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Revision 19-0; Effective July 1, 2019
Evaluation and Management | |
99201 | Office Visit. New Individual. Problem focused history/exam. Straightforward decision-making. |
99202 | Office Visit. New Individual. Expanded problem focused history/exam. Straightforward medical decision-making. |
99203 | Office Visit. New Individual. Detailed history/exam. Low complexity decision-making. |
99204 | Office Visit. New Individual. Comprehensive history/exam. Moderate complexity decision-making. |
99205 | Office Visit. New Individual. Comprehensive history/exam. High complexity decision-making. |
99211 | Office Visit. Established Individual. Minor problem focus. Straightforward decision-making. |
99212 | Office Visit. Established Individual. Problem focused history/exam. Straightforward decision-making. |
99213 | Office Visit. Established Individual. Expanded problem focused history/exam. Low complexity decision-making. |
99214 | Office Visit. Established Individual. Detailed history/exam. Moderate complexity decision-making. |
99215 | Office Visit. Established Individual. Comprehensive history/exam. High complexity decision-making. |
99241 | Office Consultation. New or Established Individual. Problem focused history/exam. Straightforward decision-making. |
99242 | Office Consultation. New or Established Individual. Expanded problem focused history/exam. Straightforward decision-making. |
99243 | Office Consultation. New or Established Individual. Detailed history/exam. Low complexity decision-making. |
99244 | Office Consultation. New or Established Individual. Comprehensive history/exam. Moderate complexity decision-making. |
99384 | Preventive Visit. New Individual. Age 12 – 17. |
99385 | Preventive Visit. New Individual. Age 18 – 39. |
99386 | Preventive Visit. New Individual. Age 40 – 64. |
99394 | Preventive Visit. Established Individual. Age 12 – 17. |
99395 | Preventive Visit. Established Individual. Age 18 – 39. |
99396 | Preventive Visit. Established Individual. Age 40 – 64. |
59430 | Postpartum visit |
Radiology | |
71010 | Chest x-ray one view frontal |
71020 | Chest x-ray two view frontal and lateral |
73060 | Radiologic examination x-ray, humerus, minimum of two views |
74000 | X-ray, abdomen, single a/p view |
74010 | X-ray, abdomen, a/p and additional views |
74740 | Hysterosalpingogram |
76098 | Radiological exam, surgical specimen |
76641 | Ultrasound, complete examination of breast including axilla, unilateral |
76642 | Ultrasound, limited examination of the breast including axilla, unilateral |
76700 | US exam, abdominal, complete |
76705 | US exam, abdominal, limited |
76770 | US exam abdominal back wall, comp |
76801 | OB US less than 14 weeks, single fetus |
76802 | OB US less than 14 weeks, additional fetus |
76805 | Ultrasound pregnant uterus, greater than or equal to 14 weeks’ gestation, single or first gestation |
76810 | US exam, pregnant uterus, multiple gestation |
76811 | OB US, detailed, single fetus |
76813 | OB US, nuchal measure, one gestation |
76815 | Ultrasound of pregnant uterus, limited |
76816 | Ultrasound of pregnant uterus as follow-up of abnormal previous scan |
76817 | Transvaginal US, obstetric |
76818 | Fetal biophysical profile with W/NST |
76819 | Fetal biophysical profile with/out NST |
76820 | Umbilical artery echo |
59025 | Fetal non-stress test |
76830 | Ultrasound, transvaginal |
76856 | Ultrasound, pelvic, non-obstetric |
76857 | Ultrasound, pelvic, non-obstetric, limited or follow-up |
76881 | Ultrasound, extremity, nonvascular, real-time with image documentation, complete |
