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1999 | ANESTHESIOLOGY GROUP | CPT | Evaluation and management services reported on the same date as ultraviolet light therapy are appropriate in the following circumstances:
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. |
E0692 | Uvl sys panel 4 ft | HCPCS | Evaluation and management services reported on the same date as ultraviolet light therapy are appropriate in the following circumstances:
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. |
97028 | Ultraviolet therapy | HCPCS | Evaluation and management services reported on the same date as ultraviolet light therapy are appropriate in the following circumstances:
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. |
S9098 | Home phototherapy visit | HCPCS | Evaluation and management services reported on the same date as ultraviolet light therapy are appropriate in the following circumstances:
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. |
E0202 | Phototherapy light w/ photom | HCPCS | Evaluation and management services reported on the same date as ultraviolet light therapy are appropriate in the following circumstances:
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. |
A4634 | Replacement bulb th lightbox | HCPCS | Evaluation and management services reported on the same date as ultraviolet light therapy are appropriate in the following circumstances:
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. |
E0694 | Uvl md cabinet sys 6 ft | HCPCS | Evaluation and management services reported on the same date as ultraviolet light therapy are appropriate in the following circumstances:
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. |
E0691 | Uvl pnl 2 sq ft or less | HCPCS | Evaluation and management services reported on the same date as ultraviolet light therapy are appropriate in the following circumstances:
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. |
A4633 | Uvl replacement bulb | HCPCS | Evaluation and management services reported on the same date as ultraviolet light therapy are appropriate in the following circumstances:
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. |
E0690 | UV CABINET APPROPRIATE HOME USE | CPT | Evaluation and management services reported on the same date as ultraviolet light therapy are appropriate in the following circumstances:
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. |
E0693 | Uvl sys panel 6 ft | HCPCS | Evaluation and management services reported on the same date as ultraviolet light therapy are appropriate in the following circumstances:
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. |
A4639 | Replacement pad for infrared heating pad system, each | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. It was changed to state the following: Home ultraviolet light is a covered service when provided to patients who have chronic or recalcitrant disease requiring long term maintenance exceeding four (4) months. |
1999 | ANESTHESIOLOGY GROUP | CPT | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. It was changed to state the following: Home ultraviolet light is a covered service when provided to patients who have chronic or recalcitrant disease requiring long term maintenance exceeding four (4) months. |
E0692 | Uvl sys panel 4 ft | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. It was changed to state the following: Home ultraviolet light is a covered service when provided to patients who have chronic or recalcitrant disease requiring long term maintenance exceeding four (4) months. |
97028 | Ultraviolet therapy | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. It was changed to state the following: Home ultraviolet light is a covered service when provided to patients who have chronic or recalcitrant disease requiring long term maintenance exceeding four (4) months. |
S9098 | Home phototherapy visit | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. It was changed to state the following: Home ultraviolet light is a covered service when provided to patients who have chronic or recalcitrant disease requiring long term maintenance exceeding four (4) months. |
E0202 | Phototherapy light w/ photom | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. It was changed to state the following: Home ultraviolet light is a covered service when provided to patients who have chronic or recalcitrant disease requiring long term maintenance exceeding four (4) months. |
A4634 | Replacement bulb th lightbox | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. It was changed to state the following: Home ultraviolet light is a covered service when provided to patients who have chronic or recalcitrant disease requiring long term maintenance exceeding four (4) months. |
E0694 | Uvl md cabinet sys 6 ft | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. It was changed to state the following: Home ultraviolet light is a covered service when provided to patients who have chronic or recalcitrant disease requiring long term maintenance exceeding four (4) months. |
