|
0001-0239
|
Not Valid For Reporting
|
|
024X
|
All Inclusive Ancillary
|
|
0240
|
General
Classification
|
99499
|
|
0241
|
Basic
|
|
0242
|
Comprehensive
|
|
0243
|
Specialty
|
|
0249
|
Other
Inclusive Ancillary
|
|
025X
|
Pharmacy
|
|
0250
|
General
Classification
|
99070
|
|
0251
|
Generic
Drugs
|
|
0252
|
Non-Generic
Drugs
|
|
0253
|
Take
Home Drugs
|
|
0254
|
Drugs
Incident to Other Diagnostic Services
|
|
0255
|
Drugs
Incident to Radiology
|
|
0256
|
Experimental
Drugs
|
T5999
|
|
0257
|
Non-Prescription
|
99070
|
|
0258
|
IV
Solutions
|
|
0259
|
Other
Pharmacy
|
|
026X
|
IV Therapy
|
|
0260
|
General
Classification
|
99070
|
|
0261
|
Infusion
Pump
|
99499
|
|
0262
|
IV
Therapy/Pharmacy Services
|
99070
|
|
0263
|
IV
Therapy/Drug/Supply Delivery
|
|
0264
|
IV
Therapy/Supplies
|
|
0269
|
Other
IV Therapy
|
|
027X
|
Medical/Surgical Supplies and Devices
|
|
0270
|
General
Classification
|
99070
|
|
0271
|
Non-Sterile
Supply
|
|
0272
|
Sterile
Supply
|
|
0273
|
Take
Home Supplies
|
|
0274
|
Prosthetic/Orthotic
Devices
|
99499
|
|
0275
|
Pacemaker
|
99070
|
|
0276
|
Intraocular
Lens
|
|
0277
|
Oxygen
- Take Home
|
|
0278
|
Other
Implants
|
|
0279
|
Other
Supplies/Devices
|
|
028X
|
Oncology
|
|
0280
|
General
Classification
|
99078
|
|
0289
|
Other
Oncology
|
|
029X
|
Durable Medical Equipment (Other Than
Renal)
|
|
0290
|
General
Classification
|
99499
|
|
0291
|
Rental
|
|
0292
|
Purchase
of New DME
|
|
0293
|
Purchase
of Used DME
|
|
0294
|
Supplies/Drugs
for DME Effectiveness (Home Health Agency only)
|
|
0299
|
Other
Equipment
|
|
030X
|
Laboratory
|
|
0300
|
General
Classification
|
99499
|
|
0301
|
Chemistry
|
|
0302
|
Immunology
|
|
0303
|
Renal
Patient (home)
|
|
0304
|
Non-Routine
Dialysis
|
|
0305
|
Hematology
|
|
0306
|
Bacteriology
& Microbiology
|
|
0307
|
Urology
|
|
0309
|
Other
Laboratory
|
|
031X
|
Laboratory Pathological
|
|
0310
|
General
Classification
|
99499
|
|
0311
|
Cytology
|
|
0312
|
Histology
|
|
0314
|
Biopsy
|
|
0319
|
Other
Laboratory Pathological
|
|
032X
|
Radiology - Diagnostic
|
|
0320
|
General
Classification
|
99499
|
|
0321
|
Angiocardiography
|
|
0322
|
Arthrography
|
|
0323
|
Arteriography
|
|
0324
|
Chest
X-Ray
|
|
0329
|
Other
Radiology - Diagnostic
|
|
033X
|
Radiology - Therapeutic
|
|
0330
|
General
Classification
|
99499
|
|
0331
|
Chemotherapy
- Injected
|
|
0332
|
Chemotherapy
- Oral
|
|
0333
|
Radiation
Therapy
|
|
0335
|
Chemotherapy
- IV
|
|
0339
|
Other
Radiology - Therapeutic
|
|
034X
|
Nuclear Medicine
|
|
0340
|
General
Classification
|
99499
|
|
0341
|
Diagnostic
Procedures
|
|
0342
|
Therapeutic
Procedures
|
|
0343
|
Diagnostic
Radiopharmaceuticals (Effective 10/01/2004)
|
|
0344
|
Therapeutic
Radiopharmaceuticals (Effective 10/01/2004)
|
|
0349
|
Other
Nuclear Medicine
|
|
035X
|
CT Scan
|
|
0350
|
General
Classification
|
99499
|
|
0351
|
Head
Scan
|
|
0352
|
Body
Scan
|
|
0359
|
Other
CT Scan
|
|
036X1
|
Operating Room Services
|
|
0360
|
General
Classification
|
99499
|
|
0361
|
Minor
Surgery
|
|
0362
|
Organ
Transplant - Other than Kidney
|
|
0367
|
Kidney
Transplant
|
|
0369
|
Other
Operating Room Services
|
|
1 These must be reported as “Other
Medical Services” in Type of Services, position 2.
