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0051T | Implant total heart system | HCPCS | The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language. POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC)
2/14/2002: Investigational definition added
3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational. FEP exception added
7/24/2003: Code References section updated, ICD-9 procedure code 37.61 deleted, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 added covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 added non-covered codes
3/2004: Reviewed by MPAC, coverage remains as written with policy statement added to limit medically necessary indications to FDA approved ventricular assist devices, total artificial hearts are considered investigational, Policy title “Ventricular Assist Devices” renamed “Ventricular Assist Devices and Total Artificial Hearts", Description section revised to be consistent with BCBSA policy # 7.03.11, FEP exceptions added, Sources added, “contraindications” moved from Policy to Policy Guidelines section
10/13/2004: Code Reference section updated, CPT code 0048T, 0049T, 0050T added covered codes, CPT 33975, 33976, 33977, 33978 description revised, ICD-9 procedure code 37.62, 37.63, 37.66 description revised, ICD-9 procedure code 37.68 added, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 deleted covered codes, CPT 0051T, 0052T, 0053T added non-covered codes, ICD-9 procedure code 37.52, 37.53, 37.54 added non-covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 deleted non-covered codes
11/11/2005: Code Reference section updated, HCPCS codes Q0480-Q0505 added
4/10/2006: Policy reviewed, no change to policy. Q0480-Q0505 already added to policy
9/6/2006: Policy updated to include information on the AbioCor artificial heart
9/18/2006: Coding revised. ICD9 2006 revisions added to policy. |
0049T | External circulation assist | CPT | POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC)
2/14/2002: Investigational definition added
3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational. FEP exception added
7/24/2003: Code References section updated, ICD-9 procedure code 37.61 deleted, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 added covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 added non-covered codes
3/2004: Reviewed by MPAC, coverage remains as written with policy statement added to limit medically necessary indications to FDA approved ventricular assist devices, total artificial hearts are considered investigational, Policy title “Ventricular Assist Devices” renamed “Ventricular Assist Devices and Total Artificial Hearts", Description section revised to be consistent with BCBSA policy # 7.03.11, FEP exceptions added, Sources added, “contraindications” moved from Policy to Policy Guidelines section
10/13/2004: Code Reference section updated, CPT code 0048T, 0049T, 0050T added covered codes, CPT 33975, 33976, 33977, 33978 description revised, ICD-9 procedure code 37.62, 37.63, 37.66 description revised, ICD-9 procedure code 37.68 added, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 deleted covered codes, CPT 0051T, 0052T, 0053T added non-covered codes, ICD-9 procedure code 37.52, 37.53, 37.54 added non-covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 deleted non-covered codes
11/11/2005: Code Reference section updated, HCPCS codes Q0480-Q0505 added
4/10/2006: Policy reviewed, no change to policy. Q0480-Q0505 already added to policy
9/6/2006: Policy updated to include information on the AbioCor artificial heart
9/18/2006: Coding revised. ICD9 2006 revisions added to policy. 5/7/2008: Policy description updated. |
33978 | Remove ventricular device | HCPCS | POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC)
2/14/2002: Investigational definition added
3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational. FEP exception added
7/24/2003: Code References section updated, ICD-9 procedure code 37.61 deleted, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 added covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 added non-covered codes
3/2004: Reviewed by MPAC, coverage remains as written with policy statement added to limit medically necessary indications to FDA approved ventricular assist devices, total artificial hearts are considered investigational, Policy title “Ventricular Assist Devices” renamed “Ventricular Assist Devices and Total Artificial Hearts", Description section revised to be consistent with BCBSA policy # 7.03.11, FEP exceptions added, Sources added, “contraindications” moved from Policy to Policy Guidelines section
10/13/2004: Code Reference section updated, CPT code 0048T, 0049T, 0050T added covered codes, CPT 33975, 33976, 33977, 33978 description revised, ICD-9 procedure code 37.62, 37.63, 37.66 description revised, ICD-9 procedure code 37.68 added, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 deleted covered codes, CPT 0051T, 0052T, 0053T added non-covered codes, ICD-9 procedure code 37.52, 37.53, 37.54 added non-covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 deleted non-covered codes
11/11/2005: Code Reference section updated, HCPCS codes Q0480-Q0505 added
4/10/2006: Policy reviewed, no change to policy. Q0480-Q0505 already added to policy
9/6/2006: Policy updated to include information on the AbioCor artificial heart
9/18/2006: Coding revised. ICD9 2006 revisions added to policy. 5/7/2008: Policy description updated. |
33977 | Remove ventricular device | HCPCS | POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC)
2/14/2002: Investigational definition added
3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational. FEP exception added
7/24/2003: Code References section updated, ICD-9 procedure code 37.61 deleted, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 added covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 added non-covered codes
3/2004: Reviewed by MPAC, coverage remains as written with policy statement added to limit medically necessary indications to FDA approved ventricular assist devices, total artificial hearts are considered investigational, Policy title “Ventricular Assist Devices” renamed “Ventricular Assist Devices and Total Artificial Hearts", Description section revised to be consistent with BCBSA policy # 7.03.11, FEP exceptions added, Sources added, “contraindications” moved from Policy to Policy Guidelines section
10/13/2004: Code Reference section updated, CPT code 0048T, 0049T, 0050T added covered codes, CPT 33975, 33976, 33977, 33978 description revised, ICD-9 procedure code 37.62, 37.63, 37.66 description revised, ICD-9 procedure code 37.68 added, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 deleted covered codes, CPT 0051T, 0052T, 0053T added non-covered codes, ICD-9 procedure code 37.52, 37.53, 37.54 added non-covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 deleted non-covered codes
11/11/2005: Code Reference section updated, HCPCS codes Q0480-Q0505 added
4/10/2006: Policy reviewed, no change to policy. Q0480-Q0505 already added to policy
9/6/2006: Policy updated to include information on the AbioCor artificial heart
9/18/2006: Coding revised. ICD9 2006 revisions added to policy. 5/7/2008: Policy description updated. |
0052T | Replace thrc unit hrt syst | HCPCS | POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC)
2/14/2002: Investigational definition added
3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational. FEP exception added
7/24/2003: Code References section updated, ICD-9 procedure code 37.61 deleted, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 added covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 added non-covered codes
3/2004: Reviewed by MPAC, coverage remains as written with policy statement added to limit medically necessary indications to FDA approved ventricular assist devices, total artificial hearts are considered investigational, Policy title “Ventricular Assist Devices” renamed “Ventricular Assist Devices and Total Artificial Hearts", Description section revised to be consistent with BCBSA policy # 7.03.11, FEP exceptions added, Sources added, “contraindications” moved from Policy to Policy Guidelines section
10/13/2004: Code Reference section updated, CPT code 0048T, 0049T, 0050T added covered codes, CPT 33975, 33976, 33977, 33978 description revised, ICD-9 procedure code 37.62, 37.63, 37.66 description revised, ICD-9 procedure code 37.68 added, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 deleted covered codes, CPT 0051T, 0052T, 0053T added non-covered codes, ICD-9 procedure code 37.52, 37.53, 37.54 added non-covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 deleted non-covered codes
