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J7181 | Injection, factor xiii a-subunit, (recombinant), per iu | HCPCS | - Q9995 Injection, emicizumab-kxwh, 0.5 mg
Other HCPCS codes for blood-clotting factors and injections are
- J7170 Injection, emicizumab-kxwh, 0.5 mg
- J7175 Injection, factor X, (human), 1 IU
- J7179 Injection, von Willebrand factor (recombinant), (Vonvendi), 1 IU VWF:RCo
- J7180 Injection, factor XIII (antihemophilic factor, human), 1 IU
- J7181 Injection, factor XIII A-subunit, (recombinant), per IU
- J7182 Injection, factor VIII, (antihemophilic factor, recombinant), (NovoEight), per IU
- J7183 Injection, von Willebrand factor complex (human), Wilate, 1 IU vWF:RCo
- J7185 Injection, factor VIII (antihemophilic factor, recombinant) (Xyntha®), per IU
- J7186 Injection, antihemophilic factor VIII/von Willebrand factor complex (human), per
factor VIII IU
- J7187 Injection, von Willebrand factor complex (Humate-P®), per IU VWF:RCO
- J7188 Injection, factor VIII (antihemophilic factor, recombinant), (Obizur), per IU
- J7189 Factor VIIa (antihemophilic factor, recombinant), per 1 mcg
- J7190 Factor VIII (antihemophilic factor, human), per IU
- J7191 Factor VIII (antihemophilic factor (porcine)), per IU
- J7192 Factor VIII (antihemophilic factor, recombinant), per IU, not otherwise specified
- J7193 Factor IX (antihemophilic factor, purified, non-recombinant), per IU
- J7194 Factor IX, complex, per IU
- J7195 Injection, factor IX (antihemophilic factor, recombinant) per IU, not otherwise
- Q4096 Injection, Von Willebrand factor complex, human, ristocetin cofactor (not otherwise specified)
COVID-19 and Hemophilia
Hemophilia News Today has pointed out that individuals of any age with blood disorders such as hemophilia, porphyria, and sickle cell disease are at increased risk of developing serious COVID-19 symptoms and they should take extra precautions to minimize the risk of getting COVID-19. It is recommended that such patients keep their blood pressure in check and follow general guidelines to keep their immune system strong. To avoid getting infected by COVID-19, they should follow preventive measures such as stocking up on necessary medications and supplies that can last for a few weeks, avoid crowds and unnecessary travel, stay at home as much as possible and consult their healthcare providers in case of any COVID-19-like symptoms. Physicians treating COVID-19, hemophilia or any bleeding disorders can consider partnering with an experienced medical billing and coding company to assign the correct codes on medical claims. |
J7175 | Inj, factor x, (human), 1iu | HCPCS | - Q9995 Injection, emicizumab-kxwh, 0.5 mg
Other HCPCS codes for blood-clotting factors and injections are
- J7170 Injection, emicizumab-kxwh, 0.5 mg
- J7175 Injection, factor X, (human), 1 IU
- J7179 Injection, von Willebrand factor (recombinant), (Vonvendi), 1 IU VWF:RCo
- J7180 Injection, factor XIII (antihemophilic factor, human), 1 IU
- J7181 Injection, factor XIII A-subunit, (recombinant), per IU
- J7182 Injection, factor VIII, (antihemophilic factor, recombinant), (NovoEight), per IU
- J7183 Injection, von Willebrand factor complex (human), Wilate, 1 IU vWF:RCo
- J7185 Injection, factor VIII (antihemophilic factor, recombinant) (Xyntha®), per IU
- J7186 Injection, antihemophilic factor VIII/von Willebrand factor complex (human), per
factor VIII IU
- J7187 Injection, von Willebrand factor complex (Humate-P®), per IU VWF:RCO
- J7188 Injection, factor VIII (antihemophilic factor, recombinant), (Obizur), per IU
- J7189 Factor VIIa (antihemophilic factor, recombinant), per 1 mcg
- J7190 Factor VIII (antihemophilic factor, human), per IU
- J7191 Factor VIII (antihemophilic factor (porcine)), per IU
- J7192 Factor VIII (antihemophilic factor, recombinant), per IU, not otherwise specified
- J7193 Factor IX (antihemophilic factor, purified, non-recombinant), per IU
- J7194 Factor IX, complex, per IU
- J7195 Injection, factor IX (antihemophilic factor, recombinant) per IU, not otherwise
- Q4096 Injection, Von Willebrand factor complex, human, ristocetin cofactor (not otherwise specified)
COVID-19 and Hemophilia
Hemophilia News Today has pointed out that individuals of any age with blood disorders such as hemophilia, porphyria, and sickle cell disease are at increased risk of developing serious COVID-19 symptoms and they should take extra precautions to minimize the risk of getting COVID-19. It is recommended that such patients keep their blood pressure in check and follow general guidelines to keep their immune system strong. To avoid getting infected by COVID-19, they should follow preventive measures such as stocking up on necessary medications and supplies that can last for a few weeks, avoid crowds and unnecessary travel, stay at home as much as possible and consult their healthcare providers in case of any COVID-19-like symptoms. Physicians treating COVID-19, hemophilia or any bleeding disorders can consider partnering with an experienced medical billing and coding company to assign the correct codes on medical claims. |
Q9995 | INJ. EMICIZUMAB-KXWH, 0.5 MG | HCPCS | - Q9995 Injection, emicizumab-kxwh, 0.5 mg
Other HCPCS codes for blood-clotting factors and injections are
- J7170 Injection, emicizumab-kxwh, 0.5 mg
- J7175 Injection, factor X, (human), 1 IU
- J7179 Injection, von Willebrand factor (recombinant), (Vonvendi), 1 IU VWF:RCo
- J7180 Injection, factor XIII (antihemophilic factor, human), 1 IU
- J7181 Injection, factor XIII A-subunit, (recombinant), per IU
- J7182 Injection, factor VIII, (antihemophilic factor, recombinant), (NovoEight), per IU
- J7183 Injection, von Willebrand factor complex (human), Wilate, 1 IU vWF:RCo
- J7185 Injection, factor VIII (antihemophilic factor, recombinant) (Xyntha®), per IU
- J7186 Injection, antihemophilic factor VIII/von Willebrand factor complex (human), per
factor VIII IU
- J7187 Injection, von Willebrand factor complex (Humate-P®), per IU VWF:RCO
- J7188 Injection, factor VIII (antihemophilic factor, recombinant), (Obizur), per IU
- J7189 Factor VIIa (antihemophilic factor, recombinant), per 1 mcg
- J7190 Factor VIII (antihemophilic factor, human), per IU
- J7191 Factor VIII (antihemophilic factor (porcine)), per IU
- J7192 Factor VIII (antihemophilic factor, recombinant), per IU, not otherwise specified
- J7193 Factor IX (antihemophilic factor, purified, non-recombinant), per IU
- J7194 Factor IX, complex, per IU
- J7195 Injection, factor IX (antihemophilic factor, recombinant) per IU, not otherwise
- Q4096 Injection, Von Willebrand factor complex, human, ristocetin cofactor (not otherwise specified)
COVID-19 and Hemophilia
Hemophilia News Today has pointed out that individuals of any age with blood disorders such as hemophilia, porphyria, and sickle cell disease are at increased risk of developing serious COVID-19 symptoms and they should take extra precautions to minimize the risk of getting COVID-19. It is recommended that such patients keep their blood pressure in check and follow general guidelines to keep their immune system strong. To avoid getting infected by COVID-19, they should follow preventive measures such as stocking up on necessary medications and supplies that can last for a few weeks, avoid crowds and unnecessary travel, stay at home as much as possible and consult their healthcare providers in case of any COVID-19-like symptoms. Physicians treating COVID-19, hemophilia or any bleeding disorders can consider partnering with an experienced medical billing and coding company to assign the correct codes on medical claims. |
J7185 | Xyntha inj | HCPCS | - Q9995 Injection, emicizumab-kxwh, 0.5 mg
Other HCPCS codes for blood-clotting factors and injections are
- J7170 Injection, emicizumab-kxwh, 0.5 mg
- J7175 Injection, factor X, (human), 1 IU
- J7179 Injection, von Willebrand factor (recombinant), (Vonvendi), 1 IU VWF:RCo
- J7180 Injection, factor XIII (antihemophilic factor, human), 1 IU
- J7181 Injection, factor XIII A-subunit, (recombinant), per IU
- J7182 Injection, factor VIII, (antihemophilic factor, recombinant), (NovoEight), per IU
- J7183 Injection, von Willebrand factor complex (human), Wilate, 1 IU vWF:RCo
- J7185 Injection, factor VIII (antihemophilic factor, recombinant) (Xyntha®), per IU
- J7186 Injection, antihemophilic factor VIII/von Willebrand factor complex (human), per
factor VIII IU
- J7187 Injection, von Willebrand factor complex (Humate-P®), per IU VWF:RCO
- J7188 Injection, factor VIII (antihemophilic factor, recombinant), (Obizur), per IU
