Cohere Health’s Scope of Management: Alignment Health
Overview
Beginning September 29, 2026, select prior authorizations must be submitted through the Cohere Health portal for any of the procedure codes listed in the table below.
Whom and what services does this affect?
Lines of Business: Medicare Advantage & Duals
Clinical Scope: Pre-service requests for:
Prior authorizations for admission to post-acute care, such as:
Skilled Nursing Facilities (SNF)
Inpatient Rehabilitation Facilities (IRF)
Long-Term Acute Care Hospitals (LTACH)
Pre-planned inpatient admissions
Outpatient procedures/surgeries (office, ASC, outpatient hospital)
Part B medications reviewed by Alignment
Physician services
Advanced Imaging
Special testing (e.g., labs, genetics, diagnostics)
Home health (HH)
Durable medical equipment (DME)
If an authorization request is currently submitted to an entity delegated for Utilization Management, please continue to follow your existing process and submit requests directly to that delegated entity.
Concurrent review requests, including unplanned hospital admission and continued stay reviews for members who are already receiving care in a hospital or SNF setting, should continue to be submitted through the Alignment Virtual Application (“ AVA”) until these services transition to Cohere Health at a future date.
Service | Procedure Codes |
Abdomen, Peritoneum, and Omentum Procedures | 49321, 49406, 49215, 49605, 49606 |
Ablation | 50593, 50592 |
Accessory Sinuses Surgery | 31040, 31080, 31081, 31084, 31085, 31086, 31087, 31090 |
Administrative, Miscellaneous and Experimental | A9501, A9504, A9506, A9507, A9508, A9510, A9512, A9521, A9270, A9279, A9524, A9528, A9529, A9531, A9532, A9536, A9546, A9547, A9548, A9551, A9553, A9554, A9556, A9557, A9558, A9566, A9568, A9569, A9570, A9571, A9572, A9582, A9583, A9598, A9503, A9584, A9586, A9560, A9505, A9537, A9561, A9562, A9592, A9526, A9516, A9538, A9539, A9541, A9567, A9509, A9550, A9588, A9520, A9559, A9580, A9591 |
Administrative, Miscellaneous and Investigational | A9268, A9269, A9280, A9282, A9291, A9292, A9293, A9573, A9603, A9697, A9698, A9900 |
Alcohol and Drug Abuse Treatment | H0012, H0013, H0014, H0016, H0044, H2013, H2016, H2031 |
Anatomic Pathology | 88005, 88007, 88012, 88014, 88016, 88020, 88025, 88027, 88028, 88029, 88036, 88037, 88040, 88045, 88099 |
Anus Procedures | 46255, 46260, 46712, 46715, 46716, 46730, 46735, 46740, 46742, 46744, 46746, 46748, 46760, 0963T, 0967T |
Arteries and Veins Surgery | 35321, 34001, 34051, 34101, 34111, 34151, 34201, 34203, 34401, 34421, 34451, 34471, 34490, 34501, 34502, 34510, 34520, 34530, 34701, 34702, 34703, 34704, 34705, 34706, 34707, 34708, 34718, 34830, 34831, 34832, 34839, 34841, 34842, 34843, 34844, 34845, 34846, 34847, 34848, 35001, 35002, 35005, 35011, 35013, 35021, 35022, 35045, 35082, 35091, 35092, 35102, 35103, 35111, 35112, 35121, 35122, 35131, 35132, 35141, 35142, 35151, 35152, 35180, 35182, 35184, 35188, 35189, 35190, 35201, 35206, 35207, 35211, 35216, 35221, 35236, 35241, 35246, 35251, 35256, 35261, 35266, 35271, 35276, 35281, 35286, 35301, 35302, 35303, 35304, 35305, 35306, 35311, 35331, 35341, 35351, 35355, 35361, 35363, 35371, 35372, 35390, 35820, 36251, 36838, 37191, 37193, 37609, 35400, 35500, 35501, 35506, 35508, 35509, 35510, 35511, 35512, 35515, 35516, 35518, 35521, 35522, 35523, 35525, 35526, 35535, 35536, 35537, 35538, 35540, 35558, 35560, 35563, 35565, 35612, 35616, 35621, 35623, 35626, 35642, 35645, 35650, 35663, 35671, 35681, 35682, 35683, 35691, 35693, 35694, 35695, 35697, 35700, 35701, 35870, 35875, 35876, 35884, 35901, 35903, 35905, 35907, 36252, 36253, 36254, 36299, 36481, 36516, 36522, 36600, 36819, 36820, 36821, 36836, 36837, 36908, 37140, 37145, 37160, 37180, 37181, 37187, 37501, 37788, 37790, 37799, 37184, 35879, 35881, 35883 |
Arthrography | 73040, 73085, 73115, 73525, 73580, 73615 |
Arthroplasty | 21240, 21242, 0200T, 0201T, 0202T, 22857, 22862, 22865, 26531, 26535, 27446, 0164T, 0165T, 21243, 22860, 23470, 27437, 27438, 27440, 27441, 27442, 27443, 27700, 27702, 27703 |
Arthroplasty: Knee & Hip | 27130, 27134, 27447, 27486, 27487, 27125, 27132, 27137, 27138 |
Arthroplasty: Shoulder | 23472, 23474, 23473 |
Arthroscopy | 29846, 29855, 29856, 29892, 29999, 29800, 29804, 29830, 29834, 29835, 29836, 29837, 29838, 29840, 29843, 29844, 29845, 29847, 29850, 29851, 29860, 29861, 29862, 29863, 29891, 29893, 29894, 29895, 29897, 29898, 29899, 29900, 29901, 29902, 29904, 29905, 29906, 29907, 29914, 29915, 29916 |
Arthroscopy: Knee | 29875, 29877, 29880, 29881, 29883, 29888, 29868, 29866, 29867, 29870, 29871, 29873, 29874, 29876, 29879, 29882, 29884, 29885, 29886, 29887, 29889 |
Arthroscopy: Shoulder | 29806, 29827, 29805, 29807, 29819, 29820, 29821, 29822, 29823, 29824, 29825, 29826, 29828 |
Assorted Devices, Implants, and Systems | C1742, C8006 |
Bariatric Surgery Procedures | 43770, 43771, 43773, 43775 |
Biliary Tract Procedures | 47531, 47539, 47400, 47538, 47540, 47579, 47701, 47760, 47765, 47780, 47785, 47800, 47999 |
Bladder Procedure | 51715, 51999, 52500, 52648, 52649, 51597, 52284 |
Bladder Procedures | 52640, C9740, 51555, 51565, 51570, 51575, 51580, 51585, 51800, 51820, 51925, 51940, 51960, C9739 |
Bladder Sling | 51990, 57287, 57288, 51992 |
Blepharoplasty | 15820, 15821, 15822, 15823, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67909, 67911, 67912, 67914, 67915, 67916, 67917, 67921, 67922, 67923, 67924, 67950 |
Bone Marrow/Stem Cell Procedures | 38240, 38241, 38242, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38232 |
Bone/Joint Studies | 77078 |
Breast Procedures | 19105, 19120, 19125, 19355 |
Breast Surgical Procedures | 0970T, 0971T |
Brochoscopy | C8005 |
Capsule Endoscopy | 0651T, 91110, 91111, 91113 |
Cardiac Ablation | 93650, 93653, 93654, 93656, 0747T |
Cardiac Devices | 0408T, 33289, 33430, 33477, C1721, C1882, 0570T, 0572T, 0573T, 0574T, 0577T, 0580T, 0614T, 0620T, 0795T, 0796T, 0797T, 0798T, 0799T, 0800T, 0801T, 0802T, 0803T, 0805T, 0806T, 0823T, 0824T, 0825T, 0826T, 33222, 33236, 33237, 33238, 33251, 33300, 33370, 33390, 33391, 33405, 33410, 33411, 33418, 33419, 33425, 33426, 33427, 33463, 33464, 33465, 33475, 33530, 33858, 33859, 33863, 33864, 33999, 93583, 93590, C1605, C1722, C1764, 0981T, 0982T, 0983T, C1740, 0915T, 0916T, 0917T, 0918T, 0919T, 0920T, 0921T, 0922T, 0923T, 0924T, 0925T, 0926T, 0927T, 0933T, 0934T, 0409T, 0410T, 0411T, 0412T, 0413T, 0414T, 0415T, 0416T, 0417T, 0418T |
Cardiac DME: Defibrillator | 33249, 33262, 33263, 33264, 33270, 33273, 93620, 0571T, 33202, 33203, 33220, 33223, 33230, 33231, 33240, 33241, 33243, 33244, 33271, 33272, C7537, C7538, C7539, C7540, G0448 |
