Your Map of the ICD-9 to ICD-10 PCS Conversion

Transcription

1 Your Map of the ICD-9 to ICD-10 PCS Conversion

2 Table of Contents Disclaimer 3 Endoscopy 4 Interventional Cardiology 20 Neuromodulation 34 Peripheral Interventions 35 Rhythm Management and Electrophysiology 61 Urology 71 Women s Health 74 2

3 Disclaimers Health economic and reimbursement information provided by Boston Scientific Corporation is gathered from third party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice. Boston Scientific encourages providers to submit accurate and appropriate claims for services. It is always the provider s responsibility to determine medical necessity, the proper site for delivery of any services and to submit appropriate codes, charges, and modifiers for services that are rendered. Boston Scientific recommends that you consult with your payers, reimbursement specialists and/or legal counsel regarding coding, coverage and reimbursement matters. Boston Scientific does not promote the use of its products outside their FDA approved label. CPT copyright 2013 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. Applicable FARS/DFARS Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors, and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Advantage, Advantage Fit, Capio, Capio SLIM, Lynx, Obtryx, Obtryx II, Polyform, Solyx, Uphold and Xenform are registered trademarks of Boston Scientific Corporation or its affiliates. All other trademarks are property of their respective owners. Accordingly for mesh for stress urinary incontinence: CAUTION: Federal Law (USA) restricts this device to sale by or on the order of a physician trained in use of mesh for the repair of stress urinary incontinence. Accordingly for mesh for transvaginal repair of pelvic organ prolapse: CAUTION: Federal Law (USA) restricts this device to sale by or on the order of a physician trained in use of surgical mesh for transvaginal repair of pelvic organ prolapse. Repliform Tissue Regeneration Matrix complies with U.S. Regulations in 21 CFR part 1270 and 1271 Human Tissue Intended for Transplantation. Coaptite is manufactured by Merz Aesthetics, Inc. and distributed by Boston Scientific. Caution: Federal Law (USA) restricts the Coaptite Implant device to sale by or on the order of a physician trained in diagnostic and therapeutic cystoscopy. Please refer to package insert provided with the product for complete Indications for Use, Contraindications, Warnings, Precautions, Adverse Events and Instructions prior to using this product. This crosswalk is not a comprehensive list of all relevant ICD-10 PCS codes, rather it is a one-way mapping (ICD-9 CM > ICD-10 PCS) based on the most frequent and most relevant ICD-9 codes used in relation to Boston Scientific devices. Please refer to your coding guidelines for the most appropriate codes to reflect the services performed. Accordingly for medical devices: CAUTION: Federal Law (USA) restricts these devices to sale by or on the order of a physician. See page 3 for important information about the uses and limitations of this document. CORP AA SEP2014 3

4 Endoscopy Endoscopic retrograde cholangio- pancreatography (ERCP) BF110ZZ BF111ZZ BF11YZZ Fluoroscopy of Biliary and Pancreatic Ducts using High Osmolar Contrast Fluoroscopy of Biliary and Pancreatic Ducts using Low Osmolar Contrast Fluoroscopy of Biliary and Pancreatic Ducts using Other Contrast Endoscopic retrograde cholangiography (ERC) BF100ZZ BF101ZZ BF10YZZ Fluoroscopy of Bile Ducts using High Osmolar Contrast Fluoroscopy of Bile Ducts using Low Osmolar Contrast Fluoroscopy of Bile Ducts using Other Contrast 0F954ZX Drainage of Right Hepatic Duct, Percutaneous Endoscopic, Diagnostic 0F957ZX Drainage of Right Hepatic Duct, Via Natural or Artificial Opening, Diagnostic 0F958ZX Drainage of Right Hepatic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic 0F964ZX Drainage of Left Hepatic Duct, Percutaneous Endoscopic, Diagnostic 0F967ZX Drainage of Left Hepatic Duct, Via Natural or Artificial Opening, Diagnostic 0F968ZX Drainage of Left Hepatic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic 0F984ZX Drainage of Cystic Duct, Percutaneous Endoscopic, Diagnostic 0F987ZX Drainage of Cystic Duct, Via Natural or Artificial Opening, Diagnostic 0F988ZX Drainage of Cystic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic 0F994ZX Drainage of Common Bile Duct, Percutaneous Endoscopic, Diagnostic 0F997ZX Drainage of Common Bile Duct, Via Natural or Artificial Opening, Diagnostic Other closed (endoscopic) biopsy of biliary duct or sphincter of Oddi 0F998ZX 0F9C4ZX 0F9C7ZX Drainage of Common Bile Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Ampulla of Vater, Percutaneous Endoscopic, Diagnostic Drainage of Ampulla of Vater, Via Natural or Artificial Opening, Diagnostic 0F9C8ZX Drainage of Ampulla of Vater, Via Natural or Artificial Opening Endoscopic, Diagnostic 0FB44ZX Excision of Gallbladder, Percutaneous Endoscopic, Diagnostic 0FB54ZX Excision of Right Hepatic Duct, Percutaneous Endoscopic, Diagnostic 0FB57ZX Excision of Right Hepatic Duct, Via Natural or Artificial Opening, Diagnostic 0FB58ZX Excision of Right Hepatic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic 0FB64ZX Excision of Left Hepatic Duct, Percutaneous Endoscopic, Diagnostic 0FB67ZX Excision of Left Hepatic Duct, Via Natural or Artificial Opening, Diagnostic 0FB68ZX Excision of Left Hepatic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic 0FB84ZX Excision of Cystic Duct, Percutaneous Endoscopic, Diagnostic 0FB87ZX Excision of Cystic Duct, Via Natural or Artificial Opening, Diagnostic 0FB88ZX Excision of Cystic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic See page 3 for important information about the uses and limitations of this document. CORP AA SEP2014 4

