Medicare Correct Coding Guide - OptumCoding.com
Medicare Correct Coding Guide - OptumCoding.com
Medicare Correct Coding Guide - OptumCoding.com
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<strong>Medicare</strong> <strong>Correct</strong> <strong>Coding</strong> <strong>Guide</strong>
Contents<br />
Getting Started with <strong>Medicare</strong> <strong>Correct</strong> <strong>Coding</strong> <strong>Guide</strong> ................................................................................Introduction–1<br />
Introduction .............................................................................................................................................Introduction–3<br />
Resource-Based Relative Value Scale (RBRVS) ..................................................................................................Introduction–3<br />
<strong>Correct</strong> <strong>Coding</strong> Initiative (CCI) ........................................................................................................................Introduction–3<br />
Medically Unlikely Edits............................................................................................................................Introduction–4<br />
Manual Organization .......................................................................................................................................Introduction–4<br />
How to Use This Book .....................................................................................................................................Introduction–5<br />
Resource-Based Relative Value Scale (RBRVS) Payment Computation .......................................................Introduction–5<br />
Modifiers ..........................................................................................................................................................Introduction–6<br />
Surgery Modifiers .....................................................................................................................................Introduction–6<br />
Modifiers Affecting <strong>Correct</strong> <strong>Coding</strong> Edits .................................................................................................Introduction–6<br />
Other Payment Indicators ................................................................................................................................Introduction–7<br />
Status Indicator ........................................................................................................................................Introduction–7<br />
Global Period ...........................................................................................................................................Introduction–7<br />
Physician Supervision Level ......................................................................................................................Introduction–7<br />
Definitions ...............................................................................................................................................Introduction–7<br />
Levels of Physician Supervision of Diagnostic Tests...................................................................................Introduction–7<br />
<strong>Correct</strong> <strong>Coding</strong> Initiative (CCI) ........................................................................................................................Introduction–8<br />
Step-by-Step Instructions .................................................................................................................................Introduction–9<br />
Code Pair Additions ................................................................................................................... Summary of Changes–1<br />
Code Pair Deletions .................................................................................................................. Summary of Changes–26<br />
Modifier Revisions .................................................................................................................... Summary of Changes–36<br />
Edit Revisions ............................................................................................................................ Summary of Changes–37<br />
General <strong>Correct</strong> <strong>Coding</strong> Policies .......................................................................................................................General–1<br />
A. Introduction ............................................................................................................................................... General–1<br />
B. <strong>Coding</strong> Based on Standard of Medical/Surgical Practice ............................................................................... General–2<br />
C. Medical/Surgical Package ............................................................................................................................ General–3<br />
D. Evaluation and Management Services ......................................................................................................... General–4<br />
E. Modifiers and Modifier Indicators ............................................................................................................... General–5<br />
F. Standard Preparation/Monitoring Services for Anesthesia ............................................................................ General–7<br />
G. Anesthesia Service Included in the Surgical Procedure ................................................................................ General–7<br />
H. HCPCS/CPT Procedure Code Definition ..................................................................................................... General–7<br />
I. CPT Manual and CMS <strong>Coding</strong> Manual Instructions ..................................................................................... General–8<br />
J. CPT “Separate Procedure” Definition ........................................................................................................... General–8<br />
K. Family of Codes .......................................................................................................................................... General–8<br />
L. More Extensive Procedure ........................................................................................................................... General–8<br />
M. Sequential Procedure .................................................................................................................................. General–9<br />
N. Laboratory Panel ......................................................................................................................................... General–9<br />
O. Misuse of Column 2 Code with Column 1 Code ......................................................................................... General–9<br />
P. Mutually Exclusive Procedures .................................................................................................................... General–9<br />
Q. Gender-Specific Procedure (formerly Designation of Sex) ........................................................................... General–9<br />
R. Add-on Codes ............................................................................................................................................. General–9<br />
S. Excluded Service ....................................................................................................................................... General–10<br />
T. Unlisted Service or Procedure ................................................................................................................... General–10<br />
U. Modified, Deleted, and Added Code Pairs/Edits ........................................................................................ General–10<br />
V. Medically Unlikely Edits ........................................................................................................................... General–10<br />
Surgery: Integumentary System (CPT Codes 10000–19999) ..................................................................Integumentary–i<br />
<strong>Correct</strong> <strong>Coding</strong> Policies ..................................................................................................................................Integumentary–i<br />
A. Introduction ......................................................................................................................................Integumentary–i<br />
B. Evaluation and Management (E/M) Services ........................................................................................Integumentary–i<br />
C. Anesthesia ..........................................................................................................................................Integumentary–i<br />
D. Incision and Drainage .......................................................................................................................Integumentary–ii<br />
E. Lesion Removal .................................................................................................................................Integumentary–ii<br />
F. Mohs Micrographic Surgery .............................................................................................................Integumentary–iii<br />
© 2012 OptumInsight January 2012 Contents–1<br />
CPT only © 2011 American Medical Association. All Rights Reserved.