11/11/2005: Code Reference section updated, HCPCS codes Q0480-Q0505 added
4/10/2006: Policy reviewed, no change to policy. Q0480-Q0505 already added to policy
9/6/2006: Policy updated to include information on the AbioCor artificial heart
9/18/2006: Coding revised. ICD9 2006 revisions added to policy. 5/7/2008: Policy description updated. |
33976 | PR INSJ VENTRIC ASSIST DEV XTRCORP BIVENTRICULAR | HCPCS | POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC)
2/14/2002: Investigational definition added
3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational. FEP exception added
7/24/2003: Code References section updated, ICD-9 procedure code 37.61 deleted, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 added covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 added non-covered codes
3/2004: Reviewed by MPAC, coverage remains as written with policy statement added to limit medically necessary indications to FDA approved ventricular assist devices, total artificial hearts are considered investigational, Policy title “Ventricular Assist Devices” renamed “Ventricular Assist Devices and Total Artificial Hearts", Description section revised to be consistent with BCBSA policy # 7.03.11, FEP exceptions added, Sources added, “contraindications” moved from Policy to Policy Guidelines section
10/13/2004: Code Reference section updated, CPT code 0048T, 0049T, 0050T added covered codes, CPT 33975, 33976, 33977, 33978 description revised, ICD-9 procedure code 37.62, 37.63, 37.66 description revised, ICD-9 procedure code 37.68 added, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 deleted covered codes, CPT 0051T, 0052T, 0053T added non-covered codes, ICD-9 procedure code 37.52, 37.53, 37.54 added non-covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 deleted non-covered codes
11/11/2005: Code Reference section updated, HCPCS codes Q0480-Q0505 added
4/10/2006: Policy reviewed, no change to policy. Q0480-Q0505 already added to policy
9/6/2006: Policy updated to include information on the AbioCor artificial heart
9/18/2006: Coding revised. ICD9 2006 revisions added to policy. 5/7/2008: Policy description updated. |
33975 | PR INSJ VENTRIC ASSIST DEV XTRCORP SINGLE VENTRICLE | HCPCS | POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC)
2/14/2002: Investigational definition added
3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational. FEP exception added
7/24/2003: Code References section updated, ICD-9 procedure code 37.61 deleted, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 added covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 added non-covered codes
3/2004: Reviewed by MPAC, coverage remains as written with policy statement added to limit medically necessary indications to FDA approved ventricular assist devices, total artificial hearts are considered investigational, Policy title “Ventricular Assist Devices” renamed “Ventricular Assist Devices and Total Artificial Hearts", Description section revised to be consistent with BCBSA policy # 7.03.11, FEP exceptions added, Sources added, “contraindications” moved from Policy to Policy Guidelines section
10/13/2004: Code Reference section updated, CPT code 0048T, 0049T, 0050T added covered codes, CPT 33975, 33976, 33977, 33978 description revised, ICD-9 procedure code 37.62, 37.63, 37.66 description revised, ICD-9 procedure code 37.68 added, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 deleted covered codes, CPT 0051T, 0052T, 0053T added non-covered codes, ICD-9 procedure code 37.52, 37.53, 37.54 added non-covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 deleted non-covered codes
11/11/2005: Code Reference section updated, HCPCS codes Q0480-Q0505 added
4/10/2006: Policy reviewed, no change to policy. Q0480-Q0505 already added to policy
9/6/2006: Policy updated to include information on the AbioCor artificial heart
9/18/2006: Coding revised. ICD9 2006 revisions added to policy. 5/7/2008: Policy description updated. |
0050T | Removal circulation assist | CPT | POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC)
2/14/2002: Investigational definition added
3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational. FEP exception added
7/24/2003: Code References section updated, ICD-9 procedure code 37.61 deleted, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 added covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 added non-covered codes
3/2004: Reviewed by MPAC, coverage remains as written with policy statement added to limit medically necessary indications to FDA approved ventricular assist devices, total artificial hearts are considered investigational, Policy title “Ventricular Assist Devices” renamed “Ventricular Assist Devices and Total Artificial Hearts", Description section revised to be consistent with BCBSA policy # 7.03.11, FEP exceptions added, Sources added, “contraindications” moved from Policy to Policy Guidelines section
10/13/2004: Code Reference section updated, CPT code 0048T, 0049T, 0050T added covered codes, CPT 33975, 33976, 33977, 33978 description revised, ICD-9 procedure code 37.62, 37.63, 37.66 description revised, ICD-9 procedure code 37.68 added, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 deleted covered codes, CPT 0051T, 0052T, 0053T added non-covered codes, ICD-9 procedure code 37.52, 37.53, 37.54 added non-covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 deleted non-covered codes
11/11/2005: Code Reference section updated, HCPCS codes Q0480-Q0505 added
4/10/2006: Policy reviewed, no change to policy. Q0480-Q0505 already added to policy
9/6/2006: Policy updated to include information on the AbioCor artificial heart
9/18/2006: Coding revised. ICD9 2006 revisions added to policy. 5/7/2008: Policy description updated. |
0053T | Replace implantable hrt syst | HCPCS | POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC)
2/14/2002: Investigational definition added
3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational. FEP exception added
7/24/2003: Code References section updated, ICD-9 procedure code 37.61 deleted, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 added covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 added non-covered codes
3/2004: Reviewed by MPAC, coverage remains as written with policy statement added to limit medically necessary indications to FDA approved ventricular assist devices, total artificial hearts are considered investigational, Policy title “Ventricular Assist Devices” renamed “Ventricular Assist Devices and Total Artificial Hearts", Description section revised to be consistent with BCBSA policy # 7.03.11, FEP exceptions added, Sources added, “contraindications” moved from Policy to Policy Guidelines section
10/13/2004: Code Reference section updated, CPT code 0048T, 0049T, 0050T added covered codes, CPT 33975, 33976, 33977, 33978 description revised, ICD-9 procedure code 37.62, 37.63, 37.66 description revised, ICD-9 procedure code 37.68 added, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 deleted covered codes, CPT 0051T, 0052T, 0053T added non-covered codes, ICD-9 procedure code 37.52, 37.53, 37.54 added non-covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 deleted non-covered codes
11/11/2005: Code Reference section updated, HCPCS codes Q0480-Q0505 added
4/10/2006: Policy reviewed, no change to policy. Q0480-Q0505 already added to policy
9/6/2006: Policy updated to include information on the AbioCor artificial heart
9/18/2006: Coding revised. ICD9 2006 revisions added to policy. 5/7/2008: Policy description updated. |
Q0480 | Driver pneumatic vad, rep | HCPCS | POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC)
2/14/2002: Investigational definition added
3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational. FEP exception added
7/24/2003: Code References section updated, ICD-9 procedure code 37.61 deleted, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 added covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 added non-covered codes
3/2004: Reviewed by MPAC, coverage remains as written with policy statement added to limit medically necessary indications to FDA approved ventricular assist devices, total artificial hearts are considered investigational, Policy title “Ventricular Assist Devices” renamed “Ventricular Assist Devices and Total Artificial Hearts", Description section revised to be consistent with BCBSA policy # 7.03.11, FEP exceptions added, Sources added, “contraindications” moved from Policy to Policy Guidelines section