5 Endoscopy 0FB94ZX Excision of Common Bile Duct, Percutaneous Endoscopic, Diagnostic Other closed (endoscopic) biopsy of biliary duct or sphincter of Oddi 0FB97ZX 0FB98ZX 0FBC4ZX 0FBC7ZX Excision of Common Bile Duct, Via Natural or Artificial Opening, Diagnostic Excision of Common Bile Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic Excision of Ampulla of Vater, Percutaneous Endoscopic, Diagnostic Excision of Ampulla of Vater, Via Natural or Artificial Opening, Diagnostic 0FBC8ZX Excision of Ampulla of Vater, Via Natural or Artificial Opening Endoscopic, Diagnostic 0F753DZ Dilation of Right Hepatic Duct with Intraluminal Device, Percutaneous 0F753ZZ Dilation of Right Hepatic Duct, Percutaneous 0F763DZ Dilation of Left Hepatic Duct with Intraluminal Device, Percutaneous 0F763ZZ Dilation of Left Hepatic Duct, Percutaneous 0F783DZ Dilation of Cystic Duct with Intraluminal Device, Percutaneous 0F783ZZ Dilation of Cystic Duct, Percutaneous 0F793DZ Dilation of Common Bile Duct with Intraluminal Device, Percutaneous 0F793ZZ Dilation of Common Bile Duct, Percutaneous 0F993ZZ Drainage of Common Bile Duct, Percutaneous 0F994ZZ Drainage of Common Bile Duct, Percutaneous Endoscopic 0F997ZZ Drainage of Common Bile Duct, Via Natural or Artificial Opening 0F998ZZ Drainage of Common Bile Duct, Via Natural or Artificial Opening Endoscopic 0FC53ZZ Extirpation of Matter from Right Hepatic Duct, Percutaneous Other percutaneous procedures on biliary tract 0FC57ZZ 0FC63ZZ Extirpation of Matter from Right Hepatic Duct, Via Natural or Artificial Opening Extirpation of Matter from Left Hepatic Duct, Percutaneous 0FC67ZZ Extirpation of Matter from Left Hepatic Duct, Via Natural or Artificial Opening 0FC83ZZ Extirpation of Matter from Cystic Duct, Percutaneous 0FC87ZZ Extirpation of Matter from Cystic Duct, Via Natural or Artificial Opening 0FL53CZ Occlusion of Right Hepatic Duct with Extraluminal Device, Percutaneous 0FL53DZ Occlusion of Right Hepatic Duct with Intraluminal Device, Percutaneous 0FL53ZZ Occlusion of Right Hepatic Duct, Percutaneous 0FL54CZ Occlusion of Right Hepatic Duct with Extraluminal Device, Percutaneous Endoscopic 0FL54DZ Occlusion of Right Hepatic Duct with Intraluminal Device, Percutaneous Endoscopic 0FL54ZZ Occlusion of Right Hepatic Duct, Percutaneous Endoscopic 0FL57DZ Occlusion of Right Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening 0FL57ZZ Occlusion of Right Hepatic Duct, Via Natural or Artificial Opening 0FL58DZ Occlusion of Right Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FL58ZZ Occlusion of Right Hepatic Duct, Via Natural or Artificial Opening Endoscopic 0FL63CZ Occlusion of Left Hepatic Duct with Extraluminal Device, Percutaneous Other percutaneous procedures on biliary tract 0FL63DZ 0FL63ZZ Occlusion of Left Hepatic Duct with Intraluminal Device, Percutaneous Occlusion of Left Hepatic Duct, Percutaneous 0FL64CZ Occlusion of Left Hepatic Duct with Extraluminal Device, Percutaneous Endoscopic See page 3 for important information about the uses and limitations of this document. CORP AA SEP2014 5

6 Endoscopy 0FL64DZ Occlusion of Left Hepatic Duct with Intraluminal Device, Percutaneous Endoscopic 0FL64ZZ Occlusion of Left Hepatic Duct, Percutaneous Endoscopic 0FL67DZ Occlusion of Left Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening 0FL67ZZ Occlusion of Left Hepatic Duct, Via Natural or Artificial Opening 0FL68DZ Occlusion of Left Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FL68ZZ Occlusion of Left Hepatic Duct, Via Natural or Artificial Opening Endoscopic 0FL83CZ Occlusion of Cystic Duct with Extraluminal Device, Percutaneous 0FL83DZ Occlusion of Cystic Duct with Intraluminal Device, Percutaneous 0FL83ZZ Occlusion of Cystic Duct, Percutaneous 0FL84CZ Occlusion of Cystic Duct with Extraluminal Device, Percutaneous Endoscopic 0FL84DZ Occlusion of Cystic Duct with Intraluminal Device, Percutaneous Endoscopic 0FL84ZZ Occlusion of Cystic Duct, Percutaneous Endoscopic 0FL87DZ Occlusion of Cystic Duct with Intraluminal Device, Via Natural or Artificial Opening 0FL87ZZ Occlusion of Cystic Duct, Via Natural or Artificial Opening 0FL88DZ Occlusion of Cystic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FL88ZZ Occlusion of Cystic Duct, Via Natural or Artificial Opening Endoscopic 0FL93CZ Occlusion of Common Bile Duct with Extraluminal Device, Percutaneous 0FL93DZ Occlusion of Common Bile Duct with Intraluminal Device, Percutaneous 0FL93ZZ Occlusion of Common Bile Duct, Percutaneous 0FL94CZ Occlusion of Common Bile Duct with Extraluminal Device, Percutaneous Endoscopic 0FL94DZ Occlusion of Common Bile Duct with Intraluminal Device, Percutaneous Endoscopic 0FL94ZZ Occlusion of Common Bile Duct, Percutaneous Endoscopic 0FL97DZ Occlusion of Common Bile Duct with Intraluminal Device, Via Natural or Artificial Opening 0FL97ZZ Occlusion of Common Bile Duct, Via Natural or Artificial Opening 0FL98DZ Occlusion of Common Bile Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FL98ZZ Occlusion of Common Bile Duct, Via Natural or Artificial Opening Endoscopic 0FM44ZZ Reattachment of Gallbladder, Percutaneous Endoscopic 0FM54ZZ Reattachment of Right Hepatic Duct, Percutaneous Endoscopic 0FM64ZZ Reattachment of Left Hepatic Duct, Percutaneous Endoscopic 0FM84ZZ Reattachment of Cystic Duct, Percutaneous Endoscopic 0FM94ZZ Reattachment of Common Bile Duct, Percutaneous Endoscopic 0FV53CZ Restriction of Right Hepatic Duct with Extraluminal Device, Percutaneous Other percutaneous procedures on biliary tract 0FV53DZ 0FV53ZZ 0FV54CZ Restriction of Right Hepatic Duct with Intraluminal Device, Percutaneous Restriction of Right Hepatic Duct, Percutaneous Restriction of Right Hepatic Duct with Extraluminal Device, Percutaneous Endoscopic 0FV54DZ Restriction of Right Hepatic Duct with Intraluminal Device, Percutaneous Endoscopic 0FV54ZZ Restriction of Right Hepatic Duct, Percutaneous Endoscopic 0FV57DZ Restriction of Right Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening See page 3 for important information about the uses and limitations of this document. CORP AA SEP2014 6

