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86825 | X-MATCHAHG | HCPCS | High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support
9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied
1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted
8/07/2009: Policy Description Section updated with definitions and descriptions for Conventional Preparative Conditioning for HSCT, Reduced-Intensity Conditioning for Allogeneic HSCT, and AML as well as WHO information and molecular studies information specific to AML, Policy Statement Section revised to add specific medically necessary criteria to the treatment of AML with Allogeneic HSCT using a myeloablative conditioning regimen, Allogeneic HSCT using a reduced-intensity conditioning regimen, and Autologous HSCT, Policy Guidelines updated to add AML with antecedent hematologic disease as a clinical feature that predicts poor outcomes of AML therapy, WHO classification of AML Risk Status table, candidate information, and donor information, Coding Section updated with a Note added to the CPT-4 Covered Codes Table, ICD-9 Procedure Code 41.00 added to Covered Table, HCPCS codes S2140 and S2142 added to covered table, removed deleted HCPCS codes G0265, G0266, G0267, and G0363 from Covered Table
04/26/2010: FEP and State and School Employee verbiage added to the Policy Exceptions section. Added new CPT codes 86825 and 86826. 09/28/2011: Policy reviewed; no changes. 09/27/2012: Policy reviewed; no changes. |
S2142 | Cord blood-derived stem-cell transplantation, allogeneic | HCPCS | High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support
9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied
1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted
8/07/2009: Policy Description Section updated with definitions and descriptions for Conventional Preparative Conditioning for HSCT, Reduced-Intensity Conditioning for Allogeneic HSCT, and AML as well as WHO information and molecular studies information specific to AML, Policy Statement Section revised to add specific medically necessary criteria to the treatment of AML with Allogeneic HSCT using a myeloablative conditioning regimen, Allogeneic HSCT using a reduced-intensity conditioning regimen, and Autologous HSCT, Policy Guidelines updated to add AML with antecedent hematologic disease as a clinical feature that predicts poor outcomes of AML therapy, WHO classification of AML Risk Status table, candidate information, and donor information, Coding Section updated with a Note added to the CPT-4 Covered Codes Table, ICD-9 Procedure Code 41.00 added to Covered Table, HCPCS codes S2140 and S2142 added to covered table, removed deleted HCPCS codes G0265, G0266, G0267, and G0363 from Covered Table
04/26/2010: FEP and State and School Employee verbiage added to the Policy Exceptions section. Added new CPT codes 86825 and 86826. 09/28/2011: Policy reviewed; no changes. 09/27/2012: Policy reviewed; no changes. |
86826 | Hla x-match noncytotoxc addl | HCPCS | High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support
9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied
1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted
8/07/2009: Policy Description Section updated with definitions and descriptions for Conventional Preparative Conditioning for HSCT, Reduced-Intensity Conditioning for Allogeneic HSCT, and AML as well as WHO information and molecular studies information specific to AML, Policy Statement Section revised to add specific medically necessary criteria to the treatment of AML with Allogeneic HSCT using a myeloablative conditioning regimen, Allogeneic HSCT using a reduced-intensity conditioning regimen, and Autologous HSCT, Policy Guidelines updated to add AML with antecedent hematologic disease as a clinical feature that predicts poor outcomes of AML therapy, WHO classification of AML Risk Status table, candidate information, and donor information, Coding Section updated with a Note added to the CPT-4 Covered Codes Table, ICD-9 Procedure Code 41.00 added to Covered Table, HCPCS codes S2140 and S2142 added to covered table, removed deleted HCPCS codes G0265, G0266, G0267, and G0363 from Covered Table
04/26/2010: FEP and State and School Employee verbiage added to the Policy Exceptions section. Added new CPT codes 86825 and 86826. 09/28/2011: Policy reviewed; no changes. 09/27/2012: Policy reviewed; no changes. 11/15/2013: Policy reviewed; no changes. |
G0267 | Bone marrow or psc harvest | CPT | High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support
9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied
1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted
8/07/2009: Policy Description Section updated with definitions and descriptions for Conventional Preparative Conditioning for HSCT, Reduced-Intensity Conditioning for Allogeneic HSCT, and AML as well as WHO information and molecular studies information specific to AML, Policy Statement Section revised to add specific medically necessary criteria to the treatment of AML with Allogeneic HSCT using a myeloablative conditioning regimen, Allogeneic HSCT using a reduced-intensity conditioning regimen, and Autologous HSCT, Policy Guidelines updated to add AML with antecedent hematologic disease as a clinical feature that predicts poor outcomes of AML therapy, WHO classification of AML Risk Status table, candidate information, and donor information, Coding Section updated with a Note added to the CPT-4 Covered Codes Table, ICD-9 Procedure Code 41.00 added to Covered Table, HCPCS codes S2140 and S2142 added to covered table, removed deleted HCPCS codes G0265, G0266, G0267, and G0363 from Covered Table
04/26/2010: FEP and State and School Employee verbiage added to the Policy Exceptions section. Added new CPT codes 86825 and 86826. 09/28/2011: Policy reviewed; no changes. 09/27/2012: Policy reviewed; no changes. 11/15/2013: Policy reviewed; no changes. |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support
9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied
1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted
8/07/2009: Policy Description Section updated with definitions and descriptions for Conventional Preparative Conditioning for HSCT, Reduced-Intensity Conditioning for Allogeneic HSCT, and AML as well as WHO information and molecular studies information specific to AML, Policy Statement Section revised to add specific medically necessary criteria to the treatment of AML with Allogeneic HSCT using a myeloablative conditioning regimen, Allogeneic HSCT using a reduced-intensity conditioning regimen, and Autologous HSCT, Policy Guidelines updated to add AML with antecedent hematologic disease as a clinical feature that predicts poor outcomes of AML therapy, WHO classification of AML Risk Status table, candidate information, and donor information, Coding Section updated with a Note added to the CPT-4 Covered Codes Table, ICD-9 Procedure Code 41.00 added to Covered Table, HCPCS codes S2140 and S2142 added to covered table, removed deleted HCPCS codes G0265, G0266, G0267, and G0363 from Covered Table
04/26/2010: FEP and State and School Employee verbiage added to the Policy Exceptions section. Added new CPT codes 86825 and 86826. 09/28/2011: Policy reviewed; no changes. 09/27/2012: Policy reviewed; no changes. 11/15/2013: Policy reviewed; no changes. |
S2140 | Cord blood harvesting for transplantation, allogeneic | HCPCS | High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support
9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied
1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted
8/07/2009: Policy Description Section updated with definitions and descriptions for Conventional Preparative Conditioning for HSCT, Reduced-Intensity Conditioning for Allogeneic HSCT, and AML as well as WHO information and molecular studies information specific to AML, Policy Statement Section revised to add specific medically necessary criteria to the treatment of AML with Allogeneic HSCT using a myeloablative conditioning regimen, Allogeneic HSCT using a reduced-intensity conditioning regimen, and Autologous HSCT, Policy Guidelines updated to add AML with antecedent hematologic disease as a clinical feature that predicts poor outcomes of AML therapy, WHO classification of AML Risk Status table, candidate information, and donor information, Coding Section updated with a Note added to the CPT-4 Covered Codes Table, ICD-9 Procedure Code 41.00 added to Covered Table, HCPCS codes S2140 and S2142 added to covered table, removed deleted HCPCS codes G0265, G0266, G0267, and G0363 from Covered Table