10/13/2004: Code Reference section updated, CPT code 0048T, 0049T, 0050T added covered codes, CPT 33975, 33976, 33977, 33978 description revised, ICD-9 procedure code 37.62, 37.63, 37.66 description revised, ICD-9 procedure code 37.68 added, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 deleted covered codes, CPT 0051T, 0052T, 0053T added non-covered codes, ICD-9 procedure code 37.52, 37.53, 37.54 added non-covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 deleted non-covered codes
11/11/2005: Code Reference section updated, HCPCS codes Q0480-Q0505 added
4/10/2006: Policy reviewed, no change to policy. Q0480-Q0505 already added to policy
9/6/2006: Policy updated to include information on the AbioCor artificial heart
9/18/2006: Coding revised. ICD9 2006 revisions added to policy. 5/7/2008: Policy description updated. |
0048T | Implant ventricular device | CPT | POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC)
2/14/2002: Investigational definition added
3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational. FEP exception added
7/24/2003: Code References section updated, ICD-9 procedure code 37.61 deleted, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 added covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 added non-covered codes
3/2004: Reviewed by MPAC, coverage remains as written with policy statement added to limit medically necessary indications to FDA approved ventricular assist devices, total artificial hearts are considered investigational, Policy title “Ventricular Assist Devices” renamed “Ventricular Assist Devices and Total Artificial Hearts", Description section revised to be consistent with BCBSA policy # 7.03.11, FEP exceptions added, Sources added, “contraindications” moved from Policy to Policy Guidelines section
10/13/2004: Code Reference section updated, CPT code 0048T, 0049T, 0050T added covered codes, CPT 33975, 33976, 33977, 33978 description revised, ICD-9 procedure code 37.62, 37.63, 37.66 description revised, ICD-9 procedure code 37.68 added, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 deleted covered codes, CPT 0051T, 0052T, 0053T added non-covered codes, ICD-9 procedure code 37.52, 37.53, 37.54 added non-covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 deleted non-covered codes
11/11/2005: Code Reference section updated, HCPCS codes Q0480-Q0505 added
4/10/2006: Policy reviewed, no change to policy. Q0480-Q0505 already added to policy
9/6/2006: Policy updated to include information on the AbioCor artificial heart
9/18/2006: Coding revised. ICD9 2006 revisions added to policy. 5/7/2008: Policy description updated. |
0051T | Implant total heart system | HCPCS | POLICY HISTORY8/1998: Approved by Medical Policy Advisory Committee (MPAC)
2/14/2002: Investigational definition added
3/2003: Reviewed by MPAC; Policy title "Ventricular Assist Devices as a Bridge to Heart Transplantation" renamed "Ventricular Assist Devices", LVAD as a "destination" therapy considered investigational. FEP exception added
7/24/2003: Code References section updated, ICD-9 procedure code 37.61 deleted, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 added covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 added non-covered codes
3/2004: Reviewed by MPAC, coverage remains as written with policy statement added to limit medically necessary indications to FDA approved ventricular assist devices, total artificial hearts are considered investigational, Policy title “Ventricular Assist Devices” renamed “Ventricular Assist Devices and Total Artificial Hearts", Description section revised to be consistent with BCBSA policy # 7.03.11, FEP exceptions added, Sources added, “contraindications” moved from Policy to Policy Guidelines section
10/13/2004: Code Reference section updated, CPT code 0048T, 0049T, 0050T added covered codes, CPT 33975, 33976, 33977, 33978 description revised, ICD-9 procedure code 37.62, 37.63, 37.66 description revised, ICD-9 procedure code 37.68 added, ICD-9 diagnosis 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9 deleted covered codes, CPT 0051T, 0052T, 0053T added non-covered codes, ICD-9 procedure code 37.52, 37.53, 37.54 added non-covered codes, ICD-9 diagnosis 038.0-038.9, 042, 090.0-097.9, 112.5, 117.5, 280.0-282.63, 282.69-289.51, 289.59-289.9, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 518.83, 518.84, 570, 571.0, 571.1, 571.2, 571.3, 572.4, 572.8, 585 deleted non-covered codes
11/11/2005: Code Reference section updated, HCPCS codes Q0480-Q0505 added
4/10/2006: Policy reviewed, no change to policy. Q0480-Q0505 already added to policy
9/6/2006: Policy updated to include information on the AbioCor artificial heart
9/18/2006: Coding revised. ICD9 2006 revisions added to policy. 5/7/2008: Policy description updated. |
0053T | Replace implantable hrt syst | HCPCS | Ventricular assist devices as destination therapy with end-stage heart failure changed from investigational to medically necessary for FDA-approved devices in patients ineligible for human heart transplant. Other policy statements revised for clarity; coverage remains the same. CPT codes 0051T-0053T moved to covered. ICD-9 procedure codes 37.52-37.54 moved to covered
9/22/2008: Annual ICD-9 updates effective 10-1-2008 applied
12/31/2008: Code Reference section updated per 2009 CPT/HCPCS revisions
8/19/2009: Policy reviewed, no changes
03/12/2010: Coding Section revised for 2010 CPT4 and HCPCS revision
12/30/2010: Policy description re-written. Policy statements revised to address only implantable VADs and total artificial hearts. |
0051T | Implant total heart system | HCPCS | Ventricular assist devices as destination therapy with end-stage heart failure changed from investigational to medically necessary for FDA-approved devices in patients ineligible for human heart transplant. Other policy statements revised for clarity; coverage remains the same. CPT codes 0051T-0053T moved to covered. ICD-9 procedure codes 37.52-37.54 moved to covered
9/22/2008: Annual ICD-9 updates effective 10-1-2008 applied
12/31/2008: Code Reference section updated per 2009 CPT/HCPCS revisions
8/19/2009: Policy reviewed, no changes
03/12/2010: Coding Section revised for 2010 CPT4 and HCPCS revision
12/30/2010: Policy description re-written. Policy statements revised to address only implantable VADs and total artificial hearts. |
Q4079 | Natalizumab injection | HCPCS | Other policy statements revised for clarity; coverage remains the same. CPT codes 0051T-0053T moved to covered. ICD-9 procedure codes 37.52-37.54 moved to covered
9/22/2008: Annual ICD-9 updates effective 10-1-2008 applied
12/31/2008: Code Reference section updated per 2009 CPT/HCPCS revisions
8/19/2009: Policy reviewed, no changes
03/12/2010: Coding Section revised for 2010 CPT4 and HCPCS revision
12/30/2010: Policy description re-written. Policy statements revised to address only implantable VADs and total artificial hearts. 03/09/2011: Added new HCPCS codes Q4078 and Q4079 to the Code Reference section. |
0053T | Replace implantable hrt syst | HCPCS | Other policy statements revised for clarity; coverage remains the same. CPT codes 0051T-0053T moved to covered. ICD-9 procedure codes 37.52-37.54 moved to covered
9/22/2008: Annual ICD-9 updates effective 10-1-2008 applied
12/31/2008: Code Reference section updated per 2009 CPT/HCPCS revisions
8/19/2009: Policy reviewed, no changes
03/12/2010: Coding Section revised for 2010 CPT4 and HCPCS revision
12/30/2010: Policy description re-written. Policy statements revised to address only implantable VADs and total artificial hearts. 03/09/2011: Added new HCPCS codes Q4078 and Q4079 to the Code Reference section. |
0051T | Implant total heart system | HCPCS | Other policy statements revised for clarity; coverage remains the same. CPT codes 0051T-0053T moved to covered. ICD-9 procedure codes 37.52-37.54 moved to covered
9/22/2008: Annual ICD-9 updates effective 10-1-2008 applied
12/31/2008: Code Reference section updated per 2009 CPT/HCPCS revisions
8/19/2009: Policy reviewed, no changes
03/12/2010: Coding Section revised for 2010 CPT4 and HCPCS revision
12/30/2010: Policy description re-written. Policy statements revised to address only implantable VADs and total artificial hearts. 03/09/2011: Added new HCPCS codes Q4078 and Q4079 to the Code Reference section. |
Q4079 | Natalizumab injection | HCPCS | ICD-9 procedure codes 37.52-37.54 moved to covered
9/22/2008: Annual ICD-9 updates effective 10-1-2008 applied
