New Preauthorization Requirements Starting Aug. 1, 2025

11400

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less

11401

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm

11403

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm

11404

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm

11420

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less

11422

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm

11423

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm

11441

Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm

11443

Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm

11602

Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm

11604

Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm

11622

Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm

11750

Excision of nail and nail matrix, partial or complete (e.g., ingrown or deformed nail), for permanent removal;

11772

Excision of pilonidal cyst or sinus; complicated

12031

Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less

12032

Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm

13131

Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm

13152

Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm

14040

Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less

14060

Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less

15733

Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (i.e., buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)

15740

Flap; island pedicle requiring identification and dissection of an anatomically named axial vessel

19120

Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions

19125

Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion

19307

Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle

20680

Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod or plate)

20694

Removal, under anesthesia, of external fixation system

21012

Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater

21013

Excision, tumor, soft tissue of face and scalp, subfascial (e.g., subgaleal, intramuscular); less than 2 cm

21014

Excision, tumor, soft tissue of face and scalp, subfascial (e.g., subgaleal, intramuscular); 2 cm or greater

21315

Closed treatment of nasal bone fracture with manipulation; without stabilization

21555

Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm

21556

Excision, tumor, soft tissue of neck or anterior thorax, subfascial (e.g., intramuscular); less than 5 cm

21931

Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater

23071

Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater

23472

Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (e.g., total shoulder))

24071

Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; 3 cm or greater

24105

Excision, olecranon bursa

25000

Incision, extensor tendon sheath, wrist (e.g., deQuervains disease)

25073

Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (e.g., intramuscular); 3 cm or greater

25075

Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; less than 3 cm

25076

Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (e.g., intramuscular); less than 3 cm

25607

Open treatment of distal radial extra-articular fracture or epiphyseal separation, with internal fixation

25608

Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 2 fragments

26055

Tendon sheath incision (e.g., for trigger finger)

26116

Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (e.g., intramuscular); less than 1.5 cm

26160

Excision of lesion of tendon sheath or joint capsule (e.g., cyst, mucous cyst, or ganglion), hand or finger

26540

Repair of collateral ligament, metacarpophalangeal or interphalangeal joint

26615

Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone

26650

Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (Bennett fracture), with manipulation

26727

Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with manipulation, each

26951

Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direct closure

27337

Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater

27339

Excision, tumor, soft tissue of thigh or knee area, subfascial (e.g., intramuscular); 5 cm or greater

27446

Arthroplasty, knee, condyle and plateau; medial OR lateral compartment

27447

Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)

28005

Incision, bone cortex (e.g., osteomyelitis or bone abscess), foot

28010

Tenotomy, percutaneous, toe; single tendon

28041

Excision, tumor, soft tissue of foot or toe, subfascial (e.g., intramuscular); 1.5 cm or greater

28090

Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (e.g., cyst or ganglion); foot

28110

Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)

28120

Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (e.g., osteomyelitis or bossing); talus or calcaneus

28124

Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (e.g., osteomyelitis or bossing); phalanx of toe

28285

Correction, hammertoe (e.g., interphalangeal fusion, partial or total phalangectomy)

28289

Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant

28295

Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal metatarsal osteotomy, any method

28296

Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method

28299

Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with double osteotomy, any method

29806

Arthroscopy, shoulder, surgical; capsulorrhaphy

29823

Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (e.g., humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, subacromial bursa, foreign body[ies])

29824

Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)

29825

Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation

29827

Arthroscopy, shoulder, surgical; with rotator cuff repair

29876

Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (e.g., medial or lateral)

29879

Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture

29882

Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)

29883

Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)

29888

Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction

30130

Excision inferior turbinate, partial or complete, any method

30140

Submucous resection inferior turbinate, partial or complete, any method

30520

Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft

31253

Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed

31257

Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy

31276

Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from frontal sinus, when performed

31541

Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or telescope

31571

Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with operating microscope or telescope

31622

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)

36561

Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older

36589

Removal of tunneled central venous catheter, without subcutaneous port or pump

38525

Biopsy or excision of lymph node(s); open, deep axillary node(s)

41520

Frenoplasty (surgical revision of frenum, e.g., with Z-plasty)

42820

Tonsillectomy and adenoidectomy; younger than age 12

42825

Tonsillectomy, primary or secondary; younger than age 12

42826

Tonsillectomy, primary or secondary; age 12 or over

43248

Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire

43251

Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique

43270

Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)

43450

Dilation of esophagus, by unguided sound or bougie, single or multiple passes

43770

Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (e.g., gastric band and subcutaneous port components)

43773

Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only

43774

Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components

44180

Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)

44361

Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple

44386

Endoscopic evaluation of small intestinal pouch (e.g., Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple

44970

Appendectomy; for ruptured appendix with abscess or generalized peritonitis

45330

Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)

45378

Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)

45381

Colonoscopy, flexible; with directed submucosal injection(s), any substance

45384

Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps

45390

Colonoscopy, flexible; with endoscopic mucosal resection

46040

Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure)

46221

Hemorrhoidectomy, internal, by rubber band ligation(s)

46255

Hemorrhoidectomy, internal and external, single column/group;

46607

Anoscopy; with high-resolution magnification (HRA) (e.g., colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple

