Original Effective Date:
07/01/2012
Current Effective Date:
01/01/2015
Table of Contents
| QUEST Integration - 3D Reconstruction | 7 |
| QUEST Integration - Abortion | 11 |
| QUEST Integration - Air Transportation | 12 |
| QUEST Integration - Ambulatory Blood Pressure Monitoring | 13 |
| QUEST Integration - Ambulatory Surgical Services | 15 |
| QUEST Integration - Anesthesia | 16 |
| QUEST Integration - Anesthesia Services for Gastrointestinal Endoscopic Procedures | 18 |
| QUEST Integration - Annual Gynecological Examination | 23 |
| QUEST Integration - Apnea Monitor for Infants | 24 |
| QUEST Integration - Artificial Disc Replacement, Cervical | 27 |
| QUEST Integration - Assistant Surgeon | 32 |
| QUEST Integration - Autologous Chondrocyte Implantation | 34 |
| QUEST Integration - Behavioral Health Services | 41 |
| QUEST Integration - Bevacizumab (Avastin) | 44 |
| QUEST Integration - Biological Agents for the Treatment of Plaque Psoriasis | 51 |
| QUEST Integration - Blepharoplasty and Repair of Blepharoptosis | 54 |
| QUEST Integration - Blood Lead Testing | 58 |
| QUEST Integration - Blood Occult Screening | 60 |
| QUEST Integration - Bone (Mineral) Density Studies | 61 |
| QUEST Integration - Bortezomib (Velcade) | 69 |
| QUEST Integration - Casts and Strappings | 73 |
| QUEST Integration - Circumcision | 74 |
| QUEST Integration - Clinical Trials | 75 |
| QUEST Integration – Cognitive Rehabilitation Services | 79 |
| QUEST Integration - Collection and Handling | 81 |
| QUEST Integration - Contraceptive Services | 82 |
| QUEST Integration - Cosmetic and Reconstructive Surgery and Services | 84 |
| QUEST Integration - Critical Care | 87 |
| QUEST Integration - Cytopathology | 90 |
| QUEST Integration - Developmental Testing | 91 |
| QUEST Integration - Diabetes Education | 92 |
| QUEST Integration - Donor Services | 95 |
| QUEST Integration - Pharmacy and Drug Formulary | 96 |
| QUEST Integration - Drug Formulary Exception | 99 |
| QUEST Integration - Durable Medical Equipment - DME, Prosthetics and Orthotics | 102 |
| QUEST Integration - Early and Periodic Screening, Diagnostic and Treatment (EPSDT) | 108 |
| QUEST Integration - Efalizumab (Raptiva) | 123 |
| QUEST Integration - Electromagnetic Stimulation - Bone Growth | 124 |
| QUEST Integration - Emergency Room Services | 125 |
| QUEST Integration - Endoscopic Radiofrequency Ablation for Barretts Esophagus | 126 |
| QUEST Integration - Home Enteral Nutrition Therapy | 130 |
| QUEST Integration - Erythropoiesis Stimulating Agents (ESA) | 133 |
| QUEST Integration - Esophageal pH Monitoring | 138 |
| QUEST Integration - Extracorporeal Membrane Oxygenation (ECMO) for Neonates | 145 |
| QUEST Integration - Family Planning | 149 |
| QUEST Integration - FDA-Approved Drugs Requiring Precertification | 150 |
| QUEST Integration - Fetal Non-Stress Test | 153 |
| QUEST Integration – Fluoride Varnish Application | 154 |
| QUEST Integration - Gamma Knife | 155 |
| QUEST Integration - Genetic Testing for Hereditary Breast and/or Ovarian Cancer | 156 |
| QUEST Integration - Genetic Testing for Lynch Syndrome/Colorectal Cancer and Polyposis Syndromes | 171 |
| QUEST Integration - Genetic Testing for Non-Cancerous Inheritable Diseases | 180 |
| QUEST Integration - Genetic Testing - Oncology | 196 |
| QUEST Integration - Global Fee for Surgery | 204 |
| QUEST Integration - Glucose Monitoring of Interstitial Fluid | 207 |
| QUEST Integration - Growth Hormone Therapy | 212 |
| QUEST Integration - Gynecological Exam | 219 |
| QUEST Integration – Habilitation Services | 220 |
| QUEST Integration - Hearing Aids | 221 |
| QUEST Integration - HIV/AIDS | 223 |
| QUEST Integration - Home Health Care | 224 |
| QUEST Integration - Home Infusion Pain Management Therapy | 227 |
| QUEST Integration - Home Inotropic Infusion Therapy | 230 |
| QUEST Integration - Home IV Therapy - Criteria for Coverage | 234 |