- J7189 Factor VIIa (antihemophilic factor, recombinant), per 1 mcg
- J7190 Factor VIII (antihemophilic factor, human), per IU
- J7191 Factor VIII (antihemophilic factor (porcine)), per IU
- J7192 Factor VIII (antihemophilic factor, recombinant), per IU, not otherwise specified
- J7193 Factor IX (antihemophilic factor, purified, non-recombinant), per IU
- J7194 Factor IX, complex, per IU
- J7195 Injection, factor IX (antihemophilic factor, recombinant) per IU, not otherwise
- Q4096 Injection, Von Willebrand factor complex, human, ristocetin cofactor (not otherwise specified)
COVID-19 and Hemophilia
Hemophilia News Today has pointed out that individuals of any age with blood disorders such as hemophilia, porphyria, and sickle cell disease are at increased risk of developing serious COVID-19 symptoms and they should take extra precautions to minimize the risk of getting COVID-19. It is recommended that such patients keep their blood pressure in check and follow general guidelines to keep their immune system strong. To avoid getting infected by COVID-19, they should follow preventive measures such as stocking up on necessary medications and supplies that can last for a few weeks, avoid crowds and unnecessary travel, stay at home as much as possible and consult their healthcare providers in case of any COVID-19-like symptoms. Physicians treating COVID-19, hemophilia or any bleeding disorders can consider partnering with an experienced medical billing and coding company to assign the correct codes on medical claims. |
J7182 | Injection, factor viii, (antihemophilic factor, recombinant), (novoeight), per iu | HCPCS | - Q9995 Injection, emicizumab-kxwh, 0.5 mg
Other HCPCS codes for blood-clotting factors and injections are
- J7170 Injection, emicizumab-kxwh, 0.5 mg
- J7175 Injection, factor X, (human), 1 IU
- J7179 Injection, von Willebrand factor (recombinant), (Vonvendi), 1 IU VWF:RCo
- J7180 Injection, factor XIII (antihemophilic factor, human), 1 IU
- J7181 Injection, factor XIII A-subunit, (recombinant), per IU
- J7182 Injection, factor VIII, (antihemophilic factor, recombinant), (NovoEight), per IU
- J7183 Injection, von Willebrand factor complex (human), Wilate, 1 IU vWF:RCo
- J7185 Injection, factor VIII (antihemophilic factor, recombinant) (Xyntha®), per IU
- J7186 Injection, antihemophilic factor VIII/von Willebrand factor complex (human), per
factor VIII IU
- J7187 Injection, von Willebrand factor complex (Humate-P®), per IU VWF:RCO
- J7188 Injection, factor VIII (antihemophilic factor, recombinant), (Obizur), per IU
- J7189 Factor VIIa (antihemophilic factor, recombinant), per 1 mcg
- J7190 Factor VIII (antihemophilic factor, human), per IU
- J7191 Factor VIII (antihemophilic factor (porcine)), per IU
- J7192 Factor VIII (antihemophilic factor, recombinant), per IU, not otherwise specified
- J7193 Factor IX (antihemophilic factor, purified, non-recombinant), per IU
- J7194 Factor IX, complex, per IU
- J7195 Injection, factor IX (antihemophilic factor, recombinant) per IU, not otherwise
- Q4096 Injection, Von Willebrand factor complex, human, ristocetin cofactor (not otherwise specified)
COVID-19 and Hemophilia
Hemophilia News Today has pointed out that individuals of any age with blood disorders such as hemophilia, porphyria, and sickle cell disease are at increased risk of developing serious COVID-19 symptoms and they should take extra precautions to minimize the risk of getting COVID-19. It is recommended that such patients keep their blood pressure in check and follow general guidelines to keep their immune system strong. To avoid getting infected by COVID-19, they should follow preventive measures such as stocking up on necessary medications and supplies that can last for a few weeks, avoid crowds and unnecessary travel, stay at home as much as possible and consult their healthcare providers in case of any COVID-19-like symptoms. Physicians treating COVID-19, hemophilia or any bleeding disorders can consider partnering with an experienced medical billing and coding company to assign the correct codes on medical claims. |
J7183 | Wilate injection | HCPCS | - Q9995 Injection, emicizumab-kxwh, 0.5 mg
Other HCPCS codes for blood-clotting factors and injections are
- J7170 Injection, emicizumab-kxwh, 0.5 mg
- J7175 Injection, factor X, (human), 1 IU
- J7179 Injection, von Willebrand factor (recombinant), (Vonvendi), 1 IU VWF:RCo
- J7180 Injection, factor XIII (antihemophilic factor, human), 1 IU
- J7181 Injection, factor XIII A-subunit, (recombinant), per IU
- J7182 Injection, factor VIII, (antihemophilic factor, recombinant), (NovoEight), per IU
- J7183 Injection, von Willebrand factor complex (human), Wilate, 1 IU vWF:RCo
- J7185 Injection, factor VIII (antihemophilic factor, recombinant) (Xyntha®), per IU
- J7186 Injection, antihemophilic factor VIII/von Willebrand factor complex (human), per
factor VIII IU
- J7187 Injection, von Willebrand factor complex (Humate-P®), per IU VWF:RCO
- J7188 Injection, factor VIII (antihemophilic factor, recombinant), (Obizur), per IU
- J7189 Factor VIIa (antihemophilic factor, recombinant), per 1 mcg
- J7190 Factor VIII (antihemophilic factor, human), per IU
- J7191 Factor VIII (antihemophilic factor (porcine)), per IU
- J7192 Factor VIII (antihemophilic factor, recombinant), per IU, not otherwise specified
- J7193 Factor IX (antihemophilic factor, purified, non-recombinant), per IU
- J7194 Factor IX, complex, per IU
- J7195 Injection, factor IX (antihemophilic factor, recombinant) per IU, not otherwise
- Q4096 Injection, Von Willebrand factor complex, human, ristocetin cofactor (not otherwise specified)
COVID-19 and Hemophilia
Hemophilia News Today has pointed out that individuals of any age with blood disorders such as hemophilia, porphyria, and sickle cell disease are at increased risk of developing serious COVID-19 symptoms and they should take extra precautions to minimize the risk of getting COVID-19. It is recommended that such patients keep their blood pressure in check and follow general guidelines to keep their immune system strong. To avoid getting infected by COVID-19, they should follow preventive measures such as stocking up on necessary medications and supplies that can last for a few weeks, avoid crowds and unnecessary travel, stay at home as much as possible and consult their healthcare providers in case of any COVID-19-like symptoms. Physicians treating COVID-19, hemophilia or any bleeding disorders can consider partnering with an experienced medical billing and coding company to assign the correct codes on medical claims. |
J7179 | VON WILLEBRAND FACTOR (RECOMB) 650 UNITS IV SOLR | HCPCS | - Q9995 Injection, emicizumab-kxwh, 0.5 mg
Other HCPCS codes for blood-clotting factors and injections are
- J7170 Injection, emicizumab-kxwh, 0.5 mg
- J7175 Injection, factor X, (human), 1 IU
- J7179 Injection, von Willebrand factor (recombinant), (Vonvendi), 1 IU VWF:RCo
- J7180 Injection, factor XIII (antihemophilic factor, human), 1 IU
- J7181 Injection, factor XIII A-subunit, (recombinant), per IU
- J7182 Injection, factor VIII, (antihemophilic factor, recombinant), (NovoEight), per IU
- J7183 Injection, von Willebrand factor complex (human), Wilate, 1 IU vWF:RCo
- J7185 Injection, factor VIII (antihemophilic factor, recombinant) (Xyntha®), per IU
- J7186 Injection, antihemophilic factor VIII/von Willebrand factor complex (human), per
factor VIII IU
- J7187 Injection, von Willebrand factor complex (Humate-P®), per IU VWF:RCO
- J7188 Injection, factor VIII (antihemophilic factor, recombinant), (Obizur), per IU
- J7189 Factor VIIa (antihemophilic factor, recombinant), per 1 mcg
- J7190 Factor VIII (antihemophilic factor, human), per IU
- J7191 Factor VIII (antihemophilic factor (porcine)), per IU
- J7192 Factor VIII (antihemophilic factor, recombinant), per IU, not otherwise specified
- J7193 Factor IX (antihemophilic factor, purified, non-recombinant), per IU
- J7194 Factor IX, complex, per IU
- J7195 Injection, factor IX (antihemophilic factor, recombinant) per IU, not otherwise
- Q4096 Injection, Von Willebrand factor complex, human, ristocetin cofactor (not otherwise specified)
COVID-19 and Hemophilia
