Codes That Do Not Meet Payment Determination Criteria

The following table lists the codes for services that do not meet payment determination criteria. If criteria for the use of modifier code GA are met, GA should be appended when billing for the services listed. See Modifier Code GA.

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Table I. CPT Codes

CPT CodesDescription
0010MOncology (high-grade prostate cancer), biochemical assay of four proteins (total PSA, free PSA, intact PSAand human kallikrein 2 [hk2]) plus patient age, digital rectal examination status, and no history of positive prostate biopsy, utilizing plasma, prognostic algorithm reported as a probability score
0011MOncology, prostate cancer, mrna expression assay of 12 genes (10 content and 2 housekeeping), rt-pcr test utilizing blood plasma and/or urine, algorithms to predict high-grade prostate cancer risk
0012MOncology (urothelial), mrna, gene expression profiling by real-time quantitative pcr of five genes (mdk, hoxa13, cdc2 [cdk1], igfbp5, and xcr2), utilizing urine, algorithm reported as a risk score for having urothelial carcinoma
0013MOncology (urothelial), mrna, gene expression profiling by real-time quantitative pcr of five genes (mdk, hoxa13, cdc2 [cdk1], igfbp5, and cxcr2), utilizing urine, algorithm reported as a risk score for having recurrent urothelial carcinoma
0019MCardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations
0351TOptical coherence tomography of breast or axillary lymph node, excised tissue, each specimen; real time intraoperative
0352TOptical coherence tomography of breast or axillary lymph node, excised tissue, each specimen, interpretation and report, real time or referred
0353TOptical coherence tomography of breast, surgical cavity; real time intraoperative
0354TOptical coherence tomography of breast, surgical cavity; interpretation and report, real time intraoperative
0355TGastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report
0356TInsertion of drug-eluting implant (including puntal dilation and implant removal when performed) into lacrimal canaliculus, each
0358TBiolectrical impedance analysis whole body composition assessment, supine position, with interpretation and report
0359TBehavior identification assessment, by the physician or other qualified health care professional, face-to-face with patient and caregiver(s), includes administration of standardization and non-standardization tests, detailed behavioral history, patient observational
0360TObservational behavioral follow-up assessment, includes physician or other qualified health care professional direction with interpretation and report, administered by one technician; first 30 minutes of technician time, face-to-face with the patient
0361TObservational behavioral follow-up assessment, includes physician or other qualified health care professional direction with interpretation and report, administered by one technician; each additional 30 minutes of technician time, face-to-face with the patient
0363TExposure behavioral follow-up assessment, includes physician or other qualified health care professional direction with interpretation and report, administered by physician or other qualified health care professional with the assistance of one or more tec
0509TElectroretinography (erg) with interpretation and report, pattern (perg)
0512T, 0513TExtracorporeal shock wave for integumentary wound healing, high energy, including topical application and dressing care; initial wound
0514TIntraoperative visual axis identification using patient fixation (list separately in addition to code for primary procedure)
0621TTrabeculostomy ab interno by laser
0622TTrabeculostomy ab interno by laser; with use of ophthalmic endoscope
0632TPercutaneous transcatheter ultrasound ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance
0634TComputed tomography, breast, including 3D rendering, when performed, unilateral; with contrast material(s)
0635TComputed tomography, breast, including 3D rendering, when performed, unilateral; without contrast, followed by contrast material(s)
0636TComputed tomography, breast, including 3D rendering, when performed, bilateral; without contrast material(s)
0637TComputed tomography, breast, including 3D rendering, when performed, bilateral; with contrast material(s)
0638TComputed tomography, breast, including 3D rendering, when performed, bilateral; without contrast, followed by contrast material(s)
0639TWireless skin sensor thermal anisotropy measurement(s) and assessment of flow in cerebrospinal fluid shunt, including ultrasound guidance, when performed
0887TEnd-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)
0867TTransperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml
0868THigh-resolution gastric electrophysiology mapping with simultaneous patient- symptom profiling, with interpretation and report
0870TImplantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed
0871TReplacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed
0872TReplacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed
0873TRevision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed
0874TRemoval of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters
0875TProgramming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional
0876TDuplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)
0881TCryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device
0882TIntraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)
0883TIntraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure
0884TEsophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed
0885TColonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed
0886TSigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed
0888THistotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance
0893TNoninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report
0894TCannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion
0895TConnection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate levels, macroscopic assessment)
0896TConnection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate levels, macroscopic assessment) (list separately in addition to code for primary procedure)
0897TNoninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report
0018UOncology (thyroid), microRNA profiling by RT-PCR of 10 microRNA sequences, utilizing fine needle aspirate, algorithm reported as a positive or negative result for moderate to high risk of malignancy
0031UCYP1A2 (cytochrome P450 family 1, subfamily A, member 2)(eg, drug metabolism), gene analysis, common variants (ie, *1F, *1K, *6, *7)
0036UNeurology (prion disease), cerebrospinal fluid, detection of prion protein by quaking- induced conformational conversion, qualitative
0041UBorrelia burgdorferi, antibody detection of 5 recombinant protein groups, by immunoblot, igm
0045UOncology (breast ductal carcinoma in situ), mrna, gene expression profiling by real- time rt-pcr of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score
0051UPrescription drug monitoring, evaluation of drugs present by lc-ms/ms, urine, 31 drug panel, reported as quantitative results, detected or not detected, per date of service
0052ULipoprotein, blood, high resolution fractionation and quantitation of lipoproteins, including all five major lipoprotein classes and subclasses of hdl, ldl, and vldl by vertical auto profile ultracentrifugation
0054UPrescription drug monitoring, 14 or more classes of drugs and substances, definitive tandem mass spectrometry with chromatography, capillary blood, quantitative report with therapeutic and toxic ranges, including steady-state range for the prescribed dose when detected, per date of service
0061UTranscutaneous measurement of five biomarkers (tissue oxygenation [sto2], oxyhemoglobin [cthbo2], deoxyhemoglobin [cthbr], papillary and reticular dermal hemoglobin concentrations [cthb1 and cthb2]), using spatial frequency domain imaging (sfdi) and multi-spectral analysis
0067UOncology (breast), immunohistochemistry, protein expression profiling of 4 biomarkers (matrix metalloproteinase-1 [mmp-1], carcinoembryonic antigen-related cell adhesion molecule 6 [ceacam6], hyaluronoglucosaminidase [hyal1], highly expressed in cancer protein [hec1]), formalin-fixed paraffin-embedded precancerous breast tissue, algorithm reported as carcinoma risk score
0068UCandida species panel (c. Albicans, c. Glabrata, c. Parapsilosis, c. Kruseii, c tropicalis, and c. Auris), amplified probe technique with qualitative report of the presence or absence of each species
0078UPain management (opioid-use disorder) genotyping panel, 16 common variants (ie, ABCB1, COMT, DAT1, DBH, DOR, DRD1, DRD2, DRD4, GABA, GAL, HTR2A, HTTLPR, MTHFR, MUOR, OPRK1, OPRM1), buccal swab or other germline tissue sample, algorithm reported as positive or negative risk of opioid-use disorder
0087UCardiology (heart transplant), mrna gene expression profiling by microarray of 1283 genes, transplant biopsy tissue, allograft rejection and injury algorithm reported as a probability score
0088UTransplantation medicine (kidney allograft rejection), microarray gene expression profiling of 1494 genes, utilizing transplant biopsy tissue, algorithm reported as a probability score for rejection
0090UOncology (cutaneous melanoma), mrna gene expression profiling by rt-pcr of 23 genes (14 content and 9 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a categorical result (ie, benign, indeterminate, malignant)
0094UGenome (eg, unexplained constitutional or heritable disorder or syndrome), rapid sequence analysis
0097UGastrointestinal pathogen, multiplex reverse transcription and multiplex amplified probe technique, multiple types or subtypes, 22 targets (campylobacter [c. Jejuni/c. Coli/c. Upsaliensis], clostridium difficile [c. Difficile] toxin a/b, plesiomonas shigelloides, salmonella, vibrio [v. Parahaemolyticus/v. Vulnificus/v. Cholerae], including specific identification of vibrio cholerae, yersinia enterocolitica, enteroaggregative escherichia coli [eaec], enteropathogenic escherichia coli [epec], enterotoxigenic escherichia coli [etec] lt/st, shiga-like toxin-producing escherichia coli [stec] stx1/stx2 [including specific identification of the e. Coli o157 serogroup within stec], shigella/enteroinvasive escherichia coli [eiec], cryptosporidium, cyclospora cayetanensis, entamoeba histolytica, giardia lamblia [also known as g. Intestinalis and g. Duodenalis], adenovirus f 40/41, astrovirus, norovirus gi/gii, rotavirus a, sapovirus [genogroups i, ii, iv, and v])
0105UNephrology (chronic kidney disease), multiplex electrochemiluminescent immunoassay (eclia) of tumor necrosis factor receptor 1a, receptor superfamily 2 (tnfr1, tnfr2), and kidney injury molecule-1 (kim-1) combined with longitudinal clinical data, including apol1 genotype if available, and plasma (isolated fresh or frozen), algorithm reported as probability score for rapid kidney function decline (RKFD)
0108UGastroenterology (Barrett’s esophagus), whole slide–digital imaging, including morphometric analysis, computer-assisted quantitative immunolabeling of 9 protein biomarkers (p16, AMACR, p53, cd68, cox-2, cd45ro, hif1a, her-2, k20) and morphology, formalin-fixed paraffin-embedded tissue, algorithm reported as risk of progression to high-grade dysplasia or cancer
0109UInfectious disease (aspergillus species), real-time PCR for detection of DNA from 4 species (a. Fumigatus, a. Terreus, a. Niger, and a. Flavus), blood, lavage fluid, or tissue, qualitative reporting of presence or absence of each species
0110UPrescription drug monitoring, one or more oral oncology drug(s) and substances, definitive tandem mass spectrometry with chromatography, serum or plasma from capillary blood or venous blood, quantitative report with steady-state range for the prescribed drug(s) when detected
0112UInfectious agent detection and identification, targeted sequence analysis (16s and 18s rRNA genes) with drug-resistance gene
0113UOncology (prostate), measurement of pca3 and tmprss2-erg in urine and PSA in serum following prostatic massage, by RNA amplification and fluorescence-based detection, algorithm reported as risk score
0114UGastroenterology (Barrett’s esophagus), vim and ccna1 methylation analysis, esophageal cells, algorithm reported as likelihood for Barrett’s esophagus
0116UPrescription drug monitoring, enzyme immunoassay of 35 or more drugs confirmed with lc-ms/ms, oral fluid, algorithm results reported as a patient-compliance measurement with risk of drug to drug interactions for prescribed medications
0117UPain management, analysis of 11 endogenous analytes (methylmalonic acid, xanthurenic acid, homocysteine, pyroglutamic acid, vanilmandelate, 5-hydroxyindoleacetic acid, hydroxymethylglutarate, ethylmalonate, 3-hydroxypropyl mercapturic acid (3-hpma), quinolinic acid, kynurenic acid), lc-ms/ms, urine, algorithm reported as a pain-index score with likelihood of atypical biochemical function associated with pain
0119UCardiology, ceramides by liquid chromatography–tandem mass spectrometry, plasma, quantitative report with risk score for major cardiovascular events
0120UOncology (b-cell lymphoma classification), mRNA, gene expression profiling by fluorescent probe hybridization of 58 genes (45 content and 13 housekeeping genes), formalin-fixed paraffin-embedded tissue, algorithm reported as likelihood for primary mediastinal b-cell lymphoma (PMBCL) and diffuse large b-cell lymphoma (DLBCL) with cell of origin subtyping in the latter
0123UMechanical fragility, RBC, shear stress and spectral analysis profiling
0130UHereditary colon cancer disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), targeted mRNA sequence analysis panel (APC, CDH1, CHEK2, MLH1, MSH2, MSH6, MUTYH, PMS2, PTEN, and, TP53) (List separately in addition to code for primary procedure)
0136UATM (ataxia telangiectasia mutated) (eg, ataxia telangiectasia) mRNA sequence analysis (List separately in addition to code for primary procedure)
0138UBRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) mRNA sequence analysis (List separately in, addition to code for primary procedure)
0143UDrug assay, definitive, 120 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metabolite description, comments including sample validation, per date of service
0144UDrug assay, definitive, 160 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metabolite description, comments including sample validation, per date of service
0145UDrug assay, definitive, 65 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metabolite description, comments including sample validation, per date of service
0146UDrug assay, definitive, 80 or more drugs or metabolites, urine, by quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metabolite description, comments including sample validation, per date of service
0147UDrug assay, definitive, 85 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metabolite description, comments including sample validation, per date of service
0148UDrug assay, definitive, 100 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metabolite description, comments including sample validation, per date of service
0149UDrug assay, definitive, 60 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metabolite description, comments including sample validation, per date of service
0150UDrug assay, definitive, 120 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metabolite description, comments including sample validation, per date of service
0163UONCOLOGY (COLORECTAL) SCREENING, BIOCHEMICAL ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA) OF 3 PLASMA OR SERUM PROTEINS (TERATOCARCINOMA DERIVED GROWTH FACTOR-1 [TDGF-1, CRIPTO- 1], CARCINOEMBRYONIC ANTIGEN [CEA], EXTRACELLULAR MATRIX PROTEIN [ECM]), WITH DEMOGRAPHIC DATA (AGE, GENDER, CRC- SCREENING COMPLIANCE) USING A PROPRIETARY ALGORITHM AND REPORTED AS LIKELIHOOD OF CRC OR ADVANCED ADENOMAS
0164UGASTROENTEROLOGY (IRRITABLE BOWEL SYNDROME [IBS]), IMMUNOASSAY FOR ANTI- CDTB AND ANTI-VINCULIN ANTIBODIES, UTILIZING PLASMA, ALGORITHM FOR ELEVATED OR NOT ELEVATED QUALITATIVE RESULTS
0166ULIVER DISEASE, 10 BIOCHEMICAL ASSAYS (A2- MACROGLOBULIN, HAPTOGLOBIN, APOLIPOPROTEIN A1, BILIRUBIN, GGT, ALT, AST, TRIGLYCERIDES, CHOLESTEROL, FASTING GLUCOSE) AND BIOMETRIC AND DEMOGRAPHIC DATA, UTILIZING SERUM, ALGORITHM REPORTED AS SCORES FOR FIBROSIS, NECROINFLAMMATORY ACTIVITY, AND STEATOSIS WITH A SUMMARY INTERPRETATION
0167UGONADOTROPIN, CHORIONIC (HCG), IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION, BLOOD
0170UNEUROLOGY (AUTISM SPECTRUM DISORDER [ASD]), RNA, NEXT-GENERATION SEQUENCING, SALIVA, ALGORITHMIC ANALYSIS, AND RESULTS REPORTED AS PREDICTIVE PROBABILITY OF ASD DIAGNOSIS
0202UInfectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected
0223UINFECTIOUS DISEASE (BACTERIAL OR VIRAL RESPIRATORY TRACT INFECTION), PATHOGEN-SPECIFIC NUCLEIC ACID (DNA OR RNA), 22 TARGETS INCLUDING SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (SARS-COV-2), QUALITATIVE RT-PCR, NASOPHARYNGEAL SWAB, EACH PATHOGEN REPORTED DETECTED OR NOT DETECTED
0224U

Antibody, severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (Coronavirus disease [COVID-19]), includes titer(s), when performed (Do not report 0224U in conjunction with 86769)

At this time deny, unclear if quantitative IgG medically useful at this time

0225UInfectious disease (bacterial or viral respiratory tract infection) pathogen-specific DNA and RNA, 21 targets, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), amplified probe technique, including multiplex reverse transcription for RNA targets, each analyte reported as detected or not detected
0226USURROGATE VIRAL NEUTRALIZATION TEST (SVNT), SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (SARS-COV-2) (CORONAVIRUS DISEASE [COVID-19]), ELISA, PLASMA, SERUM
0248U

Oncology (brain), spheroid cell culture in a 3d microenvironment, 12 drug panel, tumor-response prediction for each drug

0249U Oncology (breast), semiquantitative analysis of 32 phosphoproteins and protein analytes, includes laser capture microdissection, with algorithmic analysis and interpretative report