Cardiac DME: Electrocardiographic Services | 33285, 33286, 0650T, 93229, 93228 |
Cardiac DME: External Defibrillator | E0617, K0609, K0606 |
Cardiac DME: LAAC | 33340 |
Cardiac DME: Pacemaker | 33207, 33208, 33214, 33215, 33216, 33224, 33227, 33228, 33229, 33233, 33235, 33274, C1785, 0695T, 0696T, 33206, 33210, 33211, 33212, 33213, 33217, 33221, 33225, 33226, 33234, 33275, C1786, C2619, C2620, C2621 |
Cardiac DME: TAVR | 33361, 33362, 33363, 33364, 33365, 33366, 33367, 33368, 33369 |
Cardiac Imaging | 78466, 78468, 0716T, C8926 |
Cardiac Imaging: CCT/CCTA | 75571, 75572, 75573, 75574 |
Cardiac Imaging: Echocardiography | C8928, C8929, C8930 |
Cardiac Imaging: MRI/MRA | 75557, 75559, 75561, 75563, 75565 |
Cardiac Imaging: Non-Invasive Fractional Flow Reserve | 75580 |
Cardiac Interventions: Angioplasty and Vascular Stents | 37236, 37238, 37246, 37248, 0075T, 0076T, 33894, 33895, 33897, 37182, 37183, 37237, 37239, 37247, 37249 |
Cardiac Interventions: Percetaneous Coronary Intervention | 92920, 92924, 92928, 92933, 92937, 92943, 0659T |
Cardiac Interventions: Percutaneous Transluminal Angioplasty | 0505T, 37215 |
Cardiac Nuclear Imaging | 78429, 78430, 78431, 78432, 78433, 78434, 78451, 78452, 78453, 78454, 78459, 78469, 78472, 78473, 78481, 78483, 78491, 78492, 78494, 78496, 0742T, A9500, A9555, A9502 |
Cardiac Procedures/Services | 0345T, 0483T, 0484T |
Cardiac Procedures/Surgeries | 33927, 33928, 33929, 33930, 33933, 33935, 33940, 33944, 33945, 33975, 33976, 33979, 33981, 33982, 33983, 37200, 92970, 92971, 92986, 92997, 92998, 93548, C9600, C9602, C9604, C9607, 33030, 33031, 33050, 33120, 33130, 33140, 33141, 33250, 33254, 33255, 33256, 33257, 33258, 33259, 33261, 33265, 33266, 33267, 33268, 33269, 33305, 33310, 33315, 33320, 33321, 33322, 33330, 33335, 33404, 33406, 33412, 33413, 33414, 33415, 33416, 33417, 33420, 33422, 33440, 33460, 33468, 33474, 33476, 33478, 33496, 33500, 33501, 33502, 33503, 33504, 33505, 33506, 33507, 33510, 33511, 33512, 33513, 33514, 33516, 33517, 33518, 33519, 33521, 33522, 33523, 33533, 33534, 33535, 33536, 33542, 33545, 33548, 33572, 33600, 33602, 33606, 33608, 33610, 33611, 33612, 33615, 33617, 33619, 33620, 33621, 33622, 33641, 33645, 33647, 33660, 33665, 33670, 33675, 33676, 33677, 33681, 33684, 33688, 33690, 33692, 33694, 33697, 33702, 33710, 33720, 33724, 33726, 33730, 33732, 33735, 33736, 33741, 33745, 33746, 33750, 33755, 33762, 33764, 33766, 33767, 33768, 33770, 33771, 33774, 33775, 33776, 33777, 33778, 33779, 33780, 33781, 33782, 33783, 33786, 33788, 33800, 33802, 33803, 33814, 33820, 33822, 33824, 33840, 33845, 33851, 33852, 33853, 33866, 33871, 33875, 33877, 33880, 33881, 33883, 33886, 33900, 33901, 33902, 33903, 33910, 33915, 33916, 33917, 33920, 33922, 33925, 33926, 33977, 33978, 33980, 35081, 35226, 35231, 35531, 35533, 35539, 35556, 35566, 35570, 35571, 35572, 35583, 35585, 35587, 35600, 35601, 35606, 35631, 35632, 35633, 35634, 35636, 35637, 35638, 35646, 35647, 35654, 35656, 35661, 35665, 35666, 37216, 37217, 37218, 92987, 92990, 93581, 93582, 93591, 93592, 33990, 33991, 33995, 36245, 0913T, 0914T |
Cardiovascular Procedures | 93580 |
Carpal Tunnel | 29848 |
Cataract/Glaucoma Surgery | 0449T, 0621T, 0622T, 0671T, 66991 |
Catheterization and Angiography | 36222, 36223, 36224, 36226, 93451, 93452, 93453, 93454, 93455, 93456, 93457, 93458, 93459, 93460, 93461, 93505, 0523T, 75710, 75716, 92978 |
Cervix Uteri Procedures | 57522 |
Chemistry | 83516, 83520, 84999 |
Chemodenervation and Botulinum Toxins | 64615, J0585, J0586, J0587, J0588, 64611, 64612, 64616, 64617, 64642, 64650, 64653, 67345 |
Chemotherapy Drugs | J9057, J9175, J9213, J9215, J9225, J9226, J9230, J9285, J9332, J9219, J9376, J9275, J9333, J9334, J9011 |
Chemotherapy Drugs, Oral Administration | J8515, J8597 |
Cochlear Implant | 69930, L8614, L8619 |
Code Deleted | Q4381 |
Colon and Rectum Procedures | 44204, 44206, 44207, 44208, 44210, 44211, 44227, 45110, 45111, 45112, 45113, 45114, 45116, 45119, 45120, 45121, 45126, 45136, 45395, 45397, 45399, 45400, 45402, 45499, 45550, 45563, 45999 |
Colorectal Cancer Screening | 0464U, 74263 |
Compression Stockings | A6530, A6531, A6532, A6533, A6534, A6535, A6536, A6537, A6538, A6539, A6540, A6541, A6544, A6545, A6548, A6549 |
Computed Tomographic Angiography | 0710T, 0711T, 0712T, 0713T, 72191, 74174, 74175, 75635 |
Computed Tomography | 0558T, 72126, 72127, 72129, 72130, 72131, 72132, 72133, 72193, 72194, 73201, 73202, 74261, 74262 |
Computed Tomography (CT) | 73206, 73706 |
Conjunctiva Procedures | 68320, 68325, 68326, 68328, 68330, 68335, 68340, 68360, 68362, 68371, 68399 |
Cornea Procedures | 65778, 65785, 65730, 65755, 65756, 65780, 65710, 65750, 65757, 65760, 65765, 65767, 65770, 65771, 65772, 65775, 65779, 65781, 65782 |
Corpus Uteri Procedures | 58120, 58260, 58262, 58263, 58270, 58578, 58210, 58240, 58356, 58548, 58565, 58575, 58579, 58580 |
Cosmetic and Reconstructive Surgery | 15781, 15830, 15847, 15877, 19316, 19318, 19325, 19328, 19330, 19340, 19342, 19350, 19357, 19361, 19364, 19367, 19368, 19369, 19370, 19371, 19380, 19396, 30400, 30410, 30420, 30430, 30435, 30450, 19300, 30468, 30460, 30462, 30465, 30520 |
Cytogenetic Studies | 88299 |
Cytopathology | 88199 |
Dentoalveolar Structures Procedures | 41874, 41870, 41899 |
Destruction Procedures | 17380 |
Destruction Procedures - Integumentary System | 17340, 17360 |
Diagnostic Imaging | 0598T, 0599T |
Diagnostic Ultrasound Procedures | 76999 |
Dialysis Access Maintenance | 36903, 36907, 37186 |
Diaphragm Surgery | 39501, 39503, 39540, 39541, 39545, 39560, 39561, 39599 |
DME - Cardiac | Q0477, Q0481, Q0482, Q0483, Q0484, Q0488, Q0489, Q0490, Q0491, Q0495, Q0496, Q0506, Q0507, Q0508, Q0509 |
DMEPOS | Q1004, Q1005, Q2052, Q3031, Q4050, R0070, S4024 |
Drugs Administered Oral Method | J0571, J0572, J0573, J0574, J0575, J7500, J7502, J7503, J7507, J7508, J7510, J7515, J7517, J7518, J7527, J1202 |
