Merged in feature/proc-desc (pull request #400)

feature/proc desc

* Update crosswalks - individual code level

* add embeddings

* Update embeddings

* Proc mappings

* code description mapping for PROC codes

* Code map bug fixes

* docstrings

* Initialize Rev and Diag descriptions

* Add 0 to front for rev codes

* Comments

* Merged main into feature/proc-desc

* Comments

* Separate grouper and diag codes

* add grouper version

* Bugfix"

* Add admit type code

* add proc mod description

* Add bill type pos mapping

* Merged main into feature/proc-desc

* Uncomment test code

* Bugfix

* Remove test.py

* list bugfix

* Merged main into feature/proc-desc

* concurrency


Approved-by: Alex Galarce
This commit is contained in:
Katon Minhas
2025-02-20 04:10:33 +00:00
committed by Alex Galarce
parent a18d562d34
commit 664397d713
47 changed files with 96262 additions and 56 deletions
+1
View File
@@ -67,6 +67,7 @@ streamlit/venv
textfiles/
texts/
*.csv
!crosswalk/mapping_csvs/*/*.csv
*.json
!crosswalk/mappings/*.json
!src/prompts/*.json
+33 -4
View File
@@ -23,11 +23,16 @@ class CrosswalkBuilder:
Returns:
CrosswalkBuilder: the builder instance for method chaining
"""
if sheet_name is None:
# If sheet_name is not provided, read the first sheet
df = pd.read_excel(path, sheet_name=0)
if ".xlsx" in path:
if sheet_name is None:
# If sheet_name is not provided, read the first sheet
df = pd.read_excel(path, sheet_name=0)
else:
df = pd.read_excel(path, sheet_name=sheet_name)
elif ".csv" in path:
df = pd.read_csv(path)
else:
df = pd.read_excel(path, sheet_name=sheet_name)
raise ValueError(f"Extension '{path.split(".")[-1]}' not a valid file extension.")
if from_col not in df.columns:
raise ValueError(f"Column '{from_col}' not found in the excel file")
@@ -64,6 +69,30 @@ class CrosswalkBuilder:
self.mapping = mapping
return self
def from_df(
self,
df: pd.DataFrame,
from_col: str,
to_col: str
) -> "CrosswalkBuilder":
"""Load mapping from a DataFrame
Args:
df (pd.DataFrame): DataFrame containing the mapping
from_col (str): Column name for keys
to_col (str): Column name for values
Returns:
CrosswalkBuilder: the builder instance for method chaining
"""
self.metadata = {
"from_col": from_col,
"to_col": to_col,
}
self.mapping = dict(zip(df[from_col], df[to_col]))
return self
def from_json(self, path: str) -> "CrosswalkBuilder":
"""Load mapping from a JSON file
@@ -0,0 +1,7 @@
Code,Description
1,Emergency
2,Urgent
3,Elective
4,Newborn
5,Trauma Center
9,Information Not Available
1 Code Description
2 1 Emergency
3 2 Urgent
4 3 Elective
5 4 Newborn
6 5 Trauma Center
7 9 Information Not Available
@@ -0,0 +1,76 @@
BILL_TYPE_CD,PLACE_OF_SERVICE,DESCRIPTION
013,22,Outpatient Hospital
0131,22,Outpatient Hospital
0137,22,Outpatient Hospital
0133,22,Outpatient Hospital
0722,65,End-Stage Renal Disease Treatment Facility
0732,49,Independent Clinic
0763,53,Community Mental Health Center
0811,34,Hospice
0121,21,Inpatient Hospital
0135,22,Outpatient Hospital
0138,22,Outpatient Hospital
0222,31,Skilled Nursing Facility
0233,32,Nursing Facility
0327,12,Home
0437,22,Outpatient Hospital
0835,24,Ambulatory Surgical Center
0851,22,Outpatient Hospital
0831,24,Ambulatory Surgical Center
0733,49,Independent Clinic
0113,21,Inpatient Hospital
0114,21,Inpatient Hospital
0141,22,Outpatient Hospital
0793,49,Independent Clinic
0148,22,Outpatient Hospital
0743,49,Independent Clinic
0837,24,Ambulatory Surgical Center
0111,21,Inpatient Hospital
0136,22,Outpatient Hospital
0181,21,Inpatient Hospital
0761,53,Community Mental Health Center
0723,65,End-Stage Renal Disease Treatment Facility
0839,24,Ambulatory Surgical Center
0727,65,End-Stage Renal Disease Treatment Facility
0132,22,Outpatient Hospital
0213,31,Skilled Nursing Facility
0711,72,Rural Health Clinic
0731,49,Independent Clinic
0762,53,Community Mental Health Center
0134,22,Outpatient Hospital
0143,22,Outpatient Hospital
0724,65,End-Stage Renal Disease Treatment Facility
0742,49,Independent Clinic
0760,53,Community Mental Health Center
013A,22,Outpatient Hospital
014Q,22,Outpatient Hospital
0127,21,Inpatient Hospital
0142,22,Outpatient Hospital
0144,22,Outpatient Hospital
0146,22,Outpatient Hospital
0331,12,Home
0741,49,Independent Clinic
0147,22,Outpatient Hospital
0224,31,Skilled Nursing Facility
0734,49,Independent Clinic
0341,12,Home
014,22,Outpatient Hospital
0115,21,Inpatient Hospital
0145,22,Outpatient Hospital
0767,53,Community Mental Health Center
0792,49,Independent Clinic
0117,21,Inpatient Hospital
0334,12,Home
0737,49,Independent Clinic
0333,12,Home
0891,53,Community Mental Health Center
0112,21,Inpatient Hospital
0130,22,Outpatient Hospital
0322,12,Home
0744,49,Independent Clinic
0321,12,Home
0332,12,Home
0721,65,End-Stage Renal Disease Treatment Facility
0857,22,Outpatient Hospital
0324,12,Home
0231,32,Nursing Facility
1 BILL_TYPE_CD PLACE_OF_SERVICE DESCRIPTION
2 013 22 Outpatient Hospital
3 0131 22 Outpatient Hospital
4 0137 22 Outpatient Hospital
5 0133 22 Outpatient Hospital
6 0722 65 End-Stage Renal Disease Treatment Facility
7 0732 49 Independent Clinic
8 0763 53 Community Mental Health Center
9 0811 34 Hospice
10 0121 21 Inpatient Hospital
11 0135 22 Outpatient Hospital
12 0138 22 Outpatient Hospital
13 0222 31 Skilled Nursing Facility
14 0233 32 Nursing Facility
15 0327 12 Home
16 0437 22 Outpatient Hospital
17 0835 24 Ambulatory Surgical Center
18 0851 22 Outpatient Hospital
19 0831 24 Ambulatory Surgical Center
20 0733 49 Independent Clinic
21 0113 21 Inpatient Hospital
22 0114 21 Inpatient Hospital
23 0141 22 Outpatient Hospital
24 0793 49 Independent Clinic
25 0148 22 Outpatient Hospital
26 0743 49 Independent Clinic
27 0837 24 Ambulatory Surgical Center
28 0111 21 Inpatient Hospital
29 0136 22 Outpatient Hospital
30 0181 21 Inpatient Hospital
31 0761 53 Community Mental Health Center
32 0723 65 End-Stage Renal Disease Treatment Facility
33 0839 24 Ambulatory Surgical Center
34 0727 65 End-Stage Renal Disease Treatment Facility
35 0132 22 Outpatient Hospital
36 0213 31 Skilled Nursing Facility
37 0711 72 Rural Health Clinic
38 0731 49 Independent Clinic
39 0762 53 Community Mental Health Center
40 0134 22 Outpatient Hospital
41 0143 22 Outpatient Hospital
42 0724 65 End-Stage Renal Disease Treatment Facility
43 0742 49 Independent Clinic
44 0760 53 Community Mental Health Center
45 013A 22 Outpatient Hospital
46 014Q 22 Outpatient Hospital
47 0127 21 Inpatient Hospital
48 0142 22 Outpatient Hospital
49 0144 22 Outpatient Hospital
50 0146 22 Outpatient Hospital
51 0331 12 Home
52 0741 49 Independent Clinic
53 0147 22 Outpatient Hospital
54 0224 31 Skilled Nursing Facility
55 0734 49 Independent Clinic
56 0341 12 Home
57 014 22 Outpatient Hospital
58 0115 21 Inpatient Hospital
59 0145 22 Outpatient Hospital
60 0767 53 Community Mental Health Center
61 0792 49 Independent Clinic
62 0117 21 Inpatient Hospital
63 0334 12 Home
64 0737 49 Independent Clinic
65 0333 12 Home
66 0891 53 Community Mental Health Center
67 0112 21 Inpatient Hospital
68 0130 22 Outpatient Hospital
69 0322 12 Home
70 0744 49 Independent Clinic
71 0321 12 Home
72 0332 12 Home
73 0721 65 End-Stage Renal Disease Treatment Facility
74 0857 22 Outpatient Hospital
75 0324 12 Home
76 0231 32 Nursing Facility
File diff suppressed because it is too large Load Diff
File diff suppressed because it is too large Load Diff
File diff suppressed because it is too large Load Diff
@@ -0,0 +1,12 @@
Code,Description
00100-01999,Anesthesia
95700-95811,Sleep Medicine Testing Procedures
10004-69990,Surgery
70010-79999,Radiology Procedures
80047-89398,Pathology and Laboratory Procedures
90281-99607,Medicine Services and Procedures
99091-99499,Evaluation and Management
0001F-9007F,Category II Codes
0002M-0019M,Multianalyte Assay
0042T-0866T,Category III Codes
0001U-0438U,Proprietary Laboratory Analyses
1 Code Description
2 00100-01999 Anesthesia
3 95700-95811 Sleep Medicine Testing Procedures
4 10004-69990 Surgery
5 70010-79999 Radiology Procedures
6 80047-89398 Pathology and Laboratory Procedures
7 90281-99607 Medicine Services and Procedures
8 99091-99499 Evaluation and Management
9 0001F-9007F Category II Codes
10 0002M-0019M Multianalyte Assay
11 0042T-0866T Category III Codes
12 0001U-0438U Proprietary Laboratory Analyses
@@ -0,0 +1,310 @@
Code,Description
00100-00222,Anesthesia for Procedures on the Head
00300-00352,Anesthesia for Procedures on the Neck
00400-00474,Anesthesia for Procedures on the Thorax (Chest Wall and Shoulder Girdle)
00500-00580,Anesthesia for Intrathoracic Procedures
00600-00670,Anesthesia for Procedures on the Spine and Spinal Cord
00700-00797,Anesthesia for Procedures on the Upper Abdomen
00800-00882,Anesthesia for Procedures on the Lower Abdomen
00902-00952,Anesthesia for Procedures on the Perineum
01112-01173,Anesthesia for Procedures on the Pelvis (Except Hip)
01200-01274,Anesthesia for Procedures on the Upper Leg (Except Knee)
01320-01444,Anesthesia for Procedures on the Knee and Popliteal Area
01462-01522,Anesthesia for Procedures on the Lower Leg (Below Knee)
01610-01680,Anesthesia for Procedures on the Shoulder and Axilla
01710-01782,Anesthesia for Procedures on the Upper Arm and Elbow
01810-01860,"Anesthesia for Procedures on the Forearm, Wrist, and Hand"
01916-01942,Anesthesia for Radiological Procedures
01951-01953,Anesthesia for Burn Excisions or Debridement Procedures
01958-01969,Anesthesia for Obstetric Procedures
01990-01999,Anesthesia for Other Procedures
10004-10021,General Surgical Procedures
10030-19499,Surgical Procedures on the Integumentary System
20100-29999,Surgical Procedures on the Musculoskeletal System
30000-32999,Surgical Procedures on the Respiratory System
33016-37799,Surgical Procedures on the Cardiovascular System
38100-38999,Surgical Procedures on the Hemic and Lymphatic Systems
39000-39599,Surgical Procedures on the Mediastinum and Diaphragm
40490-49999,Surgical Procedures on the Digestive System
50010-53899,Surgical Procedures on the Urinary System
54000-55899,Surgical Procedures on the Male Genital System
55920-55920,Reproductive System Procedures
55970-55980,Intersex Surgery
56405-58999,Surgical Procedures on the Female Genital System
59000-59899,Surgical Procedures for Maternity Care and Delivery
60000-60699,Surgical Procedures on the Endocrine System
61000-64999,Surgical Procedures on the Nervous System
65091-68899,Surgical Procedures on the Eye and Ocular Adnexa
69000-69979,Surgical Procedures on the Auditory System
69990-69990,Operating Microscope Procedures
70010-76499,Diagnostic Radiology (Diagnostic Imaging) Procedures
76506-76999,Diagnostic Ultrasound Procedures
77001-77022,Radiologic Guidance
77046-77067,"Breast, Mammography"
77071-77092,Bone/Joint Studies
77261-77799,Radiation Oncology Treatment
78012-79999,Nuclear Medicine Procedures
80047-80081,Organ or Disease Oriented Panels
80143-80377,Therapeutic Drug Assays
80305-80377,Drug Assay Procedures
80400-80439,Evocative/Suppression Testing Procedures
80503-80506,Clinical Pathology Consultations
81000-81099,Urinalysis Procedures
81105-81479,Molecular Pathology Procedures
81410-81479,Genomic Sequencing Procedures and Other Molecular Multianalyte Assays
81490-81599,Multianalyte Assays with Algorithmic Analyses
82009-84999,Chemistry Procedures
85002-85999,Hematology and Coagulation Procedures
86000-86849,Immunology Procedures
86850-86999,Transfusion Medicine Procedures
87003-87999,Microbiology Procedures
88000-88099,Anatomic Pathology Procedures
88104-88199,Cytopathology Procedures
88230-88299,Cytogenetic Studies
88300-88399,Surgical Pathology Procedures
88720-88749,"In Vivo (eg, Transcutaneous) Laboratory Procedures"
89049-89240,Other Pathology and Laboratory Procedures
89250-89398,Reproductive Medicine Procedures
90281-90399,"Immune Globulins, Serum or Recombinant Products"
90460-90474,Immunization Administration for Vaccines/Toxoids
90785-90899,Psychiatry Services and Procedures
90901-90913,Biofeedback Services and Procedures
90935-90999,Dialysis Services and Procedures
91010-91322,Gastroenterology Procedures
91304-90749,"Vaccines, Toxoids"
92002-92499,Ophthalmology Services and Procedures
92502-92700,Special Otorhinolaryngologic Services and Procedures
92920-93799,Cardiovascular Procedures
93880-93998,Non-Invasive Vascular Diagnostic Studies
94002-94799,Pulmonary Procedures
95004-95199,Allergy and Clinical Immunology Procedures
95249-95251,Endocrinology Services
95700-96020,Neurology and Neuromuscular Procedures
96040-96040,Medical Genetics and Genetic Counseling Services
96105-96146,"Central Nervous System Assessments/Tests (eg, Neuro-Cognitive, Mental Status, Speech Testing)"
96156-96171,Health Behavior Assessment and Intervention Procedures
96202-96203,Behavior Management Services
96360-96549,"Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration"
96567-96574,Photodynamic Therapy Procedures
96900-96999,Special Dermatological Procedures
97010-97799,Physical Medicine and Rehabilitation Evaluations
97151-97158,Adaptive Behavior Services
97802-97804,Medical Nutrition Therapy Procedures
97810-97814,Acupuncture Procedures
98925-98929,Osteopathic Manipulative Treatment Procedures
98940-98943,Chiropractic Manipulative Treatment Procedures
98960-98962,Education and Training for Patient Self-Management
98966-98981,Non-Face-to-Face Nonphysician Services
99000-99091,"Special Services, Procedures and Reports"
99100-99140,Qualifying Circumstances for Anesthesia
99151-99157,Moderate (Conscious) Sedation
99170-99199,Other Medicine Services and Procedures
99202-99215,Office or Other Outpatient Services
99221-99239,Hospital Inpatient and Observation Care Services
99242-99255,Consultations
99281-99288,Emergency Department Services
99291-99292,Critical Care Services
99304-99316,Nursing Facility Services
99341-99350,Home or Residence Services
99358-99360,Prolonged Services
99366-99368,Case Management Services
99374-99380,Care Plan Oversight Services
99381-99429,Preventive Medicine Services
99437-99449,Non-Face-to-Face Services
99450-99459,Special Evaluation and Management Services
99460-99463,Newborn Care Services
99464-99465,Delivery/Birthing Room Attendance and Resuscitation Services
99466-99480,Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services
99483-99486,Cognitive Assessment and Care Plan Services
99484-99484,General Behavioral Health Integration Care Management
99487-99491,Care Management Services
99492-99494,Psychiatric Collaborative Care Management Services
99495-99496,Transitional Care Management Services
99497-99498,Advance Care Planning
99499-99499,Other Evaluation and Management Services
99500-99602,Home Health Procedures and Services
99605-99607,Medication Therapy Management Services
0001F-0015F,Composite Measures
0500F-0584F,Patient Management
1000F-1505F,Patient History
2000F-2060F,Physical Examination
3006F-3776F,Diagnostic/Screening Processes or Results
4000F-4563F,"Therapeutic, Preventive or Other Interventions"
5005F-5250F,Follow-up or Other Outcomes
6005F-6150F,Patient Safety
7010F-7025F,Structural Measures
9001F-9007F,Non-Measure Category II Codes
0002M-0019M,Multianalyte Assay
0042T-0232T,Various Services - Category III Codes
0234T-0238T,Atherectomy (Open or Percutaneous) for Supra-Inguinal Arteries
0253T-0253T,Anterior Segment Aqueous Drainage Device Insertion Procedure
0263T-0265T,Intramuscular Autologous Bone Marrow Cell Therapy Procedure
0266T-0273T,Carotid Sinus Baroreflex Activation Device Procedures
0274T-0275T,Percutaneous Decompressive Laminotomy/Laminectomy Procedures through Interlaminar Approach
0278T-0278T,Transcutaneous Electrical Modulation Pain Reprocessing Treatment
0308T-0308T,Ocular Telescope Prosthesis Insertion Procedure
0329T-0358T,"Imaging, Testing, Implantation and Other Services"
0362T-0373T,Adaptive Behavior Assessments
0378T-0379T,Visual Field Assessments
0394T-0395T,High Dose Rate Electronic Brachytherapy Procedures
0397T-0397T,ERCP with Endomicroscopy Procedure
0398T-0398T,Stereotactic Intracranial Lesion Ablation Procedure
0402T-0402T,Procedures performed on Cornea
0403T-0403T,Preventive Behavior Intensive Program for Prevention Of Diabetes
0408T-0418T,Permanent Cardiac Contractility Modulation System Procedures
0419T-0420T,Neurofibroma Destruction Procedure
0421T-0421T,Prostate Ablation Procedure
0422T-0422T,Breast Imaging Procedure
0437T-0437T,Implantation for Abdominal Reinforcement
0439T-0439T,Myocardial Echocardiography
0440T-0442T,Percutaneous Cryoablation Procedures
0443T-0443T,Real-time spectral analysis of prostate tissue
0444T-0445T,Placement of Drug-eluting Ocular Procedures
0446T-0448T,Insertion and Removal of Implantable Interstitial Glucose Sensor
0449T-0450T,Insertion of Aqueous Drainage Device
0464T-0474T,"Imaging, Evaluation, Programming and Recording Procedures"
0479T-0480T,Laser Ablation Procedures
0481T-0481T,Blood Products Transfusion Procedure
0483T-0484T,Transcatheter Mitral Valve Procedures
0485T-0486T,Optical Coherence Tomography (Ear)
0488T-0488T,Behavior Analysis
0489T-0490T,"Cellular Regeneration, Evaluation Study and Ablation Procedures"
0494T-0496T,Organ Transplantation Procedures
0500T-0500T,Human Papillomavirus (HPV) Analysis
0505T-0505T,Coronary and Vascular Procedures
0506T-0507T,Other Diagnostic Procedures
0509T-0513T,"Vision Studies, Implants and Therapies"
0515T-0523T,"Cardiac Device Implantation, Analysis, Relocation and Removal Procedures"
0524T-0524T,Ablation Procedure
0525T-0532T,Intracardiac Ischemia Monitoring Procedures
0537T-0540T,Cellular Therapy Procedures
0541T-0542T,Cardiac Muscle Imaging
0543T-0545T,Cardiac Valve Repair Procedures
0546T-0546T,Radiofrequency Spectroscopy Assessment
0547T-0547T,Bone Quality Testing Procedure
0552T-0552T,Laser Therapy
0553T-0553T,Iliac Arteriovenous Implant
0554T-0557T,Bone Strength And Fracture Risk Assessment
0558T-0558T,Computed Tomography Analysis
0559T-0562T,Anatomic Model And Guide Creation
0563T-0563T,Procedures on Eye Glands
0564T-0564T,Chemo Drug Essay
0565T-0566T,Autologous Cellular Implant of Adipose Tissue for Joints
0567T-0568T,Fallopian Tube Occlusion
0569T-0570T,Tricuspid Valve Repair/Replacement
0571T-0580T,Implantable Cardioverter-Defibrillator with Substernal Electrode
0581T-0582T,Ablation Procedures (Breast/Prostate)
0583T-0583T,Procedures Performed on Ear
0584T-0586T,Islet Cell Transplant Procedure
0587T-0590T,Neurostimulation Procedures
0591T-0593T,Health And Well-Being Coaching
0594T-0594T,Limb Lengthening Procedure
0596T-0597T,Female Voiding Prosthesis Procedures
0598T-0599T,Wound Imaging for Bacterial Presence
0600T-0601T,Irreversible Electroporation Ablation Procedures
0602T-0603T,Transdermal GFR Measurement and Monitoring
0604T-0606T,Eye Imaging Procedures (Remote)
0607T-0608T,Remote Monitoring of Pulmonary System
0609T-0612T,Magnetic Resonance Spectroscopy Imaging
0613T-0614T,Cardiac Implantation and Replacement Procedures
0615T-0618T,Procedures Performed on Eyes
0619T-0619T,Procedures Performed on Prostate
0620T-0620T,Endovascular Lower Limb Procedure
0621T-0622T,Trabeculostomy Procedure by Laser (Ab Interno)
0623T-0626T,Automated Analysis of Coronary Atherosclerotic plaque for CAD
0627T-0630T,Percutaneous Lumbar Intravertebral Disc Injection Procedure
0631T-0631T,Hyperspectral Imaging Measurement of Hemoglobin
0632T-0632T,Transcatheter Ultrasound Nerve Ablation Procedure
0633T-0638T,CT Breast (with/without Contrast)
0639T-0639T,CSF Shunt Analysis
0640T-0640T,Spectroscopy Studies of Flap or Wound
0643T-0646T,Transcatheter Implantation and Removal Procedures
0647T-0647T,Magnetic Gastropexy with Gastrostomy Tube Insertion Procedure
0648T-0649T,Quantitative Magnetic Resonance Tissue Composition Analysis
0650T-0650T,Cardiac Rhythm Monitor System Evaluation
0651T-0654T,Transnasal EGD and Capsule Endoscopy Procedures
0655T-0655T,Transperineal Prostate Ablation Through Laser
0656T-0657T,Vertebral Body Tethering Procedures
0658T-0659T,Impedance Spectroscopy and Intracoronary Infusion Procedures
0660T-0661T,Drug-Eluting Implant Procedures in Eye
0662T-0663T,Scalp Cooling Procedures
0664T-0667T,Donor Hysterectomy Including Preservation Procedures
0668T-0670T,Uterine Allograft Preparation and Reconstruction Procedures Prior to Transplantation
0671T-0671T,Anterior Segment Aqueous Drainage Device Insertion Procedure
0672T-0672T,Endovaginal Cryogen-cooled Procedure for Urinary Incontinence
0673T-0673T,Benign Thyroid Nodule Ablation Procedure
0674T-0685T,"Insertion, Replacement, Repositioning, Removal and Evaluation of Diaphragmatic Stimulation System and Leads"
0686T-0686T,Malignant Hepatocellular Histotripsy Procedure
0687T-0688T,Treatment of Amblyopia using Online Digital Program
0689T-0690T,Quantitative Ultrasound Tissue Characterization
0691T-0691T,Automated Analysis of Vertebral Fracture
0692T-0692T,Therapeutic Ultrafiltration Procedure
0693T-0693T,Comprehensive Full Body 3D Kinetic Motion Analysis
0694T-0694T,3-dimensional Imaging and Reconstruction of Breast or Axillary Lymph Node Tissue
0695T-0696T,Mapping of Pacemaker or Pacing Cardioverter-Defibrillator Leads
0697T-0698T,Quantitative Magnetic Resonance for Analysis of Tissue Composition
0699T-0699T,Posterior Chamber Injection Procedure
0700T-0701T,Molecular Fluorescent Imaging of Suspicious Nevus
0704T-0706T,Remote Treatment of Amblyopia
0707T-0707T,Subchondral Bone Defect Injection Procedure
0708T-0709T,Intradermal Cancer Immunotherapy
0710T-0713T,Noninvasive Arterial Plaque Analysis
0714T-0714T,Laser Ablation for Prostate
0716T-0716T,Coronary Artery Disease (CAD) Risk Score Analysis
0717T-0718T,ADRC Therapy For Partial Thickness Rotator Cuff Tear
0719T-0719T,Posterior Lumbar Vertebral Joint Replacement Procedure
0720T-0720T,Percutaneous Cranial Nerves Stimulation
0721T-0722T,Tissue Characterization by Quantitative CT
0723T-0724T,Quantitative Magnetic Resonance Cholangiopancreatography (QMRCP) Procedure
0725T-0729T,Vestibular Device Procedures with Analysis and Programming
0730T-0730T,Laser Trabeculotomy with OCT
0731T-0731T,AI-Based Facial Phenotype Analysis
0732T-0732T,Immunotherapy Administration With Electroporation
0733T-0734T,Remote Body And Limb Kinematic Measurement-Based Therapy
0735T-0735T,Intraoperative Radiation Therapy Procedure
0736T-0736T,Colonic Lavage with Insertion Of Rectal Catheter Procedure
0737T-0737T,Xenograft Implantation Procedure
0738T-0739T,Prostate Ablation Procedures including Planning
0740T-0741T,Remote Insulin Dose Calculation and Monitoring System
0742T-0742T,Myocardial Perfusion Imaging Procedure
0743T-0743T,Fracture Risk Assessment
0744T-0744T,Bioprosthetic Valve Insertion Procedure
0745T-0747T,Cardiac Radioablation Procedure for Arrhythmia
0748T-0748T,Stem Cell Injection Procedures for Perianal Fistula Treatment
0749T-0750T,Bone Strength and Fracture-Risk Assessment
0751T-0763T,Digital Pathology Glass Microscope Slides Digitization Procedures
0764T-0765T,Risk-Based Assessment for Cardiac Dysfunction
0766T-0767T,Transcutaneous Magnetic Stimulation of Peripheral Nerve
0770T-0774T,Virtual Reality Technology Services
0776T-0776T,Intra-Brain Hypothermia Induction Procedure
0777T-0777T,Pressure-Sensing Epidural Guidance System
0778T-0778T,Inertial Measurement Units for Clinical Movement Analysis
0779T-0779T,Gastrointestinal Myoelectrical Activity Study
0780T-0780T,Fecal Microbiota Transplantation Procedure
0781T-0782T,Bronchoscopy with Radiofrequency Destruction of the Pulmonary Nerves
0783T-0783T,Transcutaneous Auricular Neurostimulation Procedure
0784T-0789T,Procedures with Analysis Performed On Spinal Neurostimulator
0790T-0790T,Vertebral Body Tethering Procedures
0791T-0791T,Virtual RealityFacilitated Gait Training
0792T-0792T,Silver Diamine Fluoride For Dental Caries
0793T-0793T,Transcatheter Thermal Nerve Ablation with Catheterization and Angiography
0794T-0794T,Pharmaco-Oncologic Treatment Planning
0795T-0804T,"Permanent Dual-Chamber Leadless Pacemaker - Insertion, Removal, Replacement & Programming Device Evaluation Procedures"
0805T-0806T,Prosthetic Valve Implantation (Caval Valve Implantation) Procedures
0807T-0808T,Pulmonary Tissue Ventilation Analysis
0810T-0810T,Subretinal Injection with Vitrectomy and Retinotomies
0811T-0812T,Remote Multi-Day Complex Uroflowmetry Procedures
0813T-0813T,Esophagogastroduodenoscopy With Intragastric Bariatric Balloon Adjustment Procedure
0814T-0814T,Injectable Bone Substitutes Procedure
0815T-0815T,Fracture Risk Assessment Procedure
0816T-0819T,Integrated Neurostimulation System Procedures On Posterior Tibial Nerve
0820T-0822T,Monitoring And Intervention Procedures For Psychotherapy
0823T-0826T,Single-Chamber Leadless Pacemaker Procedures
0827T-0856T,Glass Microscope Slides Digitization Procedures
0857T-0857T,Opto-Acoustic Imaging Procedures
0858T-0858T,Transcranial Magnetic Stimulation Procedure
0859T-0860T,Noncontact Near-Infrared Spectroscopy Procedures
0861T-0863T,Pulse Generator Removal and Relocation Procedures
0864T-0864T,Extracorporeal Shock Wave Therapy Procedure
