Split (1)

train · 15.7k rows

code stringlengths 4 12	description stringlengths 2 264	codetype stringclasses 8 values	context stringlengths 160 15.5k
4127	CATH SWN/GZ VIP 5FR 110CM	CDM	For this example the concept ID 38000275 (“EHR order list entry”) is used as the procedure record is from an EHR record.\| \|MODIFIER_CONCEPT_ ID\|\|0\|\|This is meant for a concept ID representing the modifier on the procedure. For example, if the record indicated that a CPT4 procedure was performed bilaterally then the concept ID 42739579 (“Bilateral procedure”) would be used.\| \|QUANTITY\|\|0\|\|The quantity of Procedures ordered or administered. A missing Quantity, the numbers 0 and 1 all mean the same thing.\| \|PROVIDER_ID\|\|NULL\|\|If the Procedure record has a Provider listed, the ID for that Provider goes in this field. This should be a foreign key to the PROVIDER_ID from the PROVIDER table.\| \|VISIT_OCCURRENCE_ ID\|\|740\|\|If known, this is the Visit (represented as VISIT_occurrence_id taken from the VISIT_OCCURRENCE table) during which the procedure was performed.\| \|VISIT_DETAIL_ID\|\|NULL\|\|If known, this is the Visit detail (represented as VISIT_detail_id taken from the VISIT_DETAIL table) during which the procedure was performed.\| \|PROCEDURE_SOURCE_ VALUE\|\|304435002\|\|The code or information for the Procedure as it appears in the source data.\| \|PROCEDURE_SOURCE_ CONCEPT_ID\|\|4127451\|\|This is the Concept that represents the procedure source value.\| \|MODIFIER_SOURCE_ VALUE\|\|NULL\|\|The source code for the modifier as it appears in the source data.\| 4.4 Additional Information This chapter covers only a portion of the tables available in the CDM as examples of how data is represented. You are encouraged to visit the wiki site19 for more information.
0275	PACEMAKER, SINGLE CHAMBER, RATE-RESPONSIVE (IMPLANTABLE)	RC	For this example the concept ID 38000275 (“EHR order list entry”) is used as the procedure record is from an EHR record.\| \|MODIFIER_CONCEPT_ ID\|\|0\|\|This is meant for a concept ID representing the modifier on the procedure. For example, if the record indicated that a CPT4 procedure was performed bilaterally then the concept ID 42739579 (“Bilateral procedure”) would be used.\| \|QUANTITY\|\|0\|\|The quantity of Procedures ordered or administered. A missing Quantity, the numbers 0 and 1 all mean the same thing.\| \|PROVIDER_ID\|\|NULL\|\|If the Procedure record has a Provider listed, the ID for that Provider goes in this field. This should be a foreign key to the PROVIDER_ID from the PROVIDER table.\| \|VISIT_OCCURRENCE_ ID\|\|740\|\|If known, this is the Visit (represented as VISIT_occurrence_id taken from the VISIT_OCCURRENCE table) during which the procedure was performed.\| \|VISIT_DETAIL_ID\|\|NULL\|\|If known, this is the Visit detail (represented as VISIT_detail_id taken from the VISIT_DETAIL table) during which the procedure was performed.\| \|PROCEDURE_SOURCE_ VALUE\|\|304435002\|\|The code or information for the Procedure as it appears in the source data.\| \|PROCEDURE_SOURCE_ CONCEPT_ID\|\|4127451\|\|This is the Concept that represents the procedure source value.\| \|MODIFIER_SOURCE_ VALUE\|\|NULL\|\|The source code for the modifier as it appears in the source data.\| 4.4 Additional Information This chapter covers only a portion of the tables available in the CDM as examples of how data is represented. You are encouraged to visit the wiki site19 for more information.
0443	Speech-language Pathology - Group	RC	For example, if the record indicated that a CPT4 procedure was performed bilaterally then the concept ID 42739579 (“Bilateral procedure”) would be used.\| \|QUANTITY\|\|0\|\|The quantity of Procedures ordered or administered. A missing Quantity, the numbers 0 and 1 all mean the same thing.\| \|PROVIDER_ID\|\|NULL\|\|If the Procedure record has a Provider listed, the ID for that Provider goes in this field. This should be a foreign key to the PROVIDER_ID from the PROVIDER table.\| \|VISIT_OCCURRENCE_ ID\|\|740\|\|If known, this is the Visit (represented as VISIT_occurrence_id taken from the VISIT_OCCURRENCE table) during which the procedure was performed.\| \|VISIT_DETAIL_ID\|\|NULL\|\|If known, this is the Visit detail (represented as VISIT_detail_id taken from the VISIT_DETAIL table) during which the procedure was performed.\| \|PROCEDURE_SOURCE_ VALUE\|\|304435002\|\|The code or information for the Procedure as it appears in the source data.\| \|PROCEDURE_SOURCE_ CONCEPT_ID\|\|4127451\|\|This is the Concept that represents the procedure source value.\| \|MODIFIER_SOURCE_ VALUE\|\|NULL\|\|The source code for the modifier as it appears in the source data.\| 4.4 Additional Information This chapter covers only a portion of the tables available in the CDM as examples of how data is represented. You are encouraged to visit the wiki site19 for more information. The CDM is designed to support a wide range of observational research activities.
4127	CATH SWN/GZ VIP 5FR 110CM	CDM	For example, if the record indicated that a CPT4 procedure was performed bilaterally then the concept ID 42739579 (“Bilateral procedure”) would be used.\| \|QUANTITY\|\|0\|\|The quantity of Procedures ordered or administered. A missing Quantity, the numbers 0 and 1 all mean the same thing.\| \|PROVIDER_ID\|\|NULL\|\|If the Procedure record has a Provider listed, the ID for that Provider goes in this field. This should be a foreign key to the PROVIDER_ID from the PROVIDER table.\| \|VISIT_OCCURRENCE_ ID\|\|740\|\|If known, this is the Visit (represented as VISIT_occurrence_id taken from the VISIT_OCCURRENCE table) during which the procedure was performed.\| \|VISIT_DETAIL_ID\|\|NULL\|\|If known, this is the Visit detail (represented as VISIT_detail_id taken from the VISIT_DETAIL table) during which the procedure was performed.\| \|PROCEDURE_SOURCE_ VALUE\|\|304435002\|\|The code or information for the Procedure as it appears in the source data.\| \|PROCEDURE_SOURCE_ CONCEPT_ID\|\|4127451\|\|This is the Concept that represents the procedure source value.\| \|MODIFIER_SOURCE_ VALUE\|\|NULL\|\|The source code for the modifier as it appears in the source data.\| 4.4 Additional Information This chapter covers only a portion of the tables available in the CDM as examples of how data is represented. You are encouraged to visit the wiki site19 for more information. The CDM is designed to support a wide range of observational research activities.