0251UHepcidin-25, enzyme-linked immunosorbent assay (elisa), serum or plasma
0253UReproductive medicine (endometrial receptivity analysis), rna gene expression profile, 238 genes by next-generation sequencing, endometrial tissue, predictive algorithm reported as endometrial window of implantation (eg, pre-receptive, receptive, post-receptive)
0254UReproductive medicine (preimplantation genetic assessment), analysis of 24 chromosomes using embryonic dna genomic sequence analysis for aneuploidy, and a mitochondrial dna score in euploid embryos, results reported as normal (euploidy),monosomy, trisomy, or partial deletion/duplications, mosaicism, and segmental aneuploidy, per embryo tested
0255UAndrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score
0257UVery long chain acyl-coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood
0258UAutoimmune (psoriasis), mrna, next- generation sequencing, gene expression profiling of 50-100 genes, skin-surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics
0259UNephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative
0260URare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping
0261UOncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score
0262UOncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin- embedded (ffpe), algorithm reported as gene pathway activity score
0263UNeurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a- ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chromatography tandem mass spectrometry (lc-ms/ms), plasma, algorithmic analysis with result reported as negative or positive (with metabolic subtypes of asd)
0264URare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping
0265URare constitutional and other heritable disorders, whole genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin- embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants
0267URare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole genome sequencing
0275UHematology (heparin-induced thrombocytopenia), platelet antibody reactivity by flow cytometry, serum
0278UHematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid
0285UOncology, response to radiation, cell-free dna, quantitative branched chain dna amplification, plasma, reported as a radiation toxicity score
0286UCep72 (centrosomal protein, 72-kda), nudt15 (nudix hydrolase 15) and tpmt (thiopurine s-methyltransferase) (eg, drug metabolism) gene analysis, common variants
0288UOncology (lung), mrna, quantitative pcr analysis of 11 genes (bag1, brca1, cdc6, cdk2ap1, erbb3, fut3, il11, lck, rnd3, sh3bgr, wnt3a) and 3 reference genes (esd, tbp, yap1), formalin-fixed paraffin-embedded (ffpe) tumor tissue, algorithmic interpretation reported as a recurrence risk score
0289UNeurology (alzheimer disease), mrna, gene expression profiling by rna sequencing of 24 genes, whole blood, algorithm reported as predictive risk score
0290UPain management, mrna, gene expression profiling by rna sequencing of 36 genes, whole blood, algorithm reported as predictive risk score
0291UPsychiatry (mood disorders), mrna, gene expression profiling by rna sequencing of 144 genes, whole blood, algorithm reported as predictive risk score
0292UPsychiatry (stress disorders), mrna, gene expression profiling by rna sequencing of 72 genes, whole blood, algorithm reported as predictive risk score
0293UPsychiatry (suicidal ideation), mrna, gene expression profiling by rna sequencing of 54 genes, whole blood, algorithm reported as predictive risk score
0294ULongevity and mortality risk, mrna, gene expression profiling by rna sequencing of 18 genes, whole blood, algorithm reported as predictive risk score
0295UOncology (breast ductal carcinoma in situ), protein expression profiling by immunohistochemistry of 7 proteins (cox2, foxa1, her2, ki-67, p16, pr, siah2), with 4 clinicopathologic factors (size, age, margin status, palpability), utilizing formalin-fixed paraffin-embedded (ffpe) tissue, algorithm reported as a recurrence risk score
0296UOncology (oral and/or oropharyngeal cancer), gene expression profiling by rna sequencing at least 20 molecular features (eg, human and/or microbial mrna), saliva, algorithm reported as positive or negative for signature associated with malignancy
0297UOncology (pan tumor), whole genome sequencing of paired malignant and normal dna specimens, fresh or formalin-fixed paraffin-embedded (ffpe) tissue, blood or bone marrow, comparative sequence analyses and variant identification
0298UOncology (pan tumor), whole transcriptome sequencing of paired malignant and normal rna specimens, fresh or formalin-fixed paraffin-embedded (ffpe) tissue, blood or bone marrow, comparative sequence analyses and expression level and chimeric transcript identification
0299UOncology (pan tumor), whole genome optical genome mapping of paired malignant and normal DNA specimens, fresh frozen tissue, blood, or bone marrow, comparative structural variant identification
0300UOncology (pan tumor), whole genome sequencing and optical genome mapping of paired malignant and normal DNA specimens, fresh tissue, blood, or bone marrow, comparative sequence analyses and variant identification
0303UHematology, red blood cell (rbc) adhesion to endothelial/subendothelial adhesion molecules, functional assessment, whole blood, with algorithmic analysis and result reported as an rbc adhesion index; hypoxic
0304UHematology, red blood cell (rbc) adhesion to endothelial/subendothelial adhesion molecules, functional assessment, whole blood, with algorithmic analysis and result reported as an rbc adhesion index; normoxic
0305UHematology, red blood cell (rbc) functionality and deformity as a function of shear stress, whole blood, reported as a maximum elongation index
0310UPediatrics (vasculitis, kawasaki disease [kd]), analysis of 3 biomarkers (nt- probnp, c-reactive protein, and t-uptake), plasma, algorithm reported as a risk score for kd
0312UAutoimmune diseases (eg, systemic lupus erythematosus [sle]), analysis of 8 igg autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorbent immunoassay (elisa), flow cytometry and indirect immunofluorescence, serum, or plasma and whole blood, individual components reported along with an algorithmic sle-likelihood assessment
0313UOncology (pancreas), dna and mrna next-generation sequencing analysis of 74 genes and analysis of cea (ceacam5) gene expression, pancreatic cyst fluid, algorithm reported as a categorical result (ie, negative, low probability of neoplasia or positive, high probability of neoplasia)
0314UOncology (cutaneous melanoma), mrna gene expression profiling by rt-pcr of 35 genes (32 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded (ffpe) tissue, algorithm reported as a categorical result (ie, benign, intermediate, malignant)
0315UOncology (cutaneous squamous cell carcinoma), mrna gene expression profiling by rt-pcr of 40 genes (34 content and 6 housekeeping), utilizing formalin-fixed paraffin-embedded (ffpe) tissue, algorithm reported as a categorical risk result (ie, class 1, class 2a, class 2b)
0316UBorrelia burgdorferi (lyme disease), ospa protein evaluation, urine
0317UOncology (lung cancer), four-probe fish (3q29, 3p22.1, 10q22.3, 10cen) assay, whole blood, predictive algorithm- generated evaluation reported as decreased or increased risk for lung cancer
0319UNephrology (renal transplant), rna expression by select transcriptome sequencing, using pretransplant peripheral blood, algorithm reported as a risk score for early acute rejection
0320UNephrology (renal transplant), rna expression by select transcriptome sequencing, using posttransplant peripheral blood, algorithm reported as a risk score for acute cellular rejection
0322UNeurology (autism spectrum disorder [asd]), quantitative measurements of 14 acyl carnitines and microbiome-derived metabolites, liquid chromatography with tandem mass spectrometry (lc-ms/ms), plasma, results reported as negative or positive for risk of metabolic subtypes associated with asd
0323UInfectious agent detection by nucleic acid (dna and rna), central nervous system pathogen, metagenomic next-generation sequencing, cerebrospinal fluid (csf), identification of pathogenic bacteria, viruses, parasites, or fungi
0324UOncology (ovarian), spheroid cell culture, 4-drug panel (carboplatin, doxorubicin, gemcitabine, paclitaxel), tumor chemotherapy response prediction for each drug
0325UOncology (ovarian), spheroid cell culture, poly (adp-ribose) polymerase (parp) inhibitors (niraparib, olaparib, rucaparib, velparib), tumor response prediction for each drug
0327UFetal aneuploidy (trisomy 13, 18, and 21), DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy, includes sex reporting, if performed
0328UDrug assay, definitive, 120 or more drugs and metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (lc-ms/ms), includes specimen validity and algorithmic analysis describing drug or metabolite and presence or absence of risks for a significant patient-adverse event, per date of service
0329UOncology (neoplasia), exome and transcriptome sequence analysis for sequence variants, gene copy number amplifications and deletions, gene rearrangements, microsatellite instability and tumor mutational burden utilizing dna and rna from tumor with dna from normal blood or saliva for subtraction, report of clinically significant mutation(s) with therapy associations
0331UOncology (hematolymphoid neoplasia), optical genome mapping for copy number alterations and gene rearrangements utilizing dna from blood or bone marrow, report of clinically significant alternations
0333UOncology (liver), surveillance for hepatocellular carcinoma (HCC) in high- risk patients, analysis of methylation patterns on circulating cell-free DNA (cfDNA) plus measurement of serum of afp/afp-l3 and oncoprotein des-gamma-carboxy-prothrombin (DCP), algorithm reported as normal or abnormal result
0337UOncology (plasma cell disorders and myeloma), circulating plasma cell immunologic selection, identification, morphological characterization, and enumeration of plasma cells based on differential cd138, cd38, cd19, and cd45 protein biomarker expression, peripheral blood
0338UOncology (solid tumor), circulating tumor cell selection, identification, morphological characterization, detection and enumeration based on differential epcam, cytokeratins 8, 18, and 19, and cd45 protein biomarkers, and quantification of her2 protein biomarker-expressing cells, peripheral blood
0339UOncology (prostate), mRNA expression profiling of hoxc6 and dlx1, reverse transcription polymerase chain reaction (rt-PCR), first-void urine following digital rectal examination, algorithm reported as probability of high-grade cancer
0342UOncology (pancreatic cancer), multiplex immunoassay of c5, c4, cystatin c, factor b, osteoprotegerin (OPG), gelsolin, igfbp3, ca125 and multiplex electrochemiluminescent immunoassay (ECLIA) for ca19-9, serum, diagnostic algorithm reported qualitatively as positive, negative, or borderline
0343UOncology (prostate), exosome-based analysis of 442 small noncoding RNAs (sncRNAs) by quantitative reverse transcription polymerase chain reaction (rt-qPCR), urine, reported as molecular evidence of no-, low-, intermediate- or high-risk of prostate cancer
0345UPsychiatry (eg, depression, anxiety, attention deficit hyperactivity disorder [ADHD]), genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of cyp2d6
0346UBeta amyloid, ab40 and ab42 by liquid chromatography with tandem mass spectrometry (lc-ms/ms), ratio, plasma
0347UDrug metabolism or processing (multiple conditions), whole blood or buccal specimen, DNA analysis, 16 gene report, with variant analysis and reported phenotypes
0348UDrug metabolism or processing (multiple conditions), whole blood or buccal specimen, DNA analysis, 25 gene report, with variant analysis and reported phenotypes
0349UDrug metabolism or processing (multiple conditions), whole blood or buccal specimen, DNA analysis, 27 gene report, with variant analysis, including reported phenotypes and impacted gene-drug interactions
0350UDrug metabolism or processing (multiple conditions), whole blood or buccal specimen, DNA analysis, 27 gene report, with variant analysis and reported phenotypes
0351UInfectious disease (bacterial or viral), biochemical assays, tumor necrosis factor- related apoptosis-inducing ligand (trail), interferon gamma-induced protein-10 (ip- 10), and c-reactive protein, serum, algorithm reported as likelihood of bacterial infection
0352UInfectious disease (bacterial vaginosis and vaginitis), multiplex amplified probe technique, for detection of bacterial vaginosis-associated bacteria (bvab-2, atopobium vaginae, and megasphera type 1), algorithm reported as detected or not detected and separate detection of candida species (c. albicans, c. tropicalis, c. parapsilosis, c. dubliniensis), candida glabrata/candida krusei, and trichomonas vaginalis, vaginal-fluid specimen, each result reported as detected or not detected
0353UInfectious agent detection by nucleic acid (DNA), chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique, urine, vaginal, pharyngeal, or rectal, each pathogen reported as detected or not detected
0354UHuman papilloma virus (HPV), high-risk types (ie, 16, 18, 31, 33, 45, 52 and 58) qualitative mRNA expression of e6/e7 by quantitative polymerase chain reaction (qPCR)
0365UOncology (bladder), analysis of 10 protein biomarkers (A1AT, ANG, APOE, CA9, IL8, MMP9, MMP10, PAI1, SDC1 and VEGFA) by immunoassays, urine, algorithm reported, as a probability of bladder cancer
0366UOncology (bladder), analysis of 10 protein biomarkers (A1AT, ANG, APOE, CA9, IL8, MMP9, MMP10, PAI1, SDC1 and VEGFA) by immunoassays, urine, algorithm reported, as a probability of recurrent bladder cancer
0367UOncology (bladder), analysis of 10 protein biomarkers (A1AT, ANG, APOE, CA9, IL8, MMP9, MMP10, PAI1, SDC1 and VEGFA) by immunoassays, urine, diagnostic algorithm reported as a risk score for probability of rapid recurrence of recurrent or persistent cancer following transurethral resection
0368UOncology (colorectal cancer), evaluation for mutations of APC, BRAF, CTNNB1, KRAS, NRAS, PIK3CA, SMAD4, and TP53, and methylation markers (MYO1G, KCNQ5, C9ORF50, FLI1, CLIP4, ZNF132 and TWIST1), multiplex quantitative polymerase chain reaction (qPCR), circulating cell-free DNA (cfDNA), plasma, report of risk score for, advanced adenoma or colorectal cancer
0369UInfectious agent detection by nucleic acid (DNA and RNA), gastrointestinal pathogens, 31 bacterial, viral, and parasitic organisms and identification of 21 associated antibiotic-resistance genes, multiplex amplified probe technique
0370UInfectious agent detection by nucleic acid (DNA and RNA), surgical wound pathogens, 34 microorganisms and identification of 21 associated antibiotic-resistance genes,, multiplex amplified probe technique, wound swab
0371UInfectious agent detection by nucleic acid (DNA or RNA), genitourinary pathogen, semiquantitative identification, DNA from 16 bacterial organisms and 1 fungal organism, multiplex amplified probe technique via quantitative polymerase chain reaction (qPCR), urine
0372UInfectious disease (genitourinary pathogens), antibiotic-resistance gene detection, multiplex amplified probe technique, urine, reported as an antimicrobial stewardship, risk score
0373UInfectious agent detection by nucleic acid (DNA and RNA), respiratory tract infection, 17 bacteria, 8 fungus, 13 virus, and 16 antibiotic-resistance genes, multiplex amplified probe technique, upper or lower respiratory specimen
0374UInfectious agent detection by nucleic acid (DNA or RNA), genitourinary pathogens, identification of 21 bacterial and fungal organisms and identification of 21 associated, antibiotic-resistance genes, multiplex amplified probe technique, urine
0375UOncology (ovarian), biochemical assays of 7 proteins (follicle stimulating hormone, human epididymis protein 4, apolipoprotein A-1, transferrin, beta-2 macroglobulin, prealbumin [ie, transthyretin], and cancer antigen 125), algorithm reported as ovarian, cancer risk score
0376UOncology (prostate cancer), image analysis of at least 128 histologic features and clinical factors, prognostic algorithm determining the risk of distant metastases, and prostate cancer-specific mortality, includes predictive algorithm to androgen, deprivation-therapy response, if appropriate
0377UCardiovascular disease, quantification of advanced serum or plasma lipoprotein profile, by nuclear magnetic resonance (NMR) spectrometry with report of a, lipoprotein profile (including 23 variables)
0378URFC1 (replication factor C subunit 1), repeat expansion variant analysis by traditional and repeat-primed PCR, blood, saliva, or buccal swab
0380UDrug metabolism (adverse drug reactions and drug response), targeted sequence analysis, 20 gene variants and CYP2D6 deletion or duplication analysis with reported, genotype and phenotype
0381UMaple syrup urine disease monitoring by patient-collected blood card sample, quantitative measurement of allo-isoleucine, leucine, isoleucine, and valine, liquid chromatography with tandem mass spectrometry (LC-MS/MS)
0382UHyperphenylalaninemia monitoring by patient-collected blood card sample, quantitative measurement of phenylalanine and tyrosine, liquid chromatography with, tandem mass spectrometry (LC-MS/MS)
0383UTyrosinemia type I monitoring by patient-collected blood card sample, quantitative measurement of tyrosine, phenylalanine, methionine, succinylacetone, nitisinone, liquid chromatography with tandem mass spectrometry (LC-MS/MS)
0384UNephrology (chronic kidney disease), carboxymethyllysine, methylglyoxal hydroimidazolone, and carboxyethyl lysine by liquid chromatography with tandem mass spectrometry (LC-MS/MS) and HbA1c and estimated glomerular filtration rate, (GFR), with risk score reported for predictive progression to high-stage kidney disease
0385UNephrology (chronic kidney disease), apolipoprotein A4 (ApoA4), CD5 antigen-like (CD5L), and insulin-like growth factor binding protein 3 (IGFBP3) by enzyme-linked immunoassay (ELISA), plasma, algorithm combining results with HDL, estimated glomerular filtration rate (GFR) and clinical data reported as a risk score for developing, diabetic kidney disease
0386UGastroenterology (Barrett's esophagus), P16, RUNX3, HPP1, and FBN1 methylation analysis, prognostic and predictive algorithm reported as a risk score for progression to high-grade dysplasia or esophageal cancer
0387UOncology (melanoma), autophagy and beclin 1 regulator 1 (AMBRA1) and loricrin (AMLo) by immunohistochemistry, formalin-fixed paraffin-embedded (FFPE) tissue, report for risk of progression
0389UPediatric febrile illness (Kawasaki disease [KD]), interferon alpha-inducible protein 27 (IFI27) and mast cell-expressed membrane protein 1 (MCEMP1), RNA, using reverse transcription polymerase chain reaction (RT-qPCR), blood, reported as a risk score for KD
0390UObstetrics (preeclampsia), kinase insert domain receptor (KDR), Endoglin (ENG), and retinol-binding protein 4 (RBP4), by immunoassay, serum, algorithm reported as a risk score
0392UDrug metabolism (depression, anxiety, attention deficit hyperactivity disorder [ADHD]), gene-drug interactions, variant analysis of 16 genes, including deletion/duplication analysis of CYP2D6, reported as impact of gene-drug interaction for each drug
0393UNeurology (eg, Parkinson disease, dementia with Lewy bodies), cerebrospinal fluid (CSF), detection of misfolded α-synuclein protein by seed amplification assay, qualitative
0394UPerfluoroalkyl substances (PFAS) (eg, perfluorooctanoic acid, perfluorooctane sulfonic acid), 16 PFAS compounds by liquid chromatography with tandem mass spectrometry (LC-MS/MS), plasma or serum, quantitative
0395UOncology (lung), multi-omics (microbial DNA by shotgun next-generation sequencing and carcinoembryonic antigen and osteopontin by immunoassay), plasma, algorithm reported as malignancy risk for lung nodules in early-stage disease
0398UGastroenterology (Barrett esophagus), P16, RUNX3, HPP1, and FBN1 DNA methylation analysis using PCR, formalin-fixed paraffin-embedded (FFPE) tissue, algorithm reported as risk score for progression to high-grade dysplasia or cancer
0399UNeurology (cerebral folate deficiency), serum, detection of anti-human folate receptor IgG-binding antibody and blocking autoantibodies by enzyme-linked immunoassay (ELISA), qualitative, and blocking autoantibodies, using a functional blocking assay for IgG or IgM, quantitative, reported as positive or not detected
0401UCardiology (coronary heart disease [CAD]), 9 genes (12 variants), targeted variant genotyping, blood, saliva, or buccal swab, algorithm reported as a genetic risk score for a coronary event
0402UInfectious agent (sexually transmitted infection), Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, multiplex amplified probe technique, vaginal, endocervical, or male urine, each pathogen reported as detected or not detected
0403UOncology (prostate), mRNA, gene expression profiling of 18 genes, first-catch post-digital rectal examination urine (or processed first-catch urine), algorithm reported as percentage of likelihood of detecting clinically significant prostate cancer
0404UOncology (breast), semiquantitative measurement of thymidine kinase activity by immunoassay, serum, results reported as risk of disease progression
0406UOncology (lung), flow cytometry, sputum, 5 markers (meso-tetra [4-carboxyphenyl] porphyrin [TCPP], CD206, CD66b, CD3, CD19), algorithm reported as likelihood of lung cancer
0407UNephrology (diabetic chronic kidney disease [CKD]), multiplex electrochemiluminescent immunoassay (ECLIA) of soluble tumor necrosis factor receptor 1 (sTNFR1), soluble tumor necrosis receptor 2 (sTNFR2), and kidney injury molecule 1 (KIM-1) combined with clinical data, plasma, algorithm reported as risk for progressive decline in kidney function
0410UOncology (pancreatic), DNA, whole genome sequencing with 5-hydroxymethylcytosine enrichment, whole blood or plasma, algorithm reported as cancer detected or not detected
0411UPsychiatry (eg, depression, anxiety, attention deficit hyperactivity disorder [ADHD]), genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6
0412UBeta amyloid, Aβ42/40 ratio, immunoprecipitation with quantitation by liquid chromatography with tandem mass spectrometry (LC-MS/MS) and qualitative ApoE isoform-specific proteotyping, plasma combined with age, algorithm reported as presence or absence of brain amyloid pathology
0413UOncology (hematolymphoid neoplasm), optical genome mapping for copy number alterations, aneuploidy, and balanced/complex structural rearrangements, DNA from blood or bone marrow, report of clinically significant alterations
0415UCardiovascular disease (acute coronary syndrome [ACS]), IL-16, FAS, FASLigand, HGF, CTACK, EOTAXIN, and MCP-3 by immunoassay combined with age, sex, family history, and personal history of diabetes, blood, algorithm reported as a 5-year (deleted risk) score for ACS
0416UInfectious agent detection by nucleic acid (DNA), genitourinary pathogens, identification of 20 bacterial and fungal organisms, including identification of 20 associated antibiotic-resistance genes, if performed, multiplex amplified probe technique, urine
0417URare diseases (constitutional/heritable disorders), whole mitochondrial genome sequence with heteroplasmy detection and deletion analysis, nuclear-encoded mitochondrial gene analysis of 335 nuclear genes, including sequence changes, deletions, insertions, and copy number variants analysis, blood or saliva, identification and categorization of mitochondrial disorder–associated genetic variants
0418UOncology (breast), augmentative algorithmic analysis of digitized whole slide imaging of 8 histologic and immunohistochemical features, reported as a recurrence score
0419UNeuropsychiatry (eg, depression, anxiety), genomic sequence analysis panel, variant analysis of 13 genes, saliva or buccal swab, report of each gene phenotype
0420UONCOLOGY (UROTHELIAL), MRNA EXPRESSION PROFILING BY REAL-TIME QUANTITATIVE PCR OF MDK, HOXA13, CDC2, IGFBP5, AND CXCR2 IN COMBINATION WITH DROPLET DIGITAL PCR (DDPCR) ANALYSIS OF 6 SINGLE-NUCLEOTIDE POLYMORPHISMS (SNPS) GENES TERT AND FGFR3, URINE, ALGORI
0421UONCOLOGY (COLORECTAL) SCREENING, QUANTITATIVE REAL-TIME TARGET AND SIGNAL AMPLIFICATION OF 8 RNA MARKERS (GAPDH, SMAD4, ACY1, AREG, CDH1, KRAS, TNFRSF10B, EGLN2) AND FECAL HEMOGLOBIN, ALGORITHM REPORTED AS A POSITIVE OR NEGATIVE FOR COLORECTAL CANCER RISK
0423UPSYCHIATRY (EG, DEPRESSION, ANXIETY), GENOMIC ANALYSIS PANEL, INCLUDING VARIANT ANALYSIS OF 26 GENES, BUCCAL SWAB, REPORT INCLUDING METABOLIZER STATUS AND RISK OF DRUG TOXICITY BY CONDITION
0424UONCOLOGY (PROSTATE), EXOSOME- BASED ANALYSIS OF 53 SMALL NONCODING RNAS (SNCRNAS) BY QUANTITATIVE REVERSE TRANSCRIPTION POLYMERASE CHAIN REACTION (RT- QPCR), URINE, REPORTED AS NO MOLECULAR EVIDENCE, LOW-, MODERATE- OR ELEVATED-RISK OF PROSTATE CANCER
0425UGENOME (EG, UNEXPLAINED CONSTITUTIONAL OR HERITABLE DISORDER OR SYNDROME), RAPID SEQUENCE ANALYSIS, EACH COMPARATOR GENOME (EG, PARENTS, SIBLINGS)
0426UGENOME (EG, UNEXPLAINED CONSTITUTIONAL OR HERITABLE DISORDER OR SYNDROME), ULTRA-RAPID SEQUENCE ANALYSIS
0427UMONOCYTE DISTRIBUTION WIDTH, WHOLE BLOOD (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0429UHUMAN PAPILLOMAVIRUS (HPV), OROPHARYNGEAL SWAB, 14 HIGH-RISK TYPES (IE, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, AND 68)
0430UGASTROENTEROLOGY, MALABSORPTION EVALUATION OF ALPHA-1-ANTITRYPSIN, CALPROTECTIN, PANCREATIC ELASTASE AND REDUCING SUBSTANCES, FECES, QUANTITATIVE
0431UGLYCINE RECEPTOR ALPHA1 IGG, SERUM OR CEREBROSPINAL FLUID (CSF), LIVE CELL-BINDING ASSAY (LCBA), QUALITATIVE
0432UKELCH-LIKE PROTEIN 11 (KLHL11) ANTIBODY, SERUM OR CEREBROSPINAL FLUID (CSF), CELL-BINDING ASSAY, QUALITATIVE
0433UONCOLOGY (PROSTATE), 5 DNA REGULATORY MARKERS BY QUANTITATIVE PCR, WHOLE BLOOD, ALGORITHM, INCLUDING PROSTATE-SPECIFIC ANTIGEN, REPORTED AS LIKELIHOOD OF CANCER
0434UDRUG METABOLISM (ADVERSE DRUG REACTIONS AND DRUG RESPONSE), GENOMIC ANALYSIS PANEL, VARIANT ANALYSIS OF 25 GENES WITH REPORTED PHENOTYPES
0435UONCOLOGY, CHEMOTHERAPEUTIC DRUG CYTOTOXICITY ASSAY OF CANCER STEM CELLS (CSCS), FROM CULTURED CSCS AND PRIMARY TUMOR CELLS, CATEGORICAL DRUG RESPONSE REPORTED BASED ON CYTOTOXICITY PERCENTAGE OBSERVED, MINIMUM OF 14 DRUGS OR DRUG COMBINATIONS
0436UONCOLOGY (LUNG), PLASMA ANALYSIS OF 388 PROTEINS, USING APTAMER- BASED PROTEOMICS TECHNOLOGY, PREDICTIVE ALGORITHM REPORTED AS CLINICAL BENEFIT FROM IMMUNE CHECKPOINT INHIBITOR THERAPY
0437UPSYCHIATRY (ANXIETY DISORDERS), MRNA, GENE EXPRESSION PROFILING BY RNA SEQUENCING OF 15 BIOMARKERS, WHOLE BLOOD, ALGORITHM REPORTED AS PREDICTIVE RISK SCORE
0438UDRUG METABOLISM (ADVERSE DRUG REACTIONS AND DRUG RESPONSE), BUCCAL SPECIMEN, GENE-DRUG INTERACTIONS, VARIANT ANALYSIS OF 33 GENES, INCLUDING DELETION/DUPLICATION ANALYSIS OF CYP2D6, INCLUDING REPORTED PHENOTYPES AND IMPACTED GENE- DRUG INTERACTIONS
0439UCardiology (coronary heart disease [CHD]), DNA, analysis of 5 single-nucleotide polymorphisms (SNPs) (rs11716050 [LOC105376934], rs6560711 [WDR37], rs3735222 [SCIN/LOC107986769], rs6820447 [intergenic], and rs9638144 [ESYT2]) and 3 DNA methylation markers (cg00300879 [transcription start site {TSS200} of CNKSR1], cg09552548 [intergenic], and cg14789911 [body of SPATC1L]), qPCR and digital PCR, whole blood, algorithm reported as a 4-tiered risk score for a 3-year risk of symptomatic CHD
0440UCardiology (coronary heart disease [CHD]), DNA, analysis of 10 single-nucleotide polymorphisms (SNPs) (rs710987 [LINC010019], rs1333048 [CDKN2B-AS1], rs12129789 [KCND3], rs942317 [KTN1-AS1], rs1441433 [PPP3CA], rs2869675 [PREX1], rs4639796 [ZBTB41], rs4376434 [LINC00972], rs12714414 [TMEM18], and rs7585056 [TMEM18]) and 6 DNA methylation markers (cg03725309 [SARS1], cg12586707 [CXCL1, cg04988978 [MPO], cg17901584 [DHCR24-DT], cg21161138 [AHRR], and cg12655112 [EHD4]), qPCR and digital PCR, whole blood, algorithm reported as detected or not detected for CHD
0441UInfectious disease (bacterial, fungal, or viral infection), semiquantitative biomechanical assessment (via deformability cytometry), whole blood, with algorithmic analysis and result reported as an index
0442UInfectious disease (respiratory infection), Myxovirus resistance protein A (MxA) and C-reactive protein (CRP), fingerstick whole blood specimen, each biomarker reported as present or absent
0443UNeurofilament light chain (NfL), ultra-sensitive immunoassay, serum or cerebrospinal fluid
0444UOncology (solid organ neoplasia), targeted genomic sequence analysis panel of 361 genes, interrogation for gene fusions, translocations, or other rearrangements, using DNA from formalin-fixed paraffin-embedded (FFPE) tumor tissue, report of clinically significant variant(s)
0445UB-amyloid (Abeta42) and phospho tau (181P) (pTau181), electrochemiluminescent immunoassay (ECLIA), cerebral spinal fluid, ratio reported as positive or negative for amyloid pathology
0446UAutoimmune diseases (systemic lupus erythematosus [SLE]), analysis of 10 cytokine soluble mediator biomarkers by immunoassay, plasma, individual components reported with an algorithmic risk score for current disease activity
0447UAutoimmune diseases (systemic lupus erythematosus [SLE]), analysis of 11 cytokine soluble mediator biomarkers by immunoassay, plasma, individual components reported with an algorithmic prognostic risk score for developing a clinical flare
0449UCarrier screening for severe inherited conditions (eg, cystic fibrosis, spinal muscular atrophy, beta hemoglobinopathies [including sickle cell disease], alpha thalassemia), regardless of race or self-identified ancestry, genomic sequence analysis panel, must include analysis of 5 genes (CFTR, SMN1, HBB, HBA1, HBA2)
0531UInfectious disease (acid-fast bacteria and invasive fungi), DNA (673 organisms), nextgeneration sequencing, plasma
0532URare diseases (constitutional disease/hereditary disorders), rapid whole genome and mitochondrial DNA sequencing for single nucleotide variants, insertions/deletions, copy number variations, peripheral blood, buffy coat, saliva, buccal or tissue sample, r
0533UDrug metabolism (adverse drug reactions and drug response), genotyping of 16 genes (i.e., ABCG2, CYP2B6, CYP2C9, CYP2C19, CYP2C, CYP2D6, CYP3A5, CYP4F2, DPYD, G6PD, GGCX, NUDT15, SLCO1B1, TPMT, UGT1A1, VKORC1), reported as metabolizer status and transporter
0534UOncology (prostate), microRNA, single-nucleotide polymorphisms (SNPs) analysis by rt-PCR of 32 variants, using buccal swab, algorithm reported as a risk score
0535UPerfluoroalkyl substances (pfas) (e.g., perfluorooctanoic acid, perfluorooctane sulfonic acid), by liquid chromatography with tandem mass spectrometry (LCMS/MS), plasma or serum, quantitative
0537UOncology (colorectal cancer), analysis of cell-free DNA for epigenomic patterns, next generation sequencing, >2500 differentially methylated regions (DMRs), plasma, algorithm reported as positive or negative
0541UCardiovascular disease (HDL reverse cholesterol transport), cholesterol efflux capacity, LC-MS/MS, quantitative measurement of 5 distinct HDL-bound apolipoproteins (apolipoproteins A1, C1, C2, C3, AND C4), serum, algorithm reported as prediction of corona
0542UNephrology (renal transplant), urine, nuclear magnetic resonance (NMR) spectroscopy measurement of 84 urinary metabolites, combined with patient data, quantification of bk virus (human polyomavirus 1) using real-time PCR and serum creatinine, algorithm r
0545UAcetylcholine receptor (ACHR), antibody identification by immunofluorescence, using live cells, reported as positive or negative
0546ULow-density lipoprotein receptor-related protein 4 (LRP4), antibody identification by immunofluorescence, using live cells, reported as positive or negative
0547UNeurofilament light chain(NFL), chemiluminescent enzyme immunoassay, plasma, quantitative
0548UGlial fibrillary acidic protein (GFAP), chemiluminescent enzyme immunoassay, using plasma
0549UOncology (urothelial), DNA, quantitative methylated real time PCR of TRNA-Cys, SIM2, and NKX1-1, using urine, diagnostic algorithm reported as a probability index for bladder cancer and/or upper tract urothelial carcinoma (UTUC)
0550UOncology (prostate), enzyme linked immunosorbent assays (ELISA) for total prostate specific antigen (PSA) and free PSA, serum, combined with age, previous negative prostate biopsy status, digital rectal examination findings, prostate volume, and image and
0551UTau, phosphorylated, ptau217, by single-molecule array (ultrasensitive digital protein detection), using plasma
0553UReproductive medicine (preimplantation genetic assessment), analysis of 24 chromosomes using DNA genomic sequence analysis from embryonic trophectoderm for structural rearrangements, aneuploidy, and a mitochondrial DNA score, results reported as normal/balanced (euploidy/balanced), unbalanced structural rearrangement, monosomy, trisomy, segmental aneuploidy, or mosaic, per embryo tested
0554UReproductive medicine (preimplantation genetic assessment), analysis of 24 chromosomes using DNA genomic sequence analysis from trophectoderm biopsy for aneuploidy, ploidy, a mitochondrial DNA score, and embryo quality control, results reported as normal (euploidy), monosomy, trisomy, segmental aneuploidy, triploid, haploid, or mosaic, with quality control results reported as contamination detected or inconsistent cohort when applicable, per embryo tested
0555UReproductive medicine (preimplantation genetic assessment), analysis of 24 chromosomes using DNA genomic sequence analysis from embryonic trophectoderm for structural rearrangements, aneuploidy, and a mitochondrial DNA score, results reported as normal/balanced (euploidy/balanced), unbalanced structural rearrangement, monosomy, trisomy, segmental aneuploidy, or mosaic, per embryo tested
0556UInfectious Disease (Bacterial Or Viral Respiratory Tract Infection), Pathogen-Specific DNA And RNA By Real-Time PCR, 12 Targets, Nasopharyngeal Or Oropharyngeal Swab, Including Multiplex Reverse Transcription For RNA Targets, Each Analyte Reported As Detected
0558UOncology (Colorectal), Quantitative Enzyme-Linked Immunosorbent Assay (Elisa) For Secreted Colorectal Cancer Protein Marker (Bf7 Antigen), Using Serum, Result Reported As Indicative Of Response/No Response To Therapy Or Disease Progression/Regression
0559UOncology (Breast), Quantitative Enzyme-Linked Immunosorbent Assay (Elisa) For Secreted Breast Cancer Protein Marker (Bf9 Antigen), Serum, Result Reported As Indicative Of Response/No Response To Therapy Or Disease Progression/Regression
0560UOncology (minimal residual disease [MRD]), genomic sequence analysis, cell-free DNA, whole blood and tumor tissue, baseline assessment for design and construction of a personalized variant panel to evaluate current MRD and for comparison to subsequent MRD assessments
0561UOncology (minimal residual disease [MRD]), genomic sequence analysis, cell-free DNA, whole blood, subsequent assessment with comparison to initial assessment to evaluate for MRD
0562UOncology (solid tumor), targeted genomic sequence analysis, 33 genes, detection of single-nucleotide variants (SNVs), insertions and deletions, copy-number amplifications, and translocations in human genomic circulating cell-free DNA, plasma, reported as presence of actionable variants
0563UInfectious Disease (Bacterial And/Or Viral Respiratory Tract Infection), Pathogen-Specific Nucleic Acid (DNA Or RNA), 11 Viral Targets And 4 Bacterial Targets, Qualitative RT-PCR, Upper Respiratory Specimen, Each Pathogen Reported As Positive Or Negative
0564UInfectious Disease (Bacterial And/Or Viral Respiratory Tract Infection), Pathogen-Specific Nucleic Acid (DNA Or RNA), 10 Viral Targets And 4 Bacterial Targets, Qualitative RT-PCR, Upper Respiratory Specimen, Each Pathogen Reported As Positive Or Negative
0565UOncology (hepatocellular carcinoma), next-generation sequencing methylation pattern assay to detect 6626 epigenetic alterations, cell free DNA, plasma, algorithm reported as cancer signal detected or not detected
0566UOncology (lung), qPCR based analysis of 13 differentially methylated regions (CCDC181, HOXA7, LRRC8A, MARCHF11, MIR129-2, NCOR2, PANTR1, PRKCB, SLC9A3, TBR1_2, TRAP1, VWC2, ZNF781), pleural fluid, algorithm reported as a qualitative result
0567URare diseases (constitutional/heritable disorders), whole-genome sequence analysis combination of short and long reads, for single-nucleotide variants, insertions/deletions and characterized intronic variants, copy-number variants, duplications/deletions, mobile element insertions, runs of homozygosity, aneuploidy, and inversions, mitochondrial DNA sequence and deletions, short tandem repeat genes, methylation status of selected regions, blood, saliva, amniocentesis, chorionic villus sample or tissue, identification and categorization of genetic variants
0569UOncology (solid tumor), next generation sequencing analysis of tumor methylation markers (>20000 differentially methylated regions) present in cell-free circulating tumor DNA (ctDNA), whole blood, algorithm reported as presence or absence of ctDNA with tumor fraction, if appropriate
0572UOncology (Prostate), High-Throughput Telomere Length Quantification By Fish, Whole Blood, Diagnostic Algorithm Reported As Risk Of Prostate Cancer
0573UOncology (Pancreas), 3 Biomarkers (Glucose, Carcinoembryonic Antigen, And Gastricsin), Pancreatic Cyst Lesion Fluid, Algorithm Reported As Categorical Mucinous Or Non-Mucinous
0574UMycobacterium Tuberculosis, Culture Filtrate Protein–10-KDA (CFP-10), Serum Or Plasma, Liquid Chromatography Mass Spectrometry (LC-MS)
0614UInborn error of metabolism (primary mitochondrial disease), mitochondrial analysis of 4 enzyme complexes by stained blue native polyacrylamide gel electrophoresis (page), frozen tissue (muscle, liver, heart, cultured skin fibroblasts), diagnostic qualitative result
0615UBorrelia burgdorferi (lyme disease), antibody detection of 26 recombinant protein groups, by immunoassay, igm
0629UInfectious disease (tuberculosis), dna, analysis of 1 target by pcr with clustered regularly interspaced short palindromic repeat (crispr)-based probe detection, plasma or serum, qualitative report as detected or not detected
15775Punch graft for hair transplant; 1 to 15 punch grafts
15776more than 15 punch grafts
15879Suction assisted lipectomy; lower extremity
17360Chemical exfoliation for acne (eg, acne paste, acid)
19105Ablation, cryosurgical, of fibroadenoma, including ultrasound guidance, each fibroadenoma
20932Allograft, includes templating, cutting, placement and internal fixation, when performed; osteoarticular, including articular surface and contiguous bone (list separately in addition to code for primary procedure)
20933Allograft, includes templating, cutting, placement and internal fixation, when performed; hemicortical intercalary, partial (ie, hemicylindrical) (list separately in addition to code for primary procedure)
20939Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (list separately in addition to code for primary procedure)
20983Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; cryoablation
22505Manipulation of spine requiring anesthesia, any region, effective 5/1/11
22586

Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, l5-s1 interspace

For more detailed information, please see associated medical policy Spinal Interventional Pain Management and Spine Surgery

22857

Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), single interspace, lumbar

For more detailed information, please see associated medical policy Spinal Interventional Pain Management and Spine Surgery

22860Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)
22862

Revision including replacement of total disc arthroplasty (artificial disc) anterior approach, lumbar, single interspace

For more detailed information, please see associated medical policy Spinal Interventional Pain Management and Spine Surgery

22865

Removal of total disc arthroplasty (artificial disc), anterior approach, lumbar, single interspace

For more detailed information, please see associated medical policy Spinal Interventional Pain Management and Spine Surgery

22867Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level
22868Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; second level (List separately in addition to code for primary procedure)
22869Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level
22870Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; second level (List separately in addition to code for primary procedure)
24370Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar component
24371Revision of total elbow arthroplasty, including allograft when performed; humeral and ulnar component
27278Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing
28890Extracorporeal shock wave, high energy, performed by a physician, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia
33265Endoscopy, surgical; operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure), without cardiopulmonary bypass
33266Endoscopy, surgical; operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure), without cardiopulmonary bypass
33276INSERTION OF PHRENIC NERVE STIMULATOR SYSTEM (PULSE GENERATOR AND STIMULATING LEAD[S]), INCLUDING VESSEL CATHETERIZATION, ALL IMAGING GUIDANCE, AND PULSE GENERATOR INITIAL ANALYSIS WITH DIAGNOSTIC MODE ACTIVATION, WHEN PERFORMED
33277INSERTION OF PHRENIC NERVE STIMULATOR TRANSVENOUS SENSING LEAD (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
33278REMOVAL OF PHRENIC NERVE STIMULATOR, INCLUDING VESSEL CATHETERIZATION, ALL IMAGING GUIDANCE, AND INTERROGATION AND PROGRAMMING, WHEN PERFORMED; SYSTEM, INCLUDING PULSE GENERATOR AND LEAD(S)
33279REMOVAL OF PHRENIC NERVE STIMULATOR, INCLUDING VESSEL CATHETERIZATION, ALL IMAGING GUIDANCE, AND INTERROGATION AND PROGRAMMING, WHEN PERFORMED; TRANSVENOUS STIMULATION OR SENSING LEAD(S) ONLY
33280REMOVAL OF PHRENIC NERVE STIMULATOR, INCLUDING VESSEL CATHETERIZATION, ALL IMAGING GUIDANCE, AND INTERROGATION AND PROGRAMMING, WHEN PERFORMED; PULSE GENERATOR ONLY
33281REPOSITIONING OF PHRENIC NERVE STIMULATOR TRANSVENOUS LEAD(S)
33287REMOVAL AND REPLACEMENT OF PHRENIC NERVE STIMULATOR, INCLUDING VESSEL CATHETERIZATION, ALL IMAGING GUIDANCE, AND INTERROGATION AND PROGRAMMING, WHEN PERFORMED; PULSE GENERATOR
33288REMOVAL AND REPLACEMENT OF PHRENIC NERVE STIMULATOR, INCLUDING VESSEL CATHETERIZATION, ALL IMAGING GUIDANCE, AND INTERROGATION AND PROGRAMMING, WHEN PERFORMED; TRANSVENOUS STIMULATION OR SENSING LEAD(S)
33289Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring.
37788

Penile revascularization, artery, with or without vein graft

For more detailed information, please see associated medical policy Erectile Dysfunction

37790

Penile venous occlusive procedure

For more detailed information, please see associated medical policy Erectile Dysfunction