|
|
037X2
|
Anesthesia
|
|
0370
|
General
Classification
|
01999
|
|
0371
|
Anesthesia
Incident to Radiology
|
|
0372
|
Anesthesia
Incident to Other Diagnostic Services
|
|
0374
|
Acupuncture
|
T5999
|
|
0379
|
Other
Anesthesia
|
01999
|
|
2 These must be reported as “Other
Medical Services” in Type of Services, position 2.
|
|
038X
|
Blood
|
|
0380
|
General
Classification
|
99499
|
|
0381
|
Packed
Red Cells
|
|
0382
|
Whole
Blood
|
|
0383
|
Plasma
|
|
0384
|
Platelets
|
|
0385
|
Leukocytes
|
|
0386
|
Other
Components
|
|
0387
|
Other
Derivatives (cryoprecipitates)
|
|
0389
|
Other
Blood
|
|
039X
|
Blood Storage and Blood Component Administration,
Storage, and Processing
|
|
0390
|
General
Classification
|
85396
|
|
0391
|
Blood
Administration (e.g., Transfusions)
|
99499
|
|
0392
|
Blood
Storage
|
85396
|
|
0399
|
Other
Blood Storage and Processing
|
|
040X
|
Other Imaging Services
|
|
0400
|
General
Classification
|
99499
|
|
0401
|
Diagnostic
Mammography
|
|
0402
|
Ultrasound
|
|
0403
|
Screening
Mammography
|
|
0404
|
Positron
Emission Tomography
|
|
0409
|
Other
Imaging Services
|
|
041X
|
Respiratory Services
|
|
0410
|
General
Classification
|
99499
|
|
0412
|
Inhalation
Services
|
|
0413
|
Hyperbaric
Oxygen Therapy
|
|
0419
|
Other
Respiratory Services
|
|
042X
|
Physical Therapy
|
|
0420
|
General
Classification
|
99499
|
|
0421
|
Visit
Charge
|
|
0422
|
Hourly
Charge
|
|
0423
|
Group
Rate
|
|
0424
|
Evaluation
or Re-Evaluation
|
|
0429
|
Other
Physical Therapy
|
|
043X
|
Occupational Therapy
|
|
0430
|
General
Classification
|
99499
|
|
0431
|
Visit
Charge
|
|
0432
|
Hourly
Charge
|
|
0433
|
Group
Rate
|
|
0434
|
Evaluation
or Re-Evaluation
|
|
0439
|
Other
Occupational Therapy
|
|
044X
|
Speech - Language Pathology
|
|
0440
|
General
Classification
|
99499
|
|
0441
|
Visit
Charge
|
|
0442
|
Hourly
Charge
|
|
0443
|
Group
Rate
|
|
0444
|
Evaluation
or Re-Evaluation
|
|
0449
|
Other
Speech - Language Pathology
|
|
045X
|
Emergency Room
|
|
0450
|
General
Classification
|
99499
|
|
0451
|
Emergency
Medical Treatment & Active Labor Act (EMTALA)
Emergency Medical Screening Services
|
|
0452
|
ER
Beyond EMTALA Screening
|
|
0456
|
Urgent
Care
|
|
0459
|
Other
Emergency Room
|
|
046X
|
Pulmonary Function
|
|
0460
|
General
Classification
|
99499
|
|
0469
|
Other
Pulmonary Function
|
|
047X
|
Audiology
|
|
0470
|
General
Classification
|
99499
|
|
0471
|
Diagnostic
|
|
0472
|
Treatment
|
|
0479
|
Other
Audiology
|
|
048X
|
Cardiology
|
|
0480
|
General
Classification
|
99499
|
|
0481
|
Cardiac
Catheterization Laboratory
|
|
0482
|
Stress
Test
|
|
0483
|
Echocardiology
|
|
0489
|
Other
Cardiology
|
|
049X
|
Ambulatory Surgical Care
|
|
0490
|
General
Classification
|
99499
|
|
0499
|
Other
Ambulatory Surgical Care
|
|
050X
|
Outpatient Services
|
|
0500
|
General
Classification
|
99499
|
|
0509
|
Other
Outpatient Services
|
|
051X
|
Clinic
|
|
0510
|
General
Classification
|
99499
|
|
0511
|
Chronic
Pain Center
|
|
0512
|
Dental
Clinic
|
|
0513
|
Psychiatric
Clinic
|
|
0514
