Current Effective Date:
07/01/2010
The following table lists the codes for services that do not meet payment determination criteria.
Table I. CPT Codes
| CPT Codes | Description |
|---|---|
| 19105 | Ablation, cryosurgical, of fibroadenoma, including ultrasound guidance, each fibroadenoma |
| 22505 | Manipulation of spine requiring anesthesia, any region, effective 5/1/11 |
| 22857 | Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), lumbar, single interspace |
| 22862 | Revision including replacement of total disc arthroplasty (artificial disc) anterior approach, lumbar, single interspace |
| 22865 | Removal of total disc arthroplasty (artificial disc), anterior approach, lumbar, single interspace |
| 27096 | Injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid |
| 27415 | Osteochondral allograft, knee, open |
| 27416 | Osteochondral autograft(s), knee, open (e.g., mosaicplasty) (includes harvesting of autograft(s)) |
| 28446 | Open osteochondral autograft, talus (includes obtaining graft(s)) |
| 28890 | Extracorporeal shock wave, high energy, performed by a physician, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia |
| 29867 | Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty) |
| 31295 | Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa. EFFECTIVE 04/15/11 |
| 31296 | Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation). EFFECTIVE 04/15/11 |
| 31297 | Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation). EFFECTIVE 04/15/11 |
| 34806 | Transcatheter placement of wireless physiologic sensor in aneurysmal sac during endovascular repair, including radiological supervision and interpretation, instrument calibration, and collection of pressure data |
| 36515 | Therapeutic apheresis; with extracorporeal immunoadsorption and plasma reinfusion |
| 37788 | Penile revascularization, artery, with or without vein graft |
| 37790 | Penile venous occlusive procedure |
| 43257 | Upper 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 |
| 46707 | Repair of anorectal fistula with plug (e.g., porcine small intestine submucosa (SIS). Note: this code replaces 0170T. |
| 53855 | Insertion of a temporary prostatic urethral stent, including urethral measurement Note: this code replaces 0084T. |
| 53860 | Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence. EFFECTIVE 04/15/11 |
| 55706 | Biopsies, prostate, needle, transperineal, stereotactic template guided saturation samily, including imaging guidance |
| 61870 | Craniectomy for implantation of neurostimulator electrodes, cerebellar; cortical |
| 61875 | subcortical |
| 64565 | Percutaneous implantation of neurostimulator electrodes; neuromuscular |
| 64580 | Incision for implantation of neurostimulator electrodes; neuromuscular |
| 64910 | Nerve repair; with synthetic conduit or vein allograft (e.g., nerve tube), each nerve |
| 64911 | with autogenous vein graft (includes harvest of vein graft), each nerve |
| 72291 | Radiological supervision and interpretation, percutaneous vertebroplasty or vertebral augmentation including cavity creation, per vertebral body; under fluoroscopic guidance |
| 72292 | under CT guidance |
| 73542 | Radiological examination, sacroiliac joint arthrography, radiological supervision and interpretation |
| 74263 | Computed tomographic colonography screening, including image postprocessing Note: this code replaces 0066T |
| 75571 | Cardiac computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium Note: this code replaces 0144T |
| 77082 | Dual-energy x-ray absorptiometry (DXA), bone density study, one or more sites; vertebral fracture assessment |
| 78351 | Bone density (bone mineral content) study, one or more sites; dual photon absorptiometry, one or more sites |
| 81525 | Oncology (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 |
| 82172 | Apolipoprotein, each EFFECTIVE 06/01/2011 |
| 83695 | Lipoprotein (a) |
| 83700 | Lipoprotein, 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) |
| 83876 | Meyloperoxidase (MPO) |
| 83951 | Des-Gamma-Carboxy-Prothrombin (DCP) |
| 83987 | PH; exhaled breath condensate |
| 83993 | Calprotectin, fecal |
| 84145 | Procalcitonin (PCT) Note: code replaces 0194T |
| 84431 | Thromboxane metabolite(s), including thromboxane if performed, urine |
| 86141 | C-reactive protein; high sensitivity (HSCRP) |
| 86305 | Human epididymis protein 4 (HE4) |
| 86343 | Leukocyte histamine release test (LHR) |
| 86352 | Cellular function assay involving stimulation (e.g., mitogen or antigen) and detection of biomarker (e.g., ATP) |
| 86490 | Skin test; coccidioidomycosis |
| 86510 | histoplasmosis |
| 87900 | Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics |
| 89329 | Sperm evaluation; hamster penetration test |
| 90644 | Meningococcal conjugate vaccine, serogroups C&Y and Hemophilus influenza b vaccine, tetanus toxoid conjugate (Hib-MenCY-TT), 4-dose schedule, when administered to children 2-15 months of age, for intramuscular use |
| 90880 | Hypnotherapy |