43197Flexible transnasal esophagoscopy
43198Flexible transnasal esophagoscopy
43210Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed
43257Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease
43284Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (ie. Magnetic band), including curoplasty when performed
43285Removal of esophageal sphincter augmentation device
43290Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon
43291Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)
43497Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])
46707Repair of anorectal fistula with plug (e.g., porcine small intestine submucosa (SIS). Note: this code replaces 0170T
47383Ablation, 1 or more liver tumor(s), percutaneous, cryoablation
52284CYSTOURETHROSCOPY, WITH MECHANICAL URETHRAL DILATION AND URETHRAL THERAPEUTIC DRUG DELIVERY BY DRUG-COATED BALLOON CATHETER FOR URETHRAL STRICTURE OR STENOSIS, MALE, INCLUDING FLUOROSCOPY, WHEN PERFORMED
53451Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance
53452Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance
53453Periurethral transperineal adjustable balloon continence device; removal, each balloon
53454Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume
53855Insertion of a temporary prostatic urethral stent, including urethral measurement Note: this code replaces 0084T
53860Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence
57465Computer-aided mapping of cervix uteri during colposcopy, including optical dynamic spectral imaging and algorithmic quantification of the acetowhitening effect (List separately in addition to code for primary procedure)
60660Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency
60661Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)
61736Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion
61737Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)
61870Craniectomy for implantation of neurostimulator electrodes, cerebellar; cortical
62287Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle based technique to remove disc material under fluoroscopic imaging or other form of indirect visualization, with the use of an endoscope, with discography and/or epidural injection(s) at the treated level(s), when performed, single or multiple levels, lumbar
64580Incision for implantation of neurostimulator electrodes; neuromuscular
64555Percutaneous implantation of neurostimulator electrodes; peripheral nerve [excludes sacral nerve]
67516SUPRACHOROIDAL SPACE INJECTION OF PHARMACOLOGIC AGENT (SEPARATE PROCEDURE)
68841Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each
76014MR safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (e.g., surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current MR conditional status of individual components and systems, and consulting published professional guidance with written report; initial 15 minutes
76015MR safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (e.g., surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current MR conditional status of individual components and systems, and consulting published professional guidance with written report; each additional 30 minutes (list separately in addition to code for primary procedure)
76016MR safety determination by a physician or other qualified health care professional responsible for the safety of the MR procedure, including review of implant MR conditions for indicated MR examination, analysis of risk vs clinical benefit of performing MR examination, and determination of MR equipment, accessory equipment, and expertise required to perform examination, with written report
76017MR safety medical physics examination customization, planning and performance monitoring by medical physicist or MR safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor MR acquisition specific to restrictive requirements or artifacts associated with MR conditional implants or to mitigate risk of non-conditional implants or foreign bodies, with written report
76018MR safety implant electronics preparation under supervision of physician or other qualified health care professional, including MR -specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from MR electromagnetic fields, and protection of patient from risks of unintended stimulation or heating while in the MR room, with written report
76019MR safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from MR-induced translational or vibrational forces, magnetically induced functional changes, and/or prevention of radiofrequency burns from inadvertent tissue contact while in the MR room, with written report
77089Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk
77090Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere
77091Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only
77092Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional
80235LACOSAMIDE
80280VEDOLIZUMAB
81230CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22)
81283IFNL3 (Interferon, lambda 3) (eg, drug response), gene analysis, RS12979860 variant
81291MTHFR (5, 10-methylenetetrahydrofolate reductase) (e.g., hereditary hypercoagulability) gene analysis, common variants (e.g., 677T, 1298C)
81313PCA3/KLK3 (prostate cancer antigen 3 [non-protein coding]/kallikrein-related, peptidase 3 [prostate specific antigen]) ratio (eg, prostate cancer)
81327SEPT9 (Septin9) (eg, colorectal cancer) methylation analysis
81328SLCO1B1 (Solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis, common variant(s) (EG, *5)
81346TYMS (Thymidylate Synthetase) (eg, 5-Fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant)
81410Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at least 9 genes, including FBN1, TGFBR1, TGFBR2,, COL3A1, MYH11, ACTA2, SLC2A10, SMAD3, and MYLK
81411Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for TGFBR1, TGFBR2, MYH11, and COL3A1
81418Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis
81422Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood
81425Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence, analysis
81426Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (List separately in addition to code for primary procedure)
81427Genome (eg, unexplained constitutional or heritable disorder or syndrome); re- evaluation of previously obtained genome sequence (eg, updated knowledge or, unrelated condition/syndrome)
81440Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including BCS1L, C10orf2, COQ2, COX10, DGUOK, MPV17, OPA1, PDSS2, POLG, POLG2, RRM2B, SCO1, SCO2, SLC25A4, SUCLA2, SUCLG1, TAZ, TK2, and TYMP
81449Targeted genomic sequence analysis panel, solid organ neoplasm, 5-50 genes (eg, alk, braf, cdkn2a, egfr, erbb2, kit, kras, met, nras, pdgfra, pdgfrb, pgr, pik3ca, pten, ret), interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis
81451Targeted genomic sequence analysis panel, hematolymphoid neoplasm or disorder, 5-50 genes (eg, braf, cebpa, dnmt3a, ezh2, flt3, idh1, idh2, jak2, kit, kras, mll, notch1, npm1, nras), interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis
81456Targeted genomic sequence analysis panel, solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes (eg, alk, braf, cdkn2a, cebpa, dnmt3a, egfr, erbb2, ezh2, flt3, idh1, idh2, jak2, kit, kras, met, mll, notch1, npm1, nras, pdgfra, pdgfrb, pgr, pik3ca, pten, ret), interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis
81470X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, HUWE1, IL1RAPL, KDM5C, L1CAM, MECP2, MED12, MID1,, OCRL, RPS6KA3, and SLC16A2
81471X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); duplication/deletion gene analysis, must include analysis of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, HUWE1, IL1RAPL, KDM5C, L1CAM, MECP2, MED12, MID1, OCRL, RPS6KA3, and SLC16A2
81490Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score
81493Coronary artery disease, mrna, gene expression profiling by real-time rt-pcr of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score
81500Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score
81503Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2 microglobulin, transferrin, and pre-albumin), utilizing serum, algorithm reported as a risk score
81504Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores
81506Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, hba1c, insulin, hs-crp, adoponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma, algorithm reporting a risk score
81514Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associated Bacteria-2 (BVAB-2), and Lactobacillus species (L. crispatus and L. jensenii), utilizing vaginal-fluid specimens, algorithm reported as a positive or negative for high likelihood of bacterial vaginosis, includes separate detection of Trichomonas vaginalis and/or Candida species (C. albicans, C. tropicalis, C. parapsilosis, C. dubliniensis), Candida glabrata, Candida krusei, when reported
81525Oncology (colon), mrna, gene expression profiling by real-time rt-pcr of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence score
81529Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk, including likelihood of sentinel lymph node metastasis
81535Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by dapi stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combination
81536Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by dapi stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combination; each additional single drug or drug combination (list separately in addition to code for primary procedure)
81538Oncology (lung), mass spectrometric 8-protein signature, including amyloid a, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival
81539Oncology (high-grade prostate cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA, and human kallikrein-2 [hK2]), utilizing plasma or serum, prognostic algorithm reported as a probability score
81540Oncology (tumor of unknown origin), mrna, gene expression profiling by real-time rt-pcr of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a probability of a predicted main cancer type and subtype
81551Oncology (prostate), promoter methylation profiling by real-time PCR of 3 genes (GSTP1, APC, RASSF1), utilizing formalin-fixed paraffin-embedded tissue, algorithm, reported as a likelihood of prostate cancer detection on repeat biopsy
81554Pulmonary disease (idiopathic pulmonary fibrosis [IPF]), mRNA, gene expression analysis of 190 genes, utilizing transbronchial biopsies, diagnostic algorithm reported as categorical result (eg, positive or negative for high probability of usual interstitial pneumonia [UIP])
81558Transplantation medicine (allograft rejection, kidney), MRNA, gene expression profiling by quantitative polymerase chain reaction (QPCR) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant excellence, indicating subclinical rejection
81560Transplantation Medicine (Allograft Rejection, Pediatric Liver And Small Bowel), Measurement Of Donor And Third-Party-Induced Cd154+T-Cytotoxic Memory Cells, Utilizing Whole Peripheral Blood, Algorithm Reported As A Rejection Risk Score
82172Apolipoprotein, each (except when billed for hepatitis C)
83006Growth stimulation expressed gene 2 (ST2, Interleukin 1 receptor like-1)
83695Lipoprotein (a)
83698

Lipoprotein-associated phospholipase A2 (Lp-PLA2)

For more detailed information, please see associated medical policy Measurement of Lipoprotein-Associated Phospholipase A2 (Lp-PLA2) in the Assessment of Cardiovascular Risk

83700Lipoprotein, blood; electrophoretic separation and quantitation
83701

high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (e.g., electrophoresis, ultracentrifugation)

83704

quantitation of lipoprotein particle numbers and lipoprotein particle subclasses (e.g., nuclear magnetic resonance spectroscopy)

83722Lipoprotein, direct measurement; small dense ldl cholesterol
83876

Meyloperoxidase (MPO)

83884Assay neurofilament light chain (NFL)
83951Des-Gamma-Carboxy-Prothrombin (DCP)
83987PH; exhaled breath condensate
84431Thromboxane metabolite(s), including thromboxane if performed, urine
84393Tau, phosphorylated (e.g., pTau 181, pTau 217), each
84394Tau, total (tTau)
86141C-reactive protein; high sensitivity (HSCRP)
86152Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood);

For more detailed information, please see associated medical policy Genetic Testing of Inherited Cancer Predisposition

86153Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); physician interpretation and report, when required

For more detailed information, please see associated medical policy Genetic Testing of Inherited Cancer Predisposition

86305Human epididymis protein 4 (HE4)
86343Leukocyte histamine release test (LHR)
86352Cellular function assay involving stimulation (e.g., mitogen or antigen) and detection of biomarker (e.g., ATP)
86408NEUTRALIZING ANTIBODY, SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (SARS-COV-2) (CORONAVIRUS DISEASE [COVID-19]); SCREEN
86409NEUTRALIZING ANTIBODY, SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (SARS-COV-2) (CORONAVIRUS DISEASE [COVID-19]); TITER
86413Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody, quantitative
86490Skin test; coccidioidomycosis
86510histoplasmosis
86581Streptococcus pneumoniae antibody (IgG), serotypes, multiplex immunoassay, quantitative
87483Infectious agent detection by nucleic acid (DNA or RNA); central nervous system pathogen (eg, Neisseria meningitidis, Streptococcus pneumoniae, Listeria, Haemophilus influenzae, E. coli, Streptococcus agalactiae, enterovirus, human parechovirus, herpes simplex virus type 1 and 2, human herpesvirus 6, cytomegalovirus, varicella zoster virus, Cryptococcus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 12-25 targets
87513Infectious agent detection by nucleic acid (DNA or RNA); Helicobacter Pylori (H. pylori), clarithromycin resistance, amplified probe technique
87505Infectious agent detection by nucleic acid (dna or rna); gastrointestinal pathogen (eg, clostridium difficile, e. Coli, salmonella, shigella, norovirus, giardia), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 3-5 targets
87506Infectious agent detection by nucleic acid (dna or rna); gastrointestinal pathogen (eg, clostridium difficile, e. Coli, salmonella, shigella, norovirus, giardia), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 6-11 targets
87507Infectious agent detection by nucleic acid (dna or rna); gastrointestinal pathogen (eg, clostridium difficile, e. Coli, salmonella, shigella, norovirus, giardia), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 12-25 targets
87623Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), low-risk types (eg, 6, 11, 42, 43, 44)
87900Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics
88104Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with, interpretation
89290Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-, implantation genetic diagnosis); less than or equal to 5 embryos
89291Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-, implantation genetic diagnosis); greater than 5 embryos
89329Sperm evaluation; hamster penetration test
91111Gastrointestinal tract imaging, intraluminal (e.g., capsule endoscopy), esophagus with physician interpretation and report (effective 9/1/11)
91112Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report
91113Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report
92066Orthoptic training; under supervision of a physician or other qualified health care professional
92132Scanning computerized ophthalmic diagnostic imaging, anterior segment, with interpretation and report, unilateral
92145Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report
92512Nasal function studies (e.g., rhinomanometry)
92517Vestibular evoked myogenic potential (VEMP) testing, with interpretation and report; cervical (cVEMP)
92518Vestibular evoked myogenic potential (VEMP) testing, with interpretation and report; ocular (oVEMP)
92519Vestibular evoked myogenic potential (VEMP) testing, with interpretation and report; cervical (cVEMP) and ocular (oVEMP)
92548Computerized dynamic posturography
92634

Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes

This code Does Not Meet Payment Determination Criteria for Commercial but will pay for QUEST

92635

Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code for primary procedure)

This code Does Not Meet Payment Determination Criteria for Commercial but will pay for QUEST

92636

Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, and, when performed, hearing assistive device, supplemental technology fitting services; first 30 minutes

This code Does Not Meet Payment Determination Criteria for Commercial but will pay for QUEST

92637

Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code for primary procedure)

This code Does Not Meet Payment Determination Criteria for Commercial but will pay for QUEST

92638

Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)

This code Does Not Meet Payment Determination Criteria for Commercial but will pay for QUEST

92642

Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)

This code Does Not Meet Payment Determination Criteria for Commercial but will pay for QUEST

92971Cardioassist-method of circulatory assist
92972PERCUTANEOUS TRANSLUMINAL CORONARY LITHOTRIPSY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
93025Microvolt T-wave alternans for assessment of ventricular arrhythmias
93050Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity artery, non-invasive
93150THERAPY ACTIVATION OF IMPLANTED PHRENIC NERVE STIMULATOR SYSTEM, INCLUDING ALL INTERROGATION AND PROGRAMMING
93151INTERROGATION AND PROGRAMMING (MINIMUM ONE PARAMETER) OF IMPLANTED PHRENIC NERVE STIMULATOR SYSTEM
93152INTERROGATION AND PROGRAMMING OF IMPLANTED PHRENIC NERVE STIMULATOR SYSTEM DURING POLYSOMNOGRAPHY
93153INTERROGATION WITHOUT PROGRAMMING OF IMPLANTED PHRENIC NERVE STIMULATOR SYSTEM
93228External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ECG data storage (retrievable with query) with ECG triggered and patient selected events transmitted to a remote attended surveillance center for up to 30 days; review and interpretation with report by a physician or other qualified health care professional
93229External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ECG data storage (retrievable with query) with ECG triggered and patient selected events transmitted to a remote attended surveillance center for up to 30 days; technical support for connection and patient instructions for use, attended surveillance, analysis and transmission of daily and emergent data reports as prescribed by a physician or other qualified health care professional
93264Remote monitoring of a wireless pulmonary artery pressure sensor.
93278Signal-averaged electrocardiography (SAECG), with or without ECG
93702Bioimpedance spectroscopy (BIS), extracellular fluid analysis for lymphedema assessment(s)
93895Quantitative carotid intima media thickness and carotid atheroma evaluation, bilateral
94400Breathing response to CO2 (CO2 response curve)
95012Nitric oxide expired gas determination
95803Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
95919Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral
95924Testing of an autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt.
95905Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes F-wave study when performed with interpretation and report
95961Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of physician attendance
95962each additional hour of physician attendance
95980Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; intraoperative, with programming
95981subsequent, without programming
95982subsequent, with reprogramming
96000Comprehensive computer-based motion analysis by video-taping and 3D kinematics
96001with dynamic plantar pressure measurements during walking
96002Dynamic surface electromyography, during walking or other functional activities, 1 to 12 muscles
96003Dynamic fine wire electromyography, during walking or other functional activities, 1 muscle
96004Physician review & interpretation of comprehensive computer-based motion analysis, dynamic plantar pressure measurements, dynamic surface electromyography during walking or other functional activities, and dynamic fine wire electromyography, with written report
96156Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)
96158Health behavior intervention, individual, face-to-face; initial 30 minutes
96159Health behavior intervention, individual, face-to-face; each additional 15 minutes (list separately in addition to code for primary service)
96164Health behavior intervention, group (2 or more patients), face-to-face; initial 30 minutes
96165Health behavior intervention, group (2 or more patients), face-to-face; each additional 15 minutes (list separately in addition to code for primary service)
96167Health behavior intervention, family (with the patient present), face-to-face; initial 30 minutes
96168Health behavior intervention, family (with the patient present), face-to-face; each additional 15 minutes (list separately in addition to code for primary service)
96170Health behavior intervention, family (without the patient present), face-to-face; initial 30 minutes
96171Health behavior intervention, family (without the patient present), face-to-face; each additional 15 minutes (list separately in addition to code for primary service)
96202Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of parent(s)/guardian(s)/caregiver(s); initial 60 minutes
96203Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of parent(s)/guardian(s)/caregiver(s); each additional 15 minutes (list separately in addition to code for primary service)
96931Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition and interpretation and report, first lesion
96932Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition only, first lesion
96934Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition and interpretation and report, each additional lesion (list separately in addition to code for primary procedure)
96935Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition only, each additional lesion (list separately in addition to code for primary procedure)
96936Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; interpretation and report only, each additional lesion (list separately in addition to code for primary procedure)
97037APPLICATION OF A MODALITY TO 1 OR MORE AREAS; LOW-LEVEL LASER THERAPY (IE, NONTHERMAL AND NON-ABLATIVE) FOR POST-OPERATIVE PAIN REDUCTION
97610Topical wound treatment with low frequency, non-contact, non-thermal ultrasound with wound assessment and instructions
99177Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with on-site analysis
G2168SERVICES PERFORMED BY A PHYSICAL THERAPIST ASSISTANT IN THE HOME HEALTH SETTING IN THE DELIVIERY OF A SAFE AND EFFECTIVE PHYSICAL THERAPY MAINTENANCE PROGRAM, EACH 15 MINUTES
G2169SERVICES PERFORMED BY A OCCUPATIONAL THERAPIST ASSISTANT IN THE HOME HEALTH SETTING IN THE DELIVIERY OF A SAFE AND EFFECTIVE OCCUPATIONAL THERAPY MAINTENANCE PROGRAM, EACH 15 MINUTES

Table II. HCPCS Codes

HCPCS CodesDescription
A2001Hcpcs: innovamatrix ac, per square centimeter (effective 1/1/2022); irf pps: miscellaneous with motor >49.15.,without comorbidities
A2002Hcpcs: mirragen advanced wound matrix, per square centimeter (effective 1/1/2022); irf pps: miscellaneous with motor >38.75 & motor <49.15.,without comorbidities
A2004Hcpcs: xcellistem, per square centimeter (effective 1/1/2022); irf pps: miscellaneous with motor <27.85, without comorbidities
A2005Hcpcs: microlyte matrix, per square centimeter (effective 1/1/2022); irf pps: miscellaneous m <46.50 and a <77.50.,without comorbidities
A2006Novosorb synpath dermal matrix, per square centimeter
A2007Restrata, per square centimeter
A2008Theragenesis, per sq cm
A2009Symphony, per sq cm
A2010Apis, per square centimeter
A2011Supra sdrm, per square centimeter
A2012Suprathel, per square centimeter
A2013Innovamatrix fs, per square centimeter
A2019Kerecis omega3 marigen shield, per square centimeter
A2020Ac5 advanced wound system (ac5)
A2021Neomatrix, per square centimeter
A2026Restrata minimatrix, 5 mg
A2027Matriderm, per square centimeter
A2028Micromatrix flex, per mg
A2029Mirotract wound matrix sheet, per cubic centimeter
A2030Miro3d fibers, per milligram
A2031Mirodry wound matrix, per square centimeter
A2032Myriad matrix, per square centimeter
A2033Myriad morcells, 4 milligrams
A2034Foundation drs solo, per square centimeter
A2035Corplex p or Theracor p or Allacor p, per milligram
A2040Microlyte painguard, per square centimeter
A2041Foundation drs+ duo, per square centimeter
A2042Foundation drs+ solo, per square centimeter
A4543Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month
A7021Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)
A4100Skin substitute, fda cleared as a device, not otherwise specified
A4467Belt, strap, sleeve, garment, or covering, any type​
A4540DISTAL TRANSCUTANEOUS ELECTRICAL NERVE STIMULATOR, STIMULATES PERIPHERAL NERVES OF THE UPPER ARM
A4541MONTHLY SUPPLIES FOR USE OF DEVICE CODED AT E0733
A4542SUPPLIES AND ACCESSORIES FOR EXTERNAL UPPER LIMB TREMOR STIMULATOR OF THE PERIPHERAL NERVES OF THE WRIST
A2043Biobrane, per square centimeter
A2044Biobrane glove, each
A2045Novashield or novogen wound matrix, per square centimeter
A4318Female external urinary collection cup, with or without ring attachment, per day
A4560Neuromuscular electrical stimulator (nmes), disposable, replacement only
A4555Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only
A4593Neuromodulation stimulator system, adjunct to rehabilitation therapy regime
A4594Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each
A4670Automatic blood pressure monitor
A6460Synthetic resorbable wound dressing, sterile, pad size 16 sq. In. Or less, without adhesive border, each dressing
A6461Synthetic resorbable wound dressing, sterile, pad size more than 16 sq. In. But less than or equal to 48 sq. In., without adhesive border, each dressing
A6591External urinary catheter; non-disposable, for use with suction pump, per month
A7023MECHANICAL ALLERGEN PARTICLE BARRIER/INHALATION FILTER, CREAM, NASAL, TOPICAL
A7047