Drugs Administered Other Than Oral Method | J0121, J0122, J0129, J0130, J0132, J0179, J0180, J0202, J0210, J0220, J0221, J0222, J0224, J0256, J0257, J0270, J0275, J0278, J0280, J0282, J0285, J0287, J0289, J0291, J0295, J0300, J0330, J0348, J0364, J0390, J0400, J0401, J0470, J0480, J0485, J0490, J0500, J0515, J0517, J0520, J0565, J0567, J0583, J0584, J0593, J0595, J0596, J0597, J0598, J0599, J0600, J0606, J0620, J0630, J0636, J0638, J0695, J0706, J0712, J0714, J0716, J0717, J0720, J0725, J0740, J0743, J0745, J0770, J0775, J0780, J0834, J0840, J0841, J0875, J0883, J0884, J0890, J0895, J0945, J1000, J1095, J1110, J1120, J1130, J1165, J1180, J1205, J1212, J1230, J1240, J1245, J1260, J1265, J1290, J1301, J1305, J1320, J1322, J1324, J1325, J1327, J1364, J1380, J1426, J1427, J1428, J1429, J1430, J1435, J1436, J1437, J1438, J1439, J1451, J1455, J1458, J1460, J1560, J1571, J1573, J2406, J7352, J1595, J1600, J1602, J1610, J1628, J1640, J1675, J1726, J1729, J1730, J1740, J1742, J1743, J1744, J1745, J1746, J1786, J1790, J1800, J1817, J1826, J1830, J1833, J1835, J1931, J1943, J1944, J1953, J1955, J1960, J1980, J1990, J2010, J2062, J2170, J2180, J2182, J2186, J2210, J2212, J2260, J2265, J2274, J2278, J2300, J2320, J2323, J2325, J2326, J2350, J2355, J2357, J2358, J2360, J2407, J2425, J2426, J2440, J2460, J2502, J2507, J2515, J2545, J2547, J2560, J2590, J2597, J2650, J2670, J2680, J2690, J2700, J2704, J2710, J2720, J2724, J2725, J2730, J2760, J2778, J2785, J2786, J2787, J2788, J2790, J2791, J2793, J2797, J2798, J2810, J2840, J2850, J2941, J2993, J3000, J3031, J3060, J3070, J3090, J3095, J3101, J3230, J3241, J3245, J3246, J3250, J3265, J3285, J3316, J3350, J3357, J3358, J3360, J3380, J3385, J3397, J3411, J3415, J3430, J3470, J3471, J3472, J3473, J3485, J3486, J3520, J3530, J3570, J3591, J7100, J7110, J7121, J7170, J7175, J7177, J7178, J7179, J7180, J7181, J7182, J7183, J7185, J7186, J7187, J7188, J7189, J7190, J7191, J7192, J7193, J7194, J7195, J7196, J7197, J7198, J7199, J7200, J7201, J7202, J7203, J7205, J7207, J7208, J7209, J7210, J7211, J7296, J7297, J7298, J7300, J7301, J7304, J7306, J7311, J7313, J7314, J7315, J7316, J7340, J7342, J7504, J7511, J7525, J7604, J7605, J7607, J7608, J7628, J7629, J7637, J7638, J7639, J7640, J7641, J7642, J7643, J7647, J7648, J7649, J7650, J7657, J7658, J7659, J7660, J7665, J7667, J7668, J7669, J7670, J7674, J7676, J7677, J7680, J7681, J7682, J7683, J7684, J7685, J7686, J7699, J8498, Q0138, J0225, J0879, J1302, J0219, J0223, J0491, J0791, J1306, J1823, J1951, J2327, J2356, J2777, J2779, J3032, J7351, J7402, 0627T, 0628T, 0629T, 0630T, 0707T, 11950, 11951, 11952, 22510, 22511, 22512, J0216, J0218, J0591, J0691, J0799, J0801, J0802, J1203, J1411, J1440, J1748, J2267, J3247, J3393, J3394, J3399, J7165, J7171, J7212, J7213, J7294, J7354, J7355, Q5128, J0175, J0217, J0666, J1304, J2351, J2508, J3391, J3401, J7601, Q5098, Q5099, Q5100 |
Drugs Administered Other than Oral Method | J0570, J0604, J1096, J1097, J7330, J7336, J7999, J2998, J7307, J7172, J7356, J1809, J2428, J3402, J3403, J7173, J7174 |
Durable Medical Equipment | E0194, E0247, E0248, E0462, E0603, E0616, E0618, E0652, E0710, E0746, E0761, E1399, E1500, E1510, E1520, E1530, E1540, E1550, E1560, E1575, E1580, E1590, E1592, E1594, E1600, E1615, E1620, E1625, E1630, E1632, E1634, E1635, E1636, E1699, E1812, E2510, K0108, K0730, K0744, K0745, K0746, K0898, K0899, A9999, E0203, E0221, E0270, E0446, E0481, E0530, E0651, E0656, E0657, E0660, E0665, E0666, E0667, E0668, E0669, E0670, E0671, E0672, E0673, E0675, E0676, E0677, E0678, E0679, E0680, E0681, E0682, E1610, E1629, E1840, E1902, E1905, E2502, E2504, E2506, E2508, E2512, E2599, E8000, E8001, E8002, K0669, K0900, K1007, K1035, K1036, E0201, E1022, E1023, E1032, E1033, E1034, E1832, E0150, E0658, E0659 |
Electroretinography | 0509T, 0604T, 0605T, 0606T, 0615T |
Embolization | 37241, 37244, 61626, 36909, 61710, 75894 |
Enteral and Parenteral Therapy | B4168, B4172, B4176, B5100, B4193, B9998, B9999 |
Epidural Steroid Injection | 64479, 64480, 64483, 64484, 62321, 62323 |
Esophagogastroduodenoscopy | 43212, 43220, 43229, 0652T, 0653T, 0654T, 44401, 43235, 43239 |
Esophagus Procedures | 43280, 43281, 43282, 43107, 43108, 43112, 43113, 43116, 43117, 43118, 43121, 43122, 43123, 43124, 43135, 43286, 43287, 43288, 43289, 43290, 43360, 43361, 43415, 43496, 43497, 43499 |
External Ear Procedures | 69090, 69110, 69120, 69140, 69145, 69150, 69155, 69300, 69320, 69399 |
Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System Cord Procedures | 64568, 64702, 64704, 64708, 64714, 64999, 64582, 64583, 64584, 64624, 64628, 64629, 64790, 64792, 64802, 64804, 64809, 64818, 64820, 64821, 64822, 64823, 64831, 64832, 64834, 64835, 64836, 64837, 64840, 64856, 64857, 64858, 64859, 64861, 64862, 64864, 64865, 64866, 64868, 64872, 64874, 64876, 64885, 64886, 64890, 64891, 64892, 64893, 64895, 64896, 64897, 64898, 64901, 64902, 64905, 64910, 64911, 64912, 64913 |
Extraocular Muscles Procedures | 67316, 67318, 67320, 67399 |
Eye Procedures | 21282, 21280 |
Eye Procedures/Services | 0379T, 0687T, 0688T, 0704T, 0705T, 0706T |
Eye Surgery | 66999, 67971, 67974, 68761 |
Eyeball Procedures | 65091, 65093, 65101, 65103, 65105, 65110, 65112, 65114, 65125, 65130, 65135, 65140, 65150, 65155, 65175 |
Eyelid Procedures | 67961, 67966, 67973, 67975, 67999 |
Facet Pain Intervention | 0213T, 0214T, 0215T, 0216T, 0217T, 0218T, 0219T, 0220T, 0221T, 0222T, 64635, 64490, 64491, 64492, 64493, 64494, 64495, 64633, 64634, 64636 |
Femur and Knee Joint Surgery | 27337, 27380, 27381, 27385, 27405, 27425, 27397, 27400, 27403, 27407, 27409, 27418, 27420, 27422, 27424, 27427, 27428, 27429, 27430, 27435, 27448, 27450, 27454, 27455, 27457, 27465, 27466, 27470, 27472, 27475, 27477, 27479, 27485, 27488, 27495, 27580, 27599 |
Foot and Toes Surgery | 28344, 28107, 28320, 28322, 28615, 28705, 28715, 28725, 28730, 28740, 28750, 28755, 28805, 28810, 28825, 28890, 28899, 28261, 28262, 28264, 28270, 28272, 28280, 28340, 28341, 28345, 28360, 28735, 28737, 28760 |
Foot Surgery | 28112, 28118, 28122, 28124, 28238, 28288, 28291, 28296, 28297, 28298, 28299, 28300, 28304, 28309, 28285, 28286, 28289, 28292, 28295, 28313, 28315, 28308 |
Forearm and Wrist Surgery | 25312, 25400, 25405, 25445, 25447, 25449, 25820, 25825, 26055, 25999 |
Gastric Physiology Procedures | 91132, 91133 |
Gastroenterology | 50300, 50320, 49320, 49324, 49329, 56620, 43644, 43645, 43842, 43843, 43846, 43847, 49999, 50230, 55980, 57111, E0650 |
Gastroenterology Procedures | 91112 |
General Surgical Procedures - Musculoskeletal System | 20150, 20802, 20805, 20808, 20816, 20822, 20824, 20827, 20838, 20910, 20912, 20955, 20956, 20957, 20962, 20969, 20970, 20972, 20973, 20982, 20983 |
Generator (Implantable) | C1824, C1825 |