7 Endoscopy 0FV57ZZ Restriction of Right Hepatic Duct, Via Natural or Artificial Opening 0FV58DZ Restriction of Right Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FV58ZZ Restriction of Right Hepatic Duct, Via Natural or Artificial Opening Endoscopic 0FV63CZ Restriction of Left Hepatic Duct with Extraluminal Device, Percutaneous 0FV63DZ Restriction of Left Hepatic Duct with Intraluminal Device, Percutaneous 0FV63ZZ Restriction of Left Hepatic Duct, Percutaneous 0FV64CZ Restriction of Left Hepatic Duct with Extraluminal Device, Percutaneous Endoscopic 0FV64DZ Restriction of Left Hepatic Duct with Intraluminal Device, Percutaneous Endoscopic 0FV64ZZ Restriction of Left Hepatic Duct, Percutaneous Endoscopic 0FV67DZ Restriction of Left Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening 0FV67ZZ Restriction of Left Hepatic Duct, Via Natural or Artificial Opening 0FV68DZ Restriction of Left Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FV68ZZ Restriction of Left Hepatic Duct, Via Natural or Artificial Opening Endoscopic 0FV83CZ Restriction of Cystic Duct with Extraluminal Device, Percutaneous 0FV83DZ Restriction of Cystic Duct with Intraluminal Device, Percutaneous 0FV83ZZ Restriction of Cystic Duct, Percutaneous 0FV84CZ Restriction of Cystic Duct with Extraluminal Device, Percutaneous Endoscopic 0FV84DZ Restriction of Cystic Duct with Intraluminal Device, Percutaneous Endoscopic 0FV84ZZ Restriction of Cystic Duct, Percutaneous Endoscopic 0FV87DZ Restriction of Cystic Duct with Intraluminal Device, Via Natural or Artificial Opening 0FV87ZZ Restriction of Cystic Duct, Via Natural or Artificial Opening 0FV88DZ Restriction of Cystic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FV88ZZ Restriction of Cystic Duct, Via Natural or Artificial Opening Endoscopic 0FV93CZ Restriction of Common Bile Duct with Extraluminal Device, Percutaneous 0FV93DZ Restriction of Common Bile Duct with Intraluminal Device, Percutaneous 0FV93ZZ Restriction of Common Bile Duct, Percutaneous 0FV94CZ Restriction of Common Bile Duct with Extraluminal Device, Percutaneous Endoscopic 0FV94DZ Restriction of Common Bile Duct with Intraluminal Device, Percutaneous Endoscopic 0FV94ZZ Restriction of Common Bile Duct, Percutaneous Endoscopic 0FV97DZ Restriction of Common Bile Duct with Intraluminal Device, Via Natural or Artificial Opening Other percutaneous procedures on biliary tract 0FV97ZZ 0FV98DZ Restriction of Common Bile Duct, Via Natural or Artificial Opening Restriction of Common Bile Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FV98ZZ Restriction of Common Bile Duct, Via Natural or Artificial Opening Endoscopic 3E1J38X Irrigation of Biliary and Pancreatic Tract using Irrigating Substance, Percutaneous, Diagnostic 3E1J38Z Irrigation of Biliary and Pancreatic Tract using Irrigating Substance, Percutaneous 3E1R38X Irrigation of Spinal Canal using Irrigating Substance, Percutaneous, Diagnostic 3E1R38Z Irrigation of Spinal Canal using Irrigating Substance, Percutaneous 3E1S38X Irrigation of Epidural Space using Irrigating Substance, Percutaneous, Diagnostic 3E1S38Z Irrigation of Epidural Space using Irrigating Substance, Percutaneous See page 3 for important information about the uses and limitations of this document. CORP AA SEP2014 7

8 Endoscopy 0B538ZZ Destruction of Right Main Bronchus, Via Natural or Artificial Opening Endoscopic 0B548ZZ Destruction of Right Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic Bronchoscopic bronchial thermoplasty, ablation of airway smooth muscle 0B558ZZ 0B568ZZ 0B578ZZ 0B588ZZ Destruction of Right Middle Lobe Bronchus, Via Natural or Artificial Opening Endoscopic Destruction of Right Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic Destruction of Left Main Bronchus, Via Natural or Artificial Opening Endoscopic Destruction of Left Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 0B598ZZ Destruction of Lingula Bronchus, Via Natural or Artificial Opening Endoscopic 0B5B8ZZ Destruction of Left Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 0B534ZZ Destruction of Right Main Bronchus, Percutaneous Endoscopic 0B538ZZ Destruction of Right Main Bronchus, Via Natural or Artificial Opening Endoscopic 0B544ZZ Destruction of Right Upper Lobe Bronchus, Percutaneous Endoscopic 0B548ZZ Destruction of Right Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 0B554ZZ Destruction of Right Middle Lobe Bronchus, Percutaneous Endoscopic 0B558ZZ Destruction of Right Middle Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 0B564ZZ Destruction of Right Lower Lobe Bronchus, Percutaneous Endoscopic 0B568ZZ Destruction of Right Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 0B574ZZ Destruction of Left Main Bronchus, Percutaneous Endoscopic 0B578ZZ Destruction of Left Main Bronchus, Via Natural or Artificial Opening Endoscopic 0B584ZZ Destruction of Left Upper Lobe Bronchus, Percutaneous Endoscopic 0B588ZZ Destruction of Left Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 0B594ZZ Destruction of Lingula Bronchus, Percutaneous Endoscopic 0B598ZZ Destruction of Lingula Bronchus, Via Natural or Artificial Opening Endoscopic Endoscopic excision or destruction of lesion or tissue of bronchus 0B5B4ZZ 0B5B8ZZ 0BB34ZZ 0BB38ZZ Destruction of Left Lower Lobe Bronchus, Percutaneous Endoscopic Destruction of Left Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic Excision of Right Main Bronchus, Percutaneous Endoscopic Excision of Right Main Bronchus, Via Natural or Artificial Opening Endoscopic 0BB44ZZ Excision of Right Upper Lobe Bronchus, Percutaneous Endoscopic 0BB48ZZ Excision of Right Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 0BB54ZZ Excision of Right Middle Lobe Bronchus, Percutaneous Endoscopic 0BB58ZZ Excision of Right Middle Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 0BB64ZZ Excision of Right Lower Lobe Bronchus, Percutaneous Endoscopic 0BB68ZZ Excision of Right Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 0BB74ZZ Excision of Left Main Bronchus, Percutaneous Endoscopic 0BB78ZZ Excision of Left Main Bronchus, Via Natural or Artificial Opening Endoscopic 0BB84ZZ Excision of Left Upper Lobe Bronchus, Percutaneous Endoscopic 0BB88ZZ Excision of Left Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 0BB94ZZ Excision of Lingula Bronchus, Percutaneous Endoscopic 0BB98ZZ Excision of Lingula Bronchus, Via Natural or Artificial Opening Endoscopic 0BBB4ZZ Excision of Left Lower Lobe Bronchus, Percutaneous Endoscopic 0BBB8ZZ Excision of Left Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic See page 3 for important information about the uses and limitations of this document. CORP AA SEP2014 8

9 Endoscopy Other bronchoscopy Closed [endoscopic] biopsy of bronchus 0BJ08ZZ 0BJK8ZZ 0BJL8ZZ 0B933ZX 0B934ZX 0B937ZX 0B938ZX 0B943ZX 0B944ZX 0B947ZX 0B948ZX 0B953ZX 0B954ZX 0B957ZX 0B958ZX 0B963ZX 0B964ZX 0B967ZX 0B968ZX 0B973ZX 0B974ZX 0B977ZX 0B978ZX 0B983ZX 0B984ZX 0B987ZX 0B988ZX 0B993ZX 0B994ZX 0B997ZX 0B998ZX 0B9B3ZX 0B9B4ZX 0B9B7ZX 0B9B8ZX 0BB33ZX 0BB34ZX 0BB37ZX 0BB38ZX 0BB43ZX 0BB44ZX 0BB47ZX 0BB48ZX 0BB53ZX Inspection of Tracheobronchial Tree, Via Natural or Artificial Opening Endoscopic Inspection of Right Lung, Via Natural or Artificial Opening Endoscopic Inspection of Left Lung, Via Natural or Artificial Opening Endoscopic Drainage of Right Main Bronchus, Percutaneous, Diagnostic Drainage of Right Main Bronchus, Percutaneous Endoscopic, Diagnostic Drainage of Right Main Bronchus, Via Natural or Artificial Opening, Diagnostic Drainage of Right Main Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Right Upper Lobe Bronchus, Percutaneous, Diagnostic Drainage of Right Upper Lobe Bronchus, Percutaneous Endoscopic, Diagnostic Drainage of Right Upper Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic Drainage of Right Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Right Middle Lobe Bronchus, Percutaneous, Diagnostic Drainage of Right Middle Lobe Bronchus, Percutaneous Endoscopic, Diagnostic Drainage of Right Middle Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic Drainage of Right Middle Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Right Lower Lobe Bronchus, Percutaneous, Diagnostic Drainage of Right Lower Lobe Bronchus, Percutaneous Endoscopic, Diagnostic Drainage of Right Lower Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic Drainage of Right Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Left Main Bronchus, Percutaneous, Diagnostic Drainage of Left Main Bronchus, Percutaneous Endoscopic, Diagnostic Drainage of Left Main Bronchus, Via Natural or Artificial Opening, Diagnostic Drainage of Left Main Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Left Upper Lobe Bronchus, Percutaneous, Diagnostic Drainage of Left Upper Lobe Bronchus, Percutaneous Endoscopic, Diagnostic Drainage of Left Upper Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic Drainage of Left Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Lingula Bronchus, Percutaneous, Diagnostic Drainage of Lingula Bronchus, Percutaneous Endoscopic, Diagnostic Drainage of Lingula Bronchus, Via Natural or Artificial Opening, Diagnostic Drainage of Lingula Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Left Lower Lobe Bronchus, Percutaneous, Diagnostic Drainage of Left Lower Lobe Bronchus, Percutaneous Endoscopic, Diagnostic Drainage of Left Lower Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic Drainage of Left Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Excision of Right Main Bronchus, Percutaneous, Diagnostic Excision of Right Main Bronchus, Percutaneous Endoscopic, Diagnostic Excision of Right Main Bronchus, Via Natural or Artificial Opening, Diagnostic Excision of Right Main Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Excision of Right Upper Lobe Bronchus, Percutaneous, Diagnostic Excision of Right Upper Lobe Bronchus, Percutaneous Endoscopic, Diagnostic Excision of Right Upper Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic Excision of Right Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Excision of Right Middle Lobe Bronchus, Percutaneous, Diagnostic See page 3 for important information about the uses and limitations of this document. CORP AA SEP2014 9