Getting Started with <strong>Medicare</strong> <strong>Correct</strong> <strong>Coding</strong> <strong>Guide</strong><br />
Wel<strong>com</strong>e to <strong>Medicare</strong> <strong>Correct</strong> <strong>Coding</strong> <strong>Guide</strong>! This page will help you navigate the data within. For more detailed information about this data, or<br />
how to use the <strong>Medicare</strong> <strong>Correct</strong> <strong>Coding</strong> <strong>Guide</strong>, please refer to the appropriate pages in the Introduction and General <strong>Correct</strong> <strong>Coding</strong> Policies<br />
chapters. Within each section of the book, you will also find detailed information for correct coding within specific sections of CPT® codes.<br />
If you have additional questions, please contact Customer Service at 800.464.3649.<br />
CPT or HCPCS code.<br />
This code represents the column 1 code within the column 1/<br />
column 2 correct coding edits table, (formerly called the<br />
“<strong>com</strong>prehensive” code), which indicates the major service or<br />
procedure. Only codes with <strong>Correct</strong> <strong>Coding</strong> Initiative (CCI) edits<br />
and/or <strong>Medicare</strong> physician fee schedule (MPFS) relative values are<br />
included in this book.<br />
Full CPT or HCPCS Level II description.<br />
RBRVS relative value units (RVUs) from the MPFS.<br />
• When billing multiple procedures, the code with the highest<br />
RVU is generally considered the primary procedure.<br />
• For more information about RBRVS, see pages<br />
Introduction-3 and 4.<br />
• For information about calculating fees, see page Introduction-5.<br />
Global period as listed in the MPFS.<br />
• This indicator is sometimes referred to as follow-up days.<br />
• For a <strong>com</strong>plete description of this field, see page Introduction-7.<br />
MPFS modifiers.<br />
• <strong>Medicare</strong> coverage for bilateral procedures (50), multiple<br />
procedures (51), cosurgeons (62), team surgery (66), and assistant<br />
surgeon (80 and 82).<br />
• For a <strong>com</strong>plete description of MPFS modifiers and indicators, see<br />
page Introduction-6.<br />
• For a <strong>com</strong>plete list of CPT modifiers, see Appendix B.<br />
• For information about the use of modifiers with CCI, see page<br />
General-5.<br />
<strong>Medicare</strong> physician fee schedule status indicator.<br />
• Indicates codes that are included, excluded, bundled, or not<br />
valid for <strong>Medicare</strong> payment purposes.<br />
• For a <strong>com</strong>plete list of status indicators, see page Introduction-7.<br />
Physician supervision level indicator.<br />
• Applies to every diagnostic test paid under the MPFS.<br />
• Many codes have 9 to indicate that this concept does not apply.<br />
• For a full description of each indicator, see page Introduction-7.<br />
Medically Unlikely Edits<br />
• These indicate the maximum units of service (UOS) for a CPT/<br />
HCPCS code for the service provided to the same patient on the<br />
same date of service.<br />
<strong>Correct</strong> <strong>Coding</strong> Initiative (CCI) edits.<br />
• Includes column 2 of the correct coding (column 1/<br />
column 2) edits (previously called “<strong>com</strong>ponent” codes) as well<br />
as the mutually exclusive edits.<br />
• A shaded gray box over an edit code indicates a modifier may be<br />
used to bypass a CCI edit, when appropriate.<br />
• A symbol key appears on each page of data in the book.<br />
• For a full description of each symbol, see the section “General<br />
<strong>Correct</strong> <strong>Coding</strong> Policies.”<br />
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© 2012 OptumInsight January 2012 Introduction–1<br />
CPT only © 2011 American Medical Association. All Rights Reserved.