E0691 | Uvl pnl 2 sq ft or less | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. It was changed to state the following: Home ultraviolet light is a covered service when provided to patients who have chronic or recalcitrant disease requiring long term maintenance exceeding four (4) months. |
A4633 | Uvl replacement bulb | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. It was changed to state the following: Home ultraviolet light is a covered service when provided to patients who have chronic or recalcitrant disease requiring long term maintenance exceeding four (4) months. |
E0690 | UV CABINET APPROPRIATE HOME USE | CPT | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. It was changed to state the following: Home ultraviolet light is a covered service when provided to patients who have chronic or recalcitrant disease requiring long term maintenance exceeding four (4) months. |
E0693 | Uvl sys panel 6 ft | HCPCS | POLICY HISTORY7/1993: Approved by Medical Policy Advisory Committee (MPAC)
4/1997: Investigational indication of seasonal affective disorder approved by (MPAC)
8/1999: Revisions approved by MPAC
2/11/2002: Appeal statement deleted from Policy Exception section, investigational definition added
5/2/2002: Type of Service and Place of Service deleted
6/12/2002: ICD-9 procedure codes 99.82 and 99.83 added
2/19/2003: Description of E0202 and E0690 updated to be consistent with AMA
3/11/2003: Code Reference section updated
6/27/2003: HCPCS A4633, A4634 deleted, replacement included in rental
12/6/2004: Code Reference section updated, CPT 97028 added, ICD-9 diagnosis code 202.1 5th digit added and description revised, ICD-9 diagnosis 696.8, 698.9 added, HCPCS A4633, S9098 added, HCPCS A4639, E0690 deleted, HCPCS E0691, E0692, E0693, E0694 effective date added
10/24/2006: Policy reviewed, seasonal affective disorder changed from investigational to medically necessary. 10/30/2006: Code reference section updated. ICD-9 diagnosis code 296.99 added to table. 03/16/2011: The policy statement regarding home ultraviolet light was revised to remove the requirement for a documented response to UVL. It was changed to state the following: Home ultraviolet light is a covered service when provided to patients who have chronic or recalcitrant disease requiring long term maintenance exceeding four (4) months. |
87635 | SARS-COV-2 COVID-19 AMP PRB | HCPCS | For instance, the first new code — 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique — was published and effective March 13, 2020. The vaccine and immunization codes may include a note indicating they are effective once the vaccine receives Emergency Use Authorization or approval from the Food and Drug Administration. The AMA posts new codes on its COVID-19 Coding and Guidance page. The page also includes links to CPT® Assistant guides for many of the codes. HCPCS Level II Codes for SARS-CoV-2/COVID-19 Services
Medicare has released HCPCS Level II codes in response to the COVID-19 pandemic, covering services such as specimen collection and testing. |
U0002 | HC Sars-Cov-2 Naa Coronavirus | HCPCS | The AMA posts new codes on its COVID-19 Coding and Guidance page. The page also includes links to CPT® Assistant guides for many of the codes. HCPCS Level II Codes for SARS-CoV-2/COVID-19 Services
Medicare has released HCPCS Level II codes in response to the COVID-19 pandemic, covering services such as specimen collection and testing. Check with non-Medicare payers to confirm their policies on use and coverage of these codes. As an example, two HCPCS Level II codes for COVID-19 testing (U0001 and U0002) had an implementation date of April 1, 2020, which is when Medicare claims processing systems were able to accept the codes. |
U0001 | HC NOVEL CORONAVIRUS REALT TIME PCR | HCPCS | The AMA posts new codes on its COVID-19 Coding and Guidance page. The page also includes links to CPT® Assistant guides for many of the codes. HCPCS Level II Codes for SARS-CoV-2/COVID-19 Services
Medicare has released HCPCS Level II codes in response to the COVID-19 pandemic, covering services such as specimen collection and testing. Check with non-Medicare payers to confirm their policies on use and coverage of these codes. As an example, two HCPCS Level II codes for COVID-19 testing (U0001 and U0002) had an implementation date of April 1, 2020, which is when Medicare claims processing systems were able to accept the codes. |
U0002 | HC Sars-Cov-2 Naa Coronavirus | HCPCS | HCPCS Level II Codes for SARS-CoV-2/COVID-19 Services
Medicare has released HCPCS Level II codes in response to the COVID-19 pandemic, covering services such as specimen collection and testing. Check with non-Medicare payers to confirm their policies on use and coverage of these codes. As an example, two HCPCS Level II codes for COVID-19 testing (U0001 and U0002) had an implementation date of April 1, 2020, which is when Medicare claims processing systems were able to accept the codes. Dates of service for these codes can go back to Feb. 4, 2020. Healthcare organizations also need to watch for changes to medical coding modifiers. |