10 Endoscopy 0BB54ZX Excision of Right Middle Lobe Bronchus, Percutaneous Endoscopic, Diagnostic 0BB57ZX Excision of Right Middle Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic 0BB58ZX Excision of Right Middle Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic 0BB63ZX Excision of Right Lower Lobe Bronchus, Percutaneous, Diagnostic 0BB64ZX Excision of Right Lower Lobe Bronchus, Percutaneous Endoscopic, Diagnostic 0BB67ZX Excision of Right Lower Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic 0BB68ZX Excision of Right Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic 0BB73ZX Excision of Left Main Bronchus, Percutaneous, Diagnostic 0BB74ZX Excision of Left Main Bronchus, Percutaneous Endoscopic, Diagnostic 0BB77ZX Excision of Left Main Bronchus, Via Natural or Artificial Opening, Diagnostic Closed [endoscopic] biopsy of bronchus 0BB78ZX 0BB83ZX 0BB84ZX Excision of Left Main Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic Excision of Left Upper Lobe Bronchus, Percutaneous, Diagnostic Excision of Left Upper Lobe Bronchus, Percutaneous Endoscopic, Diagnostic 0BB87ZX Excision of Left Upper Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic 0BB88ZX Excision of Left Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic 0BB93ZX Excision of Lingula Bronchus, Percutaneous, Diagnostic 0BB94ZX Excision of Lingula Bronchus, Percutaneous Endoscopic, Diagnostic 0BB97ZX Excision of Lingula Bronchus, Via Natural or Artificial Opening, Diagnostic 0BB98ZX Excision of Lingula Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic 0BBB3ZX Excision of Left Lower Lobe Bronchus, Percutaneous, Diagnostic 0BBB4ZX Excision of Left Lower Lobe Bronchus, Percutaneous Endoscopic, Diagnostic 0BBB7ZX Excision of Left Lower Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic 0BBB8ZX Excision of Left Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic 0B9C8ZX Drainage of Right Upper Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic Closed endoscopic biopsy of lung 0B9D8ZX 0B9F8ZX 0B9G8ZX Drainage of Right Middle Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Right Lower Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Left Upper Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic 0B9H8ZX Drainage of Lung Lingula, Via Natural or Artificial Opening Endoscopic, Diagnostic See page 3 for important information about the uses and limitations of this document. CORP AA SEP

11 Endoscopy 0B9J8ZX Drainage of Left Lower Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic 0B9K8ZX Drainage of Right Lung, Via Natural or Artificial Opening Endoscopic, Diagnostic 0B9L8ZX Drainage of Left Lung, Via Natural or Artificial Opening Endoscopic, Diagnostic 0B9M8ZX Drainage of Bilateral Lungs, Via Natural or Artificial Opening Endoscopic, Diagnostic 0BBC7ZX Excision of Right Upper Lung Lobe, Via Natural or Artificial Opening, Diagnostic 0BBC8ZX Excision of Right Upper Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic 0BBD7ZX Excision of Right Middle Lung Lobe, Via Natural or Artificial Opening, Diagnostic 0BBD8ZX Excision of Right Middle Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic 0BBF7ZX Excision of Right Lower Lung Lobe, Via Natural or Artificial Opening, Diagnostic 0BBF8ZX Excision of Right Lower Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic Closed endoscopic biopsy of lung 0BBG7ZX 0BBG8ZX 0BBH7ZX Excision of Left Upper Lung Lobe, Via Natural or Artificial Opening, Diagnostic Excision of Left Upper Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic Excision of Lung Lingula, Via Natural or Artificial Opening, Diagnostic 0BBH8ZX Excision of Lung Lingula, Via Natural or Artificial Opening Endoscopic, Diagnostic 0BBJ7ZX Excision of Left Lower Lung Lobe, Via Natural or Artificial Opening, Diagnostic 0BBJ8ZX Excision of Left Lower Lung Lobe, Via Natural or Artificial Opening Endoscopic, Diagnostic 0BBK7ZX Excision of Right Lung, Via Natural or Artificial Opening, Diagnostic 0BBK8ZX Excision of Right Lung, Via Natural or Artificial Opening Endoscopic, Diagnostic 0BBL7ZX Excision of Left Lung, Via Natural or Artificial Opening, Diagnostic 0BBL8ZX Excision of Left Lung, Via Natural or Artificial Opening Endoscopic, Diagnostic 0BBM4ZX Excision of Bilateral Lungs, Percutaneous Endoscopic, Diagnostic 0BBM7ZX Excision of Bilateral Lungs, Via Natural or Artificial Opening, Diagnostic 0BBM8ZX Excision of Bilateral Lungs, Via Natural or Artificial Opening Endoscopic, Diagnostic 0C7S0DZ Dilation of Larynx with Intraluminal Device, Open 0C7S3DZ Dilation of Larynx with Intraluminal Device, Percutaneous 0C7S4DZ Dilation of Larynx with Intraluminal Device, Percutaneous Endoscopic Replacement of laryngeal or tracheal stent 0C7S7DZ 0C7S8DZ 0CPS0DZ Dilation of Larynx with Intraluminal Device, Via Natural or Artificial Opening Dilation of Larynx with Intraluminal Device, Via Natural or Artificial Opening Endoscopic Removal of Intraluminal Device from Larynx, Open 0CPS3DZ Removal of Intraluminal Device from Larynx, Percutaneous 0CPS7DZ Removal of Intraluminal Device from Larynx, Via Natural or Artificial Opening 0CPS8DZ Removal of Intraluminal Device from Larynx, Via Natural or Artificial Opening Endoscopic See page 3 for important information about the uses and limitations of this document. CORP AA SEP