47562

Laparoscopy, surgical; cholecystectomy

47563

Laparoscopy, surgical; cholecystectomy with cholangiography

49322

Laparoscopy, surgical; with aspiration of cavity or cyst (e.g., ovarian cyst) (single or multiple)

49505

Repair initial inguinal hernia, age 5 years or older; reducible

49591

Repair of anterior abdominal hernia(s) (i.e., epigastric, incisional, ventral, umbilical, spigelian), any approach (i.e., open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible

49650

Laparoscopy, surgical; repair initial inguinal hernia

49651

Laparoscopy, surgical; repair recurrent inguinal hernia

50590

Lithotripsy, extracorporeal shock wave

52235

Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm)

52281

Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female

52287

Cystourethroscopy, with injection(s) for chemodenervation of the bladder

52310

Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple

52332

Cystourethroscopy, with insertion of indwelling ureteral stent (e.g., Gibbons or double-J type)

52352

Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)

52354

Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion

52356

Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (e.g., Gibbons or double-J type)

54150

Circumcision, using clamp or other device with regional dorsal penile or ring block

55040

Excision of hydrocele; unilateral

55250

Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)

56405

Incision and drainage of vulva or perineal abscess

56501

Destruction of lesion(s), vulva; simple (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery)

56605

Biopsy of vulva or perineum (separate procedure); 1 lesion

57288

Sling operation for stress incontinence (e.g., fascia or synthetic)

57452

Colposcopy of the cervix including upper/adjacent vagina;

57454

Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage

57500

Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)

57520

Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser

57522

Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision

58558

Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D&C

58563

Hysteroscopy, surgical; with endometrial ablation (e.g., endometrial resection, electrosurgical ablation, thermoablation)

64718

Neuroplasty and/or transposition; ulnar nerve at elbow

64721

Neuroplasty and/or transposition; median nerve at carpal tunnel

65756

Keratoplasty (corneal transplant); endothelial

65855

Trabeculoplasty by laser surgery

66170

Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery

66761

Iridotomy/iridectomy by laser surgery (e.g., for glaucoma) (per session)

66821

Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (e.g., YAG laser) (1 or more stages)

66982

Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (e.g., iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage; without endoscopic cyclophotocoagulation

66984

Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation

66985

Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal

67028

Intravitreal injection of a pharmacologic agent (separate procedure)

67039

Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation

67042

Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (e.g., for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponade (i.e., air, gas or silicone oil)

67107

Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid

67108

Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique

67113

Repair of complex retinal detachment (e.g., proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens

67145

Prophylaxis of retinal detachment (e.g., retinal break, lattice degeneration) without drainage; photocoagulation

67210

Destruction of localized lesion of retina (e.g., macular edema, tumors), 1 or more sessions; photocoagulation

67228

Treatment of extensive or progressive retinopathy (e.g., diabetic retinopathy), photocoagulation

67311

Strabismus surgery, recession or resection procedure; 1 horizontal muscle

67400

Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy

68811

Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia

68815

Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent

69610

Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch

69645

Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction

21050

Condylectomy, temporomandibular joint (separate procedure)

21060

Meniscectomy, partial or complete, temporomandibular joint (separate procedure)

38207

Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage

69716

Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex

L8680

Implantable neurostimulator electrode, each

43290

Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon

43291

Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)

43647

Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum

43771

Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only

43772

Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only

43843

Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty

43865

Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; with vagotomy

43886

Gastric restrictive procedure, open; revision of subcutaneous port component only

43887

Gastric restrictive procedure, open; removal of subcutaneous port component only

43888

Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only

20974

Electrical stimulation to aid bone healing; noninvasive (nonoperative)

11960

Insertion of tissue expander(s) for other than breast, including subsequent expansion

15775

Punch graft for hair transplant; 1 to 15 punch grafts

15776

Punch graft for hair transplant; more than 15 punch grafts

21260

Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach

21261

Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approach

21263

Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement

21267

Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach

21268

Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach

21685

Hyoid myotomy and suspension

30540

Repair choanal atresia; intranasal

30545

Repair choanal atresia; transpalatine

30560

Lysis intranasal synechia

36473

Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated

36474

Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure)

67900

Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)

67901

Repair of blepharoptosis; frontalis muscle technique with suture or other material (e.g., banked fascia)

67902

Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia)

67903

Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach

E1030

Wheelchair accessory, ventilator tray, gimbaled

E1232

Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system

E1233

Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system

E1234

Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system

E1235

Wheelchair, pediatric size, rigid, adjustable, with seating system

E1237

Wheelchair, pediatric size, rigid, adjustable, without seating system

K0743

Suction pump, home model, portable, for use on wounds

L2330

Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only

L2525

Addition to lower extremity, thigh/weight bearing, ischial containment/narrow M-L brim molded to patient model

L2627

Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables

L2628

Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables

L3904

Wrist-hand-finger orthosis (WHFO), external powered, electric, custom fabricated

L3961

Shoulder-elbow-wrist-hand orthosis (SEWHO), shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

L3967

Shoulder-elbow-wrist-hand orthosis (SEWHO), abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