9158	Inj, pegcetacoplan, 1mg	APC	Traumatic amputation. This can range from fingers or toes on up to hands and feet or entire limbs. The typical person who suffers a traumatic amputation is male (80%), between the ages of fifteen and thirty, and has just said, Hey, Bubba, watch this! (No, actually and seriously, farming and factory accidents are the most common causes of traumatic amputation.) I wasnt entirely sure whether to put traumatic amputations in this part of Trauma and You (soft tissue) or in the last part (skeletal ... Get PDF - Evaluation of causes of traumatic amputations of extremities in children and adults and their social and occupational... Dega, W.; Bernardczyk, K.; Godycka, I.; Jankowiak, K.; Konieczna, D.; Myśliborski, T.; Nadolski, Z.; Stachowska, M., 1966: Evaluation of causes of traumatic amputations of extremities in children and adults and their social and occupational consequences ICD-9 Code 897.6 -Traumatic amputation of leg(s) (complete) (partial) bilateral (any level) without complication- Codify by AAPC ICD-9 code 897.6 for Traumatic amputation of leg(s) (complete) (partial) bilateral (any level) without complication is a medical classification as lis Ride On Blowers : Lawn Mowers Parts and Service, YOUR POWER EQUIPMENT SPECIALIST Lawn Mowers Parts and Service : Ride On Blowers - Yard Vacs Generators Mowers Paint Sprayers Truck Loaders Lawn and Garden Chipper Pressure Washers BCS No Flat Tires Aerators Small Engines Equipment Racks Ladders Arborist Equipment Curb Side Pickup Construction Mower repair, zero turn repair, pressure washer repair, pressure washer pumps, lawn mower sales, Exmark mowers,Snapperpro mowers, Snapper mowers, simplicity mowers, Push mowers, Zero turn mowers, Stihl chainsaws, Stihl parts, Echo trimmers, Echo blowers, honda parts, honda gx parts, small engine repair, paint sprayers, graco parts, titan parts, billy goat parts, billy goat blowers, claussen aerators, mantis tillers, briggs air filters, kohler parts, briggs and stratton, kawasaki parts, briggs and stratton carburetor, mower blades, blade spindles, mtd spindles, kohler oil filters, 491588s air filter 2020 ICD-10-CM Diagnosis Code S98.122A: Partial traumatic amputation of left great toe, initial encounter Free, official coding info for 2020 ICD-10-CM S98.122A - includes detailed rules, notes, synonyms, ICD-9-CM conversion, index and annotation crosswalks, DRG grouping and more.
9158	Inj, pegcetacoplan, 1mg	APC	The typical person who suffers a traumatic amputation is male (80%), between the ages of fifteen and thirty, and has just said, Hey, Bubba, watch this! (No, actually and seriously, farming and factory accidents are the most common causes of traumatic amputation.) I wasnt entirely sure whether to put traumatic amputations in this part of Trauma and You (soft tissue) or in the last part (skeletal ... Get PDF - Evaluation of causes of traumatic amputations of extremities in children and adults and their social and occupational... Dega, W.; Bernardczyk, K.; Godycka, I.; Jankowiak, K.; Konieczna, D.; Myśliborski, T.; Nadolski, Z.; Stachowska, M., 1966: Evaluation of causes of traumatic amputations of extremities in children and adults and their social and occupational consequences ICD-9 Code 897.6 -Traumatic amputation of leg(s) (complete) (partial) bilateral (any level) without complication- Codify by AAPC ICD-9 code 897.6 for Traumatic amputation of leg(s) (complete) (partial) bilateral (any level) without complication is a medical classification as lis Ride On Blowers : Lawn Mowers Parts and Service, YOUR POWER EQUIPMENT SPECIALIST Lawn Mowers Parts and Service : Ride On Blowers - Yard Vacs Generators Mowers Paint Sprayers Truck Loaders Lawn and Garden Chipper Pressure Washers BCS No Flat Tires Aerators Small Engines Equipment Racks Ladders Arborist Equipment Curb Side Pickup Construction Mower repair, zero turn repair, pressure washer repair, pressure washer pumps, lawn mower sales, Exmark mowers,Snapperpro mowers, Snapper mowers, simplicity mowers, Push mowers, Zero turn mowers, Stihl chainsaws, Stihl parts, Echo trimmers, Echo blowers, honda parts, honda gx parts, small engine repair, paint sprayers, graco parts, titan parts, billy goat parts, billy goat blowers, claussen aerators, mantis tillers, briggs air filters, kohler parts, briggs and stratton, kawasaki parts, briggs and stratton carburetor, mower blades, blade spindles, mtd spindles, kohler oil filters, 491588s air filter 2020 ICD-10-CM Diagnosis Code S98.122A: Partial traumatic amputation of left great toe, initial encounter Free, official coding info for 2020 ICD-10-CM S98.122A - includes detailed rules, notes, synonyms, ICD-9-CM conversion, index and annotation crosswalks, DRG grouping and more. ICD-10 Diagnosis Code S98.012 Complete traumatic amputation of left foot at ankle level Diagnosis Code S98.012 information, including descriptions, synonyms, code edits, diagnostic related groups, ICD-9 conversion and references to the diseases index. ICD-10 Diagnosis Code S08.119D Complete traumatic amputation of unsp ear, subs encntr Diagnosis Code S08.119D information, including descriptions, synonyms, code edits, diagnostic related groups, ICD-9 conversion and references to the diseases index.
9158	Inj, pegcetacoplan, 1mg	APC	(No, actually and seriously, farming and factory accidents are the most common causes of traumatic amputation.) I wasnt entirely sure whether to put traumatic amputations in this part of Trauma and You (soft tissue) or in the last part (skeletal ... Get PDF - Evaluation of causes of traumatic amputations of extremities in children and adults and their social and occupational... Dega, W.; Bernardczyk, K.; Godycka, I.; Jankowiak, K.; Konieczna, D.; Myśliborski, T.; Nadolski, Z.; Stachowska, M., 1966: Evaluation of causes of traumatic amputations of extremities in children and adults and their social and occupational consequences ICD-9 Code 897.6 -Traumatic amputation of leg(s) (complete) (partial) bilateral (any level) without complication- Codify by AAPC ICD-9 code 897.6 for Traumatic amputation of leg(s) (complete) (partial) bilateral (any level) without complication is a medical classification as lis Ride On Blowers : Lawn Mowers Parts and Service, YOUR POWER EQUIPMENT SPECIALIST Lawn Mowers Parts and Service : Ride On Blowers - Yard Vacs Generators Mowers Paint Sprayers Truck Loaders Lawn and Garden Chipper Pressure Washers BCS No Flat Tires Aerators Small Engines Equipment Racks Ladders Arborist Equipment Curb Side Pickup Construction Mower repair, zero turn repair, pressure washer repair, pressure washer pumps, lawn mower sales, Exmark mowers,Snapperpro mowers, Snapper mowers, simplicity mowers, Push mowers, Zero turn mowers, Stihl chainsaws, Stihl parts, Echo trimmers, Echo blowers, honda parts, honda gx parts, small engine repair, paint sprayers, graco parts, titan parts, billy goat parts, billy goat blowers, claussen aerators, mantis tillers, briggs air filters, kohler parts, briggs and stratton, kawasaki parts, briggs and stratton carburetor, mower blades, blade spindles, mtd spindles, kohler oil filters, 491588s air filter 2020 ICD-10-CM Diagnosis Code S98.122A: Partial traumatic amputation of left great toe, initial encounter Free, official coding info for 2020 ICD-10-CM S98.122A - includes detailed rules, notes, synonyms, ICD-9-CM conversion, index and annotation crosswalks, DRG grouping and more. ICD-10 Diagnosis Code S98.012 Complete traumatic amputation of left foot at ankle level Diagnosis Code S98.012 information, including descriptions, synonyms, code edits, diagnostic related groups, ICD-9 conversion and references to the diseases index. ICD-10 Diagnosis Code S08.119D Complete traumatic amputation of unsp ear, subs encntr Diagnosis Code S08.119D information, including descriptions, synonyms, code edits, diagnostic related groups, ICD-9 conversion and references to the diseases index. 2020 ICD-10-CM Diagnosis Code S98.919D: Complete traumatic amputation of unspecified foot, level unspecified, subsequent... Free, official coding info for 2020 ICD-10-CM S98.919D - includes detailed rules, notes, synonyms, ICD-9-CM conversion, index and annotation crosswalks, DRG grouping and more.