12/31/2008: Code Reference section updated per 2009 CPT/HCPCS revisions
8/19/2009: Policy reviewed, no changes
03/12/2010: Coding Section revised for 2010 CPT4 and HCPCS revision
12/30/2010: Policy description re-written. Policy statements revised to address only implantable VADs and total artificial hearts. 03/09/2011: Added new HCPCS codes Q4078 and Q4079 to the Code Reference section. 12/13/2011: Policy description and statement updated regarding percutaneous ventricular assist devices. Added the following policy statement: Percutaneous ventricular assist devices (pVADs) are considered investigational for all indications. |
Q4079 | Natalizumab injection | HCPCS | Policy statements revised to address only implantable VADs and total artificial hearts. 03/09/2011: Added new HCPCS codes Q4078 and Q4079 to the Code Reference section. 12/13/2011: Policy description and statement updated regarding percutaneous ventricular assist devices. Added the following policy statement: Percutaneous ventricular assist devices (pVADs) are considered investigational for all indications. 11/30/2012: Added the verbiage "or are undergoing evaluation to determine candidacy for heart transplantation" to the policy statement regarding total artificial hearts. |
0048T | Implant ventricular device | CPT | Replaced "cleared devices" with "clearance." Added "Implantable" to the beggining of the policy statement under the Bridge to Transplantation section. Policy statement on implantable VADs as a bridge to heart tranplantation in children was revised to change the age range from "5 to 16" to "16 years old or younger," reflecting the approval of the BERLIN heart EXCOR device for pediatric patients. Policy guidelines updated to include coagulation disorders and inadequate psychosocial support as contraindications for bridge to transplant VADs and TAH. Removed deleted CPT codes 0048T and 0050T from the Code Reference section. |
0050T | Removal circulation assist | CPT | Replaced "cleared devices" with "clearance." Added "Implantable" to the beggining of the policy statement under the Bridge to Transplantation section. Policy statement on implantable VADs as a bridge to heart tranplantation in children was revised to change the age range from "5 to 16" to "16 years old or younger," reflecting the approval of the BERLIN heart EXCOR device for pediatric patients. Policy guidelines updated to include coagulation disorders and inadequate psychosocial support as contraindications for bridge to transplant VADs and TAH. Removed deleted CPT codes 0048T and 0050T from the Code Reference section. |
0048T | Implant ventricular device | CPT | Policy statement on implantable VADs as a bridge to heart tranplantation in children was revised to change the age range from "5 to 16" to "16 years old or younger," reflecting the approval of the BERLIN heart EXCOR device for pediatric patients. Policy guidelines updated to include coagulation disorders and inadequate psychosocial support as contraindications for bridge to transplant VADs and TAH. Removed deleted CPT codes 0048T and 0050T from the Code Reference section. 07/07/2015: Code Reference section updated to add Investigational Codes table. CPT codes 33990, 33991, 33992, 33993 and ICD-9 procedure code 37.68 moved from Covered to Investigational. |
0050T | Removal circulation assist | CPT | Policy statement on implantable VADs as a bridge to heart tranplantation in children was revised to change the age range from "5 to 16" to "16 years old or younger," reflecting the approval of the BERLIN heart EXCOR device for pediatric patients. Policy guidelines updated to include coagulation disorders and inadequate psychosocial support as contraindications for bridge to transplant VADs and TAH. Removed deleted CPT codes 0048T and 0050T from the Code Reference section. 07/07/2015: Code Reference section updated to add Investigational Codes table. CPT codes 33990, 33991, 33992, 33993 and ICD-9 procedure code 37.68 moved from Covered to Investigational. |
0048T | Implant ventricular device | CPT | Policy guidelines updated to include coagulation disorders and inadequate psychosocial support as contraindications for bridge to transplant VADs and TAH. Removed deleted CPT codes 0048T and 0050T from the Code Reference section. 07/07/2015: Code Reference section updated to add Investigational Codes table. CPT codes 33990, 33991, 33992, 33993 and ICD-9 procedure code 37.68 moved from Covered to Investigational. 08/27/2015: Code Reference section updated for ICD-10. |
0050T | Removal circulation assist | CPT | Policy guidelines updated to include coagulation disorders and inadequate psychosocial support as contraindications for bridge to transplant VADs and TAH. Removed deleted CPT codes 0048T and 0050T from the Code Reference section. 07/07/2015: Code Reference section updated to add Investigational Codes table. CPT codes 33990, 33991, 33992, 33993 and ICD-9 procedure code 37.68 moved from Covered to Investigational. 08/27/2015: Code Reference section updated for ICD-10. |
0048T | Implant ventricular device | CPT | Removed deleted CPT codes 0048T and 0050T from the Code Reference section. 07/07/2015: Code Reference section updated to add Investigational Codes table. CPT codes 33990, 33991, 33992, 33993 and ICD-9 procedure code 37.68 moved from Covered to Investigational. 08/27/2015: Code Reference section updated for ICD-10. Removed deleted CPT code Q0505. |
0050T | Removal circulation assist | CPT | Removed deleted CPT codes 0048T and 0050T from the Code Reference section. 07/07/2015: Code Reference section updated to add Investigational Codes table. CPT codes 33990, 33991, 33992, 33993 and ICD-9 procedure code 37.68 moved from Covered to Investigational. 08/27/2015: Code Reference section updated for ICD-10. Removed deleted CPT code Q0505. |
G6015 | Radiation tx delivery imrt | HCPCS | IMRT remains investigational for all other uses in the abdomen and pelvis. Policy guidelines updated regarding radiation tolerance doses for normal tissues of the abdomen and pelvis. 03/13/2014: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. |
77386 | HC IMRT COMPLEX | HCPCS | IMRT remains investigational for all other uses in the abdomen and pelvis. Policy guidelines updated regarding radiation tolerance doses for normal tissues of the abdomen and pelvis. 03/13/2014: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. |
77385 | HC IMRT SIMPLE | HCPCS | IMRT remains investigational for all other uses in the abdomen and pelvis. Policy guidelines updated regarding radiation tolerance doses for normal tissues of the abdomen and pelvis. 03/13/2014: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. |
G6016 | PR DELIVERY COMP IMRT | HCPCS | IMRT remains investigational for all other uses in the abdomen and pelvis. Policy guidelines updated regarding radiation tolerance doses for normal tissues of the abdomen and pelvis. 03/13/2014: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. |
G6015 | Radiation tx delivery imrt | HCPCS | Policy guidelines updated regarding radiation tolerance doses for normal tissues of the abdomen and pelvis. 03/13/2014: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. 01/27/2015: Policy description updated regarding radiation techniques. |
77386 | HC IMRT COMPLEX | HCPCS | Policy guidelines updated regarding radiation tolerance doses for normal tissues of the abdomen and pelvis. 03/13/2014: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. 01/27/2015: Policy description updated regarding radiation techniques. |
77385 | HC IMRT SIMPLE | HCPCS | Policy guidelines updated regarding radiation tolerance doses for normal tissues of the abdomen and pelvis. 03/13/2014: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. 01/27/2015: Policy description updated regarding radiation techniques. |
G6016 | PR DELIVERY COMP IMRT | HCPCS | Policy guidelines updated regarding radiation tolerance doses for normal tissues of the abdomen and pelvis. 03/13/2014: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. 01/27/2015: Policy description updated regarding radiation techniques. |
G6015 | Radiation tx delivery imrt | HCPCS | 03/13/2014: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. 01/27/2015: Policy description updated regarding radiation techniques. Policy statements updated to change "radiation therapy" to "radiotherapy." |
77386 | HC IMRT COMPLEX | HCPCS | 03/13/2014: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. 01/27/2015: Policy description updated regarding radiation techniques. Policy statements updated to change "radiation therapy" to "radiotherapy." |