| 91111 | Gastrointestinal tract imaging, intraluminal (e.g., capsule endoscopy), esophagus with physician interpretation and report (effective 9/1/11) |
| 92132 | Scanning computerized ophthalmic diagnostic imaging, anterior segment, with interpretation and report, unilateral or bilateral (effective 10/15/11) |
| 92512 | Nasal function studies (eg, rhinomanometry) |
| 92548 | Computerized dynamic posturography |
| 92971 | Cardioassist- method of circulatory assist; external |
| 93025 | Microvolt T-wave alternans for assessment of ventricular arrhythmias |
| 93228 | Wearable mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real-time data analysis and greater than 24 months of accessible data storage (retrievable with query), with ECG triggered and patient selected events transmitted to a remote attended surveillance center for up to 30 days; physician review and interpretation with report. EFFECTIVE 04/15/11 |
| 93229 | Wearable mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real-time data analysis and greater than 24 months 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 physician prescribed transmission of daily and emergent data reports |
| 93278 | Signal-averaged electrocardiography (SAECG), with or without ECG |
| 93660 | Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention |
| 93982 | Noninvasive physiologic study of implanted wireless pressure sensor in aneurysmal sac following endovascular repair, complete study including recording, analysis of pressure and waveform tracings, interpretation and report |
| 94400 | Breathing response to CO2 (CO2 response curve) |
| 95012 | Nitric oxide expired gas determination |
| 95800 | Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time. EFFECTIVE 04/15/11 |
| 95801 | Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone). EFFECTIVE 04/15/11 |
| 95803 | Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording) |
| 95905 | Motor 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 |
| 95961 | Functional 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 |
| 95962 | each additional hour of physician attendance |
| 95965 | Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (e.g., epileptic cerebral cortex localization) |
| 95966 | for evoked magnetic fields, single modality (e.g., sensory, motor, language, or visual cortex |
| 95967 | for evoked magnetic fields, each additional modality (e.g., sensory, motor, language, or visual cortex localization) |
| 95980 | Electronic 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 |
| 95981 | subsequent, without programming |
| 95982 | subsequent, with reprogramming |
| 96000 | Comprehensive computer-based motion analysis by video-taping and 3D kinematics |
| 96001 | with dynamic plantar pressure measurements during walking |
| 96002 | Dynamic surface electromyography, during walking or other functional activities, 1 - 12 muscles |
| 96003 | Dynamic fine wire electromyography, during walking or other functional activities, 1 muscle |
| 96004 | Physician 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 |
| 97026 | Infrared |
| 99174 | Ocular photoscreening with interpretation and report, bilateral |
Table II. HCPCS Codes
| HCPCS Codes | Description |
|---|---|
| A4670 | Automatic blood pressure monitor |
| A9284 | Spirometer, non-electronic, includes all accessories |
| E0231 | Noncontact wound warming device (temperature control unit, ac adapter and power cord) for use with warming card and wound cover |
| E0232 | Warming card for use with the noncontact wound warming device and noncontact wound warming cover |
| E0446 | Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories. EFFECTIVE 04/15/11 |
| E0487 | Spirometer, electronic, includes all accessories |
| E0676 | Intermittent limb compression device (includes all accessories) not otherwise specified |
| E0830 | Ambulatory traction device, all types, each |
| E1800 | Dynamic adjustable elbow extension/flexion device, includes soft interface material |
| E1801 | Static progressive stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories |
| E1802 | Dynamic adjustable forearm pronation/supination device, includes soft interface material |
| E1805 | Dynamic adjustable wrist extension/flexion device, includes soft interface material |
| E1806 | Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories |
| E1810 | Dynamic adjustable knee extension/flexion device, includes soft interface material |
| E1811 | Static progressive stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories |
| E1812 | Dynamic knee extension/flexion device with active resistance control |
| E1815 | Dynamic adjustable ankle extension/flexion device, includes soft interface material |
| E1816 | Static progressive stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories |
| E1818 | Static progressive stretch forearm pronation/supination device, with or without range of motion adjustment, includes all components and accessories |