9158	Inj, pegcetacoplan, 1mg	APC	I wasnt entirely sure whether to put traumatic amputations in this part of Trauma and You (soft tissue) or in the last part (skeletal ... Get PDF - Evaluation of causes of traumatic amputations of extremities in children and adults and their social and occupational... Dega, W.; Bernardczyk, K.; Godycka, I.; Jankowiak, K.; Konieczna, D.; Myśliborski, T.; Nadolski, Z.; Stachowska, M., 1966: Evaluation of causes of traumatic amputations of extremities in children and adults and their social and occupational consequences ICD-9 Code 897.6 -Traumatic amputation of leg(s) (complete) (partial) bilateral (any level) without complication- Codify by AAPC ICD-9 code 897.6 for Traumatic amputation of leg(s) (complete) (partial) bilateral (any level) without complication is a medical classification as lis Ride On Blowers : Lawn Mowers Parts and Service, YOUR POWER EQUIPMENT SPECIALIST Lawn Mowers Parts and Service : Ride On Blowers - Yard Vacs Generators Mowers Paint Sprayers Truck Loaders Lawn and Garden Chipper Pressure Washers BCS No Flat Tires Aerators Small Engines Equipment Racks Ladders Arborist Equipment Curb Side Pickup Construction Mower repair, zero turn repair, pressure washer repair, pressure washer pumps, lawn mower sales, Exmark mowers,Snapperpro mowers, Snapper mowers, simplicity mowers, Push mowers, Zero turn mowers, Stihl chainsaws, Stihl parts, Echo trimmers, Echo blowers, honda parts, honda gx parts, small engine repair, paint sprayers, graco parts, titan parts, billy goat parts, billy goat blowers, claussen aerators, mantis tillers, briggs air filters, kohler parts, briggs and stratton, kawasaki parts, briggs and stratton carburetor, mower blades, blade spindles, mtd spindles, kohler oil filters, 491588s air filter 2020 ICD-10-CM Diagnosis Code S98.122A: Partial traumatic amputation of left great toe, initial encounter Free, official coding info for 2020 ICD-10-CM S98.122A - includes detailed rules, notes, synonyms, ICD-9-CM conversion, index and annotation crosswalks, DRG grouping and more. ICD-10 Diagnosis Code S98.012 Complete traumatic amputation of left foot at ankle level Diagnosis Code S98.012 information, including descriptions, synonyms, code edits, diagnostic related groups, ICD-9 conversion and references to the diseases index. ICD-10 Diagnosis Code S08.119D Complete traumatic amputation of unsp ear, subs encntr Diagnosis Code S08.119D information, including descriptions, synonyms, code edits, diagnostic related groups, ICD-9 conversion and references to the diseases index. 2020 ICD-10-CM Diagnosis Code S98.919D: Complete traumatic amputation of unspecified foot, level unspecified, subsequent... Free, official coding info for 2020 ICD-10-CM S98.919D - includes detailed rules, notes, synonyms, ICD-9-CM conversion, index and annotation crosswalks, DRG grouping and more. Traumatic Amputation of the Arm : Medical Chart All material 1999-2017 Nucleus Medical Media Inc. All rights reserved.. Nucleus Medical Media does not dispense medical or legal advice.See additional information.
0234	Incremental Nursing Charge - CCU	RC	To protect the privacy of participating patients, pseudonymization of the study data took place. Study participants were not compensated for their participation. The local ethics committee of the University of Giessen approved the RCT (AZ 73/20), and the study was registered in the German Clinical Trials Register (DRKS00023445). Inclusion and exclusion criteria of the randomized controlled trial. - 18 years or older - Previous outpatient or inpatient stay at the clinic, with an operation or conservative therapy - Need of a follow-up that does not require more than a visual examination - Ownership of a computer, laptop, tablet, or smartphone with microphone and camera - Stable internet connection - Mental and physical ability to consent and to participate - Sufficient knowledge of German in order to understand the declaration of consent - Shoulder International Classification of Diseases, Tenth Revision (ICD-10) codes: M75.1, M75.6, M75.0, Z96.60, M75.4, M19.91, S43.1, S42.20, S42.00, M75.2, M75.3, and S43.0 - Knee ICD-10 codes: S83.53, S83.54, S83.2, S83.0, M22.0, M23.32, M23.35, M17.1, M17.5, M21.16, M21.06, S83.3, S83.44, S83.43, S82.18, S82.0, S72.3, S72.43, M25.56, M76.5, S83.6, S76.1, and S86.8 - Neurological diseases that preclude the use of digital devices - Diagnosis of dementia, blindness, or deafness - Need for presence in the clinic and on-site treatment and diagnostics (ie, imaging, laboratory, stitches, and drainage) - Appointments where the patient has to be touched and moved by the treating physicians - Lack of willingness to participate - Failure to consent Sample Size and Randomization The sample size calculation of the underlying RCT was based on an a priori power analysis.
0234	Incremental Nursing Charge - CCU	RC	The local ethics committee of the University of Giessen approved the RCT (AZ 73/20), and the study was registered in the German Clinical Trials Register (DRKS00023445). Inclusion and exclusion criteria of the randomized controlled trial. - 18 years or older - Previous outpatient or inpatient stay at the clinic, with an operation or conservative therapy - Need of a follow-up that does not require more than a visual examination - Ownership of a computer, laptop, tablet, or smartphone with microphone and camera - Stable internet connection - Mental and physical ability to consent and to participate - Sufficient knowledge of German in order to understand the declaration of consent - Shoulder International Classification of Diseases, Tenth Revision (ICD-10) codes: M75.1, M75.6, M75.0, Z96.60, M75.4, M19.91, S43.1, S42.20, S42.00, M75.2, M75.3, and S43.0 - Knee ICD-10 codes: S83.53, S83.54, S83.2, S83.0, M22.0, M23.32, M23.35, M17.1, M17.5, M21.16, M21.06, S83.3, S83.44, S83.43, S82.18, S82.0, S72.3, S72.43, M25.56, M76.5, S83.6, S76.1, and S86.8 - Neurological diseases that preclude the use of digital devices - Diagnosis of dementia, blindness, or deafness - Need for presence in the clinic and on-site treatment and diagnostics (ie, imaging, laboratory, stitches, and drainage) - Appointments where the patient has to be touched and moved by the treating physicians - Lack of willingness to participate - Failure to consent Sample Size and Randomization The sample size calculation of the underlying RCT was based on an a priori power analysis. As a conservative estimate, we used half of the effect size of 2.19 that was observed for the findings of patient satisfaction with telemedicine in a study by Sharareh and Schwarzkopf . The effect size of 1.095 yielded 19 patients per study arm for a power of 90% in a 2-sided t test with a 5% significance level.
9406	Inj, nyvepria	APC	How to Code The CPT codes for tobacco cessation counseling are: 99406 Tobacco use cessation intermediate 3-10 minutes 99407 greater than 10 minutes Diagnosis codes should be carefully chosen to reflect the severity of the patient’s tobacco use, as well as the pertinent comorbidity. Disorders from chapter 5, Mental, Behavioral and Neurodevelopmental Disorders (F01-F99), should be coded, according to the provider’s judgment, as long as the tobacco use “is associated with a mental or behavioral disorder [dependence], and such a relationship is documented by the provider.” Add at least one code for the comorbid condition, such as COPD. Applicable primary diagnoses: F17.200-F17.209 Nicotine dependence, unspecified F17.210 -F17.219 Nicotine dependence, cigarettes F17.220-F17.229 Nicotine dependence, chewing tobacco F17.290 -F17.299 Nicotine dependence, other tobacco product For uncomplicated cigarette dependence/addiction, use F17.210. Code Z72.0 Tobacco use, may be reported when the provider has not documented nicotine dependence. CDC “Health effects of cigarette smoking”, https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm R.A. Patel et al “The effect of smoking on bone healing: A systematic review” in Bone & Joint Research 2013 Jun; 2(6): 102-111, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3686151/ Kasandra Bolzenius, CPC “Get paid for smoking cessation”, AAPC Knowledge Center, first published in Healthcare Business Monthly, July 2016, https://www.aapc.com/blog/35703-get-paid-for-smoking-cessation/.