12 Endoscopy Other operations on trach 0B710DZ 0B710ZZ 0B713DZ 0B713ZZ 0B714DZ 0B714ZZ 0B717DZ 0B717ZZ 0B718DZ 0B718ZZ 0B720DZ 0B720ZZ 0B723DZ 0B723ZZ 0B724DZ 0B724ZZ 0B727DZ 0B727ZZ 0B728DZ 0B728ZZ 0BL10CZ 0BL10DZ 0BL10ZZ 0BL13CZ 0BL13DZ 0BL13ZZ 0BL14CZ 0BL14DZ 0BL14ZZ 0BL17DZ 0BL17ZZ 0BL18DZ 0BL18ZZ 0BL20CZ 0BL20DZ 0BL20ZZ 0BL23CZ 0BL23DZ 0BL23ZZ 0BL24CZ 0BL24DZ 0BL24ZZ 0BL27DZ 0BL27ZZ 0BL28DZ 0BL28ZZ Dilation of Trachea with Intraluminal Device, Open Dilation of Trachea, Open Dilation of Trachea with Intraluminal Device, Percutaneous Dilation of Trachea, Percutaneous Dilation of Trachea with Intraluminal Device, Percutaneous Endoscopic Dilation of Trachea, Percutaneous Endoscopic Dilation of Trachea with Intraluminal Device, Via Natural or Artificial Opening Dilation of Trachea, Via Natural or Artificial Opening Dilation of Trachea with Intraluminal Device, Via Natural or Artificial Opening Endoscopic Dilation of Trachea, Via Natural or Artificial Opening Endoscopic Dilation of Carina with Intraluminal Device, Open Dilation of Carina, Open Dilation of Carina with Intraluminal Device, Percutaneous Dilation of Carina, Percutaneous Dilation of Carina with Intraluminal Device, Percutaneous Endoscopic Dilation of Carina, Percutaneous Endoscopic Dilation of Carina with Intraluminal Device, Via Natural or Artificial Opening Dilation of Carina, Via Natural or Artificial Opening Dilation of Carina with Intraluminal Device, Via Natural or Artificial Opening Endoscopic Dilation of Carina, Via Natural or Artificial Opening Endoscopic Occlusion of Trachea with Extraluminal Device, Open Occlusion of Trachea with Intraluminal Device, Open Occlusion of Trachea, Open Occlusion of Trachea with Extraluminal Device, Percutaneous Occlusion of Trachea with Intraluminal Device, Percutaneous Occlusion of Trachea, Percutaneous Occlusion of Trachea with Extraluminal Device, Percutaneous Endoscopic Occlusion of Trachea with Intraluminal Device, Percutaneous Endoscopic Occlusion of Trachea, Percutaneous Endoscopic Occlusion of Trachea with Intraluminal Device, Via Natural or Artificial Opening Occlusion of Trachea, Via Natural or Artificial Opening Occlusion of Trachea with Intraluminal Device, Via Natural or Artificial Opening Endoscopic Occlusion of Trachea, Via Natural or Artificial Opening Endoscopic Occlusion of Carina with Extraluminal Device, Open Occlusion of Carina with Intraluminal Device, Open Occlusion of Carina, Open Occlusion of Carina with Extraluminal Device, Percutaneous Occlusion of Carina with Intraluminal Device, Percutaneous Occlusion of Carina, Percutaneous Occlusion of Carina with Extraluminal Device, Percutaneous Endoscopic Occlusion of Carina with Intraluminal Device, Percutaneous Endoscopic Occlusion of Carina, Percutaneous Endoscopic Occlusion of Carina with Intraluminal Device, Via Natural or Artificial Opening Occlusion of Carina, Via Natural or Artificial Opening Occlusion of Carina with Intraluminal Device, Via Natural or Artificial Opening Endoscopic Occlusion of Carina, Via Natural or Artificial Opening Endoscopic See page 3 for important information about the uses and limitations of this document. CORP AA SEP

13 Endoscopy 0BQ10ZZ Repair Trachea, Open 0BQ13ZZ Repair Trachea, Percutaneous 0BQ14ZZ Repair Trachea, Percutaneous Endoscopic 0BQ17ZZ Repair Trachea, Via Natural or Artificial Opening 0BQ18ZZ Repair Trachea, Via Natural or Artificial Opening Endoscopic 0BC17ZZ Extirpation of Matter from Trachea, Via Natural or Artificial Opening 0BC18ZZ Extirpation of Matter from Trachea, Via Natural or Artificial Opening Endoscopic 0BC27ZZ Extirpation of Matter from Carina, Via Natural or Artificial Opening 0BC28ZZ Extirpation of Matter from Carina, Via Natural or Artificial Opening Endoscopic 0BC37ZZ Extirpation of Matter from Right Main Bronchus, Via Natural or Artificial Opening 0BC38ZZ Extirpation of Matter from Right Main Bronchus, Via Natural or Artificial Opening Endoscopic 0BC47ZZ Extirpation of Matter from Right Upper Lobe Bronchus, Via Natural or Artificial Opening 0BC48ZZ Extirpation of Matter from Right Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic Removal of intraluminal foreign body from trachea and bronchus without incision 0BC57ZZ 0BC58ZZ 0BC67ZZ 0BC68ZZ Extirpation of Matter from Right Middle Lobe Bronchus, Via Natural or Artificial Opening Extirpation of Matter from Right Middle Lobe Bronchus, Via Natural or Artificial Opening Endoscopic Extirpation of Matter from Right Lower Lobe Bronchus, Via Natural or Artificial Opening Extirpation of Matter from Right Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 0BC77ZZ Extirpation of Matter from Left Main Bronchus, Via Natural or Artificial Opening 0BC78ZZ Extirpation of Matter from Left Main Bronchus, Via Natural or Artificial Opening Endoscopic 0BC87ZZ Extirpation of Matter from Left Upper Lobe Bronchus, Via Natural or Artificial Opening 0BC88ZZ Extirpation of Matter from Left Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 0BC97ZZ Extirpation of Matter from Lingula Bronchus, Via Natural or Artificial Opening 0BC98ZZ Extirpation of Matter from Lingula Bronchus, Via Natural or Artificial Opening Endoscopic 0BCB7ZZ Extirpation of Matter from Left Lower Lobe Bronchus, Via Natural or Artificial Opening 0BCB8ZZ Extirpation of Matter from Left Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic See page 3 for important information about the uses and limitations of this document. CORP AA SEP