04/26/2010: FEP and State and School Employee verbiage added to the Policy Exceptions section. Added new CPT codes 86825 and 86826. 09/28/2011: Policy reviewed; no changes. 09/27/2012: Policy reviewed; no changes. 11/15/2013: Policy reviewed; no changes. |
G0265 | Cryopresevation Freeze+stora | CPT | High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support
9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied
1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted
8/07/2009: Policy Description Section updated with definitions and descriptions for Conventional Preparative Conditioning for HSCT, Reduced-Intensity Conditioning for Allogeneic HSCT, and AML as well as WHO information and molecular studies information specific to AML, Policy Statement Section revised to add specific medically necessary criteria to the treatment of AML with Allogeneic HSCT using a myeloablative conditioning regimen, Allogeneic HSCT using a reduced-intensity conditioning regimen, and Autologous HSCT, Policy Guidelines updated to add AML with antecedent hematologic disease as a clinical feature that predicts poor outcomes of AML therapy, WHO classification of AML Risk Status table, candidate information, and donor information, Coding Section updated with a Note added to the CPT-4 Covered Codes Table, ICD-9 Procedure Code 41.00 added to Covered Table, HCPCS codes S2140 and S2142 added to covered table, removed deleted HCPCS codes G0265, G0266, G0267, and G0363 from Covered Table
04/26/2010: FEP and State and School Employee verbiage added to the Policy Exceptions section. Added new CPT codes 86825 and 86826. 09/28/2011: Policy reviewed; no changes. 09/27/2012: Policy reviewed; no changes. 11/15/2013: Policy reviewed; no changes. |
G0266 | Thawing + expansion froz cel | CPT | High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support
9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied
1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted
8/07/2009: Policy Description Section updated with definitions and descriptions for Conventional Preparative Conditioning for HSCT, Reduced-Intensity Conditioning for Allogeneic HSCT, and AML as well as WHO information and molecular studies information specific to AML, Policy Statement Section revised to add specific medically necessary criteria to the treatment of AML with Allogeneic HSCT using a myeloablative conditioning regimen, Allogeneic HSCT using a reduced-intensity conditioning regimen, and Autologous HSCT, Policy Guidelines updated to add AML with antecedent hematologic disease as a clinical feature that predicts poor outcomes of AML therapy, WHO classification of AML Risk Status table, candidate information, and donor information, Coding Section updated with a Note added to the CPT-4 Covered Codes Table, ICD-9 Procedure Code 41.00 added to Covered Table, HCPCS codes S2140 and S2142 added to covered table, removed deleted HCPCS codes G0265, G0266, G0267, and G0363 from Covered Table
04/26/2010: FEP and State and School Employee verbiage added to the Policy Exceptions section. Added new CPT codes 86825 and 86826. 09/28/2011: Policy reviewed; no changes. 09/27/2012: Policy reviewed; no changes. 11/15/2013: Policy reviewed; no changes. |
86825 | X-MATCHAHG | HCPCS | High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support
9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied
1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted
8/07/2009: Policy Description Section updated with definitions and descriptions for Conventional Preparative Conditioning for HSCT, Reduced-Intensity Conditioning for Allogeneic HSCT, and AML as well as WHO information and molecular studies information specific to AML, Policy Statement Section revised to add specific medically necessary criteria to the treatment of AML with Allogeneic HSCT using a myeloablative conditioning regimen, Allogeneic HSCT using a reduced-intensity conditioning regimen, and Autologous HSCT, Policy Guidelines updated to add AML with antecedent hematologic disease as a clinical feature that predicts poor outcomes of AML therapy, WHO classification of AML Risk Status table, candidate information, and donor information, Coding Section updated with a Note added to the CPT-4 Covered Codes Table, ICD-9 Procedure Code 41.00 added to Covered Table, HCPCS codes S2140 and S2142 added to covered table, removed deleted HCPCS codes G0265, G0266, G0267, and G0363 from Covered Table
04/26/2010: FEP and State and School Employee verbiage added to the Policy Exceptions section. Added new CPT codes 86825 and 86826. 09/28/2011: Policy reviewed; no changes. 09/27/2012: Policy reviewed; no changes. 11/15/2013: Policy reviewed; no changes. |
S2142 | Cord blood-derived stem-cell transplantation, allogeneic | HCPCS | High dose chemotherapy will allogeneic stem cell support changed to investigational for treatment of AML relapsing after prior therapy with HDC and autologous stem cell support
9/11/2008: Annual ICD-9 updates effective 10-1-2008 applied
1/6/2009: Policy reviewed, "prior authorization before evaluation" deleted
8/07/2009: Policy Description Section updated with definitions and descriptions for Conventional Preparative Conditioning for HSCT, Reduced-Intensity Conditioning for Allogeneic HSCT, and AML as well as WHO information and molecular studies information specific to AML, Policy Statement Section revised to add specific medically necessary criteria to the treatment of AML with Allogeneic HSCT using a myeloablative conditioning regimen, Allogeneic HSCT using a reduced-intensity conditioning regimen, and Autologous HSCT, Policy Guidelines updated to add AML with antecedent hematologic disease as a clinical feature that predicts poor outcomes of AML therapy, WHO classification of AML Risk Status table, candidate information, and donor information, Coding Section updated with a Note added to the CPT-4 Covered Codes Table, ICD-9 Procedure Code 41.00 added to Covered Table, HCPCS codes S2140 and S2142 added to covered table, removed deleted HCPCS codes G0265, G0266, G0267, and G0363 from Covered Table
04/26/2010: FEP and State and School Employee verbiage added to the Policy Exceptions section. Added new CPT codes 86825 and 86826. 09/28/2011: Policy reviewed; no changes. 09/27/2012: Policy reviewed; no changes. 11/15/2013: Policy reviewed; no changes. |
30230Y3 | TRANSFUSION OF ALLOGENEIC UNRELATED HEMATOPOIETIC STEM CELLS INTO PERIPHERAL VEIN, OPEN APPROACH Tandem Autologous Allogeneic Unrelated Non ICU | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
0243 | All Inclusive Ancillary - Specialty | RC | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
30240Y3 | TRANSFUSION OF ALLOGENEIC UNRELATED HEMATOPOIETIC STEM CELLS INTO CENTRAL VEIN, OPEN APPROACH Tandem Autologous Allogeneic Unrelated Non ICU | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
30230G3 | TRANSFUSION OF ALLOGENEIC UNRELATED BONE MARROW INTO PERIPHERAL VEIN, OPEN APPROACH Tandem Autologous Allogeneic Unrelated Non ICU | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
30230Y2 | TRANSFUSION OF ALLOGENEIC RELATED HEMATOPOIETIC STEM CELLS INTO PERIPHERAL VEIN, OPEN APPROACH Reduced Intensity Medsurg | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
0230 | Incremental Nursing Charge - General Classification | RC | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
30233Y3 | TRANSFUSION OF ALLOGENEIC UNRELATED HAMATOPOIETIC STEM CELLS INTO PERIPHERAL VEIN, PERCUTANEOUS APPROACH Tandem Autologous Allogeneic Unrelated Non ICU | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
30243G3 | TRANSFUSION OF ALLOGENEIC UNRELATED BONE MARROW INTO CENTRAL VEIN, PERCUTANEOUS APPROACH Tandem Autologous Allogeneic Unrelated Non ICU | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