76882 | Ultrasound, extremity, nonvascular, real-time with image documentation, limited, anatomic specific |
76942 | Echo guide for biopsy |
76998 | Ultrasound guidance, intraoperative |
77051 | Computer dx mammogram add-on |
77053 | Mammary ductogram or galactogram, single duct, global fee |
77065 | Mammogram, one breast |
77066 | Mammogram, both breasts |
77067 | Mammogram, screening, appropriate for male and female |
77058 | Magnetic resonance imaging, breast, with and/or without contrast, unilateral, global fee |
77059 | Magnetic resonance imaging, breast, with and/or without contrast, bilateral, global fee |
G0202 | Screening Mammography digital |
G0204 | Diagnostic mammography, (producing direct 2-d digital image, bilateral, all views) |
G0206 | Diagnostic mammography, (producing direct 2-d digital image, unilateral, all views) |
Medications, Immunizations and Vaccines | |
90460 | IM admin first/only component |
90471 | Immunization admin |
90472 | Immunization admin, any route, each additional vaccine (single or combination) |
90632 | Hep A vaccine, adult, IM |
90633 | Hep A vaccine, ped/adol, 2 dose, IM |
90636 | Hep A/Hep B vaccine, adult, IM |
90649 | HPV vaccine 4 valent, IM |
90650 | HPV vaccine 2 valent, IM |
90651 | HPV vaccine 9 valent, IM |
90654 | Flu vaccine, split virus, preservative-free, for intradermal use |
90656 | Flu vaccine no preservative 3 years and older |
90658 | Flu vaccine 3 years and older, IM |
90660 | Flu vaccine, live, no preservative, trivalent, IM |
90670 | Pneumococcal vaccine, 13 Val IM |
90673 | Flu vaccine, no preservative, trivalent, IM |
90686 | Flu vaccine, no preservative, quadrivalent, 3 years and older |
90688 | Flu vaccine, quadrivalent, split virus |
90707 | MMR vaccine, live, SC |
90710 | MMRV vaccine, live, SC |
90714 | Td vaccine, no preservative, age 7 and older, IM |
90715 | Tdap vaccine, age 7 and older, IM |
90716 | Chicken pox vaccine, IM |
90723 | Diphtheria, pertussis, tetanus, Hepatitis B, IMPV |
90732 | Pneumococcal vaccine, SC or IM |
90733 | Meningococcal vaccine, SC |
90734 | Meningococcal vaccine, IM |
90736 | Zoster vaccine, SC |
90743 | Hep B vaccine, adolescent, 2 dose, IM |
90744 | Hep B vaccine, birth – 19 years, 3 dose, IM |
90746 | Hep B vaccine, 20+ years, 3 dose, IM |
96372 | Non-neoplastic hormonal therapy injection |
A9150 | Non-Rx drugs |
J0558 | Penicillin G benzathine/procaine injection |
J0561 | Penicillin G benzathine injection |
J0690 | Cefazolin sodium injection |
J0696 | Ceftriaxone sodium injection |
J0702 | Betamethasone sodium phosphate and acetate |
J1100 | Dexamethasone sodium phosphate |
J1725 | Hydroxyprogesterone caproate injection |
J2010 | Lincomycin injection |
J2790 | Rho D immune globulin injection |
J3490 | Injection Medication for STD or G/U infection |
S5000 | Oral prescription medication, generic |
Contraceptive Method | |
H1010 | Instruction, NFP |
A4261 | Cervical cap |
A4266 | Diaphragm |
A4267 | Condom, male, each |
A4268 | Condom, female, each |
A4269 | Spermicide (e.g., foam, gel) each, six suppositories or film are quantity of one |
S4993 | Oral contraceptive pills, one cycle |
J7297 | Lilleta IUD (52mg levonorgestrel-releasing intrauterine contraceptive) |
J7298 | Mirena IUD (52mg levonorgestrel-releasing intrauterine contraceptive) |
Q9984 | Kyleena IUD (19.5 mg levonorgestrel -releasing intrauterine contraceptive) |
J7300 | Copper intrauterine contraceptive |
J7301 | Skyla IUD (13.5 mg levonorgestrol intrauterine contraceptive) |
J7303 | Vaginal ring, each |
J7304 | Contraceptive patch, each |
J7307 | Implantable contraceptive capsule |