L3971

Shoulder-elbow-wrist-hand orthotic (SEWHO), shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

L3973

Shoulder-elbow-wrist-hand orthosis (SEWHO), abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

L3976

Shoulder-elbow-wrist-hand-finger orthosis (SEWHO), abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

L3977

Shoulder-elbow-wrist-hand-finger orthosis (SEWHO), shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

L3978

Shoulder-elbow-wrist-hand-finger orthosis (SEWHO), abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

L6975

Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device

37788

Penile revascularization, artery, with or without vein graft

37790

Penile venous occlusive procedure

54400

Insertion of penile prosthesis; non-inflatable (semi-rigid)

54408

Repair of component(s) of a multi-component, inflatable penile prosthesis

54410

Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session

54411

Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue

54417

Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue

55866

Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed

G0088

Professional services, initial visit, for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biological) for each infusion drug administration calendar day in the individual's home, each 15 minutes

G0089

Professional services, initial visit, for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes

G0090

Professional services, initial visit, for the administration of intravenous chemotherapy or other highly complex infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes

S9474

Enterostomal therapy by a registered nurse certified in enterostomal therapy, per diem

T1028

Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs

58976

Gamete, zygote, or embryo intrafallopian transfer, any method

89337

Cryopreservation, mature oocyte(s)

89342

Storage (per year); embryo(s)

89343

Cryo storage; sperm/semen

89346

Cryo storage; oocytes

S4013

Complete cycle, gamete intrafallopian transfer (GIFT), case rate

S4014

Complete cycle, zygote intrafallopian transfer (ZIFT), case rate

S4027

Storage of previously frozen embryos--- needs auth

S4028

Microsurgical epididymal sperm aspiration (MESA)

L8685

Implantable neurostimulator pulse generator, single array, rechargeable, includes extension

L8686

Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension

L8687

Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension

L8688

Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension

21120

Genioplasty; augmentation (autograft, allograft, prosthetic material)

21122

Genioplasty; sliding osteotomies, 2 or more osteotomies (e.g., wedge excision or bone wedge reversal for asymmetrical chin)

41512

Tongue base suspension, permanent suture technique

41530

Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session

41599

Unlisted procedure, tongue, floor of mouth

42145

Palatopharyngoplasty (e.g., uvulopalatopharyngoplasty, uvulopharyngoplasty)

47146

Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous anastomosis, each

50325

Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches, as necessary

37500

ENDOSCOPY LIGATE PERF VEINS

33982

Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, without cardiopulmonary bypass

0515T

Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; complete system (includes electrode and generator [transmitter and battery])

0516T

Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; electrode only

0517T

Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; both components of pulse generator (battery and transmitter) only

0518T

Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; battery component only

0519T

Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; both components (battery and transmitter)

0520T

Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only

0521T

Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording, and disconnection per patient encounter, wireless cardiac stimulator for left ventricular pacing

0522T

Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, wireless cardiac stimulator for left ventricular pacing

10040

Acne surgery (e.g., marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)

11920

Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.0 sq cm or less

11921

Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.1 to 20.0 sq cm

11922

Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; each additional 20.0 sq cm, or part thereof (List separately in addition to code for primary procedure)

11971

Removal of tissue expander without insertion of implant

14000

Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less

14001

Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm

14041

Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm

15730

Transfer, intermediate, of any pedicle flap (e.g., abdomen to wrist, Walking tube), any location

15738

Muscle, myocutaneous, or fasciocutaneous flap; lower extremity

15750

Flap; neurovascular pedicle

15757

Free skin flap with microvascular anastomosis

15758

Free fascial flap with microvascular anastomosis

26340

Manipulation, finger joint, under anesthesia, each joint

28890

Extracorporeal shock wave, high energy, performed by a physician or other qualified health care professional, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia

33251

Operative ablation of supraventricular arrhythmogenic focus or pathway (e.g., Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) and/or focus (foci); with cardiopulmonary bypass

33254

Operative tissue ablation and reconstruction of atria, limited (e.g., modified maze procedure)

33255

Operative tissue ablation and reconstruction of atria, extensive (e.g., maze procedure); without cardiopulmonary bypass

33256

Operative tissue ablation and reconstruction of atria, extensive (e.g., maze procedure); with cardiopulmonary bypass

33257

Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (e.g., modified maze procedure) (List separately in addition to code for primary procedure)

33258

Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (e.g., maze procedure), without cardiopulmonary bypass (List separately in addition to code for primary procedure)

33259

Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (e.g., maze procedure), with cardiopulmonary bypass (List separately in addition to code for primary procedure)

33261

Operative ablation of ventricular arrhythmogenic focus with cardiopulmonary bypass

33276

Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed

33277

Insertion of phrenic nerve stimulator transvenous sensing lead (List separately in addition to code for primary procedure)

33278

Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)

33279

Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only

33280

Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only

33281

Repositioning of phrenic nerve stimulator transvenous lead(s)

33287

Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator

33288

Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)

33361

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach

33362

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open femoral artery approach

33363

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open axillary artery approach

33364

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open iliac artery approach

33365

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transaortic approach (e.g., median sternotomy, mediastinotomy)