U0001 | HC NOVEL CORONAVIRUS REALT TIME PCR | HCPCS | HCPCS Level II Codes for SARS-CoV-2/COVID-19 Services
Medicare has released HCPCS Level II codes in response to the COVID-19 pandemic, covering services such as specimen collection and testing. Check with non-Medicare payers to confirm their policies on use and coverage of these codes. As an example, two HCPCS Level II codes for COVID-19 testing (U0001 and U0002) had an implementation date of April 1, 2020, which is when Medicare claims processing systems were able to accept the codes. Dates of service for these codes can go back to Feb. 4, 2020. Healthcare organizations also need to watch for changes to medical coding modifiers. |
U0002 | HC Sars-Cov-2 Naa Coronavirus | HCPCS | Check with non-Medicare payers to confirm their policies on use and coverage of these codes. As an example, two HCPCS Level II codes for COVID-19 testing (U0001 and U0002) had an implementation date of April 1, 2020, which is when Medicare claims processing systems were able to accept the codes. Dates of service for these codes can go back to Feb. 4, 2020. Healthcare organizations also need to watch for changes to medical coding modifiers. A case in point is modifier CS Cost-sharing waived for specified covid-19 testing-related services that result in and order for or administration of a covid-19 test and/or used for cost-sharing waived preventive services furnished via telehealth in rural health clinics and federally qualified health centers during the covid-19 public health emergency. |
U0001 | HC NOVEL CORONAVIRUS REALT TIME PCR | HCPCS | Check with non-Medicare payers to confirm their policies on use and coverage of these codes. As an example, two HCPCS Level II codes for COVID-19 testing (U0001 and U0002) had an implementation date of April 1, 2020, which is when Medicare claims processing systems were able to accept the codes. Dates of service for these codes can go back to Feb. 4, 2020. Healthcare organizations also need to watch for changes to medical coding modifiers. A case in point is modifier CS Cost-sharing waived for specified covid-19 testing-related services that result in and order for or administration of a covid-19 test and/or used for cost-sharing waived preventive services furnished via telehealth in rural health clinics and federally qualified health centers during the covid-19 public health emergency. |
87999 | HC UNLISTED MICROBIOLOGY PROCEDURE | 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 HISTORY8/2002: Approved by Medical Policy Advisory Committee (MPAC)
11/5/2003: Code Reference section completed
10/13/2004: Code Reference section updated, CPT code 87999 effective deletion date and note added, ICD-9 diagnosis code 154.0, 197.5, 230.4, V76.41, V76.51 deleted, HCPCS S3890 added
5/2/2006: Policy reviewed, no changes
9/25/2007: Policy reviewed, no changes
04/22/2010: Policy description updated regarding available tests. Policy statement unchanged. FEP verbiage added to the Policy Exceptions section. |
87999 | HC UNLISTED MICROBIOLOGY PROCEDURE | HCPCS | Policy statement unchanged. FEP verbiage added to the Policy Exceptions section. Deleted outdated references from the Sources section. Deleted CPT code 87999 from the codes table as HCPCS S3890 is the specific code for this test. 02/23/2011: Policy reviewed; no changes
01/17/2012: Policy reviewed; no changes
03/13/2013: Policy reviewed; no changes
03/07/2014: Policy reviewed; no changes
12/31/2014: Added the following new 2015 HCPCS code to the Code Reference section: G0464. |
G0464 | Colorec ca scr, sto bas dna | HCPCS | Policy statement unchanged. FEP verbiage added to the Policy Exceptions section. Deleted outdated references from the Sources section. Deleted CPT code 87999 from the codes table as HCPCS S3890 is the specific code for this test. 02/23/2011: Policy reviewed; no changes
01/17/2012: Policy reviewed; no changes
03/13/2013: Policy reviewed; no changes
03/07/2014: Policy reviewed; no changes
12/31/2014: Added the following new 2015 HCPCS code to the Code Reference section: G0464. |
87999 | HC UNLISTED MICROBIOLOGY PROCEDURE | HCPCS | FEP verbiage added to the Policy Exceptions section. Deleted outdated references from the Sources section. Deleted CPT code 87999 from the codes table as HCPCS S3890 is the specific code for this test. 02/23/2011: Policy reviewed; no changes
01/17/2012: Policy reviewed; no changes
03/13/2013: Policy reviewed; no changes
03/07/2014: Policy reviewed; no changes
12/31/2014: Added the following new 2015 HCPCS code to the Code Reference section: G0464. 06/15/2015: Policy title changed from "Fecal DNA Testing for Colorectal Cancer Screening and Monitoring" to "Analysis of Human DNA in Stool Samples as a Technique for Colorectal Cancer Screening." |
G0464 | Colorec ca scr, sto bas dna | HCPCS | FEP verbiage added to the Policy Exceptions section. Deleted outdated references from the Sources section. Deleted CPT code 87999 from the codes table as HCPCS S3890 is the specific code for this test. 02/23/2011: Policy reviewed; no changes