77385 | HC IMRT SIMPLE | HCPCS | 03/13/2014: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. 01/27/2015: Policy description updated regarding radiation techniques. Policy statements updated to change "radiation therapy" to "radiotherapy." |
G6016 | PR DELIVERY COMP IMRT | HCPCS | 03/13/2014: Policy reviewed; no changes. 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. 01/27/2015: Policy description updated regarding radiation techniques. Policy statements updated to change "radiation therapy" to "radiotherapy." |
G6015 | Radiation tx delivery imrt | HCPCS | 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. 01/27/2015: Policy description updated regarding radiation techniques. Policy statements updated to change "radiation therapy" to "radiotherapy." Removed "squamous cell" from the first medically necessary policy statement. |
77386 | HC IMRT COMPLEX | HCPCS | 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. 01/27/2015: Policy description updated regarding radiation techniques. Policy statements updated to change "radiation therapy" to "radiotherapy." Removed "squamous cell" from the first medically necessary policy statement. |
77385 | HC IMRT SIMPLE | HCPCS | 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. 01/27/2015: Policy description updated regarding radiation techniques. Policy statements updated to change "radiation therapy" to "radiotherapy." Removed "squamous cell" from the first medically necessary policy statement. |
G6016 | PR DELIVERY COMP IMRT | HCPCS | 12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77385 and 77386. Added the following HCPCS codes to the Code Reference section: G6015, G6016. 01/27/2015: Policy description updated regarding radiation techniques. Policy statements updated to change "radiation therapy" to "radiotherapy." Removed "squamous cell" from the first medically necessary policy statement. |
31660 | PR BRONCHOSCOPIC THERMOPLASTY ONE LOBE | HCPCS | In summary, although available data are promising, more research is needed to ascertain what role, if any, BT should play in the treatment of patients with asthma. Furthermore, there is a lack of evidence regarding the effectiveness of BT in the management of patients with chronic obstructive pulmonary disease. |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:|
|CPT codes not covered for indications listed in the CPB:|
|31660||Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe|
|31661||2 or more lobes|
|ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):|
|J41.0 - J47.9
J67.0 - J67.9
|Chronic lower respiratory diseases and hypersensitivity pneumonitis due to organic dust [including asthma]| |
31661 | PR BRONCHOSCOPIC THERMOPLASTY 2/> LOBES | HCPCS | In summary, although available data are promising, more research is needed to ascertain what role, if any, BT should play in the treatment of patients with asthma. Furthermore, there is a lack of evidence regarding the effectiveness of BT in the management of patients with chronic obstructive pulmonary disease. |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:|
|CPT codes not covered for indications listed in the CPB:|
|31660||Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe|
|31661||2 or more lobes|
|ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):|
|J41.0 - J47.9
J67.0 - J67.9
|Chronic lower respiratory diseases and hypersensitivity pneumonitis due to organic dust [including asthma]| |
31660 | PR BRONCHOSCOPIC THERMOPLASTY ONE LOBE | HCPCS | Furthermore, there is a lack of evidence regarding the effectiveness of BT in the management of patients with chronic obstructive pulmonary disease. |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:|
|CPT codes not covered for indications listed in the CPB:|
|31660||Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe|
|31661||2 or more lobes|
|ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):|
|J41.0 - J47.9
J67.0 - J67.9
|Chronic lower respiratory diseases and hypersensitivity pneumonitis due to organic dust [including asthma]| |
31661 | PR BRONCHOSCOPIC THERMOPLASTY 2/> LOBES | HCPCS | Furthermore, there is a lack of evidence regarding the effectiveness of BT in the management of patients with chronic obstructive pulmonary disease. |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:|
|CPT codes not covered for indications listed in the CPB:|
|31660||Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe|
|31661||2 or more lobes|
|ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):|
|J41.0 - J47.9
J67.0 - J67.9
|Chronic lower respiratory diseases and hypersensitivity pneumonitis due to organic dust [including asthma]| |
69421 | PR MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES | HCPCS | The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
31230 | Removal of upper jaw | HCPCS | The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
42830 | Removal of adenoids | HCPCS | The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
42821 | Remove tonsils and adenoids | HCPCS | The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
42820 | Remove tonsils and adenoids | HCPCS | The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
69433 | PR TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA | HCPCS | The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
31231 | PR NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX | HCPCS | The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
69424 | Remove ventilating tube | HCPCS | The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
31297 | PR NASAL/SINUS NDSC SURG W/DILATION SPHENOID SINUS | HCPCS | The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
42836 | Removal of adenoids | HCPCS | The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
69436 | PR TYMPANOSTOMY GENERAL ANESTHESIA | HCPCS | The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
31000 | PR LAVAGE CANNULATION MAXILLARY SINUS | HCPCS | The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
69420 | PR MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ | HCPCS | The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
69421 | PR MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES | HCPCS | It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
31230 | Removal of upper jaw | HCPCS | It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
42830 | Removal of adenoids | HCPCS | It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
42821 | Remove tonsils and adenoids | HCPCS | It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
42820 | Remove tonsils and adenoids | HCPCS | It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
69433 | PR TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA | HCPCS | It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
31231 | PR NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX | HCPCS | It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
69424 | Remove ventilating tube | HCPCS | It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
31297 | PR NASAL/SINUS NDSC SURG W/DILATION SPHENOID SINUS | HCPCS | It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
42836 | Removal of adenoids | HCPCS | It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
69436 | PR TYMPANOSTOMY GENERAL ANESTHESIA | HCPCS | It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
31000 | PR LAVAGE CANNULATION MAXILLARY SINUS | HCPCS | It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
69420 | PR MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ | HCPCS | It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. |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 :|
|CPT codes covered if selection criteria are met:|
|69420||Myringotomy including aspiration and/or eustachian tube inflation|
|69421||Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia|
|69424||Ventilating tube removal requiring general anesthesia|
|69433||Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia|
|69436||Tympanostomy (requiring insertion of ventilating tube), general anesthesia|
|CPT codes not covered for indications listed in the CPB:|
|No specific code|
|Other CPT codes related to the CPB:|
|31000 - 31230||Incision and excision of accessory sinuses|
|31231 - 31297||Sinus endoscopy|
|42820 - 42821||Tonsillectomy and adenoidectomy|
|42830 - 42836||Adenoidectomy|
|ICD-10 codes covered if selection criteria are met:|
|H65.00 - H65.93||Nonsuppurative otitis media|
|H66.001 - H66.93||Suppurative and unspecified otitis media|
|H69.00 - H69.03||Patulous Eustachian tube|
|H71.20 - H71.23