|
OB-GYN
Clinic
|
|
0515
|
Pediatric
Clinic
|
|
0516
|
Urgent
Care Clinic
|
|
0517
|
Family
Practice Clinic
|
|
0519
|
Other
Clinic
|
|
052X
|
Freestanding Clinic
|
|
0520
|
General
Classification
|
99499
|
|
0521
|
Rural
Health Clinic (RHC)/Federally Qualified Health Center (FQHC)
|
|
0522
|
RHC/FQHC
- Home
|
|
0523
|
Family
Practice Clinic
|
|
0524
|
RHC/FQHC
(SNF Stay Covered in Part A)
|
|
0525
|
RHC/FQHC
(SNF Stay Not Covered in Part A)
|
|
0526
|
Urgent
Care Clinic
|
|
0527
|
RHC/FQHC
Visiting Nurse Service - Home
|
|
0528
|
RHC/FQHC
Visit To Other Site
|
|
0529
|
Other
Freestanding Clinic
|
|
053X
|
Osteopathic Services
|
|
0530
|
General
Classification
|
99499
|
|
0531
|
Osteopathic
Therapy
|
|
0539
|
Other
Osteopathic Services
|
|
054X
|
Ambulance
|
|
0540
|
General
Classification
|
99499
|
|
0541
|
Supplies
|
|
0542
|
Medical
Transport
|
|
0543
|
Heart
Mobile
|
|
0544
|
Oxygen
|
|
0545
|
Air
Ambulance
|
|
0546
|
Neonatal
Ambulance Service
|
|
0547
|
Pharmacy
|
|
0548
|
Telephone
Transmission EKG
|
|
0549
|
Other
Ambulance
|
|
055X
|
Skilled Nursing
|
|
0550
|
General
Classification
|
99499
|
|
0551
|
Visit
Charge
|
|
0552
|
Hourly
Charge
|
|
0559
|
Other
Skilled Nursing
|
|
056X
|
Medical Social Services
|
|
0560
|
General
Classification
|
T5999
|
|
0561
|
Visit
Charge
|
|
0562
|
Hourly
Charge
|
|
0569
|
Other
Medical Social Services
|
|
057X
|
Home Health Aide (Home Health)
|
|
0570
|
General
Classification
|
99499
|
|
0571
|
Visit
Charge
|
|
0572
|
Hourly
Charge
|
|
0579
|
Other
Home Health Aide
|
|
058X
|
Other Visits (Home Health)
|
|
0580
|
General
Classification
|
99499
|
|
0581
|
Visit
Charge
|
|
0582
|
Hourly
Charge
|
|
0583
|
Assessment
|
|
0589
|
Other
Home Health Visit
|
|
059X
|
Units of Service (Home Health)
|
|
0590
|
General
Classification
|
99499
|
|
0599
|
Home
Health Other Units (Terminated 10/01/2007)
|
|
060X
|
Oxygen (Home Health)
|
|
0600
|
General
Classification
|
99499
|
|
0601
|
Oxygen
- State/Equip/Supply/or Cont
|
|
0602
|
Oxygen
- State/Equip/Supply Under 1 LPM
|
|
0603
|
Oxygen
- State/Equip/Over 4 LPM
|
|
0604
|
Oxygen
- Portable Add-On
|
|
0609
|
Other
Oxygen
|
|
061X
|
Magnetic Resonance Technology (MRT)
|
|
0610
|
General
Classification
|
99499
|
|
0611
|
Brain
(including brainstem)
|
|
0612
|
Spinal
Cord (including spine)
|
|
0614
|
MRI
- Other
|
|
0615
|
MRA
- Head and Neck
|
|
0616
|
MRA
- Lower Extremities
|
|
0618
|
MRA
- Other
|
|
0619
|
Other
MRT
|
|
062X
|
Medical/Surgical Supplies and Devices
- Other
|
|
0621
|
Supplies
Incident to Radiology
|
99070
|
|
0622
|
Supplies
Incident to Other Diagnostic Service
|
|
0623
|
Surgical
Dressings
|
|
0624
|
FDA
Investigational Devices
|
|
063X
|
Pharmacy
|
|
0631
|
Single
Source Drug
|
99070
|
|
0632
|
Multiple
Source Drug
|
|
0633
|
Restrictive
Prescription
|
|
0634
|
Erythropoietin
(EPO) Less Than 10,000 Units
|
99499
|
|
0635
|
Erythropoietin
(EPO) 10,000 or More Units
|
|
0636
|
Drugs
Requiring Detailed Coding (Blood Clotting Factor Only)
Note: Detail is not required for TRICARE.