33366

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transapical exposure (e.g., left thoracotomy)

33369

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (e.g., aorta, right atrium, pulmonary artery) (List separately in addition to code for primary procedure)

33404

Construction of apical-aortic conduit

33414

Repair of left ventricular outflow tract obstruction by patch enlargement of the outflow tract

33415

Resection or incision of subvalvular tissue for discrete subvalvular aortic stenosis

33416

Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic stenosis (e.g., asymmetric septal hypertrophy)

33417

Aortoplasty (gusset) for supravalvular stenosis

33476

Tricuspid valve repositioning and plication for Ebstein anomaly

33477

Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed

33478

Outflow tract augmentation (gusset), with or without commissurotomy or infundibular resection

33500

Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass

33501

Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary bypass

33502

Repair of anomalous coronary artery from pulmonary artery origin; by ligation

33503

Repair of anomalous coronary artery from pulmonary artery origin; by graft, without cardiopulmonary bypass

33504

Repair of anomalous coronary artery from pulmonary artery origin; by graft, with cardiopulmonary bypass

33505

Repair of anomalous coronary artery from pulmonary artery origin; with construction of intrapulmonary artery tunnel (Takeuchi procedure)

33506

Repair of anomalous coronary artery from pulmonary artery origin; by translocation from pulmonary artery to aorta

33507

Repair of anomalous (e.g., intramural) aortic origin of coronary artery by unroofing or translocation

33600

Closure of atrioventricular valve (mitral or tricuspid) by suture or patch

33602

Closure of semilunar valve (aortic or pulmonary) by suture or patch

33606

Anastomosis of pulmonary artery to aorta (Damus-Kaye-Stansel procedure)

33608

Repair of complex cardiac anomaly other than pulmonary atresia with ventricular septal defect by construction or replacement of conduit from right or left ventricle to pulmonary artery

33610

Repair of complex cardiac anomalies (e.g., single ventricle with subaortic obstruction) by surgical enlargement of ventricular septal defect

33611

Repair of double outlet right ventricle with intraventricular tunnel repair

33612

Repair of double outlet right ventricle with intraventricular tunnel repair; with repair of right ventricular outflow tract obstruction

33615

Repair of complex cardiac anomalies (e.g., tricuspid atresia) by closure of atrial septal defect and anastomosis of atria or vena cava to pulmonary artery (simple Fontan procedure)

33617

Repair of complex cardiac anomalies (e.g., single ventricle) by modified Fontan procedure

33619

Repair of single ventricle with aortic outflow obstruction and aortic arch hypoplasia (hypoplastic left heart syndrome) (e.g., Norwood procedure)

33641

Repair atrial septal defect, secundum, with cardiopulmonary bypass, with or without patch

33645

Direct or patch closure, sinus venosus, with or without anomalous pulmonary venous drainage

33647

Repair of atrial septal defect and ventricular septal defect, with direct or patch closure

33660

Repair of incomplete or partial atrioventricular canal (ostium primum atrial septal defect), with or without atrioventricular valve repair

33665

Repair of intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair

33670

Repair of complete atrioventricular canal, with or without prosthetic valve

33675

Closure of multiple ventricular septal defects

33676

Closure of multiple ventricular septal defects; with pulmonary valvotomy or infundibular resection (acyanotic)

33677

Closure of multiple ventricular septal defects; with removal of pulmonary artery band, with or without gusset

33681

Closure of single ventricular septal defect, with or without patch

33684

Closure of single ventricular septal defect, with or without patch; with pulmonary valvotomy or infundibular resection (acyanotic)

33688

Closure of single ventricular septal defect, with or without patch; with removal of pulmonary artery band, with or without gusset

33690

Banding of pulmonary artery

33692

Complete repair tetralogy of Fallot without pulmonary atresia;

33694

Complete repair tetralogy of Fallot without pulmonary atresia; with transannular patch

33697

Complete repair tetralogy of Fallot with pulmonary atresia including construction of conduit from right ventricle to pulmonary artery and closure of ventricular septal defect

33702

Repair sinus of Valsalva fistula, with cardiopulmonary bypass;

33710

Repair sinus of Valsalva fistula, with cardiopulmonary bypass; with repair of ventricular septal defect

33720

Repair sinus of Valsalva aneurysm, with cardiopulmonary bypass

33724

Repair of isolated partial anomalous pulmonary venous return (e.g., Scimitar Syndrome)

33726

Repair of pulmonary venous stenosis

33730

Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types)

33732

Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial membrane

33735

Atrial septectomy or septostomy; closed heart (Blalock-Hanlon type operation)

33736

Atrial septectomy or septostomy; open heart with cardiopulmonary bypass

33750

Shunt; subclavian to pulmonary artery (Blalock-Taussig type operation)

33755

Shunt; ascending aorta to pulmonary artery (Waterston type operation)

33762

Shunt; descending aorta to pulmonary artery (Potts-Smith type operation)

33764

Shunt; central, with prosthetic graft

33766

Shunt; superior vena cava to pulmonary artery for flow to 1 lung (classical Glenn procedure)