14 Endoscopy 0DH50DZ Intraluminal Device into Esophagus, Open 0DH50UZ Feeding Device into Esophagus, Open 0DH53DZ Intraluminal Device into Esophagus, Percutaneous 0DH53UZ Feeding Device into Esophagus, Percutaneous permanent tube into esophagus 0DH54DZ 0DH54UZ Intraluminal Device into Esophagus, Percutaneous Endoscopic Feeding Device into Esophagus, Percutaneous Endoscopic 0DH57DZ Intraluminal Device into Esophagus, Via Natural or Artificial Opening 0DH57UZ Feeding Device into Esophagus, Via Natural or Artificial Opening 0DH58DZ Intraluminal Device into Esophagus, Via Natural or Artificial Opening Endoscopic 0DH58UZ Feeding Device into Esophagus, Via Natural or Artificial Opening Endoscopic 0D788DZ Dilation of Small Intestine with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0D798DZ Dilation of Duodenum with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0D7A8DZ Dilation of Jejunum with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0D7B8DZ Dilation of Ileum with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0D7C8DZ Dilation of Ileocecal Valve with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0D7E8DZ Dilation of Large Intestine with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0D7F8DZ Dilation of Right Large Intestine with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0D7G8DZ Dilation of Left Large Intestine with Intraluminal Device, Via Natural or Artificial Opening Endoscopic Endoscopic insertion of colonic stent(s) 0D7H8DZ 0D7K8DZ 0D7L8DZ Dilation of Cecum with Intraluminal Device, Via Natural or Artificial Opening Endoscopic Dilation of Ascending Colon with Intraluminal Device, Via Natural or Artificial Opening Endoscopic Dilation of Transverse Colon with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0D7M8DZ Dilation of Descending Colon with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0D7N8DZ Dilation of Sigmoid Colon with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0DH88DZ Intraluminal Device into Small Intestine, Via Natural or Artificial Opening Endoscopic 0DH98DZ Intraluminal Device into Duodenum, Via Natural or Artificial Opening Endoscopic 0DHA8DZ Intraluminal Device into Jejunum, Via Natural or Artificial Opening Endoscopic 0DHB8DZ Intraluminal Device into Ileum, Via Natural or Artificial Opening Endoscopic 0DHE8DZ Intraluminal Device into Large Intestine, Via Natural or Artificial Opening Endoscopic 0DHP8DZ Intraluminal Device into Rectum, Via Natural or Artificial Opening Endoscopic See page 3 for important information about the uses and limitations of this document. CORP AA SEP

15 Endoscopy 0F754DZ Dilation of Right Hepatic Duct with Intraluminal Device, Percutaneous Endoscopic 0F758DZ Dilation of Right Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0F764DZ Dilation of Left Hepatic Duct with Intraluminal Device, Percutaneous Endoscopic 0F768DZ Dilation of Left Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic Endoscopic insertion of stent (tube) into bile duct 0F784DZ 0F788DZ Dilation of Cystic Duct with Intraluminal Device, Percutaneous Endoscopic Dilation of Cystic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0F794DZ Dilation of Common Bile Duct with Intraluminal Device, Percutaneous Endoscopic 0F798DZ Dilation of Common Bile Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FHB4DZ Intraluminal Device into Hepatobiliary Duct, Percutaneous Endoscopic 0FHB8DZ Intraluminal Device into Hepatobiliary Duct, Via Natural or Artificial Opening Endoscopic 0F753DZ Dilation of Right Hepatic Duct with Intraluminal Device, Percutaneous 0F753ZZ Dilation of Right Hepatic Duct, Percutaneous 0F763DZ Dilation of Left Hepatic Duct with Intraluminal Device, Percutaneous 0F763ZZ Dilation of Left Hepatic Duct, Percutaneous 0F783DZ Dilation of Cystic Duct with Intraluminal Device, Percutaneous 0F783ZZ Dilation of Cystic Duct, Percutaneous 0F793DZ Dilation of Common Bile Duct with Intraluminal Device, Percutaneous 0F793ZZ Dilation of Common Bile Duct, Percutaneous Other percutaneous procedures on biliary tract 0F993ZZ 0F994ZZ Drainage of Common Bile Duct, Percutaneous Drainage of Common Bile Duct, Percutaneous Endoscopic 0F997ZZ Drainage of Common Bile Duct, Via Natural or Artificial Opening 0F998ZZ Drainage of Common Bile Duct, Via Natural or Artificial Opening Endoscopic 0FC53ZZ Extirpation of Matter from Right Hepatic Duct, Percutaneous 0FC57ZZ Extirpation of Matter from Right Hepatic Duct, Via Natural or Artificial Opening 0FC63ZZ Extirpation of Matter from Left Hepatic Duct, Percutaneous 0FC67ZZ Extirpation of Matter from Left Hepatic Duct, Via Natural or Artificial Opening 0FC83ZZ Extirpation of Matter from Cystic Duct, Percutaneous 0FC87ZZ Extirpation of Matter from Cystic Duct, Via Natural or Artificial Opening See page 3 for important information about the uses and limitations of this document. CORP AA SEP

16 Endoscopy 0FL53CZ Occlusion of Right Hepatic Duct with Extraluminal Device, Percutaneous 0FL53DZ Occlusion of Right Hepatic Duct with Intraluminal Device, Percutaneous 0FL53ZZ Occlusion of Right Hepatic Duct, Percutaneous 0FL54CZ Occlusion of Right Hepatic Duct with Extraluminal Device, Percutaneous Endoscopic 0FL54DZ Occlusion of Right Hepatic Duct with Intraluminal Device, Percutaneous Endoscopic 0FL54ZZ Occlusion of Right Hepatic Duct, Percutaneous Endoscopic 0FL57DZ Occlusion of Right Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening 0FL57ZZ Occlusion of Right Hepatic Duct, Via Natural or Artificial Opening 0FL58DZ Occlusion of Right Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FL58ZZ Occlusion of Right Hepatic Duct, Via Natural or Artificial Opening Endoscopic 0FL63CZ Occlusion of Left Hepatic Duct with Extraluminal Device, Percutaneous 0FL63DZ Occlusion of Left Hepatic Duct with Intraluminal Device, Percutaneous 0FL63ZZ Occlusion of Left Hepatic Duct, Percutaneous 0FL64CZ Occlusion of Left Hepatic Duct with Extraluminal Device, Percutaneous Endoscopic 0FL64DZ Occlusion of Left Hepatic Duct with Intraluminal Device, Percutaneous Endoscopic 0FL64ZZ Occlusion of Left Hepatic Duct, Percutaneous Endoscopic 0FL67DZ Occlusion of Left Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening 0FL67ZZ Occlusion of Left Hepatic Duct, Via Natural or Artificial Opening Other percutaneous procedures on biliary tract 0FL68DZ 0FL68ZZ Occlusion of Left Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic Occlusion of Left Hepatic Duct, Via Natural or Artificial Opening Endoscopic 0FL83CZ Occlusion of Cystic Duct with Extraluminal Device, Percutaneous 0FL83DZ Occlusion of Cystic Duct with Intraluminal Device, Percutaneous 0FL83ZZ Occlusion of Cystic Duct, Percutaneous 0FL84CZ Occlusion of Cystic Duct with Extraluminal Device, Percutaneous Endoscopic 0FL84DZ Occlusion of Cystic Duct with Intraluminal Device, Percutaneous Endoscopic 0FL84ZZ Occlusion of Cystic Duct, Percutaneous Endoscopic 0FL87DZ Occlusion of Cystic Duct with Intraluminal Device, Via Natural or Artificial Opening 0FL87ZZ Occlusion of Cystic Duct, Via Natural or Artificial Opening 0FL88DZ Occlusion of Cystic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FL88ZZ Occlusion of Cystic Duct, Via Natural or Artificial Opening Endoscopic 0FL93CZ Occlusion of Common Bile Duct with Extraluminal Device, Percutaneous 0FL93DZ Occlusion of Common Bile Duct with Intraluminal Device, Percutaneous 0FL93ZZ Occlusion of Common Bile Duct, Percutaneous 0FL94CZ Occlusion of Common Bile Duct with Extraluminal Device, Percutaneous Endoscopic 0FL94DZ Occlusion of Common Bile Duct with Intraluminal Device, Percutaneous Endoscopic 0FL94ZZ Occlusion of Common Bile Duct, Percutaneous Endoscopic 0FL97DZ Occlusion of Common Bile Duct with Intraluminal Device, Via Natural or Artificial Opening 0FL97ZZ Occlusion of Common Bile Duct, Via Natural or Artificial Opening See page 3 for important information about the uses and limitations of this document. CORP AA SEP