9407	Inj. lumasiran, 0.5 mg	APC	How to Code The CPT codes for tobacco cessation counseling are: 99406 Tobacco use cessation intermediate 3-10 minutes 99407 greater than 10 minutes Diagnosis codes should be carefully chosen to reflect the severity of the patient’s tobacco use, as well as the pertinent comorbidity. Disorders from chapter 5, Mental, Behavioral and Neurodevelopmental Disorders (F01-F99), should be coded, according to the provider’s judgment, as long as the tobacco use “is associated with a mental or behavioral disorder [dependence], and such a relationship is documented by the provider.” Add at least one code for the comorbid condition, such as COPD. Applicable primary diagnoses: F17.200-F17.209 Nicotine dependence, unspecified F17.210 -F17.219 Nicotine dependence, cigarettes F17.220-F17.229 Nicotine dependence, chewing tobacco F17.290 -F17.299 Nicotine dependence, other tobacco product For uncomplicated cigarette dependence/addiction, use F17.210. Code Z72.0 Tobacco use, may be reported when the provider has not documented nicotine dependence. CDC “Health effects of cigarette smoking”, https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm R.A. Patel et al “The effect of smoking on bone healing: A systematic review” in Bone & Joint Research 2013 Jun; 2(6): 102-111, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3686151/ Kasandra Bolzenius, CPC “Get paid for smoking cessation”, AAPC Knowledge Center, first published in Healthcare Business Monthly, July 2016, https://www.aapc.com/blog/35703-get-paid-for-smoking-cessation/.
1996	Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration	HCPCS	Most people confuse these people with one another. But these are two totally different codes. The main difference between HCPCS and CPT is that HCPCS is a set code used by medical workers to claim their health insurance from insurance companies. CPT is a code, especially for the usage of medical students by the authorities. Let’s take a closer look at CPT vs. HCPCS \|Developed In\|\|HCPCS was developed in 1996, while CPT was in 1978\| \|Creators\|\|HCPCS was created by CMS, while CPT was by AMA\| \|Access\|\|HCPCS has free access, while CPT has a paid access\| \|Divided\|\|HCPCS was divided into three levels, while CPT was into three categories\| Table of Contents What Is HCPCS?
1996	Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration	HCPCS	But these are two totally different codes. The main difference between HCPCS and CPT is that HCPCS is a set code used by medical workers to claim their health insurance from insurance companies. CPT is a code, especially for the usage of medical students by the authorities. Let’s take a closer look at CPT vs. HCPCS \|Developed In\|\|HCPCS was developed in 1996, while CPT was in 1978\| \|Creators\|\|HCPCS was created by CMS, while CPT was by AMA\| \|Access\|\|HCPCS has free access, while CPT has a paid access\| \|Divided\|\|HCPCS was divided into three levels, while CPT was into three categories\| Table of Contents What Is HCPCS? If we look at HCPCS meaning, it is a Healthcare Common Procedural Coding System.
1996	Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration	HCPCS	The main difference between HCPCS and CPT is that HCPCS is a set code used by medical workers to claim their health insurance from insurance companies. CPT is a code, especially for the usage of medical students by the authorities. Let’s take a closer look at CPT vs. HCPCS \|Developed In\|\|HCPCS was developed in 1996, while CPT was in 1978\| \|Creators\|\|HCPCS was created by CMS, while CPT was by AMA\| \|Access\|\|HCPCS has free access, while CPT has a paid access\| \|Divided\|\|HCPCS was divided into three levels, while CPT was into three categories\| Table of Contents What Is HCPCS? If we look at HCPCS meaning, it is a Healthcare Common Procedural Coding System. These codes are specially developed by the Centre for Medicare and Medicaid organizations.
1996	Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration	HCPCS	CPT is a code, especially for the usage of medical students by the authorities. Let’s take a closer look at CPT vs. HCPCS \|Developed In\|\|HCPCS was developed in 1996, while CPT was in 1978\| \|Creators\|\|HCPCS was created by CMS, while CPT was by AMA\| \|Access\|\|HCPCS has free access, while CPT has a paid access\| \|Divided\|\|HCPCS was divided into three levels, while CPT was into three categories\| Table of Contents What Is HCPCS? If we look at HCPCS meaning, it is a Healthcare Common Procedural Coding System. These codes are specially developed by the Centre for Medicare and Medicaid organizations. These codes are used by healthcare workers to claim their medical insurance from insurance companies.
1999	ANESTHESIOLOGY GROUP	CPT	Stemming from the French Bertillon classification in the late 1800s, the WHO took over ICD in 1946. The three-volume ICD-9 CM (ICD-Version 9 Clinical Modifications) was introduced in 1979 and is also the HIPAA transaction code set. Physicians use Volumes 1 and 2 of ICD-9 CM for diagnostic codes and Current Procedural Terminology (CPT) codes for their procedures. Volume 3 of ICD-9 CM is used by hospitals for procedure codes. ICD-10, ICD-10 CM and ICD-10 PCS ICD-Version 10 has been used for morbidity and mortality statistics worldwide since 1994 and in the U.S. since 1999.
1999	ANESTHESIOLOGY GROUP	CPT	The three-volume ICD-9 CM (ICD-Version 9 Clinical Modifications) was introduced in 1979 and is also the HIPAA transaction code set. Physicians use Volumes 1 and 2 of ICD-9 CM for diagnostic codes and Current Procedural Terminology (CPT) codes for their procedures. Volume 3 of ICD-9 CM is used by hospitals for procedure codes. ICD-10, ICD-10 CM and ICD-10 PCS ICD-Version 10 has been used for morbidity and mortality statistics worldwide since 1994 and in the U.S. since 1999. ICD-10 CM, introduced in 2002, replaces ICD-9 CM with a final adoption deadline of October 1, 2013, mandated by Health and Human Services (HHS).
1999	ANESTHESIOLOGY GROUP	CPT	Physicians use Volumes 1 and 2 of ICD-9 CM for diagnostic codes and Current Procedural Terminology (CPT) codes for their procedures. Volume 3 of ICD-9 CM is used by hospitals for procedure codes. ICD-10, ICD-10 CM and ICD-10 PCS ICD-Version 10 has been used for morbidity and mortality statistics worldwide since 1994 and in the U.S. since 1999. ICD-10 CM, introduced in 2002, replaces ICD-9 CM with a final adoption deadline of October 1, 2013, mandated by Health and Human Services (HHS). ICD-10 CM includes 68,000 diagnostic codes, five times more than ICD-9 CM.
36415	VENIPUNCTURE	HCPCS	However, the organization limits you to no more than 25 searches at a time. You can access this tool at CPT Code/Relative Value Search. Also, your doctor may have a sheet (called an encounter form or "superbill") that lists the most common CPT and diagnosis codes used in her office. Your physician's office may share this form with you. Some examples of CPT codes are: - 99201 - office or other outpatient visit for the evaluation and management of a new patient - 93000 - electrocardiogram - 36415 - collection of venous blood by venipuncture (drawing blood) Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is the coding system used by Medicare.
93000	PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	HCPCS	However, the organization limits you to no more than 25 searches at a time. You can access this tool at CPT Code/Relative Value Search. Also, your doctor may have a sheet (called an encounter form or "superbill") that lists the most common CPT and diagnosis codes used in her office. Your physician's office may share this form with you. Some examples of CPT codes are: - 99201 - office or other outpatient visit for the evaluation and management of a new patient - 93000 - electrocardiogram - 36415 - collection of venous blood by venipuncture (drawing blood) Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is the coding system used by Medicare.
99201	Office Visit New Min	HCPCS	However, the organization limits you to no more than 25 searches at a time. You can access this tool at CPT Code/Relative Value Search. Also, your doctor may have a sheet (called an encounter form or "superbill") that lists the most common CPT and diagnosis codes used in her office. Your physician's office may share this form with you. Some examples of CPT codes are: - 99201 - office or other outpatient visit for the evaluation and management of a new patient - 93000 - electrocardiogram - 36415 - collection of venous blood by venipuncture (drawing blood) Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is the coding system used by Medicare.