33767

Shunt; superior vena cava to pulmonary artery for flow to both lungs (bidirectional Glenn procedure)

33768

Anastomosis, cavopulmonary, second superior vena cava (List separately in addition to primary procedure)

33770

Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; without surgical enlargement of ventricular septal defect

33771

Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; with surgical enlargement of ventricular septal defect

33774

Repair of transposition of the great arteries, atrial baffle procedure (e.g., Mustard or Senning type) with cardiopulmonary bypass

33775

Repair of transposition of the great arteries, atrial baffle procedure (e.g., Mustard or Senning type) with cardiopulmonary bypass; with removal of pulmonary band

33776

Repair of transposition of the great arteries, atrial baffle procedure (e.g., Mustard or Senning type) with cardiopulmonary bypass; with closure of ventricular septal defect

33777

Repair of transposition of the great arteries, atrial baffle procedure (e.g., Mustard or Senning type) with cardiopulmonary bypass; with repair of subpulmonic obstruction

33778

Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (e.g., Jatene type)

33779

Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (e.g., Jatene type); with removal of pulmonary band

33780

Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (e.g., Jatene type); with closure of ventricular septal defect

33781

Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (e.g., Jatene type); with repair of subpulmonic obstruction

33786

Total repair, truncus arteriosus (Rastelli type operation)

33788

Reimplantation of an anomalous pulmonary artery

33802

Division of aberrant vessel (vascular ring)

33803

Division of aberrant vessel (vascular ring); with reanastomosis

33820

Repair of patent ductus arteriosus; by ligation

33822

Repair of patent ductus arteriosus; by division, younger than 18 years

33840

Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with direct anastomosis

33845

Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with graft

33851

Excision of coarctation of aorta, with or without associated patent ductus arteriosus; repair using either left subclavian artery or prosthetic material as gusset for enlargement

33852

Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; without cardiopulmonary bypass

33853

Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; with cardiopulmonary bypass

33917

Repair of pulmonary artery stenosis by reconstruction with patch or graft

33920

Repair of pulmonary atresia with ventricular septal defect, by construction or replacement of conduit from right or left ventricle to pulmonary artery

33924

Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in conjunction with a congenital heart procedure (List separately in addition to code for primary procedure)

33927

Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy

33928

Removal and replacement of total replacement heart system (artificial heart)

33929

Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure)

36514

Therapeutic apheresis; for plasma pheresis

61850

Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical

61863

Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (e.g., thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; first array

61864

Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (e.g., thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; each additional array (List separately in addition to primary procedure)

61867

Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (e.g., thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; first array

61868

Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (e.g., thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; each additional array (List separately in addition to primary procedure)

61885

Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array

61886

Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array

61892

Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed

64405

Injection, anesthetic agent; greater occipital nerve

64570

Removal of cranial nerve (e.g., vagus nerve) neurostimulator electrode array and pulse generator

64595

Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array

64744

Transection or avulsion of; greater occipital nerve

64856

Suture of major peripheral nerve, arm or leg, except sciatic; including transposition

64892

Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length

64896

Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length

65765

Keratophakia

65767

Epikeratoplasty

66180

Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft

67909

Reduction of overcorrection of ptosis

67912

Correction of lagophthalmos, with implantation of upper eyelid lid load (e.g., gold weight)

67914

Repair of ectropion; suture

67915

Repair of ectropion; thermocauterization

67916

Repair of ectropion; excision tarsal wedge

67917

Repair of ectropion; extensive (e.g., tarsal strip operations)

67921

Repair of entropion; suture

67922

Repair of entropion; thermocauterization

67923

Repair of entropion; excision tarsal wedge

67924

Repair of entropion; extensive (e.g., tarsal strip or capsulopalpebral fascia repairs operation)

67961

Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; up to one-fourth of lid margin

69728

Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex

69729

Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex

69730

Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex

76983

Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure)

81105

Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa], antigen CD61 [GPIIIa]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-1a/b (L33P)

81106

Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib [platelet], alpha polypeptide [GPIba]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post- transfusion purpura), gene analysis, common variant, HPA-2a/b (T145M)

81107

Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex], antigen CD41 [GPIIb]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-3a/b (I843S)

81108

Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa], antigen CD61 [GPIIIa]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-4a/b (R14)

81109

Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 [CD49B, alpha 2 subunit of VLA-2 receptor] [GPIa]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant (e.g., HPA-5a/b (K505E)

81110

Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa, antigen CD61] [GPIIIa])(e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-6a/b (R489Q)

81111

Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex, antigen CD41] [GPIIb]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-9a/b (V837M)

81120

IDH1 (isocitrate dehydrogenase 1 [NADP+], soluble) (e.g., glioma), common variants (e.g., R132H, R132C)

81121

IDH2 (isocitrate dehydrogenase 2 [NADP+], mitochondrial) (e.g., glioma), common variants (e.g., R140W, R172M)

81161

DMD (dystrophin) (e.g., Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed

81170

ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (e.g., acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain

81175

ASXL1 (additional sex combs like 1, transcriptional regulator) (e.g., myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence

81176

ASXL1 (additional sex combs like 1, transcriptional regulator) (e.g., myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis (e.g., exon 12)

81200

ASPA (aspartoacylase) (e.g., Canavan disease) gene analysis, common variants (e.g., E285A, Y231X)

81205

BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (e.g., maple syrup urine disease) gene analysis, common variants (e.g., R183P, G278S, E422X)

81206

BCR/ABL1 (t(9;22)) (e.g., chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative

81207

BCR/ABL1 (t(9;22)) (e.g., chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative

81208

BCR/ABL1 (t(9;22)) (e.g., chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative

81209

BLM (Bloom syndrome, RecQ helicase-like) (e.g., Bloom syndrome) gene analysis, 2281del6ins7 variant

81210

BRAF (B-Raf proto-oncogene, serine/threonine kinase) (e.g., colon cancer, melanoma), gene analysis, V600 variant(s)

81218

CEBPA (CCAAT/enhancer binding protein [C/EBP], alpha) (e.g., acute myeloid leukemia), gene analysis, full gene sequence

81219

CALR (calreticulin) (e.g., myeloproliferative disorders), gene analysis, common variants in exon 9

81220

CFTR (cystic fibrosis transmembrane conductance regulator) (e.g., cystic fibrosis) gene analysis; common variants (e.g., ACMG/ACOG guidelines)

81221

CFTR (cystic fibrosis transmembrane conductance regulator) (e.g., cystic fibrosis) gene analysis; known familial variants

81222

CFTR (cystic fibrosis transmembrane conductance regulator) (e.g., cystic fibrosis) gene analysis; duplication/deletion variants

81223

CFTR (cystic fibrosis transmembrane conductance regulator) (e.g., cystic fibrosis) gene analysis; full gene sequence

81224

CFTR (cystic fibrosis transmembrane conductance regulator) (e.g., cystic fibrosis) gene analysis; intron 8 poly-T analysis (e.g., male infertility)

81228

Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number variants, comparative genomic hybridization [CGH] microarray analysis

81229

Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic

81235

EGFR (epidermal growth factor receptor) (e.g., non-small cell lung cancer) gene analysis, common variants (e.g., exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q)

81240

F2 (prothrombin, coagulation factor II) (e.g., hereditary hypercoagulability) gene analysis, 20210G>A variant

81241

F5 (coagulation factor V) (e.g., hereditary hypercoagulability) gene analysis, Leiden variant

81242

FANCC (Fanconi anemia, complementation group C) (e.g., Fanconi anemia, type C) gene analysis, common variant (e.g., IVS4+4A>T)

81243

FMR1 (fragile X messenger ribonucleoprotein 1) (e.g., fragile X syndrome, X-linked intellectual disability [XLID]) gene analysis; evaluation to detect abnormal (e.g., expanded) alleles

81244

FMR1 (fragile X messenger ribonucleoprotein 1) (e.g., fragile X syndrome, X-linked intellectual disability [XLID]) gene analysis; characterization of alleles (e.g., expanded size and promoter methylation status)

81245

FLT3 (fms-related tyrosine kinase 3) (e.g., acute myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (i.e., exons 14, 15)

81246

FLT3 (fms-related tyrosine kinase 3) (e.g., acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (e.g., D835, I836)

81247

G6PD (glucose-6-phosphate dehydrogenase) (e.g., hemolytic anemia, jaundice), gene analysis; common variant(s) (e.g., A, A-)

81250

G6PC (glucose-6-phosphatase, catalytic subunit) (e.g., Glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (e.g., R83C, Q347X)

81251

GBA (glucosidase, beta, acid) (e.g., Gaucher disease) gene analysis, common variants (e.g., N370S, 84GG, L444P, IVS2+1G>A)

81252

GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (e.g., nonsyndromic hearing loss) gene analysis; full gene sequence

81254

GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (e.g., nonsyndromic hearing loss) gene analysis, common variants (e.g., 309kb [del(GJB6-D13S1830)] and 232kb [del(GJB6-D13S1854)])

81255

HEXA (hexosaminidase A [alpha polypeptide]) (e.g., Tay-Sachs disease) gene analysis, common variants (e.g., 1278insTATC, 1421+1G>C, G269S)

81256

HFE (hemochromatosis) (e.g., hereditary hemochromatosis) gene analysis, common variants (e.g., C282Y, H63D)

81257

HBA1/HBA2 (alpha globin 1 and alpha globin 2) (e.g., alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis, for common deletions or variant (e.g., Southeast Asian, Thai, Filipino, Mediterranean, alpha3.7, alpha4.2, alpha20.5, and Constant Spring)

81259

HBA1/HBA2 (alpha globin 1 and alpha globin 2)(e.g., alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence

81260

HBA1/HBA2 (alpha globin 1 and alpha globin 2)(e.g., alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence

81261

IGH@ (Immunoglobulin heavy chain locus) (e.g., leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (e.g., polymerase chain reaction)

81262

IGH@ (Immunoglobulin heavy chain locus) (e.g., leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (e.g., Southern blot)