Contraceptive Method-Related Services | |
57170 | Diaphragm or cervical cap fitting with instructions |
58300 | Insertion of intrauterine device |
58301 | Removal of intrauterine device |
11982 | Removal nonbiodegradable drug delivery implant |
11983 | Removal with reinsertion, nonbiodegradable drug delivery implant |
58562 | Hysteroscopy, surgical; with removal of impacted foreign body |
J1050 | Medroxyprogesterone acetate for contraceptive use, injection |
96372 | Injection fee, Medroxyprogesterone acetate |
11976 | Removal, implantable contraceptive |
11981 | Nonbiodegradable drug delivery implant insertion |
Counseling and Education | |
90791 | Psychiatric diagnostic interview without medical services |
90792 | Psychiatric diagnostic interview for provider of medical services |
97802 | Medical nutrition therapy, initial assessment, individual, face to face, every 15 minutes |
97803 | Medical nutrition therapy, reassessment, individual, face to face, every 15 minutes |
97804 | Medical nutrition therapy, group (two or more), every 30 minutes |
99078 | Group health education |
99406 | Behavior change, smoking 3-10 minutes |
99407 | Behavior change, smoking greater than 10 minutes |
Pathology and Laboratory | |
80061 | Lipid profile with cholesterol |
80300 | Drug screen, qualitative/multiple |
80301 | Drug screen, single |
81000 | Urinalysis, by dipstick or tablet, nonautomated, with microscopy |
81001 | Urinalysis, by dipstick or tablet, automated, with microscopy |
81002 | Urinalysis, dipstick or tablet, nonautomated, without microscopy |
81003 | Urinalysis, by dipstick or tablet, automated, without microscopy |
81005 | Urinalysis, qualitative or semiquantitative |
81015 | Urinalysis, microscopic only |
81025 | Urine pregnancy test, visual comparison methods |
82947 | Glucose, blood, except reagent strip |
82948 | Glucose, blood, reagent strip |
83036 | Hemoglobin A1c |
84443 | Thyroid stimulating hormone |
84702 | Chorionic gonadotropin, quantitative (pregnancy test) |
84703 | Chorionic gonadotropin, qualitative (pregnancy test) |
85013 | Microhematocrit, spun |
85014 | Hematocrit |
85018 | Hemoglobin |
85025 | CBC with differential, automated |
85027 | CBC, automated |
86318 | Immunoassay, infection agent |
86580 | Tb skin test, intradermal |
86592 | Syphilis |
86689 | HTLV/HIV confirmatory test |
86695 | Herpes simplex, type 1 |
86696 | Herpes simplex, type 2 |
86701 | HIV-1 antibody |
86702 | HIV-2 antibody |
86703 | HIV-1 and HIV-2, single assay |
86762 | Rubella antibody |
86803 | Hepatitis C antibody |
86900 | Blood typing, ABO |
86901 | Blood typing, Rh |
87070 | Culture, bacterial; any source other than blood or stool; with presumptive identification of isolates |
87086 | Urine culture, bacterial, quantitative |
87088 | Urine culture, bacterial, with presumptive identification of isolates |
87102 | Culture, fungi, with presumptive identification of isolates, source other than blood, skin, hair or nail |
87110 | Chlamydia culture |
87205 | Smear with interpretation, routine stain for bacteria, fungi or cell types |
87210 | Wet mount for infectious agents (e.g., saline, India ink, KOH preps) |
87220 | Tissue examination by KOH slide of samples from skin, hair or nails for fungi, ectoparasite ova, mites |
87252 | Virus isolation, tissue culture inoculation and presumptive identification (herpes) |
87389 | HIV-1 AG w/ HIV-1 & HIV 2 AB |
87480 | Candida species, direct probe technique |
87490 | Chlamydia, direct probe technique |
87491 | Chlamydia, amplified probe technique |
87510 | Gardnerella vaginalis, direct probe technique |