<strong>Medicare</strong> <strong>Correct</strong> <strong>Coding</strong> <strong>Guide</strong> (CCI Version18.0)<br />
26445<br />
Tenolysis, extensor tendon, hand OR finger, each tendon<br />
RELATIVE VALUE UNITS<br />
OTHER<br />
Work MP PE-nf PE-f Total-nf Total-f Global P MUE<br />
4.45 0.78 11.68 11.68 16.91 16.91 90 —<br />
MODIFIERS<br />
INDICATORS<br />
50 51 62 66 80,82 Suprv Status<br />
0 4 NPD NPD NPD 09 A<br />
CORRECT CODING EDITS<br />
01810 l, 0213T n, 0216T n, 0228T f, 0230T f, 12032 f, 20526 n, 20527 n, 20550 n,<br />
20551 n, 20552 n, 20553 n, 25000 f, 25118 f, 25259 f, 25295 f, 26135 f, 26140 f,<br />
26185 m, 26340 f, 26460 f, 26546 3, 29075 r,29086 f, 29130 r,29131 r,29280 r,<br />
29584 r,36000 f, 36400 f, 36405 f, 36406 f, 36410 f, 36420 f, 36425 f, 36430 f,<br />
36440 f, 36600 f, 36640 f, 37202 n, 43752 f, 51701 f, 51702 f, 51703 f, 62310 f,<br />
62311 f, 62318 n, 62319 n, 64400 f, 64402 f, 64405 f, 64408 f, 64410 f, 64412 f,<br />
64413 f, 64415 n, 64416 n, 64417 n, 64418 f, 64420 f, 64421 f, 64425 f, 64430 f,<br />
64435 f, 64445 f, 64446 f, 64447 f, 64448 f, 64449 f, 64450 n, 64479 f, 64483 f,<br />
64490 n, 64493 n, 64505 f, 64508 f, 64510 f, 64517 f, 64520 f, 64530 f, 69990 n,<br />
93000 f, 93005 f, 93010 f, 93040 f, 93041 f, 93042 f, 93318 f, 94002 f, 94200 f,<br />
94250 f, 94680 f, 94681 f, 94690 f, 94770 f, 95812 f, 95813 f, 95816 f, 95819 f,<br />
95822 f, 95829 f, 95955 f, 96360 f, 96365 f, 96372 f, 96374 f, 96375 f, 96376 f,<br />
99148 n, 99149 n, 99150 n<br />
26449<br />
Tenolysis, <strong>com</strong>plex, extensor tendon, finger, including forearm, each tendon<br />
RELATIVE VALUE UNITS<br />
OTHER<br />
Work MP PE-nf PE-f Total-nf Total-f Global P MUE<br />
8.59 1.51 10.86 10.86 20.96 20.96 90 —<br />
MODIFIERS<br />
INDICATORS<br />
50 51 62 66 80,82 Suprv Status<br />
0 4 NPD NPD DOC 09 A<br />
CORRECT CODING EDITS<br />
01810 l, 0213T n, 0216T n, 0228T f, 0230T f, 20526 n, 20527 n, 20550 n, 20551 n,<br />
20552 n, 20553 n, 25000 f, 25118 f, 25259 f, 26135 f, 26140 f, 26185 m, 26340 f,<br />
26445 t, 26460 f, 26546 3, 29075 r,29086 f, 29130 r,29131 r,29280 r,29584 r,<br />
36000 f, 36400 f, 36405 f, 36406 f, 36410 f, 36420 f, 36425 f, 36430 f, 36440 f,<br />
36600 f, 36640 f, 37202 n, 43752 f, 51701 f, 51702 f, 51703 f, 62310 f, 62311 f,<br />
62318 n, 62319 n, 64400 f, 64402 f, 64405 f, 64408 f, 64410 f, 64412 f, 64413 f,<br />
64415 n, 64416 n, 64417 n, 64418 f, 64420 f, 64421 f, 64425 f, 64430 f, 64435 f,<br />
64445 f, 64446 f, 64447 f, 64448 f, 64449 f, 64450 n, 64479 f, 64483 f, 64490 n,<br />
64493 n, 64505 f, 64508 f, 64510 f, 64517 f, 64520 f, 64530 f, 69990 n, 93000 f,<br />
93005 f, 93010 f, 93040 f, 93041 f, 93042 f, 93318 f, 94002 f, 94200 f, 94250 f,<br />
94680 f, 94681 f, 94690 f, 94770 f, 95812 f, 95813 f, 95816 f, 95819 f, 95822 f,<br />