| E1820 | Replacement soft interface material, dynamic adjustable extension/flexion device |
| E1821 | Replacement soft interface material/cuffs for bi-directional static progressive stretch device |
| E1825 | Dynamic adjustable finger extension/flexion device, includes soft interface material |
| E1830 | Dynamic adjustable toe extension/flexion device, includes soft interface material |
| E1831 | Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories. EFFECTIVE 04/15/11 |
| E1840 | Dynamic adjustable shoulder flexion/abduction/rotation device, includes soft interface material |
| E1841 | Static progressive stretch shoulder device, with or without range of motion adjustment, includes all components and accessories |
| G0166 | External counterpulsation, per treatment session |
| G0259 | Injection procedure for sacroiliac joint; arthrography |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography |
| G0281 | Electrical 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 |
| G0282 | Electrical stimulation, (unattended), to one or more areas, for wound care other than described in G0281 |
| G0283 | Electrical stimulation, (unattended), to one or more areas, for indication(s) other than wound care, as part of a therapy plan of care |
| G0295 | Electromagnetic therapy, to one or more areas, for wound care other than described in G0329, or for other uses |
| G0329 | Electromagnetic 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 |
| G0409 | Social 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) |
| G0417 | Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 21-40 specimens (Effective Sept 1, 2010) |
| G0418 | Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 41-60 specimens (Effective Sept 1, 2010) |
| G0419 | Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, greater than 60 specimens (Effective Sept 1, 2010) |
| G0428 | Collagen Meniscus Implant procedure for filling meniscal defects (e.g., CMI, collagen scaffold, Menaflex) |
| G9147 | Outpatient 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. |
| J0775 | Injection, collagenase, clostridium histolyticum, 0.01 mg. EFFECTIVE 04/15/11 |
| J3530 | Nasal vaccine inhalation |
| J3570 | Laetrile, amygdalin, vitamin B-17 |
| J7346 | Dermal (substitute) tissue of human origin, injectable, with or without other bioengineered or processed elements, without metabolically active elements (Integra Matrix), per sq cm |
| L5973 | Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source |
| M0075 | Cellular therapy |
| M0076 | Prolotherapy |
| M0100 | Intragastric hypothermia using gastric freezing |
| Q4117 | Hylomatrix, per square centimeter. EFFECTIVE 04/15/11 |
| Q4118 | Matristem micromatrix, 1 mg. EFFECTIVE 04/15/11 |
| Q4119 | Matristem wound matrix, per square centimeter. EFFECTIVE 04/15/11 |
| Q4120 | Matristem burn matrix, per square centimeter. EFFECTIVE 04/15/11 |
| Q4121 | Theraskin, per square centimeter. EFFECTIVE 04/15/11 |
| S2080 | Laser-assisted uvuolopalatoplasty (LAUP) |
| S2205 | Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, under direct vision, using arterial graft(s), 2 coronary arterial grafts |
| S2206 | Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial grafts |
| S2207 | Minimally 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 |
| S2208 | Minimally 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 |
| S2209 | Minimally 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 |
| S2344 | Nasal/sinus endoscopy, surgical; with enlargement of sinus ostium opening using inflatable device (i.e., balloon sinuplasty) |
| S3650 | Saliva test, hormone level; during menopause |
| S3652 | to assess preterm labor risk |
| S3711 | Circulating tumor cell test |
| S3890 | DNA analysis, fecal, for colorectal cancer screening |
| S3902 | Ballistocardiogram |
| S3904 | Masters two step |
| S3905 | Noninvasive electrodiagnostic testing with automatic computerized hand-held device to stimulate and measure neuromuscular signals in diagnosing and evaluating systemic and entrapment neuropathies |
| S8040 | Topographic brain mapping |
| S8049 | Intraoperative radiation therapy (single administration) |
| S8080 | Scintimammography (radioimmunoscintigraphy of the breast), unilateral, including supply of radiopharmaceutical |
| S9025 | Omnicardiogram/cardiointegram |
| T1505 | Electronic medication compliance management device, includes all components and accessories, not otherwise classified. EFFECTIVE 04/15/11 |
Table III. CPT Category III Codes
| CPT Procedure Codes | Description |
|---|---|
| 0016T | Destruction of localized lesion of choroid (e.g., choroidal neovascularization), transpupillary thermotherapy |
| 0017T | Destruction of macular drusen, photocoagulation |
| 0019T | Extracorporeal shock wave involving musculoskeletal system, not otherwise specified, low energy |
| 0028T | Dual energy x-ray absorptiometry (DEXA) body composition study, one or more sites |
| 0031T | Speculoscopy |