Hemophilia News Today has pointed out that individuals of any age with blood disorders such as hemophilia, porphyria, and sickle cell disease are at increased risk of developing serious COVID-19 symptoms and they should take extra precautions to minimize the risk of getting COVID-19. It is recommended that such patients keep their blood pressure in check and follow general guidelines to keep their immune system strong. To avoid getting infected by COVID-19, they should follow preventive measures such as stocking up on necessary medications and supplies that can last for a few weeks, avoid crowds and unnecessary travel, stay at home as much as possible and consult their healthcare providers in case of any COVID-19-like symptoms. Physicians treating COVID-19, hemophilia or any bleeding disorders can consider partnering with an experienced medical billing and coding company to assign the correct codes on medical claims. |
J7170 | Inj., emicizumab-kxwh 0.5 mg | HCPCS | - Q9995 Injection, emicizumab-kxwh, 0.5 mg
Other HCPCS codes for blood-clotting factors and injections are
- J7170 Injection, emicizumab-kxwh, 0.5 mg
- J7175 Injection, factor X, (human), 1 IU
- J7179 Injection, von Willebrand factor (recombinant), (Vonvendi), 1 IU VWF:RCo
- J7180 Injection, factor XIII (antihemophilic factor, human), 1 IU
- J7181 Injection, factor XIII A-subunit, (recombinant), per IU
- J7182 Injection, factor VIII, (antihemophilic factor, recombinant), (NovoEight), per IU
- J7183 Injection, von Willebrand factor complex (human), Wilate, 1 IU vWF:RCo
- J7185 Injection, factor VIII (antihemophilic factor, recombinant) (Xyntha®), per IU
- J7186 Injection, antihemophilic factor VIII/von Willebrand factor complex (human), per
factor VIII IU
- J7187 Injection, von Willebrand factor complex (Humate-P®), per IU VWF:RCO
- J7188 Injection, factor VIII (antihemophilic factor, recombinant), (Obizur), per IU
- J7189 Factor VIIa (antihemophilic factor, recombinant), per 1 mcg
- J7190 Factor VIII (antihemophilic factor, human), per IU
- J7191 Factor VIII (antihemophilic factor (porcine)), per IU
- J7192 Factor VIII (antihemophilic factor, recombinant), per IU, not otherwise specified
- J7193 Factor IX (antihemophilic factor, purified, non-recombinant), per IU
- J7194 Factor IX, complex, per IU
- J7195 Injection, factor IX (antihemophilic factor, recombinant) per IU, not otherwise
- Q4096 Injection, Von Willebrand factor complex, human, ristocetin cofactor (not otherwise specified)
COVID-19 and Hemophilia
Hemophilia News Today has pointed out that individuals of any age with blood disorders such as hemophilia, porphyria, and sickle cell disease are at increased risk of developing serious COVID-19 symptoms and they should take extra precautions to minimize the risk of getting COVID-19. It is recommended that such patients keep their blood pressure in check and follow general guidelines to keep their immune system strong. To avoid getting infected by COVID-19, they should follow preventive measures such as stocking up on necessary medications and supplies that can last for a few weeks, avoid crowds and unnecessary travel, stay at home as much as possible and consult their healthcare providers in case of any COVID-19-like symptoms. Physicians treating COVID-19, hemophilia or any bleeding disorders can consider partnering with an experienced medical billing and coding company to assign the correct codes on medical claims. |
J7195 | Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified | HCPCS | - Q9995 Injection, emicizumab-kxwh, 0.5 mg
Other HCPCS codes for blood-clotting factors and injections are
- J7170 Injection, emicizumab-kxwh, 0.5 mg
- J7175 Injection, factor X, (human), 1 IU
- J7179 Injection, von Willebrand factor (recombinant), (Vonvendi), 1 IU VWF:RCo
- J7180 Injection, factor XIII (antihemophilic factor, human), 1 IU
- J7181 Injection, factor XIII A-subunit, (recombinant), per IU
- J7182 Injection, factor VIII, (antihemophilic factor, recombinant), (NovoEight), per IU
- J7183 Injection, von Willebrand factor complex (human), Wilate, 1 IU vWF:RCo
- J7185 Injection, factor VIII (antihemophilic factor, recombinant) (Xyntha®), per IU
- J7186 Injection, antihemophilic factor VIII/von Willebrand factor complex (human), per
factor VIII IU
- J7187 Injection, von Willebrand factor complex (Humate-P®), per IU VWF:RCO
- J7188 Injection, factor VIII (antihemophilic factor, recombinant), (Obizur), per IU
- J7189 Factor VIIa (antihemophilic factor, recombinant), per 1 mcg
- J7190 Factor VIII (antihemophilic factor, human), per IU
- J7191 Factor VIII (antihemophilic factor (porcine)), per IU
- J7192 Factor VIII (antihemophilic factor, recombinant), per IU, not otherwise specified
- J7193 Factor IX (antihemophilic factor, purified, non-recombinant), per IU
- J7194 Factor IX, complex, per IU
- J7195 Injection, factor IX (antihemophilic factor, recombinant) per IU, not otherwise
- Q4096 Injection, Von Willebrand factor complex, human, ristocetin cofactor (not otherwise specified)
COVID-19 and Hemophilia
Hemophilia News Today has pointed out that individuals of any age with blood disorders such as hemophilia, porphyria, and sickle cell disease are at increased risk of developing serious COVID-19 symptoms and they should take extra precautions to minimize the risk of getting COVID-19. It is recommended that such patients keep their blood pressure in check and follow general guidelines to keep their immune system strong. To avoid getting infected by COVID-19, they should follow preventive measures such as stocking up on necessary medications and supplies that can last for a few weeks, avoid crowds and unnecessary travel, stay at home as much as possible and consult their healthcare providers in case of any COVID-19-like symptoms. Physicians treating COVID-19, hemophilia or any bleeding disorders can consider partnering with an experienced medical billing and coding company to assign the correct codes on medical claims. |
J7194 | HC Profilnine Sd Phs Home | HCPCS | - Q9995 Injection, emicizumab-kxwh, 0.5 mg
Other HCPCS codes for blood-clotting factors and injections are
- J7170 Injection, emicizumab-kxwh, 0.5 mg
- J7175 Injection, factor X, (human), 1 IU
- J7179 Injection, von Willebrand factor (recombinant), (Vonvendi), 1 IU VWF:RCo
- J7180 Injection, factor XIII (antihemophilic factor, human), 1 IU
- J7181 Injection, factor XIII A-subunit, (recombinant), per IU
- J7182 Injection, factor VIII, (antihemophilic factor, recombinant), (NovoEight), per IU
- J7183 Injection, von Willebrand factor complex (human), Wilate, 1 IU vWF:RCo
- J7185 Injection, factor VIII (antihemophilic factor, recombinant) (Xyntha®), per IU
- J7186 Injection, antihemophilic factor VIII/von Willebrand factor complex (human), per
factor VIII IU
- J7187 Injection, von Willebrand factor complex (Humate-P®), per IU VWF:RCO
- J7188 Injection, factor VIII (antihemophilic factor, recombinant), (Obizur), per IU
- J7189 Factor VIIa (antihemophilic factor, recombinant), per 1 mcg
- J7190 Factor VIII (antihemophilic factor, human), per IU
- J7191 Factor VIII (antihemophilic factor (porcine)), per IU
- J7192 Factor VIII (antihemophilic factor, recombinant), per IU, not otherwise specified
- J7193 Factor IX (antihemophilic factor, purified, non-recombinant), per IU
- J7194 Factor IX, complex, per IU
- J7195 Injection, factor IX (antihemophilic factor, recombinant) per IU, not otherwise
- Q4096 Injection, Von Willebrand factor complex, human, ristocetin cofactor (not otherwise specified)
COVID-19 and Hemophilia
Hemophilia News Today has pointed out that individuals of any age with blood disorders such as hemophilia, porphyria, and sickle cell disease are at increased risk of developing serious COVID-19 symptoms and they should take extra precautions to minimize the risk of getting COVID-19. It is recommended that such patients keep their blood pressure in check and follow general guidelines to keep their immune system strong. To avoid getting infected by COVID-19, they should follow preventive measures such as stocking up on necessary medications and supplies that can last for a few weeks, avoid crowds and unnecessary travel, stay at home as much as possible and consult their healthcare providers in case of any COVID-19-like symptoms. Physicians treating COVID-19, hemophilia or any bleeding disorders can consider partnering with an experienced medical billing and coding company to assign the correct codes on medical claims. |
J7193 | HC Mononine-Tc/Phsa Home Phs | HCPCS | - Q9995 Injection, emicizumab-kxwh, 0.5 mg
Other HCPCS codes for blood-clotting factors and injections are
- J7170 Injection, emicizumab-kxwh, 0.5 mg
- J7175 Injection, factor X, (human), 1 IU
- J7179 Injection, von Willebrand factor (recombinant), (Vonvendi), 1 IU VWF:RCo
- J7180 Injection, factor XIII (antihemophilic factor, human), 1 IU
- J7181 Injection, factor XIII A-subunit, (recombinant), per IU