0865T-0866T,Quantitative Analysis of the Brain Through Magnetic Resonance Image (MRI)
0001U-0438U,Proprietary Laboratory Analyses
1 Code Description
2 00100-00222 Anesthesia for Procedures on the Head
3 00300-00352 Anesthesia for Procedures on the Neck
4 00400-00474 Anesthesia for Procedures on the Thorax (Chest Wall and Shoulder Girdle)
5 00500-00580 Anesthesia for Intrathoracic Procedures
6 00600-00670 Anesthesia for Procedures on the Spine and Spinal Cord
7 00700-00797 Anesthesia for Procedures on the Upper Abdomen
8 00800-00882 Anesthesia for Procedures on the Lower Abdomen
9 00902-00952 Anesthesia for Procedures on the Perineum
10 01112-01173 Anesthesia for Procedures on the Pelvis (Except Hip)
11 01200-01274 Anesthesia for Procedures on the Upper Leg (Except Knee)
12 01320-01444 Anesthesia for Procedures on the Knee and Popliteal Area
13 01462-01522 Anesthesia for Procedures on the Lower Leg (Below Knee)
14 01610-01680 Anesthesia for Procedures on the Shoulder and Axilla
15 01710-01782 Anesthesia for Procedures on the Upper Arm and Elbow
16 01810-01860 Anesthesia for Procedures on the Forearm, Wrist, and Hand
17 01916-01942 Anesthesia for Radiological Procedures
18 01951-01953 Anesthesia for Burn Excisions or Debridement Procedures
19 01958-01969 Anesthesia for Obstetric Procedures
20 01990-01999 Anesthesia for Other Procedures
21 10004-10021 General Surgical Procedures
22 10030-19499 Surgical Procedures on the Integumentary System
23 20100-29999 Surgical Procedures on the Musculoskeletal System
24 30000-32999 Surgical Procedures on the Respiratory System
25 33016-37799 Surgical Procedures on the Cardiovascular System
26 38100-38999 Surgical Procedures on the Hemic and Lymphatic Systems
27 39000-39599 Surgical Procedures on the Mediastinum and Diaphragm
28 40490-49999 Surgical Procedures on the Digestive System
29 50010-53899 Surgical Procedures on the Urinary System
30 54000-55899 Surgical Procedures on the Male Genital System
31 55920-55920 Reproductive System Procedures
32 55970-55980 Intersex Surgery
33 56405-58999 Surgical Procedures on the Female Genital System
34 59000-59899 Surgical Procedures for Maternity Care and Delivery
35 60000-60699 Surgical Procedures on the Endocrine System
36 61000-64999 Surgical Procedures on the Nervous System
37 65091-68899 Surgical Procedures on the Eye and Ocular Adnexa
38 69000-69979 Surgical Procedures on the Auditory System
39 69990-69990 Operating Microscope Procedures
40 70010-76499 Diagnostic Radiology (Diagnostic Imaging) Procedures
41 76506-76999 Diagnostic Ultrasound Procedures
42 77001-77022 Radiologic Guidance
43 77046-77067 Breast, Mammography
44 77071-77092 Bone/Joint Studies
45 77261-77799 Radiation Oncology Treatment
46 78012-79999 Nuclear Medicine Procedures
47 80047-80081 Organ or Disease Oriented Panels
48 80143-80377 Therapeutic Drug Assays
49 80305-80377 Drug Assay Procedures
50 80400-80439 Evocative/Suppression Testing Procedures
51 80503-80506 Clinical Pathology Consultations
52 81000-81099 Urinalysis Procedures
53 81105-81479 Molecular Pathology Procedures
54 81410-81479 Genomic Sequencing Procedures and Other Molecular Multianalyte Assays
55 81490-81599 Multianalyte Assays with Algorithmic Analyses
56 82009-84999 Chemistry Procedures
57 85002-85999 Hematology and Coagulation Procedures
58 86000-86849 Immunology Procedures
59 86850-86999 Transfusion Medicine Procedures
60 87003-87999 Microbiology Procedures
61 88000-88099 Anatomic Pathology Procedures
62 88104-88199 Cytopathology Procedures
63 88230-88299 Cytogenetic Studies
64 88300-88399 Surgical Pathology Procedures
65 88720-88749 In Vivo (eg, Transcutaneous) Laboratory Procedures
66 89049-89240 Other Pathology and Laboratory Procedures
67 89250-89398 Reproductive Medicine Procedures
68 90281-90399 Immune Globulins, Serum or Recombinant Products
69 90460-90474 Immunization Administration for Vaccines/Toxoids
70 90785-90899 Psychiatry Services and Procedures
71 90901-90913 Biofeedback Services and Procedures
72 90935-90999 Dialysis Services and Procedures
73 91010-91322 Gastroenterology Procedures
74 91304-90749 Vaccines, Toxoids
75 92002-92499 Ophthalmology Services and Procedures
76 92502-92700 Special Otorhinolaryngologic Services and Procedures
77 92920-93799 Cardiovascular Procedures
78 93880-93998 Non-Invasive Vascular Diagnostic Studies
79 94002-94799 Pulmonary Procedures
80 95004-95199 Allergy and Clinical Immunology Procedures
81 95249-95251 Endocrinology Services
82 95700-96020 Neurology and Neuromuscular Procedures
83 96040-96040 Medical Genetics and Genetic Counseling Services
84 96105-96146 Central Nervous System Assessments/Tests (eg, Neuro-Cognitive, Mental Status, Speech Testing)
85 96156-96171 Health Behavior Assessment and Intervention Procedures
86 96202-96203 Behavior Management Services
87 96360-96549 Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration
88 96567-96574 Photodynamic Therapy Procedures
89 96900-96999 Special Dermatological Procedures
90 97010-97799 Physical Medicine and Rehabilitation Evaluations
91 97151-97158 Adaptive Behavior Services
92 97802-97804 Medical Nutrition Therapy Procedures
93 97810-97814 Acupuncture Procedures
94 98925-98929 Osteopathic Manipulative Treatment Procedures
95 98940-98943 Chiropractic Manipulative Treatment Procedures
96 98960-98962 Education and Training for Patient Self-Management
97 98966-98981 Non-Face-to-Face Nonphysician Services
98 99000-99091 Special Services, Procedures and Reports
99 99100-99140 Qualifying Circumstances for Anesthesia
100 99151-99157 Moderate (Conscious) Sedation
101 99170-99199 Other Medicine Services and Procedures
102 99202-99215 Office or Other Outpatient Services
103 99221-99239 Hospital Inpatient and Observation Care Services
104 99242-99255 Consultations
105 99281-99288 Emergency Department Services
106 99291-99292 Critical Care Services
107 99304-99316 Nursing Facility Services
108 99341-99350 Home or Residence Services
109 99358-99360 Prolonged Services
110 99366-99368 Case Management Services
111 99374-99380 Care Plan Oversight Services
112 99381-99429 Preventive Medicine Services
113 99437-99449 Non-Face-to-Face Services
114 99450-99459 Special Evaluation and Management Services
115 99460-99463 Newborn Care Services
116 99464-99465 Delivery/Birthing Room Attendance and Resuscitation Services
117 99466-99480 Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services
118 99483-99486 Cognitive Assessment and Care Plan Services
119 99484-99484 General Behavioral Health Integration Care Management
120 99487-99491 Care Management Services
121 99492-99494 Psychiatric Collaborative Care Management Services
122 99495-99496 Transitional Care Management Services
123 99497-99498 Advance Care Planning
124 99499-99499 Other Evaluation and Management Services
125 99500-99602 Home Health Procedures and Services
126 99605-99607 Medication Therapy Management Services
127 0001F-0015F Composite Measures
128 0500F-0584F Patient Management
129 1000F-1505F Patient History
130 2000F-2060F Physical Examination
131 3006F-3776F Diagnostic/Screening Processes or Results
132 4000F-4563F Therapeutic, Preventive or Other Interventions
133 5005F-5250F Follow-up or Other Outcomes
134 6005F-6150F Patient Safety
135 7010F-7025F Structural Measures
136 9001F-9007F Non-Measure Category II Codes
137 0002M-0019M Multianalyte Assay
138 0042T-0232T Various Services - Category III Codes
139 0234T-0238T Atherectomy (Open or Percutaneous) for Supra-Inguinal Arteries
140 0253T-0253T Anterior Segment Aqueous Drainage Device Insertion Procedure
141 0263T-0265T Intramuscular Autologous Bone Marrow Cell Therapy Procedure
142 0266T-0273T Carotid Sinus Baroreflex Activation Device Procedures
143 0274T-0275T Percutaneous Decompressive Laminotomy/Laminectomy Procedures through Interlaminar Approach
144 0278T-0278T Transcutaneous Electrical Modulation Pain Reprocessing Treatment
145 0308T-0308T Ocular Telescope Prosthesis Insertion Procedure
146 0329T-0358T Imaging, Testing, Implantation and Other Services
147 0362T-0373T Adaptive Behavior Assessments
148 0378T-0379T Visual Field Assessments
149 0394T-0395T High Dose Rate Electronic Brachytherapy Procedures
150 0397T-0397T ERCP with Endomicroscopy Procedure
151 0398T-0398T Stereotactic Intracranial Lesion Ablation Procedure
152 0402T-0402T Procedures performed on Cornea
153 0403T-0403T Preventive Behavior Intensive Program for Prevention Of Diabetes
154 0408T-0418T Permanent Cardiac Contractility Modulation System Procedures
155 0419T-0420T Neurofibroma Destruction Procedure
156 0421T-0421T Prostate Ablation Procedure
157 0422T-0422T Breast Imaging Procedure
158 0437T-0437T Implantation for Abdominal Reinforcement
159 0439T-0439T Myocardial Echocardiography
160 0440T-0442T Percutaneous Cryoablation Procedures
161 0443T-0443T Real-time spectral analysis of prostate tissue
162 0444T-0445T Placement of Drug-eluting Ocular Procedures
163 0446T-0448T Insertion and Removal of Implantable Interstitial Glucose Sensor
164 0449T-0450T Insertion of Aqueous Drainage Device
165 0464T-0474T Imaging, Evaluation, Programming and Recording Procedures
166 0479T-0480T Laser Ablation Procedures
167 0481T-0481T Blood Products Transfusion Procedure
168 0483T-0484T Transcatheter Mitral Valve Procedures
169 0485T-0486T Optical Coherence Tomography (Ear)
170 0488T-0488T Behavior Analysis
171 0489T-0490T Cellular Regeneration, Evaluation Study and Ablation Procedures
172 0494T-0496T Organ Transplantation Procedures
173 0500T-0500T Human Papillomavirus (HPV) Analysis
174 0505T-0505T Coronary and Vascular Procedures
175 0506T-0507T Other Diagnostic Procedures
176 0509T-0513T Vision Studies, Implants and Therapies
177 0515T-0523T Cardiac Device Implantation, Analysis, Relocation and Removal Procedures
178 0524T-0524T Ablation Procedure
179 0525T-0532T Intracardiac Ischemia Monitoring Procedures
180 0537T-0540T Cellular Therapy Procedures
181 0541T-0542T Cardiac Muscle Imaging
182 0543T-0545T Cardiac Valve Repair Procedures
183 0546T-0546T Radiofrequency Spectroscopy Assessment
184 0547T-0547T Bone Quality Testing Procedure
185 0552T-0552T Laser Therapy
186 0553T-0553T Iliac Arteriovenous Implant
187 0554T-0557T Bone Strength And Fracture Risk Assessment
188 0558T-0558T Computed Tomography Analysis
189 0559T-0562T Anatomic Model And Guide Creation
190 0563T-0563T Procedures on Eye Glands
191 0564T-0564T Chemo Drug Essay
192 0565T-0566T Autologous Cellular Implant of Adipose Tissue for Joints
193 0567T-0568T Fallopian Tube Occlusion
194 0569T-0570T Tricuspid Valve Repair/Replacement
195 0571T-0580T Implantable Cardioverter-Defibrillator with Substernal Electrode
196 0581T-0582T Ablation Procedures (Breast/Prostate)
197 0583T-0583T Procedures Performed on Ear
198 0584T-0586T Islet Cell Transplant Procedure
199 0587T-0590T Neurostimulation Procedures
200 0591T-0593T Health And Well-Being Coaching
201 0594T-0594T Limb Lengthening Procedure
202 0596T-0597T Female Voiding Prosthesis Procedures
203 0598T-0599T Wound Imaging for Bacterial Presence
204 0600T-0601T Irreversible Electroporation Ablation Procedures
205 0602T-0603T Transdermal GFR Measurement and Monitoring
206 0604T-0606T Eye Imaging Procedures (Remote)
207 0607T-0608T Remote Monitoring of Pulmonary System
208 0609T-0612T Magnetic Resonance Spectroscopy Imaging
209 0613T-0614T Cardiac Implantation and Replacement Procedures
210 0615T-0618T Procedures Performed on Eyes
211 0619T-0619T Procedures Performed on Prostate
212 0620T-0620T Endovascular Lower Limb Procedure
213 0621T-0622T Trabeculostomy Procedure by Laser (Ab Interno)
214 0623T-0626T Automated Analysis of Coronary Atherosclerotic plaque for CAD
215 0627T-0630T Percutaneous Lumbar Intravertebral Disc Injection Procedure
216 0631T-0631T Hyperspectral Imaging Measurement of Hemoglobin
217 0632T-0632T Transcatheter Ultrasound Nerve Ablation Procedure
218 0633T-0638T CT Breast (with/without Contrast)
219 0639T-0639T CSF Shunt Analysis
220 0640T-0640T Spectroscopy Studies of Flap or Wound
221 0643T-0646T Transcatheter Implantation and Removal Procedures
222 0647T-0647T Magnetic Gastropexy with Gastrostomy Tube Insertion Procedure
223 0648T-0649T Quantitative Magnetic Resonance Tissue Composition Analysis
224 0650T-0650T Cardiac Rhythm Monitor System Evaluation
225 0651T-0654T Transnasal EGD and Capsule Endoscopy Procedures
226 0655T-0655T Transperineal Prostate Ablation Through Laser
227 0656T-0657T Vertebral Body Tethering Procedures
228 0658T-0659T Impedance Spectroscopy and Intracoronary Infusion Procedures
229 0660T-0661T Drug-Eluting Implant Procedures in Eye
230 0662T-0663T Scalp Cooling Procedures
231 0664T-0667T Donor Hysterectomy Including Preservation Procedures
232 0668T-0670T Uterine Allograft Preparation and Reconstruction Procedures Prior to Transplantation
233 0671T-0671T Anterior Segment Aqueous Drainage Device Insertion Procedure
234 0672T-0672T Endovaginal Cryogen-cooled Procedure for Urinary Incontinence
235 0673T-0673T Benign Thyroid Nodule Ablation Procedure
236 0674T-0685T Insertion, Replacement, Repositioning, Removal and Evaluation of Diaphragmatic Stimulation System and Leads
237 0686T-0686T Malignant Hepatocellular Histotripsy Procedure
238 0687T-0688T Treatment of Amblyopia using Online Digital Program
239 0689T-0690T Quantitative Ultrasound Tissue Characterization
240 0691T-0691T Automated Analysis of Vertebral Fracture
241 0692T-0692T Therapeutic Ultrafiltration Procedure
242 0693T-0693T Comprehensive Full Body 3D Kinetic Motion Analysis
243 0694T-0694T 3-dimensional Imaging and Reconstruction of Breast or Axillary Lymph Node Tissue
244 0695T-0696T Mapping of Pacemaker or Pacing Cardioverter-Defibrillator Leads
245 0697T-0698T Quantitative Magnetic Resonance for Analysis of Tissue Composition
246 0699T-0699T Posterior Chamber Injection Procedure
247 0700T-0701T Molecular Fluorescent Imaging of Suspicious Nevus
248 0704T-0706T Remote Treatment of Amblyopia
249 0707T-0707T Subchondral Bone Defect Injection Procedure
250 0708T-0709T Intradermal Cancer Immunotherapy
251 0710T-0713T Noninvasive Arterial Plaque Analysis
252 0714T-0714T Laser Ablation for Prostate
253 0716T-0716T Coronary Artery Disease (CAD) Risk Score Analysis
254 0717T-0718T ADRC Therapy For Partial Thickness Rotator Cuff Tear
255 0719T-0719T Posterior Lumbar Vertebral Joint Replacement Procedure
256 0720T-0720T Percutaneous Cranial Nerves Stimulation
257 0721T-0722T Tissue Characterization by Quantitative CT
258 0723T-0724T Quantitative Magnetic Resonance Cholangiopancreatography (QMRCP) Procedure
259 0725T-0729T Vestibular Device Procedures with Analysis and Programming
260 0730T-0730T Laser Trabeculotomy with OCT
261 0731T-0731T AI-Based Facial Phenotype Analysis
262 0732T-0732T Immunotherapy Administration With Electroporation
263 0733T-0734T Remote Body And Limb Kinematic Measurement-Based Therapy
264 0735T-0735T Intraoperative Radiation Therapy Procedure
265 0736T-0736T Colonic Lavage with Insertion Of Rectal Catheter Procedure
266 0737T-0737T Xenograft Implantation Procedure
267 0738T-0739T Prostate Ablation Procedures including Planning
268 0740T-0741T Remote Insulin Dose Calculation and Monitoring System
269 0742T-0742T Myocardial Perfusion Imaging Procedure
270 0743T-0743T Fracture Risk Assessment
271 0744T-0744T Bioprosthetic Valve Insertion Procedure
272 0745T-0747T Cardiac Radioablation Procedure for Arrhythmia
273 0748T-0748T Stem Cell Injection Procedures for Perianal Fistula Treatment
274 0749T-0750T Bone Strength and Fracture-Risk Assessment
275 0751T-0763T Digital Pathology Glass Microscope Slides Digitization Procedures
276 0764T-0765T Risk-Based Assessment for Cardiac Dysfunction
277 0766T-0767T Transcutaneous Magnetic Stimulation of Peripheral Nerve
278 0770T-0774T Virtual Reality Technology Services
279 0776T-0776T Intra-Brain Hypothermia Induction Procedure
280 0777T-0777T Pressure-Sensing Epidural Guidance System
281 0778T-0778T Inertial Measurement Units for Clinical Movement Analysis
282 0779T-0779T Gastrointestinal Myoelectrical Activity Study
283 0780T-0780T Fecal Microbiota Transplantation Procedure
284 0781T-0782T Bronchoscopy with Radiofrequency Destruction of the Pulmonary Nerves
285 0783T-0783T Transcutaneous Auricular Neurostimulation Procedure
286 0784T-0789T Procedures with Analysis Performed On Spinal Neurostimulator
287 0790T-0790T Vertebral Body Tethering Procedures
288 0791T-0791T Virtual Reality–Facilitated Gait Training
289 0792T-0792T Silver Diamine Fluoride For Dental Caries
290 0793T-0793T Transcatheter Thermal Nerve Ablation with Catheterization and Angiography
291 0794T-0794T Pharmaco-Oncologic Treatment Planning
292 0795T-0804T Permanent Dual-Chamber Leadless Pacemaker - Insertion, Removal, Replacement & Programming Device Evaluation Procedures
293 0805T-0806T Prosthetic Valve Implantation (Caval Valve Implantation) Procedures
294 0807T-0808T Pulmonary Tissue Ventilation Analysis
295 0810T-0810T Subretinal Injection with Vitrectomy and Retinotomies
296 0811T-0812T Remote Multi-Day Complex Uroflowmetry Procedures
297 0813T-0813T Esophagogastroduodenoscopy With Intragastric Bariatric Balloon Adjustment Procedure
298 0814T-0814T Injectable Bone Substitutes Procedure
299 0815T-0815T Fracture Risk Assessment Procedure
300 0816T-0819T Integrated Neurostimulation System Procedures On Posterior Tibial Nerve
301 0820T-0822T Monitoring And Intervention Procedures For Psychotherapy
302 0823T-0826T Single-Chamber Leadless Pacemaker Procedures
303 0827T-0856T Glass Microscope Slides Digitization Procedures
304 0857T-0857T Opto-Acoustic Imaging Procedures
305 0858T-0858T Transcranial Magnetic Stimulation Procedure
306 0859T-0860T Noncontact Near-Infrared Spectroscopy Procedures
307 0861T-0863T Pulse Generator Removal and Relocation Procedures
308 0864T-0864T Extracorporeal Shock Wave Therapy Procedure
309 0865T-0866T Quantitative Analysis of the Brain Through Magnetic Resonance Image (MRI)
310 0001U-0438U Proprietary Laboratory Analyses
@@ -0,0 +1,292 @@
Code,Description
10004-10021,Fine Needle Aspiration Biopsy Procedures
10030-11646,"Surgical Procedures on the Skin, Subcutaneous and Accessory Structures"
11719-11765,Surgical Procedures on the Nails
11770-11772,Surgical Procedures on the Pilonidal Cyst
11900-11983,Introduction or Removal Procedures on the Integumentary System
12001-16036,Surgical Repair (Closure) Procedures on the Integumentary System
17000-17999,Destruction Procedures on the Integumentary System
19000-19499,Surgical Procedures on the Breast
20100-20999,General Surgical Procedures on the Musculoskeletal System
21010-21499,Surgical Procedures on the Head
21501-21899,Surgical Procedures on the Neck (Soft Tissues) and Thorax
21920-21936,Surgical Procedures on the Back and Flank
22010-22899,Surgical Procedures on the Spine (Vertebral Column)
22900-22999,Surgical Procedures on the Abdomen
23000-23929,Surgical Procedures on the Shoulder
23930-24999,Surgical Procedures on the Humerus (Upper Arm) and Elbow
25000-25999,Surgical Procedures on the Forearm and Wrist
26010-26989,Surgical Procedures on the Hand and Fingers
26990-27299,Surgical Procedures on the Pelvis and Hip Joint
27301-27599,Surgical Procedures on the Femur (Thigh Region) and Knee Joint
27600-27899,Surgical Procedures on the Leg (Tibia and Fibula) and Ankle Joint
28001-28899,Surgical Procedures on the Foot and Toes
29000-29799,Application of Casts and Strapping
29800-29999,Endoscopy/Arthroscopy Procedures on the Musculoskeletal System
30000-30999,Surgical Procedures on the Nose
31000-31299,Surgical Procedures on the Accessory Sinuses
31300-31599,Surgical Procedures on the Larynx
31600-31899,Surgical Procedures on the Trachea and Bronchi
32035-32999,Surgical Procedures on the Lungs and Pleura
33016-33999,Surgical Procedures on the Heart and Pericardium
34001-37799,Surgical Procedures on Arteries and Veins
38100-38200,Surgical Procedures on the Spleen
38204-38232,General Surgical Procedures on the Hemic and Lymphatic Systems
38240-38243,Transplantation and Post-Transplantation Cellular Infusion Procedures on the Hemic and Lymphatic Systems
38300-38999,Surgical Procedures on the Lymph Nodes and Lymphatic Channels
39000-39499,Surgical Procedures on the Mediastinum
39501-39599,Surgical Procedures on the Diaphragm
40490-40799,Surgical Procedures on the Lips
40800-40899,Surgical Procedures on the Vestibule of Mouth
41000-41599,Surgical Procedures on the Tongue and Floor of Mouth
41800-41899,Surgical Procedures on the Dentoalveolar Structures
42000-42299,Surgical Procedures on the Palate and Uvula
42300-42699,Surgical Procedures on the Salivary Gland and Ducts
42700-42999,"Surgical Procedures on the Pharynx, Adenoids, and Tonsils"
43020-43499,Surgical Procedures on the Esophagus
43500-43999,Surgical Procedures on the Stomach
44005-44799,Surgical Procedures on the Intestines (Except Rectum)
44800-44899,Surgical Procedures on Meckel's Diverticulum and the Mesentery
44900-44979,Surgical Procedures on the Appendix
45000-45999,Surgical Procedures on the Colon and Rectum
46020-46999,Surgical Procedures on the Anus
47000-47399,Surgical Procedures on the Liver
47400-47999,Surgical Procedures on the Biliary Tract
48000-48999,Surgical Procedures on the Pancreas
49000-49999,"Surgical Procedures on the Abdomen, Peritoneum, and Omentum"
50010-50593,Surgical Procedures on the Kidney
50600-50980,Surgical Procedures on the Ureter
51020-52700,Surgical Procedures on the Bladder
53000-53899,Surgical Procedures on the Urethra
54000-54450,Surgical Procedures on the Penis
54500-54699,Surgical Procedures on the Testis
54700-54901,Surgical Procedures on the Epididymis
55000-55060,Surgical Procedures on the Tunica Vaginalis
55100-55180,Surgical Procedures on the Scrotum
55200-55400,Surgical Procedures on the Vas Deferens
55500-55559,Surgical Procedures on the Spermatic Cord
55600-55680,Surgical Procedures on the Seminal Vesicles
55700-55899,Surgical Procedures on the Prostate
56405-56821,"Surgical Procedures on the Vulva, Perineum and Introitus"
57000-57426,Surgical Procedures on the Vagina
57452-57800,Surgical Procedures on the Cervix Uteri
58100-58579,Surgical Procedures on the Corpus Uteri
58600-58770,Surgical Procedures on the Oviduct/Ovary
58800-58960,Surgical Procedures on the Ovary
58970-58999,Surgical Procedures for In Vitro Fertilization
58999-58999,Other Procedures on the Female Genital System
59000-59076,Antepartum and Fetal Invasive Services for Maternity Care and Delivery
59100-59160,Excision Procedures for Maternity Care and Delivery
59200-59200,Introduction Procedures for Maternity Care and Delivery
59300-59350,Repair Procedures for Maternity Care and Delivery
59400-59430,"Vaginal Delivery, Antepartum and Postpartum Care Procedures"
59510-59525,Cesarean Delivery Procedures
59610-59622,Delivery Procedures After Previous Cesarean Delivery
59812-59857,Abortion Procedures
59866-59899,Other Procedures for Maternity Care and Delivery
59000-59076,Antepartum and Fetal Invasive Services for Maternity Care and Delivery
59100-59160,Excision Procedures for Maternity Care and Delivery
59200-59200,Introduction Procedures for Maternity Care and Delivery
59300-59350,Repair Procedures for Maternity Care and Delivery
59400-59430,"Vaginal Delivery, Antepartum and Postpartum Care Procedures"
59510-59525,Cesarean Delivery Procedures
59610-59622,Delivery Procedures After Previous Cesarean Delivery
59812-59857,Abortion Procedures
59866-59899,Other Procedures for Maternity Care and Delivery
60000-60300,Surgical Procedures on the Thyroid Gland
60500-60699,"Surgical Procedures on the Parathyroid, Thymus, Adrenal Glands, Pancreas, and Carotid Body"
61000-62258,"Surgical Procedures on the Skull, Meninges, and Brain"
62263-63746,Surgical Procedures on the Spine and Spinal Cord
64400-64999,"Surgical Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System"
65091-65290,Surgical Procedures on the Eyeball
65400-66999,Surgical Procedures on the Anterior Segment of the Eye
67005-67299,Surgical Procedures on the Posterior Segment of the Eye
67311-67999,Surgical Procedures on the Ocular Adnexa
68020-68899,Surgical Procedures on the Conjunctiva
69000-69399,Surgical Procedures on the External Ear
69420-69799,Surgical Procedures on the Middle Ear
69801-69949,Surgical Procedures on the Inner Ear
69950-69979,"Surgical Procedures on the Temporal Bone, Middle Fossa Approach"
70010-70559,Diagnostic Radiology (Diagnostic Imaging) Procedures of the Head and Neck
71045-71555,Diagnostic Radiology (Diagnostic Imaging) Procedures of the Chest
72020-72295,Diagnostic Radiology (Diagnostic Imaging) Procedures of the Spine and Pelvis
73000-73225,Diagnostic Radiology (Diagnostic Imaging) Procedures of the Upper Extremities
73501-73725,Diagnostic Radiology (Diagnostic Imaging) Procedures of the Lower Extremities
74018-74190,Diagnostic Radiology (Diagnostic Imaging) Procedures of the Abdomen