Genomic Sequencing | 81162, 81170, 81206, 81212, 81218, 81219, 81225, 81226, 81227, 81235, 81240, 81241, 81270, 81272, 81275, 81276, 81291, 81292, 81295, 81298, 81314, 81317, 81321, 81401, 81432, 81435, 81437, 81445, 81450, 81455, 81519, 81520, 81525, 81535, 81536, 81538, 81540, 0037U, 0047U, 0239U, 81161, 81171, 81172, 81173, 81174, 81221, 81224, 81228, 81229, 81230, 81231, 81232, 81238, 81302, 81404, 81405, 81420, 81503, 81507, 81521, 81529, 0001U, 0002M, 0002U, 0003M, 0003U, 0005U, 0006M, 0007M, 0008U, 0009U, 0010U, 0011M, 0012M, 0013M, 0015M, 0016M, 0017M, 0018U, 0019M, 0019U, 0020M, 0021U, 0022U, 0023U, 0026U, 0029U, 0034U, 0036U, 0040U, 0045U, 0046U, 0048U, 0049U, 0050U, 0055U, 0060U, 0069U, 0070U, 0071U, 0072U, 0073U, 0074U, 0075U, 0076U, 0079U, 0080U, 0084U, 0087U, 0088U, 0089U, 0090U, 0091U, 0092U, 0094U, 0095U, 0101U, 0102U, 0103U, 0105U, 0111U, 0112U, 0113U, 0114U, 0115U, 0117U, 0118U, 0120U, 0129U, 0130U, 0133U, 0134U, 0136U, 0137U, 0138U, 0140U, 0152U, 0153U, 0154U, 0155U, 0156U, 0157U, 0158U, 0159U, 0160U, 0161U, 0162U, 0166U, 0169U, 0170U, 0171U, 0172U, 0173U, 0174U, 0175U, 0177U, 0179U, 0180U, 0182U, 0184U, 0187U, 0188U, 0189U, 0190U, 0191U, 0192U, 0193U, 0195U, 0196U, 0198U, 0199U, 0200U, 0202U, 0203U, 0206U, 0207U, 0209U, 0211U, 0212U, 0213U, 0214U, 0215U, 0216U, 0217U, 0218U, 0219U, 0221U, 0222U, 0223U, 0225U, 0229U, 0230U, 0231U, 0232U, 0233U, 0234U, 0235U, 0236U, 0237U, 0238U, 0242U, 0244U, 0245U, 0246U, 0247U, 0249U, 0250U, 0252U, 0253U, 0254U, 0258U, 0260U, 0262U, 0263U, 0264U, 0265U, 0266U, 0267U, 0268U, 0269U, 0270U, 0271U, 0272U, 0273U, 0274U, 0276U, 0277U, 0278U, 0282U, 0285U, 0287U, 0288U, 0289U, 0290U, 0291U, 0292U, 0293U, 0294U, 0295U, 0296U, 0297U, 0298U, 0299U, 0300U, 0301U, 0302U, 0306U, 0307U, 0308U, 0309U, 0310U, 0312U, 0313U, 0314U, 0315U, 0317U, 0318U, 0319U, 0320U, 0321U, 0322U, 0323U, 0326U, 0327U, 0329U, 0330U, 0331U, 0332U, 0333U, 0334U, 0335U, 0336U, 0338U, 0339U, 0340U, 0341U, 0343U, 0344U, 0345U, 0347U, 0348U, 0349U, 0350U, 0351U, 0356U, 0360U, 0362U, 0363U, 0364U, 0365U, 0366U, 0367U, 0368U, 0371U, 0372U, 0375U, 0379U, 0384U, 0385U, 0387U, 0388U, 0389U, 0391U, 0392U, 0395U, 0398U, 0400U, 0401U, 0402U, 0403U, 0405U, 0407U, 0409U, 0410U, 0411U, 0412U, 0413U, 0415U, 0417U, 0419U, 0420U, 0421U, 0422U, 0423U, 0424U, 0425U, 0426U, 0433U, 0434U, 0436U, 0437U, 0438U, 0439U, 0440U, 0444U, 0446U, 0447U, 0449U, 0454U, 0458U, 0460U, 0461U, 0463U, 0465U, 0466U, 0467U, 0468U, 0469U, 0470U, 0471U, 0473U, 0474U, 0475U, 81120, 81121, 81163, 81164, 81165, 81166, 81167, 81168, 81175, 81185, 81189, 81191, 81192, 81193, 81194, 81201, 81202, 81236, 81237, 81239, 81248, 81249, 81256, 81258, 81259, 81265, 81266, 81267, 81268, 81269, 81274, 81277, 81278, 81279, 81285, 81286, 81306, 81307, 81308, 81309, 81320, 81324, 81325, 81333, 81334, 81336, 81338, 81349, 81350, 81351, 81352, 81353, 81362, 81363, 81364, 81370, 81371, 81372, 81373, 81376, 81378, 81379, 81382, 81406, 81407, 81408, 81410, 81411, 81412, 81413, 81414, 81415, 81416, 81417, 81418, 81419, 81422, 81425, 81426, 81427, 81430, 81431, 81434, 81439, 81440, 81441, 81442, 81443, 81448, 81449, 81451, 81456, 81457, 81458, 81459, 81460, 81462, 81463, 81464, 81465, 81470, 81471, 81490, 81493, 81500, 81504, 81509, 81518, 81522, 81523, 81539, 81541, 81542, 81546, 81551, 81552, 81554, 81599 |
Glucose Monitor | A4239, E2103, A4238, A9276, A9277, A9278, E0620, E2100, E2101, E2102 |
Hand and Fingers Surgery | 26123, 26356, 26437, 26445, 26536, 26615, 26706, 26735, 26841, 26844, 26850, 26860, 26862, 26951, 26550, 26551, 26553, 26554, 26555, 26556, 26560, 26561, 26562, 26565, 26567, 26568, 26580, 26587, 26590, 26989 |
Head Surgery | 21120, 21121, 21122, 21123, 21125, 21127, 21137, 21138, 21139, 21141, 21142, 21143, 21145, 21146, 21147, 21150, 21151, 21154, 21155, 21159, 21160, 21172, 21175, 21179, 21180, 21181, 21182, 21183, 21184, 21188, 21193, 21194, 21195, 21196, 21198, 21199, 21206, 21210, 21215, 21230, 21235, 21244, 21245, 21246, 21247, 21248, 21249, 21255, 21256, 21260, 21261, 21263, 21267, 21268, 21275, 21299, 21026, 21209, 21010, 21034, 21040, 21044, 21045, 21046, 21047, 21048, 21049, 21050, 21060, 21070, 21076, 21077, 21079, 21080, 21081, 21082, 21083, 21084, 21086, 21087, 21088, 21089, 21100, 21110, 21208, 21270, 21295, 21296, 21440, 21445, 21499, 31225, 31230, 31242, 31243 |
Hearing Services | 69714, V5030, V5040, V5050, V5060, V5070, V5080, V5095, V5100, V5120, V5130, V5140, V5171, V5172, V5181, V5190, V5211, V5212, V5213, V5214, V5215, V5221, V5230, V5242, V5243, V5244, V5245, V5246, V5247, V5248, V5249, V5250, V5251, V5252, V5253, V5254, V5255, V5256, V5257, V5258, V5259, V5260, V5261, V5262, V5263, V5267, V5270, V5273, V5274, V5298, V5299, V5362, V5363 |
Hematology and Coagulation | 85999 |
Hernia Repair | 49505, 49507, 49520, 49521, 49525 |
Home Health | G0155, G0156, G0162, G0299, G0300, G0490, G0494, G0495, G0496, Q5001, Q5002, Q5003, Q5004, Q5005, Q5006, Q5007, Q5008, Q5009, Q5010 |
Home Health Procedures and Services | 99503, 99504, 99505, 99506, 99507, 99511, 99512 |
Home Health/Hospice Services | G0153, G0161, G0493 |
Home Ventilator | E0465, E0466, E0467, E0468 |
Hospital Bed or Mattress | E0193, E0277, E0300, E0302, E0304, E0316, E0328, E0329, E0371, E0372, E0373, E0181, E0185, E0186, E0187, E0197, E0198, E0250, E0251, E0255, E0256, E0260, E0261, E0265, E0266, E0290, E0291, E0292, E0293, E0294, E0295, E0296, E0297, E0301, E0303 |
Hyaluronic Acid | J7318, J7320, J7322, J7324, J7326, J7327, J7328, J7329, J7331, J7332 |
Immune Globulins, Serum or Recombinant Products | 90283, 90284 |
Immunology Procedures | 86316 |
Implant/Prosthesis (includes medication implant) | C1776, C1789, C1813, C1821, C1889, C2622, C1741 |
In Vitro Fertilization Procedures | 58970, 58974, 58976 |
Incontinence Supplies | A4520, A4553, A4554, E0350, A4337, A4459 |
Infusion Pump | 62361, 62362, 62365, E0782, E0783, E0784, E0785, E0786, G0498, K0455, Q0081, Q0084, Q0085, B9004, B9006, C1891, C2626, E0791 |
Injections | C9462 |
Inner Ear Procedures | 69805, 69806, 69905, 69910, 69915, 69949 |
Integumentary Procedures | 15780, 15782, 15783, 15786, 15787, 15788, 15789, 15792, 15793, 17106, 17107, 17999, 15824, 15825, 15756, 15757, 15758, 15760, 15769, 15770 |
Integumentary System Procedures/Services | 11920, 11921, 11922, 11960, 11971, 17108, 15826, 15828, 15829, 11970, 15570, 15572, 15574, 15576, 15630, 15650, 15730, 15731, 15733, 15734, 15736, 15738, 15740, 15750, 15775, 15776, 15832, 15833, 15834, 15835, 15836, 15837, 15838, 15839, 0973T, 0974T, 0975T, 0976T |
Intestines (Except Rectum) Procedures | 44132, 44133, 44135, 44136, 44137, 44715, 44720, 44721, 44126, 44127, 44141, 44143, 44144, 44145, 44146, 44147, 44150, 44151, 44155, 44156, 44157, 44158, 44238, 44603, 44799 |