95829 f, 95955 f, 96360 f, 96365 f, 96372 f, 96374 f, 96375 f, 96376 f, 99148 n,<br />
99149 n, 99150 n<br />
26450<br />
Tenotomy, flexor, palm, open, each tendon<br />
RELATIVE VALUE UNITS<br />
OTHER<br />
Work MP PE-nf PE-f Total-nf Total-f Global P MUE<br />
3.79 0.68 7.31 7.31 11.78 11.78 90 —<br />
MODIFIERS<br />
INDICATORS<br />
50 51 62 66 80,82 Suprv Status<br />
0 4 NPD NPD DOC 09 A<br />
CORRECT CODING EDITS<br />
01810 l, 0213T n, 0216T n, 0228T f, 0230T f, 11010 3, 20526 n, 20527 n, 20550 n,<br />
20551 n, 20552 n, 20553 n, 25259 f, 26055 f, 26145 f, 26185 m, 26340 f, 26546 3,<br />
29075 r,29086 f, 29130 r,29131 r,29280 r,29584 r,36000 f, 36400 f, 36405 f,<br />
36406 f, 36410 f, 36420 f, 36425 f, 36430 f, 36440 f, 36600 f, 36640 f, 37202 n,<br />
43752 f, 51701 f, 51702 f, 51703 f, 62310 f, 62311 f, 62318 n, 62319 n, 64400 f,<br />
64402 f, 64405 f, 64408 f, 64410 f, 64412 f, 64413 f, 64415 n, 64416 n, 64417 n,<br />
64418 f, 64420 f, 64421 f, 64425 f, 64430 f, 64435 f, 64445 f, 64446 f, 64447 f,<br />
64448 f, 64449 f, 64450 n, 64479 f, 64483 f, 64490 n, 64493 n, 64505 f, 64508 f,<br />
64510 f, 64517 f, 64520 f, 64530 f, 69990 n, 93000 f, 93005 f, 93010 f, 93040 f,<br />
93041 f, 93042 f, 93318 f, 94002 f, 94200 f, 94250 f, 94680 f, 94681 f, 94690 f,<br />
94770 f, 95812 f, 95813 f, 95816 f, 95819 f, 95822 f, 95829 f, 95955 f, 96360 f,<br />
96365 f, 96372 f, 96374 f, 96375 f, 96376 f, 99148 n, 99149 n, 99150 n<br />
26455<br />
Tenotomy, flexor, finger, open, each tendon<br />
RELATIVE VALUE UNITS<br />
OTHER<br />
Work MP PE-nf PE-f Total-nf Total-f Global P MUE<br />
3.76 0.69 7.32 7.32 11.77 11.77 90 —<br />
MODIFIERS<br />
INDICATORS<br />
50 51 62 66 80,82 Suprv Status<br />
0 4 NPD NPD DOC 09 A<br />
CORRECT CODING EDITS<br />
01810 l, 0213T n, 0216T n, 0228T f, 0230T f, 11010 3, 20526 n, 20527 n, 20550 n,<br />
20551 n, 20552 n, 20553 n, 25259 f, 26055 f, 26145 f, 26185 m, 26340 f, 26546 3,<br />
29075 r,29086 f, 29130 r,29131 r,29280 r,29584 r,36000 f, 36400 f, 36405 f,<br />
36406 f, 36410 f, 36420 f, 36425 f, 36430 f, 36440 f, 36600 f, 36640 f, 37202 n,<br />
43752 f, 51701 f, 51702 f, 51703 f, 62310 f, 62311 f, 62318 n, 62319 n, 64400 f,<br />
64402 f, 64405 f, 64408 f, 64410 f, 64412 f, 64413 f, 64415 n, 64416 n, 64417 n,<br />
64418 f, 64420 f, 64421 f, 64425 f, 64430 f, 64435 f, 64445 f, 64446 f, 64447 f,<br />
64448 f, 64449 f, 64450 n, 64479 f, 64483 f, 64490 n, 64493 n, 64505 f, 64508 f,<br />
64510 f, 64517 f, 64520 f, 64530 f, 69990 n, 93000 f, 93005 f, 93010 f, 93040 f,<br />
93041 f, 93042 f, 93318 f, 94002 f, 94200 f, 94250 f, 94680 f, 94681 f, 94690 f,<br />
94770 f, 95812 f, 95813 f, 95816 f, 95819 f, 95822 f, 95829 f, 95955 f, 96360 f,<br />
96365 f, 96372 f, 96374 f, 96375 f, 96376 f, 99148 n, 99149 n, 99150 n<br />
26460<br />
Tenotomy, extensor, hand or finger, open, each tendon<br />
RELATIVE VALUE UNITS<br />
OTHER<br />