|
|
0637
|
Self-Administrable
Drugs
|
99070
|
|
064X
|
Home IV Therapy Services
|
|
0640
|
General
Classification
|
99499
|
|
0641
|
Non-Routine
Nursing, Central Line
|
|
0642
|
IV
Site Care, Central Line
|
|
0643
|
IV
Site/Change, Peripheral Line
|
|
0644
|
Non-Routine
Nursing, Peripheral Line
|
|
0645
|
Training
Patient/Caregiver, Central Line
|
|
0646
|
Training,
Disabled Patient, Central Line
|
|
0647
|
Training,
Patient/Caregiver Peripheral Line
|
|
0648
|
Training,
Disabled Patient, Peripheral Line
|
|
0649
|
Other
IV Therapy Services
|
|
065X
|
Hospice Service
|
|
0650
|
General
Classification
|
99499
|
|
0651
|
Routine
Home Care
|
|
0652
|
Continuous
Home Care
|
|
0655
|
Inpatient
Respite Care
|
|
0656
|
General
Inpatient Care (Non-Respite)
|
|
0657
|
Physician
Services
|
|
0658
|
Hospice
Room and Board Nursing Facility
|
|
0659
|
Other
Hospice Services
|
|
066X
|
Respite Care (HHA Only)
|
|
0660
|
General
Classification
|
99499
|
|
0661
|
Hourly
Charge/Nursing
|
|
0662
|
Hourly
Charge/Home Health Aide/Home Maker/Companion
|
|
0663
|
Daily
Respite Charge
|
|
0669
|
Other
Respite Care
|
|
067X
|
Outpatient Special Residence Charge
|
|
0670
|
General
Classification
|
99499
|
|
0671
|
Hospital-Based
|
|
0672
|
Contracted
|
|
0679
|
Other
Special Residence Charges
|
|
068X
|
Trauma Response
|
|
0681
|
Level
I
|
99499
|
|
0682
|
Level
II
|
|
0683
|
Level
III
|
|
0684
|
Level
IV
|
|
0689
|
Other
Trauma Response
|
|
069X
|
Pre-Hospice
|
|
0690
|
General
Classification
|
99499
|
|
0691
|
Visit
Charge
|
|
0692
|
Hourly
Charge
|
|
0693
|
Evaluation
|
|
0694
|
Consultation
and Education
|
|
0695
|
Inpatient
Care
|
|
0696
|
Physician
Services
|
|
0697
|
RESERVED
|
|
0698
|
RESERVED
|
|
0699
|
Other
Pre-hospice/Palliative
|
|
070X
|
Cast Room
|
|
0700
|
General
Classification
|
99078
|
|
0709
|
Other
Cast Room (Terminated 10/01/2007)
|
|
071X
|
Recovery Room
|
|
0710
|
General
Classification
|
99078
|
|
0719
|
Other
Recovery Room (Terminated 10/01/2007)
|
|
072X
|
Labor Room/Delivery
|
|
0720
|
General
Classification
|
99078
|
|
0721
|
Labor
|
|
0722
|
Delivery
|
99499
|
|
0723
|
Circumcision
|
|
0724
|
Birthing
Center
|
|
0729
|
Other
Labor Room/Delivery
|
|
073X
|
EKG/ECG (Electrocardiogram)
|
|
0730
|
General
Classification
|
99499
|
|
0731
|
Holter
Monitor
|
|
0732
|
Telemetry
|
|
0739
|
Other
EKG/ECG
|
|
074X
|
EEG (Electroencephalogram)
|
|
0740
|
General
Classification
|
99499
|
|
0749
|
Other
EEG (Terminated 10/01/2007)
|
|
075X
|
Gastro-intestinal Services
|
|
0750
|
General
Classification
|
99499
|
|
0759
|
Other
Gastro-intestinal (Terminated 10/01/2007)
|
|
076X
|
Treatment or Observation Room
|
|
0760
|