74210-74363,Diagnostic Radiology (Diagnostic Imaging) Procedures of the Gastrointestinal Tract
74400-74485,Diagnostic Radiology (Diagnostic Imaging) Procedures of the Urinary Tract
74712-74775,Gynecological and Obstetrical Diagnostic Radiology (Diagnostic Imaging) Procedures
75557-75580,Diagnostic Radiology (Diagnostic Imaging) Procedures of the Heart
75600-75989,Diagnostic Radiology (Diagnostic Imaging) Procedures of the Vascular System
76000-76499,Other Diagnostic Radiology (Diagnostic Imaging) Related Procedures
76506-76536,Diagnostic Ultrasound Procedures of the Head and Neck
76604-76642,Diagnostic Ultrasound Procedures of the Chest
76700-76776,Diagnostic Ultrasound Procedures of the Abdomen and Retroperitoneum
76800-76800,Diagnostic Ultrasound Procedures of the Spinal Canal
76801-76857,Diagnostic Ultrasound Procedures of the Pelvis
76870-76873,Diagnostic Ultrasound Procedures of the Genitalia
76881-76886,Diagnostic Ultrasound Procedures of the Extremities
76932-76965,Ultrasonic Guidance Procedures
76975-76999,Other Diagnostic Ultrasound Procedures
77001-77003,Fluoroscopic Guidance
77011-77014,Computed Tomography Guidance
77021-77022,Magnetic Resonance Imaging Guidance
77261-77299,Clinical Treatment Planning (External and Internal Sources) for Radiation Treatment
77300-77370,"Medical Radiation Physics, Dosimetry, Treatment Devices, and Special Services for Radiation Treatment"
77371-77387,Stereotactic Radiation Treatment Delivery
77399-77399,Other Procedures
77401-77417,Radiation Treatment Delivery
77423-77425,Neutron Beam Treatment Delivery
77427-77499,Radiation Treatment Management
77520-77525,Proton Beam Radiation Treatment Delivery
77600-77615,Radiation Hyperthermia Treatment
77620-77620,Clinical Intracavitary Radiation Hyperthermia Treatment
77750-77799,Clinical Brachytherapy Radiation Treatment
78012-78999,Diagnostic Nuclear Medicine Procedures
79005-79999,Therapeutic Nuclear Medicine Procedures
80305-80307,Presumptive Drug Class Screening Procedures
80320-80377,Definitive Drug Testing Procedures
81105-81383,Tier 1 Molecular Pathology Procedures
81400-81408,Tier 2 Molecular Pathology Procedures
86000-86804,Qualitative or Semiquantitative Immunoassays
86805-86849,Tissue Typing Immunological Procedures
87003-87015,Inoculation and Concentration Procedures
87040-87158,Microbiology Culture and Typing Procedures
87164-87177,"Examination, Homogenization and concentration Procedures"
87181-87197,Antimicrobial Susceptibility Studies
87205-87210,Primary Source Smear Procedures
87220-87230,Tissue Examination and Culture Procedures
87250-87255,Virus Isolation Procedures
87260-87899,Infectious Agent Antigen Detection
87900-87999,Phenotype and Genotype-Infectious Agents
88000-88099,Postmortem Examination Procedures
88104-88140,"Fluid washings, Hybridization and Sex Chromatin Identification Procedures"
88141-88167,Cytopathology Screening Procedures
88172-88177,FNA Cytopathology Procedures
88182-88189,Flow Cytometry Procedures
88199-88199,Unlisted Cytopathology Procedure
90785-90785,Interactive Complexity Psychiatry Services and Procedures
90791-90899,Other Psychiatric Diagnostic Procedures
90935-90940,Hemodialysis Procedures
90945-90947,Miscellaneous Dialysis Services and Procedures
90951-90970,End-Stage Renal Disease Services
90989-90999,Other Dialysis Procedures
91010-91022,Upper Gastrointestinal Motility Studies
91030-91038,Gastroesophageal Reflux Test Studies
91040-91065,Esophageal Balloon Distension Study and Breath Test
91110-91122,"Gastrointestinal Imaging, Pressure Measurement and Manometric Studies"
91132-91133,Gastric Physiology Procedures
91200-91299,Other Diagnostic Gastroenterology Procedures
91304-91322,COVID-19 Vaccines/Toxoids
92002-92014,General Ophthalmological Services and Procedures
92015-92287,Special Ophthalmological Services and Procedures
92310-92326,Contact Lens Services
92340-92499,Spectacle Services (Including Prosthesis for Aphakia)
92499-92499,Other Ophthalmological Services or Procedures
92502-92504,Otolaryngologic and Binocular Microscopy Procedures
92507-92508,Treatment of Auditory Processing Disorder
92511-92519,"Nasopharyngoscopy, Nasal Study and Facial Nerve Study"
92520-92526,Otorhinolaryngologic Evaluation and Procedures
92531-92534,"Vestibular Function Tests, Without Electrical Recording"
92537-92549,"Vestibular Function Tests, With Recording (eg, ENG)"
92550-92597,Audiologic Function Tests
92601-92633,Evaluative and Therapeutic Otorhinolaryngologic Services
92640-92653,Special Diagnostic Otorhinolaryngologic Procedures
92700-92700,Other Otorhinolaryngological Service or Procedures
92920-92998,Therapeutic Cardiovascular Services and Procedures
93000-93153,Cardiography Procedures
93150-93153,Phrenic Nerve Stimulation System
93224-93278,Cardiovascular Monitoring Services
93279-93298,"Implantable, Insertable, and Wearable Cardiac Device Evaluations"
93303-93356,Echocardiography Procedures
93451-93598,Cardiac Catheterization Procedures
93600-93662,Intracardiac Electrophysiological Procedures/Studies
93668-93668,Peripheral Arterial Disease Rehabilitation
93701-93790,Non-invasive Physiologic Studies and Procedures
93792-93793,Home and Outpatient International Normalized Ratio (INR) Monitoring Services
93797-93799,Other Cardiovascular Procedures
93880-93895,Non-Invasive Cerebrovascular Arterial Studies
93922-93931,Non-Invasive Extremity Arterial Studies (Including Digits)
93970-93971,Non-Invasive Extremity Venous Studies (Including Digits)
93975-93981,Non-Invasive Visceral and Penile Vascular Studies
93985-93990,Non-Invasive Extremity Arterial-Venous Studies
93998-93998,Other Noninvasive Vascular Diagnostic Studies
94002-94005,Ventilator Management
94010-94799,Pulmonary Diagnostic Testing and Therapies
95004-95070,Allergy Testing Procedures
95076-95079,Ingestion Challenge Allergy and Clinical Immunology Testing Procedures
95115-95199,Allergen Immunotherapy Services and Procedures
95700-95811,Sleep Medicine Testing and Long-term EEG Procedures
95812-95830,Routine Electroencephalography (EEG) Procedures
95829-95836,Electrocorticography
95836-95857,Range of Motion Testing
95860-95872,Electromyography Procedures
95873-95887,Ischemic Muscle Testing Procedures and Guidance Procedures for Chemodenervation
95905-95913,Nerve Conduction Tests
95919-95924,Autonomic Function Testing Procedures
95925-95941,Evoked Potentials and Reflex Testing Procedures
95940-95941,Intraoperative Neurophysiology Procedures
95954-95726,Special EEG Testing Procedures
95970-95984,Neurostimulators Analysis-Programming Procedures
95990-95999,Other Neurology and Neuromuscular Procedures
96000-96004,Motion Analysis Procedures
96020-96020,Functional Brain Mapping
96105-96105,Assessment of Aphasia and Cognitive Performance Testing
96110-96113,Developmental and Behavioral Screening and Testing
96116-96146,Psychological and Neuropsychological Testing
96360-96361,Hydration Infusion
96365-96379,"Therapeutic, Prophylactic, and Diagnostic Injections and Infusions (Excludes Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration)"
96401-96549,Chemotherapy Administration and Other Highly Complex Drug or Highly Complex Biologic Agent Administration
97010-97039,Physical Medicine and Rehabilitation Modalities
97110-97546,Physical Medicine and Rehabilitation Therapeutic Procedures
97161-97164,Physical Therapy Evaluations
97165-97168,Occupational Therapy Evaluations
97169-97172,Athletic Training Evaluations
97550-97552,Caregiver Training Without the Patient Present
97597-97610,Active Wound Care Management
97750-97755,Physical Medicine and Rehabilitation Tests and Measurements
97760-97763,Orthotic Management and Training and Prosthetic Training
97799-97799,Other Physical Medicine and Rehabilitation Service or Procedures
97151-97152,Adaptive Behavior Assessment Procedures
97153-97158,Adaptive Behavior Treatment Procedures
98966-98968,Non-Face-to-Face Nonphysician Telephone Services
98970-98972,Online Digital Assessment and Management Service by Qualified Nonphysician Health Care Professional
98975-98978,Remote Therapeutic Monitoring Services
98980-98981,Remote Therapeutic Monitoring Treatment Management Services
99000-99091,Miscellaneous Medicine Services
99500-99600,Home Visit Services
99601-99602,Home Infusion Procedures and Services
99202-99205,New Patient
99211-99215,Established Patient
99221-99223,Initial Hospital Inpatient or Observation Care
99231-99233,Subsequent Hospital Inpatient or Observation Care
99234-99236,Hospital Inpatient or Observation Care Services (Including Admission and Discharge Services)
99238-99239,Hospital Inpatient or Observation Discharge Services
99242-99245,Office or Other Outpatient Consultations
99252-99255,Inpatient or Observation Consultations
99281-99285,New or Established Patient
99288-99288,Other Emergency Services
99304-99306,Initial Nursing Facility Care
99307-99310,Subsequent Nursing Facility Care
99315-99316,Nursing Facility Discharge Services
99341-99345,New Patient
99347-99350,Established Patient
99354-99357,Prolonged Service With Direct Patient Contact (Except with Office or Other Outpatient Services)
99358-99359,Prolonged Service on Date Other Than the Face-to-Face Evaluation and Management Service Without Direct Patient Contact
99360-99360,Standby Services
99415-99416,Prolonged Clinical Staff Services With Physician or Other Qualified Health Care Professional Supervision
99417-99418,Prolonged Service With or Without Direct Patient Contact on the Date of an Evaluation and Management Service
99366-99368,Medical Team Conferences
99381-99387,New Patient
99391-99397,Established Patient
99401-99429,Counseling Risk Factor Reduction and Behavior Change Intervention
99421-99423,Online Digital Evaluation and Management Service
99437-99443,Telephone Services
99446-99452,Interprofessional Telephone/Internet/Electronic Health Record Consultations
99453-99474,Digitally Stored Data Services/Remote Physiologic Monitoring
99457-99458,Remote Physiologic Monitoring Treatment Management Services
99450-99454,Basic Life and/or Disability Evaluation Services
99455-99459,Work Related or Medical Disability Evaluation Services
99466-99467,Pediatric Critical Care Patient Transport
99468-99476,Inpatient Neonatal and Pediatric Critical Care
99477-99480,Initial and Continuing Intensive Care Services
1 Code Description
2 10004-10021 Fine Needle Aspiration Biopsy Procedures
3 10030-11646 Surgical Procedures on the Skin, Subcutaneous and Accessory Structures
4 11719-11765 Surgical Procedures on the Nails
5 11770-11772 Surgical Procedures on the Pilonidal Cyst
6 11900-11983 Introduction or Removal Procedures on the Integumentary System
7 12001-16036 Surgical Repair (Closure) Procedures on the Integumentary System
8 17000-17999 Destruction Procedures on the Integumentary System
9 19000-19499 Surgical Procedures on the Breast
10 20100-20999 General Surgical Procedures on the Musculoskeletal System
11 21010-21499 Surgical Procedures on the Head
12 21501-21899 Surgical Procedures on the Neck (Soft Tissues) and Thorax
13 21920-21936 Surgical Procedures on the Back and Flank
14 22010-22899 Surgical Procedures on the Spine (Vertebral Column)
15 22900-22999 Surgical Procedures on the Abdomen
16 23000-23929 Surgical Procedures on the Shoulder
17 23930-24999 Surgical Procedures on the Humerus (Upper Arm) and Elbow
18 25000-25999 Surgical Procedures on the Forearm and Wrist
19 26010-26989 Surgical Procedures on the Hand and Fingers
20 26990-27299 Surgical Procedures on the Pelvis and Hip Joint
21 27301-27599 Surgical Procedures on the Femur (Thigh Region) and Knee Joint
22 27600-27899 Surgical Procedures on the Leg (Tibia and Fibula) and Ankle Joint
23 28001-28899 Surgical Procedures on the Foot and Toes
24 29000-29799 Application of Casts and Strapping
25 29800-29999 Endoscopy/Arthroscopy Procedures on the Musculoskeletal System
26 30000-30999 Surgical Procedures on the Nose
27 31000-31299 Surgical Procedures on the Accessory Sinuses
28 31300-31599 Surgical Procedures on the Larynx
29 31600-31899 Surgical Procedures on the Trachea and Bronchi
30 32035-32999 Surgical Procedures on the Lungs and Pleura
31 33016-33999 Surgical Procedures on the Heart and Pericardium
32 34001-37799 Surgical Procedures on Arteries and Veins
33 38100-38200 Surgical Procedures on the Spleen
34 38204-38232 General Surgical Procedures on the Hemic and Lymphatic Systems
35 38240-38243 Transplantation and Post-Transplantation Cellular Infusion Procedures on the Hemic and Lymphatic Systems
36 38300-38999 Surgical Procedures on the Lymph Nodes and Lymphatic Channels
37 39000-39499 Surgical Procedures on the Mediastinum
38 39501-39599 Surgical Procedures on the Diaphragm
39 40490-40799 Surgical Procedures on the Lips
40 40800-40899 Surgical Procedures on the Vestibule of Mouth
41 41000-41599 Surgical Procedures on the Tongue and Floor of Mouth
42 41800-41899 Surgical Procedures on the Dentoalveolar Structures
43 42000-42299 Surgical Procedures on the Palate and Uvula
44 42300-42699 Surgical Procedures on the Salivary Gland and Ducts
45 42700-42999 Surgical Procedures on the Pharynx, Adenoids, and Tonsils
46 43020-43499 Surgical Procedures on the Esophagus
47 43500-43999 Surgical Procedures on the Stomach
48 44005-44799 Surgical Procedures on the Intestines (Except Rectum)
49 44800-44899 Surgical Procedures on Meckel's Diverticulum and the Mesentery
50 44900-44979 Surgical Procedures on the Appendix
51 45000-45999 Surgical Procedures on the Colon and Rectum
52 46020-46999 Surgical Procedures on the Anus
53 47000-47399 Surgical Procedures on the Liver
54 47400-47999 Surgical Procedures on the Biliary Tract
55 48000-48999 Surgical Procedures on the Pancreas
56 49000-49999 Surgical Procedures on the Abdomen, Peritoneum, and Omentum
57 50010-50593 Surgical Procedures on the Kidney
58 50600-50980 Surgical Procedures on the Ureter
59 51020-52700 Surgical Procedures on the Bladder
60 53000-53899 Surgical Procedures on the Urethra
61 54000-54450 Surgical Procedures on the Penis
62 54500-54699 Surgical Procedures on the Testis
63 54700-54901 Surgical Procedures on the Epididymis
64 55000-55060 Surgical Procedures on the Tunica Vaginalis
65 55100-55180 Surgical Procedures on the Scrotum
66 55200-55400 Surgical Procedures on the Vas Deferens
67 55500-55559 Surgical Procedures on the Spermatic Cord
68 55600-55680 Surgical Procedures on the Seminal Vesicles
69 55700-55899 Surgical Procedures on the Prostate
70 56405-56821 Surgical Procedures on the Vulva, Perineum and Introitus
71 57000-57426 Surgical Procedures on the Vagina
72 57452-57800 Surgical Procedures on the Cervix Uteri
73 58100-58579 Surgical Procedures on the Corpus Uteri
74 58600-58770 Surgical Procedures on the Oviduct/Ovary
75 58800-58960 Surgical Procedures on the Ovary
76 58970-58999 Surgical Procedures for In Vitro Fertilization
77 58999-58999 Other Procedures on the Female Genital System
78 59000-59076 Antepartum and Fetal Invasive Services for Maternity Care and Delivery
79 59100-59160 Excision Procedures for Maternity Care and Delivery
80 59200-59200 Introduction Procedures for Maternity Care and Delivery
81 59300-59350 Repair Procedures for Maternity Care and Delivery
82 59400-59430 Vaginal Delivery, Antepartum and Postpartum Care Procedures
83 59510-59525 Cesarean Delivery Procedures
84 59610-59622 Delivery Procedures After Previous Cesarean Delivery
85 59812-59857 Abortion Procedures
86 59866-59899 Other Procedures for Maternity Care and Delivery
87 59000-59076 Antepartum and Fetal Invasive Services for Maternity Care and Delivery
88 59100-59160 Excision Procedures for Maternity Care and Delivery
89 59200-59200 Introduction Procedures for Maternity Care and Delivery
90 59300-59350 Repair Procedures for Maternity Care and Delivery
91 59400-59430 Vaginal Delivery, Antepartum and Postpartum Care Procedures
92 59510-59525 Cesarean Delivery Procedures
93 59610-59622 Delivery Procedures After Previous Cesarean Delivery
94 59812-59857 Abortion Procedures
95 59866-59899 Other Procedures for Maternity Care and Delivery
96 60000-60300 Surgical Procedures on the Thyroid Gland
97 60500-60699 Surgical Procedures on the Parathyroid, Thymus, Adrenal Glands, Pancreas, and Carotid Body
98 61000-62258 Surgical Procedures on the Skull, Meninges, and Brain
99 62263-63746 Surgical Procedures on the Spine and Spinal Cord
100 64400-64999 Surgical Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System
101 65091-65290 Surgical Procedures on the Eyeball
102 65400-66999 Surgical Procedures on the Anterior Segment of the Eye
103 67005-67299 Surgical Procedures on the Posterior Segment of the Eye
104 67311-67999 Surgical Procedures on the Ocular Adnexa
105 68020-68899 Surgical Procedures on the Conjunctiva
106 69000-69399 Surgical Procedures on the External Ear
107 69420-69799 Surgical Procedures on the Middle Ear
108 69801-69949 Surgical Procedures on the Inner Ear
109 69950-69979 Surgical Procedures on the Temporal Bone, Middle Fossa Approach
110 70010-70559 Diagnostic Radiology (Diagnostic Imaging) Procedures of the Head and Neck
111 71045-71555 Diagnostic Radiology (Diagnostic Imaging) Procedures of the Chest
112 72020-72295 Diagnostic Radiology (Diagnostic Imaging) Procedures of the Spine and Pelvis
113 73000-73225 Diagnostic Radiology (Diagnostic Imaging) Procedures of the Upper Extremities
114 73501-73725 Diagnostic Radiology (Diagnostic Imaging) Procedures of the Lower Extremities
115 74018-74190 Diagnostic Radiology (Diagnostic Imaging) Procedures of the Abdomen
116 74210-74363 Diagnostic Radiology (Diagnostic Imaging) Procedures of the Gastrointestinal Tract
117 74400-74485 Diagnostic Radiology (Diagnostic Imaging) Procedures of the Urinary Tract
118 74712-74775 Gynecological and Obstetrical Diagnostic Radiology (Diagnostic Imaging) Procedures
119 75557-75580 Diagnostic Radiology (Diagnostic Imaging) Procedures of the Heart
120 75600-75989 Diagnostic Radiology (Diagnostic Imaging) Procedures of the Vascular System
121 76000-76499 Other Diagnostic Radiology (Diagnostic Imaging) Related Procedures
122 76506-76536 Diagnostic Ultrasound Procedures of the Head and Neck
123 76604-76642 Diagnostic Ultrasound Procedures of the Chest
124 76700-76776 Diagnostic Ultrasound Procedures of the Abdomen and Retroperitoneum
125 76800-76800 Diagnostic Ultrasound Procedures of the Spinal Canal
126 76801-76857 Diagnostic Ultrasound Procedures of the Pelvis
127 76870-76873 Diagnostic Ultrasound Procedures of the Genitalia
128 76881-76886 Diagnostic Ultrasound Procedures of the Extremities
129 76932-76965 Ultrasonic Guidance Procedures
130 76975-76999 Other Diagnostic Ultrasound Procedures
131 77001-77003 Fluoroscopic Guidance
132 77011-77014 Computed Tomography Guidance
133 77021-77022 Magnetic Resonance Imaging Guidance
134 77261-77299 Clinical Treatment Planning (External and Internal Sources) for Radiation Treatment
135 77300-77370 Medical Radiation Physics, Dosimetry, Treatment Devices, and Special Services for Radiation Treatment
136 77371-77387 Stereotactic Radiation Treatment Delivery
137 77399-77399 Other Procedures
138 77401-77417 Radiation Treatment Delivery
139 77423-77425 Neutron Beam Treatment Delivery
140 77427-77499 Radiation Treatment Management
141 77520-77525 Proton Beam Radiation Treatment Delivery
142 77600-77615 Radiation Hyperthermia Treatment
143 77620-77620 Clinical Intracavitary Radiation Hyperthermia Treatment
144 77750-77799 Clinical Brachytherapy Radiation Treatment
145 78012-78999 Diagnostic Nuclear Medicine Procedures
146 79005-79999 Therapeutic Nuclear Medicine Procedures
147 80305-80307 Presumptive Drug Class Screening Procedures
148 80320-80377 Definitive Drug Testing Procedures
149 81105-81383 Tier 1 Molecular Pathology Procedures
150 81400-81408 Tier 2 Molecular Pathology Procedures
151 86000-86804 Qualitative or Semiquantitative Immunoassays
152 86805-86849 Tissue Typing Immunological Procedures
153 87003-87015 Inoculation and Concentration Procedures
154 87040-87158 Microbiology Culture and Typing Procedures
155 87164-87177 Examination, Homogenization and concentration Procedures
156 87181-87197 Antimicrobial Susceptibility Studies
157 87205-87210 Primary Source Smear Procedures
158 87220-87230 Tissue Examination and Culture Procedures
159 87250-87255 Virus Isolation Procedures
160 87260-87899 Infectious Agent Antigen Detection
161 87900-87999 Phenotype and Genotype-Infectious Agents
162 88000-88099 Postmortem Examination Procedures
163 88104-88140 Fluid washings, Hybridization and Sex Chromatin Identification Procedures
164 88141-88167 Cytopathology Screening Procedures
165 88172-88177 FNA Cytopathology Procedures
166 88182-88189 Flow Cytometry Procedures
167 88199-88199 Unlisted Cytopathology Procedure
168 90785-90785 Interactive Complexity Psychiatry Services and Procedures
169 90791-90899 Other Psychiatric Diagnostic Procedures
170 90935-90940 Hemodialysis Procedures
171 90945-90947 Miscellaneous Dialysis Services and Procedures
172 90951-90970 End-Stage Renal Disease Services
173 90989-90999 Other Dialysis Procedures
174 91010-91022 Upper Gastrointestinal Motility Studies
175 91030-91038 Gastroesophageal Reflux Test Studies
176 91040-91065 Esophageal Balloon Distension Study and Breath Test
177 91110-91122 Gastrointestinal Imaging, Pressure Measurement and Manometric Studies
178 91132-91133 Gastric Physiology Procedures
179 91200-91299 Other Diagnostic Gastroenterology Procedures
180 91304-91322 COVID-19 Vaccines/Toxoids
181 92002-92014 General Ophthalmological Services and Procedures
182 92015-92287 Special Ophthalmological Services and Procedures
183 92310-92326 Contact Lens Services
184 92340-92499 Spectacle Services (Including Prosthesis for Aphakia)
185 92499-92499 Other Ophthalmological Services or Procedures
186 92502-92504 Otolaryngologic and Binocular Microscopy Procedures
187 92507-92508 Treatment of Auditory Processing Disorder
188 92511-92519 Nasopharyngoscopy, Nasal Study and Facial Nerve Study
189 92520-92526 Otorhinolaryngologic Evaluation and Procedures
190 92531-92534 Vestibular Function Tests, Without Electrical Recording
191 92537-92549 Vestibular Function Tests, With Recording (eg, ENG)
192 92550-92597 Audiologic Function Tests
193 92601-92633 Evaluative and Therapeutic Otorhinolaryngologic Services
194 92640-92653 Special Diagnostic Otorhinolaryngologic Procedures
195 92700-92700 Other Otorhinolaryngological Service or Procedures
196 92920-92998 Therapeutic Cardiovascular Services and Procedures
197 93000-93153 Cardiography Procedures
198 93150-93153 Phrenic Nerve Stimulation System
199 93224-93278 Cardiovascular Monitoring Services
200 93279-93298 Implantable, Insertable, and Wearable Cardiac Device Evaluations
201 93303-93356 Echocardiography Procedures
202 93451-93598 Cardiac Catheterization Procedures
203 93600-93662 Intracardiac Electrophysiological Procedures/Studies
204 93668-93668 Peripheral Arterial Disease Rehabilitation
205 93701-93790 Non-invasive Physiologic Studies and Procedures
206 93792-93793 Home and Outpatient International Normalized Ratio (INR) Monitoring Services
207 93797-93799 Other Cardiovascular Procedures
208 93880-93895 Non-Invasive Cerebrovascular Arterial Studies
209 93922-93931 Non-Invasive Extremity Arterial Studies (Including Digits)
210 93970-93971 Non-Invasive Extremity Venous Studies (Including Digits)
211 93975-93981 Non-Invasive Visceral and Penile Vascular Studies
212 93985-93990 Non-Invasive Extremity Arterial-Venous Studies
213 93998-93998 Other Noninvasive Vascular Diagnostic Studies
214 94002-94005 Ventilator Management
215 94010-94799 Pulmonary Diagnostic Testing and Therapies
216 95004-95070 Allergy Testing Procedures
217 95076-95079 Ingestion Challenge Allergy and Clinical Immunology Testing Procedures
218 95115-95199 Allergen Immunotherapy Services and Procedures
219 95700-95811 Sleep Medicine Testing and Long-term EEG Procedures
220 95812-95830 Routine Electroencephalography (EEG) Procedures
221 95829-95836 Electrocorticography
222 95836-95857 Range of Motion Testing
223 95860-95872 Electromyography Procedures
224 95873-95887 Ischemic Muscle Testing Procedures and Guidance Procedures for Chemodenervation
225 95905-95913 Nerve Conduction Tests
226 95919-95924 Autonomic Function Testing Procedures
227 95925-95941 Evoked Potentials and Reflex Testing Procedures
228 95940-95941 Intraoperative Neurophysiology Procedures
229 95954-95726 Special EEG Testing Procedures
230 95970-95984 Neurostimulators Analysis-Programming Procedures
231 95990-95999 Other Neurology and Neuromuscular Procedures
232 96000-96004 Motion Analysis Procedures
233 96020-96020 Functional Brain Mapping
234 96105-96105 Assessment of Aphasia and Cognitive Performance Testing
235 96110-96113 Developmental and Behavioral Screening and Testing
236 96116-96146 Psychological and Neuropsychological Testing
237 96360-96361 Hydration Infusion
238 96365-96379 Therapeutic, Prophylactic, and Diagnostic Injections and Infusions (Excludes Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration)