| 0032T | with directed sampling |
| 0095T | each additional interspace (list separately in addition to code for primary procedure) |
| 0098T | each additional interspace (list separately in addition to code for primary procedure) |
| 0100T | Placement of a subconjunctival retinal prosthesis receiver and pulse generator, and implantation of intra-ocular retinal electrode array, with vitrectomy |
| 0101T | Extracorporeal shock wave involving musculoskeletal system, not otherwise specified; high energy |
| 0102T | Extracorporeal shock wave, high energy, performed by a physician, requiring anesthesia other than local, involving lateral humeral epicondyle |
| 0103T | Holotranscobalamin quantitative |
| 0104T | Inert gas rebreathing for cardiac output measurement; during rest |
| 0105T | during exercise |
| 0111T | Long-chain (C20-22) omega-3 fatty acids in red blood cell (RBC) membranes |
| 0123T | Fistulization of sclera for glaucoma, through ciliary body |
| 0124T | Conjunctival incision with posterior juxtascleral placement of pharmacological agent |
| 0126T | Common carotid intima-media thickness (IMT) study for evaluation of atherosclerotic burden or coronary heart disease risk factor assessment |
| 0140T | Exhaled breath condensate pH |
| 0155T | Laparoscopy, surgical; implantation or replacement of gastric stimulation electrodes, lesser curvature (i.e., morbid obesity) |
| 0156T | Laparoscopy, surgical; revision or removal of gastric stimulation electrodes, lesser curvature (i.e., morbid obesity) |
| 0157T | Laparotomy, implantation or replacement of gastric stimulation electrodes, lesser curvature (i.e., morbid obesity) |
| 0158T | Laparotomy, revision or removal of gastric stimulation electrodes, lesser curvature (i.e., morbid obesity) |
| 0159T | Computer-aided detection, including computer algorithm analysis of MRI image data for lesion detection/characterization, pharmacokinetic analysis with further physician review for interpretation, breast MRI |
| 0160T | Therapeutic repetitive transcranial magnetic stimulation treatment planning |
| 0161T | Therapeutic repetitive transcranial magnetic stimulation treatment delivery and management, per session |
| 0163T | Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), lumbar, each additional interspace |
| 0164T | Removal of total disc arthroplasty, anterior approach, lumbar, each additional interspace |
| 0165T | Revision of total disc arthroplasty, anterior approach, lumbar, each additional interspace |
| 0168T | Rhinophototherapy, intranasal application of ultraviolet and visible light, bilateral |
| 0171T | Insertion of posterior spinous process distraction device (including necessary removal of bone or ligament for insertion and imaging guidance), lumbar; single level |
| 0172T | each additional level |
| 0176T | Transluminal dilation of aqueous outflow canal; without retention of device or stent |
| 0177T | with retention of device or stent |
| 0178T | Electrocardiogram, 64 leads or greater, with graphic presentation and analysis; with interpretation and report |
| 0179T | tracing and graphics only, without interpretation and report |
| 0180T | interpretation and report only |
| 0182T | High dose rate electronic brachytherapy, per fraction |
| 0183T | Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day |
| 0186T | Suprachoroidal delivery of pharmacological agent (does not include supply of medication) |
| 0187T | Scanning computerized ophthalmic diagnostic imaging, anterior segment, with interpretation and report |
| 0190T | Placement of intraocular radiation source applicator |
| 0193T | Transurethral, radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence |
| 0198T | Measurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation and report |
| 0199T | Physiologic recording of tremor using accelerometer(s) and gyroscope(s), (including frequency and amplitude) including interpretation and report |
| 0200T | Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon or mechanical device, when used, one or more needles |
| 0201T | Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device, when used, two or more needles |
| 0202T | Posterior 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 |
| 0203T | Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by air flow or peripheral arterial tone) and sleep time |
| 0204T | Sleep study, unattended, minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by air flow or peripheral arterial tone) |
| 0206T | Algorithmic analysis, remote, of electrocardiographic-derived data with computer probability assessment, including report |
| 0207T | Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral |
| 0213T | Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; single level (To report bilateral procedures, use 0213T with modifier 50) |
| 0214T | 0214T second level (List separately in addition to code for primary procedure) (To report bilateral procedures, use 0214T with modifier 50) |