01/17/2012: Policy reviewed; no changes
03/13/2013: Policy reviewed; no changes
03/07/2014: Policy reviewed; no changes
12/31/2014: Added the following new 2015 HCPCS code to the Code Reference section: G0464. 06/15/2015: Policy title changed from "Fecal DNA Testing for Colorectal Cancer Screening and Monitoring" to "Analysis of Human DNA in Stool Samples as a Technique for Colorectal Cancer Screening." |
87999 | HC UNLISTED MICROBIOLOGY PROCEDURE | HCPCS | Deleted outdated references from the Sources section. Deleted CPT code 87999 from the codes table as HCPCS S3890 is the specific code for this test. 02/23/2011: Policy reviewed; no changes
01/17/2012: Policy reviewed; no changes
03/13/2013: Policy reviewed; no changes
03/07/2014: Policy reviewed; no changes
12/31/2014: Added the following new 2015 HCPCS code to the Code Reference section: G0464. 06/15/2015: Policy title changed from "Fecal DNA Testing for Colorectal Cancer Screening and Monitoring" to "Analysis of Human DNA in Stool Samples as a Technique for Colorectal Cancer Screening." Policy description updated regarding tests. |
G0464 | Colorec ca scr, sto bas dna | HCPCS | Deleted outdated references from the Sources section. Deleted CPT code 87999 from the codes table as HCPCS S3890 is the specific code for this test. 02/23/2011: Policy reviewed; no changes
01/17/2012: Policy reviewed; no changes
03/13/2013: Policy reviewed; no changes
03/07/2014: Policy reviewed; no changes
12/31/2014: Added the following new 2015 HCPCS code to the Code Reference section: G0464. 06/15/2015: Policy title changed from "Fecal DNA Testing for Colorectal Cancer Screening and Monitoring" to "Analysis of Human DNA in Stool Samples as a Technique for Colorectal Cancer Screening." Policy description updated regarding tests. |
87999 | HC UNLISTED MICROBIOLOGY PROCEDURE | HCPCS | Deleted CPT code 87999 from the codes table as HCPCS S3890 is the specific code for this test. 02/23/2011: Policy reviewed; no changes
01/17/2012: Policy reviewed; no changes
03/13/2013: Policy reviewed; no changes
03/07/2014: Policy reviewed; no changes
12/31/2014: Added the following new 2015 HCPCS code to the Code Reference section: G0464. 06/15/2015: Policy title changed from "Fecal DNA Testing for Colorectal Cancer Screening and Monitoring" to "Analysis of Human DNA in Stool Samples as a Technique for Colorectal Cancer Screening." Policy description updated regarding tests. Policy statement unchanged. |
G0464 | Colorec ca scr, sto bas dna | HCPCS | Deleted CPT code 87999 from the codes table as HCPCS S3890 is the specific code for this test. 02/23/2011: Policy reviewed; no changes
01/17/2012: Policy reviewed; no changes
03/13/2013: Policy reviewed; no changes
03/07/2014: Policy reviewed; no changes
12/31/2014: Added the following new 2015 HCPCS code to the Code Reference section: G0464. 06/15/2015: Policy title changed from "Fecal DNA Testing for Colorectal Cancer Screening and Monitoring" to "Analysis of Human DNA in Stool Samples as a Technique for Colorectal Cancer Screening." Policy description updated regarding tests. Policy statement unchanged. |
S8035 | MAGNETIC SOURCE IMAGING | HCPCS | HCPCS code S8035 was previously added to codes table. FEP verbiage added to the Policy Exceptions section. Deleted outdated references from the Sources section. 04/20/2011: Policy reviewed; no changes. 11/30/2012: Policy statement revised to state that magnetoencephalography/magnetic source imaging as part of the preoperative evaluation of patients with intractable epilepsy (seizures refractory to at least two first-line anticonvulsants) may be considered medically necessary when standard techniques, such as MRI and EEG, do not provide satisfactory localization of epileptic lesion(s). |
G0358 | IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG | HCPCS | The following statement was added: "High-dose chemotherapy with allogeneic stem cell support is considered medically necessary for patients with T-cell disease." Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. |
G0360 | Each additional hr 1-8 hrs | HCPCS | The following statement was added: "High-dose chemotherapy with allogeneic stem cell support is considered medically necessary for patients with T-cell disease." Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | The following statement was added: "High-dose chemotherapy with allogeneic stem cell support is considered medically necessary for patients with T-cell disease." Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. |
J9000 | INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG | HCPCS | The following statement was added: "High-dose chemotherapy with allogeneic stem cell support is considered medically necessary for patients with T-cell disease." Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. |
G0364 | HC BONE MARROW ASPIRATE & BIOPSY | HCPCS | The following statement was added: "High-dose chemotherapy with allogeneic stem cell support is considered medically necessary for patients with T-cell disease." Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. |