239 96401-96549 Chemotherapy Administration and Other Highly Complex Drug or Highly Complex Biologic Agent Administration
240 97010-97039 Physical Medicine and Rehabilitation Modalities
241 97110-97546 Physical Medicine and Rehabilitation Therapeutic Procedures
242 97161-97164 Physical Therapy Evaluations
243 97165-97168 Occupational Therapy Evaluations
244 97169-97172 Athletic Training Evaluations
245 97550-97552 Caregiver Training Without the Patient Present
246 97597-97610 Active Wound Care Management
247 97750-97755 Physical Medicine and Rehabilitation Tests and Measurements
248 97760-97763 Orthotic Management and Training and Prosthetic Training
249 97799-97799 Other Physical Medicine and Rehabilitation Service or Procedures
250 97151-97152 Adaptive Behavior Assessment Procedures
251 97153-97158 Adaptive Behavior Treatment Procedures
252 98966-98968 Non-Face-to-Face Nonphysician Telephone Services
253 98970-98972 Online Digital Assessment and Management Service by Qualified Nonphysician Health Care Professional
254 98975-98978 Remote Therapeutic Monitoring Services
255 98980-98981 Remote Therapeutic Monitoring Treatment Management Services
256 99000-99091 Miscellaneous Medicine Services
257 99500-99600 Home Visit Services
258 99601-99602 Home Infusion Procedures and Services
259 99202-99205 New Patient
260 99211-99215 Established Patient
261 99221-99223 Initial Hospital Inpatient or Observation Care
262 99231-99233 Subsequent Hospital Inpatient or Observation Care
263 99234-99236 Hospital Inpatient or Observation Care Services (Including Admission and Discharge Services)
264 99238-99239 Hospital Inpatient or Observation Discharge Services
265 99242-99245 Office or Other Outpatient Consultations
266 99252-99255 Inpatient or Observation Consultations
267 99281-99285 New or Established Patient
268 99288-99288 Other Emergency Services
269 99304-99306 Initial Nursing Facility Care
270 99307-99310 Subsequent Nursing Facility Care
271 99315-99316 Nursing Facility Discharge Services
272 99341-99345 New Patient
273 99347-99350 Established Patient
274 99354-99357 Prolonged Service With Direct Patient Contact (Except with Office or Other Outpatient Services)
275 99358-99359 Prolonged Service on Date Other Than the Face-to-Face Evaluation and Management Service Without Direct Patient Contact
276 99360-99360 Standby Services
277 99415-99416 Prolonged Clinical Staff Services With Physician or Other Qualified Health Care Professional Supervision
278 99417-99418 Prolonged Service With or Without Direct Patient Contact on the Date of an Evaluation and Management Service
279 99366-99368 Medical Team Conferences
280 99381-99387 New Patient
281 99391-99397 Established Patient
282 99401-99429 Counseling Risk Factor Reduction and Behavior Change Intervention
283 99421-99423 Online Digital Evaluation and Management Service
284 99437-99443 Telephone Services
285 99446-99452 Interprofessional Telephone/Internet/Electronic Health Record Consultations
286 99453-99474 Digitally Stored Data Services/Remote Physiologic Monitoring
287 99457-99458 Remote Physiologic Monitoring Treatment Management Services
288 99450-99454 Basic Life and/or Disability Evaluation Services
289 99455-99459 Work Related or Medical Disability Evaluation Services
290 99466-99467 Pediatric Critical Care Patient Transport
291 99468-99476 Inpatient Neonatal and Pediatric Critical Care
292 99477-99480 Initial and Continuing Intensive Care Services
File diff suppressed because it is too large Load Diff
@@ -0,0 +1,33 @@
Code,Description
A0021-A0999,Ambulance and Other Transport Services and Supplies
A2001-A2025,"Matrix for Wound Management (Placental, Equine, Synthetic)"
A4100-A4100,Skin Substitute Device
A4206-A8004,Medical And Surgical Supplies
A9150-A9999,"Administrative, Miscellaneous and Investigational"
B4034-B9999,Enteral and Parenteral Therapy
C1052-C1062,Other Therapeutic Procedures
C1600-C1604,"Surgical, Imaging Devices and Grafts"
C1713-C9899,Outpatient PPS
E0100-E8002,Durable Medical Equipment
G0008-G9987,Procedures / Professional Services
H0001-H2037,Alcohol and Drug Abuse Treatment
J0120-J8999,Drugs Administered Other than Oral Method
J9000-J9999,Chemotherapy Drugs
K0001-K0900,Durable medical equipment (DME) Medicare administrative contractors (MACs)
K1001-K1036,"Components, Accessories and Supplies"
L0112-L4631,Orthotic Procedures and services
L5000-L9900,Prosthetic Procedures
M0001-M0005,MIPS Value Pathways
M0010-M0010,EOM (Enhancing Oncology Model) Enhanced Services
M0075-M0301,Miscellaneous Medical Services
M1003-M1070,Screening Procedures
M1106-M1143,Episode of Care
M1146-M1370,Other Services
P2028-P9615,Pathology and Laboratory Services
Q0035-Q9992,Temporary Codes
R0070-R0076,Diagnostic Radiology Services
S0012-S9999,Temporary National Codes (Non-Medicare)
T1000-T5999,National Codes Established for State Medicaid Agencies
U0001-U0005,Coronavirus Diagnostic Panel
V2020-V2799,Vision Services
V5008-V5364,Hearing Services
1 Code Description
2 A0021-A0999 Ambulance and Other Transport Services and Supplies
3 A2001-A2025 Matrix for Wound Management (Placental, Equine, Synthetic)
4 A4100-A4100 Skin Substitute Device
5 A4206-A8004 Medical And Surgical Supplies
6 A9150-A9999 Administrative, Miscellaneous and Investigational
7 B4034-B9999 Enteral and Parenteral Therapy
8 C1052-C1062 Other Therapeutic Procedures
9 C1600-C1604 Surgical, Imaging Devices and Grafts
10 C1713-C9899 Outpatient PPS
11 E0100-E8002 Durable Medical Equipment
12 G0008-G9987 Procedures / Professional Services
13 H0001-H2037 Alcohol and Drug Abuse Treatment
14 J0120-J8999 Drugs Administered Other than Oral Method
15 J9000-J9999 Chemotherapy Drugs
16 K0001-K0900 Durable medical equipment (DME) Medicare administrative contractors (MACs)
17 K1001-K1036 Components, Accessories and Supplies
18 L0112-L4631 Orthotic Procedures and services
19 L5000-L9900 Prosthetic Procedures
20 M0001-M0005 MIPS Value Pathways
21 M0010-M0010 EOM (Enhancing Oncology Model) Enhanced Services
22 M0075-M0301 Miscellaneous Medical Services
23 M1003-M1070 Screening Procedures
24 M1106-M1143 Episode of Care
25 M1146-M1370 Other Services
26 P2028-P9615 Pathology and Laboratory Services
27 Q0035-Q9992 Temporary Codes
28 R0070-R0076 Diagnostic Radiology Services
29 S0012-S9999 Temporary National Codes (Non-Medicare)
30 T1000-T5999 National Codes Established for State Medicaid Agencies
31 U0001-U0005 Coronavirus Diagnostic Panel
32 V2020-V2799 Vision Services
33 V5008-V5364 Hearing Services
@@ -0,0 +1,414 @@
Code,Description
A6590-A6591,External Urinary Catheters (Disposable and Non-Disposable)
A4206-A4232,Injection and Infusion Supplies
A4233-A4239,Replacement Batteries
A4244-A4290,Other Supplies Including Diabetes Supplies and Contraceptives
A4300-A4306,Access Catheters and Drug Delivery Systems
A4310-A4360,Incontinence Devices and Supplies
A4361-A4437,Ostomy Pouches and Supplies
A4450-A4608,Various Medical Supplies Including Tapes and Surgical Dressings
A4611-A4629,Respiratory Supplies and Equipment
A4630-A4640,Replacement Parts
A4641-A4642,Diagnostic Radiopharmaceuticals
A4648-A4652,Other Supplies
A4653-A4932,Dialysis Equipment and Supplies
A5051-A5093,Ostomy Pouches and Supplies
A5102-A5200,Incontinence Devices and Supplies
A5500-A5514,Diabetic Footwear
A6000-A6208,Miscellaneous Dressing and Wound Supplies
A6209-A6215,Foam Dressings
A6216-A6233,Gauze Dressings
A6234-A6241,Hydrocolloid Dressings
A6242-A6248,Hydrogel Dressings
A6250-A6412,"Other Dressings, Coverings, and Wound Treatment Supplies"
A6413-A6461,Bandages
A6501-A6610,Compression Garments and Stockings
A7000-A7049,Breathing Aids
A7501-A7527,Tracheostoma Supplies
A8000-A8004,Helmets
A9150-A9300,Miscellaneous Supplies and Equipment
A9500-A9800,Diagnostic and Therapeutic Radiopharmaceuticals
A9900-A9999,Miscellaneous DME Supplies and Services
B4034-B4088,Enteral Feeding Supplies and Equipment
B4100-B4162,Enteral Formulas and Additives
B4164-B5200,Parenteral Solutions and Supplies
B9002-B9999,"Nutrition Infusion Pumps and Supplies Not Otherwise Classified, NOC"
C1713-C1715,Assorted Devices and Supplies
C1716-C1719,Brachytherapy Sources
C1721-C1722,Cardioverter-defibrillators
C1724-C1759,Catheters for Multiple Applications
C1760-C2615,"Assorted Devices, Implants, and Systems"
C2616-C2616,Brachytherapy Sources
C2617-C2631,Assorted Cardiovascular and Genitourinary Devices
C2634-C2699,Brachytherapy Sources
C5271-C5278,Skin Substitute Graft Application
C7500-C7561,Miscellaneous Surgical Procedures
C7900-C7903,Mental Health Evaluation and Management Services
C8900-C8920,"Magnetic Resonance Angiography, Trunk and Lower Extremities"
C8921-C8930,Transesophageal/Transthoracic Echocardiography
C8931-C8936,"Magnetic Resonance Angiography, Spine and Upper Extremities"
C8937-C8937,Breast MRI - Computer Aided Detection
C8957-C9488,"Miscellaneous Drugs, Biologicals, and Supplies"
C9507-C9507,Fresh Frozen Plasma-Covid-19
C9600-C9608,Percutaneous Transcatheter/Transluminal Coronary Procedures
C9725-C9899,Other Therapeutic Services and Supplies
E0100-E0159,Walking Aids and Attachments
E0160-E0162,Sitz Bath/Equipment
E0163-E0175,Commode Chair and Supplies
E0181-E0199,"Pressure Mattresses, Pads, and Other Supplies"
E0200-E0239,"Heat, Cold, and Light Therapies"
E0240-E0249,Bathing Supplies
E0250-E0373,Hospital Beds and Associated Supplies
E0424-E0493,Oxygen Delivery Systems and Related Supplies
E0500-E0500,Intermittent Positive Pressure Breathing Devices
E0530-E0530,Electronic Positional Obstructive Sleep Apnea Treatment
E0550-E0601,Humidifiers and Nebulizers with Related Equipment
E0602-E0604,Breast Pumps
E0605-E0606,Other Breathing Aids
E0607-E0620,Monitoring Equipment
E0621-E0642,Patient Lifts and Support Systems
E0650-E0677,Pneumatic Compressors and Appliances
E0678-E0682,Non Pneumatic Compressors and Appliances
E0691-E0694,ULTRAVIOLET LIGHT THERAPY SYSTEMS
E0700-E0711,Safety Devices
E0720-E0770,Stimulation Devices
E0776-E0791,Infusion Pumps and Supplies
E0830-E0948,Traction and Other Orthopedic Devices
E0950-E1036,Wheelchair Accessories
E1037-E1039,Transport Chairs
E1050-E1070,Fully Reclining Wheelchairs
E1083-E1086,Hemi-Wheelchairs
E1087-E1090,"Lightweight, High-strength Wheelchairs"
E1092-E1093,"Heavy Duty, Wide Wheelchairs"
E1100-E1110,Semi-reclining Wheelchairs
E1130-E1161,Standard Wheelchairs
E1170-E1200,Amputee Wheelchairs
E1220-E1228,Other Wheelchairs and Accessories
E1229-E1239,Pediatric Wheelchairs
E1240-E1270,Lightweight Wheelchairs
E1280-E1298,Heavy Duty and Special Wheelchairs
E1300-E1310,Whirlpool Baths
E1352-E1406,Accessories for Oxygen Delivery Devices
E1500-E1699,Dialysis Systems and Accessories
E1700-E1702,Jaw Motion Rehabilitation Systems
E1800-E1841,Extension/Flexion Rehabilitation Devices
E1902-E1902,Communication Boards
E2000-E2120,Miscellaneous Pumps and Monitors
E1905-E1905,Virtual Reality Cognitive Behavioral Therapy Device (CBT)
E2201-E2295,Manual Wheelchair Accessories
E2300-E2398,Power Wheelchair Accessories
E2402-E2402,Wound Therapy Pumps
E2500-E2599,"Speech Generating Devices, Software, and Accessories"
E2601-E2625,Wheelchair Seat and Back Cushions
E2626-E2633,Wheelchair Mobile Arm Supports
E3000-E3000,Speech Volume Modulation System
E8000-E8002,Pediatric Gait Trainers
G0008-G0010,Vaccine Administration
G0011-G0024,"Psychotherapy, Pre-Exposure Prophylaxis Counseling and Community Health Integration Services"
G0027-G0027,Analysis of Semen Specimen
G0028-G0067,MIPS Measures
G0068-G0070,Professional Services for Drug Infusion
G0071-G0071,Telemed Services
G0076-G0087,Home Care Management Services
G0088-G0090,Initial Visit for Professional Services
G0101-G0124,Screening Examinations and Disease Management Training
G0127-G0372,Miscellaneous Diagnostic and Therapeutic Services
G0378-G0384,Hospital Observation and Emergency Services
G0390-G0390,Other Emergency Services
G0396-G0397,Alcohol and Substance Abuse Assessments
G0398-G0400,"Sleep Studies, In Home"
G0402-G0405,Initial Services for Medicare Enrollment
G0406-G0408,Followup Telehealth Consultations
G0409-G0411,Psychological Services
G0412-G0415,Fracture Treatment
G0416-G0416,"Gross and Microscopic Examinations, Prostate Biopsy"
G0420-G0421,Face-to-Face Educational Services
G0422-G0424,Cardiac and Pulmonary Rehabilitation Services
G0425-G0427,Initial Telehealth Consultations
G0428-G0429,Filler Procedures
G0432-G0435,Laboratory Screening Tests
G0438-G0451,"Counseling, Screening, and Prevention Services"
G0452-G0465,Miscellaneous Services
G0466-G0470,Federally Qualified Health Center (FQHC) Visits
G0471-G0659,Other Services
G0913-G0918,Quality Measures for Cataract Surgery
G1001-G1028,Clinical Decision Support Mechanism (CDSM)
G2000-G2000,Convulsive Therapy Procedure
G2001-G2020,Other Evaluation and Management Services
G2021-G2025,Care Management Services
G2066-G2066,Cardiac Device Evaluation
G2067-G2075,Medication Assisted Treatment Programme
G2076-G2081,Opioid Use Disorder - Evaluation and Treatment
G2082-G2083,Evaluation and Management Services
G2086-G2088,Opioid Use Disorder - Treatment (Office Based)
G2090-G2152,Functional Status
G2167-G2167,Performance Measures
G2168-G2169,Therapy Maintenance Program in Home Health Setting
G2172-G2172,Opioid Use Disorder (OUD) Treatment Services
G2173-G2210,Clinician Documentation and Management Services
G2211-G2214,Evaluation and Care Management Services
G2215-G2216,Take Home Supplies
G2250-G2250,Documentation assessment (Remote)
G2251-G2252,Brief Communication Technology-Based Services
G3002-G3003,Chronic Pain Management And Treatment Services
G4000-G4038,MIPS Specialty Set
G6001-G6017,Radiation Therapy Services
G8395-G8635,Additional Quality Measures
G8647-G8670,Quality Measures Related for Risk-adjusted Functional Status Scoring
G8694-G8970,More Quality Measures
G9001-G9012,MCCD (Medicare Coordinated Care Demonstration)
G9013-G9140,Medicare Demonstration Projects
G9143-G9143,Warfarin Responsiveness Testing
G9147-G9147,Outpatient Intravenous Insulin Treatment
G9148-G9153,Primary Care Quality Measures
G9156-G9156,Provider Assessment for Wheelchair
G9157-G9157,Diagnostic Cardiac Doppler Ultrasound
G9187-G9187,Bundled Payment Care
G9188-G9893,Additional Assorted Quality Measures
G9894-G9897,Radiology services Prostate
G9898-G9898,Geriatric care Management
G9899-G9900,Breast screening/diagnostics/Therapeutics
G9901-G9901,Additional Geriatric care Management
G9902-G9909,Tobacco Screening
G9910-G9910,Other Geriatric care Management
G9911-G9911,Breast screening (Therapeutics)
G9912-G9915,Anti TNF Diagnostics for HBV status
G9916-G9918,Functional Status codes
G9919-G9932,Screening
G9938-G9940,Geriatric Care Management and Other Services
G9942-G9949,Pain assessment
G9954-G9961,Medications (Antiemetics and Antimicrobials)
G9962-G9963,Embolization
G9964-G9970,"Screening, Wellness and Physician visits"
G9974-G9975,Vision Assessment
G9978-G9987,Remote In-House Evaluation And Management Assessment
G9988-G9999,Palliative Care Services
H0001-H0030,"Drug, Alcohol, and Behavioral Health Services"
H0031-H0040,Mental Health Programs and Medication Administration Training
H0041-H0042,Foster Care
H0043-H0044,Supported Housing
H0045-H0050,Miscellaneous Drug and Alcohol Services
H1000-H1011,Prenatal Care and Family Planning Assessment
H2000-H2041,Other Mental Health and Community Support Services
J0120-J7175,"Drugs, Administered by Injection"
J7177-J7214,Clotting Factors
J7294-J7307,Contraceptive Systems
J7308-J7402,Miscellaneous Drugs
J7500-J7599,Immunosuppressive Drugs
J7604-J7686,Inhalation Solutions
J7699-J8499,"Drugs, Not Otherwise Classified"
J8501-J8999,"Chemotherapy Drugs, Oral Administration"
K0001-K0195,"Wheelchairs, Components, and Accessories"
K0455-K0605,INFUSION PUMPS AND SUPPLIES
K0606-K0609,Automated External Defibrillator and Supplies
K0669-K0746,Miscellaneous DME and Accessories
K0800-K0812,Power Operated Vehicles
K0813-K0899,"Wheelchairs, Power Operated"
K0900-K0900,"Customized DME, Other Than Wheelchair"
L0112-L0174,Cervical Orthotics
L0180-L0200,Cervical Orthotics Multi-post Collar
L0220-L0220,Thoracic Rib Belts
L0450-L0492,Thoracic-lumbar-sacral (TLSO) Orthotics
L0621-L0624,Sacral Orthotics
L0625-L0627,Lumbar Orthotics
L0628-L0640,Lumbar-sacral Orthotics
L0641-L0642,Lumbar Orthotics Sagittal Control
L0643-L0651,Lumbar-sacral Orthotics Sagittal Control
L0700-L0710,Cervical-thoracic-lumbar-sacral Orthotics
L0810-L0861,Cervical Halo Procedures
L0970-L0999,Accessories for Spinal Orthotics
L1000-L1120,Scoliosis Orthotic Devices
L1200-L1290,"Low-profile Additions, Thoracic-lumbar-sacral Orthotics"
L1300-L1499,Other Scoliosis and Spinal Orthotics and Procedures
L1600-L1690,Hip Orthotics
L1700-L1755,Legg Perthes Orthotics
L1810-L1860,Knee Orthotics
L1900-L1990,Ankle-foot Orthotics
L2000-L2038,Knee-ankle-foot Orthotics
L2040-L2090,Hip-knee-ankle-foot Orthotics
L2106-L2116,Ankle-foot Orthotics
L2126-L2136,Knee-ankle-foot Orthotics
L2180-L2192,"Additions, Lower Extremity, Fracture Orthotics"
L2200-L2397,"Additions, Lower Extremity Orthotics"
L2405-L2492,Orthotic Additions to Knee Joints
L2500-L2550,"Additions, Weight-bearing, Lower Extremities"
L2570-L2680,"Additions, Pelvic and/or Thoracic Control, Lower Extremities"
L2750-L2999,Other Lower Extremity Additions
L3000-L3031,"Foot Inserts, Removable"
L3040-L3090,Foot Arch Supports
L3100-L3170,Repositioning Foot Orthotics
L3201-L3207,Orthopedic Shoes
L3208-L3211,Surgical Boots
L3212-L3214,Benesch Boots
L3215-L3265,Other Orthopedic Footwear
L3300-L3334,Shoe Lifts
L3340-L3420,Shoe Wedges
L3430-L3485,Shoe Heels
L3500-L3595,Other Orthopedic Shoe Additions
L3600-L3649,Orthosis Transfers
L3650-L3678,Shoulder Orthotics
L3702-L3762,Elbow Orthotics
L3763-L3766,Elbow-wrist-hand Orthotics
L3806-L3904,Wrist-hand-finger Orthotics
L3905-L3908,Wrist-hand Orthotics
L3912-L3956,"Additional Miscellaneous Orthotics, Upper Extremities"
L3960-L3973,Shoulder-elbow-wrist-hand Orthotics
L3975-L3978,Shoulder-elbow-wrist-hand-finger Orthotics
L3980-L3999,"Fracture, Addition, and Unspecified Orthotics, Upper Extremities"
L4000-L4210,Orthotic Replacement Parts or Repair
L4350-L4631,Other Lower Extremity Orthotics
L5000-L5020,Partial Foot Prosthetics
L5050-L5060,Ankle Prosthetics
L5100-L5105,Below the Knee Prosthetics
L5150-L5160,Knee Disarticulation Prosthetics
L5200-L5230,Above the Knee Prosthetics
L5250-L5270,Hip Disarticulation Prosthetics
L5280-L5341,"Endoskeletal Prosthetics, Lower Limbs"
L5400-L5460,"Prosthetic Fitting, Immediate Postsurgical or Early, Lower Limbs"
L5500-L5505,"Supply, Initial Prosthesis"
L5510-L5600,"Supply, Preparatory Prosthesis"
L5610-L5617,"Endoskeletal Prosthetic Additions, Lower Extremities"
L5618-L5628,"Test Socket Prosthetic Additions, Lower Extremities"
L5629-L5653,Various Prosthetic Sockets
L5654-L5699,"Socket Insert, Suspensions, and Other Prosthetic Additions"
L5700-L5703,Replacement Sockets
L5704-L5707,Custom-shaped Protective Covers
L5710-L5780,Exoskeletal Knee-shin System Additions
L5781-L5782,"Vacuum Pumps, Lower Limb Prosthetic Additions"
L5785-L5795,Other Exoskeletal Additions
L5810-L5966,Endoskeletal Knee or Hip System Additions
L5968-L5999,Ankle and/or Foot Prosthetics and Additions
L6000-L6026,Partial Hand Prosthetics
L6050-L6055,"Wrist Disarticulation, Hand Prosthetics"
L6100-L6130,"Below Elbow, Forearm and Hand Prosthetics"
L6200-L6205,"Elbow Disarticulation, Forearm and Hand Prosthetics"
L6250-L6250,"Above Elbow, Forearm and Hand Prosthetics"
L6300-L6320,"Shoulder Disarticulation, Arm and Hand Prosthetics"
L6350-L6370,"Interscapular Thoracic, Arm, and Hand Prosthetics"
L6380-L6388,"Prosthetic Fitting, Immediate Postsurgical or Early, Upper Limbs"
L6400-L6570,"Molded Socket Endoskeletal Prosthetic System, Upper Limbs"
L6580-L6590,"Preparatory Prosthetic, Upper Limbs"
L6600-L6698,Upper Extremity Prosthetic Additions
L6703-L6882,Terminal Devices and Additions
L6883-L6885,"Replacement Sockets, Upper Limbs"
L6890-L6915,Hand Restoration Prosthetics and Additions
L6920-L6975,External Power Upper Limb Prosthetics
L7007-L7045,Electric Hand or Hook and Additions
L7170-L7259,Electronic Elbow and Additions
L7360-L7368,Batteries and Accessories
L7400-L7405,Additions for Upper Extremity Prosthetics
L7499-L7499,"Upper Extremity Prosthetics, Not Otherwise Specified (NOS)"
L7510-L7520,Prosthetic Repair
L7600-L7600,Prosthetic Donning Sleeve
L7700-L7700,Gasket or Seal with Prosthetic
L7900-L7902,Penile Prosthetics
L8000-L8039,Breast Prosthetics and Accessories
L8040-L8049,Facial and External Ear Prosthetics
L8300-L8330,Hernia Trusses
L8400-L8485,"Prosthetic Sheaths, Socks, and Shrinkers"
L8499-L8499,Unlisted Prosthetic Procedures
L8500-L8515,Voice Prosthetics and Accessories
L8600-L8600,Prosthetic Breast Implant
L8603-L8607,Bulking Agents
L8608-L8629,Implantable Eye and Ear Prosthetics and Accessories
L8630-L8659,Implantable Hand and Feet Prosthetics
L8670-L8670,Vascular Implants
L8678-L8689,Implantable Neurostimulators and Components
L8690-L9900,Miscellaneous Orthotic and Prosthetic Services and Supplies
M1003-M1005,TB Screening
M1006-M1014,Evaluation AND Assessment
M1016-M1018,Patient Status
M1019-M1026,"Adolescent Depression, Remission AND Management"
M1027-M1031,Head Imaging
M1032-M1036,Pharmacotherapy for OUD
M1037-M1041,Lumbar Spine Associated Conditions
M1043-M1049,Functional STATUS Measurement
M1051-M1051,Lumbar Spine Conditions
M1052-M1052,Limb Pain Assessment
M1054-M1054,Urgent Care Visit
M1055-M1057,Anticoagulation Management
M1058-M1060,Performance Assessment
M1067-M1067,Hospice Services
M1068-M1068,Mobility Status
M1069-M1070,Fall Risk Assessment
P2028-P2038,Laboratory Tests of Blood and Hair
P3000-P3001,Pap Smears
P7001-P7001,Urine Bacterial Culture and Sensitivity Studies
P9010-P9100,"Blood and Blood Products, with Associated Procedures"
P9603-P9604,"Specimen Collection, Travel Allowance"
P9612-P9615,"Specimen Collection, Catheterization"
Q0035-Q0144,Miscellaneous Drugs and Tests
Q0161-Q0181,Chemotherapy Anti-emetic Medications
Q0220-Q0249,COVID-19 Infusion Therapy
Q0477-Q0509,Ventricular Assist Devices
Q0510-Q0514,Pharmacy Supply and Dispensing Fees
Q0515-Q2028,Miscellaneous Drug and New Technology Codes
Q2034-Q2039,Influenza Virus Vaccines
Q2041-Q3031,Other Drugs and Service Fees
Q4001-Q4051,Cast and Splint Supplies
Q4074-Q4082,Miscellaneous Drugs
Q4100-Q4304,Skin Substitutes and Biologicals
Q5001-Q5010,Hospice and Home Health Care
Q5101-Q5101,Additional Miscellaneous Drugs
Q5103-Q5111,Anti-Inflammatory Medication and Chemotherapy Medication
Q5112-Q5132,Cancer and Vision Associated Drugs
Q9001-Q9004,Assessment and Couseling-Department of Veterans Affairs Chaplain Services
Q9950-Q9983,Contrast Agents/Diagnostic Imaging
Q9991-Q9992,Other Drugs and Test
S0012-S0197,Non-Medicare Drug Codes
S0199-S0400,Miscellaneous Provider Services
S0500-S0596,Vision Supplies
S0601-S0622,Screenings and Examinations
S0630-S3722,Miscellaneous Provider Services and Supplies
S3800-S3870,Genetic Testing
S3900-S3904,Miscellaneous Tests
S4005-S4989,ASSORTED OBSTETRICAL AND FERTILITY SERVICES
S4990-S5014,Miscellaneous Medications and Therapeutic Substances
S5035-S5199,Various Home Care Services
S5497-S5523,Home Infusion Therapy
S5550-S5571,Insulin and Delivery Devices
S8030-S8092,Imaging Studies
S8096-S8210,Assisted Breathing Supplies
S8265-S9152,Miscellaneous Supplies and Services
S9208-S9214,Home Management of Pregnancy
S9325-S9379,Home Infusion Therapy
S9381-S9485,Miscellaneous Supplies and Services
S9490-S9810,Home Therapy Services
S9900-S9999,"Various Services, Fees, and Costs"
T1000-T1005,Nursing Services
T1006-T1012,Alcohol and Substance Abuse Services
T1013-T1018,Other Services
T1019-T1022,Home Health Services
T1023-T1029,"Screenings, Assessments, and Treatments, Individual and Family"
T1030-T1031,Additional Nursing Services
T1032-T1033,Doula Birth Worker Services
T1040-T1041,Behavioral Health Services
T1502-T1999,Miscellaneous Services and Supplies
T2001-T2007,Transportation Services
T2010-T2011,Preadmission Screening
T2012-T2041,Waiver Services
T2042-T2046,Hospice Care
T2047-T2047,Prevocational Habilitation Waiver Services
T2048-T2048,Long-term Residential Care
T2049-T2049,Non-emergency Transportation Fees
T2050-T2051,"Financial Management and Supports Brokerage Services, Per Diem"
T2101-T2101,Services Related to Breast Milk
T4521-T4545,Incontinence Supplies
T5001-T5999,Other and Unspecified Supplies
V2020-V2025,Spectacle Frames
V2100-V2199,"Lenses, Single Vision"
V2200-V2299,"Lenses, Bifocals"
V2300-V2399,"Lenses, Trifocal"
V2410-V2499,"Lenses, Aspherical and Variable Sphericity"
V2500-V2599,Assorted Contact Lenses
V2600-V2615,Low and Near Vision Aids
V2623-V2629,Eye Prosthetics and Services
V2630-V2632,"Lenses, Intraocular"
V2700-V2799,Vision Services
V5008-V5020,Hearing Assessments and Evaluations
V5030-V5060,"Hearing Aid, Monaural"
V5070-V5110,Miscellaneous Hearing Services and Supplies
V5120-V5267,Hearing Aids
V5268-V5290,Assistive Hearing Devices