36415	VENIPUNCTURE	HCPCS	Also, your doctor may have a sheet (called an encounter form or "superbill") that lists the most common CPT and diagnosis codes used in her office. Your physician's office may share this form with you. Some examples of CPT codes are: - 99201 - office or other outpatient visit for the evaluation and management of a new patient - 93000 - electrocardiogram - 36415 - collection of venous blood by venipuncture (drawing blood) Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is the coding system used by Medicare. Level I HCPCS codes are the same as the CPT codes from the American Medical Association. Medicare also maintains a set of codes known as HCPCS Level II.
93000	PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	HCPCS	Also, your doctor may have a sheet (called an encounter form or "superbill") that lists the most common CPT and diagnosis codes used in her office. Your physician's office may share this form with you. Some examples of CPT codes are: - 99201 - office or other outpatient visit for the evaluation and management of a new patient - 93000 - electrocardiogram - 36415 - collection of venous blood by venipuncture (drawing blood) Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is the coding system used by Medicare. Level I HCPCS codes are the same as the CPT codes from the American Medical Association. Medicare also maintains a set of codes known as HCPCS Level II.
99201	Office Visit New Min	HCPCS	Also, your doctor may have a sheet (called an encounter form or "superbill") that lists the most common CPT and diagnosis codes used in her office. Your physician's office may share this form with you. Some examples of CPT codes are: - 99201 - office or other outpatient visit for the evaluation and management of a new patient - 93000 - electrocardiogram - 36415 - collection of venous blood by venipuncture (drawing blood) Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is the coding system used by Medicare. Level I HCPCS codes are the same as the CPT codes from the American Medical Association. Medicare also maintains a set of codes known as HCPCS Level II.
36415	VENIPUNCTURE	HCPCS	Your physician's office may share this form with you. Some examples of CPT codes are: - 99201 - office or other outpatient visit for the evaluation and management of a new patient - 93000 - electrocardiogram - 36415 - collection of venous blood by venipuncture (drawing blood) Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is the coding system used by Medicare. Level I HCPCS codes are the same as the CPT codes from the American Medical Association. Medicare also maintains a set of codes known as HCPCS Level II. These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office.
93000	PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	HCPCS	Your physician's office may share this form with you. Some examples of CPT codes are: - 99201 - office or other outpatient visit for the evaluation and management of a new patient - 93000 - electrocardiogram - 36415 - collection of venous blood by venipuncture (drawing blood) Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is the coding system used by Medicare. Level I HCPCS codes are the same as the CPT codes from the American Medical Association. Medicare also maintains a set of codes known as HCPCS Level II. These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office.
99201	Office Visit New Min	HCPCS	Your physician's office may share this form with you. Some examples of CPT codes are: - 99201 - office or other outpatient visit for the evaluation and management of a new patient - 93000 - electrocardiogram - 36415 - collection of venous blood by venipuncture (drawing blood) Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is the coding system used by Medicare. Level I HCPCS codes are the same as the CPT codes from the American Medical Association. Medicare also maintains a set of codes known as HCPCS Level II. These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office.
L4386	WALKING BOOT, NON-PNEUMATIC, WITH OR WITHOUT JOINTS, WITH OR WITHOUT INTERFACE MATERIAL, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE	HCPCS	Some examples of CPT codes are: - 99201 - office or other outpatient visit for the evaluation and management of a new patient - 93000 - electrocardiogram - 36415 - collection of venous blood by venipuncture (drawing blood) Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is the coding system used by Medicare. Level I HCPCS codes are the same as the CPT codes from the American Medical Association. Medicare also maintains a set of codes known as HCPCS Level II. These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office. Some examples of Level II HCPCS codes are: - L4386 - walking splint - E0605 - vaporizer - E0455 - oxygen tent Medicare provides an online list of Level II codes at HCPCS 2013 Index.
36415	VENIPUNCTURE	HCPCS	Some examples of CPT codes are: - 99201 - office or other outpatient visit for the evaluation and management of a new patient - 93000 - electrocardiogram - 36415 - collection of venous blood by venipuncture (drawing blood) Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is the coding system used by Medicare. Level I HCPCS codes are the same as the CPT codes from the American Medical Association. Medicare also maintains a set of codes known as HCPCS Level II. These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office. Some examples of Level II HCPCS codes are: - L4386 - walking splint - E0605 - vaporizer - E0455 - oxygen tent Medicare provides an online list of Level II codes at HCPCS 2013 Index.
93000	PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	HCPCS	Some examples of CPT codes are: - 99201 - office or other outpatient visit for the evaluation and management of a new patient - 93000 - electrocardiogram - 36415 - collection of venous blood by venipuncture (drawing blood) Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is the coding system used by Medicare. Level I HCPCS codes are the same as the CPT codes from the American Medical Association. Medicare also maintains a set of codes known as HCPCS Level II. These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office. Some examples of Level II HCPCS codes are: - L4386 - walking splint - E0605 - vaporizer - E0455 - oxygen tent Medicare provides an online list of Level II codes at HCPCS 2013 Index.
E0455	Oxygen tent excl croup/ped t	HCPCS	Some examples of CPT codes are: - 99201 - office or other outpatient visit for the evaluation and management of a new patient - 93000 - electrocardiogram - 36415 - collection of venous blood by venipuncture (drawing blood) Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is the coding system used by Medicare. Level I HCPCS codes are the same as the CPT codes from the American Medical Association. Medicare also maintains a set of codes known as HCPCS Level II. These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office. Some examples of Level II HCPCS codes are: - L4386 - walking splint - E0605 - vaporizer - E0455 - oxygen tent Medicare provides an online list of Level II codes at HCPCS 2013 Index.
E0605	Vaporizer, room type	HCPCS	Some examples of CPT codes are: - 99201 - office or other outpatient visit for the evaluation and management of a new patient - 93000 - electrocardiogram - 36415 - collection of venous blood by venipuncture (drawing blood) Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is the coding system used by Medicare. Level I HCPCS codes are the same as the CPT codes from the American Medical Association. Medicare also maintains a set of codes known as HCPCS Level II. These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office. Some examples of Level II HCPCS codes are: - L4386 - walking splint - E0605 - vaporizer - E0455 - oxygen tent Medicare provides an online list of Level II codes at HCPCS 2013 Index.
99201	Office Visit New Min	HCPCS	Some examples of CPT codes are: - 99201 - office or other outpatient visit for the evaluation and management of a new patient - 93000 - electrocardiogram - 36415 - collection of venous blood by venipuncture (drawing blood) Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is the coding system used by Medicare. Level I HCPCS codes are the same as the CPT codes from the American Medical Association. Medicare also maintains a set of codes known as HCPCS Level II. These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office. Some examples of Level II HCPCS codes are: - L4386 - walking splint - E0605 - vaporizer - E0455 - oxygen tent Medicare provides an online list of Level II codes at HCPCS 2013 Index.
E0455	Oxygen tent excl croup/ped t	HCPCS	Level I HCPCS codes are the same as the CPT codes from the American Medical Association. Medicare also maintains a set of codes known as HCPCS Level II. These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office. Some examples of Level II HCPCS codes are: - L4386 - walking splint - E0605 - vaporizer - E0455 - oxygen tent Medicare provides an online list of Level II codes at HCPCS 2013 Index. International Classification of Diseases The third system of coding is the International Classification of Diseases, or ICD codes.
L4386	WALKING BOOT, NON-PNEUMATIC, WITH OR WITHOUT JOINTS, WITH OR WITHOUT INTERFACE MATERIAL, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE	HCPCS	Level I HCPCS codes are the same as the CPT codes from the American Medical Association. Medicare also maintains a set of codes known as HCPCS Level II. These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office. Some examples of Level II HCPCS codes are: - L4386 - walking splint - E0605 - vaporizer - E0455 - oxygen tent Medicare provides an online list of Level II codes at HCPCS 2013 Index. International Classification of Diseases The third system of coding is the International Classification of Diseases, or ICD codes.