Oral interface used with respiratory suction pump, each

For more detailed information, please see associated medical policy Positive Airway Pressure and Oral Devices for the Treatment of Obstructive Sleep Apnea

A7049Expiratory positive airway pressure intranasal resistance valve
A9154Artificial saliva, 1 ml
A9284Spirometer, non-electronic, includes all accessories
A9291Prescription digital behavioral therapy, fda cleared, per course of treatment
A9586Florbetapir F18, diagnostic, per study dose, up to 10 millicuries
A9599Radiopharmaceutical, diagnostic, for beta-amyloid positron emission tomography (PET) imaging, per study dose
B4105In-line cartridge containing digestive enzyme(s) for enteral feeding, each
C1602ORTHOPEDIC/DEVICE/DRUG MATRIX/ABSORBABLE BONE VOID FILLER, ANTIMICROBIAL-ELUTING (IMPLANTABLE)
C1604GRAFT, TRANSMURAL TRANSVENOUS ARTERIAL BYPASS (IMPLANTABLE), WITH ALL DELIVERY SYSTEM COMPONENTS
C1605PACEMAKER, LEADLESS, DUAL CHAMBER (RIGHT ATRIAL AND RIGHT VENTRICULAR IMPLANTABLE COMPONENTS), RATE-RESPONSIVE, INCLUDING ALL NECESSARY COMPONENTS FOR IMPLANTATION
C1833Monitor, cardiac, including intracardiac lead and all system components (implantable)
C8000Support device, extravascular, for arteriovenous fistula (implantable)
C9354Acellular pericardial tissue matrix of nonhuman origin (Veritas), per square centimeter
C9356Tendon, porous matrix of cross-linked collagen and glycosaminoglycan matrix (TenoGlide Tendon Protector Sheet), per square centimeter
C9358Dermal substitute, native, non-denatured collagen, fetal bovine origin (SurgiMend Collagen Matrix), per 0.5 square centimeters
C9360Dermal substitute, native, non-denatured collagen, neonatal bovine origin (SurgiMend Collagen Matrix), per 0.5 square centimeters
C9363Skin substitute, Integra Meshed Bilayer Wound Matrix, per square centimeter
C9364Porcine implant, Permacol, per square centimeter
E0152Walker, battery powered, wheeled, folding, adjustable or fixed height
E0201Penile contracture device, manual, greater than 3 lbs traction force
E0231Noncontact wound warming device (temperature control unit, ac adapter and power cord) for use with warming card and wound cover
E0232Warming card for use with the noncontact wound warming device and noncontact wound warming cover
E0446Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories
E0469Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device
E0487Spirometer, electronic, includes all accessories
E0492POWER SOURCE AND CONTROL ELECTRONICS UNIT FOR ORAL DEVICE/APPLIANCE FOR NEUROMUSCULAR ELECTRICAL STIMULATION OF THE TONGUE MUSCLE, CONTROLLED BY PHONE APPLICATION
E0493ORAL DEVICE/APPLIANCE FOR NEUROMUSCULAR ELECTRICAL STIMULATION OF THE TONGUE MUSCLE, USED IN CONJUNCTION WITH THE POWER SOURCE AND CONTROL ELECTRONICS UNIT, CONTROLLED BY PHONE APPLICATION, 90-DAY SUPPLY
E0530ELECTRONIC POSITIONAL OBSTRUCTIVE SLEEP APNEA TREATMENT, WITH SENSOR, INCLUDES ALL COMPONENTS AND ACCESSORIES, ANY TYPE
E0670Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk
E0676Intermittent limb compression device (includes all accessories) not otherwise specified
E0677Non-pneumatic sequential compression garment, trunk
E0711Upper extremity medical tubing/lines enclosure or covering device, restricts elbow range of motion
E0715Intravaginal device intended to strengthen pelvic floor muscles during kegel exercises
E0716Supplies and accessories for intravaginal device intended to strengthen pelvic floor muscles during kegel exercises
E0721Transcutaneous electrical nerve stimulatory, stimulates nerves in the auricular region
E0732CRANIAL ELECTROTHERAPY STIMULATION (CES) SYSTEM, ANY TYPE
E0733TRANSCUTANEOUS ELECTRICAL NERVE STIMULATOR FOR ELECTRICAL STIMULATION OF THE TRIGEMINAL NERVE
E0734EXTERNAL UPPER LIMB TREMOR STIMULATOR OF THE PERIPHERAL NERVES OF THE WRIST
E0735NON-INVASIVE VAGUS NERVE STIMULATOR
E0830Ambulatory traction device, all types, each
E1800Dynamic adjustable elbow extension/flexion device, includes soft interface material
E1801Static progressive stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories
E1802Dynamic adjustable forearm pronation/supination device, includes soft interface material
E1803Dynamic adjustable elbow extension only device, includes soft interface material
E1804Dynamic adjustable elbow flexion only device, includes soft interface material
E1805Dynamic adjustable wrist extension/flexion device, includes soft interface material
E1806Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories
E1807Dynamic adjustable wrist extension only device, includes soft interface material
E1808Dynamic adjustable wrist flexion only device, includes soft interface material
E1810Dynamic adjustable knee extension/flexion device, includes soft interface material
E1811Static progressive stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories
E1812Dynamic knee extension/flexion device with active resistance control
E1813Dynamic adjustable knee extension only device, includes soft interface material
E1814Dynamic adjustable knee flexion only device, includes soft interface material
E1815Dynamic adjustable ankle extension/flexion device, includes soft interface material
E1816Static progressive stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories
E1818Static progressive stretch forearm pronation/supination device, with or without range of motion adjustment, includes all components and accessories
E1820Replacement soft interface material, dynamic adjustable extension/flexion device
E1821Replacement soft interface material/cuffs for bi-directional static progressive stretch device
E1822Dynamic adjustable ankle extension only device, includes soft interface material
E1823Dynamic adjustable ankle flexion only device, includes soft interface material
E1825Dynamic adjustable finger extension/flexion device, includes soft interface material
E1826Dynamic adjustable finger extension only device, includes soft interface material
E1827Dynamic adjustable finger flexion only device, includes soft interface material
E1828Dynamic adjustable toe extension only device, includes soft interface material
E1829Dynamic adjustable toe flexion only device, includes soft interface material
E1830Dynamic adjustable toe extension/flexion device, includes soft interface material
E1831Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories
E1832Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories
E1840Dynamic adjustable shoulder flexion/abduction/rotation device, includes soft interface material
E1841Static progressive stretch shoulder device, with or without range of motion adjustment, includes all components and accessories
E1905Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software
E2001SUCTION PUMP, HOME MODEL, PORTABLE OR STATIONARY, ELECTRIC, ANY TYPE, FOR USE WITH EXTERNAL URINE MANAGEMENT SYSTEM
E2358Power wheelchair accessory, group 34 nonsealed lead acid battery, each
E2360Power wheelchair accessory, 22 NF nonsealed lead acid battery, each
E2362Power wheelchair accessory, group 24 nonsealed lead acid battery, each
E2364Power wheelchair accessory, U-1 nonsealed lead acid battery, each
E2372Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only
E2513Accessory for speech generating device, electromyographic sensor
E3000SPEECH VOLUME MODULATION SYSTEM, ANY TYPE, INCLUDING ALL COMPONENTS AND ACCESSORIES
E3200Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only
G0183Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from CT scan(s) data of the chest/heart (with or without contrast)
G0250Physician review, interpretation and patient management of home INR testing
G0259Injection procedure for sacroiliac joint; arthrography
G0276Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial
G0281Electrical stimulation, (unattended), to one or more areas, for chronic stage III & stage IV pressure ulcers, arterial ulcers, diabetic ulcers, & venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care
G0282Electrical stimulation, (unattended), to one or more areas, for wound care other than described in G0281
G0295Electromagnetic therapy, to one or more areas, for wound care other than described in G0329, or for other uses
G0327Colorectal cancer screening; blood-based biomarker.
G0329Electromagnetic therapy, to one or more areas for chronic stage III and stage IV pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days on conventional care as part of a therapy plan of care
G0409Social work and psychological services, directly relating to and/or furthering the patient's rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a CORF qualified social worker or psychologist in a CORF)
G0428Collagen Meniscus Implant procedure for filling meniscal defects (e.g., CMI, collagen scaffold, Menaflex)
G0465Autologous platelet rich plasma (prp) for diabetic chronic wounds/ulcers, using an fda-cleared device (includes administration, dressings, phlebotomy, centrifugation, and all other preparatory procedures, per treatment)
G0537Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ASCVD) risk assessment, 5-15 minutes, not more often than every 12 months
G0538Atherosclerotic cardiovascular disease (ASCVD) risk management services; clinical staff time; per calendar month
G0552Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan
G0553First 20 minutes of monthly treatment management services directly related to the patient’s therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional ti
G0554Each additional 20 minutes of monthly treatment management services directly related to the patient’s therapeutic use of the digital mental health treatment (DMHT) device that augments a behavioral therapy plan, physician/other qualified health care professional
G0555Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring
G05663D radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy
G0680Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report
G2000Blinded administration of convulsive therapy procedure, either electroconvulsive therapy (ect, current covered gold standard) or magnetic seizure therapy (mst, non-covered experimental therapy), performed in an approved ide-based clinical trial, per treatment session
G2214Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional
G2250Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment
G9147Outpatient Intravenous Insulin Treatment (OIVIT) either pulsatile or continuous, by any means, guided by the results of measurements for: respiratory quotient; and/or, urine urea nitrogen (UUN); and/or, arterial, venous or capillary glucose; and/or potassium concentration
H2038Skills training and development, per diem
J0591Injection, deoxycholic acid, 1 mg
J0691Injection, lefamulin, 1 mg
J1072Injection, testosterone cypionate (Azmiro), 1 mg
J1938Injection, furosemide, 1 mg
J3304Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg
J3530Nasal vaccine inhalation
J3570Laetrile, amygdalin, vitamin B-17
K1002Cranial electrotherapy stimulation (CES) system with supplies access
K1004Low frequency ultrasonic diathermy treatment device for home use
K1005Disposable collection and storage bag for breast milk, any size, any type
K1023Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm
K1026Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical
K1028Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle for the reduction of snoring and obstructive sleep apnea, controlled by phone application
K1029Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day supply
K1030External recharging system for battery (internal) for use with implanted cardiac contractility modulation generator, replacement only
K1037Docking station for use with oral device/appliance used to reduce upper airway collapsibility
J1072Injection, testosterone cypionate (Azmiro), 1 mg
J1938Injection, furosemide, 1 mg
L0720Cervical-thoracic-lumbar-sacral-orthoses (CTLSO), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
L0984Protective body sock, prefabricated, off-the-shelf, each
L2221Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source
L3161FOOT, ADDUCTUS POSITIONING DEVICE, ADJUSTABLE
L5827Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping
L5969Addition, endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s)
L5973Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source
L6700Upper extremity addition, external powered feature, myoelectronic control module, additional EMG inputs, pattern-recognition decoding intent movement
L8608Miscellaneous external component, supply or accessory for use with the argus ii retinal prosthesis system
L8678Electrical stimulator supplies (external) for use with implantable neurostimulator, per month
L8701Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated
L8702Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated
M0075Cellular therapy
M0076Prolotherapy
M0100Intragastric hypothermia using gastric freezing
P9027Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit
Q2058Obecabtagene autoleucel, 10 up to 400 million CD19 CAR-positive viable T cells, including leukapheresis and dose preparation procedures, per infusion
Q4103Oasis Burn Matrix, per square centimeter
Q4104Integra Bilayer Matrix Wound Dressing (BMWD), per square centimeter
Q4108Integra Matrix, per square centimeter
Q4110PriMatrix, per square centimeter
Q4111GammaGraft, per square centimeter
Q4112Cymetra, injectable, 1 cc
Q4113Graftjacket Xpress, injectable, 1 cc
Q4115AlloSkin, per square centimeter
Q4117Hyalomatrix, per square centimeter
Q4118Matristem micromatrix, per square centimeter
Q4121Theraskin, per square centimeter
Q4123Alloskin RT, per square centimeter
Q4125Arthroflex, per square centimeter
Q4126Memoderm, Dermaspan, Transgraft or Integuply, per square centimeter
Q4127Talymed, per square centimeter
Q4128Flex HD, Allopatch HD or Matrix HD, per square centimeter [when used for Allopatch HD or Matrix HD]
Q4134hMatrix, per square centimeter
Q4135Mediskin, per square centimeter
Q4136EZ-derm, per square centimeter
Q4137Amnioexcel or BioDExCel, per square centimeter
Q4138Biodfence Dryflex, per square centimeter
Q4139Amniomatrix or BioDMatrix, injectable, 1 cc
Q4140Biodfence, per square centimeter
Q4141Alloskin AC, per square centimeter
Q4142Xcm biologic tissue matrix, per square centimeter
Q4143Repriza, per square centimeter
Q4146TenSIX, per square centimeter
Q4147Architect, Architect PX, or Architect FX, extracellular matrix, per square
Q4148Neox 1k, per square centimeter
Q4149Excellagen, 0.1 cc
Q4150Allowrap DS or dry, per square centimeter
Q4152Dermapure, per square centimeter
Q4153Dermavest and Plurivest, per square centimeter
Q4155Neox Flo or Clarix Flo, 1 mg
Q4156Neox 100, per square centimeter
Q4157Revitalon, per square centimeter
Q4158MariGen, per square centimeter
Q4160NuShield, per square centimeter
Q4161Bio-connekt wound matrix, per square centimeter
Q4162Amniopro flow, bioskin flow, biorenew flow, woundex flow, amniogen-a, amniogen-c, 0.5 cc
Q4163Amniopro, bioskin, biorenew, woundex, amniogen-45, amniogen-200, per square centimeter
Q4164Helicoll, per square centimeter
Q4165Keramatrix, per square centimeter
Q4166Cytal, per square centimeter
Q4167Truskin, per square centimeter
Q4169Artacent wound, per square centimeter
Q4170Cygnus, per square centimeter
Q4171Interfyl, 1 mg
Q4173Palingen or palingen xplus, per square centimeter
Q4174Palingen or promatrx, 0.36 mg per 0.25 cc
Q4175Miroderm, per square centimeter
Q4183Surgigraft, per square centimeter
Q4184Cellesta, per square centimeter
Q4185Cellesta flowable amnion (25 mg per cc); per 0.5 cc
Q4187Epicord, per square centimeter
Q4188Amnioarmor, per square centimeter
Q4189Artacent ac, 1 mg
Q4190Artacent ac, per square centimeter
Q4191Restorigin, per square centimeter
Q4192Restorigin, 1 cc
Q4193Coll-e-derm, per square centimeter
Q4194Novachor, per square centimeter
Q4195Puraply, per square centimeter
Q4196Puraply am, per square centimeter
Q4197Puraply xt, per square centimeter
Q4198Genesis amniotic membrane, per square centimeter
Q4199Cygnus matrix, per square centimeter
Q4200Skin te, per square centimeter
Q4201Matrion, per square centimeter
Q4202Keroxx (2.5g/cc), 1cc
Q4203Derma-gide, per square centimeter
Q4204Xwrap, per square centimeter
Q4205Membrane graft or membrane wrap, per square centimeter
Q4206Fluid flow or fluid gf, 1 cc
Q4208Novafix, per square cenitmeter
Q4209Surgraft, per square centimeter
Q4210Axolotl graft or axolotl dualgraft, per square centimeter
Q4211Amnion bio or axobiomembrane, per square centimeter
Q4212Allogen, per cc
Q4213Ascent, 0.5 mg
Q4214Cellesta cord, per square centimeter
Q4215Axolotl ambient or axolotl cryo, 0.1 mg
Q4216Artacent cord, per square centimeter
Q4217Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter
Q4218Surgicord, per square centimeter
Q4219Surgigraft-dual, per square centimeter
Q4220Bellacell hd or surederm, per square centimeter
Q4221Amniowrap2, per square centimeter
Q4222Progenamatrix, per square centimeter
Q4224Human health factor 10 amniotic patch (hhf10-p), per square centimeter
Q4225Amniobind, per square centimeter
Q4226Myown skin, includes harvesting and preparation procedures, per square centimeter
Q4234Xcellerate, per square centimeter
Q4235Amniorepair or altiply, per square centimeter
Q4236Carepatch, per square centimeter
Q4237Cryo-cord, per square centimeter
Q4238Derm-maxx, per square centimeter
Q4239Amnio-maxx or amnio-maxx lite, per square centimeter
Q4240Corecyte, for topical use only, per 0.5 cc
Q4241Polycyte, for topical use only, per 0.5 cc
Q4242Amniocyte plus, per 0.5 cc
Q4244Procenta, per 200 mg
Q4245Amniotext, per cc
Q4246Coretext or protext, per cc
Q4247Amniotext patch, per square centimeter
Q4248Dermacyte amniotic membrane allograft, per square centimeter
Q4251Vim, per square centimeter
Q4252Vendaje, per square centimeter
Q4253Zenith amniotic membrane, per square centimeter
Q4256Mlg-complete, per square centimeter
Q4257Relese, per square centimeter
Q4258Enverse, per square centimeter
Q4259Celera dual layer or celera dual membrane, per square centimeter
Q4260Signature apatch, per square centimeter
Q4262Dual layer impax membrane, per square centimeter
Q4263Surgraft tl, per square centimeter
Q4264Cocoon membrane, per square centimeter
Q4265Neostim tl, per square centimeter
Q4266Neostim membrane, per square centimeter
Q4267Neostim dl, per square centimeter
Q4268Surgraft ft, per square centimeter
Q4269Surgraft xt, per square centimeter
Q4270Complete sl, per square centimeter
Q4271Complete ft, per square centimeter
Q4272Esano a, per square centimeter
Q4273Esano aaa, per square centimeter
Q4274Esano ac, per square centimeter
Q4275Esano aca, per square centimeter
Q4276Orion, per square centimeter
Q4277Woundplus membrane or e-graft, per square centimeter
Q4278Epieffect, per square centimeter
Q4279VENDAJE AC, PER SQUARE CENTIMETER
Q4280Xcell amino matrix, per square centimeter
Q4281Barrera sl or barrera dl, per square centimeter
Q4282Cygnus dual, per square centimeter
Q4283Biovance tri-layer or biovance 3L, per square centimeter
Q4284Dermabind sl, per square centimeter
Q4287DERMABIND DL, PER SQUARE CENTIMETER
Q4288DERMABIND CH, PER SQUARE CENTIMETER
Q4289REVOSHIELD + AMNIOTIC BARRIER, PER SQUARE CENTIMETER
Q4290MEMBRANE WRAP-HYDRO, PER SQUARE CENTIMETER
Q4291LAMELLAS XT, PER SQUARE CENTIMETER
Q4292LAMELLAS, PER SQUARE CENTIMETER
Q4293ACESSO DL, PER SQUARE CENTIMETER
Q4294AMNIO QUAD-CORE, PER SQUARE CENTIMETER
Q4295AMNIO TRI-CORE AMNIOTIC, PER SQUARE CENTIMETER
Q4296REBOUND MATRIX, PER SQUARE CENTIMETER
Q4297EMERGE MATRIX, PER SQUARE CENTIMETER
Q4298AMNICORE PRO, PER SQUARE CENTIMETER
Q4299AMNICORE PRO+, PER SQUARE CENTIMETER
Q4300ACESSO TL, PER SQUARE CENTIMETER
Q4301ACTIVATE MATRIX, PER SQUARE CENTIMETER
Q4302COMPLETE ACA, PER SQUARE CENTIMETER
Q4303COMPLETE AA, PER SQUARE CENTIMETER
Q4304GRAFIX PLUS, PER SQUARE CENTIMETER
Q4305American amnion ac tri-layer, per square centimeter
Q4306American amnion ac, per square centimeter
Q4307American amnion, per square centimeter
Q4308Sanopellis, per square centimeter
Q4309Via matrix, per square centimeter
Q4310Procenta, per 100 mg
Q4311ACESSO, PER SQUARE CENTIMETER
Q4312ACESSO AC, PER SQUARE CENTIMETER
Q4313DERMABIND FM, PER SQUARE CENTIMETER
Q4314REEVA FT, PER SQUARE CENITMETER
Q4315REGENELINK AMNIOTIC MEMBRANE ALLOGRAFT, PER SQUARE CENTIMETER
Q4316AMCHOPLAST, PER SQUARE CENTIMETER
Q4317VITOGRAFT, PER SQUARE CENTIMETER
Q4318E-GRAFT, PER SQUARE CENTIMETER
Q4319SANOGRAFT, PER SQUARE CENTIMETER
Q4320PELLOGRAFT, PER SQUARE CENTIMETER
Q4321RENOGRAFT, PER SQUARE CENTIMETER
Q4322CAREGRAFT, PER SQUARE CENTIMETER
Q4323ALLOPLY, PER SQUARE CENTIMETER
Q4324AMNIOTX, PER SQUARE CENTIMETER
Q4325ACAPATCH, PER SQUARE CENTIMETER
Q4327DUOAMNION, PER SQUARE CENTIMETER
Q4328MOST, PER SQUARE CENTIMETER
Q4329SINGLAY, PER SQUARE CENTIMETER
Q4330TOTAL, PER SQUARE CENTIMETER
Q4331AXOLOTL GRAFT, PER SQUARE CENTIMETER
Q4332AXOLOTL DUALGRAFT, PER SQUARE CENTIMETER
Q4333ARDEOGRAFT, PER SQUARE CENTIMETER
Q4334Amnioplast 1, per square centimeter
Q4335Amnioplast 2, per square centimeter
Q4336Artacent c, per square centimeter
Q4337Artacent trident, per square centimeter
Q4338Artacent velos, per square centimeter
Q4339Artacent vericlen, per square centimeter
Q4340Simpligraft, per square centimeter
Q4341Simplimax, per square centimeter
Q4342Theramend, per square centimeter
Q4343Dermacyte ac matrix amniotic membrane allograft, per square centimeter
Q4344Tri-membrane wrap, per square centimeter
Q4345Matrix hd allograft dermis, per square centimeter
Q4346Shelter dm matrix, per square centimeter
Q4347Rampart dl matrix, per square centimeter
Q4348Sentry sl matrix, per square centimeter
Q4349Mantle dl matrix, per square centimeter
Q4350Palisade dm matrix, per square centimeter
Q4351Enclose tl matrix, per square centimeter
Q4352Overlay sl matrix, per square centimeter
Q4353Xceed tl matrix, per square centimeter
Q4354Palingen dual-layer membrane, per square centimeter
Q4355Abiomend Xplus membrane and Abiomend Xplus hydromembrane, per square centimeter
Q4356Abiomend membrane and Abiomend hydromembrane, per square centimeter
Q4357Xwrap plus, per square centimeter
Q4358Xwrap dual, per square centimeter
Q4359Choriply, per square centimeter
Q4360Amchoplast fd, per square centimeter
Q4361Epixpress, per square centimeter
Q4362Cygnus disk, per square centimeter
Q4363Amnio burgeon membrane and hydromembrane, per square centimeter
Q4364Amnio burgeon Xplus membrane and xplus hydromembrane, per square centimeter
Q4365Amnio burgeon dual-layer membrane, per square centimeter
Q4366Dual layer amnio burgeon x-membrane, per square centimeter
Q4367Amniocore sl, per square centimeter
Q4368Amchothick, per square centimeter
Q4369Amnioplast 3, per square centimeter
Q4370Aeroguard, per square centimeter
Q4371Neoguard, per square centimeter
Q4372Amchoplast excel, per square centimeter
Q4373Membrane wrap lite, per square centimeter
Q4375Duograft ac, per square centimeter
Q4376Duograft aa, per square centimeter
Q4377Trigraft ft, per square centimeter
Q4378Renew ft matrix, per square centimeter
Q4379Amniodefend ft matrix, per square centimeter
Q4380Advograft one, per square centimeter
Q4382Advograft dual, per square centimeter
Q4418Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)
Q4419Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)
Q4421Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)
Q4422A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)
Q4423Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)
Q4424Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4425Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)
Q4426Dermabind tl + or dermabind tl x, per square centimeter (add-on, list separately in addition to primary procedure)
Q4427Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)
Q4428Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)
Q4429Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)
Q4435Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4436Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4437Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)
Q4438Pretect, per square centimeter (add-on, list separately in addition to primary procedure)
Q4439Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)
Q4440Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q9982Flutemetamol F18, diagnostic, per study dose, up to 5 millicuries
Q9983Florbetaben F18, diagnostic, per study dose, up to 8.1 millicuries
S1091Stent, noncoronary, temporary, with delivery system (Propel)
S2080Laser-assisted uvuolopalatoplasty (LAUP)
S2103Adrenal tissue transplant to brain (effective 09/01/2014)
S2205Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, under direct vision; using arterial graft(s), 2 coronary arterial grafts
S2206Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial grafts
S2207Minimally invasive direct coronary artery bypass surgery involving mini-toracotomy or mini-sternotomy surgery, performed under direct vision; using venous graft only, single coronary venous graft
S2208Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and venous graft(s), single venous graft
S2209Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using 2 arterial grafts and single venous graft
S3650Saliva test, hormone level; during menopause
S3652to assess preterm labor risk
S3852DNA analysis for APOE epsilon 4 allele for susceptibility to Alzheimer’s disease
S3902Ballistocardiogram
S3904Masters two step
S4988Penile contracture device, manual, greater than 3 lbs traction force
S8080Scintimammography (radioimmunoscintigraphy of the breast), unilateral, including supply of radiopharmaceutical
S9002Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device
S9025Omnicardiogram/cardiointegram
S9432Medical foods for non-inborn errors of metabolism
T1505Electronic medication compliance management device, includes all components and accessories, not otherwise classified
T2050Financial management, self-directed, waiver; per diem
T2051Supports brokerage, self-directed, waiver; per diem
T4545Incontinence product, disposable, penile wrap, each
V2525Contact lens, hydrophilic, dual focus, per lens
0202Unfectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected.
0017MOncology (diffuse large b-cell lymphoma [dlbcl]), mrna, gene expression profiling by fluorescent probe hybridization of 20 genes, formalin-fixed paraffin-embedded tissue, algorithm reported as cell of origin