V5298-V5299,Other and Miscellaneous Hearing Services and Supplies
V5336-V5364,Speech-related Screenings and Communication Device Repair
1 Code Description
2 A6590-A6591 External Urinary Catheters (Disposable and Non-Disposable)
3 A4206-A4232 Injection and Infusion Supplies
4 A4233-A4239 Replacement Batteries
5 A4244-A4290 Other Supplies Including Diabetes Supplies and Contraceptives
6 A4300-A4306 Access Catheters and Drug Delivery Systems
7 A4310-A4360 Incontinence Devices and Supplies
8 A4361-A4437 Ostomy Pouches and Supplies
9 A4450-A4608 Various Medical Supplies Including Tapes and Surgical Dressings
10 A4611-A4629 Respiratory Supplies and Equipment
11 A4630-A4640 Replacement Parts
12 A4641-A4642 Diagnostic Radiopharmaceuticals
13 A4648-A4652 Other Supplies
14 A4653-A4932 Dialysis Equipment and Supplies
15 A5051-A5093 Ostomy Pouches and Supplies
16 A5102-A5200 Incontinence Devices and Supplies
17 A5500-A5514 Diabetic Footwear
18 A6000-A6208 Miscellaneous Dressing and Wound Supplies
19 A6209-A6215 Foam Dressings
20 A6216-A6233 Gauze Dressings
21 A6234-A6241 Hydrocolloid Dressings
22 A6242-A6248 Hydrogel Dressings
23 A6250-A6412 Other Dressings, Coverings, and Wound Treatment Supplies
24 A6413-A6461 Bandages
25 A6501-A6610 Compression Garments and Stockings
26 A7000-A7049 Breathing Aids
27 A7501-A7527 Tracheostoma Supplies
28 A8000-A8004 Helmets
29 A9150-A9300 Miscellaneous Supplies and Equipment
30 A9500-A9800 Diagnostic and Therapeutic Radiopharmaceuticals
31 A9900-A9999 Miscellaneous DME Supplies and Services
32 B4034-B4088 Enteral Feeding Supplies and Equipment
33 B4100-B4162 Enteral Formulas and Additives
34 B4164-B5200 Parenteral Solutions and Supplies
35 B9002-B9999 Nutrition Infusion Pumps and Supplies Not Otherwise Classified, NOC
36 C1713-C1715 Assorted Devices and Supplies
37 C1716-C1719 Brachytherapy Sources
38 C1721-C1722 Cardioverter-defibrillators
39 C1724-C1759 Catheters for Multiple Applications
40 C1760-C2615 Assorted Devices, Implants, and Systems
41 C2616-C2616 Brachytherapy Sources
42 C2617-C2631 Assorted Cardiovascular and Genitourinary Devices
43 C2634-C2699 Brachytherapy Sources
44 C5271-C5278 Skin Substitute Graft Application
45 C7500-C7561 Miscellaneous Surgical Procedures
46 C7900-C7903 Mental Health Evaluation and Management Services
47 C8900-C8920 Magnetic Resonance Angiography, Trunk and Lower Extremities
48 C8921-C8930 Transesophageal/Transthoracic Echocardiography
49 C8931-C8936 Magnetic Resonance Angiography, Spine and Upper Extremities
50 C8937-C8937 Breast MRI - Computer Aided Detection
51 C8957-C9488 Miscellaneous Drugs, Biologicals, and Supplies
52 C9507-C9507 Fresh Frozen Plasma-Covid-19
53 C9600-C9608 Percutaneous Transcatheter/Transluminal Coronary Procedures
54 C9725-C9899 Other Therapeutic Services and Supplies
55 E0100-E0159 Walking Aids and Attachments
56 E0160-E0162 Sitz Bath/Equipment
57 E0163-E0175 Commode Chair and Supplies
58 E0181-E0199 Pressure Mattresses, Pads, and Other Supplies
59 E0200-E0239 Heat, Cold, and Light Therapies
60 E0240-E0249 Bathing Supplies
61 E0250-E0373 Hospital Beds and Associated Supplies
62 E0424-E0493 Oxygen Delivery Systems and Related Supplies
63 E0500-E0500 Intermittent Positive Pressure Breathing Devices
64 E0530-E0530 Electronic Positional Obstructive Sleep Apnea Treatment
65 E0550-E0601 Humidifiers and Nebulizers with Related Equipment
66 E0602-E0604 Breast Pumps
67 E0605-E0606 Other Breathing Aids
68 E0607-E0620 Monitoring Equipment
69 E0621-E0642 Patient Lifts and Support Systems
70 E0650-E0677 Pneumatic Compressors and Appliances
71 E0678-E0682 Non Pneumatic Compressors and Appliances
72 E0691-E0694 ULTRAVIOLET LIGHT THERAPY SYSTEMS
73 E0700-E0711 Safety Devices
74 E0720-E0770 Stimulation Devices
75 E0776-E0791 Infusion Pumps and Supplies
76 E0830-E0948 Traction and Other Orthopedic Devices
77 E0950-E1036 Wheelchair Accessories
78 E1037-E1039 Transport Chairs
79 E1050-E1070 Fully Reclining Wheelchairs
80 E1083-E1086 Hemi-Wheelchairs
81 E1087-E1090 Lightweight, High-strength Wheelchairs
82 E1092-E1093 Heavy Duty, Wide Wheelchairs
83 E1100-E1110 Semi-reclining Wheelchairs
84 E1130-E1161 Standard Wheelchairs
85 E1170-E1200 Amputee Wheelchairs
86 E1220-E1228 Other Wheelchairs and Accessories
87 E1229-E1239 Pediatric Wheelchairs
88 E1240-E1270 Lightweight Wheelchairs
89 E1280-E1298 Heavy Duty and Special Wheelchairs
90 E1300-E1310 Whirlpool Baths
91 E1352-E1406 Accessories for Oxygen Delivery Devices
92 E1500-E1699 Dialysis Systems and Accessories
93 E1700-E1702 Jaw Motion Rehabilitation Systems
94 E1800-E1841 Extension/Flexion Rehabilitation Devices
95 E1902-E1902 Communication Boards
96 E2000-E2120 Miscellaneous Pumps and Monitors
97 E1905-E1905 Virtual Reality Cognitive Behavioral Therapy Device (CBT)
98 E2201-E2295 Manual Wheelchair Accessories
99 E2300-E2398 Power Wheelchair Accessories
100 E2402-E2402 Wound Therapy Pumps
101 E2500-E2599 Speech Generating Devices, Software, and Accessories
102 E2601-E2625 Wheelchair Seat and Back Cushions
103 E2626-E2633 Wheelchair Mobile Arm Supports
104 E3000-E3000 Speech Volume Modulation System
105 E8000-E8002 Pediatric Gait Trainers
106 G0008-G0010 Vaccine Administration
107 G0011-G0024 Psychotherapy, Pre-Exposure Prophylaxis Counseling and Community Health Integration Services
108 G0027-G0027 Analysis of Semen Specimen
109 G0028-G0067 MIPS Measures
110 G0068-G0070 Professional Services for Drug Infusion
111 G0071-G0071 Telemed Services
112 G0076-G0087 Home Care Management Services
113 G0088-G0090 Initial Visit for Professional Services
114 G0101-G0124 Screening Examinations and Disease Management Training
115 G0127-G0372 Miscellaneous Diagnostic and Therapeutic Services
116 G0378-G0384 Hospital Observation and Emergency Services
117 G0390-G0390 Other Emergency Services
118 G0396-G0397 Alcohol and Substance Abuse Assessments
119 G0398-G0400 Sleep Studies, In Home
120 G0402-G0405 Initial Services for Medicare Enrollment
121 G0406-G0408 Followup Telehealth Consultations
122 G0409-G0411 Psychological Services
123 G0412-G0415 Fracture Treatment
124 G0416-G0416 Gross and Microscopic Examinations, Prostate Biopsy
125 G0420-G0421 Face-to-Face Educational Services
126 G0422-G0424 Cardiac and Pulmonary Rehabilitation Services
127 G0425-G0427 Initial Telehealth Consultations
128 G0428-G0429 Filler Procedures
129 G0432-G0435 Laboratory Screening Tests
130 G0438-G0451 Counseling, Screening, and Prevention Services
131 G0452-G0465 Miscellaneous Services
132 G0466-G0470 Federally Qualified Health Center (FQHC) Visits
133 G0471-G0659 Other Services
134 G0913-G0918 Quality Measures for Cataract Surgery
135 G1001-G1028 Clinical Decision Support Mechanism (CDSM)
136 G2000-G2000 Convulsive Therapy Procedure
137 G2001-G2020 Other Evaluation and Management Services
138 G2021-G2025 Care Management Services
139 G2066-G2066 Cardiac Device Evaluation
140 G2067-G2075 Medication Assisted Treatment Programme
141 G2076-G2081 Opioid Use Disorder - Evaluation and Treatment
142 G2082-G2083 Evaluation and Management Services
143 G2086-G2088 Opioid Use Disorder - Treatment (Office Based)
144 G2090-G2152 Functional Status
145 G2167-G2167 Performance Measures
146 G2168-G2169 Therapy Maintenance Program in Home Health Setting
147 G2172-G2172 Opioid Use Disorder (OUD) Treatment Services
148 G2173-G2210 Clinician Documentation and Management Services
149 G2211-G2214 Evaluation and Care Management Services
150 G2215-G2216 Take Home Supplies
151 G2250-G2250 Documentation assessment (Remote)
152 G2251-G2252 Brief Communication Technology-Based Services
153 G3002-G3003 Chronic Pain Management And Treatment Services
154 G4000-G4038 MIPS Specialty Set
155 G6001-G6017 Radiation Therapy Services
156 G8395-G8635 Additional Quality Measures
157 G8647-G8670 Quality Measures Related for Risk-adjusted Functional Status Scoring
158 G8694-G8970 More Quality Measures
159 G9001-G9012 MCCD (Medicare Coordinated Care Demonstration)
160 G9013-G9140 Medicare Demonstration Projects
161 G9143-G9143 Warfarin Responsiveness Testing
162 G9147-G9147 Outpatient Intravenous Insulin Treatment
163 G9148-G9153 Primary Care Quality Measures
164 G9156-G9156 Provider Assessment for Wheelchair
165 G9157-G9157 Diagnostic Cardiac Doppler Ultrasound
166 G9187-G9187 Bundled Payment Care
167 G9188-G9893 Additional Assorted Quality Measures
168 G9894-G9897 Radiology services Prostate
169 G9898-G9898 Geriatric care Management
170 G9899-G9900 Breast screening/diagnostics/Therapeutics
171 G9901-G9901 Additional Geriatric care Management
172 G9902-G9909 Tobacco Screening
173 G9910-G9910 Other Geriatric care Management
174 G9911-G9911 Breast screening (Therapeutics)
175 G9912-G9915 Anti TNF Diagnostics for HBV status
176 G9916-G9918 Functional Status codes
177 G9919-G9932 Screening
178 G9938-G9940 Geriatric Care Management and Other Services
179 G9942-G9949 Pain assessment
180 G9954-G9961 Medications (Antiemetics and Antimicrobials)
181 G9962-G9963 Embolization
182 G9964-G9970 Screening, Wellness and Physician visits
183 G9974-G9975 Vision Assessment
184 G9978-G9987 Remote In-House Evaluation And Management Assessment
185 G9988-G9999 Palliative Care Services
186 H0001-H0030 Drug, Alcohol, and Behavioral Health Services
187 H0031-H0040 Mental Health Programs and Medication Administration Training
188 H0041-H0042 Foster Care
189 H0043-H0044 Supported Housing
190 H0045-H0050 Miscellaneous Drug and Alcohol Services
191 H1000-H1011 Prenatal Care and Family Planning Assessment
192 H2000-H2041 Other Mental Health and Community Support Services
193 J0120-J7175 Drugs, Administered by Injection
194 J7177-J7214 Clotting Factors
195 J7294-J7307 Contraceptive Systems
196 J7308-J7402 Miscellaneous Drugs
197 J7500-J7599 Immunosuppressive Drugs
198 J7604-J7686 Inhalation Solutions
199 J7699-J8499 Drugs, Not Otherwise Classified
200 J8501-J8999 Chemotherapy Drugs, Oral Administration
201 K0001-K0195 Wheelchairs, Components, and Accessories
202 K0455-K0605 INFUSION PUMPS AND SUPPLIES
203 K0606-K0609 Automated External Defibrillator and Supplies
204 K0669-K0746 Miscellaneous DME and Accessories
205 K0800-K0812 Power Operated Vehicles
206 K0813-K0899 Wheelchairs, Power Operated
207 K0900-K0900 Customized DME, Other Than Wheelchair
208 L0112-L0174 Cervical Orthotics
209 L0180-L0200 Cervical Orthotics Multi-post Collar
210 L0220-L0220 Thoracic Rib Belts
211 L0450-L0492 Thoracic-lumbar-sacral (TLSO) Orthotics
212 L0621-L0624 Sacral Orthotics
213 L0625-L0627 Lumbar Orthotics
214 L0628-L0640 Lumbar-sacral Orthotics
215 L0641-L0642 Lumbar Orthotics Sagittal Control
216 L0643-L0651 Lumbar-sacral Orthotics Sagittal Control
217 L0700-L0710 Cervical-thoracic-lumbar-sacral Orthotics
218 L0810-L0861 Cervical Halo Procedures
219 L0970-L0999 Accessories for Spinal Orthotics
220 L1000-L1120 Scoliosis Orthotic Devices
221 L1200-L1290 Low-profile Additions, Thoracic-lumbar-sacral Orthotics
222 L1300-L1499 Other Scoliosis and Spinal Orthotics and Procedures
223 L1600-L1690 Hip Orthotics
224 L1700-L1755 Legg Perthes Orthotics
225 L1810-L1860 Knee Orthotics
226 L1900-L1990 Ankle-foot Orthotics
227 L2000-L2038 Knee-ankle-foot Orthotics
228 L2040-L2090 Hip-knee-ankle-foot Orthotics
229 L2106-L2116 Ankle-foot Orthotics
230 L2126-L2136 Knee-ankle-foot Orthotics
231 L2180-L2192 Additions, Lower Extremity, Fracture Orthotics
232 L2200-L2397 Additions, Lower Extremity Orthotics
233 L2405-L2492 Orthotic Additions to Knee Joints
234 L2500-L2550 Additions, Weight-bearing, Lower Extremities
235 L2570-L2680 Additions, Pelvic and/or Thoracic Control, Lower Extremities
236 L2750-L2999 Other Lower Extremity Additions
237 L3000-L3031 Foot Inserts, Removable
238 L3040-L3090 Foot Arch Supports
239 L3100-L3170 Repositioning Foot Orthotics
240 L3201-L3207 Orthopedic Shoes
241 L3208-L3211 Surgical Boots
242 L3212-L3214 Benesch Boots
243 L3215-L3265 Other Orthopedic Footwear
244 L3300-L3334 Shoe Lifts
245 L3340-L3420 Shoe Wedges
246 L3430-L3485 Shoe Heels
247 L3500-L3595 Other Orthopedic Shoe Additions
248 L3600-L3649 Orthosis Transfers
249 L3650-L3678 Shoulder Orthotics
250 L3702-L3762 Elbow Orthotics
251 L3763-L3766 Elbow-wrist-hand Orthotics
252 L3806-L3904 Wrist-hand-finger Orthotics
253 L3905-L3908 Wrist-hand Orthotics
254 L3912-L3956 Additional Miscellaneous Orthotics, Upper Extremities
255 L3960-L3973 Shoulder-elbow-wrist-hand Orthotics
256 L3975-L3978 Shoulder-elbow-wrist-hand-finger Orthotics
257 L3980-L3999 Fracture, Addition, and Unspecified Orthotics, Upper Extremities
258 L4000-L4210 Orthotic Replacement Parts or Repair
259 L4350-L4631 Other Lower Extremity Orthotics
260 L5000-L5020 Partial Foot Prosthetics
261 L5050-L5060 Ankle Prosthetics
262 L5100-L5105 Below the Knee Prosthetics
263 L5150-L5160 Knee Disarticulation Prosthetics
264 L5200-L5230 Above the Knee Prosthetics
265 L5250-L5270 Hip Disarticulation Prosthetics
266 L5280-L5341 Endoskeletal Prosthetics, Lower Limbs
267 L5400-L5460 Prosthetic Fitting, Immediate Postsurgical or Early, Lower Limbs
268 L5500-L5505 Supply, Initial Prosthesis
269 L5510-L5600 Supply, Preparatory Prosthesis
270 L5610-L5617 Endoskeletal Prosthetic Additions, Lower Extremities
271 L5618-L5628 Test Socket Prosthetic Additions, Lower Extremities
272 L5629-L5653 Various Prosthetic Sockets
273 L5654-L5699 Socket Insert, Suspensions, and Other Prosthetic Additions
274 L5700-L5703 Replacement Sockets
275 L5704-L5707 Custom-shaped Protective Covers
276 L5710-L5780 Exoskeletal Knee-shin System Additions
277 L5781-L5782 Vacuum Pumps, Lower Limb Prosthetic Additions
278 L5785-L5795 Other Exoskeletal Additions
279 L5810-L5966 Endoskeletal Knee or Hip System Additions
280 L5968-L5999 Ankle and/or Foot Prosthetics and Additions
281 L6000-L6026 Partial Hand Prosthetics
282 L6050-L6055 Wrist Disarticulation, Hand Prosthetics
283 L6100-L6130 Below Elbow, Forearm and Hand Prosthetics
284 L6200-L6205 Elbow Disarticulation, Forearm and Hand Prosthetics
285 L6250-L6250 Above Elbow, Forearm and Hand Prosthetics
286 L6300-L6320 Shoulder Disarticulation, Arm and Hand Prosthetics
287 L6350-L6370 Interscapular Thoracic, Arm, and Hand Prosthetics
288 L6380-L6388 Prosthetic Fitting, Immediate Postsurgical or Early, Upper Limbs
289 L6400-L6570 Molded Socket Endoskeletal Prosthetic System, Upper Limbs
290 L6580-L6590 Preparatory Prosthetic, Upper Limbs
291 L6600-L6698 Upper Extremity Prosthetic Additions
292 L6703-L6882 Terminal Devices and Additions
293 L6883-L6885 Replacement Sockets, Upper Limbs
294 L6890-L6915 Hand Restoration Prosthetics and Additions
295 L6920-L6975 External Power Upper Limb Prosthetics
296 L7007-L7045 Electric Hand or Hook and Additions
297 L7170-L7259 Electronic Elbow and Additions
298 L7360-L7368 Batteries and Accessories
299 L7400-L7405 Additions for Upper Extremity Prosthetics
300 L7499-L7499 Upper Extremity Prosthetics, Not Otherwise Specified (NOS)
301 L7510-L7520 Prosthetic Repair
302 L7600-L7600 Prosthetic Donning Sleeve
303 L7700-L7700 Gasket or Seal with Prosthetic
304 L7900-L7902 Penile Prosthetics
305 L8000-L8039 Breast Prosthetics and Accessories
306 L8040-L8049 Facial and External Ear Prosthetics
307 L8300-L8330 Hernia Trusses
308 L8400-L8485 Prosthetic Sheaths, Socks, and Shrinkers
309 L8499-L8499 Unlisted Prosthetic Procedures
310 L8500-L8515 Voice Prosthetics and Accessories
311 L8600-L8600 Prosthetic Breast Implant
312 L8603-L8607 Bulking Agents
313 L8608-L8629 Implantable Eye and Ear Prosthetics and Accessories
314 L8630-L8659 Implantable Hand and Feet Prosthetics
315 L8670-L8670 Vascular Implants
316 L8678-L8689 Implantable Neurostimulators and Components
317 L8690-L9900 Miscellaneous Orthotic and Prosthetic Services and Supplies
318 M1003-M1005 TB Screening
319 M1006-M1014 Evaluation AND Assessment
320 M1016-M1018 Patient Status
321 M1019-M1026 Adolescent Depression, Remission AND Management
322 M1027-M1031 Head Imaging
323 M1032-M1036 Pharmacotherapy for OUD
324 M1037-M1041 Lumbar Spine Associated Conditions
325 M1043-M1049 Functional STATUS Measurement
326 M1051-M1051 Lumbar Spine Conditions
327 M1052-M1052 Limb Pain Assessment
328 M1054-M1054 Urgent Care Visit
329 M1055-M1057 Anticoagulation Management
330 M1058-M1060 Performance Assessment
331 M1067-M1067 Hospice Services
332 M1068-M1068 Mobility Status
333 M1069-M1070 Fall Risk Assessment
334 P2028-P2038 Laboratory Tests of Blood and Hair
335 P3000-P3001 Pap Smears
336 P7001-P7001 Urine Bacterial Culture and Sensitivity Studies
337 P9010-P9100 Blood and Blood Products, with Associated Procedures
338 P9603-P9604 Specimen Collection, Travel Allowance
339 P9612-P9615 Specimen Collection, Catheterization
340 Q0035-Q0144 Miscellaneous Drugs and Tests
341 Q0161-Q0181 Chemotherapy Anti-emetic Medications
342 Q0220-Q0249 COVID-19 Infusion Therapy
343 Q0477-Q0509 Ventricular Assist Devices
344 Q0510-Q0514 Pharmacy Supply and Dispensing Fees
345 Q0515-Q2028 Miscellaneous Drug and New Technology Codes
346 Q2034-Q2039 Influenza Virus Vaccines
347 Q2041-Q3031 Other Drugs and Service Fees
348 Q4001-Q4051 Cast and Splint Supplies
349 Q4074-Q4082 Miscellaneous Drugs
350 Q4100-Q4304 Skin Substitutes and Biologicals
351 Q5001-Q5010 Hospice and Home Health Care
352 Q5101-Q5101 Additional Miscellaneous Drugs
353 Q5103-Q5111 Anti-Inflammatory Medication and Chemotherapy Medication
354 Q5112-Q5132 Cancer and Vision Associated Drugs
355 Q9001-Q9004 Assessment and Couseling-Department of Veterans Affairs Chaplain Services
356 Q9950-Q9983 Contrast Agents/Diagnostic Imaging
357 Q9991-Q9992 Other Drugs and Test
358 S0012-S0197 Non-Medicare Drug Codes
359 S0199-S0400 Miscellaneous Provider Services
360 S0500-S0596 Vision Supplies
361 S0601-S0622 Screenings and Examinations
362 S0630-S3722 Miscellaneous Provider Services and Supplies
363 S3800-S3870 Genetic Testing
364 S3900-S3904 Miscellaneous Tests
365 S4005-S4989 ASSORTED OBSTETRICAL AND FERTILITY SERVICES
366 S4990-S5014 Miscellaneous Medications and Therapeutic Substances
367 S5035-S5199 Various Home Care Services
368 S5497-S5523 Home Infusion Therapy
369 S5550-S5571 Insulin and Delivery Devices
370 S8030-S8092 Imaging Studies
371 S8096-S8210 Assisted Breathing Supplies
372 S8265-S9152 Miscellaneous Supplies and Services
373 S9208-S9214 Home Management of Pregnancy
374 S9325-S9379 Home Infusion Therapy
375 S9381-S9485 Miscellaneous Supplies and Services
376 S9490-S9810 Home Therapy Services
377 S9900-S9999 Various Services, Fees, and Costs
378 T1000-T1005 Nursing Services
379 T1006-T1012 Alcohol and Substance Abuse Services
380 T1013-T1018 Other Services
381 T1019-T1022 Home Health Services
382 T1023-T1029 Screenings, Assessments, and Treatments, Individual and Family
383 T1030-T1031 Additional Nursing Services
384 T1032-T1033 Doula Birth Worker Services
385 T1040-T1041 Behavioral Health Services
386 T1502-T1999 Miscellaneous Services and Supplies
387 T2001-T2007 Transportation Services
388 T2010-T2011 Preadmission Screening
389 T2012-T2041 Waiver Services
390 T2042-T2046 Hospice Care
391 T2047-T2047 Prevocational Habilitation Waiver Services
392 T2048-T2048 Long-term Residential Care
393 T2049-T2049 Non-emergency Transportation Fees
394 T2050-T2051 Financial Management and Supports Brokerage Services, Per Diem
395 T2101-T2101 Services Related to Breast Milk
396 T4521-T4545 Incontinence Supplies
397 T5001-T5999 Other and Unspecified Supplies
398 V2020-V2025 Spectacle Frames
399 V2100-V2199 Lenses, Single Vision
400 V2200-V2299 Lenses, Bifocals
401 V2300-V2399 Lenses, Trifocal
402 V2410-V2499 Lenses, Aspherical and Variable Sphericity
403 V2500-V2599 Assorted Contact Lenses
404 V2600-V2615 Low and Near Vision Aids
405 V2623-V2629 Eye Prosthetics and Services
406 V2630-V2632 Lenses, Intraocular
407 V2700-V2799 Vision Services
408 V5008-V5020 Hearing Assessments and Evaluations
409 V5030-V5060 Hearing Aid, Monaural
410 V5070-V5110 Miscellaneous Hearing Services and Supplies
411 V5120-V5267 Hearing Aids
412 V5268-V5290 Assistive Hearing Devices
413 V5298-V5299 Other and Miscellaneous Hearing Services and Supplies
414 V5336-V5364 Speech-related Screenings and Communication Device Repair
@@ -0,0 +1,520 @@
Code,Description
0001,Total Charge
0022,Health Insurance - Prospective Payment System (HIPPS) - Skilled Nursing Facility - PPS
0023,Health Insurance - Prospective Payment System (HIPPS) - Home Health - PPS
0024,Health Insurance - Prospective Payment System (HIPPS) - Inpatient Rehab Facility - PPS
0100,All inclusive Rate - All-Inclusive room and board plus ancillary
0101,All inclusive Rate - All-Inclusive room and board
0110,Room & Board - Private (One Bed) - General Classification
0111,Room & Board - Private (One Bed) - Medical/Surgical/GYN
0112,Room & Board - Private (One Bed) - Obstetrics (OB)
0113,Room & Board - Private (One Bed) - Pediatric
0114,Room & Board - Private (One Bed) - Psychiatric
0115,Room & Board - Private (One Bed) - Hospice
0116,Room & Board - Private (One Bed) - Detoxification
0117,Room & Board - Private (One Bed) - Oncology
0118,Room & Board - Private (One Bed) - Rehabilitation
0119,Room & Board - Private (One Bed) - Other
0120,Room & Board - Semi-private (Two Beds) - General Classification
0121,Room & Board - Semi-private (Two Beds) - Medical/Surgical/GYN
0122,Room & Board - Semi-private (Two Beds) - Obstetrics (OB)
0123,Room & Board - Semi-private (Two Beds) - Pediatric
0124,Room & Board - Semi-private (Two Beds) - Psychiatric
0125,Room & Board - Semi-private (Two Beds) - Hospice
0126,Room & Board - Semi-private (Two Beds) - Detoxification
0127,Room & Board - Semi-private (Two Beds) - Oncology
0128,Room & Board - Semi-private (Two Beds) - Rehabilitation
0129,Room & Board - Semi-private (Two Beds) - Other
0130,Room & Board - Three and Four Beds - General Classification
0131,Room & Board - Three and Four Beds - Medical/Surgical/GYN
0132,Room & Board - Three and Four Beds - Obstetrics (OB)
0133,Room & Board - Three and Four Beds - Pediatric
0134,Room & Board - Three and Four Beds - Psychiatric
0135,Room & Board - Three and Four Beds - Hospice
0136,Room & Board - Three and Four Beds - Detoxification
0137,Room & Board - Three and Four Beds - Oncology
0138,Room & Board - Three and Four Beds - Rehabilitation
0139,Room & Board - Three and Four Beds - Other
0140,Room & Board - Deluxe Private - General Classification
0141,Room & Board - Deluxe Private - Medical/Surgical/GYN
0142,Room & Board - Deluxe Private - Obstetrics (OB)
0143,Room & Board - Deluxe Private - Pediatric
0144,Room & Board - Deluxe Private - Psychiatric
0145,Room & Board - Deluxe Private - Hospice
0146,Room & Board - Deluxe Private - Detoxification
0147,Room & Board - Deluxe Private - Oncology
0148,Room & Board - Deluxe Private - Rehabilitation
0149,Room & Board - Deluxe Private - Other
0150,Room & Board - Ward - General Classification
0151,Room & Board - Ward - Medical/Surgical/GYN
0152,Room & Board - Ward - Obstetrics (OB)
0153,Room & Board - Ward - Pediatric
0154,Room & Board - Ward - Psychiatric
0155,Room & Board - Ward - Hospice
0156,Room & Board - Ward - Detoxification
0157,Room & Board - Ward - Oncology
0158,Room & Board - Ward - Rehabilitation
0159,Room & Board - Ward - Other
0160,Room & Board - Other - General Classification
0164,Room & Board - Other - Sterile Environment
0167,Room & Board - Other - Self Care
0169,Room & Board - Other - Other
0170,Nursery - General Classification
0171,Nursery - Newborn - Level I
0172,Nursery - Newborn - Level II
0173,Nursery - Newborn - Level III
0174,Nursery - Newborn - Level IV
0179,Nursery - Other Nursery
0180,Leave of Absence - General Classification
0182,Leave of Absence - Patient Convenience
0183,Leave of Absence - Therapeutic Leave
0185,Leave of Absence - Nursing Home (for Hospitalization)
0189,Leave of Absence - Other LOA
0190,Subacute Care - General Classification
0191,Subacute Care - Level I
0192,Subacute Care - Level II
0193,Subacute Care - Level III
0194,Subacute Care - Level IV
0199,Subacute Care - Other Subacute Care
0200,Intensive Care Unit - General Classification
0201,Intensive Care Unit - Surgical
0202,Intensive Care Unit - Medical
0203,Intensive Care Unit - Pediatric
0204,Intensive Care Unit - Psychiatric
0206,Intensive Care Unit - Intermediate ICU
0207,Intensive Care Unit - Burn Care
0208,Intensive Care Unit - Trauma
0209,Intensive Care Unit - Other Intensive Care
0210,Coronary Care Unit - General Classification
0211,Coronary Care Unit - Myocardial Infarction
0212,Coronary Care Unit - Pulmonary Care
0213,Coronary Care Unit - Heart Transplant
0214,Coronary Care Unit - Intermediate CCU
0219,Coronary Care Unit - Other Coronary CCU
0220,Special Charges - General Classification
0221,Special Charges - Admission Charges
0222,Special Charges - Technical Support Charge
0223,Special Charges - U.R. Service Charge
0224,"Special Charges - Late Discharge, Medically Necessary"
0229,Special Charges - Other Special Charges
0230,Incremental Nursing Charge - General Classification
0231,Incremental Nursing Charge - Nursery