87535 | HIV-1 probe and reverse transcription |
87590 | Gonorrhea, direct probe technique |
87591 | Gonorrhea, amplified probe technique |
87624 | HPV, high-risk types |
87625 | HPV, types 16 and 18 only |
87660 | Trichomonas vaginalis, direct probe technique |
87797 | Infectious agent, NOS, direct probe |
87800 | Infectious agent, multiple organisms, direct probe technique |
87801 | Infectious agent, multiple organisms, amplified probe technique |
87810 | Chlamydia, immunoassay with direct optical observation |
87850 | Gonorrhea, immunoassay with direct optical observation |
88142 | Cytopathology, cervical/vaginal, liquid based, automated |
88150 | Cytopathology, cervical/vaginal, slides, manual |
88164 | Cytopathology, cervical/vaginal, slides, manual, the Bethesda System |
88175 | Cytopathology, cervical/vaginal, any reporting system, fluid based, automated screening with manual rescreening or review. |
80048 | Basic metabolic panel |
80053 | Comprehensive metabolic panel |
85730 | Thromboplastin time, partial |
88305 | Tissue exam by pathologist |
88307 | Tissue exam by pathologist |
93000 | Electrocardiogram, complete |
88141 | Cytopath, cervical or vaginal (C/V), interpret |
88143 | Cytopath, C/V thin layer, redo |
88173 | Cytopath evaluation, FNA, report |
88174 | Cytopath, C/V auto, in fluid |
80050 | General health panel |
80051 | Electrolyte panel |
80053 | Comprehensive metabolic panel |
80069 | Renal function panel |
80074 | Acute hepatitis panel |
80076 | Hepatic function panel |
82270 | Occult blood, feces |
82465 | Total cholesterol |
82950 | Glucose test |
83020 | Hemoglobin electrophoresis |
83021 | Hemoglobin chromatography |
83036 | Glycosylated hemoglobin test |
84450 | Transferase (AST) (SGOT) |
84460 | Alanine amino (ALT) (SGPT) |
84478 | Assay of Triglycerides |
84479 | Assay of thyroid (T3 or T4) |
85007 | Differential WBC count |
85610 | Prothrombin time (PT) |
85660 | RBC sickle cell test |
85730 | Thromboplastin time, partial (PTT) |
86631 | Chlamydia trachomatis, immunofluorescent technique |
86677 | Helicobacter pylori antibody |
86704 | Hepatitis B core antibody, total |
86706 | Hepatitis B surface antibody |
86780 | Treponema pallidum |
86885 | Coombs test, indirect, qualitative |
87270 | Chlamydia trachomatis, immunofluorescent technique |
87512 | Gardnerella vaginalis, quantification |
87529 | HSV, DNA, amplified probe |
87530 | HSV, DNA, quantitative |
87661 | Trichomonas vaginalis, amplified |
88155 | Cytopath, C/V, index add-on |
88160 | Cytopath smear, other source |
88161 | Cytopath smear, other source |
88165 | Cyopath, bethesda system, w/manual screen/rescreen |
88167 | Cytopathology, Bethesda system, cervical/vaginal, select |
88172 | Cytopathology, evaluation of fine needle aspirate |
80055 | Obstetric panel |
80300 | Drug screen, single |
82105 | Alpha-fetoprotein, serum |
82677 | Estriol (UE3) |
82951 | Glucose tolerance test (GTT) |
84436 | T4 |
84479 | Assay of thyroid (T3 or T4) |
85384 | Fibrinogen |
85610 | Prothrombin time |
86336 | Inhibin A |
86777 | Toxoplasmosis, IgG IFA |
86778 | Toxoplasmosis, IgM |
86850 | Blood, antibody screen |
86900 | Blood group type |
86901 | Rh type |
87081 | GBS culture |
87184 | Susceptibility test |
87340 | Hepatitis B surface antigen, by enzyme immunoassay |
94760 | Non-invasive pulse oximetry for oxygen saturation |
99000 | Specimen handling or conveyance |
Anesthesia | |
00851 | Anesthesia for sterilization, lower abdomen |
00400 | Anesthesia for procedures on the integumentary system, anterior trunk |
00940 | Anesthesia for vaginal procedures (including biopsy of cervix), NOS |