| QUEST Integration - Home IV Therapy - Per Diem Payment Method | 236 |
| QUEST Integration - Home Phototherapy for Neonatal Jaundice | 241 |
| QUEST Integration - Home Total Parenteral Nutrition for Adults | 244 |
| QUEST Integration - Hormone Therapy | 251 |
| QUEST Integration - Hospice Care | 252 |
| QUEST Integration - Hospital and Long-Term Care Facility Visits | 253 |
| QUEST Integration - Hospital Inpatient Confinements | 254 |
| QUEST Integration - Hospital Pass Days | 255 |
| QUEST Integration - Home IV Hydration Therapy for Hyperemesis Gravidarum | 256 |
| QUEST Integration - Home IV Hydration Therapy for Adults | 259 |
| QUEST Integration - Hyperbaric Oxygen Pressurization (HBO) | 262 |
| QUEST Integration – Hysterectomy | 282 |
| QUEST Integration - Ibritumomab tiuxetan (Zevalin) | 284 |
| QUEST Integration - Radiology Guidelines for Advanced Imaging Studies | 288 |
| QUEST Integration - Immune Globulin Therapy | 289 |
| QUEST Integration - Immunizations | 299 |
| QUEST Integration - Implantable Ventricular Assist Device and Total Artificial Hearts | 301 |
| QUEST Integration - Infliximab (Remicade) | 308 |
| QUEST Integration - Insulin Pumps - External | 316 |
| QUEST Integration - Intrastromal Corneal Ring Segments for Keratoconus | 320 |
| QUEST Integration - Intensity Modulated Radiation Therapy (IMRT) | 323 |
| QUEST Integration - Interferon, gamma-1b (Actimmune) for Idiopathic Pulmonary Fibrosis | 330 |
| QUEST Integration - Interisland Transportation | 334 |
| QUEST Integration - In Vitro Fertilization | 335 |
| QUEST Integration - Kyphoplasty and Vertebroplasty | 336 |
| QUEST Integration - Laboratory Panels | 342 |
| QUEST Integration - Language Translation | 344 |
| QUEST Integration - Lenalidomide (Revlimid) | 345 |
| QUEST Integration - Leuprolide Acetate (Lupron) and Histrelin Acetate (Supprelin LA) Subcutaneous Implant | 350 |
| QUEST Integration - Lipid Risk Factors (Novel) in Risk Assessment and Management of Cardiovascular Disease | 357 |
| QUEST Integration - Long-Acting Opioid Analgesics | 385 |
| QUEST Integration – Long-Term Services and Supports (LTSS) | 388 |
| QUEST Integration - Low-Molecular-Weight Heparin | 395 |
| QUEST Integration - Lung-Volume Reduction Surgery | 400 |
| QUEST Integration - Maternity - Global Billing | 407 |
| QUEST Integration - Medical Policies | 410 |
| QUEST Integration - Mammography | 413 |
| QUEST Integration - Maternity - Length of Stay and Provisions of the Newborns' and Mothers' Health Protection Act (NMHPA) | 417 |
| QUEST Integration - Medical Foods for Inborn Errors of Metabolism | 418 |
| QUEST Integration - Metabolic Screening Program - Newborns | 424 |
| QUEST Integration - Miscellaneous Home Intravenous Administration | 427 |
| QUEST Integration - Modafinil (Provigil) and Armodafinil (Nuvigil) | 430 |
| QUEST Integration - Modifier Code 25 | 434 |
| QUEST Integration - Modifier Code 47 | 437 |
| QUEST Integration - MRI, Functional | 440 |
| QUEST Integration - Negative Pressure Wound Therapy (NPWT) | 444 |
| QUEST Integration - Neonatal Intensive Care | 449 |
| QUEST Integration - Noncovered Services | 451 |
| QUEST Integration - Bariatric Surgery | 452 |
| QUEST Integration - Observation Services | 456 |
| QUEST Integration - Occupational Therapy | 459 |
| QUEST Integration - Office Consultations and Visits | 467 |
| QUEST Integration - Off-Label Drug Use | 469 |
| QUEST Integration - Omalizumab (Xolair) | 472 |
| QUEST Integration - OncoScint | 477 |
| QUEST Integration - Oncotype DX | 478 |
| QUEST Integration - Optical Coherence Biometry | 491 |
| QUEST Integration - Organ Transplants | 493 |
| QUEST Integration - Organ Transplants - Donor Services | 496 |
| QUEST Integration - Oscillatory Device for Bronchial Drainage (The Vest) | 497 |
| QUEST Integration - Out-of-State Transportation | 502 |