0232,Incremental Nursing Charge - OB
0233,Incremental Nursing Charge - ICU
0234,Incremental Nursing Charge - CCU
0235,Incremental Nursing Charge - Hospice
0239,Incremental Nursing Charge - Other
0240,All Inclusive Ancillary - General Classification
0241,All Inclusive Ancillary - Basic
0242,All Inclusive Ancillary - Comprehensive
0243,All Inclusive Ancillary - Specialty
0249,All Inclusive Ancillary - Other All Inclusive Ancillary
0250,Pharmacy - General Classification
0251,Pharmacy - Generic Drugs
0252,Pharmacy - Non-Generic Drugs
0253,Pharmacy - Take Home Drugs
0254,Pharmacy - Drugs Incident to Other Diagnostic Services
0255,Pharmacy - Drugs Incident to Radiology
0256,Pharmacy - Experimental Drugs
0257,Pharmacy - Non-Prescription
0258,Pharmacy - IV Solutions
0259,Pharmacy - Other Pharmacy
0260,IV Therapy - General Classification
0261,IV Therapy - Infusion Pump
0262,IV Therapy - IV Therapy/Pharmacy Svcs
0263,IV Therapy - IV Therapy/Drug/Supply Delivery
0264,IV Therapy - IV Therapy/Supplies
0269,IV Therapy - Other IV Therapy
0270,Medical/Surgical Supplies and Devices - General Classification
0271,Medical/Surgical Supplies and Devices - Non-sterile Supply
0272,Medical/Surgical Supplies and Devices - Sterile Supply
0273,Medical/Surgical Supplies and Devices - Take Home Supplies
0274,Medical/Surgical Supplies and Devices - Prosthetic/Orthotic Devices
0275,Medical/Surgical Supplies and Devices - Pacemaker
0276,Medical/Surgical Supplies and Devices - Intraocular Lens
0277,Medical/Surgical Supplies and Devices - Oxygen - Take Home
0278,Medical/Surgical Supplies and Devices - Other Implant
0279,Medical/Surgical Supplies and Devices - Other Supplies/Devices
0280,Oncology - General Classification
0289,Oncology - Other Oncology
0290,Durable Medical Equipment (other than renal) - General Classification
0291,Durable Medical Equipment (other than renal) - Rental
0292,Durable Medical Equipment (other than renal) - Purchase of New DME
0293,Durable Medical Equipment (other than renal) - Purchase of Used DME
0294,Durable Medical Equipment (other than renal) - Supplies/Drugs for DME
0299,Durable Medical Equipment (other than renal) - Other Equipment
0300,Laboratory - General Classification
0301,Laboratory - Chemistry
0302,Laboratory - Immunology
0303,Laboratory - Renal Patient (Home)
0304,Laboratory - Non-Routine Dialysis
0305,Laboratory - Hematology
0306,Laboratory - Bacteriology & Microbiology
0307,Laboratory - Urology
0309,Laboratory - Other Laboratory
0310,Laboratory Pathology - General Classification
0311,Laboratory Pathology - Cytology
0312,Laboratory Pathology - Histology
0314,Laboratory Pathology - Biopsy
0319,Laboratory Pathology - Other Laboratory Pathology
0320,Radiology - Diagnostic - General Classification
0321,Radiology - Diagnostic - Angiocardiology
0322,Radiology - Diagnostic - Arthrography
0323,Radiology - Diagnostic - Arteriography
0324,Radiology - Diagnostic - Chest X-Ray
0329,Radiology - Diagnostic - Other Radiology - Diagnostic
0330,Radiology - Therapeutic and/or Chemotherapy Administration - General Classification
0331,Radiology - Therapeutic and/or Chemotherapy Administration - Chemotherapy Admin - Injected
0332,Radiology - Therapeutic and/or Chemotherapy Administration - Chemotherapy Admin - Oral
0333,Radiology - Therapeutic and/or Chemotherapy Administration - Radiation Therapy
0335,Radiology - Therapeutic and/or Chemotherapy Administration - Chemotherapy Admin - IV
0339,Radiology - Therapeutic and/or Chemotherapy Administration - Other Radiology - Therapeutic
0340,Nuclear Medicine - General Classification
0341,Nuclear Medicine - Diagnostic
0342,Nuclear Medicine - Therapeutic
0343,Nuclear Medicine - Diagnostic Radiopharmaceuticals
0344,Nuclear Medicine - Therapeutic Radiopharmaceuticals
0349,Nuclear Medicine - Other Nuclear Medicine
0350,CT Scan - General Classification
0351,CT Scan - CT - Head Scan
0352,CT Scan - CT - Body Scan
0359,CT Scan - CT Other
0360,Operating Room Services - General Classification
0361,Operating Room Services - Minor Surgery
0362,Operating Room Services - Organ Transplant - Other than Kidney
0367,Operating Room Services - Kidney Transplant
0369,Operating Room Services - Other OR Services
0370,Anesthesia - General Classification
0371,Anesthesia - Anesthesia Incident to Radiology
0372,Anesthesia - Anesthesia Incident to Other Dx Services
0374,Anesthesia - Acupuncture
0379,Anesthesia - Other Anesthesia
0380,Blood and Blood Components - General Classification
0381,Blood and Blood Components - Packed Red Cells
0382,Blood and Blood Components - Whole Blood
0383,Blood and Blood Components - Plasma
0384,Blood and Blood Components - Platelets
0385,Blood and Blood Components - Leukocytes
0386,Blood and Blood Components - Other Blood Components
0387,Blood and Blood Components - Other Derivatives (Cryoprecipitate)
0389,Blood and Blood Components - Other Blood and Blood Components
0390,"Administration, Processing and Storage for Blood and Blood Components - General Classification"
0391,"Administration, Processing and Storage for Blood and Blood Components - Administration (e.g., Transfusion)"
0392,"Administration, Processing and Storage for Blood and Blood Components - Processing and Storage"
0399,"Administration, Processing and Storage for Blood and Blood Components - Other Blood Handling"
0400,Other Imaging Services - General Classification
0401,Other Imaging Services - Diagnostic Mammography
0402,Other Imaging Services - Ultrasound
0403,Other Imaging Services - Screening Mammography
0404,Other Imaging Services - Positron Emission Tomography
0409,Other Imaging Services - Other Imaging Services
0410,Respiratory Services - General Classification
0412,Respiratory Services - Inhalation Services
0413,Respiratory Services - Hyperbaric Oxygen Therapy
0419,Respiratory Services - Other Respiratory Services
0420,Physical Therapy - General Classification
0421,Physical Therapy - Visit
0422,Physical Therapy - Hourly
0423,Physical Therapy - Group
0424,Physical Therapy - Evaluation or Re-evaluation
0429,Physical Therapy - Other Physical Therapy
0430,Occupational Therapy - General Classification
0431,Occupational Therapy - Visit
0432,Occupational Therapy - Hourly
0433,Occupational Therapy - Group
0434,Occupational Therapy - Evaluation or Reevaluation
0439,Occupational Therapy - Other Occupational Therapy
0440,Speech Therapy - Language Pathology - General Classification
0441,Speech Therapy - Language Pathology - Visit
0442,Speech Therapy - Language Pathology - Hourly
0443,Speech Therapy - Language Pathology - Group
0444,Speech Therapy - Language Pathology - Evaluation or Reevaluation
0449,Speech Therapy - Language Pathology - Other Speech Therapy
0450,Emergency Room - General Classification
0451,Emergency Room - EMTALA Emergency Medical Screening
0452,Emergency Room - ER Beyond EMTALA
0456,Emergency Room - Urgent Care
0459,Emergency Room - Other Emergency Room
0460,Pulmonary Function - General Classification
0469,Pulmonary Function - Other Pulmonary
0470,Audiology - General Classification
0471,Audiology - Diagnostic
0472,Audiology - Treatment
0479,Audiology - Other Audiology
0480,Cardiology - General Classification
0481,Cardiology - Cardiac Cath Lab
0482,Cardiology - Stress Test
0483,Cardiology - Echocardiology
0489,Cardiology - Other Cardiology
0490,Ambulatory Surgical Care - General Classification
0499,Ambulatory Surgical Care - Other Ambulatory Surgical
0500,Outpatient Services - General Classification
0509,Outpatient Services - Other Outpatient
0510,Clinic - General Classification
0511,Clinic - Chronic Pain Center
0512,Clinic - Dental Clinic
0513,Clinic - Psychiatric Clinic
0514,Clinic - OB-GYN Clinic
0515,Clinic - Pediatric Clinic
0516,Clinic - Urgent Care Clinic
0517,Clinic - Family Practice Clinic
0519,Clinic - Other Clinic
0520,Free-Standing Clinic - General Classification
0521,Free-Standing Clinic - Clinic Visit by Member to RHC/FQHC
0522,Free-Standing Clinic - Home Visit by RHC/FQHC Practitioner
0523,Free-Standing Clinic - Family Practice Clinic
0524,Free-Standing Clinic - Visit by RHC/FQHC Practitioner to a Member in a Covered Part A Stay at SNF
0525,Free-Standing Clinic - Visit by RHC/FQHC Practitioner to a Member in a SNF (not in a Covered Part A Stay) or NF or ICF MR or Other Residential Facility
0526,Free-Standing Clinic - Urgent Care Clinic
0527,Free-Standing Clinic - Visiting Nurse Service(s) to a Member's Home when in a Home Health Shortage Area
0528,"Free-Standing Clinic - Visit by RHC/FQHC Practitioner to Other non-RHC/FQHC site (e.g., Scene of Accident)"
0529,Free-Standing Clinic - Other Freestanding Clinic
0530,Osteopathic Services - General Classification
0531,Osteopathic Services - Osteopathic Therapy
0539,Osteopathic Services - Other Osteopathic Services
0540,Ambulance - General Classification
0541,Ambulance - Supplies
0542,Ambulance - Medical Transport
0543,Ambulance - Heart Mobile
0544,Ambulance - Oxygen
0545,Ambulance - Air Ambulance
0546,Ambulance - Neonatal Ambulance Services
0547,Ambulance - Pharmacy
0548,Ambulance - EKG Transmission
0549,Ambulance - Other Ambulance
0550,Skilled Nursing - General Classification
0551,Skilled Nursing - Visit Charge
0552,Skilled Nursing - Hourly Rate
0559,Skilled Nursing - Other Skilled Nursing
0560,Home Health (HH) - Medical Social Services - General Classification
0561,Home Health (HH) - Medical Social Services - Visit Charge
0562,Home Health (HH) - Medical Social Services - Hourly Charge
0569,Home Health (HH) - Medical Social Services - Other Med. Social Service
0570,Home Health (HH) Aide - General Classification
0571,Home Health (HH) Aide - Visit Charge
0572,Home Health (HH) Aide - Hourly Charge
0579,Home Health (HH) Aide - Other HH Aide
0580,Home Health (HH) - Other Visits - General Classification
0581,Home Health (HH) - Other Visits - Visit Charge
0582,Home Health (HH) - Other Visits - Hourly Charge
0583,Home Health (HH) - Other Visits - Assessment
0589,Home Health (HH) - Other Visits - Other Home Health Visit
0590,Home Health (HH) Units of Service - General Classification
0600,Home Health (HH) - Oxygen - General Classification
0601,Home Health (HH) - Oxygen - Oxygen - Stat Equip/Supply/Content
0602,Home Health (HH) - Oxygen - Oxygen - Stat Equip/Supply < 1 LPM
0603,Home Health (HH) - Oxygen - Oxygen - Stat Equip/Supply > 4 LPM
0604,Home Health (HH) - Oxygen - Oxygen - Port Add-on
0609,Home Health (HH) - Oxygen - Oxygen - Other
0610,Magnetic Resonance Technology (MRT) - General Classification
0611,Magnetic Resonance Technology (MRT) - MRI - Brain/Brainstem
0612,Magnetic Resonance Technology (MRT) - MRI - Spinal Cord/Spine
0614,Magnetic Resonance Technology (MRT) - MRI - Other
0615,Magnetic Resonance Technology (MRT) - MRA - Head and Neck
0616,Magnetic Resonance Technology (MRT) - MRA - Lower Extremities
0618,Magnetic Resonance Technology (MRT) - MRA - Other
0619,Magnetic Resonance Technology (MRT) - Other MRT
0621,Medical Surgical Supplies - Supplies Incident to Radiology
0622,Medical Surgical Supplies - Supplies Incident to Other DX Services
0623,Medical Surgical Supplies - Surgical Dressings
0624,Medical Surgical Supplies - FDA Investigational Devices
0631,Pharmacy - Single Source Drug
0632,Pharmacy - Multiple Source Drug
0633,Pharmacy - Restrictive Prescription
0634,"Pharmacy - Erythropoietin (EPO)< 10,000 units"
0635,"Pharmacy - Erythropoietin (EPO)> 10,000 Units"
0636,Pharmacy - Drugs Requiring Detailed Coding
0637,Pharmacy - Self-administrable Drugs
0640,Home IV Therapy Services - General Classification
0641,"Home IV Therapy Services - Non-routine Nursing, Central Line"
0642,"Home IV Therapy Services - IV Site Care, Central Line"
0643,"Home IV Therapy Services - IV Start/Care, Peripheral Line"
0644,"Home IV Therapy Services - Non-routine Nursing, Peripheral Line"
0645,"Home IV Therapy Services - Training Patient/Caregiver, Central Line"
0646,"Home IV Therapy Services - Training Disabled Patient, Central Line"
0647,"Home IV Therapy Services - Training Patient/Caregiver, Peripheral Line"
0648,"Home IV Therapy Services - Training Disabled Patient, Peripheral Line"
0649,Home IV Therapy Services - Other IV Therapy Services
0650,Hospice Service - General Classification
0651,Hospice Service - Routine Home Care
0652,Hospice Service - Continuous Home Care
0655,Hospice Service - Inpatient Respite Care
0656,Hospice Service - General Inpatient Care Non-Respite
0657,Hospice Service - Physician Services
0658,Hospice Service - Hospice Room & Board - Nursing Facility
0659,Hospice Service - Other Hospice Service
0660,Respite Care - General Classification
0661,Respite Care - Hourly Charge - Nursing
0662,Respite Care - Hourly Charge/Aide/Homemaker/Companion
0663,Respite Care - Daily Respite Charge
0669,Respite Care - Other Respite Care
0670,Outpatient Special Residence Charges - General Classification
0671,Outpatient Special Residence Charges - Hospital Owned
0672,Outpatient Special Residence Charges - Contracted
0679,Outpatient Special Residence Charges - Other Special Residence Charge
0681,Trauma Response - Level I Trauma
0682,Trauma Response - Level II Trauma
0683,Trauma Response - Level III Trauma
0684,Trauma Response - Level IV Trauma
0689,Trauma Response - Other Trauma Response
0700,Cast Room - General Classification
0710,Recovery Room - General Classification
0720,Labor Room/Delivery - General Classification
0721,Labor Room/Delivery - Labor
0722,Labor Room/Delivery - Delivery Room
0723,Labor Room/Delivery - Circumcision
0724,Labor Room/Delivery - Birthing Center
0729,Labor Room/Delivery - Other Labor Room/Delivery
0730,EKG/ECG (Electrocardiogram) - General Classification
0731,EKG/ECG (Electrocardiogram) - Holter Monitor
0732,EKG/ECG (Electrocardiogram) - Telemetry
0739,EKG/ECG (Electrocardiogram) - Other EKG/ECG
0740,EEG (Electroencephalogram) - General Classification
0750,Gastro-Intestinal (GI) Services - General Classification
0760,Specialty Services - General Classification
0761,Specialty Services - Treatment Room
0762,Specialty Services - Observation Hours
0769,Specialty Services - Other Specialty Services
0770,Preventive Care Services - General Classification
0771,Preventive Care Services - Vaccine Administration
0780,Telemedicine - General Classification
0790,Extra-Corporeal Shock Wave Therapy - General Classification
0800,Inpatient Renal Dialysis - General Classification
0801,Inpatient Renal Dialysis - Inpatient Hemodialysis
0802,Inpatient Renal Dialysis - Inpatient Peritoneal (Non-CAPD)
0803,Inpatient Renal Dialysis - Inpatient Continuous Ambulatory Peritoneal Dialysis (CAPD)
0804,Inpatient Renal Dialysis - Inpatient Continuous Cycling Peritoneal Dialysis (CCPD)
0809,Inpatient Renal Dialysis - Other Inpatient Dialysis
0810,Acquisition of Body Components - General Classification
0811,Acquisition of Body Components - Living Donor
0812,Acquisition of Body Components - Cadaver Donor
0813,Acquisition of Body Components - Unknown Donor
0814,Acquisition of Body Components - Unsuccessful Organ Search - Donor Bank Charges
0819,Acquisition of Body Components - Other Donor
0820,Hemodialysis - Outpatient or Home - General Classification
0821,Hemodialysis - Outpatient or Home - Hemodialysis Composite or Other Rate
0822,Hemodialysis - Outpatient or Home - Home Supplies
0823,Hemodialysis - Outpatient or Home - Home Equipment
0824,Hemodialysis - Outpatient or Home - Maintenance - 100%
0825,Hemodialysis - Outpatient or Home - Support Services
0829,Hemodialysis - Outpatient or Home - Other OP Hemodialysis
0830,Peritoneal Dialysis - Outpatient or Home - General Classification
0831,Peritoneal Dialysis - Outpatient or Home - Peritoneal/Composite or Other Rate
0832,Peritoneal Dialysis - Outpatient or Home - Home Supplies
0833,Peritoneal Dialysis - Outpatient or Home - Home Equipment
0834,Peritoneal Dialysis - Outpatient or Home - Maintenance - 100%
0835,Peritoneal Dialysis - Outpatient or Home - Support Services
0839,Peritoneal Dialysis - Outpatient or Home - Other Outpatient Peritoneal Dialysis
0840,Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - General Classification
0841,Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - CAPD/Composite or Other Rate
0842,Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Home Supplies
0843,Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Home Equipment
0844,Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Maintenance - 100%
0845,Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Support Services
0849,Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Other Outpatient CAPD
0850,Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - General Classification
0851,Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - CCPD/Composite or Other Rate
0852,Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Home Supplies
0853,Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Home Equipment
0854,Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Maintenance - 100%
0855,Continuous Cycling Peritoneal Dialysis (CAPD) - Outpatient or Home - Support Services
0859,Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Other Outpatient CCPD
0860,Magnetoencephalography (MEG) - General Classification
0861,Magnetoencephalography (MEG) - MEG
0880,Miscellaneous Dialysis - General Classification
0881,Miscellaneous Dialysis - Ultrafiltration
0882,Miscellaneous Dialysis - Home Dialysis Aid Visit
0889,Miscellaneous Dialysis - Other Miscellaneous Dialysis
0900,Behavioral Health Treatment/Services - General Classification
0901,Behavioral Health Treatment/Services - Electroshock Treatment
0902,Behavioral Health Treatment/Services - Milieu Therapy
0903,Behavioral Health Treatment/Services - Play Therapy
0904,Behavioral Health Treatment/Services - Activity Therapy
0905,Behavioral Health Treatment/Services - Intensive Outpatient Services - Psychiatric
0906,Behavioral Health Treatment/Services - Intensive Outpatient Services - Chemical Dependency
0907,Behavioral Health Treatment/Services - Community Behavioral Health Program (Day Treatment)
0911,Behavioral Health Treatment/Services - Rehabilitation
0912,Behavioral Health Treatment/Services - Partial Hospitalization - Less Intensive
0913,Behavioral Health Treatment/Services - Partial Hospitalization - Intensive
0914,Behavioral Health Treatment/Services - Individual Therapy
0915,Behavioral Health Treatment/Services - Group Therapy
0916,Behavioral Health Treatment/Services - Family Therapy
0917,Behavioral Health Treatment/Services - Bio Feedback
0918,Behavioral Health Treatment/Services - Testing
0919,Behavioral Health Treatment/Services - Other Behavioral Health Treatments
0920,Other Diagnostic Services - General Classification
0921,Other Diagnostic Services - Peripheral Vascular Lab
0922,Other Diagnostic Services - Electromyelgram
0923,Other Diagnostic Services - Pap Smear
0924,Other Diagnostic Services - Allergy Test
0925,Other Diagnostic Services - Pregnancy Test
0929,Other Diagnostic Services - Other Diagnostic Service
0931,Medical Rehabilitation Day Program - Half Day
0932,Medical Rehabilitation Day Program - Full Day
0940,Other Therapeutic Services - General Classification
0941,Other Therapeutic Services - Recreational Therapy
0942,Other Therapeutic Services - Education/Training
0943,Other Therapeutic Services - Cardiac Rehabilitation
0944,Other Therapeutic Services - Drug Rehabilitation
0945,Other Therapeutic Services - Alcohol Rehabilitation
0946,Other Therapeutic Services - Complex Medical Equipment Routine
0947,Other Therapeutic Services - Complex Medical Equipment Ancillary
0948,Other Therapeutic Services - Pulmonary Rehabilitation
0949,Other Therapeutic Services - Other Therapeutic Service
0951,Other Therapeutic Services - Athletic Training
0952,Other Therapeutic Services - Kinesiotherapy
0960,Professional Fees - General Classification
0961,Professional Fees - Psychiatric
0962,Professional Fees - Ophthalmology
0963,Professional Fees - Anesthesiologist (MD)
0964,Professional Fees - Anesthesiologist (CRNA)
0969,Professional Fees - Other Professional Fee
0971,Professional Fees - Laboratory
0972,Professional Fees - Radiology - Diagnostic
0973,Professional Fees - Radiology - Therapeutic
0974,Professional Fees - Radiology Nuclear
0975,Professional Fees - Operating Room
0976,Professional Fees - Respiratory Therapy
0977,Professional Fees - Physical Therapy
0978,Professional Fees - Occupational Therapy
0979,Professional Fees - Speech Pathology
0981,Professional Fees - Emergency Room Services
0982,Professional Fees - Outpatient Services
0983,Professional Fees - Clinic
0984,Professional Fees - Medical Social Services
0985,Professional Fees - EKG
0986,Professional Fees - EEG
0987,Professional Fees - Hospital Visit
0988,Professional Fees - Consultation
0989,Professional Fees - Private Duty Nurse
0990,Patient Convenience Items - General Classification
0991,Patient Convenience Items - Cafeteria/Guest Tray
0992,Patient Convenience Items - Private Linen Service
0993,Patient Convenience Items - Telephone/Telecom
0994,Patient Convenience Items - TV/Radio
0995,Patient Convenience Items - Non-patient Room Rentals
0996,Patient Convenience Items - Late Discharge
0997,Patient Convenience Items - Admission Kits
0998,Patient Convenience Items - Beauty Shop/Barber
0999,Patient Convenience Items - Other Convenience Items
1000,Behavior Health Accommodations - General Classification
1001,Behavior Health Accommodations - Residential Treatment - Psychiatric
1002,Behavior Health Accommodations - Residential Treatment - Chemical Dependency
1003,Behavior Health Accommodations - Supervised Living
1004,Behavior Health Accommodations - Halfway House
1005,Behavior Health Accommodations - Group Home
2100,Alternative Therapy Services - General Classification
2101,Alternative Therapy Services - Acupuncture
2102,Alternative Therapy Services - Acupressure
2103,Alternative Therapy Services - Massage
2104,Alternative Therapy Services - Reflexology
2105,Alternative Therapy Services - Biofeedback
2106,Alternative Therapy Services - Hypnosis
2109,Alternative Therapy Services - Other Alternative Therapy Service
3101,"Adult Care - Adult Day Care, Medical and Social Hourly"
3102,"Adult Care - Adult Day Care, Social - Hourly"
3103,"Adult Care - Adult Day Care, Medical and Social - Daily"
3104,"Adult Care - Adult Day Care, Social - Daily"
3105,Adult Care - Adult Foster Care Daily
3109,Adult Care - Other Adult Care
9999,Not Applicable
1 Code Description
2 0001 Total Charge
3 0022 Health Insurance - Prospective Payment System (HIPPS) - Skilled Nursing Facility - PPS
4 0023 Health Insurance - Prospective Payment System (HIPPS) - Home Health - PPS
5 0024 Health Insurance - Prospective Payment System (HIPPS) - Inpatient Rehab Facility - PPS
6 0100 All inclusive Rate - All-Inclusive room and board plus ancillary
7 0101 All inclusive Rate - All-Inclusive room and board
8 0110 Room & Board - Private (One Bed) - General Classification
9 0111 Room & Board - Private (One Bed) - Medical/Surgical/GYN
10 0112 Room & Board - Private (One Bed) - Obstetrics (OB)
11 0113 Room & Board - Private (One Bed) - Pediatric
12 0114 Room & Board - Private (One Bed) - Psychiatric
13 0115 Room & Board - Private (One Bed) - Hospice
14 0116 Room & Board - Private (One Bed) - Detoxification
15 0117 Room & Board - Private (One Bed) - Oncology
16 0118 Room & Board - Private (One Bed) - Rehabilitation
17 0119 Room & Board - Private (One Bed) - Other
18 0120 Room & Board - Semi-private (Two Beds) - General Classification
19 0121 Room & Board - Semi-private (Two Beds) - Medical/Surgical/GYN
20 0122 Room & Board - Semi-private (Two Beds) - Obstetrics (OB)
21 0123 Room & Board - Semi-private (Two Beds) - Pediatric
22 0124 Room & Board - Semi-private (Two Beds) - Psychiatric
23 0125 Room & Board - Semi-private (Two Beds) - Hospice
24 0126 Room & Board - Semi-private (Two Beds) - Detoxification
25 0127 Room & Board - Semi-private (Two Beds) - Oncology
26 0128 Room & Board - Semi-private (Two Beds) - Rehabilitation
27 0129 Room & Board - Semi-private (Two Beds) - Other
28 0130 Room & Board - Three and Four Beds - General Classification
29 0131 Room & Board - Three and Four Beds - Medical/Surgical/GYN
30 0132 Room & Board - Three and Four Beds - Obstetrics (OB)
31 0133 Room & Board - Three and Four Beds - Pediatric
32 0134 Room & Board - Three and Four Beds - Psychiatric
33 0135 Room & Board - Three and Four Beds - Hospice
34 0136 Room & Board - Three and Four Beds - Detoxification
35 0137 Room & Board - Three and Four Beds - Oncology
36 0138 Room & Board - Three and Four Beds - Rehabilitation
37 0139 Room & Board - Three and Four Beds - Other
38 0140 Room & Board - Deluxe Private - General Classification
39 0141 Room & Board - Deluxe Private - Medical/Surgical/GYN
40 0142 Room & Board - Deluxe Private - Obstetrics (OB)
41 0143 Room & Board - Deluxe Private - Pediatric
42 0144 Room & Board - Deluxe Private - Psychiatric
43 0145 Room & Board - Deluxe Private - Hospice
44 0146 Room & Board - Deluxe Private - Detoxification