- J7182 Injection, factor VIII, (antihemophilic factor, recombinant), (NovoEight), per IU
- J7183 Injection, von Willebrand factor complex (human), Wilate, 1 IU vWF:RCo
- J7185 Injection, factor VIII (antihemophilic factor, recombinant) (Xyntha®), per IU
- J7186 Injection, antihemophilic factor VIII/von Willebrand factor complex (human), per
factor VIII IU
- J7187 Injection, von Willebrand factor complex (Humate-P®), per IU VWF:RCO
- J7188 Injection, factor VIII (antihemophilic factor, recombinant), (Obizur), per IU
- J7189 Factor VIIa (antihemophilic factor, recombinant), per 1 mcg
- J7190 Factor VIII (antihemophilic factor, human), per IU
- J7191 Factor VIII (antihemophilic factor (porcine)), per IU
- J7192 Factor VIII (antihemophilic factor, recombinant), per IU, not otherwise specified
- J7193 Factor IX (antihemophilic factor, purified, non-recombinant), per IU
- J7194 Factor IX, complex, per IU
- J7195 Injection, factor IX (antihemophilic factor, recombinant) per IU, not otherwise
- Q4096 Injection, Von Willebrand factor complex, human, ristocetin cofactor (not otherwise specified)
COVID-19 and Hemophilia
Hemophilia News Today has pointed out that individuals of any age with blood disorders such as hemophilia, porphyria, and sickle cell disease are at increased risk of developing serious COVID-19 symptoms and they should take extra precautions to minimize the risk of getting COVID-19. It is recommended that such patients keep their blood pressure in check and follow general guidelines to keep their immune system strong. To avoid getting infected by COVID-19, they should follow preventive measures such as stocking up on necessary medications and supplies that can last for a few weeks, avoid crowds and unnecessary travel, stay at home as much as possible and consult their healthcare providers in case of any COVID-19-like symptoms. Physicians treating COVID-19, hemophilia or any bleeding disorders can consider partnering with an experienced medical billing and coding company to assign the correct codes on medical claims. |
88384 | Eval molecular probes 11-50 | CPT | Neither CancerType ID® nor miRview® (or Rosetta Cancer Origin™) have been submitted to FDA for approval. Gene expression profiling is considered investigational to evaluate the site of origin of a tumor of unknown primary, or to distinguish a primary from a metastatic tumor. Effective in July 2013, there is a specific CPT coding for the Pathwork Tissue of Origin test:
81504 - Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as tissue similarity scores
Prior to July 2013, the preparation of the probes might have been coded using a combination of the molecular diagnostic codes 83890-83913 and the analysis of the probes might have been coded using array-based evaluation of multiple molecular probes codes 88384-88386 based on the number of probes analyzed. Prior to July 2013, Pathwork Diagnostics stated that they used 84999 (unlisted chemistry procedure). The other tests described below do not have specific CPT codes. |
88384 | Eval molecular probes 11-50 | CPT | Gene expression profiling is considered investigational to evaluate the site of origin of a tumor of unknown primary, or to distinguish a primary from a metastatic tumor. Effective in July 2013, there is a specific CPT coding for the Pathwork Tissue of Origin test:
81504 - Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as tissue similarity scores
Prior to July 2013, the preparation of the probes might have been coded using a combination of the molecular diagnostic codes 83890-83913 and the analysis of the probes might have been coded using array-based evaluation of multiple molecular probes codes 88384-88386 based on the number of probes analyzed. Prior to July 2013, Pathwork Diagnostics stated that they used 84999 (unlisted chemistry procedure). The other tests described below do not have specific CPT codes. If the test result is calculated using an algorithm and reported as a numeric score(s) or as a probability, the unlisted multianalyte assays with algorithmic analyses code 81599 would be reported. |
81599 | Unlisted multianalyte assay with algorithmic analysis | CPT | Gene expression profiling is considered investigational to evaluate the site of origin of a tumor of unknown primary, or to distinguish a primary from a metastatic tumor. Effective in July 2013, there is a specific CPT coding for the Pathwork Tissue of Origin test:
81504 - Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as tissue similarity scores
Prior to July 2013, the preparation of the probes might have been coded using a combination of the molecular diagnostic codes 83890-83913 and the analysis of the probes might have been coded using array-based evaluation of multiple molecular probes codes 88384-88386 based on the number of probes analyzed. Prior to July 2013, Pathwork Diagnostics stated that they used 84999 (unlisted chemistry procedure). The other tests described below do not have specific CPT codes. If the test result is calculated using an algorithm and reported as a numeric score(s) or as a probability, the unlisted multianalyte assays with algorithmic analyses code 81599 would be reported. |
88384 | Eval molecular probes 11-50 | CPT | Effective in July 2013, there is a specific CPT coding for the Pathwork Tissue of Origin test:
81504 - Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as tissue similarity scores
Prior to July 2013, the preparation of the probes might have been coded using a combination of the molecular diagnostic codes 83890-83913 and the analysis of the probes might have been coded using array-based evaluation of multiple molecular probes codes 88384-88386 based on the number of probes analyzed. Prior to July 2013, Pathwork Diagnostics stated that they used 84999 (unlisted chemistry procedure). The other tests described below do not have specific CPT codes. If the test result is calculated using an algorithm and reported as a numeric score(s) or as a probability, the unlisted multianalyte assays with algorithmic analyses code 81599 would be reported. If not, the unlisted molecular pathology code 81479 would be reported. |
81599 | Unlisted multianalyte assay with algorithmic analysis | CPT | Effective in July 2013, there is a specific CPT coding for the Pathwork Tissue of Origin test:
81504 - Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as tissue similarity scores
Prior to July 2013, the preparation of the probes might have been coded using a combination of the molecular diagnostic codes 83890-83913 and the analysis of the probes might have been coded using array-based evaluation of multiple molecular probes codes 88384-88386 based on the number of probes analyzed. Prior to July 2013, Pathwork Diagnostics stated that they used 84999 (unlisted chemistry procedure). The other tests described below do not have specific CPT codes. If the test result is calculated using an algorithm and reported as a numeric score(s) or as a probability, the unlisted multianalyte assays with algorithmic analyses code 81599 would be reported. If not, the unlisted molecular pathology code 81479 would be reported. |
81599 | Unlisted multianalyte assay with algorithmic analysis | CPT | Prior to July 2013, Pathwork Diagnostics stated that they used 84999 (unlisted chemistry procedure). The other tests described below do not have specific CPT codes. If the test result is calculated using an algorithm and reported as a numeric score(s) or as a probability, the unlisted multianalyte assays with algorithmic analyses code 81599 would be reported. If not, the unlisted molecular pathology code 81479 would be reported. BlueCard/National Account Issues
State or federal mandates (e.g., FEP) may dictate that all FDA-approved devices may not be considered investigational and thus these devices may be assessed only on the basis of their medical necessity. |
81599 | Unlisted multianalyte assay with algorithmic analysis | CPT | The other tests described below do not have specific CPT codes. If the test result is calculated using an algorithm and reported as a numeric score(s) or as a probability, the unlisted multianalyte assays with algorithmic analyses code 81599 would be reported. If not, the unlisted molecular pathology code 81479 would be reported. BlueCard/National Account Issues
State or federal mandates (e.g., FEP) may dictate that all FDA-approved devices may not be considered investigational and thus these devices may be assessed only on the basis of their medical necessity. This policy was created in December 2008 and has been updated annually. |