Table III. CPT Category III Codes

CPT Procedure CodesDescription
0202UInfectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected.
0017MOncology (diffuse large b-cell lymphoma [dlbcl]), mrna, gene expression profiling by fluorescent probe hybridization of 20 genes, formalin-fixed paraffin-embedded tissue, algorithm reported as cell of origin
0085TBreath test for heart transplant rejection
0095T

Removal of total disc arthroplasty (artificial disc), interior approach, each additional interspace, cervical

For more detailed information, please see associated medical policy Spinal Interventional Pain Management and Spine Surgery

0098T

Revision, including replacement of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, cervical

For more detailed information, please see associated medical policy Spinal Interventional Pain Management and Spine Surgery

0100TPlacement of a subconjunctival retinal prosthesis receiver and pulse generator, and implantation of intra-ocular retinal electrode array, with vitrectomy
0101TExtracorporeal shock wave involving musculoskeletal system, not otherwise specified; high energy
0102TExtracorporeal shock wave, high energy, performed by a physician, requiring anesthesia other than local, involving lateral humeral epicondyle
0111TLong-chain (C20-22) omega-3 fatty acids in red blood cell (RBC) membranes
0126TCommon carotid intima-media thickness (IMT) study for evaluation of atherosclerotic burden or coronary heart disease risk factor assessment
0159TComputer-aided detection, including computer algorithm analysis of MRI image data for lesion detection/characterization, pharmacokinetic analysis with further physician review for interpretation, breast MRI
0163T

Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), lumbar, each additional interspace

For more detailed information, please see associated medical policy Spinal Interventional Pain Management and Spine Surgery

0164TRemoval of total disc arthroplasty (artificial disc), anterior approach, lumbar, each additional interspace
0165T

Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, lumbar, each additional interspace

For more detailed information, please see associated medical policy Spinal Interventional Pain Management and Spine Surgery

0190TPlacement of intraocular radiation source applicator
0195T

Arthrodesis, pre-sacral interbody technique, disc space preparation, discectomy, without instrumentation, with image guidance, includes bone graft when performed; L5-S1 interspace

For more detailed information, please see associated medical policy Spinal Interventional Pain Management and Spine Surgery

0196T

Arthrodesis, pre-sacral interbody technique, disc space preparation, discectomy, without instrumentation, with image guidance, includes bone graft when performed; L4-L5 interspace (List separately in addition to code for primary procedure)

For more detailed information, please see associated medical policy Spinal Interventional Pain Management and Spine Surgery

0198TMeasurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation and report
0200TPercutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon or mechanical device, when used, one or more needles
0201TPercutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device, when used, two or more needles
0202TPosterior vertebral joint(s) arthroplasty (e.g., facet joint(s) replacement) including facetectomy, laminectomy, foraminotomy, and vertebral column fixation, injection of bone cement, when performed, including fluoroscopy, single level, lumbar spine
0206TAlgorithmic analysis, remote, of electrocardiographic-derived data with computer probability assessment, including report
0207TEvacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral
0219TPlacement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; cervical (Do not report 0219T-0221T with any radiological service)
0220Tthoracic (Do not report 0219T-0221T with any radiological service)
0221T

lumbar (Do not report 0219T-0221T with any radiological service)

For more detailed information, please see associated medical policy Spinal Interventional Pain Management and Spine Surgery

0222T

each additional vertebral segment (List separately in addition to code for primary procedure) (Use 0222T in conjunction with 0219T-0221T)

For more detailed information, please see associated medical policy Spinal Interventional Pain Management and Spine Surgery