E0605	Vaporizer, room type	HCPCS	Level I HCPCS codes are the same as the CPT codes from the American Medical Association. Medicare also maintains a set of codes known as HCPCS Level II. These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office. Some examples of Level II HCPCS codes are: - L4386 - walking splint - E0605 - vaporizer - E0455 - oxygen tent Medicare provides an online list of Level II codes at HCPCS 2013 Index. International Classification of Diseases The third system of coding is the International Classification of Diseases, or ICD codes.
E0455	Oxygen tent excl croup/ped t	HCPCS	Medicare also maintains a set of codes known as HCPCS Level II. These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office. Some examples of Level II HCPCS codes are: - L4386 - walking splint - E0605 - vaporizer - E0455 - oxygen tent Medicare provides an online list of Level II codes at HCPCS 2013 Index. International Classification of Diseases The third system of coding is the International Classification of Diseases, or ICD codes. These codes, developed by the World Health Organization (WHO), identify your health condition, or diagnosis.
L4386	WALKING BOOT, NON-PNEUMATIC, WITH OR WITHOUT JOINTS, WITH OR WITHOUT INTERFACE MATERIAL, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE	HCPCS	Medicare also maintains a set of codes known as HCPCS Level II. These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office. Some examples of Level II HCPCS codes are: - L4386 - walking splint - E0605 - vaporizer - E0455 - oxygen tent Medicare provides an online list of Level II codes at HCPCS 2013 Index. International Classification of Diseases The third system of coding is the International Classification of Diseases, or ICD codes. These codes, developed by the World Health Organization (WHO), identify your health condition, or diagnosis.
E0605	Vaporizer, room type	HCPCS	Medicare also maintains a set of codes known as HCPCS Level II. These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office. Some examples of Level II HCPCS codes are: - L4386 - walking splint - E0605 - vaporizer - E0455 - oxygen tent Medicare provides an online list of Level II codes at HCPCS 2013 Index. International Classification of Diseases The third system of coding is the International Classification of Diseases, or ICD codes. These codes, developed by the World Health Organization (WHO), identify your health condition, or diagnosis.
E0455	Oxygen tent excl croup/ped t	HCPCS	These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office. Some examples of Level II HCPCS codes are: - L4386 - walking splint - E0605 - vaporizer - E0455 - oxygen tent Medicare provides an online list of Level II codes at HCPCS 2013 Index. International Classification of Diseases The third system of coding is the International Classification of Diseases, or ICD codes. These codes, developed by the World Health Organization (WHO), identify your health condition, or diagnosis. ICD codes are often used in combination with the CPT codes to make sure that your health condition and the services you received match.
L4386	WALKING BOOT, NON-PNEUMATIC, WITH OR WITHOUT JOINTS, WITH OR WITHOUT INTERFACE MATERIAL, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE	HCPCS	These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office. Some examples of Level II HCPCS codes are: - L4386 - walking splint - E0605 - vaporizer - E0455 - oxygen tent Medicare provides an online list of Level II codes at HCPCS 2013 Index. International Classification of Diseases The third system of coding is the International Classification of Diseases, or ICD codes. These codes, developed by the World Health Organization (WHO), identify your health condition, or diagnosis. ICD codes are often used in combination with the CPT codes to make sure that your health condition and the services you received match.
E0605	Vaporizer, room type	HCPCS	These codes are used to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment (wheelchairs and hospital beds), prosthetics, orthotics, and supplies that are used outside your doctor's office. Some examples of Level II HCPCS codes are: - L4386 - walking splint - E0605 - vaporizer - E0455 - oxygen tent Medicare provides an online list of Level II codes at HCPCS 2013 Index. International Classification of Diseases The third system of coding is the International Classification of Diseases, or ICD codes. These codes, developed by the World Health Organization (WHO), identify your health condition, or diagnosis. ICD codes are often used in combination with the CPT codes to make sure that your health condition and the services you received match.
55289-211-60	METFORMIN HCL 500 MG PO TAB	NDC	Answers to the “quiz” Code Source Term 1. 55454-3 LOINC Hemoglobin A1C 2. 250.02 ICD-9-CM Diabetes Mellitus without complications 3. E11.9 ICD-10-CM Type 2 Diabetes Mellitus without Complications 4. 55289-211-60 NDC GLUCOPHAGE 500 MG TABLET [PD-RX PHARM 60ea F/C] 5.
55289-211-60	METFORMIN HCL 500 MG PO TAB	NDC	55454-3 LOINC Hemoglobin A1C 2. 250.02 ICD-9-CM Diabetes Mellitus without complications 3. E11.9 ICD-10-CM Type 2 Diabetes Mellitus without Complications 4. 55289-211-60 NDC GLUCOPHAGE 500 MG TABLET [PD-RX PHARM 60ea F/C] 5. 3E013VG ICD-10-PCS Intro of Insulin into SubQ Tissue, Percutaneous Approach 6.
55289-211-60	METFORMIN HCL 500 MG PO TAB	NDC	250.02 ICD-9-CM Diabetes Mellitus without complications 3. E11.9 ICD-10-CM Type 2 Diabetes Mellitus without Complications 4. 55289-211-60 NDC GLUCOPHAGE 500 MG TABLET [PD-RX PHARM 60ea F/C] 5. 3E013VG ICD-10-PCS Intro of Insulin into SubQ Tissue, Percutaneous Approach 6. 1-800-783-3637 US Phone Stanley Steemer (1-800-STEEMER) (go ahead... sing the rest)
55289-211-60	METFORMIN HCL 500 MG PO TAB	NDC	E11.9 ICD-10-CM Type 2 Diabetes Mellitus without Complications 4. 55289-211-60 NDC GLUCOPHAGE 500 MG TABLET [PD-RX PHARM 60ea F/C] 5. 3E013VG ICD-10-PCS Intro of Insulin into SubQ Tissue, Percutaneous Approach 6. 1-800-783-3637 US Phone Stanley Steemer (1-800-STEEMER) (go ahead... sing the rest)
55289-211-60	METFORMIN HCL 500 MG PO TAB	NDC	55289-211-60 NDC GLUCOPHAGE 500 MG TABLET [PD-RX PHARM 60ea F/C] 5. 3E013VG ICD-10-PCS Intro of Insulin into SubQ Tissue, Percutaneous Approach 6. 1-800-783-3637 US Phone Stanley Steemer (1-800-STEEMER) (go ahead... sing the rest)
44950	PR APPENDECTOMY	HCPCS	it is a collection of standard prices for services and items that a provider organization offers. Computer-assisted coding (CAC) solutions can help speed up the medical coding process and increase coding accuracy and efficiency. For Evaluating Patient: CPT = 99285 ICD = K35.80 For Procedure: CPT = 44950 ICD = K35.80 The medical coder should have Industry specific skills such as ICD-10 coding, CPT coding, HCPCS coding, Medical terminology, Anatomy, Healthcare regulations, etc., and Professional skills such as Communication, critical thinking, Time management, Attention to detail, Research, and computer literacy. Quintessence is a leading Revenue cycle management services and technology company offering performance-guaranteed and effective solutions to Medical billing and Medical coding companies. Medical coding has a Financial aspect.
99285	PROFESSIONAL FEE LEVEL 5	HCPCS	it is a collection of standard prices for services and items that a provider organization offers. Computer-assisted coding (CAC) solutions can help speed up the medical coding process and increase coding accuracy and efficiency. For Evaluating Patient: CPT = 99285 ICD = K35.80 For Procedure: CPT = 44950 ICD = K35.80 The medical coder should have Industry specific skills such as ICD-10 coding, CPT coding, HCPCS coding, Medical terminology, Anatomy, Healthcare regulations, etc., and Professional skills such as Communication, critical thinking, Time management, Attention to detail, Research, and computer literacy. Quintessence is a leading Revenue cycle management services and technology company offering performance-guaranteed and effective solutions to Medical billing and Medical coding companies. Medical coding has a Financial aspect.