90850 | nan | CPT | Cancers of unknown primary site: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. Sep 2011;22 Suppl 6:vi64-68. PMID 21908507
|CPT||81504||Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as tissue similarity scores|
|ICD-9 Diagnosis||Investigational for all codes|
|ICD-10-CM (effective 10/1/15)||Investigational for all relevant diagnoses|
|C79.9||Secondary malignant neoplasm of unspecified site|
|C80.0||Disseminated malignant neoplasm, unspecified|
|C80.1||Malignant (primary) neoplasm, unspecified|
|ICD-10-PCS (effective 10/1/15)||Not applicable. ICD-10-PCS codes are only used for inpatient services. |
90850 | nan | CPT | Ann Oncol. Sep 2011;22 Suppl 6:vi64-68. PMID 21908507
|CPT||81504||Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as tissue similarity scores|
|ICD-9 Diagnosis||Investigational for all codes|
|ICD-10-CM (effective 10/1/15)||Investigational for all relevant diagnoses|
|C79.9||Secondary malignant neoplasm of unspecified site|
|C80.0||Disseminated malignant neoplasm, unspecified|
|C80.1||Malignant (primary) neoplasm, unspecified|
|ICD-10-PCS (effective 10/1/15)||Not applicable. ICD-10-PCS codes are only used for inpatient services. There are no ICD procedure codes for laboratory tests.|
|Type of Service||Pathology/Laboratory|
|Place of Service||Laboratory/Reference Laboratory|
Pathwork Tissue of Unknown Origin
Add to Medicine section
|12/03/09||Replace policy||Policy updated with literature search; reference 12 added, reference 13 updated. |
90850 | nan | CPT | Sep 2011;22 Suppl 6:vi64-68. PMID 21908507
|CPT||81504||Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as tissue similarity scores|
|ICD-9 Diagnosis||Investigational for all codes|
|ICD-10-CM (effective 10/1/15)||Investigational for all relevant diagnoses|
|C79.9||Secondary malignant neoplasm of unspecified site|
|C80.0||Disseminated malignant neoplasm, unspecified|
|C80.1||Malignant (primary) neoplasm, unspecified|
|ICD-10-PCS (effective 10/1/15)||Not applicable. ICD-10-PCS codes are only used for inpatient services. There are no ICD procedure codes for laboratory tests.|
|Type of Service||Pathology/Laboratory|
|Place of Service||Laboratory/Reference Laboratory|
Pathwork Tissue of Unknown Origin
Add to Medicine section
|12/03/09||Replace policy||Policy updated with literature search; reference 12 added, reference 13 updated. No change to policy statement|
|11/11/10||Replace policy||Policy updated with literature search; reference 12 added, reference 1 and 13 updated; new test for formalin-fixed paraffin-embedded (FFPE) specimens added as investigational, no change to existing policy statement|
|11/10/11||Replace policy||Policy updated with literature search; references 11, 12 and 14 added. |
90850 | nan | CPT | PMID 21908507
|CPT||81504||Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin embedded tissue, algorithm reported as tissue similarity scores|
|ICD-9 Diagnosis||Investigational for all codes|
|ICD-10-CM (effective 10/1/15)||Investigational for all relevant diagnoses|
|C79.9||Secondary malignant neoplasm of unspecified site|
|C80.0||Disseminated malignant neoplasm, unspecified|
|C80.1||Malignant (primary) neoplasm, unspecified|
|ICD-10-PCS (effective 10/1/15)||Not applicable. ICD-10-PCS codes are only used for inpatient services. There are no ICD procedure codes for laboratory tests.|
|Type of Service||Pathology/Laboratory|
|Place of Service||Laboratory/Reference Laboratory|
Pathwork Tissue of Unknown Origin
Add to Medicine section
|12/03/09||Replace policy||Policy updated with literature search; reference 12 added, reference 13 updated. No change to policy statement|
|11/11/10||Replace policy||Policy updated with literature search; reference 12 added, reference 1 and 13 updated; new test for formalin-fixed paraffin-embedded (FFPE) specimens added as investigational, no change to existing policy statement|
|11/10/11||Replace policy||Policy updated with literature search; references 11, 12 and 14 added. No change to policy statement.|
|11/08/12||Replace policy||Policy updated with literature search; references 14- 21 added. |
00100 | ANESTH SALIVARY GLAND | CPT | The more than 7,000 five-character CPT Codes are an important part of the billing process. They are used by insurers to aid in determining the amount of reimbursement the physician or healthcare provider will receive for services rendered. CPT Codes are copyrighted and maintained by the American Medical Association (AMA). Updated annually, these codes fall into three major categories. - Category I- The codes range is 00100 to 99499. |
00100 | ANESTH SALIVARY GLAND | CPT | CPT Codes are copyrighted and maintained by the American Medical Association (AMA). Updated annually, these codes fall into three major categories. - Category I- The codes range is 00100 to 99499. Each five-digit code has a corresponding description of the procedure or service. - Category II – These are more of alphanumeric tracking codes to describe clinical components in clinic services or evaluation and management. |
1999 | ANESTHESIOLOGY GROUP | CPT | CPT codes help government agencies keep tabs on the value and prevalence of particular procedures whereas hospitals may evaluate the efficiency of divisions and individuals in their facility using Current Procedural Terminology Codes. CPT Code Categories
Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA, and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
- Evaluation and Management (99201-99499) – which includes hospital observation services, office and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. - Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, infrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. |
00100 | ANESTH SALIVARY GLAND | CPT | CPT codes help government agencies keep tabs on the value and prevalence of particular procedures whereas hospitals may evaluate the efficiency of divisions and individuals in their facility using Current Procedural Terminology Codes. CPT Code Categories
Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA, and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
- Evaluation and Management (99201-99499) – which includes hospital observation services, office and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. - Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, infrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. |
01999 | Unlisted anesth procedure | CPT | CPT codes help government agencies keep tabs on the value and prevalence of particular procedures whereas hospitals may evaluate the efficiency of divisions and individuals in their facility using Current Procedural Terminology Codes. CPT Code Categories
Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA, and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
- Evaluation and Management (99201-99499) – which includes hospital observation services, office and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. - Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, infrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. |
1999 | ANESTHESIOLOGY GROUP | CPT | CPT Code Categories
Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA, and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
- Evaluation and Management (99201-99499) – which includes hospital observation services, office and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. - Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, infrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. - Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few. |
00100 | ANESTH SALIVARY GLAND | CPT | CPT Code Categories
Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA, and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
- Evaluation and Management (99201-99499) – which includes hospital observation services, office and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. - Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, infrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. - Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few. |
10000 | Incision & drainage of sebaceous cyst-one | CPT | CPT Code Categories
Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA, and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
- Evaluation and Management (99201-99499) – which includes hospital observation services, office and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. - Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, infrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. - Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few. |