30230G2 | TRANSFUSION OF ALLOGENEIC RELATED BONE MARROW INTO PERIPHERAL VEIN, OPEN APPROACH Reduced Intensity Medsurg | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
30240G2 | TRANSFUSION OF ALLOGENEIC RELATED BONE MARROW INTO CENTRAL VEIN, OPEN APPROACH Reduced Intensity Medsurg | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
30243Y2 | TRANSFUSION OF ALLOGENEIC RELATED HEMATOPOIETIC STEM CELLS INTO CENTRAL VEIN, PERCUTANEOUS APPROACH Reduced Intensity Medsurg | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
0233 | Incremental Nursing Charge - ICU | RC | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
30243G2 | TRANSFUSION OF ALLOGENEIC RELATED BONE MARROW INTO CENTRAL VEIN, PERCUTANEOUS APPROACH Reduced Intensity Medsurg | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
30243Y3 | TRANSFUSION OF ALLOGENEIC UNRELATED HEMATOPOIETIC STEM CELLS INTO CENTRAL VEIN, PERCUTANEOUS APPROACH Tandem Autologous Allogeneic Unrelated Non ICU | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
30240Y2 | TRANSFUSION OF ALLOGENEIC RELATED HEMATOPOIETIC STEM CELLS INTO CENTRAL VEIN, OPEN APPROACH Reduced Intensity Medsurg | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
30233G3 | TRANSFUSION OF ALLOGENEIC UNRELATED BONE MARROW INTO PERIPHERAL VEIN, PERCUTANEOUS APPROACH Tandem Autologous Allogeneic Unrelated Non ICU | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
0240 | HC BH RESIDENTIAL FULL MONTH STAY | RC | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
30240G3 | TRANSFUSION OF ALLOGENEIC UNRELATED BONE MARROW INTO CENTRAL VEIN, OPEN APPROACH Tandem Autologous Allogeneic Unrelated Non ICU | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
30233G2 | TRANSFUSION OF ALLOGENEIC RELATED BONE MARROW INTO PERIPHERAL VEIN, PERCUTANEOUS APPROACH Reduced Intensity Medsurg | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
30233Y2 | TRANSFUSION OF ALLOGENEIC RELATED HEMATOPOIETIC STEM CELLS INTO PERIPHERAL VEIN, PERCUTANEOUS APPROACH Reduced Intensity Medsurg | ICD | 03/21/2016: Policy description updated regarding FDA regulations. Policy statements unchanged. 05/25/2016: Policy number added. 09/30/2016: Code Reference section updated to add the following new ICD-10 procedure codes: 30230G2, 30233G2, 30240G2, 30243G2, 30230G3, 30233G3, 30240G3, 30243G3, 30230G4, 30233G4, 30240G4, 30243G4, 30230Y2, 30233Y2, 30240Y2, 30243Y2, 30230Y3, 30233Y3, 30240Y3, 30243Y3, 30230Y4, 30233Y4, 30240Y4, and 30243Y4. SOURCE(S)Blue Cross Blue Shield Association Policy # 8.01.26
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy. |
90805 | Psytx off 20-30 min w/e&m | HCPCS | The CPT codes were established and are sustained by the American Medical Association. Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). |
38221 | PR DIAGNOSTIC BONE MARROW BIOPSIES | HCPCS | The CPT codes were established and are sustained by the American Medical Association. Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). |
99263 | Follow-up inpatient consult | HCPCS | The CPT codes were established and are sustained by the American Medical Association. Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). |
99261 | Follow-up inpatient consult | HCPCS | The CPT codes were established and are sustained by the American Medical Association. Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). |
99054 | MEDICAL SERVICES-UNUSUAL HRS | CPT | The CPT codes were established and are sustained by the American Medical Association. Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). |
38211 | Tumor cell deplete of harvst | HCPCS | The CPT codes were established and are sustained by the American Medical Association. Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). |
90805 | Psytx off 20-30 min w/e&m | HCPCS | Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. |
38221 | PR DIAGNOSTIC BONE MARROW BIOPSIES | HCPCS | Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. |
99263 | Follow-up inpatient consult | HCPCS | Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. |
99261 | Follow-up inpatient consult | HCPCS | Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. |
99054 | MEDICAL SERVICES-UNUSUAL HRS | CPT | Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. |
38211 | Tumor cell deplete of harvst | HCPCS | Medical coders use CPT to code outpatient procedures and procedures done in physicians' offices. CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. |
90805 | Psytx off 20-30 min w/e&m | HCPCS | CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. |
38221 | PR DIAGNOSTIC BONE MARROW BIOPSIES | HCPCS | CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. |
99263 | Follow-up inpatient consult | HCPCS | CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. |
99261 | Follow-up inpatient consult | HCPCS | CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. |
99054 | MEDICAL SERVICES-UNUSUAL HRS | CPT | CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. |
38211 | Tumor cell deplete of harvst | HCPCS | CPT codes are numeric. Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. |
90805 | Psytx off 20-30 min w/e&m | HCPCS | Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. |
38221 | PR DIAGNOSTIC BONE MARROW BIOPSIES | HCPCS | Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. |
99263 | Follow-up inpatient consult | HCPCS | Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. |
99261 | Follow-up inpatient consult | HCPCS | Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. |
99054 | MEDICAL SERVICES-UNUSUAL HRS | CPT | Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. |
38211 | Tumor cell deplete of harvst | HCPCS | Changes and additions to the CPT are generally made, at most, four times a year. Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. |
90805 | Psytx off 20-30 min w/e&m | HCPCS | Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. |
38221 | PR DIAGNOSTIC BONE MARROW BIOPSIES | HCPCS | Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. |
99263 | Follow-up inpatient consult | HCPCS | Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. |
99261 | Follow-up inpatient consult | HCPCS | Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. |
99054 | MEDICAL SERVICES-UNUSUAL HRS | CPT | Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. |
38211 | Tumor cell deplete of harvst | HCPCS | Here are just a few examples of CPT codes:
- 90805 = outpatient psychotherapy
- 38221 = bone marrow biopsy, trocar or needle
- 38211 = tumor cell depletion
- 99261 - 99263 = follow-up inpatient consultation
- 99054 = services requested on holidays or Sundays
HCPCS (Healthcare Common Procedure Coding System). Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. |
J8700 | Temozolomide per 5 mg | HCPCS | Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes:
- J8700 = Temozolmide, oral, 5 mg.
- A0030 = Ambulance service, conventional air service, transport, one way
- JO530 = Injection of penicillin
- J3490 = Unclassified drugs
- P9010 = Blood (whole) for transfusion
To meet the standards set by HIPAA (Health Information Portability and Accounting Act), the Final Rule was instituted in 2000. |
J3490 | ZINC SULFATE 220MG 220MG CP | HCPCS | Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes:
- J8700 = Temozolmide, oral, 5 mg.
- A0030 = Ambulance service, conventional air service, transport, one way
- JO530 = Injection of penicillin
- J3490 = Unclassified drugs
- P9010 = Blood (whole) for transfusion
To meet the standards set by HIPAA (Health Information Portability and Accounting Act), the Final Rule was instituted in 2000. |
P9010 | WHOLE BLOOD FOR TRANSFUSION | HCPCS | Medical coders who work with Medicare or Medicaid must become proficient in HCPCS. Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes:
- J8700 = Temozolmide, oral, 5 mg.
- A0030 = Ambulance service, conventional air service, transport, one way
- JO530 = Injection of penicillin
- J3490 = Unclassified drugs
- P9010 = Blood (whole) for transfusion
To meet the standards set by HIPAA (Health Information Portability and Accounting Act), the Final Rule was instituted in 2000. |
J8700 | Temozolomide per 5 mg | HCPCS | Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes:
- J8700 = Temozolmide, oral, 5 mg.