1999	ANESTHESIOLOGY GROUP	CPT	Code 02703DZ specifies the procedure for dilation of one coronary artery using an intraluminal device via percutaneous approach (i.e., percutaneous transluminal coronary angioplasty with stent) Current Procedure Terminology (CPT) is one of the three main medical code sets that is owned and maintained by American Medical Association (AMA). The CPT descriptive terminology and associated code numbers provide the most widely accepted medical nomenclature used to report medical procedures and services for processing claims, conducting research, evaluating healthcare utilization, and developing medical guidelines and other forms of healthcare documentation. CPT coding system is the preferred system for coding and describing healthcare services and procedures in federal programs (Medicare and Medicaid) and throughout the United States by private insurers and providers of healthcare services. CPT codes are five characters long and may be numeric or alphanumeric. It can be identified by one of the following three categories : - Category I CPT: Eg: Anesthesia (00100–01999), Radiology Procedures (70010–79999), etc - Category II CPT: E.g.
00100	ANESTH SALIVARY GLAND	CPT	Code 02703DZ specifies the procedure for dilation of one coronary artery using an intraluminal device via percutaneous approach (i.e., percutaneous transluminal coronary angioplasty with stent) Current Procedure Terminology (CPT) is one of the three main medical code sets that is owned and maintained by American Medical Association (AMA). The CPT descriptive terminology and associated code numbers provide the most widely accepted medical nomenclature used to report medical procedures and services for processing claims, conducting research, evaluating healthcare utilization, and developing medical guidelines and other forms of healthcare documentation. CPT coding system is the preferred system for coding and describing healthcare services and procedures in federal programs (Medicare and Medicaid) and throughout the United States by private insurers and providers of healthcare services. CPT codes are five characters long and may be numeric or alphanumeric. It can be identified by one of the following three categories : - Category I CPT: Eg: Anesthesia (00100–01999), Radiology Procedures (70010–79999), etc - Category II CPT: E.g.
01999	Unlisted anesth procedure	CPT	Code 02703DZ specifies the procedure for dilation of one coronary artery using an intraluminal device via percutaneous approach (i.e., percutaneous transluminal coronary angioplasty with stent) Current Procedure Terminology (CPT) is one of the three main medical code sets that is owned and maintained by American Medical Association (AMA). The CPT descriptive terminology and associated code numbers provide the most widely accepted medical nomenclature used to report medical procedures and services for processing claims, conducting research, evaluating healthcare utilization, and developing medical guidelines and other forms of healthcare documentation. CPT coding system is the preferred system for coding and describing healthcare services and procedures in federal programs (Medicare and Medicaid) and throughout the United States by private insurers and providers of healthcare services. CPT codes are five characters long and may be numeric or alphanumeric. It can be identified by one of the following three categories : - Category I CPT: Eg: Anesthesia (00100–01999), Radiology Procedures (70010–79999), etc - Category II CPT: E.g.
1999	ANESTHESIOLOGY GROUP	CPT	The CPT descriptive terminology and associated code numbers provide the most widely accepted medical nomenclature used to report medical procedures and services for processing claims, conducting research, evaluating healthcare utilization, and developing medical guidelines and other forms of healthcare documentation. CPT coding system is the preferred system for coding and describing healthcare services and procedures in federal programs (Medicare and Medicaid) and throughout the United States by private insurers and providers of healthcare services. CPT codes are five characters long and may be numeric or alphanumeric. It can be identified by one of the following three categories : - Category I CPT: Eg: Anesthesia (00100–01999), Radiology Procedures (70010–79999), etc - Category II CPT: E.g. 2029F: complete physical skin exam performed, Patient Management (0500F–0584F), Physical Examination (2000F–2060F - Category III CPT: E.g.
00100	ANESTH SALIVARY GLAND	CPT	The CPT descriptive terminology and associated code numbers provide the most widely accepted medical nomenclature used to report medical procedures and services for processing claims, conducting research, evaluating healthcare utilization, and developing medical guidelines and other forms of healthcare documentation. CPT coding system is the preferred system for coding and describing healthcare services and procedures in federal programs (Medicare and Medicaid) and throughout the United States by private insurers and providers of healthcare services. CPT codes are five characters long and may be numeric or alphanumeric. It can be identified by one of the following three categories : - Category I CPT: Eg: Anesthesia (00100–01999), Radiology Procedures (70010–79999), etc - Category II CPT: E.g. 2029F: complete physical skin exam performed, Patient Management (0500F–0584F), Physical Examination (2000F–2060F - Category III CPT: E.g.
01999	Unlisted anesth procedure	CPT	The CPT descriptive terminology and associated code numbers provide the most widely accepted medical nomenclature used to report medical procedures and services for processing claims, conducting research, evaluating healthcare utilization, and developing medical guidelines and other forms of healthcare documentation. CPT coding system is the preferred system for coding and describing healthcare services and procedures in federal programs (Medicare and Medicaid) and throughout the United States by private insurers and providers of healthcare services. CPT codes are five characters long and may be numeric or alphanumeric. It can be identified by one of the following three categories : - Category I CPT: Eg: Anesthesia (00100–01999), Radiology Procedures (70010–79999), etc - Category II CPT: E.g. 2029F: complete physical skin exam performed, Patient Management (0500F–0584F), Physical Examination (2000F–2060F - Category III CPT: E.g.
1999	ANESTHESIOLOGY GROUP	CPT	CPT coding system is the preferred system for coding and describing healthcare services and procedures in federal programs (Medicare and Medicaid) and throughout the United States by private insurers and providers of healthcare services. CPT codes are five characters long and may be numeric or alphanumeric. It can be identified by one of the following three categories : - Category I CPT: Eg: Anesthesia (00100–01999), Radiology Procedures (70010–79999), etc - Category II CPT: E.g. 2029F: complete physical skin exam performed, Patient Management (0500F–0584F), Physical Examination (2000F–2060F - Category III CPT: E.g. 0307T: near - infrared spectroscopy study for lower extremity wounds
00100	ANESTH SALIVARY GLAND	CPT	CPT coding system is the preferred system for coding and describing healthcare services and procedures in federal programs (Medicare and Medicaid) and throughout the United States by private insurers and providers of healthcare services. CPT codes are five characters long and may be numeric or alphanumeric. It can be identified by one of the following three categories : - Category I CPT: Eg: Anesthesia (00100–01999), Radiology Procedures (70010–79999), etc - Category II CPT: E.g. 2029F: complete physical skin exam performed, Patient Management (0500F–0584F), Physical Examination (2000F–2060F - Category III CPT: E.g. 0307T: near - infrared spectroscopy study for lower extremity wounds
01999	Unlisted anesth procedure	CPT	CPT coding system is the preferred system for coding and describing healthcare services and procedures in federal programs (Medicare and Medicaid) and throughout the United States by private insurers and providers of healthcare services. CPT codes are five characters long and may be numeric or alphanumeric. It can be identified by one of the following three categories : - Category I CPT: Eg: Anesthesia (00100–01999), Radiology Procedures (70010–79999), etc - Category II CPT: E.g. 2029F: complete physical skin exam performed, Patient Management (0500F–0584F), Physical Examination (2000F–2060F - Category III CPT: E.g. 0307T: near - infrared spectroscopy study for lower extremity wounds
1999	ANESTHESIOLOGY GROUP	CPT	CPT codes are five characters long and may be numeric or alphanumeric. It can be identified by one of the following three categories : - Category I CPT: Eg: Anesthesia (00100–01999), Radiology Procedures (70010–79999), etc - Category II CPT: E.g. 2029F: complete physical skin exam performed, Patient Management (0500F–0584F), Physical Examination (2000F–2060F - Category III CPT: E.g. 0307T: near - infrared spectroscopy study for lower extremity wounds
00100	ANESTH SALIVARY GLAND	CPT	CPT codes are five characters long and may be numeric or alphanumeric. It can be identified by one of the following three categories : - Category I CPT: Eg: Anesthesia (00100–01999), Radiology Procedures (70010–79999), etc - Category II CPT: E.g. 2029F: complete physical skin exam performed, Patient Management (0500F–0584F), Physical Examination (2000F–2060F - Category III CPT: E.g. 0307T: near - infrared spectroscopy study for lower extremity wounds
01999	Unlisted anesth procedure	CPT	CPT codes are five characters long and may be numeric or alphanumeric. It can be identified by one of the following three categories : - Category I CPT: Eg: Anesthesia (00100–01999), Radiology Procedures (70010–79999), etc - Category II CPT: E.g. 2029F: complete physical skin exam performed, Patient Management (0500F–0584F), Physical Examination (2000F–2060F - Category III CPT: E.g. 0307T: near - infrared spectroscopy study for lower extremity wounds
1999	ANESTHESIOLOGY GROUP	CPT	It can be identified by one of the following three categories : - Category I CPT: Eg: Anesthesia (00100–01999), Radiology Procedures (70010–79999), etc - Category II CPT: E.g. 2029F: complete physical skin exam performed, Patient Management (0500F–0584F), Physical Examination (2000F–2060F - Category III CPT: E.g. 0307T: near - infrared spectroscopy study for lower extremity wounds
00100	ANESTH SALIVARY GLAND	CPT	It can be identified by one of the following three categories : - Category I CPT: Eg: Anesthesia (00100–01999), Radiology Procedures (70010–79999), etc - Category II CPT: E.g. 2029F: complete physical skin exam performed, Patient Management (0500F–0584F), Physical Examination (2000F–2060F - Category III CPT: E.g. 0307T: near - infrared spectroscopy study for lower extremity wounds
01999	Unlisted anesth procedure	CPT	It can be identified by one of the following three categories : - Category I CPT: Eg: Anesthesia (00100–01999), Radiology Procedures (70010–79999), etc - Category II CPT: E.g. 2029F: complete physical skin exam performed, Patient Management (0500F–0584F), Physical Examination (2000F–2060F - Category III CPT: E.g. 0307T: near - infrared spectroscopy study for lower extremity wounds
S9562	HT inj palivizumab diem	HCPCS	In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated.