Work MP PE-nf PE-f Total-nf Total-f Global P MUE<br />
3.58 0.63 7.24 7.24 11.45 11.45 90 —<br />
MODIFIERS<br />
INDICATORS<br />
50 51 62 66 80,82 Suprv Status<br />
0 4 NPD NPD NPD 09 A<br />
CORRECT CODING EDITS<br />
01810 l, 0213T n, 0216T n, 0228T f, 0230T f, 11010 3, 20526 n, 20527 n, 20550 n,<br />
20551 n, 20552 n, 20553 n, 25116 f, 25118 f, 25259 f, 25295 f, 26135 f, 26140 f,<br />
26185 m, 26340 f, 26546 3, 29075 r,29086 f, 29130 r,29131 r,29280 r,29584 r,<br />
36000 f, 36400 f, 36405 f, 36406 f, 36410 f, 36420 f, 36425 f, 36430 f, 36440 f,<br />
36600 f, 36640 f, 37202 n, 43752 f, 51701 f, 51702 f, 51703 f, 62310 f, 62311 f,<br />
62318 n, 62319 n, 64400 f, 64402 f, 64405 f, 64408 f, 64410 f, 64412 f, 64413 f,<br />
64415 n, 64416 n, 64417 n, 64418 f, 64420 f, 64421 f, 64425 f, 64430 f, 64435 f,<br />
64445 f, 64446 f, 64447 f, 64448 f, 64449 f, 64450 n, 64479 f, 64483 f, 64490 n,<br />
64493 n, 64505 f, 64508 f, 64510 f, 64517 f, 64520 f, 64530 f, 69990 n, 93000 f,<br />
93005 f, 93010 f, 93040 f, 93041 f, 93042 f, 93318 f, 94002 f, 94200 f, 94250 f,<br />
94680 f, 94681 f, 94690 f, 94770 f, 95812 f, 95813 f, 95816 f, 95819 f, 95822 f,<br />
95829 f, 95955 f, 96360 f, 96365 f, 96372 f, 96374 f, 96375 f, 96376 f, 99148 n,<br />
99149 n, 99150 n<br />
26471<br />
Tenodesis; of proximal interphalangeal joint, each joint<br />
Surgery: Musculoskeletal System<br />
RELATIVE VALUE UNITS<br />
OTHER<br />
Work MP PE-nf PE-f Total-nf Total-f Global P MUE<br />
5.90 1.03 10.99 10.99 17.92 17.92 90 —<br />
MODIFIERS<br />
INDICATORS<br />
50 51 62 66 80,82 Suprv Status<br />
0 4 NPD NPD DOC 09 A<br />
CORRECT CODING EDITS<br />
01810 l, 0213T n, 0216T n, 0228T f, 0230T f, 20526 n, 20527 n, 20550 n, 20551 n,<br />
20552 n, 20553 n, 25259 f, 26055 f, 26180 3, 26185 m, 26340 f, 26546 3, 26746 f,<br />
26785 f, 29075 r,29086 f, 29130 r,29131 r,29280 r,29584 r,36000 f, 36400 f,<br />
36405 f, 36406 f, 36410 f, 36420 f, 36425 f, 36430 f, 36440 f, 36600 f, 36640 f,<br />
37202 n, 43752 f, 51701 f, 51702 f, 51703 f, 62310 f, 62311 f, 62318 n, 62319 n,<br />
64400 f, 64402 f, 64405 f, 64408 f, 64410 f, 64412 f, 64413 f, 64415 n, 64416 n,<br />
64417 n, 64418 f, 64420 f, 64421 f, 64425 f, 64430 f, 64435 f, 64445 f, 64446 f,<br />
64447 f, 64448 f, 64449 f, 64450 n, 64479 f, 64483 f, 64490 n, 64493 n, 64505 f,<br />
64508 f, 64510 f, 64517 f, 64520 f, 64530 f, 69990 n, 93000 f, 93005 f, 93010 f,<br />
93040 f, 93041 f, 93042 f, 93318 f, 94002 f, 94200 f, 94250 f, 94680 f, 94681 f,<br />
94690 f, 94770 f, 95812 f, 95813 f, 95816 f, 95819 f, 95822 f, 95829 f, 95955 f,<br />
96360 f, 96365 f, 96372 f, 96374 f, 96375 f, 96376 f, 99148 n, 99149 n, 99150 n<br />
l<br />
f<br />
u<br />
Anesthesia Included in Surgical Procedure<br />
Standards of Medical/Surgical Practice<br />
CPT/HCPCS Procedure Code Definition<br />
r<br />
m<br />