01999 | Unlisted anesth procedure | CPT | CPT Code Categories
Category I is concerning procedures and contemporary medical practices performed across the United States. This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA, and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
- Evaluation and Management (99201-99499) – which includes hospital observation services, office and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. - Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, infrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. - Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few. |
1999 | ANESTHESIOLOGY GROUP | CPT | This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA, and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
- Evaluation and Management (99201-99499) – which includes hospital observation services, office and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. - Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, infrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. - Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few. - Radiology (70000-79999) –including ultrasound, mammography, bone/joint, oncology and nuclear medicine. |
00100 | ANESTH SALIVARY GLAND | CPT | This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA, and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
- Evaluation and Management (99201-99499) – which includes hospital observation services, office and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. - Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, infrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. - Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few. - Radiology (70000-79999) –including ultrasound, mammography, bone/joint, oncology and nuclear medicine. |
10000 | Incision & drainage of sebaceous cyst-one | CPT | This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA, and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
- Evaluation and Management (99201-99499) – which includes hospital observation services, office and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. - Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, infrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. - Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few. - Radiology (70000-79999) –including ultrasound, mammography, bone/joint, oncology and nuclear medicine. |
01999 | Unlisted anesth procedure | CPT | This category is generally identified with the 5-character CPT Codes that identify a service or procedure sanctioned by the FDA, and performed by a physician or healthcare professional. This category is broken down into six sections and they are:
- Evaluation and Management (99201-99499) – which includes hospital observation services, office and other outpatient services, consultations, hospital inpatient services, emergency department, critical care services, nursing facility services, custodial care services and so on. - Anesthesiology (00100–01999; 99100–99150) – which includes procedures of the head, neck, thorax, infrathoracic, spine and spinal column, upper and lower abdomen, obstetrics and more. - Surgery (10000–69990) – which includes general surgery, integumentary system, musculoskeletal system, respiratory system, cardiovascular system, digestive system, urinary system, eye and reproductive, to name a few. - Radiology (70000-79999) –including ultrasound, mammography, bone/joint, oncology and nuclear medicine. |
99199 | Unlisted special svc px/rprt | CPT | - Radiology (70000-79999) –including ultrasound, mammography, bone/joint, oncology and nuclear medicine. - Pathology and Laboratory (80000–89398) – including organ or disease-oriented panels, drug testing, therapeutic drug assays, evocative/suppression testing, consultations (clinical pathology), urinalysis, transfusion medicine, microbiology and more. - Medicine (90281–99099; 99151–99199; 99500–99607) – including vaccines, toxoids, psychiatry, biofeedback, dialysis, gastroenterology, ophthalmology, special otorhinolaryngologic services, cardiovascular, noninvasive vascular diagnostic studies, pulmonary, allergy and clinical immunology, endocrinology and more. Category II pertains to clinical laboratory services. CPT codes for this category consist of secondary tracking codes employed for collecting information regarding quality of care rendered, and performance measurement. |
99199 | Unlisted special svc px/rprt | CPT | - Medicine (90281–99099; 99151–99199; 99500–99607) – including vaccines, toxoids, psychiatry, biofeedback, dialysis, gastroenterology, ophthalmology, special otorhinolaryngologic services, cardiovascular, noninvasive vascular diagnostic studies, pulmonary, allergy and clinical immunology, endocrinology and more. Category II pertains to clinical laboratory services. CPT codes for this category consist of secondary tracking codes employed for collecting information regarding quality of care rendered, and performance measurement. The use of these codes is not mandatory. Breakdown of Category II CPT Codes are:
- Composite Measures (0001F-0015F)
- Patient Management (0500F-0575F)
- Patient History (1000F-1220F)
- Physical Examination (2000F-2050F)
- Diagnostic/Screening Processes or Results (3006F-3573F)
- Therapeutic, Preventive or Other Interventions (4000F-4306F)
- Follow-up or Other Outcomes (5005F-5100F)
- Patient Safety (6005F-6045F)
- Structural Measures (7010F-7025F)
Category III is reserved for emerging technologies, with CPT codes of 0016T-0207T. |
20987 | Cptr-asst dir ms px pre img | CPT | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY1/17/2008: Policy added
12/29/2008: Code reference section updated per the 2009 CPT/HCPCS revisions
1/8/2009: Policy reviewed, no changes
6/23/2010: Description section revised. FEP verbiage was added to Policy Exceptions section. Code Reference section revised to remove CPT Codes 20986 and 20987 because the codes were deleted 12/31/2008. |
20986 | Cptr-asst dir ms px io img | CPT | In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY1/17/2008: Policy added
12/29/2008: Code reference section updated per the 2009 CPT/HCPCS revisions
1/8/2009: Policy reviewed, no changes
6/23/2010: Description section revised. FEP verbiage was added to Policy Exceptions section. Code Reference section revised to remove CPT Codes 20986 and 20987 because the codes were deleted 12/31/2008. |
96379 | HC THER/PRO/DIAG INJ/INF PRO | HCPCS | RiaSTAP is available as single-use vials containing 900 to 1,300 mg lyophilized fibrinogen concentrate powder for reconstitution. Actual fibrinogen potency for each lot is printed on vial label and carton. The dosing of RiaSTAP is as follows (Israels, 2009; CSL Behring US Package Insert, 2009):
|CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|ICD-10 codes will become effective as of October 1, 2015:|
|Other CPT codes related to the CPB:|
|96374||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug|
|96375||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)|
|96376||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)|
|96379||Unlisted therapeutic; prophylactic, or diagnostic intravenous or intra-arterial injection or infusion|
|HCPCS codes covered if selection criteria are met:|
|J7178||Injection, human fibrinogen concentrate, 1mg|
|ICD-10 codes covered if selection criteria are met:|
|D68.2||Hereditary deficiency of other clotting factors|
|ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):|
|D65||Disseminated intravascular coagulation [defibrination syndrome]|
|D78.01 - D78.02
D78.21 - D78.22
E36.01 - E36.02
G97.31 - G97.32
G97.51 - G97.52
H59.111 - H59.129
H59.311 - H59.312
|Hemorrhage and hematoma complicating a procedure|
|O72.0 - O72.3||Postpartum hemorrhage|
|O86.0, O90.2||Other complications of obstetrical surgical wounds| |
96375 | TX/PRO/DX INJ NEW DRUG ADDON | HCPCS | RiaSTAP is available as single-use vials containing 900 to 1,300 mg lyophilized fibrinogen concentrate powder for reconstitution. Actual fibrinogen potency for each lot is printed on vial label and carton. The dosing of RiaSTAP is as follows (Israels, 2009; CSL Behring US Package Insert, 2009):
|CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|ICD-10 codes will become effective as of October 1, 2015:|
|Other CPT codes related to the CPB:|
|96374||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug|
|96375||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)|
|96376||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)|