General
Classification
|
99499
|
|
0761
|
Treatment
Room
|
|
0762
|
Observation
Room
|
G0378
|
|
0769
|
Other
Treatment Room/Observation Room
|
99499
|
|
077X
|
Preventive Care Services
|
|
0770
|
General
Classification
|
99078
|
|
0771
|
Vaccine
Administration
|
|
0779
|
Other
(Terminated 10/01/2007)
|
|
078X
|
Telemedicine
|
|
0780
|
General
Classification
|
99499
|
|
0789
|
Other
Telemedicine (Terminated 10/01/2007)
|
|
079X
|
Lithotripsy
|
|
0790
|
General
Classification
|
99499
|
|
0799
|
Other
Lithotripsy (Terminated 10/01/2007)
|
|
080X
|
Inpatient Renal Dialysis
|
|
0800
|
General
Classification
|
99499
|
|
0801
|
Inpatient
Hemodialysis
|
|
0802
|
Inpatient
Peritoneal (non-CAPD)
|
|
0803
|
Inpatient
Continuous Ambulatory Peritoneal Dialysis (CAPD)
|
|
0804
|
Inpatient
Continuous Cycling Peritoneal Dialysis
|
|
0809
|
Other
Inpatient Dialysis
|
|
081X
|
Acquisition of Stem Cell and Body Components
|
|
0810
|
General
Classification
|
C9899
|
|
0811
|
Living
Donor
|
|
0812
|
Cadaver
Donor
|
|
0813
|
Unknown
Donor
|
|
0814
|
Unsuccessful
Organ Search - Donor Bank Charges
|
|
0815
|
Cadaver
Donor - Heart (Terminated 10/01/2000)
|
|
0815
|
Allogeneic
Stem Cell Acquisition Services (Effective 01/01/2017)
|
|
0816
|
Other
Heart Acquisition (Terminated 10/01/2000)
|
|
0817
|
Donor
- Liver (Terminated 10/01/2000)
|
|
0819
|
Other
Donor
|
|
082X
|
Hemodialysis - Outpatient or Home
|
|
0820
|
General
Classification
|
99499
|
|
0821
|
Hemodialysis/Composite
or Other Rate
|
|
0822
|
Home
Supplies
|
|
0823
|
Home
Equipment
|
|
0824
|
Maintenance/100%
|
|
0825
|
Support
Services
|
|
0829
|
Other
Outpatient Hemodialysis
|
|
083X
|
Peritoneal Dialysis - Outpatient or
Home
|
|
0830
|
General
Classification
|
99499
|
|
0831
|
Peritoneal/Composite
or Other Rate
|
|
0832
|
Home
Supplies
|
|
0833
|
Home
Equipment
|
|
0834
|
Maintenance/100%
|
|
0835
|
Support
Services
|
|
0839
|
Other
Outpatient Peritoneal Dialysis
|
|
084X
|
Cont. Ambulatory Peritoneal Dialysis
(CAPD) - Outpatient or Home
|
|
0840
|
General
Classification
|
99499
|
|
0841
|
CAPD/Composite
or Other Rate
|
|
0842
|
Home
Supplies
|
|
0843
|
Home
Equipment
|
|
0844
|
Maintenance/100%
|
|
0845
|
Support
Services
|
|
0849
|
Other
Outpatient CAPD
|
|
085X
|
Cont. Cycling Peritoneal Dialysis (CCPD)
- Outpatient or Home
|
|
0850
|
General
Classification
|
99499
|
|
0851
|
CCPD/Composite
or Other Rate
|
|
0852
|
Home
Supplies
|
|
0853
|
Home
Equipment
|
|
0854
|
Maintenance/100%
|
|
0855
|
Support
Services
|
|
0859
|
Other
Outpatient CCPD
|
|
086X
|
Magnetoencephalography (MEG) - An imaging
technique that identifies brain activity to pinpoint the source
of seizures.