- A0030 = Ambulance service, conventional air service, transport, one way
- JO530 = Injection of penicillin
- J3490 = Unclassified drugs
- P9010 = Blood (whole) for transfusion
To meet the standards set by HIPAA (Health Information Portability and Accounting Act), the Final Rule was instituted in 2000. It stated that the CPT and HCPCS codes are defined as procedure codes for "physician services, physical and occupational therapy services, radiological procedures, clinical laboratory tests, other medical diagnostic procedures, hearing and vision services and transportation services including ambulance." |
J3490 | ZINC SULFATE 220MG 220MG CP | HCPCS | Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes:
- J8700 = Temozolmide, oral, 5 mg.
- A0030 = Ambulance service, conventional air service, transport, one way
- JO530 = Injection of penicillin
- J3490 = Unclassified drugs
- P9010 = Blood (whole) for transfusion
To meet the standards set by HIPAA (Health Information Portability and Accounting Act), the Final Rule was instituted in 2000. It stated that the CPT and HCPCS codes are defined as procedure codes for "physician services, physical and occupational therapy services, radiological procedures, clinical laboratory tests, other medical diagnostic procedures, hearing and vision services and transportation services including ambulance." |
P9010 | WHOLE BLOOD FOR TRANSFUSION | HCPCS | Maintained by the American Medical Association, the HCPCS has two levels. CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes:
- J8700 = Temozolmide, oral, 5 mg.
- A0030 = Ambulance service, conventional air service, transport, one way
- JO530 = Injection of penicillin
- J3490 = Unclassified drugs
- P9010 = Blood (whole) for transfusion
To meet the standards set by HIPAA (Health Information Portability and Accounting Act), the Final Rule was instituted in 2000. It stated that the CPT and HCPCS codes are defined as procedure codes for "physician services, physical and occupational therapy services, radiological procedures, clinical laboratory tests, other medical diagnostic procedures, hearing and vision services and transportation services including ambulance." |
J8700 | Temozolomide per 5 mg | HCPCS | CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes:
- J8700 = Temozolmide, oral, 5 mg.
- A0030 = Ambulance service, conventional air service, transport, one way
- JO530 = Injection of penicillin
- J3490 = Unclassified drugs
- P9010 = Blood (whole) for transfusion
To meet the standards set by HIPAA (Health Information Portability and Accounting Act), the Final Rule was instituted in 2000. It stated that the CPT and HCPCS codes are defined as procedure codes for "physician services, physical and occupational therapy services, radiological procedures, clinical laboratory tests, other medical diagnostic procedures, hearing and vision services and transportation services including ambulance." (Source:American Medical Association)
You can learn more about CPT and HCPCS - including how codes are determined and new changes are made - at the American Medical Association's website by clicking here. |
J3490 | ZINC SULFATE 220MG 220MG CP | HCPCS | CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes:
- J8700 = Temozolmide, oral, 5 mg.
- A0030 = Ambulance service, conventional air service, transport, one way
- JO530 = Injection of penicillin
- J3490 = Unclassified drugs
- P9010 = Blood (whole) for transfusion
To meet the standards set by HIPAA (Health Information Portability and Accounting Act), the Final Rule was instituted in 2000. It stated that the CPT and HCPCS codes are defined as procedure codes for "physician services, physical and occupational therapy services, radiological procedures, clinical laboratory tests, other medical diagnostic procedures, hearing and vision services and transportation services including ambulance." (Source:American Medical Association)
You can learn more about CPT and HCPCS - including how codes are determined and new changes are made - at the American Medical Association's website by clicking here. |
P9010 | WHOLE BLOOD FOR TRANSFUSION | HCPCS | CPT procedure codes are level one, and HCPCS are level two. HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes:
- J8700 = Temozolmide, oral, 5 mg.
- A0030 = Ambulance service, conventional air service, transport, one way
- JO530 = Injection of penicillin
- J3490 = Unclassified drugs
- P9010 = Blood (whole) for transfusion
To meet the standards set by HIPAA (Health Information Portability and Accounting Act), the Final Rule was instituted in 2000. It stated that the CPT and HCPCS codes are defined as procedure codes for "physician services, physical and occupational therapy services, radiological procedures, clinical laboratory tests, other medical diagnostic procedures, hearing and vision services and transportation services including ambulance." (Source:American Medical Association)
You can learn more about CPT and HCPCS - including how codes are determined and new changes are made - at the American Medical Association's website by clicking here. |
J8700 | Temozolomide per 5 mg | HCPCS | HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes:
- J8700 = Temozolmide, oral, 5 mg.
- A0030 = Ambulance service, conventional air service, transport, one way
- JO530 = Injection of penicillin
- J3490 = Unclassified drugs
- P9010 = Blood (whole) for transfusion
To meet the standards set by HIPAA (Health Information Portability and Accounting Act), the Final Rule was instituted in 2000. It stated that the CPT and HCPCS codes are defined as procedure codes for "physician services, physical and occupational therapy services, radiological procedures, clinical laboratory tests, other medical diagnostic procedures, hearing and vision services and transportation services including ambulance." (Source:American Medical Association)
You can learn more about CPT and HCPCS - including how codes are determined and new changes are made - at the American Medical Association's website by clicking here. ICD-9. |
J3490 | ZINC SULFATE 220MG 220MG CP | HCPCS | HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes:
- J8700 = Temozolmide, oral, 5 mg.
- A0030 = Ambulance service, conventional air service, transport, one way
- JO530 = Injection of penicillin
- J3490 = Unclassified drugs
- P9010 = Blood (whole) for transfusion
To meet the standards set by HIPAA (Health Information Portability and Accounting Act), the Final Rule was instituted in 2000. It stated that the CPT and HCPCS codes are defined as procedure codes for "physician services, physical and occupational therapy services, radiological procedures, clinical laboratory tests, other medical diagnostic procedures, hearing and vision services and transportation services including ambulance." (Source:American Medical Association)
You can learn more about CPT and HCPCS - including how codes are determined and new changes are made - at the American Medical Association's website by clicking here. ICD-9. |
P9010 | WHOLE BLOOD FOR TRANSFUSION | HCPCS | HCPCS codes are all alphanumeric and include services, products and supplies - such as prosthetics and ambulance services - not covered in the CPT. Here are several examples of HCPCS codes:
- J8700 = Temozolmide, oral, 5 mg.
- A0030 = Ambulance service, conventional air service, transport, one way
- JO530 = Injection of penicillin
- J3490 = Unclassified drugs
- P9010 = Blood (whole) for transfusion
To meet the standards set by HIPAA (Health Information Portability and Accounting Act), the Final Rule was instituted in 2000. It stated that the CPT and HCPCS codes are defined as procedure codes for "physician services, physical and occupational therapy services, radiological procedures, clinical laboratory tests, other medical diagnostic procedures, hearing and vision services and transportation services including ambulance." (Source:American Medical Association)
You can learn more about CPT and HCPCS - including how codes are determined and new changes are made - at the American Medical Association's website by clicking here. ICD-9. |
J8700 | Temozolomide per 5 mg | HCPCS | Here are several examples of HCPCS codes:
- J8700 = Temozolmide, oral, 5 mg.
- A0030 = Ambulance service, conventional air service, transport, one way
- JO530 = Injection of penicillin
- J3490 = Unclassified drugs
- P9010 = Blood (whole) for transfusion
To meet the standards set by HIPAA (Health Information Portability and Accounting Act), the Final Rule was instituted in 2000. It stated that the CPT and HCPCS codes are defined as procedure codes for "physician services, physical and occupational therapy services, radiological procedures, clinical laboratory tests, other medical diagnostic procedures, hearing and vision services and transportation services including ambulance." (Source:American Medical Association)
You can learn more about CPT and HCPCS - including how codes are determined and new changes are made - at the American Medical Association's website by clicking here. ICD-9. According to the Final Rule, ICD-9 provides coding for diagnosis, procedures and inpatient hospital services. |
J3490 | ZINC SULFATE 220MG 220MG CP | HCPCS | Here are several examples of HCPCS codes:
- J8700 = Temozolmide, oral, 5 mg.