Investigational and Experimental Codes | 0100T, 0308T, 0378T, 0402T, 0479T, 0480T, 0481T, 0485T, 0486T, 0488T, 0489T, 0490T, 0494T, 0495T, 0496T, 0506T, 0507T, 0510T, 0511T, 0512T, 0513T, 0515T, 0516T, 0517T, 0518T, 0519T, 0520T, 0521T, 0522T, 0525T, 0526T, 0527T, 0528T, 0529T, 0530T, 0531T, 0532T, 0541T, 0542T, 0543T, 0544T, 0545T, 0546T, 0547T, 0552T, 0554T, 0555T, 0556T, 0557T, 0559T, 0560T, 0561T, 0562T, 0563T, 0565T, 0566T, 0575T, 0576T, 0578T, 0579T, 0581T, 0582T, 0583T, 0584T, 0585T, 0586T, 0587T, 0588T, 0589T, 0590T, 0591T, 0592T, 0593T, 0594T, 0596T, 0597T, 0600T, 0601T, 0602T, 0603T, 0607T, 0608T, 0609T, 0610T, 0611T, 0612T, 0613T, 0632T, 0633T, 0634T, 0635T, 0636T, 0637T, 0638T, 0639T, 0640T, 0643T, 0644T, 0645T, 0646T, 0647T, 0648T, 0649T, 0655T, 0658T, 0660T, 0661T, 0664T, 0665T, 0666T, 0667T, 0668T, 0669T, 0670T, 0672T, 0673T, 0674T, 0675T, 0676T, 0677T, 0678T, 0679T, 0680T, 0681T, 0682T, 0683T, 0684T, 0685T, 0686T, 0689T, 0690T, 0691T, 0692T, 0693T, 0694T, 0697T, 0698T, 0699T, 0700T, 0701T, 0708T, 0709T, 0714T, 0717T, 0718T, 0721T, 0722T, 0723T, 0725T, 0726T, 0727T, 0728T, 0729T, 0730T, 0731T, 0732T, 0733T, 0734T, 0735T, 0736T, 0738T, 0739T, 0740T, 0741T, 0743T, 0744T, 0745T, 0746T, 0748T, 0749T, 0750T, 0751T, 0752T, 0753T, 0754T, 0755T, 0756T, 0757T, 0758T, 0759T, 0760T, 0761T, 0762T, 0763T, 0764T, 0765T, 0766T, 0767T, 0770T, 0771T, 0772T, 0773T, 0774T, 0776T, 0777T, 0778T, 0779T, 0780T, 0781T, 0782T, 0786T, 0787T, 0788T, 0789T, 0790T, 0791T, 0792T, 0793T, 0794T, 0804T, 0807T, 0808T, 0810T, 0811T, 0812T, 0813T, 0814T, 0815T, 0816T, 0817T, 0818T, 0819T, 0820T, 0821T, 0822T, 0827T, 0828T, 0829T, 0830T, 0831T, 0832T, 0833T, 0834T, 0835T, 0836T, 0837T, 0838T, 0839T, 0840T, 0841T, 0842T, 0843T, 0844T, 0845T, 0846T, 0847T, 0848T, 0849T, 0850T, 0851T, 0852T, 0853T, 0854T, 0855T, 0856T, 0857T, 0858T, 0859T, 0860T, 0861T, 0862T, 0863T, 0864T, 0865T, 0866T, 0867T, 0868T, 0869T, 0870T, 0871T, 0872T, 0873T, 0874T, 0875T, 0876T, 0877T, 0878T, 0879T, 0880T, 0881T, 0882T, 0883T, 0884T, 0885T, 0886T, 0887T, 0888T, 0889T, 0890T, 0891T, 0892T, 0893T, 0894T, 0895T, 0896T, 0897T, 0898T, 0899T, 0900T, 0948T, 0949T, 0950T |
Kidney Procedure | 50433, 50220, 50225, 50234, 50236, 50240, 50405, 50543, 50545 |
Kidney Procedures | 50541, 58321, 58322, 58323, 58544, 58285 |
Kidney Stones | 50590, 50961, C9761 |
Laboratory/Pathology | 0961T |
Lacrimal System Procedures | 68500, 68505, 68520, 68540, 68550, 68750, 68760, 68770, 68899 |
Larynx Surgery | 31360, 31365, 31367, 31368, 31370, 31375, 31380, 31382, 31390, 31395, 31400, 31420, 31551, 31552, 31553, 31580, 31584, 31587, 31590, 31591, 31592, 31599, 31600 |
Lift DME | E0635, E0636, E0639, E1035, E1036, E0630 |
Lip Procedures | 40525, 40527, 40530, 40700, 40701, 40702, 40720, 40761 |
Liver Procedures | 47379, 47382, 47135, 47143, 47147, 47133, 47140, 47141, 47142, 47144, 47145, 47146, 47120, 47122, 47125, 47130, 47360, 47361, 47362, 47370, 47371, 47380, 47381, 47383, 47399 |
Lower Extremity Orthoses | 1990, L1834, L1844, L1904, L1920, L2000, L2005, L2010, L2020, L2030, L2034, L2036, L2037, L2038, L2126, L2136, L2232, L2320, L2387, L2520, L2525, L2526, L3160, L4030, L4040, L4045, L4050, L4055, L4631, L1831, L1832, L1833, L1840, L1843, L1845, L1846, L1847, L1848, L1851, L1852, L1860, L1900, L1907, L1932, L1940, L1945, L1950, L1951, L1960, L1970, L1971, L1980, L1990, L2006, L2350, L2510, L3000, L3230, L3250, L3251, L3252, L3253 |
Lower Leg and Ankle joint Surgery | 27685, 27687, 27690, 27691, 27695, 27696, 27698 |
Lower Leg and Ankle Joint Surgery | 27709, 27720, 27766, 27829, 27886, 27704, 27705, 27707, 27712, 27715, 27722, 27724, 27725, 27726, 27727, 27730, 27732, 27734, 27740, 27742, 27745, 27899 |
Lower Limb Prosthetics | L5230, L5250, L5270, L5280, L5301, L5312, L5321, L5331, L5341, L5590, L5595, L5600, L5700, L5701, L5702, L5781, L5782, L5814, L5840, L5856, L5857, L5961, L5968, L5973, L5979, L5980, L5981, L5987, L5000, L5010, L5020, L5050, L5060, L5100, L5105, L5150, L5160, L5200, L5210, L5220, L5510, L5520, L5530, L5535, L5540, L5560, L5570, L5580, L5585, L5610, L5611, L5613, L5614, L5615, L5616, L5617, L5618, L5630, L5631, L5632, L5634, L5636, L5637, L5643, L5645, L5646, L5647, L5649, L5650, L5651, L5652, L5653, L5654, L5655, L5656, L5658, L5661, L5665, L5671, L5672, L5673, L5676, L5677, L5679, L5680, L5681, L5682, L5683, L5699, L5704, L5705, L5706, L5707, L5710, L5711, L5712, L5714, L5716, L5718, L5722, L5724, L5726, L5728, L5780, L5783, L5785, L5790, L5795, L5810, L5811, L5812, L5816, L5818, L5822, L5824, L5826, L5828, L5830, L5841, L5845, L5848, L5858, L5859, L5910, L5920, L5925, L5926, L5930, L5940, L5950, L5960, L5962, L5964, L5966, L5969, L5970, L5971, L5972, L5976, L5978, L5982, L5984, L5985, L5986, L5988, L5990, L5991 |
Lung Transplant | S2060, S2061 |
Lungs and Pleura Surgery | 32850, 32851, 32852, 32853, 32854, 32856, 32855, 32035, 32036, 32096, 32097, 32098, 32100, 32110, 32120, 32124, 32140, 32141, 32150, 32151, 32200, 32215, 32220, 32310, 32320, 32440, 32442, 32445, 32480, 32482, 32484, 32486, 32488, 32491, 32503, 32504, 32505, 32506, 32507, 32540, 32650, 32651, 32652, 32653, 32654, 32655, 32656, 32658, 32659, 32661, 32662, 32663, 32664, 32665, 32666, 32667, 32668, 32669, 32670, 32671, 32672, 32673, 32674, 32800, 32810, 32815, 32820, 32900, 32905, 32906, 32940, 32994, 32998 |
Luxturna | J3398 |
Lymph Nodes and Lymphatic Channels Surgery | 38380, 38381, 38382, 38589, 38700, 38720, 38724, 38999 |
Magnetic Resonance Angiography | 70545, 70544, 70546, 70547, 70548, 70549, 71555, 72159, 72198, 73725, 74185 |
Magnetic Resonance Imaging | 0724T, 70540, 70542, 70543, 70554, 70555, 71550, 71551, 71552, 72141, 72142, 72146, 72147, 72148, 72149, 72156, 72157, 72158, 72195, 72196, 72197, 73218, 73219, 73220, 73221, 73222, 73223, 73225, 74181, 74182, 74183, 76390, 76391 |
Magnetic Resonance Imaging (MRI) | L0859 |
Maternity Care and Delivery | 59012, 59898, 59899 |
Mediastinum Surgery | 39000, 39010, 39200, 39220, 39499 |
Medical And Surgical Supplies | A4335, A2026, A4555, A4649, A5501, A2031, A2032, A2033, A2034, A2035, A2036, A2037, A2038, A2039, A4288 |
Medical and Surgical Supplies | A2017, A4400, A4542, A4563, A4596, A4633, A4634, A4650, A4890, A6559, A2030, A5500, A5503, A5504, A5505, A5506, A5507, A5508, A5510, A5512, A5513, A5514 |
Medical Pharmacy: Aflibercept | J0178, J0177 |
Medical Services | M0075, M0076, M0100, M0224, M0249, M0250, M0300, M0301, M1059, M1067, M1159, M1167, M1186, M1191, M1275, M0235, M0236, M0237, M0238 |
Microbiology | 87999 |
Middle Ear Procedures | 69440, 69501, 69502, 69505, 69511, 69530, 69535, 69550, 69552, 69554, 69601, 69602, 69603, 69604, 69631, 69632, 69633, 69635, 69636, 69637, 69641, 69642, 69643, 69644, 69645, 69646, 69650, 69660, 69661, 69662, 69666, 69667, 69670, 69676, 69705, 69706, 69710, 69711, 69716, 69717, 69719, 69720, 69725, 69726, 69727, 69728, 69729, 69730, 69740, 69745, 69799, 0951T, 0952T, 0953T, 0954T, 0955T |