17 Endoscopy 0FL98DZ Occlusion of Common Bile Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FL98ZZ Occlusion of Common Bile Duct, Via Natural or Artificial Opening Endoscopic 0FM44ZZ Reattachment of Gallbladder, Percutaneous Endoscopic 0FM54ZZ Reattachment of Right Hepatic Duct, Percutaneous Endoscopic 0FM64ZZ Reattachment of Left Hepatic Duct, Percutaneous Endoscopic 0FM84ZZ Reattachment of Cystic Duct, Percutaneous Endoscopic 0FM94ZZ Reattachment of Common Bile Duct, Percutaneous Endoscopic 0FV53CZ Restriction of Right Hepatic Duct with Extraluminal Device, Percutaneous 0FV53DZ Restriction of Right Hepatic Duct with Intraluminal Device, Percutaneous 0FV53ZZ Restriction of Right Hepatic Duct, Percutaneous 0FV54CZ Restriction of Right Hepatic Duct with Extraluminal Device, Percutaneous Endoscopic 0FV54DZ Restriction of Right Hepatic Duct with Intraluminal Device, Percutaneous Endoscopic 0FV54ZZ Restriction of Right Hepatic Duct, Percutaneous Endoscopic 0FV57DZ Restriction of Right Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening 0FV57ZZ Restriction of Right Hepatic Duct, Via Natural or Artificial Opening 0FV58DZ Restriction of Right Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FV58ZZ Restriction of Right Hepatic Duct, Via Natural or Artificial Opening Endoscopic Other percutaneous procedures on biliary tract 0FV63CZ 0FV63DZ Restriction of Left Hepatic Duct with Extraluminal Device, Percutaneous Restriction of Left Hepatic Duct with Intraluminal Device, Percutaneous 0FV63ZZ Restriction of Left Hepatic Duct, Percutaneous 0FV64CZ Restriction of Left Hepatic Duct with Extraluminal Device, Percutaneous Endoscopic 0FV64DZ Restriction of Left Hepatic Duct with Intraluminal Device, Percutaneous Endoscopic 0FV64ZZ Restriction of Left Hepatic Duct, Percutaneous Endoscopic 0FV67DZ Restriction of Left Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening 0FV67ZZ Restriction of Left Hepatic Duct, Via Natural or Artificial Opening 0FV68DZ Restriction of Left Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FV68ZZ Restriction of Left Hepatic Duct, Via Natural or Artificial Opening Endoscopic 0FV83CZ Restriction of Cystic Duct with Extraluminal Device, Percutaneous 0FV83DZ Restriction of Cystic Duct with Intraluminal Device, Percutaneous 0FV83ZZ Restriction of Cystic Duct, Percutaneous 0FV84CZ Restriction of Cystic Duct with Extraluminal Device, Percutaneous Endoscopic 0FV84DZ Restriction of Cystic Duct with Intraluminal Device, Percutaneous Endoscopic 0FV84ZZ Restriction of Cystic Duct, Percutaneous Endoscopic 0FV87DZ Restriction of Cystic Duct with Intraluminal Device, Via Natural or Artificial Opening 0FV87ZZ Restriction of Cystic Duct, Via Natural or Artificial Opening 0FV88DZ Restriction of Cystic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FV88ZZ Restriction of Cystic Duct, Via Natural or Artificial Opening Endoscopic See page 3 for important information about the uses and limitations of this document. CORP AA SEP

18 Endoscopy 0FV93CZ Restriction of Common Bile Duct with Extraluminal Device, Percutaneous 0FV93DZ Restriction of Common Bile Duct with Intraluminal Device, Percutaneous 0FV93ZZ Restriction of Common Bile Duct, Percutaneous 0FV94CZ Restriction of Common Bile Duct with Extraluminal Device, Percutaneous Endoscopic 0FV94DZ Restriction of Common Bile Duct with Intraluminal Device, Percutaneous Endoscopic 0FV94ZZ Restriction of Common Bile Duct, Percutaneous Endoscopic 0FV97DZ Restriction of Common Bile Duct with Intraluminal Device, Via Natural or Artificial Opening Other percutaneous procedures on biliary tract 0FV97ZZ 0FV98DZ Restriction of Common Bile Duct, Via Natural or Artificial Opening Restriction of Common Bile Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0FV98ZZ Restriction of Common Bile Duct, Via Natural or Artificial Opening Endoscopic 3E1J38X Irrigation of Biliary and Pancreatic Tract using Irrigating Substance, Percutaneous, Diagnostic 3E1J38Z Irrigation of Biliary and Pancreatic Tract using Irrigating Substance, Percutaneous 3E1R38X Irrigation of Spinal Canal using Irrigating Substance, Percutaneous, Diagnostic 3E1R38Z Irrigation of Spinal Canal using Irrigating Substance, Percutaneous 3E1S38X Irrigation of Epidural Space using Irrigating Substance, Percutaneous, Diagnostic 3E1S38Z Irrigation of Epidural Space using Irrigating Substance, Percutaneous 0F758DZ Dilation of Right Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0F767DZ Dilation of Left Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Replacement of stent (tube) in biliary or pancreatic duct 0F768DZ 0F787DZ Dilation of Left Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic Dilation of Cystic Duct with Intraluminal Device, Via Natural or Artificial Opening 0F788DZ Dilation of Cystic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0F797DZ Dilation of Common Bile Duct with Intraluminal Device, Via Natural or Artificial Opening 0F798DZ Dilation of Common Bile Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic 0F7D7DZ Dilation of Pancreatic Duct with Intraluminal Device, Via Natural or Artificial Opening 0F7D8DZ Dilation of Pancreatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic Replacement of stent (tube) in biliary or pancreatic duct 0FPB7DZ 0FPB8DZ 0FPBXDZ Removal of Intraluminal Device from Hepatobiliary Duct, Via Natural or Artificial Opening Removal of Intraluminal Device from Hepatobiliary Duct, Via Natural or Artificial Opening Endoscopic Removal of Intraluminal Device from Hepatobiliary Duct, External 0FPD7DZ Removal of Intraluminal Device from Pancreatic Duct, Via Natural or Artificial Opening 0FPD8DZ Removal of Intraluminal Device from Pancreatic Duct, Via Natural or Artificial Opening Endoscopic 0FPDXDZ Removal of Intraluminal Device from Pancreatic Duct, External See page 3 for important information about the uses and limitations of this document. CORP AA SEP