- A0030 = Ambulance service, conventional air service, transport, one way
- JO530 = Injection of penicillin
- J3490 = Unclassified drugs
- P9010 = Blood (whole) for transfusion
To meet the standards set by HIPAA (Health Information Portability and Accounting Act), the Final Rule was instituted in 2000. It stated that the CPT and HCPCS codes are defined as procedure codes for "physician services, physical and occupational therapy services, radiological procedures, clinical laboratory tests, other medical diagnostic procedures, hearing and vision services and transportation services including ambulance." (Source:American Medical Association)
You can learn more about CPT and HCPCS - including how codes are determined and new changes are made - at the American Medical Association's website by clicking here. ICD-9. According to the Final Rule, ICD-9 provides coding for diagnosis, procedures and inpatient hospital services. |
P9010 | WHOLE BLOOD FOR TRANSFUSION | HCPCS | Here are several examples of HCPCS codes:
- J8700 = Temozolmide, oral, 5 mg.
- A0030 = Ambulance service, conventional air service, transport, one way
- JO530 = Injection of penicillin
- J3490 = Unclassified drugs
- P9010 = Blood (whole) for transfusion
To meet the standards set by HIPAA (Health Information Portability and Accounting Act), the Final Rule was instituted in 2000. It stated that the CPT and HCPCS codes are defined as procedure codes for "physician services, physical and occupational therapy services, radiological procedures, clinical laboratory tests, other medical diagnostic procedures, hearing and vision services and transportation services including ambulance." (Source:American Medical Association)
You can learn more about CPT and HCPCS - including how codes are determined and new changes are made - at the American Medical Association's website by clicking here. ICD-9. According to the Final Rule, ICD-9 provides coding for diagnosis, procedures and inpatient hospital services. |
1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | HCPCS | - Why are CPT® codes also called HCPCS Level I codes? - Why are HCPCS Level II codes, which appear to represent everything but routine medical procedures, considered a national procedure code set? To understand the answers to these questions and gain a better grasp of HCPCS coding, you need to know how these two code sets came into existence. History of HCPCS Coding
The history of HCPCS coding began in 1978 when the federal government created this coding system to standardize the reporting of medical services to the federal government for reimbursement. The HCPCS system, however, underwent several changes before adoption by commercial payers, which was eventually mandated by HIPAA in 1996. |
1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | HCPCS | - Why are HCPCS Level II codes, which appear to represent everything but routine medical procedures, considered a national procedure code set? To understand the answers to these questions and gain a better grasp of HCPCS coding, you need to know how these two code sets came into existence. History of HCPCS Coding
The history of HCPCS coding began in 1978 when the federal government created this coding system to standardize the reporting of medical services to the federal government for reimbursement. The HCPCS system, however, underwent several changes before adoption by commercial payers, which was eventually mandated by HIPAA in 1996. Prior to the advent of procedure coding, providers submitted written descriptions of the services they performed to payers for reimbursement. |
1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | HCPCS | To understand the answers to these questions and gain a better grasp of HCPCS coding, you need to know how these two code sets came into existence. History of HCPCS Coding
The history of HCPCS coding began in 1978 when the federal government created this coding system to standardize the reporting of medical services to the federal government for reimbursement. The HCPCS system, however, underwent several changes before adoption by commercial payers, which was eventually mandated by HIPAA in 1996. Prior to the advent of procedure coding, providers submitted written descriptions of the services they performed to payers for reimbursement. This proved inefficient, in that 100 providers could report the same service with 100 different descriptions. |
1996 | Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration | HCPCS | The HCPCS system, however, underwent several changes before adoption by commercial payers, which was eventually mandated by HIPAA in 1996. Prior to the advent of procedure coding, providers submitted written descriptions of the services they performed to payers for reimbursement. This proved inefficient, in that 100 providers could report the same service with 100 different descriptions. The American Medical Association (AMA) was the first to tackle the problem. In efforts to standardize reporting of medical, surgical, and diagnostic services and procedures, the association created a coding system and introduced CPT® in 1966. |
J9355 | trastuzumab per 10 mg | HCPCS | HCPCS At A Glance
Among medical code sets—ICD-10, CPT®, and HCPCS Level II—HCPCS Level II is the most dynamic. CMS updates HCPCS Level II codes throughout the year, based on factors that include public input and feedback from providers, manufacturers, vendors, specialty societies, Blue Cross, and others. Further distinctions between CPT® codes (HCPCS Level I) and HCPCS Level II codes include:
||Period in Use
||Frequency of Updates
|HCPCS Level I: Current Procedural Terminology, Fourth Edition
||Procedures and services provided by physicians and other allied healthcare professionals
||5 numeric characters; some codes with a fifth alpha character
||1966 to present
||Yearly, in late summer or early fall for Jan. 1 implementation; some codes updated on Jan. 1 and July 1 for use six months later
|HCPCS Level II: National Healthcare Common Procedure Coding System
||Drugs, supplies, equipment, non-physician services and services not represented in CPT®
||5 characters, beginning with a letter and followed by 4 numbers
||1983 to present
||Yearly updates of the permanent code set, with quarterly updates of temporary codes
Structure of Level II HCPCS Codes
All HCPCS Level II codes consist of five characters, beginning with a letter—A through V—and followed by four numeric digits. The letter that begins the HCPCS Level II code represents the code chapter to which the HCPCS code belongs, thereby grouping similar items together. Some examples of HCPCS Level II codes include:
- J9355 — Injection, trastuzumab, excludes biosimilar, 10 mg
- G9631 — Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery
- C1823 — Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads
- V2599 — Contact lens, other type
The codes in each HCPCS code range are categorically referred to by the letter they begin with. |
V2599 | HB=CONTACT LENS SYNERGEYES ULTRAHEALTH PER LENS | HCPCS | HCPCS At A Glance
Among medical code sets—ICD-10, CPT®, and HCPCS Level II—HCPCS Level II is the most dynamic. CMS updates HCPCS Level II codes throughout the year, based on factors that include public input and feedback from providers, manufacturers, vendors, specialty societies, Blue Cross, and others. Further distinctions between CPT® codes (HCPCS Level I) and HCPCS Level II codes include:
||Period in Use
||Frequency of Updates
|HCPCS Level I: Current Procedural Terminology, Fourth Edition
||Procedures and services provided by physicians and other allied healthcare professionals
||5 numeric characters; some codes with a fifth alpha character
||1966 to present
||Yearly, in late summer or early fall for Jan. 1 implementation; some codes updated on Jan. 1 and July 1 for use six months later
|HCPCS Level II: National Healthcare Common Procedure Coding System
||Drugs, supplies, equipment, non-physician services and services not represented in CPT®
||5 characters, beginning with a letter and followed by 4 numbers
||1983 to present
||Yearly updates of the permanent code set, with quarterly updates of temporary codes
Structure of Level II HCPCS Codes
All HCPCS Level II codes consist of five characters, beginning with a letter—A through V—and followed by four numeric digits. The letter that begins the HCPCS Level II code represents the code chapter to which the HCPCS code belongs, thereby grouping similar items together. Some examples of HCPCS Level II codes include:
- J9355 — Injection, trastuzumab, excludes biosimilar, 10 mg
- G9631 — Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery
- C1823 — Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads
- V2599 — Contact lens, other type
The codes in each HCPCS code range are categorically referred to by the letter they begin with. |
C1823 | LEAD STIMULATION RESPISTIM R 20MMX50CM REMEDE | HCPCS | HCPCS At A Glance
Among medical code sets—ICD-10, CPT®, and HCPCS Level II—HCPCS Level II is the most dynamic. CMS updates HCPCS Level II codes throughout the year, based on factors that include public input and feedback from providers, manufacturers, vendors, specialty societies, Blue Cross, and others. Further distinctions between CPT® codes (HCPCS Level I) and HCPCS Level II codes include:
||Period in Use
||Frequency of Updates
|HCPCS Level I: Current Procedural Terminology, Fourth Edition
||Procedures and services provided by physicians and other allied healthcare professionals
||5 numeric characters; some codes with a fifth alpha character
||1966 to present
||Yearly, in late summer or early fall for Jan. 1 implementation; some codes updated on Jan. 1 and July 1 for use six months later
|HCPCS Level II: National Healthcare Common Procedure Coding System
||Drugs, supplies, equipment, non-physician services and services not represented in CPT®
||5 characters, beginning with a letter and followed by 4 numbers
||1983 to present
||Yearly updates of the permanent code set, with quarterly updates of temporary codes
Structure of Level II HCPCS Codes
All HCPCS Level II codes consist of five characters, beginning with a letter—A through V—and followed by four numeric digits. The letter that begins the HCPCS Level II code represents the code chapter to which the HCPCS code belongs, thereby grouping similar items together. Some examples of HCPCS Level II codes include:
- J9355 — Injection, trastuzumab, excludes biosimilar, 10 mg
- G9631 — Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery
- C1823 — Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads
- V2599 — Contact lens, other type
The codes in each HCPCS code range are categorically referred to by the letter they begin with. |
J9355 | trastuzumab per 10 mg | HCPCS | CMS updates HCPCS Level II codes throughout the year, based on factors that include public input and feedback from providers, manufacturers, vendors, specialty societies, Blue Cross, and others. Further distinctions between CPT® codes (HCPCS Level I) and HCPCS Level II codes include:
||Period in Use
||Frequency of Updates
|HCPCS Level I: Current Procedural Terminology, Fourth Edition
||Procedures and services provided by physicians and other allied healthcare professionals
||5 numeric characters; some codes with a fifth alpha character
||1966 to present
||Yearly, in late summer or early fall for Jan. 1 implementation; some codes updated on Jan. 1 and July 1 for use six months later
|HCPCS Level II: National Healthcare Common Procedure Coding System
||Drugs, supplies, equipment, non-physician services and services not represented in CPT®
||5 characters, beginning with a letter and followed by 4 numbers
||1983 to present
||Yearly updates of the permanent code set, with quarterly updates of temporary codes
Structure of Level II HCPCS Codes
All HCPCS Level II codes consist of five characters, beginning with a letter—A through V—and followed by four numeric digits. The letter that begins the HCPCS Level II code represents the code chapter to which the HCPCS code belongs, thereby grouping similar items together. Some examples of HCPCS Level II codes include:
- J9355 — Injection, trastuzumab, excludes biosimilar, 10 mg
- G9631 — Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery
- C1823 — Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads
- V2599 — Contact lens, other type
The codes in each HCPCS code range are categorically referred to by the letter they begin with. For example, codes beginning with the letter J—used to report non-orally administered medication and chemotherapy drugs—are called J codes. |
V2599 | HB=CONTACT LENS SYNERGEYES ULTRAHEALTH PER LENS | HCPCS | CMS updates HCPCS Level II codes throughout the year, based on factors that include public input and feedback from providers, manufacturers, vendors, specialty societies, Blue Cross, and others. Further distinctions between CPT® codes (HCPCS Level I) and HCPCS Level II codes include:
||Period in Use
||Frequency of Updates
|HCPCS Level I: Current Procedural Terminology, Fourth Edition
||Procedures and services provided by physicians and other allied healthcare professionals
||5 numeric characters; some codes with a fifth alpha character
||1966 to present
||Yearly, in late summer or early fall for Jan. 1 implementation; some codes updated on Jan. 1 and July 1 for use six months later
|HCPCS Level II: National Healthcare Common Procedure Coding System
||Drugs, supplies, equipment, non-physician services and services not represented in CPT®
||5 characters, beginning with a letter and followed by 4 numbers
||1983 to present
||Yearly updates of the permanent code set, with quarterly updates of temporary codes
Structure of Level II HCPCS Codes
All HCPCS Level II codes consist of five characters, beginning with a letter—A through V—and followed by four numeric digits. The letter that begins the HCPCS Level II code represents the code chapter to which the HCPCS code belongs, thereby grouping similar items together. Some examples of HCPCS Level II codes include:
- J9355 — Injection, trastuzumab, excludes biosimilar, 10 mg
- G9631 — Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery
- C1823 — Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads
- V2599 — Contact lens, other type
The codes in each HCPCS code range are categorically referred to by the letter they begin with. For example, codes beginning with the letter J—used to report non-orally administered medication and chemotherapy drugs—are called J codes. |
C1823 | LEAD STIMULATION RESPISTIM R 20MMX50CM REMEDE | HCPCS | CMS updates HCPCS Level II codes throughout the year, based on factors that include public input and feedback from providers, manufacturers, vendors, specialty societies, Blue Cross, and others. Further distinctions between CPT® codes (HCPCS Level I) and HCPCS Level II codes include:
||Period in Use
||Frequency of Updates
|HCPCS Level I: Current Procedural Terminology, Fourth Edition
||Procedures and services provided by physicians and other allied healthcare professionals
||5 numeric characters; some codes with a fifth alpha character
||1966 to present
||Yearly, in late summer or early fall for Jan. 1 implementation; some codes updated on Jan. 1 and July 1 for use six months later
|HCPCS Level II: National Healthcare Common Procedure Coding System
||Drugs, supplies, equipment, non-physician services and services not represented in CPT®
||5 characters, beginning with a letter and followed by 4 numbers
||1983 to present
||Yearly updates of the permanent code set, with quarterly updates of temporary codes
Structure of Level II HCPCS Codes
All HCPCS Level II codes consist of five characters, beginning with a letter—A through V—and followed by four numeric digits. The letter that begins the HCPCS Level II code represents the code chapter to which the HCPCS code belongs, thereby grouping similar items together. Some examples of HCPCS Level II codes include:
- J9355 — Injection, trastuzumab, excludes biosimilar, 10 mg
- G9631 — Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery
- C1823 — Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads
- V2599 — Contact lens, other type
The codes in each HCPCS code range are categorically referred to by the letter they begin with. For example, codes beginning with the letter J—used to report non-orally administered medication and chemotherapy drugs—are called J codes. |
J9355 | trastuzumab per 10 mg | HCPCS | Further distinctions between CPT® codes (HCPCS Level I) and HCPCS Level II codes include:
||Period in Use
||Frequency of Updates
|HCPCS Level I: Current Procedural Terminology, Fourth Edition
||Procedures and services provided by physicians and other allied healthcare professionals
||5 numeric characters; some codes with a fifth alpha character
||1966 to present