H71.90 - H71.93
|Cholesteatoma of mastoid and unspecified part [middle ear]|
|H72.10 - H72.13||Attic perforation of tympanic membrane [Pars flaccida]|
|H90.0 - H91.93||Hearing loss|
|Q35.1 - Q37.9||Cleft lip and cleft palate| |
99213 | Telehealth visit INT | HCPCS | HCPCS codes are essential for Medicare and Medicaid billing and reimbursement. In summary, CPT codes describe medical procedures and services, ICD codes classify diagnoses and conditions, and HCPCS codes identify additional healthcare services and supplies. Examples of CPT Codes
CPT codes cover a wide range of medical procedures, services, and tests. Here are a few examples of commonly used CPT codes:
1. 99213 - Office or other outpatient visit for the evaluation and management of an established patient, which typically includes a detailed history, examination, and medical decision-making. |
99213 | Telehealth visit INT | HCPCS | In summary, CPT codes describe medical procedures and services, ICD codes classify diagnoses and conditions, and HCPCS codes identify additional healthcare services and supplies. Examples of CPT Codes
CPT codes cover a wide range of medical procedures, services, and tests. Here are a few examples of commonly used CPT codes:
1. 99213 - Office or other outpatient visit for the evaluation and management of an established patient, which typically includes a detailed history, examination, and medical decision-making. 2. |
0430 | REV - OCCUPATIONAL THERAPY | RC | Documentation and SOAP What do payers want and why? General guidelines of medical
Ophthalmology Coding ICD-9 9 CM & CPT By Alice Landry, Registered Health Information Administrator and Certified Procedural Coder Harvey & Bernice Jones Eye Institute University of Arkansas for Medical
July 22, 2015 It s Time to Transition to ICD-10 What do the changes mean to your SNF? Presented by: Linda S. Little, RN-BSN Clinical Consultant HMM Consulting Office: (631) 265-6289 E-Mail: [email protected]
Narrative changes appear in bold text Items underlined have been moved within the guidelines since the FY 2014 version Italics are used to indicate revisions to heading changes The Centers for Medicare
ELIM OUTREACH TRAINING CENTER 1820 Ridge Rd Suite 300-301 Homewood, IL 60430 Tel:708-922-9547-Fax: 708-922-9568 E-mail: [email protected] Website: elimotc.com MEDICAL BILLING & CODING PROGRAM ELIM OUTREACH
Introduction to ICD-10 and what you need to know for a Successful Transition Sheila Goethel, RHIT, CCS Coding Consultant AHIMA ICD-10-CM/PCS Certified Trainer May 2011 Objectives Introduction of ICD Brief
Preparing for ICD-10: What You Should Be Doing Now PHCA November 11, 2014 Presented by: Reinsel Kuntz Lesher LLP Senior Living Services Consulting Stephanie Kessler, Partner Karin Sherman, Senior Consultant
Monterey County I 50T02 II 50T03 HEALTH INFORMATION MANAGEMENT CODER I/II DEFINITION Under general supervision, reviews, interprets, codes and abstracts medical records information according to standard
Frequently Asked Questions Frequently asked questions: ICD-10 To help health care providers and payers prepare for ICD-10, Optum has prepared the following answers to frequently asked questions. ICD-10
Preparing for the ICD-10 Transition By Melody W. Mulaik President: Coding Strategies, Inc. On October 1, 2014, after more than 30 years with the ICD-9-CM coding system, the U.S. healthcare industry will
ICD-10 FAQs for Doctors What is ICD-10? ICD-10 is the 10 th revision of the International Classification of Diseases (ICD), used by health care systems to report diagnoses and procedures for purposes of
ICD -10 TRANSITION AS IT RELATES TO VISION Presented by: MARCH Vision Care, 2013 INTRODUCTION During the summer of 2008, the Department of Health and Human Services (HHS) initiated the implementation process
CODING Policy The terms of this policy set forth the guidelines for reporting the provision of care rendered by NHP participating providers, including but not limited to use of standard diagnosis and procedure
A Guide to Education and Training for ICD-10 Implementation Table of Contents Chapter One: Phases of implementation Chapter Two: Timelines for implementation Chapter Three: Part One: Part Two: Part Three:
APPLICATIONS AND TECHNOLOGIES COLLABORATIVE ICD-10 A Primer AUTHOR Joseph C. Nichols, MD This research report is provided in response to requests from members of both the IT Strategy Council (ITSC) and
Introduction to ICD - 10 Andrea Devlin, CPMA, CPC Alta Partners, LLC 2015 Agenda Introduction Benefits of ICD-10 Features of ICD-10 ICD-9 vs. ICD-10 ICD-10 Structure Question & Answer Introducing ICD-10
Coding Clinic update Conditions documented at the time of discharge, diabetes opportunities highlight important updates for CDI specialists W h i t e p a p e r Editor s note: The following article is provided
Narrative changes appear in bold text Items underlined have been moved within the guidelines since October 1, 2010 The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health |
0430 | REV - OCCUPATIONAL THERAPY | RC | General guidelines of medical
Ophthalmology Coding ICD-9 9 CM & CPT By Alice Landry, Registered Health Information Administrator and Certified Procedural Coder Harvey & Bernice Jones Eye Institute University of Arkansas for Medical
July 22, 2015 It s Time to Transition to ICD-10 What do the changes mean to your SNF? Presented by: Linda S. Little, RN-BSN Clinical Consultant HMM Consulting Office: (631) 265-6289 E-Mail: [email protected]
Narrative changes appear in bold text Items underlined have been moved within the guidelines since the FY 2014 version Italics are used to indicate revisions to heading changes The Centers for Medicare
ELIM OUTREACH TRAINING CENTER 1820 Ridge Rd Suite 300-301 Homewood, IL 60430 Tel:708-922-9547-Fax: 708-922-9568 E-mail: [email protected] Website: elimotc.com MEDICAL BILLING & CODING PROGRAM ELIM OUTREACH
Introduction to ICD-10 and what you need to know for a Successful Transition Sheila Goethel, RHIT, CCS Coding Consultant AHIMA ICD-10-CM/PCS Certified Trainer May 2011 Objectives Introduction of ICD Brief
Preparing for ICD-10: What You Should Be Doing Now PHCA November 11, 2014 Presented by: Reinsel Kuntz Lesher LLP Senior Living Services Consulting Stephanie Kessler, Partner Karin Sherman, Senior Consultant
Monterey County I 50T02 II 50T03 HEALTH INFORMATION MANAGEMENT CODER I/II DEFINITION Under general supervision, reviews, interprets, codes and abstracts medical records information according to standard
Frequently Asked Questions Frequently asked questions: ICD-10 To help health care providers and payers prepare for ICD-10, Optum has prepared the following answers to frequently asked questions. ICD-10
Preparing for the ICD-10 Transition By Melody W. Mulaik President: Coding Strategies, Inc. On October 1, 2014, after more than 30 years with the ICD-9-CM coding system, the U.S. healthcare industry will
ICD-10 FAQs for Doctors What is ICD-10? ICD-10 is the 10 th revision of the International Classification of Diseases (ICD), used by health care systems to report diagnoses and procedures for purposes of
ICD -10 TRANSITION AS IT RELATES TO VISION Presented by: MARCH Vision Care, 2013 INTRODUCTION During the summer of 2008, the Department of Health and Human Services (HHS) initiated the implementation process
CODING Policy The terms of this policy set forth the guidelines for reporting the provision of care rendered by NHP participating providers, including but not limited to use of standard diagnosis and procedure
A Guide to Education and Training for ICD-10 Implementation Table of Contents Chapter One: Phases of implementation Chapter Two: Timelines for implementation Chapter Three: Part One: Part Two: Part Three:
APPLICATIONS AND TECHNOLOGIES COLLABORATIVE ICD-10 A Primer AUTHOR Joseph C. Nichols, MD This research report is provided in response to requests from members of both the IT Strategy Council (ITSC) and
Introduction to ICD - 10 Andrea Devlin, CPMA, CPC Alta Partners, LLC 2015 Agenda Introduction Benefits of ICD-10 Features of ICD-10 ICD-9 vs. ICD-10 ICD-10 Structure Question & Answer Introducing ICD-10
Coding Clinic update Conditions documented at the time of discharge, diabetes opportunities highlight important updates for CDI specialists W h i t e p a p e r Editor s note: The following article is provided
Narrative changes appear in bold text Items underlined have been moved within the guidelines since October 1, 2010 The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health |