Migraine Surgery | 30802, 31200, 31201, 31205 |
Mobility DME | E0970, E0983, E0984, E0986, E0988, E1002, E1003, E1004, E1005, E1006, E1007, E1008, E1009, E1010, E1011, E1017, E1018, E1020, E1029, E1030, E1037, E1050, E1070, E1084, E1085, E1086, E1087, E1089, E1100, E1110, E1161, E1170, E1171, E1172, E1180, E1190, E1195, E1200, E1222, E1224, E1227, E1228, E1229, E1230, E1231, E1232, E1233, E1234, E1235, E1236, E1237, E1238, E1239, E1270, E1280, E1295, E1296, E1297, E1298, E2301, E2310, E2311, E2321, K0020, K0037, K0039, K0056, K0065, K0073, K0105, K0800, K0801, K0802, K0806, K0807, K0808, K0812, K0813, K0814, K0815, K0816, K0820, K0821, K0822, K0823, K0824, K0825, K0826, K0827, K0828, K0829, K0830, K0831, K0835, K0836, K0837, K0838, K0839, K0840, K0841, K0842, K0843, K0848, K0849, K0850, K0851, K0852, K0853, K0854, K0855, K0856, K0857, K0858, K0859, K0860, K0861, K0862, K0863, K0864, K0869, K0870, K0871, K0877, K0878, K0879, K0880, K0884, K0885, K0886, K0890, K0891, E1038, E1039, E1060, E1088, E1090, E1092, E1093, E1130, E1150, E1160, E1220, E1226, E1240, E1250, E1260, E1285, E1290, E2203, E2204, E2227, E2228, E2230, E2231, E2291, E2292, E2293, E2294, E2295, E2298, E2312, E2322, E2325, E2327, E2328, E2329, E2330, E2331, E2351, E2373, E2374, E2375, E2376, E2377, E2378, E2609, E2617, E2625, K0001, K0002, K0003, K0004, K0005, K0006, K0007, K0008, K0009, K0010, K0011, K0012, K0013, K0014, K0868, E1012 |
Molecular Diagnostic and Genetic Testing | 0569T, 91299, 0552U, 0553U, 0554U, 0560U, 0561U, 0562U, 0565U, 0566U, 0567U, 0569U, 0571U, 0572U |
Molecular Pathology | 81479 |
Nasal Duct Dilation | 68801, 68810, 68811, 68815, 68816, 68840 |
Nasal Endoscopy | 31237, 31238, 31239, 31253, 31254, 31257, 31288, 31290, 31291, 31292, 31293, 31294 |
Neck (Soft Tissues) and Thorax Surgery | 21685, 21740, 21742, 21743, 21610, 21615, 21616, 21630, 21700, 21705, 21720, 21725, 21750, 21899, 22100 |
Negative Pressure Wound Therapy | A6550, E2402 |
Nerve Ablation | 67255, 67299, 67311 |
Nerve Blocks and Destruction | 64405, 64417, 64418, 64420, 64421, 64425, 64430, 64445, 64446, 64450, 64454, 64461, 64462, 64463, 64505, 64510, 64517, 64520, 64530, 64600, 64605, 64610, 64620, 64630, 64632, 64640, 64680, 64681 |
Nerve Stimulators | 61885, 61886, 63650, 63655, 63685, 64555, 64561, 64581, 64585, 64590, 64595, 95970, 95971, 95972, 63663, 63664, 63688, C1767, C1822, L8680, L8687, 33276, 33277, 33278, 33279, 33280, 33281, 33287, 33288, 61880, 61888, 63661, 63662, 64553, 64566, 64569, 64570, 64575, 64580, 64596, 64597, 64598, C1823, C1826, C1827, L8679, L8681, L8682, L8683, L8684, L8685, L8686, L8688, L8689 |
Neurology and Neuromuscular Procedures | 64712, 64713, 64722, 64726, 67312, 15840, 15841, 15842, 64907, 67314, 67332, 0959T, 0960T |
Neurostimulator | 0783T, 0784T, 0785T, 43881, 43882 |
Neurostimulators | 43647, 43648, 0956T, 0957T, 0958T, 0968T, 0969T, 0977T |
Nose Surgery | 30120, 30540, 30545, 30560, 30620, 30150, 30160, 30469, 30580, 30600, 30630, 30915, 30920 |
Not Found | 1999 |
Nuclear Medicine - Cardiovascular System | 78445, 78456, 78457, 78458, 78499, 78428 |
Nuclear Medicine - Endocrine System | 78099 |
Nuclear Medicine - Gastrointestinal System | 78261, 78299 |
Nuclear Medicine - Genitourinary System | 78725, 78700, 78701, 78707, 78708, 78709, 78740, 78799 |
Nuclear Medicine - Hematopoietic, Reticuloendothelial and Lymphatic System | 78199 |
Nuclear Medicine - Musculoskeletal System | 78399 |
Nuclear Medicine - Nervous System | 78600, 78601, 78605, 78606, 78610, 78630, 78635, 78645, 78650, 78660, 78699 |
Nuclear Medicine - Other | 78999 |
Nuclear Medicine - Respiratory System | 78599 |
Office or Other Outpatient Consultations | 99242, 99243, 99244, 99245 |
Opioid Treatment | G2067, G2068, G2069, G2073, G2074, G2076, G2077, G2075, G2078, G2079, G2080 |
Orthopedic Procedures and Service | 0054T, 0055T |
Orthotic Procedures and Services | L1001, L2861, L3962 |
Orthotics | L0700, L0710, L0810, L0820, L0830, L0999, L1000, L1005, L1200, L1300, L1310, L1499, L1640, L1680, L1685, L1700, L1710, L1720, L1730, L1755, L2050, L2060, L2080, L2090, L2627, L2628, L3720, L3764, L3765, L3766, L3891, L3900, L3901, L3904, L3921, L3956, L3961, L3967, L3971, L3973, L3975, L3976, L3977, L3978, L4000, L1686, L1690, L2999, L3671, L3674, L3702, L3730, L3740, L3760, L3761, L3763, L3808, L3905, L3906, L3913, L3915, L3916, L3960, L3999, L1007 |
Other Diagnostic imaging | 0984T, 0985T, 0986T, 0987T |
Other Diagnostic Imaging Related Procedures | 76496, 76497, 76499 |
Other DME | E0170, E0483, E0692, E0693, E0694, E0700, E0766, E0830, E1310, K0743, E0200, E0205, E0217, E0225, E0235, E0239, E0480, E0482, E0500, E0574, E0575, E0585, E0637, E0638, E0641, E0642, E0691, E1841 |
Other Female Genital System Procedures | 58999 |
Other MSK Procedure | 27870, 0737T, 27412, 27415, 27416 |
Other Nuclear Imaging | 78835, 78070, 78071, 78808, 78830, 78831, 78832 |
Other Pain Injections | 20560, 20561 |
Outpatient PPS | C9046, C9047, C9250, C9101, C1818, C1832, C7509, C7510, C7511, C7512, C7531, C7532, C7533, C7534, C7535, C7541, C7542, C7543, C7544, C7545, C7546, C7547, C7548, C7549, C7550, C7551, C7554, C7555, C7556, C7560, C9143, C9254, C9293, C9352, C9353, C9354, C9355, C9356, C9359, C9361, C9362, C9507, C9733, C9758, C9759, C9760, C9782, C9783, C9792, C9796, C9899 |
Ovary Procedures | 58952, 58953, 58954, 58956, 58958 |
Oviduct/Ovary Procedures | 58661, 58670, 58671, 58679 |
Oxygen DME | A4575, E1390, E0430, E0431, E0433, E0434, E0435, E0439, E0440, E0441, E0442, E0443, E0444, E0447, E0550, E1391, E1392, E1406, K0738 |
PAL Category | Applicable Codes |
Palate and Uvula Procedures | 42145, 42299 |
Pancreas Procedures | 48000, 48551, 48552, 48554, 48105, 48120, 48140, 48145, 48146, 48148, 48150, 48152, 48153, 48154, 48155, 48160, 48547, 48548, 48999 |
PAP Devices | E0471, A7030, E0470, E0472, E0601 |
Parathyroid, Thymus, Adrenal Glands, Pancreas, and Carotid Body Procedures | 60505, 60521, 60522, 60540, 60545, 60600, 60605, 60650, 60659, 60699 |
Pathology and Laboratory Services | P9020, P9099 |
Pelvis and Hip Joint Surgery | 27062, 27266, 27279, 27280, 27033, 27035, 27036, 27067, 27070, 27071, 27075, 27076, 27077, 27078, 27110, 27111, 27120, 27122, 27140, 27146, 27147, 27151, 27156, 27158, 27161, 27165, 27170, 27175, 27176, 27177, 27178, 27179, 27181, 27185, 27187, 27258, 27259, 27278, 27282, 27284, 27286, 27290, 27295, 27299 |
Penis Procedures | 54400, 54440 |
Performance Measurement and Quality Reporting Tracking Codes | 0500F, 3218F, 3321F, 3510F, 4182F, 4185F, 4186F, 4188F, 4189F, 4192F, 4450F, 4470F, 4480F, 4481F, 4500F, 4510F, 4526F |