||Yearly, in late summer or early fall for Jan. 1 implementation; some codes updated on Jan. 1 and July 1 for use six months later
|HCPCS Level II: National Healthcare Common Procedure Coding System
||Drugs, supplies, equipment, non-physician services and services not represented in CPT®
||5 characters, beginning with a letter and followed by 4 numbers
||1983 to present
||Yearly updates of the permanent code set, with quarterly updates of temporary codes
Structure of Level II HCPCS Codes
All HCPCS Level II codes consist of five characters, beginning with a letter—A through V—and followed by four numeric digits. The letter that begins the HCPCS Level II code represents the code chapter to which the HCPCS code belongs, thereby grouping similar items together. Some examples of HCPCS Level II codes include:
- J9355 — Injection, trastuzumab, excludes biosimilar, 10 mg
- G9631 — Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery
- C1823 — Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads
- V2599 — Contact lens, other type
The codes in each HCPCS code range are categorically referred to by the letter they begin with. For example, codes beginning with the letter J—used to report non-orally administered medication and chemotherapy drugs—are called J codes. Incidentally, J codes are among the most commonly reported codes in the HCPCS Level II code set. |
V2599 | HB=CONTACT LENS SYNERGEYES ULTRAHEALTH PER LENS | HCPCS | Further distinctions between CPT® codes (HCPCS Level I) and HCPCS Level II codes include:
||Period in Use
||Frequency of Updates
|HCPCS Level I: Current Procedural Terminology, Fourth Edition
||Procedures and services provided by physicians and other allied healthcare professionals
||5 numeric characters; some codes with a fifth alpha character
||1966 to present
||Yearly, in late summer or early fall for Jan. 1 implementation; some codes updated on Jan. 1 and July 1 for use six months later
|HCPCS Level II: National Healthcare Common Procedure Coding System
||Drugs, supplies, equipment, non-physician services and services not represented in CPT®
||5 characters, beginning with a letter and followed by 4 numbers
||1983 to present
||Yearly updates of the permanent code set, with quarterly updates of temporary codes
Structure of Level II HCPCS Codes
All HCPCS Level II codes consist of five characters, beginning with a letter—A through V—and followed by four numeric digits. The letter that begins the HCPCS Level II code represents the code chapter to which the HCPCS code belongs, thereby grouping similar items together. Some examples of HCPCS Level II codes include:
- J9355 — Injection, trastuzumab, excludes biosimilar, 10 mg
- G9631 — Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery
- C1823 — Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads
- V2599 — Contact lens, other type
The codes in each HCPCS code range are categorically referred to by the letter they begin with. For example, codes beginning with the letter J—used to report non-orally administered medication and chemotherapy drugs—are called J codes. Incidentally, J codes are among the most commonly reported codes in the HCPCS Level II code set. |
C1823 | LEAD STIMULATION RESPISTIM R 20MMX50CM REMEDE | HCPCS | Further distinctions between CPT® codes (HCPCS Level I) and HCPCS Level II codes include:
||Period in Use
||Frequency of Updates
|HCPCS Level I: Current Procedural Terminology, Fourth Edition
||Procedures and services provided by physicians and other allied healthcare professionals
||5 numeric characters; some codes with a fifth alpha character
||1966 to present
||Yearly, in late summer or early fall for Jan. 1 implementation; some codes updated on Jan. 1 and July 1 for use six months later
|HCPCS Level II: National Healthcare Common Procedure Coding System
||Drugs, supplies, equipment, non-physician services and services not represented in CPT®
||5 characters, beginning with a letter and followed by 4 numbers
||1983 to present
||Yearly updates of the permanent code set, with quarterly updates of temporary codes
Structure of Level II HCPCS Codes
All HCPCS Level II codes consist of five characters, beginning with a letter—A through V—and followed by four numeric digits. The letter that begins the HCPCS Level II code represents the code chapter to which the HCPCS code belongs, thereby grouping similar items together. Some examples of HCPCS Level II codes include:
- J9355 — Injection, trastuzumab, excludes biosimilar, 10 mg
- G9631 — Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery
- C1823 — Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads
- V2599 — Contact lens, other type
The codes in each HCPCS code range are categorically referred to by the letter they begin with. For example, codes beginning with the letter J—used to report non-orally administered medication and chemotherapy drugs—are called J codes. Incidentally, J codes are among the most commonly reported codes in the HCPCS Level II code set. |
J9355 | trastuzumab per 10 mg | HCPCS | Some examples of HCPCS Level II codes include:
- J9355 — Injection, trastuzumab, excludes biosimilar, 10 mg
- G9631 — Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery
- C1823 — Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads
- V2599 — Contact lens, other type
The codes in each HCPCS code range are categorically referred to by the letter they begin with. For example, codes beginning with the letter J—used to report non-orally administered medication and chemotherapy drugs—are called J codes. Incidentally, J codes are among the most commonly reported codes in the HCPCS Level II code set. HCPCS CODES RANGE
How HCPCS Level II Codes Are Used
HCPCS Level II codes report what a provider used during a service provided to a patient to treat or assess a given diagnosis. As such, HCPCS codes are used in conjunction with CPT® and ICD-10 codes, as these three code sets are interdependent and come together in medical coding and billing, often in a single claim. |
V2599 | HB=CONTACT LENS SYNERGEYES ULTRAHEALTH PER LENS | HCPCS | Some examples of HCPCS Level II codes include:
- J9355 — Injection, trastuzumab, excludes biosimilar, 10 mg
- G9631 — Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery
- C1823 — Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads
- V2599 — Contact lens, other type
The codes in each HCPCS code range are categorically referred to by the letter they begin with. For example, codes beginning with the letter J—used to report non-orally administered medication and chemotherapy drugs—are called J codes. Incidentally, J codes are among the most commonly reported codes in the HCPCS Level II code set. HCPCS CODES RANGE
How HCPCS Level II Codes Are Used
HCPCS Level II codes report what a provider used during a service provided to a patient to treat or assess a given diagnosis. As such, HCPCS codes are used in conjunction with CPT® and ICD-10 codes, as these three code sets are interdependent and come together in medical coding and billing, often in a single claim. |
C1823 | LEAD STIMULATION RESPISTIM R 20MMX50CM REMEDE | HCPCS | Some examples of HCPCS Level II codes include:
- J9355 — Injection, trastuzumab, excludes biosimilar, 10 mg
- G9631 — Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery
- C1823 — Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads
- V2599 — Contact lens, other type
The codes in each HCPCS code range are categorically referred to by the letter they begin with. For example, codes beginning with the letter J—used to report non-orally administered medication and chemotherapy drugs—are called J codes. Incidentally, J codes are among the most commonly reported codes in the HCPCS Level II code set. HCPCS CODES RANGE
How HCPCS Level II Codes Are Used
HCPCS Level II codes report what a provider used during a service provided to a patient to treat or assess a given diagnosis. As such, HCPCS codes are used in conjunction with CPT® and ICD-10 codes, as these three code sets are interdependent and come together in medical coding and billing, often in a single claim. |
J9030 | HC Bcg Vaccine Tice Bu 1mg | HCPCS | A HCPCS code is then added to the claim (when required by the payer) to report products that may have been prescribed, injected, or otherwise delivered to the patient during the service. In general terms—with some exceptions—medical coders use the three code sets when submitting medical claims to report the following:
- CPT® codes: what the provider did. - HCPCS codes: what the provider used. - ICD-10-CM: why the provider 'did' and 'used'. For example, if a urologist diagnoses a patient with bladder cancer and performs a bladder instillation of 1 mg of Bacillus Calmette-Guerin (BCG) to treat the tumor, the medical coder might assign:
- CPT® codes (did): 51720 (Bladder instillation of anticarcinogenic agent (including retention time))
- HCPCS code (used): J9030 (BCG live intravesical instillation, 1mg)
- ICD-10 code (why): C67.9 (Malignant neoplasm of bladder, unspecified)
As mentioned above, though, there are some exceptions to these general code set concepts. |
51720 | Treatment of bladder lesion | HCPCS | A HCPCS code is then added to the claim (when required by the payer) to report products that may have been prescribed, injected, or otherwise delivered to the patient during the service. In general terms—with some exceptions—medical coders use the three code sets when submitting medical claims to report the following:
- CPT® codes: what the provider did. - HCPCS codes: what the provider used. - ICD-10-CM: why the provider 'did' and 'used'. For example, if a urologist diagnoses a patient with bladder cancer and performs a bladder instillation of 1 mg of Bacillus Calmette-Guerin (BCG) to treat the tumor, the medical coder might assign:
- CPT® codes (did): 51720 (Bladder instillation of anticarcinogenic agent (including retention time))
- HCPCS code (used): J9030 (BCG live intravesical instillation, 1mg)
- ICD-10 code (why): C67.9 (Malignant neoplasm of bladder, unspecified)
As mentioned above, though, there are some exceptions to these general code set concepts. |
J9030 | HC Bcg Vaccine Tice Bu 1mg | HCPCS | In general terms—with some exceptions—medical coders use the three code sets when submitting medical claims to report the following:
- CPT® codes: what the provider did. - HCPCS codes: what the provider used. - ICD-10-CM: why the provider 'did' and 'used'. For example, if a urologist diagnoses a patient with bladder cancer and performs a bladder instillation of 1 mg of Bacillus Calmette-Guerin (BCG) to treat the tumor, the medical coder might assign:
- CPT® codes (did): 51720 (Bladder instillation of anticarcinogenic agent (including retention time))
- HCPCS code (used): J9030 (BCG live intravesical instillation, 1mg)
- ICD-10 code (why): C67.9 (Malignant neoplasm of bladder, unspecified)
As mentioned above, though, there are some exceptions to these general code set concepts. WHEN TO CHOOSE CPT® Vs HCPCS
First, not all payers accept HCPCS Level II codes. |
51720 | Treatment of bladder lesion | HCPCS | In general terms—with some exceptions—medical coders use the three code sets when submitting medical claims to report the following:
- CPT® codes: what the provider did. - HCPCS codes: what the provider used. - ICD-10-CM: why the provider 'did' and 'used'. For example, if a urologist diagnoses a patient with bladder cancer and performs a bladder instillation of 1 mg of Bacillus Calmette-Guerin (BCG) to treat the tumor, the medical coder might assign:
- CPT® codes (did): 51720 (Bladder instillation of anticarcinogenic agent (including retention time))
- HCPCS code (used): J9030 (BCG live intravesical instillation, 1mg)
- ICD-10 code (why): C67.9 (Malignant neoplasm of bladder, unspecified)
As mentioned above, though, there are some exceptions to these general code set concepts. WHEN TO CHOOSE CPT® Vs HCPCS
First, not all payers accept HCPCS Level II codes. |
J9030 | HC Bcg Vaccine Tice Bu 1mg | HCPCS | - HCPCS codes: what the provider used. - ICD-10-CM: why the provider 'did' and 'used'. For example, if a urologist diagnoses a patient with bladder cancer and performs a bladder instillation of 1 mg of Bacillus Calmette-Guerin (BCG) to treat the tumor, the medical coder might assign:
- CPT® codes (did): 51720 (Bladder instillation of anticarcinogenic agent (including retention time))
- HCPCS code (used): J9030 (BCG live intravesical instillation, 1mg)
- ICD-10 code (why): C67.9 (Malignant neoplasm of bladder, unspecified)
As mentioned above, though, there are some exceptions to these general code set concepts. WHEN TO CHOOSE CPT® Vs HCPCS
First, not all payers accept HCPCS Level II codes. Initially intended for Medicare claims, many private payers have since adopted the HCPCS Level II code set. |
51720 | Treatment of bladder lesion | HCPCS | - HCPCS codes: what the provider used. - ICD-10-CM: why the provider 'did' and 'used'. For example, if a urologist diagnoses a patient with bladder cancer and performs a bladder instillation of 1 mg of Bacillus Calmette-Guerin (BCG) to treat the tumor, the medical coder might assign:
- CPT® codes (did): 51720 (Bladder instillation of anticarcinogenic agent (including retention time))
- HCPCS code (used): J9030 (BCG live intravesical instillation, 1mg)
- ICD-10 code (why): C67.9 (Malignant neoplasm of bladder, unspecified)
As mentioned above, though, there are some exceptions to these general code set concepts. WHEN TO CHOOSE CPT® Vs HCPCS
First, not all payers accept HCPCS Level II codes. Initially intended for Medicare claims, many private payers have since adopted the HCPCS Level II code set. |
J9030 | HC Bcg Vaccine Tice Bu 1mg | HCPCS | - ICD-10-CM: why the provider 'did' and 'used'. For example, if a urologist diagnoses a patient with bladder cancer and performs a bladder instillation of 1 mg of Bacillus Calmette-Guerin (BCG) to treat the tumor, the medical coder might assign:
- CPT® codes (did): 51720 (Bladder instillation of anticarcinogenic agent (including retention time))
- HCPCS code (used): J9030 (BCG live intravesical instillation, 1mg)
- ICD-10 code (why): C67.9 (Malignant neoplasm of bladder, unspecified)
As mentioned above, though, there are some exceptions to these general code set concepts. WHEN TO CHOOSE CPT® Vs HCPCS
First, not all payers accept HCPCS Level II codes. Initially intended for Medicare claims, many private payers have since adopted the HCPCS Level II code set. In fact, under the HIPAA requirement for standardized coding systems, HCPCS level II was selected for describing healthcare equipment and supplies not represented in CPT® due to its widespread commercial acceptance. |
51720 | Treatment of bladder lesion | HCPCS | - ICD-10-CM: why the provider 'did' and 'used'. For example, if a urologist diagnoses a patient with bladder cancer and performs a bladder instillation of 1 mg of Bacillus Calmette-Guerin (BCG) to treat the tumor, the medical coder might assign:
- CPT® codes (did): 51720 (Bladder instillation of anticarcinogenic agent (including retention time))
- HCPCS code (used): J9030 (BCG live intravesical instillation, 1mg)
- ICD-10 code (why): C67.9 (Malignant neoplasm of bladder, unspecified)
As mentioned above, though, there are some exceptions to these general code set concepts. WHEN TO CHOOSE CPT® Vs HCPCS
First, not all payers accept HCPCS Level II codes. Initially intended for Medicare claims, many private payers have since adopted the HCPCS Level II code set. In fact, under the HIPAA requirement for standardized coding systems, HCPCS level II was selected for describing healthcare equipment and supplies not represented in CPT® due to its widespread commercial acceptance. |
J9030 | HC Bcg Vaccine Tice Bu 1mg | HCPCS | For example, if a urologist diagnoses a patient with bladder cancer and performs a bladder instillation of 1 mg of Bacillus Calmette-Guerin (BCG) to treat the tumor, the medical coder might assign:
- CPT® codes (did): 51720 (Bladder instillation of anticarcinogenic agent (including retention time))
- HCPCS code (used): J9030 (BCG live intravesical instillation, 1mg)
- ICD-10 code (why): C67.9 (Malignant neoplasm of bladder, unspecified)
As mentioned above, though, there are some exceptions to these general code set concepts. WHEN TO CHOOSE CPT® Vs HCPCS
First, not all payers accept HCPCS Level II codes. Initially intended for Medicare claims, many private payers have since adopted the HCPCS Level II code set. In fact, under the HIPAA requirement for standardized coding systems, HCPCS level II was selected for describing healthcare equipment and supplies not represented in CPT® due to its widespread commercial acceptance. That said, the existence of a HCPCS Level II code does not indicate third-party coverage. |
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