 33 All Codes

23 Domiciliary care, rest home, assisted living visits Domiciliary care, rest home, assisted living visits domiciliary or rest home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused internal history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Physicians typically spend 25 minutes with the patient and/or family or caregiver. 02/01/2010 domiciliary or rest home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 40 minutes with the patient and/or family or caregiver. 02/01/2010 Revised 12/2010 Page 23 of 33 All Codes

24 Home visits Domiciliary care, rest home, assisted living visits domiciliary or rest home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive interval history; A comprehensive examination; Medical decision making of moderate to high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. The patient may be unstable or may have developed a significant new problem requiring immediate physical attention. Physicians typically spend 60 minutes with the patient and/or family or caregiver. 02/01/2010 home visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. consistent wit the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low severity. Physicians typically spend 20 minutes face-to-face with the patient and/or family. 02/01/2010 Revised 12/2010 Page 24 of 33 All Codes

25 99342 Home visits Home visits home visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseling and/or agencies are provided consistent wit the and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Physicians typically spend 30 minutes face-toface with the patient and/or family. 02/01/2010 home visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. Counseling and/or agencies are provided consistent wit the and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 45 minutes face-toface with the patient and/or family. 02/01/2010 Revised 12/2010 Page 25 of 33 All Codes

26 99344 Home visits Home visits Home visits home visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. consistent wit the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high severity. Physicians typically spend 60 minutes face-to-face with the patient and/or family. 02/01/2010 home visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. consistent wit the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant new problem requiring immediate physician attention. Physicians typically spend 75 minutes face-to-face with the patient and/or family. 02/01/2010 home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused internal history; A problem focused examination; and Straightforward medical decision making. Counseling and/or agencies are provided consistent with the and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Physicians typically spend 15 minutes face-toface with the patient and/or family. 02/01/2010 Revised 12/2010 Page 26 of 33 All Codes

27 99348 Home visits Home visits home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of low complexity. consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Physicians typically spend 25 minutes face-to-face with the patient and/or family. 02/01/2010 home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are moderate to high severity. Physicians typically spend 40 minutes face-to-face with the patient and/or family. 02/01/2010 Revised 12/2010 Page 27 of 33 All Codes

28 99350 Home visits Prolonged services outside customary services home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive interval history; A comprehensive examination; Medical decision making of moderate to high complexity. consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Physicians typically spend 60 minutes face-to-face with the patient and/or family. 02/01/2010 prolonged physician service in the office or other outpatient setting requiring direct (faceto-face) patient contact beyond the usual service. First hour list separately in addition to code the office or other outpatient Evaluation and Management service. 02/01/ Init pm e/m, new pat, inf initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age younger than 1 year) 02/01/2011 Revised 12/2010 Page 28 of 33 All Codes

29 99382 Init pm e/m, new pat 1-4 yrs Prev visit, new, age Prev visit, new, age Prev visit, new, age initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood (age 1 through 4 years) 02/01/2011 initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (age 5 through 11 years) 02/01/2011 initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age 12 through 17 years) 02/01/2011 initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; years 02/01/2011 Revised 12/2010 Page 29 of 33 All Codes

30 99386 Prev visit, new, age Init pm e/m, new pat 65+ yrs Per pm reeval, est pat, inf Prev visit, est, age 1-4 yrs initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; years 02/01/2011 initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and older 02/01/2011 periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infant (age younger than 1 year) 02/01/2011 periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early childhood (age 1 through 4 years) 02/01/2011 Revised 12/2010 Page 30 of 33 All Codes

31 99393 Prev visit, est, age Prev visit, est, age periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late childhood (age 5 through 11 years) 02/01/2011 periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adolescent (age 12 through 17 years) 02/01/ Preventive medicine visits years 02/01/ Prev visit, est, age Per pm reeval est pat 65+ yrs periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; years 02/01/2011 periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 years and older 02/01/2011 Revised 12/2010 Page 31 of 33 All Codes

32 99401 Counseling services: Risk factor and behavioral change modification preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure), approximately 15 minutes 02/01/ Counseling services: Risk factor and behavioral change modification approximately 30 minutes 02/01/2010 Counseling services: Risk factor and behavioral change modification approximately 45 minutes 02/01/2010 Counseling services: Risk factor and behavioral change modification approximately 60 minutes 02/01/2010 Counseling services: Risk factor and behavioral change modification preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure), approximately 30 minutes 02/01/2010 Counseling services: Risk factor and behavioral change modification approximately 60 minutes 02/01/2010 Critical care transport age 24 months or younger critical care services delivered by a physician, face-to-face, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or less, first minutes of hands-on care during transport. 02/01/2010 Revised 12/2010 Page 32 of 33 All Codes

33 E0424 Stationary compressed gas 02 E0431 Portable gaseous 02 E0434 Portable liquid 02 E0439 Stationary liquid 02 G9141 Influenza A H1N1,admin w counsel HCPCS CODES stationary compressed, gaseous oxygen, rental; incl. container, contents, 01/01/2005 portable gaseous oxygen system, rental; portable container, regulator 01/01/2005 portable liquid oxygen system, includes container, flowmeter, etc. 01/01/2005 stationary liquid oxygen system, rental; includes container, contents, regulator 01/01/2005 influenza A (H1N1) immunization administration (includes the physician counseling the patient/family) 09/15/2009 J2505 Injection, pegfilgrastim 6mg injection pegfilgrastim 6mg 05/15/2008 Q0513 S0270 S0271 S0272 S4040 Disp fee inhal drugs/30 days Home std case rate 30 days Home hospice case 30 days Home episodic case 30 days Monit store cryo embryo 30 days pharmacy dispensing fee for inhalation drug(s); per 30 days 05/15/2008 physician management of patient home care, standard monthly case rate (per 30 days) 05/15/2008 physician management of patient home care, hospice monthly case rate (per 30 days) 05/15/2008 physician management of patient home care, episodic care monthly case rate (per 30 days) 05/15/2008 monitoring and storage of cryopreserved embryos, per 30 days 05/15/2008 Revised 12/2010 Page 33 of 33 All Codes