45 0147 Room & Board - Deluxe Private - Oncology
46 0148 Room & Board - Deluxe Private - Rehabilitation
47 0149 Room & Board - Deluxe Private - Other
48 0150 Room & Board - Ward - General Classification
49 0151 Room & Board - Ward - Medical/Surgical/GYN
50 0152 Room & Board - Ward - Obstetrics (OB)
51 0153 Room & Board - Ward - Pediatric
52 0154 Room & Board - Ward - Psychiatric
53 0155 Room & Board - Ward - Hospice
54 0156 Room & Board - Ward - Detoxification
55 0157 Room & Board - Ward - Oncology
56 0158 Room & Board - Ward - Rehabilitation
57 0159 Room & Board - Ward - Other
58 0160 Room & Board - Other - General Classification
59 0164 Room & Board - Other - Sterile Environment
60 0167 Room & Board - Other - Self Care
61 0169 Room & Board - Other - Other
62 0170 Nursery - General Classification
63 0171 Nursery - Newborn - Level I
64 0172 Nursery - Newborn - Level II
65 0173 Nursery - Newborn - Level III
66 0174 Nursery - Newborn - Level IV
67 0179 Nursery - Other Nursery
68 0180 Leave of Absence - General Classification
69 0182 Leave of Absence - Patient Convenience
70 0183 Leave of Absence - Therapeutic Leave
71 0185 Leave of Absence - Nursing Home (for Hospitalization)
72 0189 Leave of Absence - Other LOA
73 0190 Subacute Care - General Classification
74 0191 Subacute Care - Level I
75 0192 Subacute Care - Level II
76 0193 Subacute Care - Level III
77 0194 Subacute Care - Level IV
78 0199 Subacute Care - Other Subacute Care
79 0200 Intensive Care Unit - General Classification
80 0201 Intensive Care Unit - Surgical
81 0202 Intensive Care Unit - Medical
82 0203 Intensive Care Unit - Pediatric
83 0204 Intensive Care Unit - Psychiatric
84 0206 Intensive Care Unit - Intermediate ICU
85 0207 Intensive Care Unit - Burn Care
86 0208 Intensive Care Unit - Trauma
87 0209 Intensive Care Unit - Other Intensive Care
88 0210 Coronary Care Unit - General Classification
89 0211 Coronary Care Unit - Myocardial Infarction
90 0212 Coronary Care Unit - Pulmonary Care
91 0213 Coronary Care Unit - Heart Transplant
92 0214 Coronary Care Unit - Intermediate CCU
93 0219 Coronary Care Unit - Other Coronary CCU
94 0220 Special Charges - General Classification
95 0221 Special Charges - Admission Charges
96 0222 Special Charges - Technical Support Charge
97 0223 Special Charges - U.R. Service Charge
98 0224 Special Charges - Late Discharge, Medically Necessary
99 0229 Special Charges - Other Special Charges
100 0230 Incremental Nursing Charge - General Classification
101 0231 Incremental Nursing Charge - Nursery
102 0232 Incremental Nursing Charge - OB
103 0233 Incremental Nursing Charge - ICU
104 0234 Incremental Nursing Charge - CCU
105 0235 Incremental Nursing Charge - Hospice
106 0239 Incremental Nursing Charge - Other
107 0240 All Inclusive Ancillary - General Classification
108 0241 All Inclusive Ancillary - Basic
109 0242 All Inclusive Ancillary - Comprehensive
110 0243 All Inclusive Ancillary - Specialty
111 0249 All Inclusive Ancillary - Other All Inclusive Ancillary
112 0250 Pharmacy - General Classification
113 0251 Pharmacy - Generic Drugs
114 0252 Pharmacy - Non-Generic Drugs
115 0253 Pharmacy - Take Home Drugs
116 0254 Pharmacy - Drugs Incident to Other Diagnostic Services
117 0255 Pharmacy - Drugs Incident to Radiology
118 0256 Pharmacy - Experimental Drugs
119 0257 Pharmacy - Non-Prescription
120 0258 Pharmacy - IV Solutions
121 0259 Pharmacy - Other Pharmacy
122 0260 IV Therapy - General Classification
123 0261 IV Therapy - Infusion Pump
124 0262 IV Therapy - IV Therapy/Pharmacy Svcs
125 0263 IV Therapy - IV Therapy/Drug/Supply Delivery
126 0264 IV Therapy - IV Therapy/Supplies
127 0269 IV Therapy - Other IV Therapy
128 0270 Medical/Surgical Supplies and Devices - General Classification
129 0271 Medical/Surgical Supplies and Devices - Non-sterile Supply
130 0272 Medical/Surgical Supplies and Devices - Sterile Supply
131 0273 Medical/Surgical Supplies and Devices - Take Home Supplies
132 0274 Medical/Surgical Supplies and Devices - Prosthetic/Orthotic Devices
133 0275 Medical/Surgical Supplies and Devices - Pacemaker
134 0276 Medical/Surgical Supplies and Devices - Intraocular Lens
135 0277 Medical/Surgical Supplies and Devices - Oxygen - Take Home
136 0278 Medical/Surgical Supplies and Devices - Other Implant
137 0279 Medical/Surgical Supplies and Devices - Other Supplies/Devices
138 0280 Oncology - General Classification
139 0289 Oncology - Other Oncology
140 0290 Durable Medical Equipment (other than renal) - General Classification
141 0291 Durable Medical Equipment (other than renal) - Rental
142 0292 Durable Medical Equipment (other than renal) - Purchase of New DME
143 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME
144 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME
145 0299 Durable Medical Equipment (other than renal) - Other Equipment
146 0300 Laboratory - General Classification
147 0301 Laboratory - Chemistry
148 0302 Laboratory - Immunology
149 0303 Laboratory - Renal Patient (Home)
150 0304 Laboratory - Non-Routine Dialysis
151 0305 Laboratory - Hematology
152 0306 Laboratory - Bacteriology & Microbiology
153 0307 Laboratory - Urology
154 0309 Laboratory - Other Laboratory
155 0310 Laboratory Pathology - General Classification
156 0311 Laboratory Pathology - Cytology
157 0312 Laboratory Pathology - Histology
158 0314 Laboratory Pathology - Biopsy
159 0319 Laboratory Pathology - Other Laboratory Pathology
160 0320 Radiology - Diagnostic - General Classification
161 0321 Radiology - Diagnostic - Angiocardiology
162 0322 Radiology - Diagnostic - Arthrography
163 0323 Radiology - Diagnostic - Arteriography
164 0324 Radiology - Diagnostic - Chest X-Ray
165 0329 Radiology - Diagnostic - Other Radiology - Diagnostic
166 0330 Radiology - Therapeutic and/or Chemotherapy Administration - General Classification
167 0331 Radiology - Therapeutic and/or Chemotherapy Administration - Chemotherapy Admin - Injected
168 0332 Radiology - Therapeutic and/or Chemotherapy Administration - Chemotherapy Admin - Oral
169 0333 Radiology - Therapeutic and/or Chemotherapy Administration - Radiation Therapy
170 0335 Radiology - Therapeutic and/or Chemotherapy Administration - Chemotherapy Admin - IV
171 0339 Radiology - Therapeutic and/or Chemotherapy Administration - Other Radiology - Therapeutic
172 0340 Nuclear Medicine - General Classification
173 0341 Nuclear Medicine - Diagnostic
174 0342 Nuclear Medicine - Therapeutic
175 0343 Nuclear Medicine - Diagnostic Radiopharmaceuticals
176 0344 Nuclear Medicine - Therapeutic Radiopharmaceuticals
177 0349 Nuclear Medicine - Other Nuclear Medicine
178 0350 CT Scan - General Classification
179 0351 CT Scan - CT - Head Scan
180 0352 CT Scan - CT - Body Scan
181 0359 CT Scan - CT Other
182 0360 Operating Room Services - General Classification
183 0361 Operating Room Services - Minor Surgery
184 0362 Operating Room Services - Organ Transplant - Other than Kidney
185 0367 Operating Room Services - Kidney Transplant
186 0369 Operating Room Services - Other OR Services
187 0370 Anesthesia - General Classification
188 0371 Anesthesia - Anesthesia Incident to Radiology
189 0372 Anesthesia - Anesthesia Incident to Other Dx Services
190 0374 Anesthesia - Acupuncture
191 0379 Anesthesia - Other Anesthesia
192 0380 Blood and Blood Components - General Classification
193 0381 Blood and Blood Components - Packed Red Cells
194 0382 Blood and Blood Components - Whole Blood
195 0383 Blood and Blood Components - Plasma
196 0384 Blood and Blood Components - Platelets
197 0385 Blood and Blood Components - Leukocytes
198 0386 Blood and Blood Components - Other Blood Components
199 0387 Blood and Blood Components - Other Derivatives (Cryoprecipitate)
200 0389 Blood and Blood Components - Other Blood and Blood Components
201 0390 Administration, Processing and Storage for Blood and Blood Components - General Classification
202 0391 Administration, Processing and Storage for Blood and Blood Components - Administration (e.g., Transfusion)
203 0392 Administration, Processing and Storage for Blood and Blood Components - Processing and Storage
204 0399 Administration, Processing and Storage for Blood and Blood Components - Other Blood Handling
205 0400 Other Imaging Services - General Classification
206 0401 Other Imaging Services - Diagnostic Mammography
207 0402 Other Imaging Services - Ultrasound
208 0403 Other Imaging Services - Screening Mammography
209 0404 Other Imaging Services - Positron Emission Tomography
210 0409 Other Imaging Services - Other Imaging Services
211 0410 Respiratory Services - General Classification
212 0412 Respiratory Services - Inhalation Services
213 0413 Respiratory Services - Hyperbaric Oxygen Therapy
214 0419 Respiratory Services - Other Respiratory Services
215 0420 Physical Therapy - General Classification
216 0421 Physical Therapy - Visit
217 0422 Physical Therapy - Hourly
218 0423 Physical Therapy - Group
219 0424 Physical Therapy - Evaluation or Re-evaluation
220 0429 Physical Therapy - Other Physical Therapy
221 0430 Occupational Therapy - General Classification
222 0431 Occupational Therapy - Visit
223 0432 Occupational Therapy - Hourly
224 0433 Occupational Therapy - Group
225 0434 Occupational Therapy - Evaluation or Reevaluation
226 0439 Occupational Therapy - Other Occupational Therapy
227 0440 Speech Therapy - Language Pathology - General Classification
228 0441 Speech Therapy - Language Pathology - Visit
229 0442 Speech Therapy - Language Pathology - Hourly
230 0443 Speech Therapy - Language Pathology - Group
231 0444 Speech Therapy - Language Pathology - Evaluation or Reevaluation
232 0449 Speech Therapy - Language Pathology - Other Speech Therapy
233 0450 Emergency Room - General Classification
234 0451 Emergency Room - EMTALA Emergency Medical Screening
235 0452 Emergency Room - ER Beyond EMTALA
236 0456 Emergency Room - Urgent Care
237 0459 Emergency Room - Other Emergency Room
238 0460 Pulmonary Function - General Classification
239 0469 Pulmonary Function - Other Pulmonary
240 0470 Audiology - General Classification
241 0471 Audiology - Diagnostic
242 0472 Audiology - Treatment
243 0479 Audiology - Other Audiology
244 0480 Cardiology - General Classification
245 0481 Cardiology - Cardiac Cath Lab
246 0482 Cardiology - Stress Test
247 0483 Cardiology - Echocardiology
248 0489 Cardiology - Other Cardiology
249 0490 Ambulatory Surgical Care - General Classification
250 0499 Ambulatory Surgical Care - Other Ambulatory Surgical
251 0500 Outpatient Services - General Classification
252 0509 Outpatient Services - Other Outpatient
253 0510 Clinic - General Classification
254 0511 Clinic - Chronic Pain Center
255 0512 Clinic - Dental Clinic
256 0513 Clinic - Psychiatric Clinic
257 0514 Clinic - OB-GYN Clinic
258 0515 Clinic - Pediatric Clinic
259 0516 Clinic - Urgent Care Clinic
260 0517 Clinic - Family Practice Clinic
261 0519 Clinic - Other Clinic
262 0520 Free-Standing Clinic - General Classification
263 0521 Free-Standing Clinic - Clinic Visit by Member to RHC/FQHC
264 0522 Free-Standing Clinic - Home Visit by RHC/FQHC Practitioner
265 0523 Free-Standing Clinic - Family Practice Clinic
266 0524 Free-Standing Clinic - Visit by RHC/FQHC Practitioner to a Member in a Covered Part A Stay at SNF
267 0525 Free-Standing Clinic - Visit by RHC/FQHC Practitioner to a Member in a SNF (not in a Covered Part A Stay) or NF or ICF MR or Other Residential Facility
268 0526 Free-Standing Clinic - Urgent Care Clinic
269 0527 Free-Standing Clinic - Visiting Nurse Service(s) to a Member's Home when in a Home Health Shortage Area
270 0528 Free-Standing Clinic - Visit by RHC/FQHC Practitioner to Other non-RHC/FQHC site (e.g., Scene of Accident)
271 0529 Free-Standing Clinic - Other Freestanding Clinic
272 0530 Osteopathic Services - General Classification
273 0531 Osteopathic Services - Osteopathic Therapy
274 0539 Osteopathic Services - Other Osteopathic Services
275 0540 Ambulance - General Classification
276 0541 Ambulance - Supplies
277 0542 Ambulance - Medical Transport
278 0543 Ambulance - Heart Mobile
279 0544 Ambulance - Oxygen
280 0545 Ambulance - Air Ambulance
281 0546 Ambulance - Neonatal Ambulance Services
282 0547 Ambulance - Pharmacy
283 0548 Ambulance - EKG Transmission
284 0549 Ambulance - Other Ambulance
285 0550 Skilled Nursing - General Classification
286 0551 Skilled Nursing - Visit Charge
287 0552 Skilled Nursing - Hourly Rate
288 0559 Skilled Nursing - Other Skilled Nursing
289 0560 Home Health (HH) - Medical Social Services - General Classification
290 0561 Home Health (HH) - Medical Social Services - Visit Charge
291 0562 Home Health (HH) - Medical Social Services - Hourly Charge
292 0569 Home Health (HH) - Medical Social Services - Other Med. Social Service
293 0570 Home Health (HH) Aide - General Classification
294 0571 Home Health (HH) Aide - Visit Charge
295 0572 Home Health (HH) Aide - Hourly Charge
296 0579 Home Health (HH) Aide - Other HH Aide
297 0580 Home Health (HH) - Other Visits - General Classification
298 0581 Home Health (HH) - Other Visits - Visit Charge
299 0582 Home Health (HH) - Other Visits - Hourly Charge
300 0583 Home Health (HH) - Other Visits - Assessment
301 0589 Home Health (HH) - Other Visits - Other Home Health Visit
302 0590 Home Health (HH) Units of Service - General Classification
303 0600 Home Health (HH) - Oxygen - General Classification
304 0601 Home Health (HH) - Oxygen - Oxygen - Stat Equip/Supply/Content
305 0602 Home Health (HH) - Oxygen - Oxygen - Stat Equip/Supply < 1 LPM
306 0603 Home Health (HH) - Oxygen - Oxygen - Stat Equip/Supply > 4 LPM
307 0604 Home Health (HH) - Oxygen - Oxygen - Port Add-on
308 0609 Home Health (HH) - Oxygen - Oxygen - Other
309 0610 Magnetic Resonance Technology (MRT) - General Classification
310 0611 Magnetic Resonance Technology (MRT) - MRI - Brain/Brainstem
311 0612 Magnetic Resonance Technology (MRT) - MRI - Spinal Cord/Spine
312 0614 Magnetic Resonance Technology (MRT) - MRI - Other
313 0615 Magnetic Resonance Technology (MRT) - MRA - Head and Neck
314 0616 Magnetic Resonance Technology (MRT) - MRA - Lower Extremities
315 0618 Magnetic Resonance Technology (MRT) - MRA - Other
316 0619 Magnetic Resonance Technology (MRT) - Other MRT
317 0621 Medical Surgical Supplies - Supplies Incident to Radiology
318 0622 Medical Surgical Supplies - Supplies Incident to Other DX Services
319 0623 Medical Surgical Supplies - Surgical Dressings
320 0624 Medical Surgical Supplies - FDA Investigational Devices
321 0631 Pharmacy - Single Source Drug
322 0632 Pharmacy - Multiple Source Drug
323 0633 Pharmacy - Restrictive Prescription
324 0634 Pharmacy - Erythropoietin (EPO)< 10,000 units
325 0635 Pharmacy - Erythropoietin (EPO)> 10,000 Units
326 0636 Pharmacy - Drugs Requiring Detailed Coding
327 0637 Pharmacy - Self-administrable Drugs
328 0640 Home IV Therapy Services - General Classification
329 0641 Home IV Therapy Services - Non-routine Nursing, Central Line
330 0642 Home IV Therapy Services - IV Site Care, Central Line
331 0643 Home IV Therapy Services - IV Start/Care, Peripheral Line
332 0644 Home IV Therapy Services - Non-routine Nursing, Peripheral Line
333 0645 Home IV Therapy Services - Training Patient/Caregiver, Central Line
334 0646 Home IV Therapy Services - Training Disabled Patient, Central Line
335 0647 Home IV Therapy Services - Training Patient/Caregiver, Peripheral Line
336 0648 Home IV Therapy Services - Training Disabled Patient, Peripheral Line
337 0649 Home IV Therapy Services - Other IV Therapy Services
338 0650 Hospice Service - General Classification
339 0651 Hospice Service - Routine Home Care
340 0652 Hospice Service - Continuous Home Care
341 0655 Hospice Service - Inpatient Respite Care
342 0656 Hospice Service - General Inpatient Care Non-Respite
343 0657 Hospice Service - Physician Services
344 0658 Hospice Service - Hospice Room & Board - Nursing Facility
345 0659 Hospice Service - Other Hospice Service
346 0660 Respite Care - General Classification
347 0661 Respite Care - Hourly Charge - Nursing
348 0662 Respite Care - Hourly Charge/Aide/Homemaker/Companion
349 0663 Respite Care - Daily Respite Charge
350 0669 Respite Care - Other Respite Care
351 0670 Outpatient Special Residence Charges - General Classification
352 0671 Outpatient Special Residence Charges - Hospital Owned
353 0672 Outpatient Special Residence Charges - Contracted
354 0679 Outpatient Special Residence Charges - Other Special Residence Charge
355 0681 Trauma Response - Level I Trauma
356 0682 Trauma Response - Level II Trauma
357 0683 Trauma Response - Level III Trauma
358 0684 Trauma Response - Level IV Trauma
359 0689 Trauma Response - Other Trauma Response
360 0700 Cast Room - General Classification
361 0710 Recovery Room - General Classification
362 0720 Labor Room/Delivery - General Classification
363 0721 Labor Room/Delivery - Labor
364 0722 Labor Room/Delivery - Delivery Room
365 0723 Labor Room/Delivery - Circumcision
366 0724 Labor Room/Delivery - Birthing Center
367 0729 Labor Room/Delivery - Other Labor Room/Delivery
368 0730 EKG/ECG (Electrocardiogram) - General Classification
369 0731 EKG/ECG (Electrocardiogram) - Holter Monitor
370 0732 EKG/ECG (Electrocardiogram) - Telemetry
371 0739 EKG/ECG (Electrocardiogram) - Other EKG/ECG
372 0740 EEG (Electroencephalogram) - General Classification
373 0750 Gastro-Intestinal (GI) Services - General Classification
374 0760 Specialty Services - General Classification
375 0761 Specialty Services - Treatment Room
376 0762 Specialty Services - Observation Hours
377 0769 Specialty Services - Other Specialty Services
378 0770 Preventive Care Services - General Classification
379 0771 Preventive Care Services - Vaccine Administration
380 0780 Telemedicine - General Classification
381 0790 Extra-Corporeal Shock Wave Therapy - General Classification
382 0800 Inpatient Renal Dialysis - General Classification
383 0801 Inpatient Renal Dialysis - Inpatient Hemodialysis
384 0802 Inpatient Renal Dialysis - Inpatient Peritoneal (Non-CAPD)
385 0803 Inpatient Renal Dialysis - Inpatient Continuous Ambulatory Peritoneal Dialysis (CAPD)
386 0804 Inpatient Renal Dialysis - Inpatient Continuous Cycling Peritoneal Dialysis (CCPD)
387 0809 Inpatient Renal Dialysis - Other Inpatient Dialysis
388 0810 Acquisition of Body Components - General Classification
389 0811 Acquisition of Body Components - Living Donor
390 0812 Acquisition of Body Components - Cadaver Donor
391 0813 Acquisition of Body Components - Unknown Donor
392 0814 Acquisition of Body Components - Unsuccessful Organ Search - Donor Bank Charges
393 0819 Acquisition of Body Components - Other Donor
394 0820 Hemodialysis - Outpatient or Home - General Classification
395 0821 Hemodialysis - Outpatient or Home - Hemodialysis Composite or Other Rate
396 0822 Hemodialysis - Outpatient or Home - Home Supplies
397 0823 Hemodialysis - Outpatient or Home - Home Equipment
398 0824 Hemodialysis - Outpatient or Home - Maintenance - 100%
399 0825 Hemodialysis - Outpatient or Home - Support Services
400 0829 Hemodialysis - Outpatient or Home - Other OP Hemodialysis
401 0830 Peritoneal Dialysis - Outpatient or Home - General Classification
402 0831 Peritoneal Dialysis - Outpatient or Home - Peritoneal/Composite or Other Rate
403 0832 Peritoneal Dialysis - Outpatient or Home - Home Supplies
404 0833 Peritoneal Dialysis - Outpatient or Home - Home Equipment
405 0834 Peritoneal Dialysis - Outpatient or Home - Maintenance - 100%
406 0835 Peritoneal Dialysis - Outpatient or Home - Support Services
407 0839 Peritoneal Dialysis - Outpatient or Home - Other Outpatient Peritoneal Dialysis
408 0840 Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - General Classification
409 0841 Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - CAPD/Composite or Other Rate
410 0842 Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Home Supplies
411 0843 Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Home Equipment
412 0844 Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Maintenance - 100%
413 0845 Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Support Services
414 0849 Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - Other Outpatient CAPD
415 0850 Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - General Classification
416 0851 Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - CCPD/Composite or Other Rate
417 0852 Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Home Supplies
418 0853 Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Home Equipment
419 0854 Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Maintenance - 100%
420 0855 Continuous Cycling Peritoneal Dialysis (CAPD) - Outpatient or Home - Support Services
421 0859 Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Other Outpatient CCPD
422 0860 Magnetoencephalography (MEG) - General Classification
423 0861 Magnetoencephalography (MEG) - MEG
424 0880 Miscellaneous Dialysis - General Classification
425 0881 Miscellaneous Dialysis - Ultrafiltration
426 0882 Miscellaneous Dialysis - Home Dialysis Aid Visit
427 0889 Miscellaneous Dialysis - Other Miscellaneous Dialysis
428 0900 Behavioral Health Treatment/Services - General Classification
429 0901 Behavioral Health Treatment/Services - Electroshock Treatment
430 0902 Behavioral Health Treatment/Services - Milieu Therapy
431 0903 Behavioral Health Treatment/Services - Play Therapy
432 0904 Behavioral Health Treatment/Services - Activity Therapy
433 0905 Behavioral Health Treatment/Services - Intensive Outpatient Services - Psychiatric
434 0906 Behavioral Health Treatment/Services - Intensive Outpatient Services - Chemical Dependency
435 0907 Behavioral Health Treatment/Services - Community Behavioral Health Program (Day Treatment)
436 0911 Behavioral Health Treatment/Services - Rehabilitation
437 0912 Behavioral Health Treatment/Services - Partial Hospitalization - Less Intensive
438 0913 Behavioral Health Treatment/Services - Partial Hospitalization - Intensive
439 0914 Behavioral Health Treatment/Services - Individual Therapy
440 0915 Behavioral Health Treatment/Services - Group Therapy
441 0916 Behavioral Health Treatment/Services - Family Therapy
442 0917 Behavioral Health Treatment/Services - Bio Feedback
443 0918 Behavioral Health Treatment/Services - Testing
444 0919 Behavioral Health Treatment/Services - Other Behavioral Health Treatments
445 0920 Other Diagnostic Services - General Classification
446 0921 Other Diagnostic Services - Peripheral Vascular Lab
447 0922 Other Diagnostic Services - Electromyelgram
448 0923 Other Diagnostic Services - Pap Smear
449 0924 Other Diagnostic Services - Allergy Test
450 0925 Other Diagnostic Services - Pregnancy Test
451 0929 Other Diagnostic Services - Other Diagnostic Service
452 0931 Medical Rehabilitation Day Program - Half Day
453 0932 Medical Rehabilitation Day Program - Full Day
454 0940 Other Therapeutic Services - General Classification
455 0941 Other Therapeutic Services - Recreational Therapy
456 0942 Other Therapeutic Services - Education/Training
457 0943 Other Therapeutic Services - Cardiac Rehabilitation
458 0944 Other Therapeutic Services - Drug Rehabilitation
459 0945 Other Therapeutic Services - Alcohol Rehabilitation
460 0946 Other Therapeutic Services - Complex Medical Equipment Routine
461 0947 Other Therapeutic Services - Complex Medical Equipment Ancillary
462 0948 Other Therapeutic Services - Pulmonary Rehabilitation
463 0949 Other Therapeutic Services - Other Therapeutic Service
464 0951 Other Therapeutic Services - Athletic Training
465 0952 Other Therapeutic Services - Kinesiotherapy
466 0960 Professional Fees - General Classification
467 0961 Professional Fees - Psychiatric
468 0962 Professional Fees - Ophthalmology
469 0963 Professional Fees - Anesthesiologist (MD)
470 0964 Professional Fees - Anesthesiologist (CRNA)
471 0969 Professional Fees - Other Professional Fee
472 0971 Professional Fees - Laboratory
473 0972 Professional Fees - Radiology - Diagnostic
474 0973 Professional Fees - Radiology - Therapeutic
475 0974 Professional Fees - Radiology Nuclear
476 0975 Professional Fees - Operating Room
477 0976 Professional Fees - Respiratory Therapy
478 0977 Professional Fees - Physical Therapy
479 0978 Professional Fees - Occupational Therapy
480 0979 Professional Fees - Speech Pathology
481 0981 Professional Fees - Emergency Room Services
482 0982 Professional Fees - Outpatient Services
483 0983 Professional Fees - Clinic
484 0984 Professional Fees - Medical Social Services
485 0985 Professional Fees - EKG
486 0986 Professional Fees - EEG
487 0987 Professional Fees - Hospital Visit
488 0988 Professional Fees - Consultation
489 0989 Professional Fees - Private Duty Nurse
490 0990 Patient Convenience Items - General Classification
491 0991 Patient Convenience Items - Cafeteria/Guest Tray
492 0992 Patient Convenience Items - Private Linen Service
