Original Effective Date:
04/01/2004
Current Effective Date:
01/01/2015
Miscellaneous services that are specific to QUEST Integration must be billed with HIPAA-compliant codes. Following is a list of these services and applicable HIPAA-compliant codes. This list represents the common locally assigned codes accepted by QUEST Integration. It is not all-inclusive. Some codes (not included in this list) are specifically assigned for specialized services. Providers who commonly render such specialized services are furnished with the appropriate codes to use in billing for these services.
| Code | Rev Code | Description |
|---|---|---|
| Equipment | ||
| T1999 | Emergency responder system for home use – monthly rate | |
| Laboratory | ||
| 83898 | Viral load testing; HIV-1 DNA-PCR; quantitative | |
| 87901 | HIV-1 drug resistance: genotyping | |
| Medical/Clinic Visits | ||
| T1015-HF | Medical clinic visit – methadone | |
| T1015-HD | Medical clinic visits – family planning | |
| H0020 | Methadone treatment | |
| 90801-SE | DHS 1271 evaluation | |
| 90801-52 | DHS 1271 reevaluation | |
| 99213-SE | TANF mental/medical disability determination | |
| T1015-22 | All inclusive family planning services | |
| Behavioral Health/Clinic Visits | ||
| T1015-HE | Clinic visit – DOH-CAMHD | |
| H0007-52 | Crisis response: crisis intervention 1 hour; phone contact | |
| H0007 | Crisis response: crisis intervention 1 hour; phone contact and face to face | |
| H0023-52 | Outreach; outreach attempt: per 15 minute increment | |
| H0023 | Outreach; outreach contact, per 15 minute increment | |
| H0036 | Bio-psycho-social rehabilitation; social skills | |
| H0036-52 | Bio-psycho-social rehabilitation; social recreation | |
| T1017 | Clozaril (Clozapine) | |
| H2001-52 | Bio-psycho-social rehabilitation; pre-vocational rehab | |
| 90804-HE | Psychiatric clinic group therapy by non-psychiatrist (DOH) | |
| 80853-HE | Psychiatric clinic visit (DOH) | |
| 90801-HA | Child behavioral health evaluation for eligibility in the Felix vs. Waihee class, by psychologist | |
| 944 | Social detoxification – drugs | |
| 945 | Social detoxification – alcohol | |
| 100 | All-inclusive room and board plus ancillary | |
| 124 | Room and board, semi-private, two bed, psychiatric | |
| 134 | Room and board, semi-private, three and four beds, psychiatric | |
| 144 | Room and board, private (deluxe) psychiatric | |
| 154 | Room and board, ward, psychiatric | |
| 126 | Room and board, semi-private, two bed, detoxification | |
| 136 | Room and board, semi-private, three and four beds, detoxification | |
| 146 | Room and board, private (deluxe) detoxification | |
| 156 | Room and board, ward, detoxification | |
| 762 | Observation room (23-hour hold) | |
| 911 | Behavioral health, general classification | |
| 905 | Intensive outpatient (IOP) for mental health | |
| 906 | Intensive outpatient (IOP) for substance abuse | |
| 900 | Partial hospitalization for mental health | |
| 900 | Partial hospitalization for substance abuse | |
| 1001 | Residential treatment for mental health | |
| 1002 | Residential treatment for substance abuse | |
| Vision Services | ||
| V2799 | Nose pads (include description on claim) | |
| V2799 | Eyeglass case (include description on claim) | |
| Miscellaneous Services | ||
| 99082 | Neighbor Islands travel for dental work done in hospital | |
| T1017-22 | Case assessment | |
| T1017-51 | Case planning | |
| T1017 | Ongoing monitoring and service coordination | |
| T1013 | Foreign language translation; per 15 minutes | |
| H0023-22 | Noncompliance counseling | |
| T2003 | Nonemergency transportation | |
| Home IV Therapy | ||
| A4641 | Tc99m DMSA (include description of claim) | |
| A4641 | Dicopac (include description on claim) | |
| A4641 | 111 Indium Oxine (1 test) (include description on claim) | |
| A4641 | 111 Indium DTPA (0.5 MC1) (include description on claim) | |
| Q0081-22 | 260 | Intravenous therapy; general classification |
| 76X | Treatment/observation room | |
| 25X | Pharmacy | |
| Applicable HCPCS | 27X | Medical/surgical supplies and devices |
| Applicable HCPCS | 290, 291 | Durable medical equipment (Other than renal) |
| J1626, J2340, J3490 | 636 | Drugs requiring specific identification; detailed coding |
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform. |