81263

IGH@ (Immunoglobulin heavy chain locus) (e.g., leukemia and lymphoma, B-cell), variable region somatic mutation analysis

81264

IGK@ (Immunoglobulin kappa light chain locus) (e.g., leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s)

81265

Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (e.g., pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient germline [e.g., buccal swab or other germline tissue sample] and donor testing, twin zygosity testing, or maternal cell contamination of fetal cells)

81266

Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (e.g., additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in multiple birth pregnancies) (List separately in addition to code for primary procedure)

81267

Chimerism (engraftment) analysis, post transplantation specimen (e.g., hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection

81268

Chimerism (engraftment) analysis, post transplantation specimen (e.g., hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (e.g., CD3, CD33), each cell type

81269

HBA1/HBA2 (alpha globin 1 and alpha globin 2)(e.g., alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants

81270

JAK2 (Janus kinase 2) (e.g., myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant

81272

KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (e.g., gastrointestinal stromal tumor [GIST], acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (e.g., exons 8, 11, 13, 17, 18)

81273

KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (e.g., mastocytosis), gene analysis, D816 variant(s)

81275

KRAS (Kirsten rat sarcoma viral oncogene homolog) (e.g., carcinoma) gene analysis; variants in exon 2 (e.g., codons 12 and 13)

81276

KRAS (Kirsten rat sarcoma viral oncogene homolog) (e.g., carcinoma) gene analysis; additional variant(s) (e.g., codon 61, codon 146)

81277

Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities

81283

IFNL3 (interferon, lambda 3) (e.g., drug response), gene analysis, rs12979860 variant

81287

MGMT (O-6-methylguanine-DNA methyltransferase) (e.g., glioblastoma multiforme), methylation analysis

81288

MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; promoter methylation analysis

81290

MCOLN1 (mucolipin 1) (e.g., Mucolipidosis, type IV) gene analysis, common variants (e.g., IVS3-2A>G, del6.4kb)

81291

MTHFR (5,10-methylenetetrahydrofolate reductase) (e.g., hereditary hypercoagulability) gene analysis, common variants (e.g., 677T, 1298C)

81292

MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis

81293

MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants

81294

MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants

81295

MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis

81296

MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants

81297

MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants

81298

MSH6 (mutS homolog 6 [E. coli]) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis

81299

MSH6 (mutS homolog 6 [E. coli]) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants

81300

MSH6 (mutS homolog 6 [E. coli]) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants

81301

Microsatellite instability analysis (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (e.g., BAT25, BAT26), includes comparison of neoplastic and normal tissue, if performed

81302

MECP2 (methyl CpG binding protein 2) (e.g., Rett syndrome) gene analysis; full sequence analysis

81304

MECP2 (methyl CpG binding protein 2) (e.g., Rett syndrome) gene analysis; duplication/deletion variants

81309

PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (e.g., colorectal and breast cancer) gene analysis, targeted sequence analysis (e.g., exons 7, 9, 20)

81310

NPM1 (nucleophosmin) (e.g., acute myeloid leukemia) gene analysis, exon 12 variants

81311

NRAS (neuroblastoma RAS viral [v-ras] oncogene homolog) (e.g., colorectal carcinoma), gene analysis, variants in exon 2 (e.g., codons 12 and 13) and exon 3 (e.g., codon 61)

81314

PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (e.g., gastrointestinal stromal tumor [GIST]), gene analysis, targeted sequence analysis (e.g., exons 12, 18)

81315

PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (e.g., promyelocytic leukemia) translocation analysis; common breakpoints (e.g., intron 3 and intron 6), qualitative or quantitative

81316

PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (e.g., promyelocytic leukemia) translocation analysis; single breakpoint (e.g., intron 3, intron 6 or exon 6), qualitative or quantitative

81317

PMS2 (postmeiotic segregation increased 2 [S. cerevisiae]) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis

81319

PMS2 (postmeiotic segregation increased 2 [S. cerevisiae]) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants

81324

PMP22 (peripheral myelin protein 22) (e.g., Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis

81330

SMPD1(sphingomyelin phosphodiesterase 1, acid lysosomal) (e.g., Niemann-Pick disease, Type A) gene analysis, common variants (e.g., R496L, L302P, fsP330)

81331

SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A) (e.g., Prader-Willi syndrome and/or Angelman syndrome), methylation analysis

81332

SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) (e.g., alpha-1-antitrypsin deficiency), gene analysis, common variants (e.g., *S and *Z)

81334

RUNX1 (runt related transcription factor 1) (e.g., acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy), gene analysis, targeted sequence analysis (e.g., exons 3-8)

81335

TPMT(thiopurine S-methyltransferase) (e.g., drug metabolism), gene analysis, common variants (e.g., *2, *3)

81340

TRB@ (T cell antigen receptor, beta) (e.g., leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (e.g., polymerase chain reaction)

81341

TRB@ (T cell antigen receptor, beta) (e.g., leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (e.g., Southern blot)

81342

TRG@ (T cell antigen receptor, gamma) (e.g., leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s)

81346

TYMS (thymidylate synthetase) (e.g., 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (e.g., tandem repeat variant)