G0362 | Each add sequential infusion | HCPCS | The following statement was added: "High-dose chemotherapy with allogeneic stem cell support is considered medically necessary for patients with T-cell disease." Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. |
J9999 | Not otherwise classified, antineoplastic drugs | HCPCS | The following statement was added: "High-dose chemotherapy with allogeneic stem cell support is considered medically necessary for patients with T-cell disease." Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. |
G0359 | Chemotherapy IV one hr initi | HCPCS | The following statement was added: "High-dose chemotherapy with allogeneic stem cell support is considered medically necessary for patients with T-cell disease." Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. |
38230 | PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC | HCPCS | The following statement was added: "High-dose chemotherapy with allogeneic stem cell support is considered medically necessary for patients with T-cell disease." Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. |
G0361 | Prolong chemo infuse>8hrs pu | HCPCS | The following statement was added: "High-dose chemotherapy with allogeneic stem cell support is considered medically necessary for patients with T-cell disease." Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. |
G0357 | IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG | HCPCS | The following statement was added: "High-dose chemotherapy with allogeneic stem cell support is considered medically necessary for patients with T-cell disease." Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. |
G0356 | HORMONAL ANTINEOPLASTIC | HCPCS | The following statement was added: "High-dose chemotherapy with allogeneic stem cell support is considered medically necessary for patients with T-cell disease." Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. |
G0355 | CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC | HCPCS | The following statement was added: "High-dose chemotherapy with allogeneic stem cell support is considered medically necessary for patients with T-cell disease." Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. |
G0358 | IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG | HCPCS | Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). |
G0360 | Each additional hr 1-8 hrs | HCPCS | Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). |
J9000 | INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG | HCPCS | Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). |
G0364 | HC BONE MARROW ASPIRATE & BIOPSY | HCPCS | Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). |
G0362 | Each add sequential infusion | HCPCS | Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). |
J9999 | Not otherwise classified, antineoplastic drugs | HCPCS | Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). |
G0359 | Chemotherapy IV one hr initi | HCPCS | Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). |
38230 | PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC | HCPCS | Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). |
G0361 | Prolong chemo infuse>8hrs pu | HCPCS | Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). |
G0357 | IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG | HCPCS | Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). |
G0356 | HORMONAL ANTINEOPLASTIC | HCPCS | Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). |
G0355 | CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC | HCPCS | Code Reference section updated; Non-Covered table was split into two tables -- Covered and Non-Covered. 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). |
G0358 | IV PUSH TECHNIQUE EACH ADD SUBSTANCE/DRUG | HCPCS | 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). 04/26/2010: Policy title revised to change “Stem-Cell Support” to “Stem-Cell Transplantation.” Policy description updated regarding treatment approaches. |
G0360 | Each additional hr 1-8 hrs | HCPCS | 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). 04/26/2010: Policy title revised to change “Stem-Cell Support” to “Stem-Cell Transplantation.” Policy description updated regarding treatment approaches. |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). 04/26/2010: Policy title revised to change “Stem-Cell Support” to “Stem-Cell Transplantation.” Policy description updated regarding treatment approaches. |
J9000 | INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG | HCPCS | 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). 04/26/2010: Policy title revised to change “Stem-Cell Support” to “Stem-Cell Transplantation.” Policy description updated regarding treatment approaches. |
G0364 | HC BONE MARROW ASPIRATE & BIOPSY | HCPCS | 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). 04/26/2010: Policy title revised to change “Stem-Cell Support” to “Stem-Cell Transplantation.” Policy description updated regarding treatment approaches. |