Surgical Procedures | |
55250 | Male sterilization, vasectomy |
58340 | Catheter for hysterography |
58565 | Female sterilization, hysteroscopy with bilateral fallopian tube cannulation and placement of permanent implants to occlude the fallopian tubes |
58600 | Female sterilization, fallopian tube transection, blocking or other procedure |
58611 | Female sterilization, fallopian tube transection performed at time of cesarean delivery |
58615 | Female sterilization, occlusion of fallopian tubes by device, vaginal approach |
58670 | Female sterilization, laparoscopy with fulguration of oviducts |
58671 | Female sterilization, laparoscopy with occlusion of oviducts by device |
10022 | FNA with image |
19000 | Drainage of breast lesion |
19081 | Breast biopsy first lesion, includes stereotactic guidance |
19082 | Breast biopsy, with placement of localization device and imaging of biopsy specimen, percutaneous, stereotactic guidance, each additional lesion |
19083 | Breast biopsy, first lesion, US imaging |
19084 | Breast biopsy, with placement of localization device and imaging of biopsy specimen, percutaneous, US guidance, each additional lesion |
19100 | Breast biopsy, percutaneous, needle core, not using imaging guidance, one or more lesion |
19101 | Incisional breast biopsy, one or more lesions |
19120 | Removal of breast lesion |
19125 | Excision of abnormal breast tissue, duct, nipple or areolar lesion, single lesion; identified by preoperative placement of radiological marker (physician in facility) |
19126 | Excision of abnormal breast tissue, duct, nipple or areolar lesion, each additional lesion (physician in facility) |
19281 | Preoperative placement of breast localization device, percutaneous: mammographic guidance, first lesion (physician in office) |
19282 | Preoperative placement of breast localization device, percutaneous: mammographic guidance, each additional lesion (physician in office) |
19283 | Preoperative placement of breast localization device, percutaneous: stereotactic guidance, first lesion (physician in office) |
19284 | Preoperative placement of breast localization device, percutaneous: stereotactic guidance, each additional lesion (physician in office) |
19285 | Preoperative placement of breast localization device, percutaneous: ultrasound guidance, first lesion (physician in office) |
19286 | Preoperative placement of breast localization device, percutaneous: ultrasound guidance, each additional lesion (physician in office) |
56405 | I & D of vulva/perineum |
56420 | Drainage of gland abscess |
56501 | Destroy, vulva lesions, simple |
56515 | Destroy vulva lesions, complex |
56605 | Biopsy of vulva/perineum |
56606 | Biopsy of vulva/perineum |
56820 | Exam of vulva w/scope |
57023 | I & D vaginal hematoma, non-ob |
57061 | Destroy vaginal lesions, simple |
57100 | Biopsy of vagina |
57421 | Exam/biopsy of vagina w/scope |
57511 | Cryocautery of cervix |
58100 | Biopsy of uterine lining |
Cervical Cancer Screening Services | |
57452 | Examination of vagina – colposcopy |
57454 | Vagina examination and biopsy |
57455 | Biopsy of cervix with scope |
57456 | Endocervical curettage with scope |
57460 | Cervix excision |
57461 | Conization of cervix with scope, leep |
57500 | Biopsy of cervix |
57505 | Endocervical curettage |
57520 | Conization of cervix, cold knife or laser |
57522 | Conization of cervix, leep |
58110 | Biopsy done w/colposcopy add-on |
Supplies | |
A4253 | Blood glucose/reagent strips |
A4258 | Springload device for lancet |
A4259 | Lancets per box (100 count) |
A4264 | Intratubal occlusion device |