| QUEST Integration - Outpatient Surgical Procedure Related Groups (PRG) | 503 |
| QUEST Integration - Oxygen and Oxygen Equipment | 504 |
| QUEST Integration - Pre-admission Testing | 511 |
| QUEST Integration - Precertification Request - Home IV Therapy | 512 |
| QUEST Integration - Prenatal Visit - Initial | 513 |
| QUEST Integration - Private Duty Nursing | 515 |
| QUEST Integration - Prostate Specific Antigen (PSA) Test | 516 |
| QUEST Integration - Palivizumab (Synagis) | 517 |
| QUEST Integration - Panitumumab (Vectibix) | 522 |
| QUEST Integration - Panniculectomy/Abdominoplasty | 526 |
| QUEST Integration - Pediatric Standby | 529 |
| QUEST Integration - Pemetrexed (Alimta) | 530 |
| QUEST Integration - Percutaneous Transluminal Angioplasty | 534 |
| QUEST Integration - Perinatal Care | 535 |
| QUEST Integration - Photochemotherapy | 536 |
| QUEST Integration - Photodynamic Therapy for the Treatment of Actinic Keratoses and Other Skin Lesions | 542 |
| QUEST Integration - Physical Examinations | 548 |
| QUEST Integration - Physical Therapy | 549 |
| QUEST Integration - Place of Treatment - Office Procedures List | 557 |
| QUEST Integration - Place of Treatment - Outpatient Procedures List | 574 |
| QUEST Integration - Polysomnography - Sleep Studies | 595 |
| QUEST Integration - Positive Airway Pressure Devices for the Treatment of Obstructive Sleep Apnea | 603 |
| QUEST Integration - Prophylactic Mastectomy | 611 |
| QUEST Integration - Pulmonary Hypertension Drugs | 617 |
| QUEST Integration - Pulse Oximeter for Children | 624 |
| QUEST Integration - Reference Laboratory | 627 |
| QUEST Integration - Catheter Ablation of the Pulmonary Veins as Treatment for Atrial Fibrillation | 628 |
| QUEST Integration - Readmissions and Transfers | 641 |
| QUEST Integration - Reduction Mammaplasty | 644 |
| QUEST Integration - Smoking Cessation | 648 |
| QUEST Integration - Standby Services | 649 |
| QUEST Integration - Sterilizations | 651 |
| QUEST Integration - Surgery - Cutting | 654 |
| QUEST Integration - Surgery - Non-Cutting | 657 |
| QUEST Integration - Screening Colonoscopy | 658 |
| QUEST Integration - Speech Therapy | 660 |
| QUEST Integration - Spinal Cord Stimulators for Pain Management | 668 |
| QUEST Integration - Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy | 676 |
| QUEST Integration - Subcutaneous and Intramuscular Injectables | 681 |
| QUEST Integration - Supplies | 683 |
| QUEST Integration - Surgical Treatment of Femoroacetabular Impingement | 685 |
| QUEST Integration - Telemedicine | 692 |
| QUEST Integration - Transplants | 695 |
| QUEST Integration - Transportation - Ground (Non-Emergent) | 696 |
| QUEST Integration - Transportation - Interisland Air Transportation | 699 |
| QUEST Integration - Transportation - Out-of-State | 702 |
| QUEST Integration - Trigger Point Injections | 704 |
| QUEST Integration - Tuberculin Testing/Treatment | 705 |
| QUEST Integration - Tympanometry | 706 |
| QUEST Integration - Teriparatide (Forteo) | 707 |
| QUEST Integration - Thoracic Sympathectomy for Hyperhidrosis | 712 |
| QUEST Integration - Transcutaneous Electrical Nerve Stimulation (TENS) | 716 |
| QUEST Integration - Treatment of Varicose Veins | 721 |
| QUEST Integration - Ultrasound | 726 |
| QUEST Integration - Unbundling (Fragmentation) | 728 |
| QUEST Integration - Uterine Artery Embolization to Treat Fibroids | 730 |
| QUEST Integration - Vision Examination With Refraction | 735 |
| QUEST Integration - Vision Eyewear | 737 |
| QUEST Integration - Vacation Supplies | 741 |
| QUEST Integration - Vacuum Assisted Breast Biopsy | 742 |
| QUEST Integration - Venipuncture | 747 |
| QUEST Integration - Virtual Colonoscopy | 748 |
| QUEST Integration - Well-Child Care Visits | 749 |
| QUEST Integration - Well-Woman Exam | 750 |
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform. |