Pharynx, Adenoids, and Tonsils Procedures | 42844, 42845, 42890, 42892, 42894, 42999 |
Physical, Occupational and Speech Therapy | 97039, 97139 |
Positron Emission Tomography | 78608, 78609, G0235, A9552, A9596, A9601, A9602, A9609, A9800 |
Positron Emission Tomography (PET) | A9587, A9597 |
Posterior Sclera Procedures | 67250 |
Procedure - Vascular - Other | 0524T |
Procedures / Professional Services | 45990 |
Procedures/Professional Services | G0166, G0341, G0342, G0343, G0138, G0182, G0276, G0288, G0289, G0293, G0294, G0330, G0402, G0412, G0413, G0414, G0415, G0416, G0428, G0429, G0453, G0460, G0465, G2082, G2083, G9143, G9147, G9474, G9475, G9476, G9477, G9478, G9479, G9687, G9688, G9690, G9691, G9692, G9693, G9694, G9700, G9702, G9709, G9710, G9713, G9714, G9720, G9723, G9740, G9741, G9758, G9761, G9768, G9805, G9819, G9858, G9860, G9861, G0183, G0566 |
Proprietary Laboratory Analysis | 0018M, 0035U, 0051U, 0058U, 0059U, 0062U, 0063U, 0067U, 0082U, 0106U, 0108U, 0116U, 0121U, 0122U, 0123U, 0163U, 0165U, 0178U, 0220U, 0248U, 0257U, 0261U, 0303U, 0304U, 0305U, 0316U, 0337U, 0342U, 0358U, 0359U, 0376U, 0390U, 0393U, 0394U, 0399U, 0404U, 0406U, 0414U, 0418U, 0435U, 0441U, 0445U, 0459U, 0532U, 0533U, 0534U, 0537U, 0538U, 0539U, 0540U, 0541U, 0542U, 0543U, 0549U, 0555U, 0568U, 0570U, 0573U, 0575U, 0576U, 0577U, 0578U, 0579U, 0580U, 0581U, 0582U, 0583U, 0584U, 0585U, 0586U, 0587U, 0588U, 0589U, 0590U, 0591U, 0592U, 0593U, 0594U, 0595U, 0596U, 0597U, 0598U, 0599U |
Prostate Procedures | 55899, 55873 |
Prostatectomy | 55866, 55812, 55815 |
Prosthetic Procedures | L8035, L8600, L8039, L8605, L8607, L8608, L8613, L8693, L8694, L8698, L8701, L8702 |
Prosthetics | L6026, L6050, L6055, L6110, L6205, L6350, L6360, L6450, L6500, L6550, L6570, L6624, L6648, L6715, L6880, L6881, L6882, L6883, L6885, L6920, L6925, L6930, L6935, L6940, L6945, L6950, L6955, L6960, L6965, L6970, L6975, L7007, L7008, L7009, L7170, L7180, L7181, L7185, L7186, L7190, L7191, L8041, L8042, L8043, L8044, L8609, L8690, L8691, L8692, L5999, L6100, L6120, L6130, L6200, L6250, L6300, L6310, L6320, L6370, L6400, L6580, L6582, L6584, L6586, L6588, L6590, L6600, L6605, L6610, L6611, L6621, L6623, L6625, L6628, L6629, L6630, L6680, L6682, L6684, L6686, L6687, L6688, L6689, L6690, L6691, L6692, L6693, L6694, L6695, L6696, L6697, L6698, L6703, L6706, L6721, L6722, L6805, L6810, L6884, L6890, L6895, L6900, L6905, L6910, L7040, L7045, L7259, L7404, L7499, L7900, L8046, L8499, L8500, L8606, L8610, L8612, L8699, L9900, L5827, L6028, L6029, L6030, L6031, L6032, L6033, L6037, L6700, L7406, L5657, L6034, L6035, L6036, L6038, L6039 |
Psychiatric Diagnostic Procedures | 90849 |
Radiologic Exam | 73565 |
Radiological Procedure Supplies | C9067 |
Rehabilitative Services | H0008, H0009, H0010, H0011, H0015, H0017, H0018, H0019 |
Reproductive Medicine | 89253 |
Reproductive Medicine Procedures | 89250, 89251, 89254, 89255, 89257, 89258, 89259, 89260, 89261, 89264, 89268, 89272, 89280, 89281, 89290, 89291, 89335, 89337, 89342, 89343, 89344, 89346, 89352, 89353, 89354, 89356 |
Retina or Choroid Procedures | 67025, 67036, 67039, 67040, 67041, 67042, 67043, J3396, 66821, 67010, 67015, 67027, 67030, 67031, 67208, 67210, 67220, 67221, 67227, 67228, 67229, G0186 |
Revascularization, Endovascular, Open or Percutaneous | C9764, C9765, C9766, C9767, C9772, C9773, C9774, C9775 |
Salivary Gland and Ducts Procedures | 42699 |
Scar Revision | 14000, 14001, 14020, 14021, 14040, 14041, 14060, 14061, 14301, 14302, 23921, 67343 |
Shoulder Surgery | 23105, 23395, 23405, 23410, 23412, 23415, 23420, 23430, 23397, 23460, 23462, 23465, 23466, 23480, 23485, 23490, 23491, 23800, 23802, 23900, 23920, 23929 |
SI Joint Injection and Procedures | 27096, 64451, 64625, G0260 |
Skin and Tissue Substitutes | 15771, A4100 |
Skin Substitutes | Q4101, Q4102, Q4103, Q4104, Q4105, Q4107, Q4108, Q4110, Q4111, Q4112, Q4113, Q4114, Q4115, Q4116, Q4117, Q4118, Q4121, Q4122, Q4123, Q4124, Q4125, Q4126, Q4127, Q4128, Q4130, Q4132, Q4133, Q4134, Q4135, Q4136, Q4137, Q4138, Q4139, Q4140, Q4141, Q4142, Q4143, Q4145, Q4146, Q4147, Q4148, Q4149, Q4150, Q4151, Q4152, Q4153, Q4154, Q4155, Q4156, Q4157, Q4158, Q4159, Q4160, Q4161, Q4162, Q4163, Q4164, Q4165, Q4166, Q4167, Q4168, Q4169, Q4170, Q4171, Q4173, Q4174, Q4175, Q4176, Q4177, Q4178, Q4179, Q4180, Q4181, Q4182, Q4183, Q4184, Q4185, Q4186, Q4187, Q4188, Q4189, Q4190, Q4191, Q4192, Q4193, Q4194, Q4195, Q4196, Q4197, Q4198, Q4200, Q4201, Q4202, Q4203, Q4204, Q4205, Q4206, Q4208, Q4209, Q4211, Q4212, Q4213, Q4214, Q4215, Q4216, Q4232, Q4217, Q4218, Q4219, Q4220, Q4221, Q4222, Q4226, Q4227, Q4234, Q4237, Q4238, Q4239, Q4249, Q4199, Q4229, Q4235, Q4246, Q4247, Q4248, Q4252, Q4258, 15271, 15272, 15273, 15274, 15275, 15276, 15277, 15278, A2001, A2002, A2004, A2005, A2006, A2007, A2008, A2009, A2010, A2011, A2012, A2013, A2014, A2015, A2016, A2018, A2019, A2020, A2021, A2022, A2023, A2024, A2025, C9358, C9360, C9363, C9364, Q4225, Q4230, Q4233, Q4240, Q4241, Q4242, Q4245, Q4250, Q4251, Q4253, Q4254, Q4255, Q4256, Q4257, Q4259, Q4260, Q4261, Q4262, Q4263, Q4264, Q4265, Q4266, Q4267, Q4268, Q4269, Q4270, Q4271, Q4272, Q4273, Q4274, Q4275, Q4276, Q4278, Q4279, Q4280, Q4281, Q4282, Q4283, Q4284, Q4285, Q4286, Q4287, Q4288, Q4289, Q4290, Q4291, Q4292, Q4293, Q4294, Q4295, Q4296, Q4297, Q4298, Q4299, Q4300, Q4301, Q4302, Q4303, Q4304, Q4305, Q4306, Q4307, Q4308, Q4309, Q4310 |
Skull, Meninges, and Brain Procedures | 61850, 61863, 61864, 61867, 61868, 61510, 61697, 61140, 61150, 61151, 61154, 61156, 61250, 61253, 61304, 61305, 61312, 61313, 61314, 61315, 61320, 61321, 61322, 61323, 61330, 61333, 61340, 61343, 61345, 61450, 61458, 61460, 61500, 61501, 61512, 61514, 61516, 61518, 61519, 61520, 61521, 61522, 61524, 61526, 61530, 61531, 61533, 61534, 61535, 61536, 61537, 61538, 61539, 61540, 61541, 61543, 61544, 61545, 61546, 61548, 61550, 61552, 61556, 61557, 61558, 61559, 61563, 61564, 61566, 61567, 61570, 61571, 61575, 61576, 61580, 61581, 61582, 61583, 61584, 61585, 61586, 61590, 61591, 61592, 61595, 61596, 61597, 61598, 61600, 61601, 61605, 61606, 61607, 61608, 61611, 61613, 61615, 61616, 61618, 61619, 61630, 61635, 61680, 61682, 61684, 61686, 61690, 61692, 61698, 61700, 61702, 61703, 61705, 61708, 61711, 61735, 61736, 61737, 61750, 61751, 61760, 61860, 61889, 61891, 61892, 62000, 62005, 62010, 62100, 62115, 62117, 62120, 62121, 62140, 62141, 62142, 62143, 62145, 62146, 62147, 62161, 62162, 62164, 62165, 62180, 62190, 62192, 62200, 62201, 62220, 62223, 62258 |
Sleep Test | G0398, G0399, G0400, 95810, 95811 |
Sleep: Obstructive Sleep Apnea Oral Appliances | E0486, 21085, K1027, K1037 |