0232TInjection(s), platelet rich plasma, any tissue, including image guidance, harvesting and preparation when performed
0263TIntramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg, including ultrasound guidance, if performed; complete procedure including unilateral or bilateral bone marrow harvest (effective 7/1/11)
0264Tcomplete procedure excluding bone marrow harvest
0265Tunilateral or bilateral bone marrow harvest only for intramuscular autologous bone marrow cell therapy
0266TImplantation or replacement of carotid sinus baroreflex activation device; total system (includes generator placement, unilateral or bilateral lead placement, intra-operative interrogation, programming, and repositioning, when performed) (effective 7/1/11)
0267Tlead only, unilateral (includes intra-operative interrogation, programming, and repositioning, when performed) (effective 7/1/11)
0268Tpulse generator only (includes intra-operative interrogation, programming, and repositioning, when performed) (effective 7/1/11)
0269TRevision or removal of carotid sinus baroflex activation device; total system (includes generator placement, unilateral or bilateral lead placement, intra-operative interrogation, programming, and repositioning, when performed) (effective 7/1/11)
0270Tlead only, unilateral (includes intra-operative interrogation, programming, and repositioning, when performed) (effective 7/1/11)
0271Tpulse generator only (includes intra-operative interrogation, programming, and repositioning, when performed) (effective 7/1/11)
0272TInterrogation device evaluation (in person), carotid sinus baroreflex activation system, including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, lead impedance, pulse amplitude, pulse width, therapy frequency, pathway mode, burst mode, therapy start/stop times each day) (effective 7/1/11)
0273Twith programming (effective 7/1/11)
0274TPercutaneous laminotomy/laminectomy (intralaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy) any method under indirect image guidance (eg, fluoroscopic, CT), with or without the use of an endoscope, single or multiple levels, unilateral or bilateral; cervical or thoracic (effective 7/1/11)
0275Tlumbar
0278TTranscutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each treatment session (includes placement of electrodes)
0312TVagus nerve blocking therapy (morbid obesity); laparoscopic implantation of neurostimulator electrode array, anterior and posterior vagal trunks adjacent to esophagogastric junction (EGJ), with implantation of pulse generator, includes programming
0313TVagus nerve blocking therapy (morbid obesity); laparoscopic revision or replacement of vagal trunk neurostimulator electrode array, including connection to existing pulse generator
0314TVagus nerve blocking therapy (morbid obesity); laparoscopic removal of vagal trunk neurostimulator electrode array and pulse generator
0315TVagus nerve blocking therapy (morbid obesity); removal of pulse generator
0316TVagus nerve blocking therapy (morbid obesity); replacement of pulse generator
0317TVagus nerve blocking therapy (morbid obesity); neurostimulator pulse generator electronic analysis, includes reprogramming when performed
0330TTear film imaging, unilateral or bilateral, with interpretation and report
0333TVisual evoked potential, screening of visual acuity, automated
0335TExtra-osseous subtalar joint implant for talotarsal stabilization
0337TEndothelial function assessment, using peripheral vascular response to reactive hyperemia, non-invasive (eg, brachial artery ultrasound, peripheral artery tonometry), unilateral or bilateral
0338TTranscatheter renal sympathetic denervation, percutaneous approach including arterial puncture, selective catheter placement(s) renal artery(ies), fluoroscopy, contrast injection(s), intraprocedural roadmapping and radiological supervision and interpretation, including pressure gradient measurements, flush aortogram and diagnostic renal angiography when performed; unilateral
0339TTranscatheter renal sympathetic denervation, percutaneous approach including arterial puncture, selective catheter placement(s) renal artery(ies), fluoroscopy, contrast injection(s), intraprocedural roadmapping and radiological supervision and interpretation, including pressure gradient measurements, flush aortogram and diagnostic renal angiography when performed; bilateral
0340TAblation, pulmonary tumor(s), including pleura or chest wall when involved by tumor extension, percutaneous, cryoablation, unilateral, includes imaging guidance
0341TQuantitative pupillometry with interpretation and report, unilateral or bilateral
0342TTherapeutic apheresis with selective hdl delipidation and plasma reinfusion
0346TUltrasound, elastography (list separately in addition to code for primary procedure) (except when billed for hepatitis C)
0356TInsertion of drug-eluting implant (including punctual dilation and implant removal when performed) into lacrimal canaliculus, each
0358TBioelectrical impedance analysis whole body composition assessment, supine position, with interpretation and report
0378TVisual field assessment, with concurrent real time data analysis and accessible data storage with patient initiated data transmitted to a remote surveillance center for up to 30 days; review and interpretation with report by a physician or other qualified health care professional
0379TTechnical support and patient instructions, surveillance, analysis and transmission of daily and emergent data reports as prescribed by a physician or other qualified health care professional
0380TComputer-aided animation and analysis of time series retinal images for the monitoring of disease progression, unilateral or bilateral, with interpretation and report
0381TExternal heart rate and 3-axis accelerometer data recording up to 14 days to assess changes in heart rate and to monitor motion analysis for the purposes of diagnosing nocturnal epilepsy seizure events; includes report, scanning analysis with report, review and interpretation by a physician or other qualified health care professional
0382TExternal heart rate and 3-axis accelerometer data recording up to 14 days to assess changes in heart rate and to monitor motion analysis for the purposes of diagnosing nocturnal epilepsy seizure events; review and interpretation only
0383TExternal heart rate and 3-axis accelerometer data recording from 15 to 30 days to assess changes in heart rate to monitor motion analysis for the purposes of diagnosing nocturnal epilepsy seizure events; includes report, scanning analysis with report, review and interpretation by a physician or other qualified health care professional
0384TExternal heart rate and 3-axis accelerometer data recording from 15 to 30 days to assess changes in heart rate to monitor motion analysis for the purposes of diagnosing nocturnal epilepsy seizure events; review and interpretation only
0385TExternal heart rate and 3-axis accelerometer data recording more than 30 days to assess changes in heart rate to monitor motion analysis for the purposes of diagnosing nocturnal epilepsy seizure events; includes report, scanning analysis with report, review and interpretation by a physician or other qualified health care professional
0386TExternal heart rate and 3-axis accelerometer data recording more than 30 days to assess changes in heart rate to monitor motion analysis for the purposes of diagnosing nocturnal epilepsy seizure events; review and interpretation only
0387TTranscatheter insertion or replacement of permanent leadless pacemaker, ventricular
0388TTranscatheter removal of permanent leadless pacemaker, ventricular
0389TProgramming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report, leadless pacemaker system
0390TPeri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure or test with analysis, review and report, leadless pacemaker system
0391TInterrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter, leadless pacemaker system
0397TEndoscopic retrograde cholangiopancreatography (ercp), with optical endomicroscopy (list separately in addition to code for primary procedure)
0398TMagnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation lesion, intracranial for movement disorder including stereotactic navigation and frame placement when performed
0404TTranscervical uterine fibroid(s) ablation with ultrasound guidance, radiofrequency
0408TInsertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; pulse generator with transvenous electrodes
0409TInsertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; pulse generator only
0410TInsertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; atrial electrode only
0411TInsertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; ventricular electrode only
0412TRemoval of permanent cardiac contractility modulation system; pulse generator only
0413TRemoval of permanent cardiac contractility modulation system; transvenous electrode (atrial or ventricular)
0414TRemoval and replacement of permanent cardiac contractility modulation system pulse generator only
0415TRepositioning of previously implanted cardiac contractility modulation transvenous electrode, (atrial or ventricular lead)
0416TRelocation of skin pocket for implanted cardiac contractility modulation pulse generator
0417TProgramming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility m
0418TInterrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter; implantable cardiac contractility modulation system
0421TTransurethral waterjet ablation of prostate, including control of post-operative bleeding, including ultrasound guidance, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included when performed)
0423TSecretory type ii phospholipase a2 (spla2-iia)
0424TInsertion or replacement of neurostimulator system for treatment of central sleep apnea; complete system (transvenous placement of right or left stimulation lead, sensing lead, implantable pulse generator)
0425TInsertion or replacement of neurostimulator system for treatment of central sleep apnea; sensing lead only
0426TInsertion or replacement of neurostimulator system for treatment of central sleep apnea; stimulation lead only
0427TInsertion or replacement of neurostimulator system for treatment of central sleep apnea; pulse generator only
0428TRemoval of neurostimulator system for treatment of central sleep apnea; pulse generator only
0429TRemoval of neurostimulator system for treatment of central sleep apnea; sensing lead only
0430TRemoval of neurostimulator system for treatment of central sleep apnea; stimulation lead only
0431TRemoval and replacement of neurostimulator system for treatment of central sleep apnea, pulse generator only
0432TRepositioning of neurostimulator system for treatment of central sleep apnea; stimulation lead only
0433TRepositioning of neurostimulator system for treatment of central sleep apnea; sensing lead only
0434TInterrogation device evaluation implanted neurostimulator pulse generator system for central sleep apnea
0435TProgramming device evaluation of implanted neurostimulator pulse generator system for central sleep apnea; single session
0436TProgramming device evaluation of implanted neurostimulator pulse generator system for central sleep apnea; during sleep study
0437TImplantation of non-biologic or synthetic implant (eg, polypropylene) for fascial reinforcement of the abdominal wall (list separately in addition to primary procedure)
0439TMyocardial contrast perfusion echocardiography; at rest or with stress, for assessment of myocardial ischemia or viability (list separately in addition to primary procedure)
0440TAblation, percutaneous, cryoablation, includes imaging guidance; upper extremity distal/peripheral nerve
0441TAblation, percutaneous, cryoablation, includes imaging guidance; upper extremity distal/peripheral nerve; lower extremity distal/peripheral nerve
0442TAblation, percutaneous, cryoablation, includes imaging guidance; upper extremity distal/peripheral nerve; nerve plexus or other truncal nerve (eg, brachial plexus, pudendal nerve)
0443TReal time spectral analysis of prostate tissue by fluorescence spectroscopy
0444TInitial placement of a drug-eluting ocular insert under one or more eyelids, including fitting, training, and insertion, unilateral or bilateral
0445TSubsequent placement of a drug-eluting ocular insert under one or more eyelids, including re-training, and removal of existing insert, unilateral or bilateral
0450TInsertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; initial device; each additional device (list separately in addition to code for primary procedure)
0451TInsertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system, endovascular approach, and programming of sensing and therapeutic parameters; complete system (counterpulsation device, vascular graft, implantable vascular hemostatic seal, mechano-electrical skin interface and subcutaneous electrodes)
0452TInsertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system, endovascular approach, and programming of sensing and therapeutic parameters; complete system (counterpulsation device, vascular graft, implantable vascular hemostatic seal, mechano-electrical skin interface and subcutaneous electrodes); aortic counterpulsation device and vascular hemostatic seal
0453TInsertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system, endovascular approach, and programming of sensing and therapeutic parameters; complete system (counterpulsation device, vascular graft, implantable vascular hemostatic seal, mechano-electrical skin interface and subcutaneous electrodes); mechano-electrical skin interface
0454TInsertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system, endovascular approach, and programming of sensing and therapeutic parameters; complete system (counterpulsation device, vascular graft, implantable vascular hemostatic seal, mechano-electrical skin interface and subcutaneous electrodes); subcutaneous electrode
0455TRemoval of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device, vascular hemostatic seal, mechano-electrical skin interface and electrodes)
0456TRemoval of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device, vascular hemostatic seal, mechano-electrical skin interface and electrodes); aortic counterpulsation device and vascular
0457TRemoval of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device, vascular hemostatic seal, mechano-electrical skin interface and electrodes); mechano-electrical skin interface
0458TRemoval of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device, vascular hemostatic seal, mechano-electrical skin interface and electrodes); subcutaneous electrode
0459TRelocation of skin pocket with replacement of implanted aortic counterpulsation ventricular assist device,mechano- electrical skin interface and electrodes
0460TRepositioning of previously implanted aortic counterpulsation ventricular assist device, subcutaneous electrode
0461TRepositioning of previously implanted aortic counterpulsation ventricular assist device, subcutaneous electrode; aortic counterpulsation device
0462TProgramming device evaluation (in person) with iterative adjustment of the implantable mechano-electrical skin interface and/or external driver to test the function of the device and select optimal permanent programmed values with analysis, including review
0463TInterrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter, implantable aortic counterpulsation ventricular assist system, per day
0464TVisual evoked potential, testing for glaucoma, with interpretation and report
0465TSuprachoroidal injection of a pharmacologic agent (does not include supply of medication)
0466TInsertion of chest wall respiratory sensor electrode or electrode array, including connection to pulse generator (list separately in addition to code for primary procedure)
0467TRevision or replacement of chest wall respiratory sensor electrode or electrode array, including connection to existing pulse generator
0468TRemoval of chest wall respiratory sensor electrode or electrode array
0470TOptical coherence tomography (oct) for microstructural and morphological imaging of skin, image acquisition, interpretation, and report; first lesion
0474TInsertion of anterior segment aqueous drainage device, with creation of intraocular reservoir, internal approach, into the supraciliary space​
0471TOptical coherence tomography (oct) for microstructural and morphological imaging of skin, image acquisition, interpretation, and report; each additional lesion (list separately in additional to code for primary procedure)
0472TDevice evaluation, interrogation, and initial programming of intra-ocular retinal electrode array (eg, retinal prosthesis), in person, with iterative adjustment of the implantable device to test functionality, select optimal permanent programmed values with analysis, including visual training, with review and report by a qualified health care professional
0473TDevice evaluation and interrogation of intra-ocular retinal electrode array (eg, retinal prosthesis), in person, including reprogramming and visual training, when performed, with review and report by a qualified health care professional
0497TExternal patient-activated, physician- or other qualified health care professional-prescribed, electrocardiographic rhythm derived event recorder without 24 hour attended monitoring; in-office connection
For more detailed information, please see associated medical policy Ambulatory Event Monitors and Mobile Cardiac Outpatient Telemetry.
0498TExternal patient-activated, physician- or other qualified health care professional-prescribed, electrocardiographic rhythm derived event recorder without 24 hour attended monitoring; review and interpretation by a physician or other qualified health care professional per 30 days with at least one patient-generated triggered event
For more detailed information, please see associated medical policy Ambulatory Event Monitors and Mobile Cardiac Outpatient Telemetry.
0541TMyocardial imaging by magnetocardiography (mcg) for detection of cardiac ischemia, by signal acquisition using minimum 36 channel grid, generation of magnetic-field time-series images, quantitative analysis of magnetic dipoles, machine learning- derived clinical scoring, and automated report generation, single study
0542TMyocardial imaging by magnetocardiography (mcg) for detection of cardiac ischemia, by signal acquisition using minimum 36 channel grid, generation of magnetic-field time-series images, quantitative analysis of magnetic dipoles, machine learning- derived clinical scoring, and automated report generation, single study; interpretation and report
0525TInsertion or replacement of intracardiac ischemia monitoring system, including testing of the lead and monitor, initial system programming, and imaging supervision and interpretation; complete system (electrode and implantable monitor)
0526TInsertion or replacement of intracardiac ischemia monitoring system, including testing of the lead and monitor, initial system programming, and imaging supervision and interpretation; electrode only
0527TInsertion or replacement of intracardiac ischemia monitoring system, including testing of the lead and monitor, initial system programming, and imaging supervision and interpretation; implantable monitor only
0528TProgramming device evaluation (in person) of intracardiac ischemia monitoring system with iterative adjustment of programmed values, with analysis, review, and report
0529TInterrogation device evaluation (in person) of intracardiac ischemia monitoring system with analysis, review, and report
0530TRemoval of intracardiac ischemia monitoring system, including all imaging supervision and interpretation; complete system (electrode and implantable monitor)
0531TRemoval of intracardiac ischemia monitoring system, including all imaging supervision and interpretation; electrode only
0532TRemoval of intracardiac ischemia monitoring system, including all imaging supervision and interpretation; implantable monitor only
0533TContinuous recording of movement disorder symptoms, including bradykinesia, dyskinesia, and tremor for 6 days up to 10 days; includes set-up, patient training, configuration of monitor, data upload, analysis and initial report configuration, download review, interpretation and report
0534TContinuous recording of movement disorder symptoms, including bradykinesia, dyskinesia, and tremor for 6 days up to 10 days; set-up, patient training, configuration of monitor
0535TContinuous recording of movement disorder symptoms, including bradykinesia, dyskinesia, and tremor for 6 days up to 10 days; data upload, analysis and initial report configuration
0536TContinuous recording of movement disorder symptoms, including bradykinesia, dyskinesia, and tremor for 6 days up to 10 days; download review, interpretation and report
0546TRadiofrequency spectroscopy, real time, intraoperative margin assessment, at the time of partial mastectomy, with report
0547TBone-material quality testing by microindentation(s) of the tibia(s), with results reported as a score
0548TTransperineal periurethral balloon continence device; bilateral placement, including cystoscopy and fluoroscopy
0549TTransperineal periurethral balloon continence device; unilateral placement, including cystoscopy and fluoroscopy
0550TTransperineal periurethral balloon continence device; removal, each balloon
0551TTransperineal periurethral balloon continence device; adjustment of balloon(s) fluid volume
0552TLow-level laser therapy, dynamic photonic and dynamic thermokinetic energies, provided by a physician or other qualified health care professional
0553TPercutaneous transcatheter placement of iliac arteriovenous anastomosis implant, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention
0554TBone strength and fracture risk using finite element analysis of functional data, and bone-mineral density, utilizing data from a computed tomography scan; retrieval and transmission of the scan data, assessment of bone strength and fracture risk and bone mineral density, interpretation and report
0555TBone strength and fracture risk using finite element analysis of functional data, and bone-mineral density, utilizing data from a computed tomography scan; retrieval and transmission of the scan data
0556TBone strength and fracture risk using finite element analysis of functional data, and bone-mineral density, utilizing data from a computed tomography scan; assessment of bone strength and fracture risk and bone mineral density
0557TBone strength and fracture risk using finite element analysis of functional data, and bone-mineral density, utilizing data from a computed tomography scan; interpretation and report
0558TComputed tomography scan taken for the purpose of biomechanical computed tomography analysis
0559TAnatomic model 3d-printed from image data set(s); first individually prepared and processed component of an anatomic structure
0560TAnatomic model 3d-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (list separately in addition to code for primary procedure)
0561TAnatomic guide 3d-printed and designed from image data set(s); first anatomic guide
0562TAnatomic guide 3d-printed and designed from image data set(s); each additional anatomic guide (list separately in addition to code for primary procedure)
0565TAutologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; tissue harvesting and cellular implant creation
0566TAutologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; injection of cellular implant into knee joint including ultrasound guidance, unilateral
0567TPermanent fallopian tube occlusion with degradable biopolymer implant, transcervical approach, including transvaginal ultrasound
0568TIntroduction of mixture of saline and air for sonosalpingography to confirm occlusion of fallopian tubes, transcervical approach, including transvaginal ultrasound and pelvic ultrasound
0571TInsertion or replacement of implantable cardioverter-defibrillator system with substernal electrode(s), including all imaging guidance and electrophysiological evaluation (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters), when performed
0572TInsertion of substernal implantable defibrillator electrode
0573TRemoval of substernal implantable defibrillator electrode
0574TRepositioning of previously implanted substernal implantable defibrillator-pacing electrode
0575TProgramming device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional
0576TInterrogation device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter
0577TElectrophysiological evaluation of implantable cardioverter- defibrillator system with substernal electrode (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)
0578TInterrogation device evaluation(s) (remote), up to 90 days, substernal lead implantable cardioverter-defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional
0579TInterrogation device evaluation(s) (remote), up to 90 days, substernal lead implantable cardioverter-defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results
0580TRemoval of substernal implantable defibrillator pulse generator only
0596TTemporary female intraurethral valve-pump (ie, voiding prosthesis); initial insertion, including urethral measurement
0597TTemporary female intraurethral valve-pump (ie, voiding prosthesis); replacement
0598TReal-time fluorescence wound imaging with clinical darkness, to identify location of bacterial wound pathogens and measure wound size, per session; first anatomic site (e.g., lower extremity, right leg)
0599T;Real-time fluorescence wound imaging with clinical darkness, to identify location of bacterial wound pathogens and measure wound size, per session; each additional anatomic site (e.g., upper extremity, left leg) (list separately in addition to code for primary procedure)
0600TAblation, irreversible electroporation; 1 or more tumors per organ, other than liver or prostate, including imaging guidance, when performed, percutaneous
0601TAblation, irreversible electroporation; 1 or more tumors, including fluoroscopic and ultrasound guidance, when performed, open
0602TGlomerular filtration rate (GFR) measurement(s), transdermal
0603TGlomerular filtration rate (GFR) monitoring, transdermal, including sensor placement and administration of more than one dose of fluorescent pyrazine agent, each 24 hours
0607TRemote monitoring of an external continuous pulmonary fluid monitoring system
0608TRemote monitoring of an external continuous pulmonary fluid monitoring system, including measurement of radiofrequency- derived pulmonary fluid levels, heart rate, respiration rate, activity, posture, and cardiovascular rhythm
0609TMagnetic resonance spectroscopy, determination and localization of discogenic pain (cervical, thoracic, or lumbar); acquisition of single voxel data, per disc, on biomarkers
0610TMagnetic resonance spectroscopy, determination and localization of discogenic pain (cervical, thoracic, or lumbar); transmission of biomarker data for software analysis
0611TMagnetic resonance spectroscopy, determination and localization of discogenic pain (cervical, thoracic, or lumbar);
0612TMagnetic resonance spectroscopy, determination and localization of discogenic pain (cervical, thoracic, or lumbar); interpretation and report
0615TEye-movement analysis without spatial calibration, with interpretation and report
0616TInsertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; without removal of crystalline lens or intraocular lens, without insertion of intraocular lens
0617TInsertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; with removal of crystalline lens and insertion of intraocular lens
0618TInsertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; with secondary intraocular lens placement or intraocular lens exchange
0619TCystourethroscopy with transurethral anterior prostate commissurotomy and drug delivery, including transrectal ultrasound and fluoroscopy, when performed
0640TNoncontact near-infrared spectroscopy studies of flap or wound (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation [sto2]); image acquisition, interpretation and report, each flap or wound
0641TNoncontact near-infrared spectroscopy studies of flap or wound (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation [sto2]); image acquisition only, each flap or wound
0642TNoncontact near-infrared spectroscopy studies of flap or wound (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation [sto2]); interpretation and report only, each flap or wound
0662TScalp cooling, mechanical; initial measurement and calibration of cap
0663TScalp cooling, mechanical; placement of device, monitoring, and removal of device (list separately in addition to code for primary procedure)
0672TEndovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence
0674TLaparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)