CPT/CMS <strong>Coding</strong> Manual Instructions<br />
CPT Separate Procedure Definition<br />
´<br />
t<br />
Designation of Gender-specific Procedures<br />
More Extensive Procedure<br />
© 2011 OptumInsight<br />
CPT only © 2011 American Medical Association. All Rights Reserved.<br />
January 2012<br />
Musculoskeletal — 159
<strong>Medicare</strong> <strong>Correct</strong> <strong>Coding</strong> <strong>Guide</strong> (CCI Version18.0)<br />
Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with<br />
82820<br />
oxygen)<br />
RELATIVE VALUE UNITS<br />
OTHER<br />
Work MP PE-nf PE-f Total-nf Total-f Global P MUE<br />
0.00 0.00 0.00 0.00 0.00 0.00 NA 1<br />
MODIFIERS<br />
INDICATORS<br />
50 51 62 66 80,82 Suprv Status<br />
NA NA NA NA NA 09 NON<br />
CORRECT CODING EDITS<br />
80500 f, 80502 f<br />
82930<br />
Gastric acid analysis, includes pH if performed, each specimen<br />
RELATIVE VALUE UNITS<br />
Work MP PE-nf<br />
0.00 0.00 0.00<br />
MODIFIERS<br />
50 51 62<br />
NA NA NA<br />
CORRECT CODING EDITS<br />
83986 u<br />
82945<br />
PE-f<br />
0.00<br />
66<br />
NA<br />
Glucose, body fluid, other than blood<br />
RELATIVE VALUE UNITS<br />
Work MP PE-nf<br />
0.00 0.00 0.00<br />
MODIFIERS<br />
50 51 62<br />
NA NA NA<br />
CORRECT CODING EDITS<br />
82947 3, 82948 3<br />
PE-f<br />
0.00<br />
66<br />
NA<br />
OTHER<br />
Total-nf Total-f Global P MUE<br />
0.00 0.00 NA —<br />
INDICATORS<br />
80,82 Suprv Status<br />
NA 09 NON<br />
OTHER<br />
Total-nf Total-f Global P MUE<br />
0.00 0.00 NA —<br />
INDICATORS<br />
80,82 Suprv Status<br />
NA 09 NON<br />
82951<br />
Glucose; tolerance test (GTT), 3 specimens (includes glucose)<br />
RELATIVE VALUE UNITS<br />
Work MP PE-nf PE-f<br />
0.00 0.00 0.00 0.00<br />
MODIFIERS<br />
50 51 62 66<br />
NA NA NA NA<br />
CORRECT CODING EDITS<br />
80500 f, 80502 f, 82948 f, 82953 3<br />
OTHER<br />
Total-nf Total-f Global P MUE<br />
0.00 0.00 NA 1<br />
INDICATORS<br />
80,82 Suprv Status<br />
NA 09 NON<br />
Glucose; tolerance test, each additional beyond 3 specimens (List separately<br />
82952<br />
in addition to code for primary procedure)<br />
RELATIVE VALUE UNITS<br />
OTHER<br />
Work MP PE-nf PE-f Total-nf Total-f Global P MUE<br />
0.00 0.00 0.00 0.00 0.00 0.00 NA 3<br />
MODIFIERS<br />
INDICATORS<br />
50 51 62 66 80,82 Suprv Status<br />
NA NA NA NA NA 09 NON<br />
CORRECT CODING EDITS<br />
80500 f, 80502 f, 82947 3, 82953 3<br />
82953<br />
Glucose; tolbutamide tolerance test<br />
RELATIVE VALUE UNITS<br />
Work MP PE-nf<br />
0.00 0.00 0.00<br />
MODIFIERS<br />
50 51 62<br />
NA NA NA<br />
CORRECT CODING EDITS<br />
80500 f, 80502 f<br />
PE-f<br />
0.00<br />
66<br />
NA<br />
Pathology and Laboratory Services<br />
OTHER<br />
Total-nf Total-f Global P MUE<br />
0.00 0.00 NA 1<br />
INDICATORS<br />
80,82 Suprv Status<br />
NA 09 NON<br />