|96379||Unlisted therapeutic; prophylactic, or diagnostic intravenous or intra-arterial injection or infusion|
|HCPCS codes covered if selection criteria are met:|
|J7178||Injection, human fibrinogen concentrate, 1mg|
|ICD-10 codes covered if selection criteria are met:|
|D68.2||Hereditary deficiency of other clotting factors|
|ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):|
|D65||Disseminated intravascular coagulation [defibrination syndrome]|
|D78.01 - D78.02
D78.21 - D78.22
E36.01 - E36.02
G97.31 - G97.32
G97.51 - G97.52
H59.111 - H59.129
H59.311 - H59.312
|Hemorrhage and hematoma complicating a procedure|
|O72.0 - O72.3||Postpartum hemorrhage|
|O86.0, O90.2||Other complications of obstetrical surgical wounds| |
96374 | THER/PROPH/DIAG INJ IV PUSH | HCPCS | RiaSTAP is available as single-use vials containing 900 to 1,300 mg lyophilized fibrinogen concentrate powder for reconstitution. Actual fibrinogen potency for each lot is printed on vial label and carton. The dosing of RiaSTAP is as follows (Israels, 2009; CSL Behring US Package Insert, 2009):
|CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|ICD-10 codes will become effective as of October 1, 2015:|
|Other CPT codes related to the CPB:|
|96374||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug|
|96375||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)|
|96376||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)|
|96379||Unlisted therapeutic; prophylactic, or diagnostic intravenous or intra-arterial injection or infusion|
|HCPCS codes covered if selection criteria are met:|
|J7178||Injection, human fibrinogen concentrate, 1mg|
|ICD-10 codes covered if selection criteria are met:|
|D68.2||Hereditary deficiency of other clotting factors|
|ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):|
|D65||Disseminated intravascular coagulation [defibrination syndrome]|
|D78.01 - D78.02
D78.21 - D78.22
E36.01 - E36.02
G97.31 - G97.32
G97.51 - G97.52
H59.111 - H59.129
H59.311 - H59.312
|Hemorrhage and hematoma complicating a procedure|
|O72.0 - O72.3||Postpartum hemorrhage|
|O86.0, O90.2||Other complications of obstetrical surgical wounds| |
J7178 | Inj human fibrinogen con nos | HCPCS | RiaSTAP is available as single-use vials containing 900 to 1,300 mg lyophilized fibrinogen concentrate powder for reconstitution. Actual fibrinogen potency for each lot is printed on vial label and carton. The dosing of RiaSTAP is as follows (Israels, 2009; CSL Behring US Package Insert, 2009):
|CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|ICD-10 codes will become effective as of October 1, 2015:|
|Other CPT codes related to the CPB:|
|96374||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug|
|96375||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)|
|96376||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)|
|96379||Unlisted therapeutic; prophylactic, or diagnostic intravenous or intra-arterial injection or infusion|
|HCPCS codes covered if selection criteria are met:|
|J7178||Injection, human fibrinogen concentrate, 1mg|
|ICD-10 codes covered if selection criteria are met:|
|D68.2||Hereditary deficiency of other clotting factors|
|ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):|
|D65||Disseminated intravascular coagulation [defibrination syndrome]|
|D78.01 - D78.02
D78.21 - D78.22
E36.01 - E36.02
G97.31 - G97.32
G97.51 - G97.52
H59.111 - H59.129
H59.311 - H59.312
|Hemorrhage and hematoma complicating a procedure|
|O72.0 - O72.3||Postpartum hemorrhage|
|O86.0, O90.2||Other complications of obstetrical surgical wounds| |
96376 | TX/PRO/DX INJ SAME DRUG ADON | HCPCS | RiaSTAP is available as single-use vials containing 900 to 1,300 mg lyophilized fibrinogen concentrate powder for reconstitution. Actual fibrinogen potency for each lot is printed on vial label and carton. The dosing of RiaSTAP is as follows (Israels, 2009; CSL Behring US Package Insert, 2009):
|CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|ICD-10 codes will become effective as of October 1, 2015:|
|Other CPT codes related to the CPB:|
|96374||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug|
|96375||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)|
|96376||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)|
|96379||Unlisted therapeutic; prophylactic, or diagnostic intravenous or intra-arterial injection or infusion|
|HCPCS codes covered if selection criteria are met:|
|J7178||Injection, human fibrinogen concentrate, 1mg|
|ICD-10 codes covered if selection criteria are met:|
|D68.2||Hereditary deficiency of other clotting factors|
|ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):|
|D65||Disseminated intravascular coagulation [defibrination syndrome]|
|D78.01 - D78.02
D78.21 - D78.22
E36.01 - E36.02
G97.31 - G97.32
G97.51 - G97.52
H59.111 - H59.129
H59.311 - H59.312
|Hemorrhage and hematoma complicating a procedure|
|O72.0 - O72.3||Postpartum hemorrhage|
|O86.0, O90.2||Other complications of obstetrical surgical wounds| |
96379 | HC THER/PRO/DIAG INJ/INF PRO | HCPCS | Actual fibrinogen potency for each lot is printed on vial label and carton. The dosing of RiaSTAP is as follows (Israels, 2009; CSL Behring US Package Insert, 2009):
|CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|ICD-10 codes will become effective as of October 1, 2015:|
|Other CPT codes related to the CPB:|
|96374||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug|
|96375||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)|
|96376||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)|
|96379||Unlisted therapeutic; prophylactic, or diagnostic intravenous or intra-arterial injection or infusion|
|HCPCS codes covered if selection criteria are met:|
|J7178||Injection, human fibrinogen concentrate, 1mg|
|ICD-10 codes covered if selection criteria are met:|
|D68.2||Hereditary deficiency of other clotting factors|
|ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):|
|D65||Disseminated intravascular coagulation [defibrination syndrome]|
|D78.01 - D78.02
D78.21 - D78.22
E36.01 - E36.02
G97.31 - G97.32
G97.51 - G97.52
H59.111 - H59.129
H59.311 - H59.312
|Hemorrhage and hematoma complicating a procedure|
|O72.0 - O72.3||Postpartum hemorrhage|
|O86.0, O90.2||Other complications of obstetrical surgical wounds| |
96375 | TX/PRO/DX INJ NEW DRUG ADDON | HCPCS | Actual fibrinogen potency for each lot is printed on vial label and carton. The dosing of RiaSTAP is as follows (Israels, 2009; CSL Behring US Package Insert, 2009):
|CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|ICD-10 codes will become effective as of October 1, 2015:|
|Other CPT codes related to the CPB:|
|96374||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug|
|96375||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)|
|96376||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)|
|96379||Unlisted therapeutic; prophylactic, or diagnostic intravenous or intra-arterial injection or infusion|
|HCPCS codes covered if selection criteria are met:|
|J7178||Injection, human fibrinogen concentrate, 1mg|
|ICD-10 codes covered if selection criteria are met:|
|D68.2||Hereditary deficiency of other clotting factors|
|ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):|
|D65||Disseminated intravascular coagulation [defibrination syndrome]|
|D78.01 - D78.02
D78.21 - D78.22
E36.01 - E36.02
G97.31 - G97.32
G97.51 - G97.52
H59.111 - H59.129
H59.311 - H59.312
|Hemorrhage and hematoma complicating a procedure|
|O72.0 - O72.3||Postpartum hemorrhage|
|O86.0, O90.2||Other complications of obstetrical surgical wounds| |
96374 | THER/PROPH/DIAG INJ IV PUSH | HCPCS | Actual fibrinogen potency for each lot is printed on vial label and carton. The dosing of RiaSTAP is as follows (Israels, 2009; CSL Behring US Package Insert, 2009):
|CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|ICD-10 codes will become effective as of October 1, 2015:|
|Other CPT codes related to the CPB:|
|96374||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug|
|96375||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)|
|96376||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)|
|96379||Unlisted therapeutic; prophylactic, or diagnostic intravenous or intra-arterial injection or infusion|
|HCPCS codes covered if selection criteria are met:|
|J7178||Injection, human fibrinogen concentrate, 1mg|
|ICD-10 codes covered if selection criteria are met:|
|D68.2||Hereditary deficiency of other clotting factors|
|ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):|