493 0993 Patient Convenience Items - Telephone/Telecom
494 0994 Patient Convenience Items - TV/Radio
495 0995 Patient Convenience Items - Non-patient Room Rentals
496 0996 Patient Convenience Items - Late Discharge
497 0997 Patient Convenience Items - Admission Kits
498 0998 Patient Convenience Items - Beauty Shop/Barber
499 0999 Patient Convenience Items - Other Convenience Items
500 1000 Behavior Health Accommodations - General Classification
501 1001 Behavior Health Accommodations - Residential Treatment - Psychiatric
502 1002 Behavior Health Accommodations - Residential Treatment - Chemical Dependency
503 1003 Behavior Health Accommodations - Supervised Living
504 1004 Behavior Health Accommodations - Halfway House
505 1005 Behavior Health Accommodations - Group Home
506 2100 Alternative Therapy Services - General Classification
507 2101 Alternative Therapy Services - Acupuncture
508 2102 Alternative Therapy Services - Acupressure
509 2103 Alternative Therapy Services - Massage
510 2104 Alternative Therapy Services - Reflexology
511 2105 Alternative Therapy Services - Biofeedback
512 2106 Alternative Therapy Services - Hypnosis
513 2109 Alternative Therapy Services - Other Alternative Therapy Service
514 3101 Adult Care - Adult Day Care, Medical and Social Hourly
515 3102 Adult Care - Adult Day Care, Social - Hourly
516 3103 Adult Care - Adult Day Care, Medical and Social - Daily
517 3104 Adult Care - Adult Day Care, Social - Daily
518 3105 Adult Care - Adult Foster Care Daily
519 3109 Adult Care - Other Adult Care
520 9999 Not Applicable
@@ -0,0 +1,32 @@
{
"metadata": {
"from_col": "AARETE_DERIVED_BILL_TYPE_CD",
"to_col": "PLACE_OF_SERVICE"
},
"mapping": {
"011X": "Hospital Inpatient (Part A)",
"012X": "Hospital Inpatient Part B",
"013X": "Hospital Outpatient",
"014X": "Hospital Other Part B",
"018X": "Hospital Swing Bed",
"021X": "SNF Inpatient",
"022X": "SNF Inpatient Part B",
"023X": "SNF Outpatient",
"028X": "SNF Swing Bed",
"032X": "Home Health",
"033X": "Home Health",
"034X": "Home Health (Part B Only)",
"041X": "Religious Nonmedical Health Care Institutions",
"071X": "Clinical Rural Health",
"072X": "Clinic ESRD",
"073X": "Federally Qualified Health Centers",
"074X": "Clinic OPT",
"075X": "Clinic CORF",
"076X": "Community Mental Health Centers",
"081X": "Nonhospital based hospice",
"082X": "Hospital based hospice",
"083X": "Hospital Outpatient (ASC)",
"085X": "Critical Access Hospital"
}
}
@@ -0,0 +1,131 @@
{
"metadata": {
"from_col": "AARETE_DERIVED_PROVIDER_SPECIALTY",
"to_col": "CONTRACT_PROVIDER_SPECIALTY"
},
"mapping": {
"01": "General Practice",
"02": "General Surgery",
"03": "Allergy/Immunology",
"04": "Otolaryngology",
"05": "Anesthesiology",
"06": "Cardiology",
"07": "Dermatology",
"08": "Family Practice",
"09": "Interventional Pain Management",
"10": "Gastroenterology",
"11": "Internal Medicine",
"12": "Osteopathic Manipulative Medicine",
"13": "Neurology",
"14": "Neurosurgery",
"15": "Speech Language Pathologist in Private Practice",
"16": "Obstetrics/Gynecology",
"17": "Hospice and Palliative Care",
"18": "Ophthalmology",
"19": "Oral Surgery (Dentists only)",
"20": "Orthopedic Surgery",
"21": "Cardiac Electrophysiology",
"22": "Pathology",
"23": "Sports Medicine",
"24": "Plastic and Reconstructive Surgery",
"25": "Physical Medicine and Rehabilitation",
"26": "Psychiatry",
"27": "Geriatric Psychiatry",
"28": "Colorectal Surgery (formerly Proctology)",
"29": "Pulmonary Disease",
"30": "Diagnostic Radiology",
"31": "Intensive Cardiac Rehabilitation (ICR)",
"32": "Anesthesiologist Assistant",
"33": "Thoracic Surgery",
"34": "Urology",
"35": "Chiropractic",
"36": "Nuclear Medicine",
"37": "Pediatric Medicine",
"38": "Geriatric Medicine",
"39": "Nephrology",
"40": "Hand Surgery",
"41": "Optometry",
"42": "Certified Nurse Midwife",
"43": "Certified Registered Nurse Anesthetist (CRNA)",
"44": "Infectious Disease",
"45": "Mammography Screening Center",
"46": "Endocrinology",
"47": "Independent Diagnostic Testing Facility (DTL)",
"48": "Podiatry",
"49": "Ambulatory Surgical Center",
"50": "Nurse Practitioner",
"59": "Ambulance Service Supplier",
"60": "Public Health/Welfare Agency",
"61": "Volunteer Health/Charitable Agency",
"62": "Psychologist (Billing Independently)",
"63": "Portable X-Ray Supplier (Billing Independently)",
"64": "Audiologist (Billing Independently)",
"65": "Physical Therapist in Private Practice",
"66": "Rheumatology",
"67": "Occupational Therapist in Private Practice",
"68": "Clinical Psychologist",
"69": "Clinical Laboratory (Billing Independently)",
"70": "Single or Multispecialty Clinic or Group Practice",
"71": "Registered Dietitian/Nutrition Professional",
"72": "Pain Management",
"73": "Mass Immunization Roster Biller",
"74": "Radiation Therapy Centers",
"75": "Slide Preparation Facilities",
"76": "Peripheral Vascular Disease",
"77": "Vascular Surgery",
"78": "Cardiac Surgery",
"79": "Addiction Medicine",
"80": "Licensed Clinical Social Worker",
"81": "Critical Care (Intensivist)",
"82": "Hematology",
"83": "Hematology/Oncology",
"84": "Preventative Medicine",
"85": "Maxillofacial Surgery",
"86": "Neuropsychiatry",
"88": "Unknown Provider",
"89": "Certified Clinical Nurse Specialist",
"90": "Medical Oncology",
"91": "Surgical Oncology",
"92": "Radiation Oncology",
"93": "Emergency Medicine",
"94": "Interventional Radiology",
"95": "Unknown Supplier",
"97": "Physician Assistant",
"98": "Gynecological Oncology",
"99": "Unknown Physician Specialty",
"A5": "Pharmacy",
"C0": "Sleep Medicine",
"C1": "Centralized Flu",
"C2": "Indirect Payment Procedure",
"C3": "Interventional Cardiology",
"C4": "Restricted Use",
"C5": "General Dentist",
"C6": "Hospitalist",
"C7": "Advanced Heart Failure and Transplant Cardiology",
"C8": "Medical Toxicology",
"C9": "Hematopoietic Cell Transplantation and Cellular Therapy",
"D1": "Medicare Diabetes Prevention Program",
"D2": "Restricted Use",
"D3": "Medical Genetics and Genomics",
"D4": "Undersea and Hyperbaric Medicine",
"D5": "Opioid Treatment Program",
"D6": "Home Infusion Therapy Services",
"D7": "Micrographic Dermatologic Surgery",
"D8": "Adult Congenital Heart Disease",
"E1": "Marriage and Family Therapist",
"E2": "Mental Health Counselors",
"E3": "Dental Anesthesiology",
"E4": "Dental Public Health",
"E5": "Endodontics",
"E6": "Oral and Maxillofacial Pathology",
"E7": "Oral and Maxillofacial Radiology",
"E9": "Oral Medicine",
"F1": "Orofacial Pain",
"F2": "Orthodontics and Dentofacial Orthopedics",
"F3": "Pediatric Dentistry",
"F4": "Periodontics",
"F5": "Prosthodontics",
"F6": "Epileptologists"
}
}
Binary file not shown.
Binary file not shown.
Binary file not shown.
Binary file not shown.
Binary file not shown.
Binary file not shown.
Binary file not shown.
Binary file not shown.
Binary file not shown.
Binary file not shown.
Binary file not shown.
Binary file not shown.
Binary file not shown.
Binary file not shown.
+896 -3
View File
File diff suppressed because it is too large Load Diff
+2
View File
@@ -25,6 +25,8 @@ langchain-text-splitters = "^0.3.5"
langchain-community = "^0.3.15"
nltk = "^3.9.1"
rank-bm25 = "^0.2.2"
sentence-transformers = "^3.4.1"
faiss-cpu = "^1.10.0"
[tool.poetry.group.dev.dependencies]
black = "^24.10.0"
@@ -0,0 +1,34 @@
import src.utils.embedding_utils as embedding_utils
from src.investment.code_funcs import get_proc_crosswalk, get_clean_value
from crosswalk.crosswalk_utils import CrosswalkBuilder
import faiss
import pickle
import os
import pandas as pd
import numpy as np
from sentence_transformers import SentenceTransformer
# Load model
roberta_model = SentenceTransformer("all-roberta-large-v1")
# If running for the first time
mapping_dir = "crosswalk/mapping_csvs/proc_cd"
pkl_dir = "embeddings"
for filename in os.listdir(mapping_dir):
if filename.endswith(".csv"):
print(f"Creating embeddings for {filename}")
stripped_filename = filename.strip(".csv")
mapping_df = pd.read_csv(os.path.join(mapping_dir, filename))
proc_crosswalk = CrosswalkBuilder().from_df(mapping_df, from_col="Code", to_col="Description")
proc_choices = [get_clean_value(x) for x in proc_crosswalk.mapping.values()]
os.makedirs(os.path.join(pkl_dir, stripped_filename), exist_ok=True)
proc_index = embedding_utils.create_faiss_index(choices=proc_choices,
model=roberta_model,
save_path=os.path.join(pkl_dir, stripped_filename, "index.bin"),
embedding_path=os.path.join(pkl_dir, stripped_filename, "embeddings.npy"),
choices_path=os.path.join(pkl_dir, stripped_filename, "choices.pkl")
)
@@ -15,6 +15,43 @@ VALID_LOBS = [
"TRICARE"
]
# Provider Type
VALID_PROV_TYPE = [
"Physician",
"Primary Care Provider",
"Dual Capacity Physician",
"Mid-Level Practicioner",
"Primary Care Mid-Level Practicioner",
"Specialist",
"OB/GYN",
"Behavioral Health",
"Therapist",
"Surgery",
"Independent RHC",
"Ambulance Services",
"Home Health",
"DME",
"Durable Medical Equipment",
"Radiology",
"Lab",
"Hospice",
"Dialysis",
"PT/OT/ST",
"Physical Therapy, Occupational Therapy, Speech Therapy",
"Urgent Care",
"Home Infusion",
"Ambulatory Surgery Center",
"ASC",
"Skilled Nursing Facility",
"Hospital",
"Clinic",
"Rural Health Clinic",
"FQHC",
"Long Term Care",
"Community Mental Health Center",
]
VALID_CONTRACT_NETWORKS = [
"HMO",
"HEALTH MAINTENANCE ORGANIZATION",
@@ -0,0 +1,235 @@
from src.prompts.investment_prompts import Field, FieldSet
import src.config as config
import src.utils.string_utils as string_utils
import src.utils.llm_utils as llm_utils
import src.prompts.investment_prompts as investment_prompts
import src.utils.embedding_utils as embedding_utils
import pandas as pd
import os
import re
import string
import ast
import src.constants.investment_values as investment_values
from crosswalk.crosswalk_utils import CrosswalkBuilder
import faiss
import numpy as np
from sentence_transformers import SentenceTransformer
# Load model
model = SentenceTransformer("all-roberta-large-v1")
def create_faiss_index(choices):
embeddings = model.encode(choices, normalize_embeddings=True).astype("float32")
index = faiss.IndexFlatIP(embeddings.shape[1]) # Inner product for cosine similarity
index.add(embeddings)
return index
def get_matches_above_threshold(target, choices, index, threshold=0.7, top_k=5):
target_vec = model.encode([target], normalize_embeddings=True).astype("float32")
similarity_scores, match_indices = index.search(target_vec, top_k)
return [
(choices[idx], score)
for idx, score in zip(match_indices[0], similarity_scores[0])
if score >= threshold
]
def code_primary(answer_dicts, filename):
code_primary_questions = FieldSet(file_path=config.FIELD_JSON_PATH, field_type="code_primary_breakout").get_prompt_dict()
code_breakout_answers = []
for answer_dict in answer_dicts:
service, methodology = answer_dict.get("CONTRACT_SERVICE_CD_OR_DESC"), answer_dict.get("CONTRACT_REIMBURSEMENT_METHOD")
if service:
code_answer_dict = string_utils.universal_json_load(
llm_utils.invoke_claude(
investment_prompts.CODE_PRIMARY_BREAKOUT(service, methodology, code_primary_questions),
config.MODEL_ID_CLAUDE35_SONNET,
filename
)
)
else:
code_answer_dict = {}
code_breakout_answers.append({**answer_dict, **code_answer_dict})
return code_breakout_answers
def get_proc_crosswalk():
all_mappings = []
mapping_dir = "crosswalk/mapping_csvs/proc_cd"
for filename in os.listdir(mapping_dir):
if filename.endswith(".csv"):
mapping_df = pd.read_csv(os.path.join(mapping_dir, filename))
all_mappings.append(mapping_df)
proc_df = pd.concat(all_mappings, ignore_index=True)
return CrosswalkBuilder().from_df(proc_df, from_col="Code", to_col="Description")
def get_clean_value(service_description):
stop_words = {"the", "is", "in", "and", "to", "of", "a", "an", "that", "this", "it", "for", "on", "with", "as", "was", "were", "at", "by", "but", "be"} # Experiment with not removing 'and'
def remove_stop_words(text):
words = text.split()
return " ".join(word for word in words if word.lower() not in stop_words)
service_clean = service_description.lower()
# Replace "Services" and "Procedures"
service_clean = service_clean.replace("services", "").replace("procedures", "")
service_clean = service_clean.replace("DME", "Durable Medical Equipment") # Explore adding other acronyms
service_clean = remove_stop_words(service_clean)
# Explore lemmatization here
return service_clean
def get_best_match(target, model, thresholds={
"cpt": 0.85, "cpt_level3": 0.8, "cpt_level2": 0.75, "cpt_level1": 0.7,
"hcpcs": 0.85, "hcpcs_level3": 0.8, "hcpcs_level2": 0.75, "hcpcs_level1": 0.7
}):
levels = ["cpt", "hcpcs", "cpt_level3", "cpt_level2", "hcpcs_level2", "cpt_level1", "hcpcs_level1"]
# Get necessary mappings
crosswalk_dict = {}
for level in levels:
mapping_df = pd.read_csv(f"crosswalk/mapping_csvs/proc_cd/{level}.csv", dtype=str)
level_crosswalk = CrosswalkBuilder().from_df(mapping_df, from_col="Code", to_col="Description")
clean_to_description = {get_clean_value(x) : x for x in level_crosswalk.mapping.values()}
description_to_code = level_crosswalk.create_reverse_mapping()
crosswalk_dict[level] = (clean_to_description, description_to_code)
target_vec = model.encode([target], normalize_embeddings=True).astype("float32")
for level in levels:
index, _, choices = embedding_utils.load_faiss_index(index_path=os.path.join("embeddings", level, "faiss_index.bin"),
embedding_path=os.path.join("embeddings", level, "embeddings.npy"),
choices_path=os.path.join("embeddings", level, "choices.pkl"),)
similarity_scores, match_indices = index.search(target_vec, 1)
best_match, best_score = choices[match_indices[0][0]], similarity_scores[0][0]
if best_score >= thresholds[level]:
best_description = crosswalk_dict[level][0][best_match]
best_code = crosswalk_dict[level][1][best_description]
return best_code, best_description, best_score
return None, None, 0 # No valid match found
def code_indirect(answer_dicts):
"""
Maps free-form service descriptions to the best-matching code and description.
Caches results for efficiency and skips entries with existing codes or irrelevant text.
ONLY FOR PROC CODES RN
Args:
answer_dicts (list): List of dictionaries containing 1:N answers
filename (str): Unused parameter (can be removed if unnecessary).
Returns:
list: Updated list of dictionaries with mapped CPT4 procedure codes and descriptions.
"""
results = []
already_seen = {}
for answer_dict in answer_dicts:
service = answer_dict.get("CONTRACT_SERVICE_CD_OR_DESC", "")
proc_code = answer_dict.get("CPT4_PROC_CD")
if (not service # Service DNE
or "covered service" in service.lower() # Is generic
or isinstance(proc_code, list) # Is a list
or string_utils.is_empty(proc_code) # Is empty
):
pass # pass for now - we may need to add functionality here later
else:
if service in already_seen:
code = already_seen[service]['code']
description = already_seen[service]['description']
else:
code, description, score = get_best_match(service, model)
# print(service, " | ", description, " | ", code, " | ", score)
answer_dict["CPT4_PROC_CD"] = code
answer_dict["CPT4_PROC_DESC"] = description
results.append(answer_dict)
return results
def get_code_description(code, code_mapping):
if isinstance(code, str):
if string_utils.is_empty(code):
return "N/A"
elif "[" in code and "]" in code:
code_list = ast.literal_eval(code)
elif isinstance(code, list):
code_list = code
else:
code_list = [code]
code_description = []
for code in code_list:
code_str = str(code).strip()
description = code_mapping.mapping.get(code_str, "mismap")
if string_utils.is_empty(description) or description == "mismap":
# If mismap, prepend "0" and try again (useful for rev codes)
code_str = "0" + code_str
description = code_mapping.mapping.get(code_str, "mismap")
# We need similar logic for Diag codes with X (e.g. 123X)
# Could either: a) convert to list ([1230, 1231, ...]), b) convert to range (1230-1239), c) leave as is (123X) but have the descriptions be a list ["desc1","desc2", etc]
# for i in range(10): code is '123' + i' map that code
if not string_utils.is_empty(description):
code_description.append(description)
return ",".join(code_description)
def code_description_mapping(answer_dicts):
# Get mappings
# PROC codes
mapping_path = "crosswalk/mapping_csvs/"
all_proc_mappings = pd.concat([pd.read_csv(os.path.join(mapping_path, "proc_cd", file), dtype=str) for file in os.listdir(os.path.join(mapping_path, "proc_cd")) if file.endswith(".csv")])
proc_mapping = CrosswalkBuilder().from_df(all_proc_mappings, from_col="Code", to_col="Description")
# Diag codes
all_diag_mappings = pd.concat([pd.read_csv(os.path.join(mapping_path, "diag_cd", file), dtype=str) for file in os.listdir(os.path.join(mapping_path, "diag_cd")) if file.endswith(".csv")])
diag_mapping = CrosswalkBuilder().from_df(all_diag_mappings, from_col="Code", to_col="Description")
# Grouper codes
all_grouper_mappings = pd.concat([pd.read_csv(os.path.join(mapping_path, "grouper_cd", file), dtype=str) for file in os.listdir(os.path.join(mapping_path, "grouper_cd")) if file.endswith(".csv")])
grouper_mapping = CrosswalkBuilder().from_df(all_grouper_mappings, from_col="Code", to_col="Description")
grouper_version_mapping = CrosswalkBuilder().from_df(all_grouper_mappings, from_col="Code", to_col="Version")
# Rev codes
rev_mapping = CrosswalkBuilder().from_excel(path=os.path.join(mapping_path, "rev_cd", "rev_mapping.csv"), from_col="Code", to_col="Description")
# Admit Type codes
admit_mapping = CrosswalkBuilder().from_excel(path=os.path.join(mapping_path, "admit_type_cd", "admit_mapping.csv"), from_col="Code", to_col="Description")
for answer_dict in answer_dicts:
proc_code = answer_dict.get("CPT4_PROC_CD")
proc_mod = answer_dict.get("CPT4_PROC_MOD")
diag_code = answer_dict.get("DIAG_CD")
rev_code = answer_dict.get("REVENUE_CD")
grouper_code = answer_dict.get("FACILITY_GROUPER_CD")
admit_type_code = answer_dict.get("CLAIM_ADMIT_TYPE_CD")
answer_dict["CPT4_PROC_DESC"] = get_code_description(proc_code, proc_mapping)
answer_dict["CPT4_PROC_MOD_DESC"] = get_code_description(proc_mod, proc_mapping)
answer_dict["DIAG_CD_DESC"] = get_code_description(diag_code, diag_mapping)
answer_dict["REVENUE_CD_DESC"] = get_code_description(rev_code, rev_mapping)
answer_dict["FACILITY_GROUPER_DESC"] = get_code_description(grouper_code, grouper_mapping)
answer_dict["GROUPER_TYPE"] = get_code_description(grouper_code, grouper_version_mapping)
answer_dict["AUTH_ADMIT_TYPE_DESC"] = get_code_description(admit_type_code, admit_mapping)
return answer_dicts
def get_code_breakout(answer_dicts: list[dict], filename: str):
# Code Primary (Pull codes directly from CONTRACT_SERVICE_CD_OR_DESC and CONTRACT_REIMBURSEMENT_METHOD)
code_primary_answers = code_primary(answer_dicts, filename)
# Only used for Implicit. Code Indirect (Derive codes indirectly from CONTRACT_SERVICE_CD_OR_DESC and CONTRACT_REIMBURSEMENT_METHOD)
code_indirect_answers = code_indirect(code_primary_answers)
# Code Descriptions (Pull standardized descriptions from codes)
code_description_answers = code_description_mapping(code_indirect_answers)
return code_description_answers
+1 -1
View File
@@ -36,7 +36,7 @@ def main(testing=False, test_params = {}):
with concurrent.futures.ThreadPoolExecutor(max_workers=max_workers) as executor:
results = executor.map(lambda item: file_processing.process_file(item, run_timestamp), input_dict.items())
all_results.extend(results)
FINAL_RESULT_DF = pd.concat(all_results)
if not testing:
@@ -5,6 +5,7 @@ import re
import src.constants.valid as valid
import src.utils.llm_utils as llm_utils
import src.utils.string_utils as string_utils
import src.investment.code_funcs as code_funcs
from src import config, postprocessing_funcs
from src.enums.delimiters import Delimiter
from src.prompts.investment_prompts import FieldSet, Field
@@ -233,26 +234,6 @@ def get_methodology_breakout(reimbursement_primary_answers: list[dict], filename
return methodology_breakout_answers
def get_code_breakout(answer_dicts: list[dict], filename: str):
code_primary_questions = FieldSet(file_path=config.FIELD_JSON_PATH, field_type="code_primary_breakout").get_prompt_dict()
code_breakout_answers = []
for answer_dict in answer_dicts:
service, methodology = answer_dict.get("CONTRACT_SERVICE_CD_OR_DESC"), answer_dict.get("CONTRACT_REIMBURSEMENT_METHOD")
if service:
code_answer_dict = string_utils.universal_json_load(
llm_utils.invoke_claude(
investment_prompts.CODE_PRIMARY_BREAKOUT(service, methodology, code_primary_questions),
config.MODEL_ID_CLAUDE35_SONNET,
filename
)
)
else:
code_answer_dict = {}
code_breakout_answers.append({**answer_dict, **code_answer_dict})
return code_breakout_answers
def reimbursement_tin_npi(exhibit_chunk: str, reimbursement_level_fields: FieldSet) -> tuple[dict, FieldSet]:
"""
Extracts Reimbursement-Level TIN and NPI values from the given exhibit chunk using regex patterns. For multiple TIN/NPIs in Exhibit, assigns the field to be run as part of Reimbursement-Level Primary
@@ -288,31 +269,6 @@ def reimbursement_tin_npi(exhibit_chunk: str, reimbursement_level_fields: FieldS
return answer_dict, reimbursement_level_fields
def reimbursement_level(exhibit_text, filename, reimbursement_level_fields):
"""
Processes reimbursement-level fields.
Currently, runs REIMBURSEMENT_LEVEL_PRIMARY prompt only. Future secondary prompts will go in this function
Args:
exhibit_text (str): The text data to process.
filename (str): The name of the file
reimbursement_level_fields (FieldSet): A FieldSet object containing field prompts.
Returns:
dict: The parsed LLM response as a list of dictionaries
"""
reimbursement_primary_answers = get_reimbursement_primary(reimbursement_level_fields, exhibit_text, filename) # Returns list of dicts
carveout_answers = get_carveout_ind(reimbursement_primary_answers, filename)
# Later, we will only run methodology breakout for those without certain carveout indicators. We will run carveout-specific breakouts for the others
methodology_breakout_answers = get_methodology_breakout(carveout_answers, filename)
code_breakout_answers = get_code_breakout(methodology_breakout_answers, filename)
return code_breakout_answers
def combine_one_to_n_answers(exhibit_level_answers: dict, reimbursement_level_answers: list[dict], tin_npi_answers: dict) -> list[dict]:
"""
Combines exhibit-level answers with each dictionary in the reimbursement-level answers.
@@ -335,3 +291,25 @@ def combine_one_to_n_answers(exhibit_level_answers: dict, reimbursement_level_an
return combined_answers
def reimbursement_level(exhibit_text, filename, reimbursement_level_fields):
"""
Processes reimbursement-level fields.
Currently, runs REIMBURSEMENT_LEVEL_PRIMARY prompt only. Future secondary prompts will go in this function
Args:
exhibit_text (str): The text data to process.
filename (str): The name of the file
reimbursement_level_fields (FieldSet): A FieldSet object containing field prompts.
Returns:
dict: The parsed LLM response as a list of dictionaries
"""
reimbursement_primary_answers = get_reimbursement_primary(reimbursement_level_fields, exhibit_text, filename) # Returns list of dicts
carveout_answers = get_carveout_ind(reimbursement_primary_answers, filename)
# Later, we will only run methodology breakout for those without certain carveout indicators. We will run carveout-specific breakouts for the others
methodology_breakout_answers = get_methodology_breakout(carveout_answers, filename)
code_breakout_answers = code_funcs.get_code_breakout(methodology_breakout_answers, filename)
return code_breakout_answers
@@ -28,9 +28,8 @@ from itertools import chain, count, groupby
import shutil
# Setup bedrock
bedrock_client = boto3.client("bedrock-runtime", region_name="us-east-1")
embeddings_model = BedrockEmbeddings(
client=bedrock_client, model_id="amazon.titan-embed-text-v1"
client=config.BEDROCK_RUNTIME, model_id="amazon.titan-embed-text-v1"
)
@@ -416,7 +416,7 @@
"prompt": "TBD"
},
{
"field_name": "DIAG_CD_LIST",
"field_name": "DIAG_CD",
"relationship": "one_to_n",
"field_type": "code_primary_breakout",
"prompt": "Identify diagnosis codes (ICD-10) in the text: - 3-7 characters in length - First character must be a letter - Characters 2-3 must be numbers - Characters 4-7 (if present) can be numbers or letters."
@@ -0,0 +1,35 @@
import faiss
import pickle
import numpy as np
def create_faiss_index(choices, model, save_path="faiss_index.bin", embedding_path="embeddings.npy", choices_path="choices.pkl"):
embeddings = model.encode(choices, normalize_embeddings=True).astype("float32")
# Create FAISS index
index = faiss.IndexFlatIP(embeddings.shape[1])
index.add(embeddings)
# Save index
faiss.write_index(index, save_path)
# Save embeddings and choices for future use
np.save(embedding_path, embeddings)
with open(choices_path, "wb") as f:
pickle.dump(choices, f)
return index
def load_faiss_index(index_path="faiss_index.bin", embedding_path="embeddings.npy", choices_path="choices.pkl"):
index = faiss.read_index(index_path)
embeddings = np.load(embedding_path)
with open(choices_path, "rb") as f:
choices = pickle.load(f)
return index, embeddings, choices