86756	HC RESPITORY SYNCYTIAL VIRUS AB 86756	HCPCS	In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated.
90781	IV infusion, additional hour	HCPCS	In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated.
J1565	RSV-ivig	HCPCS	In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated.
90780	IV infusion therapy, 1 hour	HCPCS	In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated.
90782	Injection, sc/im	HCPCS	In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated.
S9562	HT inj palivizumab diem	HCPCS	The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised.
86756	HC RESPITORY SYNCYTIAL VIRUS AB 86756	HCPCS	The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised.
90781	IV infusion, additional hour	HCPCS	The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised.
J1565	RSV-ivig	HCPCS	The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised.
90780	IV infusion therapy, 1 hour	HCPCS	The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised.
90782	Injection, sc/im	HCPCS	The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised.
S9562	HT inj palivizumab diem	HCPCS	POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447.
86756	HC RESPITORY SYNCYTIAL VIRUS AB 86756	HCPCS	POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447.
90781	IV infusion, additional hour	HCPCS	POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447.
J1565	RSV-ivig	HCPCS	POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447.
90780	IV infusion therapy, 1 hour	HCPCS	POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447.
90782	Injection, sc/im	HCPCS	POLICY HISTORY8/1998: RSV policy approved by Medical Policy Advisory Committee (MPAC) 11/1998: Synagis® criteria approved by MPAC; policy merged with RSV and renamed 2/2/2001: Entire "Policy Section" revised 10/26/2001: Infants < 28 weeks of gestation up to 12 months of age "at the start of RSV season" added 1/30/2002: Above statement added to Infants 29-32 weeks and 32-35 weeks 2/14/2002: Investigational definition added 5/2/2002: Type of Service and Place of Service deleted 5/28/2002: Code Reference section updated, CPT 86756 added 11/6/2002: Nova Factor new telephone and fax numbers added. Telephone # 1-800-235-8498 and fax # 1-888-355-6652 deleted. 9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447.
S9562	HT inj palivizumab diem	HCPCS	9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication.
86756	HC RESPITORY SYNCYTIAL VIRUS AB 86756	HCPCS	9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication.
90378	HC RESPIRATORY SYNCYTIAL VIRUS IG IM 50 MG E	HCPCS	9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication.
90781	IV infusion, additional hour	HCPCS	9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication.
90379	Rsv Ig, Iv	HCPCS	9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication.
90772	Ther/Proph/Diag Inj, Sc/Im	HCPCS	9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication.
J1565	RSV-ivig	HCPCS	9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication.
90766	Ther/Proph/Dg Iv Inf, Add-On	HCPCS	9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication.
90765	Ther/Proph/Diag Iv Inf, Init	HCPCS	9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication.
90780	IV infusion therapy, 1 hour	HCPCS	9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication.
90782	Injection, sc/im	HCPCS	9/17/2004: Code Reference section updated, CPT 86756, 90780, 90781, 90782 deleted, ICD-9 diagnosis code 460.0 invalid and deleted, ICD-9 diagnosis code range 460-466.0, 478.8-480.0, 493.0-493.1, 765.00-765.19, 770.0-770.9 listed separately, ICD-9 diagnosis code range 493.0-493.1 5th digit added, HCPCS J1565 description revised, HCPCS S9562 added 9/30/2004: Code Reference section updated, ICD-9 diagnosis code 745.10, 745.11, 745.2, 745.4, 745.5, 745.60, 745.61, 745.69, 745.8, 746.02, 746.2, 746.7, 746.81, 746.83, 747.0, 747.10, 747.3, 747.49 added covered codes 10/28/2005: Description section updated. FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication.
90379	Rsv Ig, Iv	HCPCS	FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication. 11/14/2006: Code Reference section updated: ICD-9 code V04.82 added 1/12/2006: Code reference section updated.
90378	HC RESPIRATORY SYNCYTIAL VIRUS IG IM 50 MG E	HCPCS	FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication. 11/14/2006: Code Reference section updated: ICD-9 code V04.82 added 1/12/2006: Code reference section updated.
90772	Ther/Proph/Diag Inj, Sc/Im	HCPCS	FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication. 11/14/2006: Code Reference section updated: ICD-9 code V04.82 added 1/12/2006: Code reference section updated.
90766	Ther/Proph/Dg Iv Inf, Add-On	HCPCS	FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication. 11/14/2006: Code Reference section updated: ICD-9 code V04.82 added 1/12/2006: Code reference section updated.
J1565	RSV-ivig	HCPCS	FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication. 11/14/2006: Code Reference section updated: ICD-9 code V04.82 added 1/12/2006: Code reference section updated.
90765	Ther/Proph/Diag Iv Inf, Init	HCPCS	FDA approved indications revised. Policy section updated: changed preferred provider to Accredo, changed telephone # from 1-866-591-9075 to 1-866-240-3373, changed fax # from 1-866-591-9094 to 1-877-369-3447. Sources updated; American Academy of Pediatrics Web Site, Synagis® and RespiGam® added 11/4/2005: Code Reference section updated, ICD9 diagnosis codes 491.00-491.02, 491.20-491.22, 491.9, 493.20-493.22, 496, 765.20-765.27, V46.2 added; ICD9 procedure code 99.29 added. 11/2005: Approved by Pharmacy & Therapeutics (P & T) Committee 2/7/2006: Code Reference table updated: The notes under CPT codes 90378 and 90379 and HCPCS code J1565 were updated to include the new intramuscular and IV infusion administration codes (90772, 90765-90766); ICD9 diagnosis codes 079.6, 079.89, 460.0-466.0, 466.11, 478.8-478.9, 480.0-480.9, 487.1, 519.8, 769, 770.0-770.9, 786.9 deleted, V58.65 added 8/22/2006: Respigam deleted from policy due to discontinuation of medication. 11/14/2006: Code Reference section updated: ICD-9 code V04.82 added 1/12/2006: Code reference section updated.

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