0675TLaparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead
0676TLaparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary procedure)
0677TLaparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead
0678TLaparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary procedure) repositioned lead
0679TLaparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function
0680TInsertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)
0681TRelocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads
0682TRemoval of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function
0683TProgramming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function
0684TPeri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function
0685TInterrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function
0691TAutomated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report
0692TTherapeutic ultrafiltration
0693TComprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report
0695TBody surface–activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement
0696TBody surface–activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluation
0700TMolecular fluorescent imaging of suspicious nevus; first lesion
0701TMolecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)
0704TRemote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment
0705TRemote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days
0706TRemote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month
0707TInjection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization
0708TIntradermal cancer immunotherapy; preparation and initial injection
0709TIntradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)
0710TNoninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability, data review, interpretation and report
0711TNoninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission
0712TNoninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability
0713TNoninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report
0714TTransperineal laser ablation of benign prostatic hyperplasia, including imaging guidance
0715TPercutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)
0716TCardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score
0717TAutologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing and concentration of ADRCS
0718TAutologous adipose-derived regenerative cell (ADRC) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral
0719TPosterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment
0720TPercutaneous electrical nerve field stimulation, cranial nerves, without implantation
0725TVestibular device implantation, unilateral
0726TRemoval of implanted vestibular device, unilateral
0727TRemoval and replacement of implanted vestibular device, unilateral
0728TDiagnostic analysis of vestibular implant, unilateral; with initial programming
0729TDiagnostic analysis of vestibular implant, unilateral; with subsequent programming
0730TTrabeculotomy by laser, including optical coherence tomography (OCT) guidance
0731TAugmentative AI-based facial phenotype analysis with report
0732TImmunotherapy administration with electroporation, intramuscular
0733TRemote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days
0734TRemote body and limb kinematic measurement-based therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month
0737TXenograft implantation into the articular surface
0779TGastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report
0792TApplication of silver diamine fluoride 38%, by a physician or other qualified health care professional
0793TPercutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance
0794TPatient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patient's tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and reported separately
0805TTranscatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach
0806TTranscatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach
0807TPulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data review, interpretation and report
0808TPulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images;in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantification of pulmonary tissue ventilation, data review, interpretation and report
0810TSubretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies
0813TESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL, WITH VOLUME ADJUSTMENT OF INTRAGASTRIC BARIATRIC BALLOON
0814TPERCUTANEOUS INJECTION OF CALCIUM-BASED BIODEGRADABLE OSTEOCONDUCTIVE MATERIAL, PROXIMAL FEMUR, INCLUDING IMAGING GUIDANCE, UNILATERAL
0816TOPEN INSERTION OR REPLACEMENT OF INTEGRATED NEUROSTIMULATION SYSTEM FOR BLADDER DYSFUNCTION INCLUDING ELECTRODE(S) (EG, ARRAY OR LEADLESS), AND PULSE GENERATOR OR RECEIVER, INCLUDING ANALYSIS, PROGRAMMING, AND IMAGING GUIDANCE, WHEN PERFORMED, POSTERIOR TIBIAL NERVE; SUBCUTANEOUS
0817TOPEN INSERTION OR REPLACEMENT OF INTEGRATED NEUROSTIMULATION SYSTEM FOR BLADDER DYSFUNCTION INCLUDING ELECTRODE(S) (EG, ARRAY OR LEADLESS), AND PULSE GENERATOR OR RECEIVER, INCLUDING ANALYSIS, PROGRAMMING, AND IMAGING GUIDANCE, WHEN PERFORMED, POSTERIOR TIBIAL NERVE; SUBFASCIAL
0818TREVISION OR REMOVAL OF INTEGRATED NEUROSTIMULATION SYSTEM FOR BLADDER DYSFUNCTION, INCLUDING ANALYSIS, PROGRAMMING, AND IMAGING, WHEN PERFORMED, POSTERIOR TIBIAL NERVE; SUBCUTANEOUS
0819TREVISION OR REMOVAL OF INTEGRATED NEUROSTIMULATION SYSTEM FOR BLADDER DYSFUNCTION, INCLUDING ANALYSIS, PROGRAMMING, AND IMAGING, WHEN PERFORMED, POSTERIOR TIBIAL NERVE; SUBFASCIAL
0823TTRANSCATHETER INSERTION OF PERMANENT SINGLE-CHAMBER LEADLESS PACEMAKER, RIGHT ATRIAL, INCLUDING IMAGING GUIDANCE (EG, FLUOROSCOPY, VENOUS ULTRASOUND, RIGHT ATRIAL ANGIOGRAPHY AND/OR RIGHT VENTRICULOGRAPHY, FEMORAL VENOGRAPHY, CAVOGRAPHY) AND DEVICE EVALUATION (EG INTERROGATION OR PRORAMMING), WHEN PERFORMED
0824TTRANSCATHETER REMOVAL OF PERMANENT SINGLE-CHAMBER LEADLESS PACEMAKER, RIGHT ATRIAL, INCLUDING IMAGING GUIDANCE (EG, FLUOROSCOPY, VENOUS ULTRASOUND, RIGHT ATRIAL ANGIOGRAPHY AND/OR RIGHT VENTRICULOGRAPHY, FEMORAL VENOGRAPHY, CAVOGRAPHY), WHEN PERFORMED
0825TTRANSCATHETER REMOVAL AND REPLACEMENT OF PERMANENT SINGLE-CHAMBER LEADLESS PACEMAKER, RIGHT ATRIAL, INCLUDING IMAGING GUIDANCE (EG, FLUOROSCOPY, VENOUS ULTRASOUND, RIGHT ATRIAL ANGIOGRAPHY AND/OR RIGHT VENTRICULOGRAPHY, FEMORAL VENOGRAPHY, CAVOGRAPHY) AND DEVICE EVALUATION (EG, INTERROGATION OR PROGRAMMING), WHEN PERFORMED
0826TPROGRAMMING DEVICE EVALUATION (IN PERSON) WITH ITERATIVE ADJUSTMENT OF THE IMPLANTABLE DEVICE TO TEST THE FUNCTION OF THE DEVICE AND SELECT OPTIMAL PERMANENT PROGRAMMED VALUES WITH ANALYSIS, REVIEW AND REPORT BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, LEADLESS PACEMAKER SYSTEM IN SINGLE-CARDIAC CHAMBER
0827TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR CYTOPATHOLOGY, FLUIDS, WASHINGS, OR BRUSHINGS, EXCEPT CERVICAL OR VAGINAL; SMEARS WITH INTERPRETATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0828TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR CYTOPATHOLOGY, FLUIDS, WASHINGS, OR BRUSHINGS, EXCEPT CERVICAL OR VAGINAL; SIMPLE FILTER METHOD WITH INTERPRETATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0829TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR CYTOPATHOLOGY, CONCENTRATION TECHNIQUE, SMEARS, AND INTERPRETATION (EG, SACCOMANNO TECHNIQUE) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0830TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR CYTOPATHOLOGY, SELECTIVE-CELLULAR ENHANCEMENT TECHNIQUE WITH INTERPRETATION (EG, LIQUID-BASED SLIDE PREPARATION METHOD), EXCEPT CERVICAL OR VAGINAL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0831TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), REQUIRING INTERPRETATION BY PHYSICIAN (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0832TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR CYTOPATHOLOGY, SMEARS, ANY OTHER SOURCE; SCREENING AND INTERPRETATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0833TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR CYTOPATHOLOGY, SMEARS, ANY OTHER SOURCE; PREPARATION, SCREENING AND INTERPRETATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0834TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR CYTOPATHOLOGY, SMEARS, ANY OTHER SOURCE; EXTENDED STUDY INVOLVING OVER 5 SLIDES AND/OR MULTIPLE STAINS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0835TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR CYTOPATHOLOGY, EVALUATION OF FINE NEEDLE ASPIRATE; IMMEDIATE CYTOHISTOLOGIC STUDY TO DETERMINE ADEQUACY FOR DIAGNOSIS, FIRST EVALUATION EPISODE, EACH SITE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDU
0836TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR CYTOPATHOLOGY, EVALUATION OF FINE NEEDLE ASPIRATE; IMMEDIATE CYTOHISTOLOGIC STUDY TO DETERMINE ADEQUACY FOR DIAGNOSIS, EACH SEPARATE ADDITIONAL EVALUATION EPISODE, SAME SITE (LIST SEPARATELY IN ADDITION TO CODE
0837TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR CYTOPATHOLOGY, EVALUATION OF FINE NEEDLE ASPIRATE; INTERPRETATION AND REPORT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0838TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR CONSULTATION AND REPORT ON REFERRED SLIDES PREPARED ELSEWHERE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0839TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR CONSULTATION AND REPORT ON REFERRED MATERIAL REQUIRING PREPARATION OF SLIDES (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0840TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR CONSULTATION, COMPREHENSIVE, WITH REVIEW OF RECORDS AND SPECIMENS, WITH REPORT ON REFERRED MATERIAL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0841TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR PATHOLOGY CONSULTATION DURING SURGERY; FIRST TISSUE BLOCK, WITH FROZEN SECTION(S), SINGLE SPECIMEN (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0842TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR PATHOLOGY CONSULTATION DURING SURGERY; EACH ADDITIONAL TISSUE BLOCK WITH FROZEN SECTION(S) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0843TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR PATHOLOGY CONSULTATION DURING SURGERY; CYTOLOGIC EXAMINATION (EG, TOUCH PREPARATION, SQUASH PREPARATION), INITIAL SITE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0844TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR PATHOLOGY CONSULTATION DURING SURGERY; CYTOLOGIC EXAMINATION (EG, TOUCH PREPARATION, SQUASH PREPARATION), EACH ADDITIONAL SITE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0845TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR IMMUNOFLUORESCENCE, PER SPECIMEN; INITIAL SINGLE ANTIBODY STAIN PROCEDURE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0846TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR IMMUNOFLUORESCENCE, PER SPECIMEN; EACH ADDITIONAL SINGLE ANTIBODY STAIN PROCEDURE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0847TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR EXAMINATION AND SELECTION OF RETRIEVED ARCHIVAL (IE, PREVIOUSLY DIAGNOSED) TISSUE(S) FOR MOLECULAR ANALYSIS (EG, KRAS MUTATIONAL ANALYSIS) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0848TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR IN SITU HYBRIDIZATION (EG, FISH), PER SPECIMEN; INITIAL SINGLE PROBE STAIN PROCEDURE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0849TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR IN SITU HYBRIDIZATION (EG, FISH), PER SPECIMEN; EACH ADDITIONAL SINGLE PROBE STAIN PROCEDURE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0850TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR IN SITU HYBRIDIZATION (EG, FISH), PER SPECIMEN; EACH MULTIPLEX PROBE STAIN PROCEDURE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0851TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR MORPHOMETRIC ANALYSIS, IN SITU HYBRIDIZATION (QUANTITATIVE OR SEMIQUANTITATIVE), MANUAL, PER SPECIMEN; INITIAL SINGLE PROBE STAIN PROCEDURE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0852TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR MORPHOMETRIC ANALYSIS, IN SITU HYBRIDIZATION (QUANTITATIVE OR SEMIQUANTITATIVE), MANUAL, PER SPECIMEN; EACH ADDITIONAL SINGLE PROBE STAIN PROCEDURE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0853TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR MORPHOMETRIC ANALYSIS, IN SITU HYBRIDIZATION (QUANTITATIVE OR SEMIQUANTITATIVE), MANUAL, PER SPECIMEN; EACH MULTIPLEX PROBE STAIN PROCEDURE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0854TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR BLOOD SMEAR, PERIPHERAL, INTERPRETATION BY PHYSICIAN WITH WRITTEN REPORT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0855TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR BONE MARROW, SMEAR INTERPRETATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0856TDIGITIZATION OF GLASS MICROSCOPE SLIDES FOR ELECTRON MICROSCOPY, DIAGNOSTIC (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0857TOPTO-ACOUSTIC IMAGING, BREAST, UNILATERAL, INCLUDING AXILLA WHEN PERFORMED, REAL-TIME WITH IMAGE DOCUMENTATION, AUGMENTATIVE ANALYSIS AND REPORT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
0858TEXTERNALLY APPLIED TRANSCRANIAL MAGNETIC STIMULATION WITH CONCOMITANT MEASUREMENT OF EVOKED CORTICAL POTENTIALS WITH AUTOMATED REPORT
0859TNONCONTACT NEAR-INFRARED SPECTROSCOPY (EG, FOR MEASUREMENT OF DEOXYHEMOGLOBIN, OXYHEMOGLOBIN, AND RATIO OF TISSUE OXYGENATION), OTHER THAN FOR SCREENING FOR PERIPHERAL ARTERIAL DISEASE, IMAGE ACQUISITION, INTERPRETATION, AND REPORT; EACH ADDITIONAL ANATOMIC SITE
0860TNONCONTACT NEAR-INFRARED SPECTROSCOPY (EG, FOR MEASUREMENT OF DEOXYHEMOGLOBIN, OXYHEMOGLOBIN, AND RATIO OF TISSUE OXYGENATION), FOR SCREENING FOR PERIPHERAL ARTERIAL DISEASE, INCLUDING PROVOCATIVE MANEUVERS, IMAGE ACQUISITION, INTERPRETATION, AND REPORT, ONE OR BOTH LOWER EXTREMITIES
0861TREMOVAL OF PULSE GENERATOR FOR WIRELESS CARDIAC STIMULATOR FOR LEFT VENTRICULAR PACING; BOTH COMPONENTS (BATTERY AND TRANSMITTER)
0862TRELOCATION OF PULSE GENERATOR FOR WIRELESS CARDIAC STIMULATOR FOR LEFT VENTRICULAR PACING, INCLUDING DEVICE INTERROGATION AND PROGRAMMING; BATTERY COMPONENT ONLY
0863TRELOCATION OF PULSE GENERATOR FOR WIRELESS CARDIAC STIMULATOR FOR LEFT VENTRICULAR PACING, INCLUDING DEVICE INTERROGATION AND PROGRAMMING; TRANSMITTER COMPONENT ONLY
0864TLOW-INTENSITY EXTRACORPOREAL SHOCK WAVE THERAPY INVOLVING CORPUS CAVERNOSUM, LOW ENERGY
0867TTransperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml
0868THigh-resolution gastric electrophysiology mapping with simultaneous patient- symptom profiling, with interpretation and report
0870TImplantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed
0871TReplacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed
0872TReplacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed
0873TRevision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed
0874TRemoval of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters
0875TProgramming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional
0876TDuplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)
0881TCryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device
0882TIntraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)
0883TIntraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure
0884TEsophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed
0885TColonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed
0886TSigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed
0887TEnd-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)
0888THistotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance
0893TNoninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report
0894TCannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion
0895TConnection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate levels, macroscopic assessment)
0896TConnection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate levels, macroscopic assessment) (list separately in addition to code for primary procedure)
0897TNoninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report
0901TPlacement of bone marrow sampling port, including imaging guidance when performed
0902TQTC interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ECG device
0915TInsertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads
0916TInsertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only
0917TInsertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only
0918TInsertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only
0919TRemoval of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only
0920TRemoval of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only
0921TRemoval of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only
0922TRemoval of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only
0923TRemoval and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only
0924TRepositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters
0925TRelocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator
0926TProgramming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system
0927TInterrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system
0928TInterrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional
0929TInterrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results
0930TElectrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contractility modulation-defibrillator pulse generator
0931TElectrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac contractility modulation-defibrillator pulse generator
0932TNoninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional
0933TTranscatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation
0934TRemote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, when performed, and report(s) by a physician or other qualified health care professional
0935TCystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral
0936TPhotobiomodulation therapy of retina, single session
0937TExternal electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional
0938TExternal electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)
0939TExternal electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report
0940TExternal electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional
0941TCystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization
0942TCystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold
0943TCystourethroscopy, flexible; with removal of prostatic urethral scaffold
0944T3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation
0945TIntraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (e.g., lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)
0946TOrthopedic implant movement analysis using paired computed tomography (CT) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including CT scan of the joint or extremity performed with paired views)
0947TMagnetic resonance image guided low intensity focused ultrasound (MRGFUS), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic nav
0002UOncology (colorectal), quantitative assessment of three urine metabolites (ascorbic acid, succinic acid and carnitine) by liquid chromatography with tandem mass spectrometry (lc-ms/ms) using multiple reaction monitoring acquisition, algorithm reported as likelihood of adenomatous polyps
0003UOncology (ovarian) biochemical assays of five proteins (apolipoprotein a-1, ca 125 ii, follicle stimulating hormone, human epididymis protein 4, transferrin), utilizing serum, algorithm reported as a likelihood score
0007UDrug test(s), presumptive, with definitive confirmation of positive results, any number of drug classes, urine, includes specimen verification including dna authentication in comparison to buccal dna, per date of service
0008UHelicobacter pylori detection and antibiotic resistance, dna, 16s and 23s rrna, gyra, pbp1, rdxa and rpob, next generation sequencing, formalin-fixed paraffin embedded or fresh tissue, predictive, reported as positive or negative for resistance to clarithromycin, fluoroquinolones, metronidazole, amoxicillin, tetracycline and rifabutin
0009UOncology (breast cancer), erbb2 (her2) copy number by fish, tumor cells from formalin fixed paraffin embedded tissue isolated using image-based dielectrophoresis (dep) sorting, reported as erbb2 gene amplified or non-amplified
0010UInfectious disease (bacterial), strain typing by whole genome sequencing, phylogenetic-based report of strain relatedness, per submitted isolate
0011UPrescription drug monitoring, evaluation of drugs present by lc- ms/ms, using oral fluid, reported as a comparison to an estimated steady-state range, per date of service including all drug compounds and metabolites
0018UOncology (thyroid), microrna profiling by rt-pcr of 10 microrna sequences, utilizing fine needle aspirate, algorithm reported as a positive or negative result for moderate to high risk of malignancy
0019UOncology, rna, gene expression by whole transcriptome sequencing, formalin-fixed paraffin embedded tissue or fresh frozen tissue, predictive algorithm reported as potential targets for therapeutic agents
0021UOncology (prostate), detection of 8 autoantibodies (arf 6, nkx3-1, 5’- utr-bmi1, cep 164, 3’-utr-ropporin, desmocollin, aurkaip- 1, csnk2a2), multiplexed immunoassay and flow cytometry serum, algorithm reported as risk score
0022UTargeted genomic sequence analysis panel, non-small cell lung neoplasia, dna and rna analysis, 23 genes, interrogation for sequence variants and rearrangements, reported as presence/absence of variants and associated therapy(ies) to consider
0024UGlycosylated acute phase proteins (glyca), nuclear magnetic resonance spectroscopy, quantitative
0025UTenofovir, by liquid chromatography with tandem mass spectrometry (lc-ms/ms), urine, quantitative
0029UDrug metabolism (adverse drug reactions and drug response), targeted sequence analysis (ie, cyp1a2, cyp2c19, cyp2c9, cyp2d6, cyp3a4, cyp3a5, cyp4f2, slco1b1, vkorc1 and rs12777823)
0032UComt (catechol-o-methyltransferase)(drug metabolism) gene analysis, c.472g>a (rs4680) variant
0033UHtr2a (5-hydroxytryptamine receptor 2a), htr2c (5-hydroxytryptamine receptor 2c) (eg, citalopram metabolism) gene analysis, common variants (ie, htr2a rs7997012 [c.614-2211t>c], htr2c rs3813929 [c.- 759c>t] and rs1414334 [c.551-3008c>g])
0039UDeoxyribonucleic acid (dna) antibody, double stranded, high avidity
0050UTargeted genomic sequence analysis panel, acute myelogenous leukemia, DNA analysis, 194 genes, interrogation for sequence variants, copy number variants or rearrangements
0053UOncology (prostate cancer), fish analysis of 4 genes (asap1, hdac9, chd1 and pten), needle biopsy specimen, algorithm reported as probability of higher tumor grade
0055UCardiology (heart transplant), cell-free DNA, PCR assay of 96 DNA target sequences (94 single nucleotide polymorphism targets and two control targets), plasma
0056UHematology (acute myelogenous leukemia), DNA, whole genome next- generation sequencing to detect gene rearrangement(s), blood or bone marrow, report of specific gene rearrangement(s)
0058UOncology (merkel cell carcinoma), detection of antibodies to the merkel cell polyoma virus oncoprotein (small t antigen), serum, quantitative
0059UOncology (merkel cell carcinoma), detection of antibodies to the merkel cell polyoma virus capsid protein (vp1), serum, reported as positive or negative
0060UTWIN ZYGOSITY, GENOMIC TARGETED SEQUENCE ANALYSIS OF CHROMOSOME 2, USING CIRCULATING CELL-FREE FETAL DNA IN MATERNAL BLOOD
0062UAutoimmune (systemic lupus erythematosus), igg and igm analysis of 80 biomarkers, utilizing serum, algorithm reported with a risk score
0063UNeurology (autism), 32 amines by lc-ms/ms, using plasma, algorithm reported as metabolic signature associated with autism spectrum disorder
0070UCYP2D6 (Cytochrome P450, family 2, subfamily D, Polypeptide 6) (eg, drug metabolism) gene analysis, common and select rare variants (IE, *2, *3, *4, *4N, *5, *6, *7, *8, *9, *10, *11, *12, *13, *14A, *14B, *15, *17, *29, *35, *36, *41, *57, *61, *63, *68, *83, *XN)
0071UCYP2D6 (Cytochrome P450, family 2, subfamily d, polypeptide 6) (eg, drug metabolism) gene analysis, full gene sequence (list separately in addition to code for primary procedure)
0072UCYP2D6 (Cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, CYP2D6-2D7 hybrid gene) (list separately in addition to code for primary procedure)
0073UCYP2D6 (Cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, CYP2D7-2D6 hybrid gene) (list separately in addition to code for primary procedure)
0074UCYP2D6 (Cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, non-duplicated gene when duplication/multiplication is trans) (list separately in addition to code for primary procedure)
0075UCYP2D6 (Cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, 5' gene duplication/multiplication) (list separately in addition to code for primary procedure)
0076UCYP2D6 (Cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, 3' gene duplication/ multiplication) (list separately in addition to code for primary procedure)
0153UOncology (breast), MRNA, gene expression profiling by next-generation sequencing of 101 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a triple negative breast cancer clinical subtype(s) with information on immune cell involvement
0173UPsychiatry (ie, depression, anxiety), genomic analysis panel, includes variant analysis of 14 genes
0174UOncology (solid tumor), mass spectrometric 30 protein targets, formalin- fixed paraffin-embedded tissue,
0175UPsychiatry (eg, depression, anxiety), genomic analysis panel, variant analysis of 15 genes
0355UApol1 (apolipoprotein l1) (eg, chronic kidney disease), risk variants (g1, g2)
0356UOncology (oropharyngeal), evaluation of 17 dna biomarkers using droplet digital pcr (ddpcr), cell-free dna, algorithm reported as a prognostic risk score for cancer recurrence
0357UOncology (melanoma), artificial intelligence (ai)-enabled quantitative mass spectrometry analysis of 142 unique pairs of glycopeptide and product fragments, plasma, prognostic, and predictive algorithm reported as likely, unlikely, or uncertain benefit from immunotherapy agents
0358UNeurology (mild cognitive impairment), analysis of ?-amyloid 1-42 and 1-40, chemiluminescence enzyme immunoassay, cerebral spinal fluid, reported as positive, likely positive, or negative
0359UOncology (prostate cancer), analysis of all prostate-specific antigen (psa) structural isoforms by phase separation and immunoassay, plasma, algorithm reports risk of cancer
0360UOncology (lung), enzyme-linked immunosorbent assay (elisa) of 7 autoantibodies (p53, ny-eso-1, cage, gbu4-5, sox2, mage a4, and hud), plasma, algorithm reported as a categorical result for risk of malignancy
0361UNeurofilament light chain, digital immunoassay, plasma, quantitative
0362UOncology (papillary thyroid cancer), gene-expression profiling via targeted hybrid capture-enrichment rna sequencing of 82 content genes and 10 housekeeping genes, formalin-fixed paraffin embedded (ffpe) tissue, algorithm reported as one of three molecular subtypes
0363UOncology (urothelial), mrna, gene- expression profiling by real-time quantitative pcr of 5 genes (mdk, hoxa13, cdc2 [cdk1], igfbp5, and cxcr2), utilizing urine, algorithm incorporates age, sex, smoking history, and macrohematuria frequency, reported as a risk score for having urothelial carcinoma
0522UCarbonic anhydrase VI, parotid specific/secretory protein and salivary protein 1 (SP1), IgG, IgM, and IgA antibodies, chemiluminescence, semiqualitative, blood
0524UObstetrics (preeclampsia), sFlt1/PlGF ratio, immunoassay, utilizing serum or plasma, reported as a value
0525UOncology, spheroid cell culture, 11-drug panel (carboplatin, docetaxel, doxorubicin, etoposide, gemcitabine, niraparib, olaparib, paclitaxel, rucaparib, topotecan, veliparib) ovarian, fallopian, or peritoneal response prediction for each drug
0526UNephrology (renal transplant), quantification of CXCL10 chemokines, flow cytometry, urine, reported as pg/mL creatinine baseline and monitoring over time
0527UHerpes simplex virus (HSV) types 1 and 2 and Varicella zoster virus (VZV), amplified probe technique, each pathogen reported as detected or not detected
0528ULower respiratory tract infectious agent detection, 18 bacteria, 8 viruses, and 7 antimicrobial resistance genes, amplified probe technique, including reverse transcription for RNA targets, each analyte reported as detected or not detected with semiquantitative results for 15 bacteria
0529UHematology (venous thromboembolism [VTE]), genome-wide single-nucleotide polymorphism variants, including F2 and F5 gene analysis, and Leiden variant, by microarray analysis, saliva, report as risk score for VTE

Revision History

Date Nature of Revision
08/03/2026 Migrated to new platform.
09/11/2026 Added code L0984.