19 Endoscopy Endoscopic retrograde cholangiopancreatography (ERCP) BF110ZZ BF111ZZ BF11YZZ Fluoroscopy of Biliary and Pancreatic Ducts using High Osmolar Contrast Fluoroscopy of Biliary and Pancreatic Ducts using Low Osmolar Contrast Fluoroscopy of Biliary and Pancreatic Ducts using Other Contrast Endoscopic retrograde cholangiography (ERC) BF100ZZ BF101ZZ BF10YZZ Fluoroscopy of Bile Ducts using High Osmolar Contrast Fluoroscopy of Bile Ducts using Low Osmolar Contrast Fluoroscopy of Bile Ducts using Other Contrast 0F954ZX Drainage of Right Hepatic Duct, Percutaneous Endoscopic, Diagnostic 0F957ZX Drainage of Right Hepatic Duct, Via Natural or Artificial Opening, Diagnostic 0F958ZX Drainage of Right Hepatic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic 0F964ZX Drainage of Left Hepatic Duct, Percutaneous Endoscopic, Diagnostic 0F967ZX Drainage of Left Hepatic Duct, Via Natural or Artificial Opening, Diagnostic 0F968ZX Drainage of Left Hepatic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic 0F984ZX Drainage of Cystic Duct, Percutaneous Endoscopic, Diagnostic Other closed (endoscopic) biopsy of biliary duct or sphincter of Oddi 0F987ZX 0F988ZX 0F994ZX 0F997ZX Drainage of Cystic Duct, Via Natural or Artificial Opening, Diagnostic Drainage of Cystic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic Drainage of Common Bile Duct, Percutaneous Endoscopic, Diagnostic Drainage of Common Bile Duct, Via Natural or Artificial Opening, Diagnostic 0F998ZX Drainage of Common Bile Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic 0F9C4ZX Drainage of Ampulla of Vater, Percutaneous Endoscopic, Diagnostic 0F9C7ZX Drainage of Ampulla of Vater, Via Natural or Artificial Opening, Diagnostic 0F9C8ZX Drainage of Ampulla of Vater, Via Natural or Artificial Opening Endoscopic, Diagnostic 0FB44ZX Excision of Gallbladder, Percutaneous Endoscopic, Diagnostic 0FB54ZX Excision of Right Hepatic Duct, Percutaneous Endoscopic, Diagnostic 0FB57ZX Excision of Right Hepatic Duct, Via Natural or Artificial Opening, Diagnostic 0FB58ZX Excision of Right Hepatic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic 0FB64ZX Excision of Left Hepatic Duct, Percutaneous Endoscopic, Diagnostic 0FB67ZX Excision of Left Hepatic Duct, Via Natural or Artificial Opening, Diagnostic 0FB68ZX Excision of Left Hepatic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic 0FB84ZX Excision of Cystic Duct, Percutaneous Endoscopic, Diagnostic Other closed (endoscopic) biopsy of biliary duct or sphincter of Oddi 0FB87ZX 0FB88ZX 0FB94ZX Excision of Cystic Duct, Via Natural or Artificial Opening, Diagnostic Excision of Cystic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic Excision of Common Bile Duct, Percutaneous Endoscopic, Diagnostic 0FB97ZX Excision of Common Bile Duct, Via Natural or Artificial Opening, Diagnostic 0FB98ZX Excision of Common Bile Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic 0FBC4ZX Excision of Ampulla of Vater, Percutaneous Endoscopic, Diagnostic 0FBC7ZX Excision of Ampulla of Vater, Via Natural or Artificial Opening, Diagnostic 0FBC8ZX Excision of Ampulla of Vater, Via Natural or Artificial Opening Endoscopic, Diagnostic See page 3 for important information about the uses and limitations of this document. CORP AA SEP

20 Interventional Cardiology Right heart cardiac catheterization Left heart cardiac catheterization Combined right and left heart cardiac catheterization Procedure on single Procedure on two s 4A0 4A020N6 4A023N6 4A0 4A020N7 4A023N7 4A0 4A020N8 4A023N8 Measurement / Physiological Systems Measurement of Cardiac Sampling and Pressure, Right Heart, Open Measurement of Cardiac Sampling and Pressure, Right Heart, Percutaneous Measurement / Physiological Systems Measurement of Cardiac Sampling and Pressure, Left Heart, Open Measurement of Cardiac Sampling and Pressure, Left Heart, Percutaneous Measurement / Physiological Systems Measurement of Cardiac Sampling and Pressure, Bilateral, Open Measurement of Cardiac Sampling and Pressure, Bilateral, Percutaneous 027 Dilation / Heart and Great Vessels 0270 Dilation / Coronary Artery, One Site Dilation of Coronary Artery, One Site, Bifurcation, with Drug-eluting Intraluminal Device, Open Z 02700D DZ 02700T TZ 02700Z ZZ Dilation of Coronary Artery, One Site with Drug-eluting Intraluminal Device, Open Dilation of Coronary Artery, One Site, Bifurcation, with Intraluminal Device, Open Dilation of Coronary Artery, One Site with Intraluminal Device, Open Dilation of Coronary Artery, One Site, Bifurcation, with Radioactive Intraluminal Device, Open Dilation of Coronary Artery, One Site with Radioactive Intraluminal Device, Open Dilation of Coronary Artery, One Site, Bifurcation, Open Dilation of Coronary Artery, One Site, Open Dilation of Coronary Artery, One Site, Bifurcation, with Drug-eluting Intraluminal Device, Percutaneous Z 02703D DZ 02703T TZ 02703Z ZZ Z 02704D DZ 02704T TZ 02704Z ZZ 02C 02C0 02C03ZZ Dilation of Coronary Artery, One Site with Drug-eluting Intraluminal Device, Percutaneous Dilation of Coronary Artery, One Site, Bifurcation, with Intraluminal Device, Percutaneous Dilation of Coronary Artery, One Site with Intraluminal Device, Percutaneous Dilation of Coronary Artery, One Site, Bifurcation, with Radioactive Intraluminal Device, Percutaneous Dilation of Coronary Artery, One Site with Radioactive Intraluminal Device, Percutaneous Dilation of Coronary Artery, One Site, Bifurcation, Percutaneous Dilation of Coronary Artery, One Site, Percutaneous Dilation of Coronary Artery, One Site, Bifurcation, with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Coronary Artery, One Site with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Coronary Artery, One Site, Bifurcation, with Intraluminal Device, Percutaneous Endoscopic Dilation of Coronary Artery, One Site with Intraluminal Device, Percutaneous Endoscopic Dilation of Coronary Artery, One Site, Bifurcation, with Radioactive Intraluminal Device, Percutaneous Endoscopic Dilation of Coronary Artery, One Site with Radioactive Intraluminal Device, Percutaneous Endoscopic Dilation of Coronary Artery, One Site, Bifurcation, Percutaneous Endoscopic Dilation of Coronary Artery, One Site, Percutaneous Endoscopic Extirpation / Heart and Great Vessels Extirpation / Coronary Artery, One Site Extirpation of Matter from Coronary Artery, One Site, Percutaneous 027 Dilation / Heart and Great Vessels 0271 Dilation / Coronary Artery, Two Sites Dilation of Coronary Artery, Two Sites, Bifurcation, with Drug-eluting Intraluminal Device, Open Z 02710D DZ 02710T6 Dilation of Coronary Artery, Two Sites with Drug-eluting Intraluminal Device, Open Dilation of Coronary Artery, Two Sites, Bifurcation, with Intraluminal Device, Open Dilation of Coronary Artery, Two Sites with Intraluminal Device, Open Dilation of Coronary Artery, Two Sites, Bifurcation, with Radioactive Intraluminal Device, Open See page 3 for important information about the uses and limitations of this document. CORP AA SEP