|
|
0860
|
General
Classification
|
99070
|
|
0861
|
Magnetoencephalography
(MEG)
|
|
087X
|
Cell/Gene Therapy (Effective
01/01/2018)
|
|
0870
|
General
Classification
|
99499
|
|
0871
|
Cell
Collection
|
|
0872
|
Specialized
Biologic Processing and Storage - Prior to Transport
|
|
0873
|
Storage
and Processing after Receipt of Cells from Manufacturer
|
|
0874
|
Infusion
of Modified Cells
|
|
0875
|
Injection
of Modified Cells
|
|
0876
|
RESERVED
|
|
0877
|
RESERVED
|
|
0878
|
RESERVED
|
|
0879
|
RESERVED
|
|
088X
|
Miscellaneous Dialysis
|
|
0880
|
General
Classification
|
99499
|
|
0881
|
Ultrafiltration
|
|
0882
|
Home
Dialysis Aid Visit
|
|
0889
|
Other
Miscellaneous Dialysis
|
|
089X
|
Pharmacy - Extension
of 025X and 063X (Effective 01/01/2018)
|
|
0890
|
RESERVED (Use
0250 for General Classification)
|
99070
|
|
0891
|
Special
Processed Drugs - FDA Approved Cell (Charges for drugs and biologics for
modified cell therapy requiring specific identification as required
by the payer. If using a HCPCS to describe the drug, enter the HCPCS
code in the appropriate HCPCS column.)
|
99499
|
|
0892
|
RESERVED
|
99070
|
|
0893
|
RESERVED
|
|
0894
|
RESERVED
|
|
0895
|
RESERVED
|
|
0896
|
RESERVED
|
|
0897
|
RESERVED
|
|
0898
|
RESERVED
|
|
0899
|
RESERVED
|
|
090X
|
Behavioral Health Treatments/Services
|
|
0900
|
General
Classification
|
99499
|
|
0901
|
Electroshock
Treatment
|
|
0902
|
Milieu
Therapy
|
T5999
|
|
0903
|
Play
Therapy
|
|
0904
|
Activity
Therapy
|
|
0905
|
Intensive
Outpatient Services - Psychiatric (Effective 10/16/2003)
|
99499
|
|
0906
|
Intensive
Outpatient Services - Clinical Dependency (Effective 10/16/2003)
|
|
0907
|
Community
Behavioral Health Program (Day Treatment)
(Effective 10/16/2003)
|
|
0908
|
RESERVED
for National Use (Effective 10/16/2003)
|
|
0909
|
RESERVED
for National Use
|
|
091X
|
Behavioral Health Treatments/Services
|
|
0910
|
RESERVED
for National Use
|
99499
|
|
0911
|
Rehabilitation
|
|
0912
|
Partial
Hospitalization - Less Intensive
|
H0035
|
|
0913
|
Partial
Hospitalization - Intensive
|
H0037
|
|
0914
|
Individual
Therapy
|
99499
|
|
0915
|
Group
Therapy
|
|
0916
|
Family
Therapy
|
|
091X
|
Behavioral Health Treatments/Services
(Continued)
|
|
0917
|
Biofeedback
|
99499
|
|
0918
|
Testing
|
|
0919
|
Other
Behavioral Health Treatments/Services
|
|
092X
|
Other Diagnostic Services
|
|
0920
|
General
Classification
|
99499
|
|
0921
|
Peripheral
Vascular Laboratory
|
|
0922
|
Electromyogram
|
|
0923
|
Pap
Smear
|
|
0924
|
Allergy
Test
|
|
0925
|
Pregnancy
Test
|
|
0929
|
Other
Diagnostic Services
|
|
093X
|
Medical Rehabilitation Day Program
|
|
0931
|
Half
Day
|
T5999
|
|
0932
|
Full
Day
|
|
094X
|
Other Therapeutic Services
|
|
0940
|
General
Classification
|
T5999
|
|
0941
|
Recreational
Therapy
|
|
0942
|
Education/Training
|
99499
|
|
0943
|
Cardiac