0430 | REV - OCCUPATIONAL THERAPY | RC | Presented by: Linda S. Little, RN-BSN Clinical Consultant HMM Consulting Office: (631) 265-6289 E-Mail: [email protected]
Narrative changes appear in bold text Items underlined have been moved within the guidelines since the FY 2014 version Italics are used to indicate revisions to heading changes The Centers for Medicare
ELIM OUTREACH TRAINING CENTER 1820 Ridge Rd Suite 300-301 Homewood, IL 60430 Tel:708-922-9547-Fax: 708-922-9568 E-mail: [email protected] Website: elimotc.com MEDICAL BILLING & CODING PROGRAM ELIM OUTREACH
Introduction to ICD-10 and what you need to know for a Successful Transition Sheila Goethel, RHIT, CCS Coding Consultant AHIMA ICD-10-CM/PCS Certified Trainer May 2011 Objectives Introduction of ICD Brief
Preparing for ICD-10: What You Should Be Doing Now PHCA November 11, 2014 Presented by: Reinsel Kuntz Lesher LLP Senior Living Services Consulting Stephanie Kessler, Partner Karin Sherman, Senior Consultant
Monterey County I 50T02 II 50T03 HEALTH INFORMATION MANAGEMENT CODER I/II DEFINITION Under general supervision, reviews, interprets, codes and abstracts medical records information according to standard
Frequently Asked Questions Frequently asked questions: ICD-10 To help health care providers and payers prepare for ICD-10, Optum has prepared the following answers to frequently asked questions. ICD-10
Preparing for the ICD-10 Transition By Melody W. Mulaik President: Coding Strategies, Inc. On October 1, 2014, after more than 30 years with the ICD-9-CM coding system, the U.S. healthcare industry will
ICD-10 FAQs for Doctors What is ICD-10? ICD-10 is the 10 th revision of the International Classification of Diseases (ICD), used by health care systems to report diagnoses and procedures for purposes of
ICD -10 TRANSITION AS IT RELATES TO VISION Presented by: MARCH Vision Care, 2013 INTRODUCTION During the summer of 2008, the Department of Health and Human Services (HHS) initiated the implementation process
CODING Policy The terms of this policy set forth the guidelines for reporting the provision of care rendered by NHP participating providers, including but not limited to use of standard diagnosis and procedure
A Guide to Education and Training for ICD-10 Implementation Table of Contents Chapter One: Phases of implementation Chapter Two: Timelines for implementation Chapter Three: Part One: Part Two: Part Three:
APPLICATIONS AND TECHNOLOGIES COLLABORATIVE ICD-10 A Primer AUTHOR Joseph C. Nichols, MD This research report is provided in response to requests from members of both the IT Strategy Council (ITSC) and
Introduction to ICD - 10 Andrea Devlin, CPMA, CPC Alta Partners, LLC 2015 Agenda Introduction Benefits of ICD-10 Features of ICD-10 ICD-9 vs. ICD-10 ICD-10 Structure Question & Answer Introducing ICD-10
Coding Clinic update Conditions documented at the time of discharge, diabetes opportunities highlight important updates for CDI specialists W h i t e p a p e r Editor s note: The following article is provided
Narrative changes appear in bold text Items underlined have been moved within the guidelines since October 1, 2010 The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health |
93784 | PR AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R | HCPCS | ABPM serves as a standard for detecting hypertension, particularly white coat hypertension (WCH). This ensures precise measurement outside clinical Setups. Essential Medical Codes for ABPM
For streamlining proper billing and coding for ABPM, it is essential to remain up to date with the right CPT, ICD-10, and HCPCS codes. CPT Codes for ABPM
CPT Code 93784: This Code is used for Comprehensive monitoring that includes recording, scanning analysis, interpretation, and report. CPT Code 93786: This Code is used for recording only. |
93786 | PR AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY | HCPCS | ABPM serves as a standard for detecting hypertension, particularly white coat hypertension (WCH). This ensures precise measurement outside clinical Setups. Essential Medical Codes for ABPM
For streamlining proper billing and coding for ABPM, it is essential to remain up to date with the right CPT, ICD-10, and HCPCS codes. CPT Codes for ABPM
CPT Code 93784: This Code is used for Comprehensive monitoring that includes recording, scanning analysis, interpretation, and report. CPT Code 93786: This Code is used for recording only. |
93784 | PR AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R | HCPCS | This ensures precise measurement outside clinical Setups. Essential Medical Codes for ABPM
For streamlining proper billing and coding for ABPM, it is essential to remain up to date with the right CPT, ICD-10, and HCPCS codes. CPT Codes for ABPM
CPT Code 93784: This Code is used for Comprehensive monitoring that includes recording, scanning analysis, interpretation, and report. CPT Code 93786: This Code is used for recording only. CPT Code 93788: This Code is used for Scanning and analysis with a report. |
93786 | PR AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY | HCPCS | This ensures precise measurement outside clinical Setups. Essential Medical Codes for ABPM
For streamlining proper billing and coding for ABPM, it is essential to remain up to date with the right CPT, ICD-10, and HCPCS codes. CPT Codes for ABPM
CPT Code 93784: This Code is used for Comprehensive monitoring that includes recording, scanning analysis, interpretation, and report. CPT Code 93786: This Code is used for recording only. CPT Code 93788: This Code is used for Scanning and analysis with a report. |
93788 | PR AMBULATORY BP MNTR W/SW 24 HR+ SCANNING A/R | HCPCS | This ensures precise measurement outside clinical Setups. Essential Medical Codes for ABPM
For streamlining proper billing and coding for ABPM, it is essential to remain up to date with the right CPT, ICD-10, and HCPCS codes. CPT Codes for ABPM
CPT Code 93784: This Code is used for Comprehensive monitoring that includes recording, scanning analysis, interpretation, and report. CPT Code 93786: This Code is used for recording only. CPT Code 93788: This Code is used for Scanning and analysis with a report. |
93784 | PR AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R | HCPCS | Essential Medical Codes for ABPM
For streamlining proper billing and coding for ABPM, it is essential to remain up to date with the right CPT, ICD-10, and HCPCS codes. CPT Codes for ABPM
CPT Code 93784: This Code is used for Comprehensive monitoring that includes recording, scanning analysis, interpretation, and report. CPT Code 93786: This Code is used for recording only. CPT Code 93788: This Code is used for Scanning and analysis with a report. CPT Code 93790: This Code is used to Review with interpretation and report. |
93786 | PR AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY | HCPCS | Essential Medical Codes for ABPM
For streamlining proper billing and coding for ABPM, it is essential to remain up to date with the right CPT, ICD-10, and HCPCS codes. CPT Codes for ABPM
CPT Code 93784: This Code is used for Comprehensive monitoring that includes recording, scanning analysis, interpretation, and report. CPT Code 93786: This Code is used for recording only. CPT Code 93788: This Code is used for Scanning and analysis with a report. CPT Code 93790: This Code is used to Review with interpretation and report. |
93788 | PR AMBULATORY BP MNTR W/SW 24 HR+ SCANNING A/R | HCPCS | Essential Medical Codes for ABPM
For streamlining proper billing and coding for ABPM, it is essential to remain up to date with the right CPT, ICD-10, and HCPCS codes. CPT Codes for ABPM
CPT Code 93784: This Code is used for Comprehensive monitoring that includes recording, scanning analysis, interpretation, and report. CPT Code 93786: This Code is used for recording only. CPT Code 93788: This Code is used for Scanning and analysis with a report. CPT Code 93790: This Code is used to Review with interpretation and report. |
93790 | PR AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R | HCPCS | Essential Medical Codes for ABPM
For streamlining proper billing and coding for ABPM, it is essential to remain up to date with the right CPT, ICD-10, and HCPCS codes. CPT Codes for ABPM
CPT Code 93784: This Code is used for Comprehensive monitoring that includes recording, scanning analysis, interpretation, and report. CPT Code 93786: This Code is used for recording only. CPT Code 93788: This Code is used for Scanning and analysis with a report. CPT Code 93790: This Code is used to Review with interpretation and report. |