81349

Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis

81350

UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (e.g., irinotecan metabolism), gene analysis, common variants (e.g., *28, *36, *37)

81351

TP53 (tumor protein 53) (e.g., Li-Fraumeni syndrome) gene analysis; full gene sequence

81353

TP53 (tumor protein 53) (e.g., Li-Fraumeni syndrome) gene analysis; known familial variant

81355

VKORC1 (vitamin K epoxide reductase complex, subunit 1) (e.g., warfarin metabolism), gene analysis, common variant(s) (e.g., -1639G>A, c.173+1000C>T)

81361

HBB (hemoglobin, subunit beta) (e.g., sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (e.g., HbS, HbC, HbE)

81363

HBB (hemoglobin, subunit beta) (e.g., sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s)

81370

HLA Class I and II typing, low resolution (e.g., antigen equivalents); HLA-A, -B, -C, -DRB1/3/4/5, and -DQB1

81371

HLA Class I and II typing, low resolution (e.g., antigen equivalents); HLA-A, -B, and -DRB1 (e.g., verification typing)

81372

HLA Class I typing, low resolution (e.g., antigen equivalents); complete (i.e., HLA-A, -B, and -C)

81373

HLA Class I typing, low resolution (e.g., antigen equivalents); one locus (e.g., HLA-A, -B, or -C), each

81374

HLA Class I typing, low resolution (e.g., antigen equivalents); one antigen equivalent (e.g., B*27), each

81375

HLA Class II typing, low resolution (e.g., antigen equivalents); HLA-DRB1/3/4/5 and -DQB1

81376

HLA Class II typing, low resolution (e.g., antigen equivalents); one locus (e.g., HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each

81377

HLA Class II typing, low resolution (e.g., antigen equivalents); one antigen equivalent, each

81378

HLA Class I and II typing, high resolution (i.e., alleles or allele groups), HLA-A, -B, -C, and -DRB1

81379

HLA Class I typing, high resolution (i.e., alleles or allele groups); complete (i.e., HLA-A, -B, and -C)

81380

HLA Class I typing, high resolution (i.e., alleles or allele groups); one locus (e.g., HLA-A, -B, or -C), each

81381

HLA Class I typing, high resolution (i.e., alleles or allele groups); one allele or allele group (e.g., B*57:01P), each

81382

HLA Class II typing, high resolution (i.e., alleles or allele groups); one locus (e.g., HLA-DRB1, -DRB3/4/5, -DQB1, -DQA1, -DPB1, or -DPA1), each

81383

HLA Class II typing, high resolution (i.e., alleles or allele groups); one allele or allele group (e.g., HLA-DQB1*06:02P), each

81411

Aortic dysfunction or dilation (e.g., Marfan syndrome, Loeys Dietz syndrome, Ehler Danlos syndrome type IV, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for TGFBR1, TGFBR2, MYH11, and COL3A1

81414

Cardiac ion channelopathies (e.g., Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include analysis of at least 2 genes, including KCNH2 and KCNQ1

81435

Hereditary colon cancer-related disorders (e.g., Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel, 5 or more genes, interrogation for sequence variants and copy number variants

81596

Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic algorithm reported as scores for fibrosis and necroinflammatory activity in liver

93581

Percutaneous transcatheter closure of a congenital ventricular septal defect with implant

93595

Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections

93750

Interrogation of ventricular assist device (VAD), in person

95965

Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (e.g., epileptic cerebral cortex localization)

95966

Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (e.g., sensory, motor, language, or visual cortex localization)

95980

Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; intraoperative, with programming

95981

Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; subsequent, without reprogramming

95982

Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; subsequent, with reprogramming

A4563

Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each

A9285

Inversion/eversion correction device

C1825

Generator, neurostimulator (implantable), non-rechargeable with carotid sinus baroreceptor stimulation lead(s)

C9758

Blinded procedure for NYHA Class III/IV heart failure; transcatheter implantation of interatrial shunt or placebo control, including right heart catheterization, transesophageal echocardiography (TEE)/intracardiac echocardiography (ICE), and all imaging with or without guidance (e.g., ultrasound, fluoroscopy), performed in an approved investigational device exemption (IDE) study

C9782

Blinded procedure for New York Heart Association (NYHA) class II or III heart failure, or Canadian Cardiovascular Society (CCS) class III or IV chronic refractory angina; transcatheter intramyocardial transplantation of autologous bone marrow cells (e.g., mononuclear) or placebo control, autologous bone marrow harvesting and preparation for transplantation, left heart catheterization including ventriculography, all laboratory services, and all imaging with or without guidance (e.g., transthoracic echocardiography, ultrasound, fluoroscopy), performed in an approved investigational device exemption (IDE) study

C9783

Blinded procedure for transcatheter implantation of coronary sinus reduction device or placebo control, including vascular access and closure, right heart catheterization, venous and coronary sinus angiography, imaging guidance and supervision and interpretation when performed in an approved investigational device exemption (IDE) study

E0217

Water circulating heat pad with pump

L8042

Orbital prosthesis, provided by a nonphysician