82947<br />
Glucose; quantitative, blood (except reagent strip)<br />
RELATIVE VALUE UNITS<br />
Work MP PE-nf<br />
0.00 0.00 0.00<br />
MODIFIERS<br />
50 51 62<br />
NA NA NA<br />
CORRECT CODING EDITS<br />
80500 f, 80502 f, 82948 t,<br />
PE-f<br />
0.00<br />
66<br />
NA<br />
82951 3, 82953 3<br />
OTHER<br />
Total-nf Total-f Global P MUE<br />
0.00 0.00 NA —<br />
INDICATORS<br />
80,82 Suprv Status<br />
NA 09 NON<br />
Glucose, blood by glucose monitoring device(s) cleared by the FDA<br />
82962<br />
specifically for home use<br />
RELATIVE VALUE UNITS<br />
OTHER<br />
Work MP PE-nf PE-f Total-nf Total-f Global P MUE<br />
0.00 0.00 0.00 0.00 0.00 0.00 NA —<br />
MODIFIERS<br />
INDICATORS<br />
50 51 62 66 80,82 Suprv Status<br />
NA NA NA NA NA 09 NON<br />
CORRECT CODING EDITS<br />
82947 3, 82948 3, 82950 3, 82951 3, 82952 3, 82953 3<br />
82948<br />
Glucose; blood, reagent strip<br />
RELATIVE VALUE UNITS<br />
Work MP PE-nf PE-f<br />
0.00 0.00 0.00 0.00<br />
MODIFIERS<br />
50 51 62 66<br />
NA NA NA NA<br />
CORRECT CODING EDITS<br />
82950 3, 82952 3, 82953 3<br />
OTHER<br />
Total-nf Total-f Global P MUE<br />
0.00 0.00 NA —<br />
INDICATORS<br />
80,82 Suprv Status<br />
NA 09 NON<br />
82985<br />
Glycated protein<br />
RELATIVE VALUE UNITS<br />
Work MP PE-nf<br />
0.00 0.00 0.00<br />
MODIFIERS<br />
50 51 62<br />
NA NA NA<br />
CORRECT CODING EDITS<br />
83036 f, 83037 f<br />
PE-f<br />
0.00<br />
66<br />
NA<br />
OTHER<br />
Total-nf Total-f Global P MUE<br />
0.00 0.00 NA 1<br />
INDICATORS<br />
80,82 Suprv Status<br />
NA 09 NON<br />
82950<br />
Glucose; post glucose dose (includes glucose)<br />
RELATIVE VALUE UNITS<br />
Work MP PE-nf<br />
0.00 0.00 0.00<br />
MODIFIERS<br />
50 51 62<br />
NA NA NA<br />
CORRECT CODING EDITS<br />
82951 3, 82953 3<br />
PE-f<br />
0.00<br />
66<br />
NA<br />
OTHER<br />
Total-nf Total-f Global P MUE<br />
0.00 0.00 NA 3<br />
INDICATORS<br />
80,82 Suprv Status<br />
NA 09 NON<br />
83001<br />
Gonadotropin; follicle stimulating hormone (FSH)<br />
RELATIVE VALUE UNITS<br />
Work MP PE-nf<br />
0.00 0.00 0.00<br />
MODIFIERS<br />
50 51 62<br />
NA NA NA<br />
CORRECT CODING EDITS<br />
80500 f, 80502 f<br />
PE-f<br />
0.00<br />
66<br />
NA<br />
OTHER<br />
Total-nf Total-f Global P MUE<br />
0.00 0.00 NA —<br />
INDICATORS<br />
80,82 Suprv Status<br />
NA 09 NON<br />
l<br />
f<br />
u<br />
Anesthesia Included in Surgical Procedure<br />
Standards of Medical/Surgical Practice<br />
CPT/HCPCS Procedure Code Definition<br />
r<br />
m<br />
CPT/CMS <strong>Coding</strong> Manual Instructions<br />
CPT Separate Procedure Definition<br />
´<br />
t<br />
Designation of Gender-specific Procedures<br />
More Extensive Procedure<br />
© 2011 OptumInsight<br />
CPT only © 2011 American Medical Association. All Rights Reserved.<br />
January 2012<br />
Pathology — 9