G0362 | Each add sequential infusion | HCPCS | 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). 04/26/2010: Policy title revised to change “Stem-Cell Support” to “Stem-Cell Transplantation.” Policy description updated regarding treatment approaches. |
J9999 | Not otherwise classified, antineoplastic drugs | HCPCS | 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). 04/26/2010: Policy title revised to change “Stem-Cell Support” to “Stem-Cell Transplantation.” Policy description updated regarding treatment approaches. |
G0359 | Chemotherapy IV one hr initi | HCPCS | 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). 04/26/2010: Policy title revised to change “Stem-Cell Support” to “Stem-Cell Transplantation.” Policy description updated regarding treatment approaches. |
38230 | PR BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC | HCPCS | 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). 04/26/2010: Policy title revised to change “Stem-Cell Support” to “Stem-Cell Transplantation.” Policy description updated regarding treatment approaches. |
G0361 | Prolong chemo infuse>8hrs pu | HCPCS | 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). 04/26/2010: Policy title revised to change “Stem-Cell Support” to “Stem-Cell Transplantation.” Policy description updated regarding treatment approaches. |
G0357 | IV PUSH TECHNIQUE SINGLE/INIT SUBSTANCE/DRUG | HCPCS | 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). 04/26/2010: Policy title revised to change “Stem-Cell Support” to “Stem-Cell Transplantation.” Policy description updated regarding treatment approaches. |
G0356 | HORMONAL ANTINEOPLASTIC | HCPCS | 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). 04/26/2010: Policy title revised to change “Stem-Cell Support” to “Stem-Cell Transplantation.” Policy description updated regarding treatment approaches. |
G0355 | CHEMO ADMN SUBQ/IM NONHORMONAL ANTINEOPLASTIC | HCPCS | 10/27/2005: Code Reference section updated: Covered table -- CPT-4 code 38230 added; ICD-9 Procedure codes 41.02, 41.03, HCPCS G0355, G0356, G0357, G0358, G0359, G0360, G0361, G0362, G0363, G0364 added, J9000-J9999 deleted; Non-Covered table -- ICD-9 Procedure codes 41.01, 41.09
3/22/2006: Coding policy updated. CPT4/HCPCS revisions added to policy. 12/20/2007: Coding updated per 2008 CPT/HCPCS revisions
9/29/2008: Description updated; terminology modified but materially unchanged. High dose chemotherapy terminology removed from title and policy statement and replaced with stem cell transplantation (SCT). 04/26/2010: Policy title revised to change “Stem-Cell Support” to “Stem-Cell Transplantation.” Policy description updated regarding treatment approaches. |
86826 | Hla x-match noncytotoxc addl | HCPCS | Added new CPT codes 86825 and 86826. Also added HCPCS S2140 and S2142 to the covered table. Deleted HCPCS G0265, G0266, and G0267 from the code section as these codes were deleted on 12/31/2007. 04/19/2011: Policy reviewed; no changes. 03/02/2012: Policy reviewed; no changes. |
G0267 | Bone marrow or psc harvest | CPT | Added new CPT codes 86825 and 86826. Also added HCPCS S2140 and S2142 to the covered table. Deleted HCPCS G0265, G0266, and G0267 from the code section as these codes were deleted on 12/31/2007. 04/19/2011: Policy reviewed; no changes. 03/02/2012: Policy reviewed; no changes. |
S2140 | Cord blood harvesting for transplantation, allogeneic | HCPCS | Added new CPT codes 86825 and 86826. Also added HCPCS S2140 and S2142 to the covered table. Deleted HCPCS G0265, G0266, and G0267 from the code section as these codes were deleted on 12/31/2007. 04/19/2011: Policy reviewed; no changes. 03/02/2012: Policy reviewed; no changes. |
G0265 | Cryopresevation Freeze+stora | CPT | Added new CPT codes 86825 and 86826. Also added HCPCS S2140 and S2142 to the covered table. Deleted HCPCS G0265, G0266, and G0267 from the code section as these codes were deleted on 12/31/2007. 04/19/2011: Policy reviewed; no changes. 03/02/2012: Policy reviewed; no changes. |
G0266 | Thawing + expansion froz cel | CPT | Added new CPT codes 86825 and 86826. Also added HCPCS S2140 and S2142 to the covered table. Deleted HCPCS G0265, G0266, and G0267 from the code section as these codes were deleted on 12/31/2007. 04/19/2011: Policy reviewed; no changes. 03/02/2012: Policy reviewed; no changes. |
86825 | X-MATCHAHG | HCPCS | Added new CPT codes 86825 and 86826. Also added HCPCS S2140 and S2142 to the covered table. Deleted HCPCS G0265, G0266, and G0267 from the code section as these codes were deleted on 12/31/2007. 04/19/2011: Policy reviewed; no changes. 03/02/2012: Policy reviewed; no changes. |
S2142 | Cord blood-derived stem-cell transplantation, allogeneic | HCPCS | Added new CPT codes 86825 and 86826. Also added HCPCS S2140 and S2142 to the covered table. Deleted HCPCS G0265, G0266, and G0267 from the code section as these codes were deleted on 12/31/2007. 04/19/2011: Policy reviewed; no changes. 03/02/2012: Policy reviewed; no changes. |