Special EEG Tests | 95965 |
Special Ophthalmological Services and Procedures | 92145 |
Specialty Drug | Q0515, Q2026, Q2028, Q4082, Q9982, Q9983, Q5153, Q5154, Q5155, Q5156, Q5157, Q5158, Q5159 |
Specialty Drug - Hematology/Oncology | Q0083, Q0139 |
Specialty Drug - Immunology | Q5121, Q3027, Q3028, Q5103, Q5104, Q5137, Q5138, Q9999, Q9997, Q9998 |
Specialty Drug - Infectious Disease | Q0224 |
Specialty Drug - Neurology | Q5134 |
Specialty Drug - Ophthalmology | Q5124, Q5147, Q5149, Q5150 |
Specialty Drug- Skin Substitute | Q4236, Q4224, Q4311, Q4312, Q4313, Q4314, Q4315, Q4316, Q4317, Q4318, Q4319, Q4320, Q4321, Q4322, Q4323, Q4324, Q4325, Q4326, Q4327, Q4328, Q4329, Q4330, Q4331, Q4332, Q4333, Q4343, Q4354, Q4355, Q4356, Q4358, Q4359, Q4360, Q4362, Q4363, Q4364, Q4365, Q4366, Q4368, Q4369, Q4370, Q4371, Q4372, Q4373, Q4375, Q4376, Q4377, Q4378, Q4379, Q4380, Q4382, Q4340, Q4345, Q4346, Q4347, Q4348, Q4350, Q4353, Q4383, Q4384, Q4385, Q4386, Q4387, Q4388, Q4389, Q4390, Q4391, Q4392, Q4393, Q4394, Q4395, Q4396, Q4397 |
Speech Therapy | 92523, 92524 |
Spinal Orthoses | L0622, L0624, L0629, L0631, L0632, L0634, L0636, L0638, L0635, L0637, L0639, L0640, L0648, L0650, L0651 |
Spine Surgery | 0274T, 22513, 22514, 22869, 22899, 62360, 63020, 63030, 63042, 0656T, 0657T, 0719T, 20999, 22101, 22102, 22103, 22110, 22112, 22114, 22116, 22206, 22207, 22208, 22210, 22212, 22214, 22216, 22220, 22222, 22224, 22226, 22515, 22526, 22527, 22532, 22556, 22610, 22808, 22810, 22812, 22818, 22819, 22836, 22837, 22838, 22840, 22841, 22845, 22846, 22847, 22848, 22850, 22852, 22853, 22854, 22855, 22859, 22867, 22868, 22999, 62287, 62380, 63001, 63003, 63011, 63015, 63016, 63040, 63043, 63044, 63045, 63046, 63050, 63051, 63055, 63064, 63066, 63075, 63076, 63077, 63081, 63082, 63085, 63086, 63101, 63172, 63173, 63191, 63197, 63250, 63251, 63265, 63266, 63268, 63270, 63271, 63273, 63275, 63276, 63278, 63280, 63281, 63283, 63285, 63286, 63295, 63300, 63301, 63302, 63303, 63304, 63305, 63306, 63307, 63308, 63052 |
Spine Surgery: Cervical Disc Replacement | 22856, 22858, 0098T, 22861, 22864 |
Spine Surgery: Cervical Fusion | 22551, 22554, 22548, 22552, 22590, 22595, 22600 |
Spine Surgery: Instrumentation | 22800, 22802, 22804, 22842, 22843, 22844, 22849 |
Spine Surgery: Lumbar Decompression | 63047, 63267, 63005, 63012, 63017, 63056, 63057, 63087, 63088, 63090, 63091, 63102, 63103, 63170, 63185, 63190, 63200, 63252, 63272, 63277, 63282, 63287, 63290, 63048 |
Spine Surgery: Lumbar Fusion | 22612, 22533, 22534, 22558, 22586, 22630, 22632, 22633, 22614, 22634 |
Spine/Spinal Cord Procedures | 62292, 62294, 63600, 63610, 63700, 63702, 63704, 63706, 63707, 63709, 63710, 63740, 63741, 63744, 63746 |
Spleen Surgery | 38100, 38101, 38102, 38115, 38129 |
State Medicaid Agency Codes | T1001, T1002, T1003, T1004, T1021, T1022, T1028, T1030, T1031, T1502, T4521, T4522, T4523, T4524, T4525, T4526, T4527, T4528, T4529, T4530, T4531, T4532, T4533, T4534, T4535, T4536, T4537, T4538, T4539, T4540, T4541, T4542, T4543, T4544, T4545, T1015, T1020, T1025, T1029, T1040, T1041, T1999, T2001, T2025, T2026, T2027, T2028, T2029, T2032, T2033, T2034, T2035, T2039, T2042, T2043, T2044, T2045, T2046, T2048, T5001, T5999 |
Stomach Procedures | 43659, 43500, 43502, 43620, 43621, 43622, 43631, 43632, 43633, 43634, 43652, 43653, 43800, 43810, 43820, 43825, 43831, 43832, 43840, 43845, 43848, 43860, 43865, 43999, C9785 |
Surgical Dressings | A6023, A6501, A6502, A6504, A6505, A6506, A6507, A6508, A6509 |
Surgical Repair (Closure) Procedures | 15772, 15773, 15774 |
Surgical Repair (Closure) Procedures - Integumentary System | 15876, 15878, 15879, 15845 |
Surgical Services | 31295, 31296, 31297, 31298, 31299 |
Temporal Bone, Middle Fossa Approach Procedures | 69950, 69955, 69960, 69970, 69979 |
Temporary Codes | Q9004, Q0235, Q0237 |
Testis Procedures | 54530, 54699 |
Therapy and Rehab: Cold Therapy | E0218, E0236 |
Therapy and Rehab: Hyperbaric Oxygen Therapy | G0277 |
Therapy and Rehab: Physical/Occupational Therapy | 97010, 97012, 97033, 97034, 97035, 97036, 97110, 97112, 97113, 97116, 97124, 97140, 97162, 97163, 97164, 97165, 97166, 97167, 97168, 97530, 97535, 97161, 97545, 97546, G0151, G0152, G0157, G0158, G0159, G0160, 97610, G2168, K1004, 97016 |
Therapy and Rehab: TENS/NMES | 20974, 20975, 20979, E0740, E0747, E0748, E0749, E0760, E0764, E0770, A4560, A4595, E0720, E0730, E0731, E0744, E0745, E0762, 97014, 97032, G0283 |
Thyroid Gland Procedures | 60254, 60270, 60271 |
Tongue and Floor of Mouth Procedures | 41512, 41530, 41599, 41120, 41130, 41135, 41140, 41145, 41150, 41153, 41155, 0978T, 0979T, 0980T |
Trachea and Bronchi Surgery | 31601, 31605, 31610, 31611, 31613, 31614, 31660, 31661, 31750, 31755, 31760, 31766, 31770, 31775, 31780, 31781, 31785, 31786, 31800, 31805, 31820, 31825, 31899 |
Transfusion Medicine | 86999 |
Transplant Surgery | S2152 |
Transportation Services | A0430, A0431, A0435, A0436, A0225, A0434, A0999 |
Ultrasound - Extremities | 76885, 76886 |
Unclassified Drugs or Biologicals | C9399 |
Unlisted Procedure | 0962T, 0964T, 0965T, 0966T, 0972T |
Upper Arm and Elbow Surgery | 24105, 24301, 24341, 24360, 24363, 24365, 24366, 24435, 24344, 24345, 24346, 24361, 24362, 24370, 24371, 24400, 24410, 24420, 24430, 24800, 24802, 24931, 24935, 24940, 24999 |
Ureter Procedure | 50695, 50705, 50825 |
Urethra Procedure | 53410, 53854, 53899 |
Urethra Procedures | 53440, 53445, 53446, 53447, 53850, 53852, 53860, E0565 |
Urology | 50323, 50340, 50360, 50365, 50370, 50380, 50547, 50432, 50693, 54161, 54401, 54405, 54410, 50325, 50546, 50548, 50549, 50830, 50947, 50949, 51590, 51595, 51596, 54135, 55559, 55970 |
Vagina Procedures | 57425, 57291, 57335 |
Varicose Veins | 36482, 37761, 37766, 36473, 36475, 36478, 37700, 37718, 37722, 37780, 36465, 36466, 36468, 36470, 36471, 36474, 36476, 36479, 37765, 37785 |
Vestibule of Mouth Procedures | 40840, 40842, 40843, 40844, 40845 |
Vision Aids | V2785, V2531, V2599, V2623, V2625, V2627, V2629, V2630, V2631, V2632, V2787, V2788, V2790, V2799 |
Vulva, Perineum and Introitus Procedures | 56637, 56640 |
Waterjet Prostate Ablation | C2596 |
X-ray - Aorta and Arteries | 75600, 75605, 75625, 75630, 75705, 75731, 75733, 75736, 75741, 75743, 75746, 75756, C8004 |
X-ray - Spine and Pelvis | 72240, 72255, 72265, 72270, 72285, 72295 |
X-ray - Urinary Tract | 74485 |
X-ray - Vascular System | 75898 |
X-ray - Veins and Lymphatics | 75801, 75803, 75805, 75807, 75810, 75820, 75822, 75825, 75827, 75831, 75833, 75840, 75860, 75870, 75872, 75880, 75885, 75887, 75889, 75891, 75893 |