|D65||Disseminated intravascular coagulation [defibrination syndrome]|
|D78.01 - D78.02
D78.21 - D78.22
E36.01 - E36.02
G97.31 - G97.32
G97.51 - G97.52
H59.111 - H59.129
H59.311 - H59.312
|Hemorrhage and hematoma complicating a procedure|
|O72.0 - O72.3||Postpartum hemorrhage|
|O86.0, O90.2||Other complications of obstetrical surgical wounds| |
J7178 | Inj human fibrinogen con nos | HCPCS | Actual fibrinogen potency for each lot is printed on vial label and carton. The dosing of RiaSTAP is as follows (Israels, 2009; CSL Behring US Package Insert, 2009):
|CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|ICD-10 codes will become effective as of October 1, 2015:|
|Other CPT codes related to the CPB:|
|96374||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug|
|96375||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)|
|96376||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)|
|96379||Unlisted therapeutic; prophylactic, or diagnostic intravenous or intra-arterial injection or infusion|
|HCPCS codes covered if selection criteria are met:|
|J7178||Injection, human fibrinogen concentrate, 1mg|
|ICD-10 codes covered if selection criteria are met:|
|D68.2||Hereditary deficiency of other clotting factors|
|ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):|
|D65||Disseminated intravascular coagulation [defibrination syndrome]|
|D78.01 - D78.02
D78.21 - D78.22
E36.01 - E36.02
G97.31 - G97.32
G97.51 - G97.52
H59.111 - H59.129
H59.311 - H59.312
|Hemorrhage and hematoma complicating a procedure|
|O72.0 - O72.3||Postpartum hemorrhage|
|O86.0, O90.2||Other complications of obstetrical surgical wounds| |
96376 | TX/PRO/DX INJ SAME DRUG ADON | HCPCS | Actual fibrinogen potency for each lot is printed on vial label and carton. The dosing of RiaSTAP is as follows (Israels, 2009; CSL Behring US Package Insert, 2009):
|CPT Codes / HCPCS Codes / ICD-10 Codes|
|Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":|
|ICD-10 codes will become effective as of October 1, 2015:|
|Other CPT codes related to the CPB:|
|96374||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug|
|96375||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)|
|96376||Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)|
|96379||Unlisted therapeutic; prophylactic, or diagnostic intravenous or intra-arterial injection or infusion|
|HCPCS codes covered if selection criteria are met:|
|J7178||Injection, human fibrinogen concentrate, 1mg|
|ICD-10 codes covered if selection criteria are met:|
|D68.2||Hereditary deficiency of other clotting factors|
|ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):|
|D65||Disseminated intravascular coagulation [defibrination syndrome]|
|D78.01 - D78.02
D78.21 - D78.22
E36.01 - E36.02
G97.31 - G97.32
G97.51 - G97.52
H59.111 - H59.129
H59.311 - H59.312
|Hemorrhage and hematoma complicating a procedure|
|O72.0 - O72.3||Postpartum hemorrhage|
|O86.0, O90.2||Other complications of obstetrical surgical wounds| |
G0358 | IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
38214 | Volume deplete of harvest | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
38209 | Wash harvest stem cells | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
G0360 | Each additional hr 1-8 hrs | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
38204 | PR MGMT RCP HEMATOP PROGENITOR CELL DONOR &ACQUISJ | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
38213 | PR TRNSPL PREPJ HEMATOP PROGEN PLTLT DEPLJ | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
38215 | PR TRNSPL PREPJ HEMATOP PROGEN CONCENTRATION PLSM | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
J9999 | Not otherwise classified, antineoplastic drugs | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
G0361 | Prolong chemo infuse>8hrs pu | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
38211 | Tumor cell deplete of harvst | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
38207 | PR TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
38208 | Thaw preserved stem cells | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
G0359 | Chemotherapy IV one hr initi | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
38210 | T-cell depletion of harvest | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
38230 | PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
38212 | Rbc depletion of harvest | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
J9000 | INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
G0364 | HC BONE MARROW ASPIRATE & BIOPSY | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
38205 | PR BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ ALGNC | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
G0362 | Each add sequential infusion | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
G0357 | IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
G0356 | HORMONAL ANTINEOPLASTIC | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
G0355 | CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC | HCPCS | Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary. The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. |
G0358 | IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
38214 | Volume deplete of harvest | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
38209 | Wash harvest stem cells | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
G0360 | Each additional hr 1-8 hrs | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
38204 | PR MGMT RCP HEMATOP PROGENITOR CELL DONOR &ACQUISJ | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
38213 | PR TRNSPL PREPJ HEMATOP PROGEN PLTLT DEPLJ | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
38215 | PR TRNSPL PREPJ HEMATOP PROGEN CONCENTRATION PLSM | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
J9999 | Not otherwise classified, antineoplastic drugs | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
G0361 | Prolong chemo infuse>8hrs pu | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
38211 | Tumor cell deplete of harvst | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
38207 | PR TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
38208 | Thaw preserved stem cells | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
G0359 | Chemotherapy IV one hr initi | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
38210 | T-cell depletion of harvest | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
38230 | PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
38212 | Rbc depletion of harvest | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
J9000 | INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
G0364 | HC BONE MARROW ASPIRATE & BIOPSY | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
38205 | PR BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ ALGNC | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
G0362 | Each add sequential infusion | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
G0357 | IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
G0356 | HORMONAL ANTINEOPLASTIC | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
G0355 | CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. |
G0358 | IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG | HCPCS | POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. ICD-9 2007 revisions added to policy
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/28/2009: Code reference section updated. |
38214 | Volume deplete of harvest | HCPCS | POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. ICD-9 2007 revisions added to policy
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/28/2009: Code reference section updated. |
38209 | Wash harvest stem cells | HCPCS | POLICY HISTORY3/25/2004: See policy "Allogeneic Stem Cell Transplant" prior to 3/25/2004, separate policy developed and aligned with BCBSA policy # 8.01.22
8/19/2004: Code Reference section completed
11/18/2004: Reviewed by MPAC; no changes
10/27/2005: Code Reference section updated; CPT-4 codes 38204, 38205, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230 added; ICD-9 Procedures 41.02, 41.03, 41.05, 41.08 added; HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted
03/10/2006: Coding updated. CPT4/HCPCS 2006 revisions added to policy. 09/12/2006: Coding updated. ICD9 2006 revisions added to policy
12/21/2006: Policy reviewed, no changes
9/18/2007: Code reference section updated. ICD-9 2007 revisions added to policy
12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/28/2009: Code reference section updated. |
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