38241 | Transplt autol hct/donor | HCPCS | Policy statements unchanged. Policy guidelines updated. 08/26/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. Blue Cross Blue Shield Association policy # 8.01.15
This may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document. |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | Policy statements unchanged. Policy guidelines updated. 08/26/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. Blue Cross Blue Shield Association policy # 8.01.15
This may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document. |
38240 | Transplt allo hct/donor | HCPCS | Policy statements unchanged. Policy guidelines updated. 08/26/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. Blue Cross Blue Shield Association policy # 8.01.15
This may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document. |
38242 | Transplt allo lymphocytes | HCPCS | Policy statements unchanged. Policy guidelines updated. 08/26/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. Blue Cross Blue Shield Association policy # 8.01.15
This may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document. |
96445 | Chemotherapy, intracavitary | HCPCS | Policy statements unchanged. Policy guidelines updated. 08/26/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. Blue Cross Blue Shield Association policy # 8.01.15
This may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document. |
96446 | PR CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH | HCPCS | Policy statements unchanged. Policy guidelines updated. 08/26/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. Blue Cross Blue Shield Association policy # 8.01.15
This may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document. |
38241 | Transplt autol hct/donor | HCPCS | Policy guidelines updated. 08/26/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. Blue Cross Blue Shield Association policy # 8.01.15
This may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document. |
G0363 | IRRIG IMPLANTED VENOUS ACESS DEVICE DRUG DEL SYS | HCPCS | Policy guidelines updated. 08/26/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. Blue Cross Blue Shield Association policy # 8.01.15
This may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document. |
38240 | Transplt allo hct/donor | HCPCS | Policy guidelines updated. 08/26/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. Blue Cross Blue Shield Association policy # 8.01.15
This may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document. |
38242 | Transplt allo lymphocytes | HCPCS | Policy guidelines updated. 08/26/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. Blue Cross Blue Shield Association policy # 8.01.15
This may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document. |
96445 | Chemotherapy, intracavitary | HCPCS | Policy guidelines updated. 08/26/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. Blue Cross Blue Shield Association policy # 8.01.15
This may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document. |
96446 | PR CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH | HCPCS | Policy guidelines updated. 08/26/2015: Code Reference section updated to add ICD-10 codes, updated the code descriptions for 38240, 38241, and 38242; removed deleted HCPCS code G0363, and removed deleted code CPT 96445 and replaced with CPT code 96446. Blue Cross Blue Shield Association policy # 8.01.15
This may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document. |
1745 | Thoracoscopic robotic assisted procedure | ICD | PMID 17141745. doi:10.1016/j.biopsych.2006.08.041. - World Health Organisation. (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organisation. |
Q3014 | TELEH ORG SITE FAC FEE Injectable Drugs Not on Fee Schedule | HCPCS | Under Medicare billing rules, for example, the consulting practitioner can bill for the level of service provided, but cannot bill for a similar in-person visit for the same service on the same day. "Claims for professional consultations, office visits, individual psychotherapy and pharmacologic management provided via a telemedicine model are submitted to the carrier that processes claims for the performing physician/practitioner's service area. Physicians/practitioners submit the appropriate Current Procedural Terminology (CPT®) procedure code for covered professional telehealth services along with the ‘GT’ modifier (‘via interactive audio and video telecommunications system’). By coding and billing the GT modifier with a covered telehealth procedure code, the distant site physician/practitioner certifies that the beneficiary was present at an eligible originating site when the telemedicine service was provided. To claim the facility payment, physicians/practitioners bill Healthcare Common Procedure Coding System (HCPCS) code ‘Q3014, telehealth originating site facility fee,’ with the short description ‘telehealth facility fee.’"1
Are there special licensure, credentialing and privileging requirements that are applicable to telemedicine? |
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