Rehabilitation
|
T5999
|
|
0944
|
Drug
Rehabilitation
|
|
0945
|
Alcohol
Rehabilitation
|
|
0946
|
Complex
Medical Equipment - Routine
|
|
0947
|
Complex
Medical Equipment - Ancillary
|
|
0948
|
Pulmonary
Rehabilitation
|
|
0949
|
Other
Therapeutic Service
|
|
095X
|
Other Therapeutic Services (cont)
|
|
0950
|
RESERVED
for National Use
|
|
|
0951
|
Athletic
Training
|
T5999
|
|
0952
|
Kinesiotherapy
|
|
0953
|
Chemical
Dependency
|
99499
|
|
096X
|
Professional Fees
|
|
0960
|
General
Classification
|
99499
|
|
0961
|
Psychiatric
|
|
0962
|
Ophthalmology
|
|
0963
|
Anesthesiologist
(MD)
|
|
0964
|
Anesthetist
(CRNA)
|
|
0969
|
Other
Professional Fees
|
|
097X
|
Professional Fees (cont)
|
|
0971
|
Laboratory
|
99499
|
|
0972
|
Radiology
- Diagnostic
|
|
0973
|
Radiology
- Therapeutic
|
|
0974
|
Radiology
- Nuclear Medicine
|
|
0975
|
Operating
Room
|
|
0976
|
Respiratory
Therapy
|
|
0977
|
Physical
Therapy
|
|
0978
|
Occupational
Therapy
|
|
0979
|
Speech
Pathology
|
|
098X
|
Professional Fees (cont)
|
|
0981
|
Emergency
Room
|
99499
|
|
0982
|
Outpatient
Services
|
|
0983
|
Clinic
|
|
0984
|
Medical
Social Services
|
|
0985
|
EKG
|
|
0986
|
EEG
|
|
0987
|
Hospital
Visit
|
|
0988
|
Consultation
|
|
0989
|
Private
Duty Nursing
|
T5999
|
|
099X
|
Patient Convenience Items
|
|
0990
|
General
Classification
|
T5999
|
|
0991
|
Cafeteria/Guest
Tray
|
|
0992
|
Private
Linen Service
|
|
0993
|
Telephone/Telegraph
|
|
0994
|
TV/Radio
|
|
0995
|
Non-Patient
Room Rentals
|
|
0996
|
Late
Discharge Charge
|
|
0997
|
Admission
Kits
|
|
0998
|
Beauty
Shop/Barber
|
|
0999
|
Other
Patient Convenience Items
|
|
100X
|
Behavioral Health Accommodations
|
|
1000
|
General
Classification (Effective 10/16/2003)
|
T5999
|
|
1001
|
Residential
Treatment - Psychiatric (Effective 10/16/2003)
|
|
1002
|
Residential
Treatment - Chemical Dependency (Effective 10/16/2003)
|
|
1003
|
Supervised
Living (Effective 10/16/2003)
|
|
1004
|
Halfway
House (Effective 10/16/2003)
|
|
1005
|
Group
Home (Effective 10/16/2003)
|
|
1006
|
Outdoor/Wilderness
Behavioral Health (Effective 07/01/2017)
|
|
101X to 209X
|
RESERVED for National Assignment
|
|
210X
|
Alternative Therapy Services
|
|
2100
|
General
Classification
|
T5999
(Outpatient)
|
|
2101
|
Acupuncture
|
|
2102
|
Acupressure
|
|
2103
|
Massage
|
|
2104
|
Reflexology
|
|
2105
|
Biofeedback
|
T5999
(Outpatient/Inpatient)
|
|
2106
|
Hypnosis
|
|
2109
|
Other
Alternative Therapy Services
|
T5999
(Outpatient)
|
|
211X to 309X
|
RESERVED for National Assignment
|
|
310X
|
Adult Care
|
|
3101
|
Adult
Day Care, Medical and Social - Hourly
|
T5999
|
|
3102
|
Adult
Day Care, Social - Hourly
|
|
3103
|
Adult
Day Care, Medical and Social - Daily
|
|
3104
|
Adult
Day Care, Social - Daily
|
|
3105
|
Adult
Foster Care - Daily
|
|
3109
|
Other
Adult Care
|
|
311X to 999X
|
RESERVED for National Assignment
|