| 0215T | 0215T third and any additional level(s) (List separately in addition to code for primary procedure) (Do not report 0215T more than once per day) (Use 0214T, 0215T in conjunction with 0213T) (To report bilateral procedures, use 0215T with modifier 50) |
| 0216T | Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; single level (To report bilateral procedures, use 0216T with modifier 50) |
| 0217T | second level (List separately in addition to code for primary procedure) (To report bilateral procedures, use 0217T with modifier 50) |
| 0218T | third and any additional level(s) (List separately in addition to code for primary procedure) (Do not report 0218T more than once per day) (Use 0217T, 0218T in conjunction with 0216T) (To report bilateral procedures, use 0218T with modifier 50) |
| 0219T | Placement 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) |
| 0220T | thoracic (Do not report 0219T-0221T with any radiological service) |
| 0221T | lumbar (Do not report 0219T-0221T with any radiological service) |
| 0222T | each additional vertebral segment (List separately in addition to code for primary procedure) (Use 0222T in conjunction with 0219T-0221T) |
| 0223T | Acoustic cardiography, including automated analysis of combined acoustic and electrical intervals, single, with interpretation and report |
| 0224T | Acoustic cardiography, including automated analysis of combined acoustic and electrical intervals; multiple, including serial trended analysis and limited reprogramming of device parameter – AV or VV delays only, with interpretation and report |
| 0225T | Acoustic cardiography, including automated analysis of combined acoustic and electrical intervals; multiple, including serial trended analysis and limited reprogramming of device parameter – AV and VV delays, with interpretation and report |
| 0232T | Injection(s), platelet rich plasma, any tissue, including image guidance, harvesting and preparation when performed |
| 0233T | Skin advanced glycation endproducts (AGE) measurement by multi-wavelength fluorescent spectroscopy |
| 0240T | Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with 3-dimensional high resolution esophageal pressure topography. |
| 0241T | Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with 3-dimensional high resolution esophageal pressure topography; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (List separately in addition to code for primary procedure). |
| 0242T | Gastrointestinal tract transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report. |
| 0243T | Intermittent measurement of wheeze rate for bronchodilator or bronchial-challenge diagnostic evaluation(s), with interpretation and report. |
| 0244T | Continuous measurement of wheeze rate during treatment assessment or during sleep for documentation of nocturnal wheeze and cough for diagnostic evaluation 3 to 24 hours, with interpretation and report. |
| 0249T | Ligation, hemorrhoidal vascular bundle(s), including ultrasound guidance. |
| 0254T | Endovascular repair of iliac artery bifurcation (eg, aneurysm, pseudoaneurysm, arteriovenous malformation, trauma) using bifurcated endoprosthesis from the common iliac artery into both the external and internal iliac artery, unilateral; |
| 0255T | Endovascular repair of iliac artery bifurcation (eg, aneurysm, pseudoaneurysm, arteriovenous malformation, trauma) using bifurcated endoprosthesis from the common iliac artery into both the external and internal iliac artery, unilateral; radiological supervision and interpretation. |
| 0262T | Implantation of catheter-delivered prosthetic pulmonary valve, endovascular approach (effective 7/1/11) |
| 0263T | Intramuscular 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) |
| 0264T | complete procedure excluding bone marrow harvest |
| 0265T | unilateral or bilateral bone marrow harvest only for intramuscular autologous bone marrow cell therapy |
| 0266T | Implantation 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) |
| 0267T | lead only, unilateral (includes intra-operative interrogation, programming, and repositioning, when performed) (effective 7/1/11) |
| 0268T | pulse generator only (includes intra-operative interrogation, programming, and repositioning, when performed) (effective 7/1/11) |
| 0269T | Revision 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) |
| 0270T | lead only, unilateral (includes intra-operative interrogation, programming, and repositioning, when performed) (effective 7/1/11) |
| 0271T | pulse generator only (includes intra-operative interrogation, programming, and repositioning, when performed) (effective 7/1/11) |
| 0272T | Interrogation 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) |
| 0273T | with programming (effective 7/1/11) |
| 0274T | Percutaneous 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) |
| 0275T | lumbar |
| 0276T- 0280T,0286T – 0288T, 0291T – 0301T | Effective 02/01/12 |
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform.
|