93784 | PR AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R | HCPCS | CPT Code 93790: This Code is used to Review with interpretation and report. While all four CPT codes exist, only three are covered by Medicare. Code 93784 is recommended when providing both technical and professional components. Code 93786 is used for the technical component only, and code 93790 is for the professional component only. HCPCS Code for ABPM
HCPCS A4670: This standard is used for Automatic blood pressure monitoring. |
93786 | PR AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY | HCPCS | CPT Code 93790: This Code is used to Review with interpretation and report. While all four CPT codes exist, only three are covered by Medicare. Code 93784 is recommended when providing both technical and professional components. Code 93786 is used for the technical component only, and code 93790 is for the professional component only. HCPCS Code for ABPM
HCPCS A4670: This standard is used for Automatic blood pressure monitoring. |
A4670 | Automatic bp monitor, dial | HCPCS | CPT Code 93790: This Code is used to Review with interpretation and report. While all four CPT codes exist, only three are covered by Medicare. Code 93784 is recommended when providing both technical and professional components. Code 93786 is used for the technical component only, and code 93790 is for the professional component only. HCPCS Code for ABPM
HCPCS A4670: This standard is used for Automatic blood pressure monitoring. |
93790 | PR AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R | HCPCS | CPT Code 93790: This Code is used to Review with interpretation and report. While all four CPT codes exist, only three are covered by Medicare. Code 93784 is recommended when providing both technical and professional components. Code 93786 is used for the technical component only, and code 93790 is for the professional component only. HCPCS Code for ABPM
HCPCS A4670: This standard is used for Automatic blood pressure monitoring. |
93784 | PR AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R | HCPCS | While all four CPT codes exist, only three are covered by Medicare. Code 93784 is recommended when providing both technical and professional components. Code 93786 is used for the technical component only, and code 93790 is for the professional component only. HCPCS Code for ABPM
HCPCS A4670: This standard is used for Automatic blood pressure monitoring. ICD-10 Codes for ABPM Diagnosis
ICD-10-CM Diagnosis Codes for ABPM include essential hypertension (I10), hypertensive heart disease without heart failure (I11.9), and other forms of angina pectoris (I20.8). |
93786 | PR AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY | HCPCS | While all four CPT codes exist, only three are covered by Medicare. Code 93784 is recommended when providing both technical and professional components. Code 93786 is used for the technical component only, and code 93790 is for the professional component only. HCPCS Code for ABPM
HCPCS A4670: This standard is used for Automatic blood pressure monitoring. ICD-10 Codes for ABPM Diagnosis
ICD-10-CM Diagnosis Codes for ABPM include essential hypertension (I10), hypertensive heart disease without heart failure (I11.9), and other forms of angina pectoris (I20.8). |
A4670 | Automatic bp monitor, dial | HCPCS | While all four CPT codes exist, only three are covered by Medicare. Code 93784 is recommended when providing both technical and professional components. Code 93786 is used for the technical component only, and code 93790 is for the professional component only. HCPCS Code for ABPM
HCPCS A4670: This standard is used for Automatic blood pressure monitoring. ICD-10 Codes for ABPM Diagnosis
ICD-10-CM Diagnosis Codes for ABPM include essential hypertension (I10), hypertensive heart disease without heart failure (I11.9), and other forms of angina pectoris (I20.8). |
93790 | PR AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R | HCPCS | While all four CPT codes exist, only three are covered by Medicare. Code 93784 is recommended when providing both technical and professional components. Code 93786 is used for the technical component only, and code 93790 is for the professional component only. HCPCS Code for ABPM
HCPCS A4670: This standard is used for Automatic blood pressure monitoring. ICD-10 Codes for ABPM Diagnosis
ICD-10-CM Diagnosis Codes for ABPM include essential hypertension (I10), hypertensive heart disease without heart failure (I11.9), and other forms of angina pectoris (I20.8). |
93784 | PR AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R | HCPCS | Code 93784 is recommended when providing both technical and professional components. Code 93786 is used for the technical component only, and code 93790 is for the professional component only. HCPCS Code for ABPM
HCPCS A4670: This standard is used for Automatic blood pressure monitoring. ICD-10 Codes for ABPM Diagnosis
ICD-10-CM Diagnosis Codes for ABPM include essential hypertension (I10), hypertensive heart disease without heart failure (I11.9), and other forms of angina pectoris (I20.8). Moreover, it also deals with orthostatic hypotension (I95.1), elevated blood pressure diagnosis (R03.0), syncope and collapse (R55), and encounters for blood pressure examination with or without abnormal findings (Z01.30 and Z01.31). |
93786 | PR AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY | HCPCS | Code 93784 is recommended when providing both technical and professional components. Code 93786 is used for the technical component only, and code 93790 is for the professional component only. HCPCS Code for ABPM
HCPCS A4670: This standard is used for Automatic blood pressure monitoring. ICD-10 Codes for ABPM Diagnosis
ICD-10-CM Diagnosis Codes for ABPM include essential hypertension (I10), hypertensive heart disease without heart failure (I11.9), and other forms of angina pectoris (I20.8). Moreover, it also deals with orthostatic hypotension (I95.1), elevated blood pressure diagnosis (R03.0), syncope and collapse (R55), and encounters for blood pressure examination with or without abnormal findings (Z01.30 and Z01.31). |
A4670 | Automatic bp monitor, dial | HCPCS | Code 93784 is recommended when providing both technical and professional components. Code 93786 is used for the technical component only, and code 93790 is for the professional component only. HCPCS Code for ABPM
HCPCS A4670: This standard is used for Automatic blood pressure monitoring. ICD-10 Codes for ABPM Diagnosis
ICD-10-CM Diagnosis Codes for ABPM include essential hypertension (I10), hypertensive heart disease without heart failure (I11.9), and other forms of angina pectoris (I20.8). Moreover, it also deals with orthostatic hypotension (I95.1), elevated blood pressure diagnosis (R03.0), syncope and collapse (R55), and encounters for blood pressure examination with or without abnormal findings (Z01.30 and Z01.31). |
93790 | PR AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R | HCPCS | Code 93784 is recommended when providing both technical and professional components. Code 93786 is used for the technical component only, and code 93790 is for the professional component only. HCPCS Code for ABPM
HCPCS A4670: This standard is used for Automatic blood pressure monitoring. ICD-10 Codes for ABPM Diagnosis
ICD-10-CM Diagnosis Codes for ABPM include essential hypertension (I10), hypertensive heart disease without heart failure (I11.9), and other forms of angina pectoris (I20.8). Moreover, it also deals with orthostatic hypotension (I95.1), elevated blood pressure diagnosis (R03.0), syncope and collapse (R55), and encounters for blood pressure examination with or without abnormal findings (Z01.30 and Z01.31). |
93786 | PR AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY | HCPCS | Code 93786 is used for the technical component only, and code 93790 is for the professional component only. HCPCS Code for ABPM
HCPCS A4670: This standard is used for Automatic blood pressure monitoring. ICD-10 Codes for ABPM Diagnosis
ICD-10-CM Diagnosis Codes for ABPM include essential hypertension (I10), hypertensive heart disease without heart failure (I11.9), and other forms of angina pectoris (I20.8). Moreover, it also deals with orthostatic hypotension (I95.1), elevated blood pressure diagnosis (R03.0), syncope and collapse (R55), and encounters for blood pressure examination with or without abnormal findings (Z01.30 and Z01.31). Challenges in Ambulatory Medical Billing and Coding
Ambulatory medical billing presents a set of challenges due to the diverse nature of outpatient services. |
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