doczyai-pipelines/fieldExtraction/crosswalk/mapping_csvs/rev_cd/rev_mapping.csv

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